# SurgGoal: Rethinking Surgical Planning Evaluation via Goal-Satisfiability

arXiv: https://arxiv.org/abs/2601.10455 · HTML: https://mlsanity.com/paper/2601.10455/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 9 of its 25 references that are in the map.
- First posted on arXiv 15 Jan 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 9 of 9)

- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [LLaVA-NeXT-Interleave: Tackling Multi-image, Video, and 3D in Large Multimodal Models](https://mlsanity.com/paper/2407.07895/) (2024)
- [VideoLLaMA 3: Frontier Multimodal Foundation Models for Image and Video Understanding](https://mlsanity.com/paper/2501.13106/) (2025)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [Hulu-Med: A Transparent Generalist Model towards Holistic Medical Vision-Language Understanding](https://mlsanity.com/paper/2510.08668/) (2025)
- [AntGPT: Can Large Language Models Help Long-term Action Anticipation from Videos?](https://mlsanity.com/paper/2307.16368/) (2023)
- [Optimus-3: Dual-Router Aligned Mixture-of-Experts Agent with Dual-Granularity Reasoning-Aware Policy Optimization](https://mlsanity.com/paper/2506.10357/) (2025)
- [SAP-Bench: Benchmarking Multimodal Large Language Models in Surgical Action Planning](https://mlsanity.com/paper/2506.07196/) (2025)
- [DARIL: When Imitation Learning outperforms Reinforcement Learning in Surgical Action Planning](https://mlsanity.com/paper/2507.05011/) (2025)

## Abstract (arXiv)

Surgical planning integrates visual perception, long-horizon reasoning, and procedural knowledge, yet it remains unclear whether current evaluation protocols reliably assess vision-language models (VLMs) in safety-critical settings. Motivated by a goal-oriented view of surgical planning, we define planning correctness via phase-goal satisfiability, where plan validity is determined by expert-defined surgical rules. Based on this definition, we introduce a multicentric meta-evaluation benchmark with valid procedural variations and invalid plans containing order and content errors. Using this benchmark, we show that sequence similarity metrics systematically misjudge planning quality, penalizing valid plans while failing to identify invalid ones. We therefore adopt a rule-based goal-satisfiability metric as a high-precision meta-evaluation reference to assess Video-LLMs under progressively constrained settings, revealing failures due to perception errors and under-constrained reasoning. Structural knowledge consistently improves performance, whereas semantic guidance alone is unreliable and benefits larger models only when combined with structural constraints.