# Towards Controllable Video Synthesis of Routine and Rare OR Events

arXiv: https://arxiv.org/abs/2602.21365 · HTML: https://mlsanity.com/paper/2602.21365/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 16 of its 26 references that are in the map.
- First posted on arXiv 24 Feb 2026.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 16 of 16)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Scalable Diffusion Models with Transformers](https://mlsanity.com/paper/2212.09748/) (2022)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [Improved Techniques for Training GANs](https://mlsanity.com/paper/1606.03498/) (2016)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [Wan: Open and Advanced Large-Scale Video Generative Models](https://mlsanity.com/paper/2503.20314/) (2025)
- [Stable Video Diffusion: Scaling Latent Video Diffusion Models to Large Datasets](https://mlsanity.com/paper/2311.15127/) (2023)
- [LTX-Video: Realtime Video Latent Diffusion](https://mlsanity.com/paper/2501.00103/) (2024)
- [Exploring Video Quality Assessment on User Generated Contents from Aesthetic and Technical Perspectives](https://mlsanity.com/paper/2211.04894/) (2022)
- [DragNUWA: Fine-grained Control in Video Generation by Integrating Text, Image, and Trajectory](https://mlsanity.com/paper/2308.08089/) (2023)
- [Video Depth Anything: Consistent Depth Estimation for Super-Long Videos](https://mlsanity.com/paper/2501.12375/) (2025)
- [Temporal Generative Adversarial Nets with Singular Value Clipping](https://mlsanity.com/paper/1611.06624/) (2016)
- [4D-OR: Semantic Scene Graphs for OR Domain Modeling](https://mlsanity.com/paper/2203.11937/) (2022)
- [MM-OR: A Large Multimodal Operating Room Dataset for Semantic Understanding of High-Intensity Surgical Environments](https://mlsanity.com/paper/2503.02579/) (2025)
- [SurgSora: Object-Aware Diffusion Model for Controllable Surgical Video Generation](https://mlsanity.com/paper/2412.14018/) (2024)

## Abstract (arXiv)

Purpose: Curating large-scale datasets of operating room (OR) workflow, encompassing rare, safety-critical, or atypical events, remains operationally and ethically challenging. This data bottleneck complicates the development of ambient intelligence for detecting, understanding, and mitigating rare or safety-critical events in the OR. Methods: This work presents an OR video diffusion framework that enables controlled synthesis of rare and safety-critical events. The framework integrates a geometric abstraction module, a conditioning module, and a fine-tuned diffusion model to first transform OR scenes into abstract geometric representations, then condition the synthesis process, and finally generate realistic OR event videos. Using this framework, we also curate a synthetic dataset to train and validate AI models for detecting near-misses of sterile-field violations. Results: In synthesizing routine OR events, our method outperforms off-the-shelf video diffusion baselines, achieving lower FVD/LPIPS and higher SSIM/PSNR in both in- and out-of-domain datasets. Through qualitative results, we illustrate its ability for controlled video synthesis of counterfactual events. An AI model trained and validated on the generated synthetic data achieved a RECALL of 70.13% in detecting near safety-critical events. Finally, we conduct an ablation study to quantify performance gains from key design choices. Conclusion: Our solution enables controlled synthesis of routine and rare OR events from abstract geometric representations. Beyond demonstrating its capability to generate rare and safety-critical scenarios, we show its potential to support the development of ambient intelligence models.