# Optimize Surgical Triplet Recognition: A Knowledge-Driven Mixture-of-Experts Solution

arXiv: https://arxiv.org/abs/2608.22972 · HTML: https://mlsanity.com/paper/2608.22972/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical MoE, one of 12 directions in Mixture-of-experts.
- Builds on 26 of its 48 references that are in the map.
- First posted on arXiv 24 Aug 2026.

## Placed in

- Mixture-of-experts / [Medical and biomedical MoE](https://mlsanity.com/moe/medical-and-biomedical-moe/)

## Builds on (most cited first, 26 of 26)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Outrageously Large Neural Networks: The Sparsely-Gated Mixture-of-Experts Layer](https://mlsanity.com/paper/1701.06538/) (2017)
- [Switch Transformers: Scaling to Trillion Parameter Models with Simple and Efficient Sparsity](https://mlsanity.com/paper/2101.03961/) (2021)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Class-Balanced Loss Based on Effective Number of Samples](https://mlsanity.com/paper/1901.05555/) (2019)
- [DeepSeekMoE: Towards Ultimate Expert Specialization in Mixture-of-Experts Language Models](https://mlsanity.com/paper/2401.06066/) (2024)
- [ActionFormer: Localizing Moments of Actions with Transformers](https://mlsanity.com/paper/2202.07925/) (2022)
- [Equalization Loss for Long-Tailed Object Recognition](https://mlsanity.com/paper/2003.05176/) (2020)
- [ST-Adapter: Parameter-Efficient Image-to-Video Transfer Learning](https://mlsanity.com/paper/2206.13559/) (2022)
- [Rendezvous: Attention Mechanisms for the Recognition of Surgical Action Triplets in Endoscopic Videos](https://mlsanity.com/paper/2109.03223/) (2021)
- [Recognition of Instrument-Tissue Interactions in Endoscopic Videos via Action Triplets](https://mlsanity.com/paper/2007.05405/) (2020)
- [Temporal Memory Relation Network for Workflow Recognition from Surgical Video](https://mlsanity.com/paper/2103.16327/) (2021)
- [Towards Better Explanations of Class Activation Mapping](https://mlsanity.com/paper/2102.05228/) (2021)
- [CholecTriplet2021: A benchmark challenge for surgical action triplet recognition](https://mlsanity.com/paper/2204.04746/) (2022)
- [Fair Resource Allocation in Multi-Task Learning](https://mlsanity.com/paper/2402.15638/) (2024)
- [A Survey of Embodied Learning for Object-Centric Robotic Manipulation](https://mlsanity.com/paper/2408.11537/) (2024)
- [Rendezvous in Time: An Attention-based Temporal Fusion approach for Surgical Triplet Recognition](https://mlsanity.com/paper/2211.16963/) (2022)
- [Data Splits and Metrics for Method Benchmarking on Surgical Action Triplet Datasets](https://mlsanity.com/paper/2204.05235/) (2022)
- [Surgical Workflow Recognition and Blocking Effectiveness Detection in Laparoscopic Liver Resections with Pringle Maneuver](https://mlsanity.com/paper/2408.10538/) (2024)
- [Self-distillation for surgical action recognition](https://mlsanity.com/paper/2303.12915/) (2023)
- [Deep Semantic Parsing of Freehand Sketches with Homogeneous Transformation, Soft-Weighted Loss, and Staged Learning](https://mlsanity.com/paper/1910.06023/) (2019)
- [SurgPETL: Parameter-Efficient Image-to-Surgical-Video Transfer Learning for Surgical Phase Recognition](https://mlsanity.com/paper/2409.20083/) (2024)

## Abstract (arXiv)

Surgical action triplet recognition constitutes a critical task in context-aware robot-assisted surgery, facilitating automatic surgical action perception by identifying instrument, verb, target, and their association. However, existing works struggle to analyze such complex surgical scenes due to three main issues: (1) component-level optimization conflicts caused by entangled feature spaces, (2) category-level optimization conflicts arising from severe data imbalance, and (3) lack of domain knowledge guidance that limits model interpretability and robustness. To address these challenges, we propose a Mixture-of-Experts-guided Co-Optimization (textitMoeCo) framework powered by knowledge-driven learning. Within the co-optimization pipeline, to first mitigate component-level conflicts, we introduce a component-tailored adapter that disentangles task-specific features across spatial-temporal regimes, facilitating effective component specialization. Next, we develop a coordinated gradient learning strategy to handle category-level conflicts, which adaptively rebalances positive-negative gradients to enhance the perception of rare categories. Notably, inspired by surgical domain expertise, we introduce a knowledge-driven mixture-of-experts mechanism that dynamically integrates multimodal large language model-guided knowledge via activated experts, thereby enriching the co-optimization pipeline with more expressive and robust representations. Extensive experiments on the public CholecT45 and CholecT50 datasets confirm the effectiveness of the proposed co-optimization pipeline and the superiority of dynamic priors integration via the knowledge-driven mixture-of-experts mechanism.