# Hierarchical Curriculum Learning for Surgical Video Generation: Focusing on Bilateral Axillo-Breast Approach Robotic Thyroidectomy Datasets

arXiv: https://arxiv.org/abs/2610.17684 · HTML: https://mlsanity.com/paper/2610.17684/

## 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 32 of its 53 references that are in the map.
- First posted on arXiv 13 Oct 2026.

## Placed in

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

## Builds on (most cited first, 30 of 32)

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [Diffusion Models Beat GANs on Image Synthesis](https://mlsanity.com/paper/2105.05233/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [Video Diffusion Models](https://mlsanity.com/paper/2204.03458/) (2022)
- [CogVideoX: Text-to-Video Diffusion Models with An Expert Transformer](https://mlsanity.com/paper/2408.06072/) (2024)
- [Imagen Video: High Definition Video Generation with Diffusion Models](https://mlsanity.com/paper/2210.02303/) (2022)
- [Make-A-Video: Text-to-Video Generation without Text-Video Data](https://mlsanity.com/paper/2209.14792/) (2022)
- [WorldSimBench: Towards Video Generation Models as World Simulators](https://mlsanity.com/paper/2410.18072/) (2024)
- [Open-Sora: Democratizing Efficient Video Production for All](https://mlsanity.com/paper/2412.20404/) (2024)
- [Lumiere: A Space-Time Diffusion Model for Video Generation](https://mlsanity.com/paper/2401.12945/) (2024)
- [Rendezvous: Attention Mechanisms for the Recognition of Surgical Action Triplets in Endoscopic Videos](https://mlsanity.com/paper/2109.03223/) (2021)
- [ARTboldsymbol·V: Auto-Regressive Text-to-Video Generation with Diffusion Models](https://mlsanity.com/paper/2311.18834/) (2023)
- [Endora: Video Generation Models as Endoscopy Simulators](https://mlsanity.com/paper/2403.11050/) (2024)
- [HecVL: Hierarchical Video-Language Pretraining for Zero-shot Surgical Phase Recognition](https://mlsanity.com/paper/2405.10075/) (2024)
- [Procedure-Aware Surgical Video-language Pretraining with Hierarchical Knowledge Augmentation](https://mlsanity.com/paper/2410.00263/) (2024)
- [Deform3DGS: Flexible Deformation for Fast Surgical Scene Reconstruction with Gaussian Splatting](https://mlsanity.com/paper/2405.17835/) (2024)
- [FloLPIPS: A Bespoke Video Quality Metric for Frame Interpoation](https://mlsanity.com/paper/2207.08119/) (2022)
- [ACPL: Anti-curriculum Pseudo-labelling for Semi-supervised Medical Image Classification](https://mlsanity.com/paper/2111.12918/) (2021)
- [Video Diffusion Models: A Survey](https://mlsanity.com/paper/2405.03150/) (2024)
- [EndoGaussian: Real-time Gaussian Splatting for Dynamic Endoscopic Scene Reconstruction](https://mlsanity.com/paper/2401.12561/) (2024)
- [SurGen: Text-Guided Diffusion Model for Surgical Video Generation](https://mlsanity.com/paper/2408.14028/) (2024)
- [SurgSora: Object-Aware Diffusion Model for Controllable Surgical Video Generation](https://mlsanity.com/paper/2412.14018/) (2024)
- [VISAGE: Video Synthesis using Action Graphs for Surgery](https://mlsanity.com/paper/2410.17751/) (2024)
- [Ophora: A Large-Scale Data-Driven Text-Guided Ophthalmic Surgical Video Generation Model](https://mlsanity.com/paper/2505.07449/) (2025)
- [Optical Flow Representation Alignment Mamba Diffusion Model for Medical Video Generation](https://mlsanity.com/paper/2411.01647/) (2024)
- [SurReal: enhancing Surgical simulation Realism using style transfer](https://mlsanity.com/paper/1811.02946/) (2018)
- [MeshBrush: Painting the Anatomical Mesh with Neural Stylization for Endoscopy](https://mlsanity.com/paper/2404.02999/) (2024)

## Abstract (arXiv)

High-fidelity surgical video generation is increasingly important for surgical education, simulation, and downstream AI training, as conventional simulation pipelines are limited by cost, realism, and scenario diversity. Adapting generic text-to-video diffusion models to surgical procedures remains difficult, however, due to complex anatomical structures, intricate tool-tissue interactions, the inherently hierarchical nature of surgical workflows, and the scarcity of curated training data outside a few well-studied procedures. We propose a surgical video generation framework that combines hierarchical procedural annotation with curriculum transfer learning. Surgical procedures are decomposed into three levels (phase, task, and action) and a pretrained text-to-video diffusion model is progressively adapted from coarse to fine-grained surgical context, supported by a dynamic sampling strategy that handles variable-resolution and variable-length surgical clips. We instantiate the framework on Bilateral Axillo-Breast Approach robotic thyroidectomy, a procedure for which no curated benchmark currently exists. Relative to the preceding task-level model, the final action-level model reduces FVD by 20.1% and FID by 15.7%, and a matched-budget ablation indicates that these gains arise from the curriculum design rather than from additional training. A user study with six clinicians rates visual realism highly while highlighting remaining gaps in anatomical accuracy and clinical reliability. The proposed framework offers a step toward AI-driven surgical simulation in procedures where curated data are scarce.