Large-Small Model Collaboration for Zero-Shot Surgical Phase Recognition

2026-08-24

AI Summary

为解决手术阶段识别中的领域迁移问题，提出LaST框架，结合大型和小型模型优势，通过迭代时间细化和循环重放策略实现零样本适应。

Abstract

Task-specific lightweight models for surgical phase recognition excel at capturing temporal dynamics but generalize poorly under domain shift. Conversely, surgical foundation models (FMs) offer superior transferability via large-scale pretraining, yet their lack of explicit temporal modeling often yields temporally inconsistent predictions, leading to degraded performance. To exploit the complementary strengths of both paradigms, we propose \textbf{La}rge-\textbf{S}mall \textbf{T}emporal adaptation (\textbf{LaST}), a novel large-small collaborative framework that enables zero-shot adaptation to unseen clinical domains. In LaST, the FM initiates the pipeline by generating frame-level phase priors that serve as initial weak supervision. To effectively utilize these noisy phase priors, we introduce an iterative temporal refinement scheme that integrates dynamic quality control to filter reliable predictions and dual-model cross-learning to mitigate confirmation bias. Simultaneously, the lightweight model leverages its intrinsic temporal modeling ability to progressively correct inconsistent predictions and enhance overall accuracy across iterations. At the end, a cycle replay strategy is employed to close the loop: the refined, more accurate predictions are utilized as upgraded supervision signals for the subsequent iterations, fostering a self-reinforcing evolution of both label quality and model capability. Extensive experiments demonstrate that LaST achieves robust adaptation to unseen domains for zero-shot surgical phase recognition, outperforming the baseline (PeskaVLP) by 24.85\%-43.17\% in accuracy and even surpassing fully supervised linear probing and several state-of-the-art few-shot approaches. Codes will be released at https://github.com/YIYIZH/LaST.

Problem

• surgical phase recognition
• domain shift
• temporal dynamics
• foundation models
• zero-shot adaptation

Innovation

• zero-shot surgical phase recognition
• large-small model collaboration
• temporal adaptation
• iterative temporal refinement
• cycle replay strategy