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This paper introduces SurgHiBench, the first evaluation suite designed to assess surgical video-language models using hierarchy-aware metrics rather than flat accuracy scores. The authors propose HyperSurg, a hyperbolic model that leverages geometric constraints to better capture the phase-to-step relationships inherent in complex medical procedures. By demonstrating that error severity varies significantly even when raw accuracy is identical, this work highlights critical gaps in current benchmarks and offers a principled approach for improving model reliability in high-stakes domains.
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A Hierarchy-Aware Video-Language Model Evaluation and Hyperbolic Baseline for Surgery

arXiv2 min read

arXiv:2609.27139v1 Announce Type: cross Abstract: Surgical procedures follow a phase-to-step hierarchy, yet the video-language models used to recognize them are evaluated with flat per-level metrics that ignore cross-level coherence and error structure. In this paper we make two contributions to address this problem, (i) we introduce SurgHiBench, the first hierarchy-aware evaluation suite for surgical video understanding, with three tasks measuring recognition, consistency, and severity across granularity levels. We evaluate a general-purpose CLIP model, a Euclidean surgical model, and, as second contribution: (ii) HyperSurg, a new hyperbolic model that enforces phase-step containment via entailment cones, across four (existing) datasets spanning three procedure types. The suite reveals that two models with the same accuracy can produce predictions of very different error severity, ranging from sibling confusions within the correct phase to unrelated cross-phase predictions. Hyperbolic geometry shifts predictions toward the correct procedural neighborhood, and these gains scale with the tree-likeness of each dataset's annotation hierarchy, providing a principled indicator when hierarchy-aware geometry helps.

Abstract:Surgical procedures follow a phase-to-step hierarchy, yet the video-language models used to recognize them are evaluated with flat per-level metrics that ignore cross-level coherence and error structure. In this paper we make two contributions to address this problem, (i) we introduce SurgHiBench, the first hierarchy-aware evaluation suite for surgical video understanding, with three tasks measuring recognition, consistency, and severity across granularity levels. We evaluate a general-purpose CLIP model, a Euclidean surgical model, and, as second contribution: (ii) HyperSurg, a new hyperbolic model that enforces phase-step containment via entailment cones, across four (existing) datasets spanning three procedure types. The suite reveals that two models with the same accuracy can produce predictions of very different error severity, ranging from sibling confusions within the correct phase to unrelated cross-phase predictions. Hyperbolic geometry shifts predictions toward the correct procedural neighborhood, and these gains scale with the tree-likeness of each dataset's annotation hierarchy, providing a principled indicator when hierarchy-aware geometry helps.

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)

arXiv:2609.27139 [cs.CV]

(or arXiv:2609.27139v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2609.27139 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 256 words

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