Sum-of-Checks: Structured Reasoning for Surgical Safety with Large Vision-Language Models
Purpose: Accurate assessment of the Critical View of Safety (CVS) during laparoscopic cholecystectomy is essential to prevent bile duct injury, a complication associated with significant morbidity and mortality. While large vision-language models (LVLMs) offer flexible reasoning, their predictions remain difficult to audit and unreliable on safety-critical surgical tasks. Methods: We introduce Sum-of-Checks, a framework that decomposes each CVS criterion into expert-defined reasoning checks reflecting clinically relevant visual evidence. Given a laparoscopic frame, an LVLM evaluates each check, producing a binary judgment and justification. Criterion-level scores are computed via fixed, w...
| Authors | Weiqiu You, Cassandra Goldberg, Amin Madani et al. |
|---|---|
| Primary category | cs.LG |
| Published | 24 April 2026 |
| Last updated at source | 24 April 2026 |
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