Abstract
Surgical procedures unfold in complex environments demanding coordination between surgical teams, tools, imaging and increasingly, intelligent robotic systems. Ensuring safety and efficiency in ORs of the future requires intelligent systems, like surgical robots, smart instruments and digital copilots, capable of understanding complex activities and hazards of surgeries. Yet, existing computational approaches, lack the breadth, and generalization needed for comprehensive OR understanding. We introduce ORQA, a multimodal foundation model unifying visual, auditory, and structured data for holistic surgical understanding. ORQA's question-answering framework empowers diverse tasks, serving as an intelligence core for a broad spectrum of surgical technologies. We benchmark ORQA against generalist vision-language models, including ChatGPT and Gemini, and show that while they struggle to perceive surgical scenes, ORQA delivers substantially stronger, consistent performance. Recognizing the ex