Abstract
Surgical video understanding is crucial for facilitating Computer-Assisted Surgery (CAS) systems. Despite significant progress in existing studies, two major limitations persist, including inadequate visual content perception and insufficient temporal awareness in surgical videos, and hinder the development of versatile CAS solutions. In this work, we propose the SurgLLM framework, an effective large multimodal model tailored for versatile surgical video understanding tasks with enhanced spatial focus and temporal awareness. Specifically, to empower the spatial focus of surgical videos, we first devise Surgical Context-aware Multimodal Pretraining (Surg-Pretrain) for the video encoder of SurgLLM, by performing instrument-centric Masked Video Reconstruction (MV-Recon) and subsequent multimodal alignment. To incorporate surgical temporal knowledge into SurgLLM, we further propose Temporal-aware Multimodal Tuning (TM-Tuning) to enhance temporal reasoning with interleaved multimodal embedd