Optimize Surgical Triplet Recognition: A Knowledge-Driven Mixture-of-Experts Solution.

Surgical action triplet recognition constitutes a critical task in context-aware robot-assisted surgery, facilitating automatic surgical action perception by identifying instrument, verb, target, and their association. However, existing works struggle to analyze such complex surgical scenes due to three main issues: (1) component-level optimization conflicts caused by entangled feature spaces, (2) category-level optimization conflicts arising from severe data imbalance, and (3) lack of domain knowledge guidance that limits model interpretability and robustness. To address these challenges, we propose a Mixture-of-Experts-guided Co-Optimization (MoeCo) framework powered by knowledge-driven learning. Within the co-optimization pipeline, to first mitigate component-level conflicts, we introduce a component-tailored adapter that disentangles task-specific features across spatial-temporal regimes, facilitating effective component specialization. Next, we develop a coordinated gradient learning strategy to handle category-level conflicts, which adaptively rebalances positive-negative gradients to enhance the perception of rare categories. Notably, inspired by surgical domain expertise, we introduce a knowledge-driven mixture-of-experts mechanism that dynamically integrates multimodal large language model-guided knowledge via activated experts, thereby enriching the co-optimization pipeline with more expressive and robust representations. Extensive experiments on the public CholecT45 and CholecT50 datasets confirm the effectiveness of the proposed co-optimization pipeline and the superiority of dynamic priors integration via the knowledge-driven mixture-of-experts mechanism. Code will be available at https://github.com/YIYIZH/MoeCo.