Registration opens until May 15th
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SAVE FOCUS CHALLENGE

Enter the ORena

Help push long-range video understanding to make surgery safer.
ORena SAVE FOCUS is the first challenge to test whether AI can truly comprehend full-length surgeries in order to solve crucial clinical problems that matter everywhere in the world.

The Medical Goal

To help prevent retained surgical items by enabling models to track, contextualize, count, and localize foreign objects, such as sponges and needles, throughout an entire surgical procedure.

The Technical Goal

To benchmark and advance  long-context video understanding, spanning the full spectrum from single-frame perception to procedure-level surgical understanding.

Why it matters

Unintentionally retaining foreign objects during minimally invasive surgery can cause serious complications requiring reoperation (Badiee et al., 2025). SAVE FOCUS addresses this patient safety challenge by benchmarking AI on tasks surgeons face intraoperatively: continuous counting and tracking of surgical items, real-time localization of unaccounted objects, and verification of complete retrieval before closure.
At the same time, the challenge targets a critical technical frontier: can vision-language models maintain accurate understanding across hours-long procedures when safety decisions depend on remembering what happened much earlier in the operation?

Three Competition Tracks

The challenge has been designed according to the Equator guideline BIAS. The full challenge design can be found here.
SAVE FOCUS – Foreign Object Contextual Understanding for Safe Surgical AI – is organized in three tracks.

Frame Track
The FRAME Track evaluates a model’s ability to answer clinically relevant questions from a single image. This track targets core surgical scene understanding skills such as foreign object detection, identification, attribute recognition, and spatial localization within a single moment in time.
Challenge Design
Segment Track
The SEGMENT Track focuses on short video segments (up to 5 min), requiring models to incorporate local temporal context to answer questions about foreign objects and their interactions with anatomy and instruments.
Challenge Design
Procedure Track
The PROCEDURE Track challenges models with long surgical video contexts, ranging from extended segments to full-length laparoscopic procedures, to assess their capacity for long-term memory, persistent tracking, and global reasoning.
Challenge Design

Together, these tracks enable a systematic characterization of where current VLMs succeed and fail as task complexity transitions from instantaneous perception to long-context intraoperative reasoning.

Sample data

When was the first sponge inserted in the abdomen?

Please return the time-point.
This video includes surgical scenes. 
Viewer discretion is advised.

Our team

Coordinators

Lena Maier-Hein
German Cancer Research Center (DKFZ)
Thomas G. Weiser
Wellcome Leap, Stanford University

Clinical Chairs

Daniel Hashimoto
University of Pennsylvania
Fiona Kolbinger
Purdue University
Thomas Pausch
University of Heidelberg
Thomas G. Weiser
Wellcome Leap, Stanford University

Technical Chairs

Salman Khan
Mohamed Bin Zayed University of Artificial Intelligence
Lena Maier-Hein
German Cancer Research Center (DKFZ)
Stefanie Speidel
National Center for Tumor Diseases
Danail Stoyanov
University College London

Executive committee

Lucas Luttner
 - 
PhD lead
German Cancer Research Center (DKFZ)
Patrick Godau
 - 
Postdoc lead
German Cancer Research Center (DKFZ)
Jule Brandt
German Cancer Research Center (DKFZ)
Evangelia Christodoulou
German Cancer Research Center (DKFZ)
Doreen Heckmann-Nötzel
German Cancer Research Center (DKFZ)
Kai Fritzsche
Janne Heinecke
German Cancer Research Center (DKFZ)
Michelle Karadeema
Wellcome Leap
Marcel Knopp
German Cancer Research Center (DKFZ)
Leon Mayer
German Cancer Research Center (DKFZ)
Annika Reinke
German Cancer Research Center (DKFZ)
Niklas Holzwarth
German Cancer Research Center (DKFZ)

Funding

ORena SAVE FOCUS is a joint initiative of the Wellcome Leap SAVE program and the ORena initiative of the DKFZ Intelligent Medical Systems (IMSY) lab, co-sponsored by Helmholtz Imaging.

The SAVE program is a US $50 million research and innovation initiative launched by Wellcome Leap, a nonprofit aimed at accelerating breakthroughs in global human health. SAVE stands for Surgery: Assess, Validate, Expand and focuses on addressing critical challenges in global surgical care. It is led by Prof. Thomas G. Weiser, clinical coordinator of the SAVE FOCUS challenge.

Helmholtz Imaging is an interdisciplinary platform of the Helmholtz Association of German Research Centres designed to unlock the scientific potential of imaging data and methods across all disciplines and scales of research. It serves as a central hub for expertise, tools, funding, and collaboration in imaging science. Within this framework, the DKFZ IMSY lab leads the benchmarking activities, driving the development of standards and evaluation strategies for imaging methods.

ORena is an umbrella framework for surgical AI competitions designed specifically for Operating Room challenges. It provides standardized benchmarks, curated datasets, and community leaderboards to drive progress on AI systems that can support real clinical workflows. SAVE FOCUS is the inaugural challenge, with future editions planned to address other critical problems in surgical safety and quality assurance.

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