ActOR: Ambient AI-Based Agentic Orchestration for Humanoid Autonomy in Operating Rooms

Abstract

Operating rooms (ORs) increasingly contain ambient sensing infrastructure to enable AI-based optimization of workflows and utilization. We pursue an alternative path: using ambient AI to guide robot action and optimize utilization. Deploying humanoids in the OR without ambient AI is severely limited by cumbersome de novo orientation and planning due to partial onboard observations. We posit that this can be achieved by coupling an ambient AI-based agentic orchestrator with the humanoid robotic actor, providing shared perception and execution feedback for humanoid autonomy in the OR. ActOR fuses a wall-mounted ambient camera and the robot's head-mounted camera into a shared object-level digital twin (DT). A large language model agent plans over the DT using pre-programmed locomotion and manipulation skills without task-specific training. During execution, DT updates and execution outcomes inform retries, alternative approaches, or replanning. We evaluated ActOR in simulated and physical environments. Across three tasks in two simulated ORs reconstructed from real rooms, ambient perception reduced exploration from 1.05 to 0.12 Explore calls per trial when targets were initially outside the robot's view. Closed-loop feedback increased success from 46.7% to 83.3% under nominal execution and from 8.3% to 51.7% under injected navigation, object-relocation, and grasp perturbations. In a physical mock OR with a humanoid, ActOR completed 14 of 20 single-object disposal trials and demonstrated replanning after scene changes. Ambient AI-based observations provide scene state that improves robot action planning, increasing success and reducing exploration compared with robot-only observations. Feeding skill outcomes and DT updates back to the planner improves multi-step task success. Our results show the feasibility of humanoid task autonomy for multi-step disposal tasks in a mock OR.