# NVIDIA — NVIDIA Cosmos3-H-Dreams: Bringing Clinical Surgery to Life Through Generative Simulation

- Company: NVIDIA (nvidia.com)
- Announced: 2026-10-20T18:17:47+00:00
- Category: new-model
- Coverage: not counted
- Announcement: yes
- Group: models
- Source: https://huggingface.co/blog/nvidia/cosmos3-h-dreams
- Record: https://forck.live/items/25365-nvidia-cosmos3-h-dreams-bringing-clinical-surgery-to-life-through-generative
- Models affected: Cosmos3-H-Dreams, Cosmos-H-Dreams, Cosmos-Predict2.5, Cosmos3-H-Embodied-Nano, Cosmos 3

NVIDIA introduced Cosmos3-H-Dreams, a real-time generative surgical simulator trained on clinical cholecystectomy recordings and controlled live by robot kinematics. The company says it is the first real-time generative surgical simulator trained on clinical cholecystectomy recordings to support live kinematic control. It builds on Cosmos3-H-Embodied-Nano, a 16-billion-parameter model pretrained on Open-H-Embodiment, and specializes a bidirectional teacher on curated cholecystectomy video and kinematics. The model uses 28 action dimensions covering pose and gripper information for both arms plus energy controls and thumbstick axes and buttons, with training on 832 x 480 video and actions aligned at 10 Hz. Two released checkpoints use four and two denoising steps per generated block; the two-step model is separately trained, and fewer steps mean faster inference at lower visual quality. Powered by Cosmos 3 and accelerated with FlashDreams, it runs interactively on a single NVIDIA RTX PRO 6000 GPU, with an adapted FadeMem module consolidating the key/value cache during long rollouts.

## Evidence

Verbatim from https://huggingface.co/blog/nvidia/cosmos3-h-dreams:

> Today, Cosmos3-H-Dreams advances this capability by learning from video and robot kinematics recording during clinical procedures on the CMR Surgical Versius platform. To our knowledge, this is the first real-time generative surgical simulator trained on clinical cholecystectomy recordings to support live kinematic control.

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