In some embodiments, surgical data structure is accessed that includes a plurality of nodes (relating to a plurality of discrete procedural states for a surgical procedure and being associated with procedural metadata) connected by a plurality of edges. Each edge can be associated with a procedural action causing a state transition. A new node can be generated based on an identification of a new procedural state. A first and second node from the plurality of nodes can be identified, to which the new node is to be connected. Edges can be generated to connect the new node to the first and second nodes.