Monocular Endoscopic Tissue 3D Reconstruction with Multi-Level Geometry Regularization

Dynamic endoscopic reconstruction is fundamental to robotic surgery and computer-assisted interventions. While 3D Gaussian Splatting (3DGS) realises real-time rendering, its application to deformable intraoperative environments remains constrained by spurious geometry and varying illuminations. To address these limitations, we introduce EndoPrior-GS, a novel pipeline that explicitly couples frame-extracted vision heuristics and estimated depth maps. EndoPrior-GS derives a joint texture prior from a tool-filtered valid tissue mask, a non-specular photometric filter, and anatomical structural salience, yielding a probability map that guides primitive initialisation and subsequent density control. The prior is further extended to the temporal domain through a texture-aware term that dynamically weighs pairwise primitive contributions during training. We conduct extensive experiments on benchmark datasets EndoNeRF and SCARED, and the obtained results show that our method EndoPrior-GS reduces Flow Error by 27.7% and 25.8% over the representative approaches while preserving competitive rendering quality and real-time rendering speed. Our project website is available at https://jiaqi-huang-77.github.io/EndoPrior-GS/.

Real-time reconstruction of deformable surgical scenes is vital for advancing robotic surgery, improving intraoperative guidance, and enabling automation. Recent methods achieve dense reconstructions from da Vinci robotic surgery videos, with Gaussian Splatting (GS) offering real-time performance via graphics acceleration. However, reconstruction quality in occluded regions remains limited, and depth accuracy has not been fully assessed, as benchmarks like EndoNeRF and StereoMIS lack 3D ground truth. We propose Diff2DGS, a two-stage framework for reliable 3D reconstruction of occluded surgical scenes. First, a diffusion-based video module with temporal priors inpaints tissue occluded by instruments with high spatiotemporal consistency. Second, we adapt 2D Gaussian Splatting (2DGS) with a Learnable Deformation Model (LDM) to capture dynamic tissue deformation and anatomical geometry, and introduce adaptive depth weight to improve geometric fidelity. We further extend evaluation beyond image-quality metrics by performing quantitative depth analysis on the SCARED dataset. Diff2DGS outperforms state-of-the-art methods in both appearance and geometry, reaching 38.02 dB PSNR on EndoNeRF and 34.40 dB on StereoMIS. Our experiments also show that optimizing image quality alone does not necessarily ensure accurate 3D geometry.The code is available at https://diff2dgs.github.io/.

Accurate 3D reconstruction of deformable soft tissues is essential for surgical robotic perception. However, low-texture surfaces, specular highlights, and instrument occlusions often fragment geometric continuity, posing a challenge for existing fixed-topology approaches. To address this, we propose EndoVGGT, a geometry-centric framework equipped with a Deformation-aware Graph Attention (DeGAT) module. Rather than using static spatial neighborhoods, DeGAT dynamically constructs feature-space semantic graphs to capture long-range correlations among coherent tissue regions. This enables robust propagation of structural cues across occlusions, enforcing global consistency and improving non-rigid deformation recovery. Extensive experiments on SCARED show that our method significantly improves fidelity, increasing PSNR by 24.6% and SSIM by 9.1% over prior state-of-the-art. Crucially, EndoVGGT exhibits strong zero-shot cross-dataset generalization to the unseen SCARED and EndoNeRF domains, confirming that DeGAT learns domain-agnostic geometric priors. These results highlight the efficacy of dynamic feature-space modeling for consistent surgical 3D reconstruction.