SurgCUT3R: Surgical Scene-Aware Continuous Understanding of Temporal 3D Representation

Reconstructing deformable surgical scenes from endoscopic videos is challenging and clinically important. Recent state-of-the-art methods based on implicit neural representations or 3D Gaussian splatting have made notable progress. However, most are designed for deformable scenes with fixed endoscope viewpoints and rely on stereo depth priors or accurate structure-from-motion for initialization and optimization, limiting their ability to handle monocular sequences with large camera motion in real clinical settings. To address this, we propose Local-EndoGS, a high-quality 4D reconstruction framework for monocular endoscopic sequences with arbitrary camera motion. Local-EndoGS introduces a progressive, window-based global representation that allocates local deformable scene models to each observed window, enabling scalability to long sequences with substantial motion. To overcome unreliable initialization without stereo depth or accurate structure-from-motion, we design a coarse-to-fine strategy integrating multi-view geometry, cross-window information, and monocular depth priors, providing a robust foundation for optimization. We further incorporate long-range 2D pixel trajectory constraints and physical motion priors to improve deformation plausibility. Experiments on three public endoscopic datasets with deformable scenes and varying camera motions show that Local-EndoGS consistently outperforms state-of-the-art methods in appearance quality and geometry. Ablation studies validate the effectiveness of our key designs. Code will be released upon acceptance at: https://github.com/IRMVLab/Local-EndoGS.

Achieving 3D spatial awareness is crucial for surgical robotic manipulation, where precise and delicate operations are required. Existing methods either explicitly reconstruct the surgical scene prior to manipulation, or enhance multi-view features by adding wrist-mounted cameras to supplement the default stereo endoscopes. However, both paradigms suffer from notable limitations: the former easily leads to error accumulation and prevents end-to-end optimization due to its multi-stage nature, while the latter is rarely adopted in clinical practice since wrist-mounted cameras can interfere with the motion of surgical robot arms. In this work, we introduce the Spatial Surgical Transformer (SST), an end-to-end visuomotor policy that empowers surgical robots with 3D spatial awareness by directly exploring 3D spatial cues embedded in endoscopic images. First, we build Surgical3D, a large-scale photorealistic dataset containing 30K stereo endoscopic image pairs with accurate 3D geometry, addressing the scarcity of 3D data in surgical scenes. Based on Surgical3D, we finetune a powerful geometric transformer to extract robust 3D latent representations from stereo endoscopes images. These representations are then seamlessly aligned with the robot's action space via a lightweight multi-level spatial feature connector (MSFC), all within an endoscope-centric coordinate frame. Extensive real-robot experiments demonstrate that SST achieves state-of-the-art performance and strong spatial generalization on complex surgical tasks such as knot tying and ex-vivo organ dissection, representing a significant step toward practical clinical deployment. The dataset and code will be released.

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.