CoGE: Sim-to-Real Online Geometric Estimation for Monocular Colonoscopy

Monocular colonoscopic 3D reconstruction is important for surgical robotic colonoscopy, but remains challenging due to weak texture, specular reflections, limited view overlap, and non-rigid tissue motion. Conventional multi-view 3D reconstruction methods rely on stable correspondences and approximate rigidity, which are often violated in colonoscopy. Existing endoscopic methods often rely on domain-specific supervision, whereas there are not enough in-vivo labeled data available to adapt geometry foundation models to clinical colonoscopy. We present Colon3R, a cross-domain semi-supervised framework built on pretrained VGGT that transfers coupled camera, depth, and pointmap geometry from labeled phantom and simulated data to unlabeled in-vivo colonoscopy without requiring target-domain geometric annotations. Unlike source-only fine-tuning, which learns only from phantom and simulated data, Colon3R directly exploits unlabeled in-vivo video through teacher-derived cross-view supervision. Our proposed hierarchical quasi-rigid reliability selects reliable supervision at the sequence, directed-pair, and pixel levels, while source-preserving adaptation retains the learned coupled geometry during target-domain adaptation. Extensive experiments demonstrate that our method achieves superior overall performance over state-of-the-art approaches in depth, pointmap, and camera pose estimation. Qualitative comparisons on real in-vivo colonoscopy further show substantially more complete and geometrically consistent reconstructions than competing methods under clinical domain shift. The code will be public available after the paper is accepted.

Accurate vision-based navigation in monocular endoscopy is difficult due to limited depth cues, weak tissue texture, non-rigid deformation, and substantial appearance variation across domains, all of which complicate pose estimation, depth prediction, and image-to-anatomy alignment. Although recent vision foundation models have shown promise, their learned representations often remain insufficiently geometry-consistent, hindering stable feature correspondence and limiting their reliability for downstream navigation tasks. We propose a unified framework for learning geometry-consistent and domain-robust image representations for monocular endoscopy. The framework combines a synthetic data pipeline that provides accurate geometric supervision with Hierarchy-Aware Geometry-Semantic Adaptation, a structured alternative to standard LoRA that inserts low-rank adapters selectively across the transformer hierarchy and couples them with layer-wise training objectives to encourage geometric correspondence in intermediate features and semantic consistency in deeper features. Experiments on public and proprietary datasets show improved geometric and semantic representation quality, leading to better performance on downstream navigation tasks including pose estimation and monocular depth estimation. The learned representations show favorable synthetic-to-real transfer on clinical bronchoscopy and provide a useful initialization for adaptation to sinus endoscopy and colonoscopy under limited supervision. The framework also shows favorable scaling with model size and training data. These results support hierarchy-aware, geometry-guided adaptation as a practical approach for endoscopic representation learning.

Monocular depth estimation has achieved strong open-domain generalization, yet reliable robotic deployment remains difficult in transparent, reflective, and specular environments, where depth sensors often produce missing or biased depth. Existing methods often handle such optical failures with scene-specific preprocessing, auxiliary modules, or post-hoc fine-tuning. While effective in constrained settings, these designs increase architectural redundancy and can over-specialize general geometry models to narrow optical scenarios. We revisit this problem as a localized failure mode within base-model training and identify sensor-induced supervision bias as a key bottleneck: models inherit sensor failure patterns from biased real-depth supervision in optically challenging regions. We then introduce OptiGeo, a bias-aware training framework that rehabilitates biased real supervision using a clean-geometry teacher and residual-trimmed alignment. We redefine transparency-targeted rendering as a compact source of clean optical geometry, rather than a large domain-specific fine-tuning set. With only a small targeted rendering set, OptiGeo learns the geometric structure of transparent objects and regions, correcting local geometry distortions that real sensors cannot reliably supervise. Despite only 30M parameters, OptiGeo outperforms substantially larger 300M-scale monocular models and billion-scale multi-view baselines on transparent-scene benchmarks, while remaining competitive on general zero-shot depth and boundary sharpness. Real-world navigation cases further validate its practicality as an efficient perception module in optically challenging scenes.