Gastroendoscopy View Synthesis: A New Real Dataset and Evaluation

Robot-assisted minimally invasive surgery (MIS) critically depends on reliable endoscopic perception for navigation and safety. However, conventional endoscopes provide only a limited field of view, leaving large portions of the surrounding anatomy unobserved. Recent neural rendering approaches, such as Neural Radiance Fields and 3D Gaussian Splatting, enable novel view synthesis from endoscopic videos, but their reliance on sparse observations often leads to severe artifacts when extrapolating beyond the training trajectory. In this work, we propose ExtraGS, a framework for enhancing endoscopic view extrapolation through diffusion-guided 3D Gaussian Splatting. Starting from an initial reconstruction, we introduce an uncertainty-guided virtual camera sampling strategy to actively explore blind spots and maximize information gain. The rendered views from these sampled locations are refined using a diffusion model to recover plausible anatomical structures, producing pseudo-observations that guide further optimization. To prevent the generated content from degrading reliable regions, we adopt a confidence-weighted fine-tuning strategy when incorporating these pseudo-observations. Extensive experiments on multiple public endoscopic datasets demonstrate that ExtraGS significantly reduces extrapolation artifacts and achieves state-of-the-art performance in endoscopic novel view synthesis.

Developing foundation generative models for endoscopy is limited by the gap between natural and clinical images and the computational cost of training large Diffusion Transformers. Although representation alignment has improved efficiency in general computer vision, its role within the highly specialized endoscopic image space remains unclear. We introduce REVEAL (Representation-driven Endoscopic Visual Embedding Alignment), the largest generative foundation model for endoscopy to date, trained on GastroNet-5M (GN-5M), a multicenter dataset of 5 million endoscopic frames. Instead of depending on out-of-domain priors, REVEAL employs encoders pretrained directly on the endoscopic distribution to align diffusion latents with domain-specific visual features, preserving fine textures and intricate anatomical structures. Beyond image generation, REVEAL also serves as a powerful feature extractor; in multiple benchmarks, it delivers performance that is competitive with, and in several cases exceeds, endoscopic foundation models such as EndoViT and Endo-FM, specifically tuned for classification tasks, while demonstrating strong representation robustness under realistic imaging corruptions. REVEAL produces high-fidelity images and maintains robust structural coherence in latent-space edits such as inpainting and outpainting. This high-capacity backbone lowers the computational threshold for building specialized clinical tools, offering an open, versatile foundation for conditional synthesis, segmentation, and out-of-distribution detection in future intelligent gastroenterology systems.

Neural radiance field (NeRF) and 3D Gaussian splatting (3DGS) are two mainstream approaches for novel view synthesis. They often show complementary performance, i.e., 3DGS demonstrating faster rendering speed and NeRF demonstrating higher rendering quality. Motivated by this, we propose leveraging NeRF-rendered images for 3DGS. Specifically, we target street scenes and utilize a pre-trained street-specific NeRF method to produce training images for a target 3DGS method. In our 3DGS training, NeRF-rendered images are used to remove transient objects in street-level input views and to generate bird's-eye views as additional views, inheriting the higher-quality rendering of NeRF into 3DGS. We further incorporate a diffusion-based image enhancement to improve the image quality of the additional views. Experimental results on one synthetic and two real datasets demonstrate that our proposed method improves street-scene rendering while preserving the speed of 3DGS and the quality of NeRF.