Boosting Generalizable Depth Estimation in Endoscopy by Mixture of Lightweight Experts and Intrinsic Image Alignment

Depth estimation is a significant task for 3D perception in endoscopic surgeries. However, illumination interference and feature diversity in various endoscopic scenes are still challenges for generalizable depth estimation and ego-motion estimation. Based on this, a novel self-supervised framework, EndoMINI, is proposed for depth estimation in endoscopic scenes. Specifically, mixture of low-rank experts (MiLoRE) is proposed to perform parameter-efficient fine-tuning, which can also boost the model adaptation to scenes with different characteristics. Meanwhile, an intrinsic image alignment (IIA) is introduced into the training loss to alleviate the influence of light reflectance in endoscopy with a novel intrinsic image decomposition network. The proposed method is evaluated on SCARED datasets for supervised depth estimation, and two endoscopic datasets, Hamlyn and SERV-CT, for zero-shot depth estimation, compared with state-of-the-art works as well. The experimental results demonstrate outstanding performance of the proposed model and the effects of the main contributions.

Metric Surface Reconstruction of Neurosurgical Scenes from Monocular Operating Microscope Images and Microscope Pose

Objective: We evaluated whether metric 3D geometry of neurosurgical operative exposure can be recovered from standard monocular operating-microscope images combined with microscope pose data. Methods: In a phantom-based laboratory study, two aneurysm training phantoms were imaged with a ZEISS Pentero 800 microscope integrated with Brainlab Cranial Navigation. Microscope images from the standard composite video output were stored with synchronous microscope poses. After intrinsic and extrinsic calibration, depth was estimated with the pretrained Depth Anything 3 model without task-specific fine-tuning. Fused point clouds were converted to meshes using Poisson surface reconstruction. Reconstructions were compared with reference surfaces from structured-light scanning and fine-slice CT. Results: For phantom A, representing a deeper surgical corridor, reconstruction accuracy ranged from 1.95 $\pm$ 1.70 mm to 2.33 $\pm$ 2.15 mm. For phantom B, representing a directly exposed surface, accuracy ranged from 1.02 $\pm$ 0.93 mm to 1.52 $\pm$ 1.21 mm. Larger image sets mainly improved completeness, while accuracy remained within a narrower range. Corridor analysis showed preservation of overall geometry with local deviations in incompletely reconstructed regions. Conclusions: Standard monocular microscope images combined with navigation-derived pose data can reconstruct millimeter-range 3D surfaces using a foundation-model-based pipeline. These results show technical feasibility in a controlled phantom setting and support further development toward objective quantification of operative exposure, image fusion, and characterization of working spaces for future surgical instrumentation.

Geometry-Consistent Endoscopic Representations for Image-Guided Navigation via Structured Foundation Model Adaptation

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.

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.