# Surgical Gaussian Surfels: Highly Accurate Real-time Surgical Scene Rendering using Gaussian Surfels

arXiv: https://arxiv.org/abs/2503.04079 · HTML: https://mlsanity.com/paper/2503.04079/

## Key facts

- Cited by 10 papers in the map (data through 14 Oct 2026).
- Builds on 25 of its 45 references that are in the map.
- First posted on arXiv 6 Mar 2025.

## Builds on (most cited first, 25 of 25)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [3D Gaussian Splatting for Real-Time Radiance Field Rendering](https://mlsanity.com/paper/2308.04079/) (2023)
- [Instant Neural Graphics Primitives with a Multiresolution Hash Encoding](https://mlsanity.com/paper/2201.05989/) (2022)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [4D Gaussian Splatting for Real-Time Dynamic Scene Rendering](https://mlsanity.com/paper/2310.08528/) (2023)
- [2D Gaussian Splatting for Geometrically Accurate Radiance Fields](https://mlsanity.com/paper/2403.17888/) (2024)
- [K-Planes: Explicit Radiance Fields in Space, Time, and Appearance](https://mlsanity.com/paper/2301.10241/) (2023)
- [HexPlane: A Fast Representation for Dynamic Scenes](https://mlsanity.com/paper/2301.09632/) (2023)
- [Understanding Deep Image Representations by Inverting Them](https://mlsanity.com/paper/1412.0035/) (2014)
- [Omnidata: A Scalable Pipeline for Making Multi-Task Mid-Level Vision Datasets from 3D Scans](https://mlsanity.com/paper/2110.04994/) (2021)
- [GaussianPro: 3D Gaussian Splatting with Progressive Propagation](https://mlsanity.com/paper/2402.14650/) (2024)
- [High-quality Surface Reconstruction using Gaussian Surfels](https://mlsanity.com/paper/2404.17774/) (2024)
- [3DGStream: On-the-Fly Training of 3D Gaussians for Efficient Streaming of Photo-Realistic Free-Viewpoint Videos](https://mlsanity.com/paper/2403.01444/) (2024)
- [Neural Rendering for Stereo 3D Reconstruction of Deformable Tissues in Robotic Surgery](https://mlsanity.com/paper/2206.15255/) (2022)
- [Real-time Neural Radiance Caching for Path Tracing](https://mlsanity.com/paper/2106.12372/) (2021)
- [EndoSurf: Neural Surface Reconstruction of Deformable Tissues with Stereo Endoscope Videos](https://mlsanity.com/paper/2307.11307/) (2023)
- [Neural LerPlane Representations for Fast 4D Reconstruction of Deformable Tissues](https://mlsanity.com/paper/2305.19906/) (2023)
- [Deform3DGS: Flexible Deformation for Fast Surgical Scene Reconstruction with Gaussian Splatting](https://mlsanity.com/paper/2405.17835/) (2024)
- [EndoGS: Deformable Endoscopic Tissues Reconstruction with Gaussian Splatting](https://mlsanity.com/paper/2401.11535/) (2024)
- [Does 3D Gaussian Splatting Need Accurate Volumetric Rendering?](https://mlsanity.com/paper/2502.19318/) (2025)
- [Beyond Photometric Loss for Self-Supervised Ego-Motion Estimation](https://mlsanity.com/paper/1902.09103/) (2019)
- [SurgicalGaussian: Deformable 3D Gaussians for High-Fidelity Surgical Scene Reconstruction](https://mlsanity.com/paper/2407.05023/) (2024)
- [Modeling Continuous Motion for 3D Point Cloud Object Tracking](https://mlsanity.com/paper/2303.07605/) (2023)

## Built on by (most cited first, 10 of 10)

- [HUD: Hierarchical Uncertainty-Aware Disambiguation Network for Composed Video Retrieval](https://mlsanity.com/paper/2512.02792/) (2025)
- [MonoFusion: Sparse-View 4D Reconstruction via Monocular Fusion](https://mlsanity.com/paper/2507.23782/) (2025)
- [Advances in Global Solvers for 3D Vision](https://mlsanity.com/paper/2602.14662/) (2026)
- [EEO-TFV: Escape-Explore Optimizer for Web-Scale Time-Series Forecasting and Vision Analysis](https://mlsanity.com/paper/2602.02551/) (2026)
- [CATCH: A Modular Cross-domain Adaptive Template with Hook](https://mlsanity.com/paper/2510.26582/) (2025)
- [Rethinking LoRA for Privacy-Preserving Federated Learning in Large Models](https://mlsanity.com/paper/2602.19926/) (2026)
- [ColonSplat: Reconstruction of Peristaltic Motion in Colonoscopy with Dynamic Gaussian Splatting](https://mlsanity.com/paper/2603.06860/) (2026)
- [Coarse-to-Fine Personalized LLM Impressions for Streamlined Radiology Reports](https://mlsanity.com/paper/2508.15845/) (2025)
- [G-SHARP: Gaussian Surgical Hardware Accelerated Real-time Pipeline](https://mlsanity.com/paper/2512.02482/) (2025)
- [EndoPrior-GS: Dynamic Endoscopic Reconstruction with a Joint Texture Prior](https://mlsanity.com/paper/2609.37874/) (2026)

## Abstract (arXiv)

Accurate geometric reconstruction of deformable tissues in monocular endoscopic video remains a fundamental challenge in robot-assisted minimally invasive surgery. Although recent volumetric and point primitive methods based on neural radiance fields (NeRF) and 3D Gaussian primitives have efficiently rendered surgical scenes, they still struggle with handling artifact-free tool occlusions and preserving fine anatomical details. These limitations stem from unrestricted Gaussian scaling and insufficient surface alignment constraints during reconstruction. To address these issues, we introduce Surgical Gaussian Surfels (SGS), which transform anisotropic point primitives into surface-aligned elliptical splats by constraining the scale component of the Gaussian covariance matrix along the view-aligned axis. We also introduce the Fully Fused Deformation Multilayer Perceptron (FFD-MLP), a lightweight Multi-Layer Perceptron (MLP) that predicts accurate surfel motion fields up to 5x faster than a standard MLP. This is coupled with locality constraints to handle complex tissue deformations. We use homodirectional view-space positional gradients to capture fine image details by splitting Gaussian Surfels in over-reconstructed regions. In addition, we define surface normals as the direction of the steepest density change within each Gaussian surfel primitive, enabling accurate normal estimation without requiring monocular normal priors. We evaluate our method on two in-vivo surgical datasets, where it outperforms current state-of-the-art methods in surface geometry, normal map quality, and rendering efficiency, while remaining competitive in real-time rendering performance. We make our code available at https://github.com/aloma85/SurgicalGaussianSurfels