A Survey of Artificial Intelligence in Endoscopic Surgery Workflow: From Perception to Surgical Support

Abstract

Endoscopic surgery demands continuous real-time visual decision-making under severe constraints, including a limited field of view, motion blur, and dynamically deforming anatomy. These factors impose substantial cognitive load on surgeons and motivate the integration of artificial intelligence (AI) throughout the endoscopic surgical workflow. This survey reviews recent progress in AI for endoscopic surgery and organizes the literature into four stages that span perception to action: (1) image enhancement and analysis methods that improve visual perception; (2) multimodal video understanding approaches that model and reason surgical instruments and anatomical structures over space and time; (3) 3D reconstruction techniques that enable robust tracking and interpretation of deformable anatomy; and (4) emerging paradigms of embodied surgical intelligence, where action-conditioned world models link perception to intraoperative assistance.

Across these stages, we summarize current capabilities and limitations and identify key open challenges for clinical deployment. In addition, we provide an overview of 18 publicly available datasets, highlighting their scope and annotations. We hope this survey will stimulate further research toward reliable and clinically deployable AI systems for endoscopic surgery.