Abstract <p>With the increasing use of image-based 3D reconstruction in medical procedures, accurate scene reconstruction plays a crucial role in surgical navigation and assisted treatment. However, the monotonous colors, limited image features, and obvious brightness fluctuations of thoracoscopic scenes make the feature point matching process, on which traditional 3D reconstruction methods rely, unstable and unreliable. It brings a great challenge to accurate 3D reconstruction. In this study, a new method for implicit 3D reconstruction of monocular thoracoscopic scenes is proposed. The method combines a pre-trained metric depth estimation model with neural radiation field (NeRF) technique and uses dense SLAM to accurately compute the camera pose. To ensure the accuracy of the depth values and the structural consistency of the reconstructed scene, depth and normal constraints are added to the original color constraints of the NeRF network to achieve high-quality scene reconstruction results. We conducted experiments on the SCARED dataset and the clinical dataset. After comparing with other methods, the depth estimation accuracy and point cloud reconstruction quality of this paper outperform the existing methods. The method in this paper can provide more accurate 3D reconstruction of complex thoracic surgical scenes, which can significantly improve the accuracy and therapeutic efficacy of surgical navigation.</p> Graphical abstract <p></p>