Complete reconstruction of surgical scenes is crucial for robot-assisted surgery (RAS). Deep depth estimation is promising but existing works struggle with depth discontinuities, resulting in noisy predictions at object boundaries and do not achieve complete reconstruction omitting occluded surfaces. To address these issues we propose EndoLRMGS, that combines Large Reconstruction Modelling (LRM) and Gaussian Splatting (GS), for complete surgical scene reconstruction. GS reconstructs deformable tissues and LRM generates 3D models for surgical tools while position and scale are subsequently optimized by introducing orthogonal perspective joint projection optimization (OPjPO) to enhance accuracy. In experiments on four surgical videos from three public datasets, our method improves the Intersection-over-union (IoU) of tool 3D models in 2D projections by>40%. Additionally, EndoLRMGS improves the PSNR of the tools projection from 3.82% to 11.07%. Tissue rendering quality also improves, with PSNR increasing from 0.46% to 49.87%, and SSIM from 1.53% to 29.21% across all test videos.
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