arXiv:2507.02252v1 Announce Type: cross Abstract: Precise surgical interventions are vital to patient safety, and advanced enhancement algorithms have been developed to assist surgeons in decision-making. Despite significant progress, these algorithms are typically designed for single tasks in specific scenarios, limiting their effectiveness in complex real-world situations. To address this limitation, we propose SurgVisAgent, an end-to-end intelligent surgical vision agent built on multimodal large language models (MLLMs). SurgVisAgent dynamically identifies distortion categories and severity levels in endoscopic images, enabling it to perform a variety of enhancement tasks such as low-light enhancement, overexposure correction, motion blur elimination, and smoke removal. Specifically, to achieve superior surgical scenario understanding, we design a prior model that provides domain-specific knowledge. Additionally, through in-context few-shot learning and chain-of-thought (CoT) reasoning, SurgVisAgent delivers customized image enhancements tailored to a wide range of distortion types and severity levels, thereby addressing the diverse requirements of surgeons. Furthermore, we construct a comprehensive benchmark simulating real-world surgical distortions, on which extensive experiments demonstrate that SurgVisAgent surpasses traditional single-task models, highlighting its potential as a unified solution for surgical assistance.