WCE produces large-scale gastrointestinal image data yet pathological findings remain significantly underrepresented limiting the generalization performance of deep-learning based abnormality detection systems. SDG methods offer a practical solution to mitigate this imbalance. However their training directly on scarce abnormal samples often results in instability overfitting and structural distortions. Addressing these challenges requires controlled adaptation mechanisms that preserve anatomical priors while enabling realistic pathological variation. This paper presents EndoFSA a GAN-based model for Endoscopic Few-Shot image generation by Adaptation in WCE imaging. EndoFSA leverages a generator pretrained on abundant normal data and adapts it to abnormal domains using limited number of training samples through a rank-constrained parameter adaptation where only a small number of modulation parameters is updated while the pretrained weights remain frozen. By restricting parameter updates to a low dimensional subspace and incorporating perceptual boundary regularization and cluster-wise diversity control EndoFSA enables efficient model adaptation under limited data conditions and mitigates mode collapse while preserving the anatomical priors learned from normal data. Importantly EndoFSA operates without requiring pixel-level annotations, masks or bounding box supervision. Evaluation on publicly available WCE benchmark datasets spanning various abnormal categories demonstrates that EndoFSA generates abnormal images reproducing real lesions morphology. Moreover in a downstream classification task training an image classifier solely on synthetic abnormal images generated by EndoFSA yields performance comparable to that obtained with real images.

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