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Computer-based simulation is an important tool for surgical skills training and assessment. In general, the degree of realism experienced by the trainees is determined by the visual and biomechanical fidelity of the simulator. In minimally invasive surgery, specular reflections provide an important visual cue for tissue deformation, depth and orientation. This paper describes a novel image-based lighting technique that is particularly suitable for modeling mucous-covered tissue surfaces. We describe how noise functions can be used to control the shape of the specular highlights, and how texture noise is generated and encoded in image-based structure at a pre-processing stage. The proposed technique can be implemented at run-time by using the graphics processor to efficiently attain pixel-level control and photo-realism. The practical value of the technique is assessed with detailed visual scoring and cross comparison experiments by two groups of observers.