# AdaptiveSAM: Towards Efficient Tuning of SAM for Surgical Scene Segmentation

arXiv: https://arxiv.org/abs/2308.03726 · HTML: https://mlsanity.com/paper/2308.03726/

## Key facts

- Cited by 37 papers in the map (data through 14 Oct 2026).
- Builds on 32 of its 40 references that are in the map.
- First posted on arXiv 7 Aug 2023.

## Builds on (most cited first, 30 of 32)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [Masked-attention Mask Transformer for Universal Image Segmentation](https://mlsanity.com/paper/2112.01527/) (2021)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [BitFit: Simple Parameter-efficient Fine-tuning for Transformer-based Masked Language-models](https://mlsanity.com/paper/2106.10199/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.12620/) (2023)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [LinkNet: Exploiting Encoder Representations for Efficient Semantic Segmentation](https://mlsanity.com/paper/1707.03718/) (2017)
- [2017 Robotic Instrument Segmentation Challenge](https://mlsanity.com/paper/1902.06426/) (2019)
- [Segment Anything Model (SAM) for Digital Pathology: Assess Zero-shot Segmentation on Whole Slide Imaging](https://mlsanity.com/paper/2304.04155/) (2023)
- [2018 Robotic Scene Segmentation Challenge](https://mlsanity.com/paper/2001.11190/) (2020)
- [CholecSeg8k: A Semantic Segmentation Dataset for Laparoscopic Cholecystectomy Based on Cholec80](https://mlsanity.com/paper/2012.12453/) (2020)
- [Ambiguous Medical Image Segmentation using Diffusion Models](https://mlsanity.com/paper/2304.04745/) (2023)
- [Automatic Instrument Segmentation in Robot-Assisted Surgery Using Deep Learning](https://mlsanity.com/paper/1803.01207/) (2018)
- [Boundary-preserving Mask R-CNN](https://mlsanity.com/paper/2007.08921/) (2020)
- [ISINet: An Instance-Based Approach for Surgical Instrument Segmentation](https://mlsanity.com/paper/2007.05533/) (2020)
- [How to Efficiently Adapt Large Segmentation Model(SAM) to Medical Images](https://mlsanity.com/paper/2306.13731/) (2023)
- [When SAM Meets Medical Images: An Investigation of Segment Anything Model (SAM) on Multi-phase Liver Tumor Segmentation](https://mlsanity.com/paper/2304.08506/) (2023)
- [TraSeTR: Track-to-Segment Transformer with Contrastive Query for Instance-level Instrument Segmentation in Robotic Surgery](https://mlsanity.com/paper/2202.08453/) (2022)
- [A Structure-Aware Relation Network for Thoracic Diseases Detection and Segmentation](https://mlsanity.com/paper/2104.10326/) (2021)
- [From Forks to Forceps: A New Framework for Instance Segmentation of Surgical Instruments](https://mlsanity.com/paper/2211.16200/) (2022)

## Built on by (most cited first, 30 of 37)

- [MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentation](https://mlsanity.com/paper/2309.08842/) (2023)
- [Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions](https://mlsanity.com/paper/2404.03264/) (2024)
- [ScribblePrompt: Fast and Flexible Interactive Segmentation for Any Biomedical Image](https://mlsanity.com/paper/2312.07381/) (2023)
- [Beyond Adapting SAM: Towards End-to-End Ultrasound Image Segmentation via Auto Prompting](https://mlsanity.com/paper/2309.06824/) (2023)
- [How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Model](https://mlsanity.com/paper/2404.09957/) (2024)
- [Interactive Medical Image Segmentation: A Benchmark Dataset and Baseline](https://mlsanity.com/paper/2411.12814/) (2024)
- [Foundation Models for Biomedical Image Segmentation: A Survey](https://mlsanity.com/paper/2401.07654/) (2024)
- [SAM 2 in Robotic Surgery: An Empirical Evaluation for Robustness and Generalization in Surgical Video Segmentation](https://mlsanity.com/paper/2408.04593/) (2024)
- [MultiverSeg: Scalable Interactive Segmentation of Biomedical Imaging Datasets with In-Context Guidance](https://mlsanity.com/paper/2412.15058/) (2024)
- [Improving SAM for Camouflaged Object Detection via Dual Stream Adapters](https://mlsanity.com/paper/2503.06042/) (2025)
- [CRISP-SAM2: SAM2 with Cross-Modal Interaction and Semantic Prompting for Multi-Organ Segmentation](https://mlsanity.com/paper/2506.23121/) (2025)
- [S-SAM: SVD-based Fine-Tuning of Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2408.06447/) (2024)
- [Diffusion-empowered AutoPrompt MedSAM](https://mlsanity.com/paper/2502.06817/) (2025)
- [SAM-MPA: Applying SAM to Few-shot Medical Image Segmentation using Mask Propagation and Auto-prompting](https://mlsanity.com/paper/2411.17363/) (2024)
- [Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Review](https://mlsanity.com/paper/2502.14886/) (2025)
- [Recent Advances in Medical Imaging Segmentation: A Survey](https://mlsanity.com/paper/2505.09274/) (2025)
- [Augmenting Efficient Real-time Surgical Instrument Segmentation in Video with Point Tracking and Segment Anything](https://mlsanity.com/paper/2403.08003/) (2024)
- [Multitask Learning in Minimally Invasive Surgical Vision: A Review](https://mlsanity.com/paper/2401.08256/) (2024)
- [Deep Instruction Tuning for Segment Anything Model](https://mlsanity.com/paper/2404.00650/) (2024)
- [A Federated Learning-Friendly Approach for Parameter-Efficient Fine-Tuning of SAM in 3D Segmentation](https://mlsanity.com/paper/2407.21739/) (2024)
- [ProMISe: Promptable Medical Image Segmentation using SAM](https://mlsanity.com/paper/2403.04164/) (2024)
- [CycleSAM: Few-Shot Surgical Scene Segmentation with Cycle- and Scene-Consistent Feature Matching](https://mlsanity.com/paper/2407.06795/) (2024)
- [AMNCutter: Affinity-Attention-Guided Multi-View Normalized Cutter for Unsupervised Surgical Instrument Segmentation](https://mlsanity.com/paper/2411.03695/) (2024)
- [AI-SAM: Automatic and Interactive Segment Anything Model](https://mlsanity.com/paper/2312.03119/) (2023)
- [Continual Learning for Segment Anything Model Adaptation](https://mlsanity.com/paper/2412.06418/) (2024)
- [RP-SAM2: Refining Point Prompts for Stable Surgical Instrument Segmentation](https://mlsanity.com/paper/2504.07117/) (2025)
- [Segment Any Medical Model Extended](https://mlsanity.com/paper/2403.18114/) (2024)
- [AMA-SAM: Adversarial Multi-Domain Alignment of Segment Anything Model for High-Fidelity Histology Nuclei Segmentation](https://mlsanity.com/paper/2503.21695/) (2025)
- [SAM-PTx: Text-Guided Fine-Tuning of SAM with Parameter-Efficient, Parallel-Text Adapters](https://mlsanity.com/paper/2508.00213/) (2025)
- [Hierarchical Prototype-Memory Adaptation of SAM for Surgical Instrument Segmentation](https://mlsanity.com/paper/2608.24541/) (2026)

## Abstract (arXiv)

Segmentation is a fundamental problem in surgical scene analysis using artificial intelligence. However, the inherent data scarcity in this domain makes it challenging to adapt traditional segmentation techniques for this task. To tackle this issue, current research employs pretrained models and finetunes them on the given data. Even so, these require training deep networks with millions of parameters every time new data becomes available. A recently published foundation model, Segment-Anything (SAM), generalizes well to a large variety of natural images, hence tackling this challenge to a reasonable extent. However, SAM does not generalize well to the medical domain as is without utilizing a large amount of compute resources for fine-tuning and using task-specific prompts. Moreover, these prompts are in the form of bounding-boxes or foreground/background points that need to be annotated explicitly for every image, making this solution increasingly tedious with higher data size. In this work, we propose AdaptiveSAM - an adaptive modification of SAM that can adjust to new datasets quickly and efficiently, while enabling text-prompted segmentation. For finetuning AdaptiveSAM, we propose an approach called bias-tuning that requires a significantly smaller number of trainable parameters than SAM (less than 2%). At the same time, AdaptiveSAM requires negligible expert intervention since it uses free-form text as prompt and can segment the object of interest with just the label name as prompt. Our experiments show that AdaptiveSAM outperforms current state-of-the-art methods on various medical imaging datasets including surgery, ultrasound and X-ray. Code is available at https://github.com/JayParanjape/biastuning