Surgical-DeSAM: Decoupling SAM for Instrument Segmentation in Robotic Surgery
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Abstract (arXiv)
Purpose: The recent Segment Anything Model (SAM) has demonstrated impressive performance with point, text or bounding box prompts, in various applications. However, in safety-critical surgical tasks, prompting is not possible due to (i) the lack of per-frame prompts for supervised learning, (ii) it is unrealistic to prompt frame-by-frame in a real-time tracking application, and (iii) it is expensive to annotate prompts for offline applications. Methods: We develop Surgical-DeSAM to generate automatic bounding box prompts for decoupling SAM to obtain instrument segmentation in real-time robotic surgery. We utilise a commonly used detection architecture, DETR, and fine-tuned it to obtain bounding box prompt for the instruments. We then empolyed decoupling SAM (DeSAM) by replacing the image encoder with DETR encoder and fine-tune prompt encoder and mask decoder to obtain instance segmentation for the surgical instruments. To improve detection performance, we adopted the Swin-transformer to better feature representation. Results: The proposed method has been validated on two publicly available datasets from the MICCAI surgical instruments segmentation challenge EndoVis 2017 and 2018. The performance of our method is also compared with SOTA instrument segmentation methods and demonstrated significant improvements with dice metrics of 89.62 and 90.70 for the EndoVis 2017 and 2018. Conclusion: Our extensive experiments and validations demonstrate that Surgical-DeSAM enables real-time instrument segmentation without any additional prompting and outperforms other SOTA segmentation methods.
Key facts. Cited by 8 papers in the map (data through 14 Oct 2026). Builds on 15 of its 16 references that are in the map. First posted on arXiv 22 Apr 2024.
Builds on
15 of 16 references.
References · 15
- 2015Deep Residual Learning for Image Recognitioncited by 52,096
- 2021Swin Transformer: Hierarchical Vision Transformer using Shifted Windowscited by 12,139
- 2023Segment Anythingcited by 8,234
- 2020End-to-End Object Detection with Transformerscited by 7,414
- 2019Generalized Intersection over Union: A Metric and A Loss for Bounding Box Regressioncited by 1,368
- 2021TrackFormer: Multi-Object Tracking with Transformerscited by 518
- 2023Segment Anything in Medical Imagescited by 227
- 2023SurgicalSAM: Efficient Class Promptable Surgical Instrument Segmentationcited by 104
- 2018TernausNet: U-Net with VGG11 Encoder Pre-Trained on ImageNet for Image Segmentationcited by 76
- 2020ISINet: An Instance-Based Approach for Surgical Instrument Segmentationcited by 67
- 2019Incorporating Temporal Prior from Motion Flow for Instrument Segmentation in Minimally Invasive Surgery Videocited by 64
- 2022TraSeTR: Track-to-Segment Transformer with Contrastive Query for Instance-level Instrument Segmentation in Robotic Surgerycited by 40
3 more
- 2020Learning Motion Flows for Semi-supervised Instrument Segmentation from Robotic Surgical Videocited by 35
- 2022From Forks to Forceps: A New Framework for Instance Segmentation of Surgical Instrumentscited by 32
- 2023SAM Meets Robotic Surgery: An Empirical Study on Generalization, Robustness and Adaptationcited by 30
Built on by
Citing papers per year: 2024: 2; 2025: 3; 2026: 3.
8 papers.
- 2024SAM 2 in Robotic Surgery: An Empirical Evaluation for Robustness and Generalization in Surgical Video Segmentationcited by 21
- 2025Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Reviewcited by 8
- 2024Systematic Evaluation and Guidelines for Segment Anything Model in Surgical Video Analysiscited by 5
- 2025SASVi -- Segment Any Surgical Videocited by 4
- 2025LapFM: A Laparoscopic Segmentation Foundation Model via Hierarchical Concept Evolving Pre-trainingcited by 1
- 2026Hierarchical Prototype-Memory Adaptation of SAM for Surgical Instrument Segmentationcited by 1
- 2026Dense Structural Priors for Sparse Functional Landmark Localization in Surgical Videoscited by 0
- 2026Toward Mask Annotation-Free Surgical Instrument Segmentation from Endoscopic Images Using Text-Prompted Segment Anything Model 3 (SAM3)cited by 0
- 2026Hierarchical Prototype-Memory Adaptation of SAM for Surgical Instrument Segmentation25 Aug 2026
- 2026Toward Mask Annotation-Free Surgical Instrument Segmentation from Endoscopic Images Using Text-Prompted Segment Anything Model 3 (SAM3)9 Aug 2026
- 2026Dense Structural Priors for Sparse Functional Landmark Localization in Surgical Videos30 Jun 2026
- 2025LapFM: A Laparoscopic Segmentation Foundation Model via Hierarchical Concept Evolving Pre-training9 Dec 2025
- 2025Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Review16 Feb 2025
- 2025SASVi -- Segment Any Surgical Video12 Feb 2025
- 2024Systematic Evaluation and Guidelines for Segment Anything Model in Surgical Video Analysis31 Dec 2024
- 2024SAM 2 in Robotic Surgery: An Empirical Evaluation for Robustness and Generalization in Surgical Video Segmentation8 Aug 2024