# CLIP-RL: Surgical Scene Segmentation Using Contrastive Language-Vision Pretraining & Reinforcement Learning

arXiv: https://arxiv.org/abs/2507.04317 · HTML: https://mlsanity.com/paper/2507.04317/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 20 of its 45 references that are in the map.
- First posted on arXiv 6 Jul 2025.

## Builds on (most cited first, 20 of 20)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [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)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Segmenter: Transformer for Semantic Segmentation](https://mlsanity.com/paper/2105.05633/) (2021)
- [Personalize Segment Anything Model with One Shot](https://mlsanity.com/paper/2305.03048/) (2023)
- [Track Anything: Segment Anything Meets Videos](https://mlsanity.com/paper/2304.11968/) (2023)
- [2017 Robotic Instrument Segmentation Challenge](https://mlsanity.com/paper/1902.06426/) (2019)
- [2018 Robotic Scene Segmentation Challenge](https://mlsanity.com/paper/2001.11190/) (2020)
- [SurgicalSAM: Efficient Class Promptable Surgical Instrument Segmentation](https://mlsanity.com/paper/2308.08746/) (2023)
- [ISINet: An Instance-Based Approach for Surgical Instrument Segmentation](https://mlsanity.com/paper/2007.05533/) (2020)
- [MATIS: Masked-Attention Transformers for Surgical Instrument Segmentation](https://mlsanity.com/paper/2303.09514/) (2023)
- [DeSAM: Decoupled Segment Anything Model for Generalizable Medical Image Segmentation](https://mlsanity.com/paper/2306.00499/) (2023)
- [Deep Learning for Surgical Instrument Recognition and Segmentation in Robotic-Assisted Surgeries: A Systematic Review](https://mlsanity.com/paper/2410.07269/) (2024)
- [S3Net: A Single Stream Structure for Depth Guided Image Relighting](https://mlsanity.com/paper/2105.00681/) (2021)

## Abstract (arXiv)

Understanding surgical scenes can provide better healthcare quality for patients, especially with the vast amount of video data that is generated during MIS. Processing these videos generates valuable assets for training sophisticated models. In this paper, we introduce CLIP-RL, a novel contrastive language-image pre-training model tailored for semantic segmentation for surgical scenes. CLIP-RL presents a new segmentation approach which involves reinforcement learning and curriculum learning, enabling continuous refinement of the segmentation masks during the full training pipeline. Our model has shown robust performance in different optical settings, such as occlusions, texture variations, and dynamic lighting, presenting significant challenges. CLIP model serves as a powerful feature extractor, capturing rich semantic context that enhances the distinction between instruments and tissues. The RL module plays a pivotal role in dynamically refining predictions through iterative action-space adjustments. We evaluated CLIP-RL on the EndoVis 2018 and EndoVis 2017 datasets. CLIP-RL achieved a mean IoU of 81%, outperforming state-of-the-art models, and a mean IoU of 74.12% on EndoVis 2017. This superior performance was achieved due to the combination of contrastive learning with reinforcement learning and curriculum learning.