# ReGround-Surg: Reliability-Guided Anchor Grounding for Referring Surgical Video Segmentation

arXiv: https://arxiv.org/abs/2608.24671 · HTML: https://mlsanity.com/paper/2608.24671/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 26 of its 28 references that are in the map.
- First posted on arXiv 25 Aug 2026.

## Builds on (most cited first, 26 of 26)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [AdaptFormer: Adapting Vision Transformers for Scalable Visual Recognition](https://mlsanity.com/paper/2205.13535/) (2022)
- [XMem: Long-Term Video Object Segmentation with an Atkinson-Shiffrin Memory Model](https://mlsanity.com/paper/2207.07115/) (2022)
- [LAVT: Language-Aware Vision Transformer for Referring Image Segmentation](https://mlsanity.com/paper/2112.02244/) (2021)
- [Hiera: A Hierarchical Vision Transformer without the Bells-and-Whistles](https://mlsanity.com/paper/2306.00989/) (2023)
- [Language as Queries for Referring Video Object Segmentation](https://mlsanity.com/paper/2201.00487/) (2022)
- [2017 Robotic Instrument Segmentation Challenge](https://mlsanity.com/paper/1902.06426/) (2019)
- [Surgical Data Science: Enabling Next-Generation Surgery](https://mlsanity.com/paper/1701.06482/) (2017)
- [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)
- [OnlineRefer: A Simple Online Baseline for Referring Video Object Segmentation](https://mlsanity.com/paper/2307.09356/) (2023)
- [Referred by Multi-Modality: A Unified Temporal Transformer for Video Object Segmentation](https://mlsanity.com/paper/2305.16318/) (2023)
- [Surgical SAM 2: Real-time Segment Anything in Surgical Video by Efficient Frame Pruning](https://mlsanity.com/paper/2408.07931/) (2024)
- [SAMWISE: Infusing Wisdom in SAM2 for Text-Driven Video Segmentation](https://mlsanity.com/paper/2411.17646/) (2024)
- [TraSeTR: Track-to-Segment Transformer with Contrastive Query for Instance-level Instrument Segmentation in Robotic Surgery](https://mlsanity.com/paper/2202.08453/) (2022)
- [MATIS: Masked-Attention Transformers for Surgical Instrument Segmentation](https://mlsanity.com/paper/2303.09514/) (2023)
- [RefSAM: Efficiently Adapting Segmenting Anything Model for Referring Video Object Segmentation](https://mlsanity.com/paper/2307.00997/) (2023)
- [ReSurgSAM2: Referring Segment Anything in Surgical Video via Credible Long-term Tracking](https://mlsanity.com/paper/2505.08581/) (2025)
- [Memory-Augmented SAM2 for Training-Free Surgical Video Segmentation](https://mlsanity.com/paper/2507.09577/) (2025)
- [Where It Moves, It Matters: Referring Surgical Instrument Segmentation via Motion](https://mlsanity.com/paper/2601.12224/) (2026)

## Abstract (arXiv)

Referring surgical video segmentation requires segmenting a target instrument or tissue region across video frames according to a natural language expression. Recent Segment Anything Model 2 (SAM2) based two-stage methods (e.g., ReSurgSAM2) first ground the referred target in an initial or selected frame, then propagate the selected mask via tracking. Although effective, their performance is highly sensitive to the quality of the initial grounded mask: once an incorrect anchor is selected, subsequent tracking tends to propagate the error. This issue is especially challenging in surgical videos due to visually similar instruments, occlusion, and complex tissue-tool interactions. To address this issue, we propose ReGround-Surg, a lightweight reliability-guided anchor grounding framework to improve SAM2-based referring surgical video segmentation. It first predicts a text-conditioned spatial reliability map from the referring expression and current-frame visual features. The map is then reused in two complementary branches: a Gated Side Adapter enhances expression-relevant visual regions before text-to-vision fusion, while a Reliability-Weighted Vision-to-Text Attention module suppresses off-target visual evidence during prompt-token aggregation. Experiments on Ref-EndoVis17 and Ref-EndoVis18 show consistent improvements over state-of-the-art methods across three evaluation splits with negligible speed reduction. Code is publicly available at https://github.com/JiaxinWen1/ReGround-Surg.