Augmenting efficient real‐time surgical instrument segmentation in video with point tracking and Segment Anything

Abstract The Segment Anything model (SAM) is a powerful vision foundation model that is revolutionizing the traditional paradigm of segmentation. Despite this, a reliance on prompting each frame and large computational cost limit its usage in robotically assisted surgery. Applications, such as augmented reality guidance, require little user intervention along with efficient inference to be usable clinically. This study addresses these limitations by adopting lightweight SAM variants to meet the efficiency requirement and employing fine‐tuning techniques to enhance their generalization in surgical scenes. Recent advancements in tracking any point have shown promising results in both accuracy and efficiency, particularly when points are occluded or leave the field of view. Inspired by this progress, a novel framework is presented that combines an online point tracker with a lightweight SAM model that is fine‐tuned for surgical instrument segmentation. Sparse points within the region of interest are tracked and used to prompt SAM throughout the video sequence, providing temporal consistency. The quantitative results surpass the state‐of‐the‐art semi‐supervised video object segmentation method XMem on the EndoVis 2015 dataset with 84.8 IoU and 91.0 Dice. The method achieves promising performance that is comparable to XMem and transformer‐based fully supervised segmentation methods on ex vivo UCL dVRK and in vivo CholecSeg8k datasets. In addition, the proposed method shows promising zero‐shot generalization ability on the label‐free STIR dataset. In terms of efficiency, the method was tested on a single GeForce RTX 4060/4090 GPU respectively, achieving an over 25/90 FPS inference speed. Code is available at: https://github.com/zijianwu1231/SIS‐PT‐SAM.