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Autores principales: Lou, Ange, Li, Yamin, Chang, Qi, Xi, Nan, Xie, Luyuan, Li, Zichao, Luan, Tianyu
Formato: Preprint
Publicado: 2026
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Acceso en línea:https://arxiv.org/abs/2602.09252
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author Lou, Ange
Li, Yamin
Chang, Qi
Xi, Nan
Xie, Luyuan
Li, Zichao
Luan, Tianyu
author_facet Lou, Ange
Li, Yamin
Chang, Qi
Xi, Nan
Xie, Luyuan
Li, Zichao
Luan, Tianyu
contents Surgical image segmentation is essential for robot-assisted surgery and intraoperative guidance. However, existing methods are constrained to predefined categories, produce one-shot predictions without adaptive refinement, and lack mechanisms for clinician interaction. We propose IR-SIS, an iterative refinement system for surgical image segmentation that accepts natural language descriptions. IR-SIS leverages a fine-tuned SAM3 for initial segmentation, employs a Vision-Language Model to detect instruments and assess segmentation quality, and applies an agentic workflow that adaptively selects refinement strategies. The system supports clinician-in-the-loop interaction through natural language feedback. We also construct a multi-granularity language-annotated dataset from EndoVis2017 and EndoVis2018 benchmarks. Experiments demonstrate state-of-the-art performance on both in-domain and out-of-distribution data, with clinician interaction providing additional improvements. Our work establishes the first language-based surgical segmentation framework with adaptive self-refinement capabilities.
format Preprint
id arxiv_https___arxiv_org_abs_2602_09252
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle VLM-Guided Iterative Refinement for Surgical Image Segmentation with Foundation Models
Lou, Ange
Li, Yamin
Chang, Qi
Xi, Nan
Xie, Luyuan
Li, Zichao
Luan, Tianyu
Computer Vision and Pattern Recognition
Artificial Intelligence
Multiagent Systems
Surgical image segmentation is essential for robot-assisted surgery and intraoperative guidance. However, existing methods are constrained to predefined categories, produce one-shot predictions without adaptive refinement, and lack mechanisms for clinician interaction. We propose IR-SIS, an iterative refinement system for surgical image segmentation that accepts natural language descriptions. IR-SIS leverages a fine-tuned SAM3 for initial segmentation, employs a Vision-Language Model to detect instruments and assess segmentation quality, and applies an agentic workflow that adaptively selects refinement strategies. The system supports clinician-in-the-loop interaction through natural language feedback. We also construct a multi-granularity language-annotated dataset from EndoVis2017 and EndoVis2018 benchmarks. Experiments demonstrate state-of-the-art performance on both in-domain and out-of-distribution data, with clinician interaction providing additional improvements. Our work establishes the first language-based surgical segmentation framework with adaptive self-refinement capabilities.
title VLM-Guided Iterative Refinement for Surgical Image Segmentation with Foundation Models
topic Computer Vision and Pattern Recognition
Artificial Intelligence
Multiagent Systems
url https://arxiv.org/abs/2602.09252