Answering what-if queries about a scene with a VLM usually means injecting the assumption as text or repainting the scene with a generative model. We instead move the edit to the representation level, before the model input. The image is abstracted into a set of object-level tokens, and the original image never enters the VLM. This design rests on an open question: when do frozen VLMs actually respond to such token edits? We introduce an answer-key-free protocol: no post-edit answer is annotated. It scores edits whose answers are logically determined, and audits itself by reversing each scoreable choice. The protocol reveals three structures. The response is not free: explicit edit teaching, not ordinary VQA training, produces it in dense scenes and multiplies it in sparse ones, on all three operations. Once on, it is governed by token cleanliness and density, with deployable detector+segmenter tokens competitive with the oracle and outperforming it on VRSBench. And reading is a separable axis: the image-free token route preserves 92-96% of a matched patch-token baseline's free-text VQA, and the answers measurably depend on the tokens. The response, cleanliness, and reading structures are sign-preserved across two remote-sensing datasets (iSAID, VRSBench) and three frozen LM backbones. We release the probe generator, records, judge logs, and code.
Yiping Li, Ronald de Jong, Romy van Jaarsveld +5cs.CV
Visual Question Answering (VQA) in robotic surgery, referred to as surgical VQA, requires high-level understanding of complex surgical scenes and the integration of visual perception with language reasoning, with the potential to support surgical training and intraoperative decision-making. Recent Vision-Language Models (VLMs) have shown promising performance through parameter-efficient fine-tuning; however, most existing approaches rely on coarse visual grounding, typically limited to bounding boxes, which fails to capture the fine-grained spatial structure of surgical objects. In this work, we propose a unified framework that jointly performs pixel-level segmentation and visual question answering within a single framework. Our approach integrates a VLM with a Segment Anything Model (SAM)-based decoder and represents scene elements as object tokens generated by the VLM. These object tokens guide answer prediction and are further projected to the SAM-based decoder to produce segmentation masks. By optimizing the object token embeddings through both segmentation and question answering objectives, the model learns spatially grounded representations that enhance visual reasoning while providing explicit pixel-level grounding. We evaluate the proposed method on the private RAMIE (Robot-Assisted Minimally Invasive Esophagectomy) dataset and the public EndoVis18 dataset, where it consistently outperforms baseline methods for surgical VQA. These results demonstrate that incorporating context-aware object tokens into vision-language models improves fine-grained surgical scene understanding.