Recent token merging techniques for Vision Transformers (ViTs) provide substantial speedups by reducing the number of tokens processed by self-attention, often without retraining. However, their direct application to the Segment Anything Model (SAM) family is nontrivial: SAM's image encoder mixes windowed and global attention, and its mask decoder relies on dense, prompt-conditioned features for precise boundary prediction. We systematically evaluate representative token-merging methods on SAM and Medical SAM in a strict off-the-shelf setting, and find that existing destination-selection heuristics can erode boundaries and leak prompt information as merge rates increase. We propose \textbf{StructSAM}, a resolution-preserving merge-unmerge framework tailored to SAM. StructSAM computes a lightweight token-energy score from first-order feature gradients, uses grid-based flatness screening to protect boundary and prompt regions, and merges tokens within flat areas toward low-energy destinations with explicit token recovery. We further provide a spectral graph coarsening view showing that score-guided merging yields bounded Laplacian spectral distortion compared to random or window-restricted baselines. Across eight natural and medical benchmarks, StructSAM reduces encoder FLOPs by 25-30\% (up to 40\%+ with prompt-aware merging) with minor drops in mIoU/Dice, consistently outperforming ToMe, PiToMe, ToMeSD, VidToMe, and ALGM at the same compute.

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