Design and evaluation of an eye tracking support system for the scrub nurse

Background: The availability of an increasing number of medical devices in the digital operating room has led to increased interaction demands of the surgical staff. To counteract the risk of bacterial contamination induced by device interactions, touchless interaction techniques are required. Support systems based on eye tracking enable interaction while maintaining sterility and freeing the hands to manipulate surgical instruments. Methods: A system using eye tracking glasses was developed. In an evaluation, participants completed tasks using gaze gestures. Three use cases were evaluated in an intraoperative setup. System performance, user acceptance, and workload were measured. Results: The system was evaluated in a laboratory environment with 26 participants. The precision of the gaze gesture recognition is 97.9%, and the true positive rate is 98.5%. The participants rated the system useful and were satisfied. Conclusions: Touchless interaction ensures sterility, although the increasing availability of medical devices in the operating room.