Revista de Cirurgia e Prática Clínica

Evaluation of Eye-Tracking vs Color-code Tracking for Robotic Camera Assistance in Minimally Invasive Surgery

Ahmed Elsherbiny, Sebastian Koller, Nils Kohn, Daniel Ostler, Armin Schneider, Thomas Vogel Dirk Wilhelm Helmut Friess, Hubertus Feussner and Michael Kranzfelder

Purpose: Robotic camera assistance enhances manual dexterity, precision, and ergonomic control in minimally invasive surgery. However, the optimal control interface for robotic camera assistance is still a matter of research and development. Tracking systems seem to offer a potential solution for an autonomous maneuvering of a robotic camera holder.
Methods: We evaluated two potential tracking solutions in a preliminary ex-vivo study (n=20 participants) using either eyetracking or color-code tracking for control of the robotic camera holder SOLOASSIST (AKTORMed, Barbing, Germany). Performance time (maneuvering robotic camera holder to five distinct markers) and system usability scale (SUS) were evaluated. Joystick-control of the SOLOASSIST (standard control interface) was used as reference. Each participant carried out three repetitions with each navigation modality.
Results: Camera control by joystick (81 ± 32.1 sec.) was quicker compared to eye- or color- code tracking (124.3 ± 68.1 sec., p= 0.36 and 114.2 ± 59.1 sec., p= 0.17). No statistically significant difference between eye- and color-code tracking was noted (p= 0.36). The system usability scale (SUS) scored highest for the joystick control (87.5 ± 13.4 pts.). Color-code tracking revealed a SUS of 73 ± 20 pts. and eye-tracking of 57.8 ± 19.6 pts. Despite these findings, participants would prefer eye- and color-code tracking for real surgery.
Conclusion: Our study showed that manoeuvring the robotic camera holder SOLOASSIST with eye- and color-code tracking is possible and feasible. Clinicians prefer control interfaces other than the joystick (current standard). Further efforts should be taken to develop intuitive control interfaces, e.g. by use of remote eye tracking, to facilitate a broader use of robotic camera assistance systems in surgery.