Eye tracking provides value for clinical staff, patients, and hospital administrations.

The benefits of minimally invasive robotic surgery are well documented. Compared with open surgery, this type of procedure lowers stress on the immune system and the risk of complications. Patients benefit from speedier recoveries and shorter hospital stays. Surgeons who perform procedures at ergonomically designed consoles experience increased wellbeing. And hospital administrations benefit through a rise in patient capacity and working environments that promote employee satisfaction. On the flip side, the surgical systems used in minimally invasive procedures often require specialized training and can initially appear to be expensive.

The widespread benefits of robotic surgery are, however, beginning to outweigh any cost concerns. And that’s created a development wave in high-tech components and surgical devices — which is great for the reasons I just mentioned. However, it presents product managers developing next-generation systems with a challenge: making the right choices for their technology strategies and solution designs from an ever-widening range of options. To make it onto the shortlist, a component solution needs to be mature and highly compatible, but it also needs to show value without adding complexity.

As a component solution, eye tracking is emerging in innovative medical devices and systems. Some of our partners have successfully brought eye tracking enabled products to market, others are in clinical trials, and more are in discovery. I’ve been working with this technology for over a decade. For me, it’s clear that today’s eye tracking has not only reached the necessary level of maturity required for surgical systems but critically, its value has been proven.

In this post, I touch on that value and how a modular architecture maximizes compatibility with other subsystems and components as well as ensuring maximum product lifetime.

Relieve load on busy hands

Surgeons rely on their hands. Even during robot-assisted procedures, seated at well-designed workstations, the load on a surgeon’s hands remains high. Eye tracking can alleviate some of this load. Tobii’s core technology can simplify workflows in the operating theater because it allows surgeons to use their gaze instead of their hands to perform tasks such as control robots, move the surgical camera, or pan, zoom, and select objects on the screen.

Because the user’s eyes control the action and not their hands, adding eye tracking to a surgical system doesn’t introduce yet another peripheral into the mix. For me, this is one of the significant benefits of the technology — it adds functionality without overloading complexity, helping surgeons keep their hands on the controls and attention on their patients.

Alleviate communication

In some scenarios, equipment in the operating theater, such as a surgical camera, is operated by assisting clinical staff. Adding eye tracking provides surgeons with the functionality to control such cameras as they wish. Doing so not only removes the burden of commanding others how and when to move machinery, it also helps the surgeon to maintain focus.

The surgical camera feed is often broadcast to additional monitors in operating theaters, helping clinical staff follow the procedure. By adding eye tracking, the surgeon’s gaze can be superimposed on the camera feed to provide useful insights that may help staff prepare for subsequent steps or potential problems.

Becoming a surgeon requires years of education and a ton of experience. As people become proficient in their field, learning becomes intuitive. We learn by doing, by making mistakes, and devising shortcuts, best practices, and methodologies to achieve what we want. This type of on-the-job know-how makes experienced surgeons highly valuable, but these skills are also the hardest to transfer to trainees and even other clinical staff.

A valuable tutorial could be created by combining the data provided by eye tracking and the surgical camera feed with a surgeon’s narration.

An application that uses eye tracking could assess trainees based on how closely they emulate an experienced surgeon’s eye movements and how they improve over time.

A modular architecture

In simple terms, eye tracking is a sensor technology that follows a person’s eye movements, converting what they are looking at into a data stream. Tobii’s solution includes purpose-built cameras, near-infrared light sources, and processing to calculate a range of detailed eye movements, such as what a person is looking at, pupil size variations, head position, and eye openness.

This data can be used by a surgical system to, for example, zoom in to a specific point, pan to the gaze point, move a surgical instrument, or disable equipment if the surgeon is not present or showing signs of drowsiness.

Tobii’s eye tracking architecture is modular. Designed on a couple of circuit boards, it fits into the bezel of most screens, adapting to any space limitations. The Tobii EyeCore carries out image processing locally to ensure that the host CPU receives just the data it needs.

To be considered a candidate for next-generation medical devices, any component needs to have proven value and designed according to best practices for quality and functional separation. For eye tracking, some additional criteria apply:

• Universal — to serve all users, eye types, and lighting conditions.

• Fit for purpose — with granular data.

• Modular — to fit available space.

• Accurate — to deliver reliable data.

• Fast — for use in real-time applications and meet latency requirements.

In this post, I’ve outlined just a few of the benefits for surgical systems equipped with eye tracking have to offer. A deeper dive is available in our recent white paper, 
Why next-generation surgical systems will include eye tracking. This paper describes how eye tracking works, its history, and the value it provides in terms of simplifying surgical workflows, facilitating skills transfer, and enabling additional safety features.