Eye tracking for tele-robotic surgery: A comparative evaluation of head-worn solutions

Regine Büter, Roger D. Soberanis-Mukul, Paola Ruiz Puentes, Ahmed Ghazi, Jie Ying Wu, Mathias Unberath

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Purpose: Metrics derived from eye-gaze-Tracking and pupillometry show promise for cognitive load assessment, potentially enhancing training and patient safety through user-specific feedback in tele-robotic surgery. However, current eye-Tracking solutions' effectiveness in tele-robotic surgery is uncertain compared to everyday situations due to close-range interactions causing extreme pupil angles and occlusions. To assess the effectiveness of modern eye-gaze-Tracking solutions in tele-robotic surgery, we compare the Tobii Pro 3 Glasses and Pupil Labs Core, evaluating their pupil diameter and gaze stability when integrated with the da Vinci Research Kit (dVRK). Methods: The study protocol includes a nine-point gaze calibration followed by pick-And-place task using the dVRK and is repeated three times. After a final calibration, users view a 3x3 grid of AprilTags, focusing on each marker for 10 seconds, to evaluate gaze stability across dVRK-screen positions with the L2-norm. Different gaze calibrations assess calibration's temporal deterioration due to head movements. Pupil diameter stability is evaluated using the FFT from the pupil diameter during the pick-And-place tasks. Users perform this routine with both head-worn eye-Tracking systems. Results: Data collected from ten users indicate comparable pupil diameter stability. FFTs of pupil diameters show similar amplitudes in high-frequency components. Tobii Glasses show more temporal gaze stability compared to Pupil Labs, though both eye trackers yield a similar 4cm error in gaze estimation without an outdated calibration. Conclusion: Both eye trackers demonstrate similar stability of the pupil diameter and gaze, when the calibration is not outdated, indicating comparable eye-Tracking and pupillometry performance in tele-robotic surgery settings.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2024
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
EditorsJeffrey H. Siewerdsen, Maryam E. Rettmann
ISBN (Electronic)9781510671607
StatePublished - 2024
EventMedical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling - San Diego, United States
Duration: Feb 19 2024Feb 22 2024

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


ConferenceMedical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/TerritoryUnited States
CitySan Diego


  • Eye-Tracking
  • Gaze Estimation
  • Head-worn eye trackers
  • Pupillometry
  • Tele-Robotic surgery

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging


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