Utility of an endoscopic image processing system for framing laparoscopic images using surgeon’s gaze point and voice commands during laparoscopic percutaneous extraperitoneal closure of inguinal hernia in children

INTRODUCTION: In laparoscopic surgery, it is the assistant who manipulates the laparoscope and manages the field of view. AIM: To develop an endoscopic image processing system that can adjust laparoscopic images as intended by the surgeon without interrupting the surgical procedure. MATERIAL AND METHODS: We developed a touchless user interface that displays a magnified image of the endoscope using information of the surgeon’s gaze point acquired by an eye-tracking device and the surgeon’s voice commands, and evaluated its usefulness during laparoscopic percutaneous extraperitoneal closure (LPEC) of pediatric inguinal hernia. RESULTS: LPEC was performed in 15 clinical cases of pediatric inguinal hernia using this system. In all cases, the internal inguinal ring could be ligated by digitally zooming and moving the endoscopic image by eye tracking and voice command while the scope was fixed. CONCLUSIONS: This new touchless user interface with eye tracking shows promise as a support system for laparoscopic surgery.