SurgGaze: Implicit Calibration for Accurate Gaze Analysis in Operating Rooms with Wearable Eyetrackers

Abstract: Accurate gaze tracking is essential for understanding surgeons' visual attention and cognitive processes during laparoscopic surgery, yet wearable eye trackers produce large errors systematically correlated with ground-truth gaze locations, as demonstrated in Study 1. We introduce SurgGaze, an implicit calibration method that corrects these errors using high-confidence surgical moments. Building on evidence that surgeons' gaze converges near the tool-tissue contact point (TTCP) during dissection, SurgGaze uses TTCP as a surrogate for true gaze to construct training pairs. We evaluate SurgGaze in a simulated operating room trial and an authentic operating room case study. In simulation, SurgGaze reduced gaze estimation error by 40.6%, significantly outperforming conventional 9-point explicit calibration. The case study showed that these moments provide reliable training data and that calibrated gaze improves interpretation of surgeons' attention beyond numeric error reduction. These findings demonstrate that structured behavioral signals can enable implicit calibration for gaze tracking in complex real-world settings.