Table 1.

Key findings and issues of pointing systems developed for laparoscopic surgery

References	Year	Interaction	Tracking	Findings	Issues
Ursic et al. [9]	1997	Hand-held laser pointer	–	Reduced risk of self-contamination, frustration and inaccuracy compared to conventional pointing	No hands-free use possible
Jayaraman et al. [10]	2009	Head pointing	Optical Tracking Camera	Improved instruction efficiency (less task completion time) compared to conventional pointing	Use of tracking camera limits working area
Prescher et al. [11]	2014	Laparoscopic camera	–	Improved instruction efficiency (less task completion time) compared to conventional pointing	Laparoscopic camera position cannot be changed without moving the pointer
Chetwood et al. [12]	2012	Gaze position	Eye Tracking Camera	Improved instruction efficiency (less task completion time, reduced error rates) compared to conventional pointing	Users cannot change their gaze focus without moving the pointer
Ward et al. [13]	2012	Head pointing	Optical Tracking Camera, Inertial Tracking	Improved interaction performance (less total pointer movement, smoother trajectory) compared to commercial pointer system	Use of tracking camera limits working area
Trejos et al. [14]	2015	Head pointing	Optical Tracking Camera, Inertial Tracking	Less hand pointing required, improved instruction efficiency (subjective questionnaires) compared to conventional pointing	Use of tracking camera limits working area
Feng et al. [15, 16]	2018	Hand gestures	Depth Camera	Improved economy of instrument movement, improved gaze behavior (more concentrated and more clustered fixations)	No hands-free use possible