“…In general, they are accurate but require line-of-sight (a straight path without obstacles between cameras and tracked objects), and as an additional drawback, they are affected by lighting, so they are only useful in environments with well-controlled conditions. Zappella et al, Gray et al, and Uemura et al used digital video systems to capture hand and instruments movements of surgical trainees, information is processed and used to perform surgical gesture classification and assess laparoscopic skills objectively [32,33,34]. Harada et al designed instrumented tweezers with the ability to measure several parameters of instrument manipulation during anastomosis simulations, hardware include an Infrared optical motion tracking system, IMUs, and strain gauges [35].…”