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The use of Augmented Reality (AR) for navigation purposes has shownbeneficial in assisting physicians during the performance of surgicalprocedures. These applications commonly require knowing the pose of surgicaltools and patients to provide visual information that surgeons can use duringthe task performance. Existing medical-grade tracking systems use infraredcameras placed inside the Operating Room (OR) to identify retro-reflectivemarkers attached to objects of interest and compute their pose. Somecommercially available AR Head-Mounted Displays (HMDs) use similar cameras forself-localization, hand tracking, and estimating the objects' depth. This workpresents a framework that uses the built-in cameras of AR HMDs to enableaccurate tracking of retro-reflective markers, such as those used in surgicalprocedures, without the need to integrate any additional components. Thisframework is also capable of simultaneously tracking multiple tools. Ourresults show that the tracking and detection of the markers can be achievedwith an accuracy of 0.09 +- 0.06 mm on lateral translation, 0.42 +- 0.32 mm onlongitudinal translation, and 0.80 +- 0.39 deg for rotations around thevertical axis. Furthermore, to showcase the relevance of the proposedframework, we evaluate the system's performance in the context of surgicalprocedures. This use case was designed to replicate the scenarios of k-wireinsertions in orthopedic procedures. For evaluation, two surgeons and onebiomedical researcher were provided with visual navigation, each performing 21injections. Results from this use case provide comparable accuracy to thosereported in the literature for AR-based navigation procedures.

STTAR: Surgical Tool Tracking using off-the-shelf Augmented Reality Head-Mounted Displays