BACKGROUND: An alternative mode of interaction with navigation systems for open liver surgery was requested. Surgeons who use such systems are impeded by having to constantly switch between viewing the navigation system screen and the patient during an operation. METHODS: To this end, an auditory display system for open liver surgery is introduced with support for guiding the tracked instrument towards and remaining on a predefined resection line. To evaluate the method, a clinically orientated user study with 12 surgeons was conducted. RESULTS: It is shown in qualitative results from the user study that the proposed auditory display is recognized as a useful addition to the current visual mode of interaction. It was revealed in a statistical analysis that participants spent less time looking on the screen (10% vs. 96%). Accuracy for resection guidance was significantly improved when using auditory display as an additional information channel (0.6 vs. 1.4 mm); however, the overall time for the resection task was shorter without auditory display (47 vs. 24 s). CONCLUSIONS: By reducing dependence on the visual modality during resection guidance, the auditory display is well suited to become integrated in navigation systems for liver surgery.