Preliminary in vivo evaluation of a needle insertion manipulator for central venous catheterization

Central venous catheterization is associated with potential complications secondary to accidental puncture, including venous bleeding and pneumothorax. We developed a system that avoids these complications and simplifies the procedure using a robot to provide puncture assistance. We herein report a puncture experiment conducted in vivo in a porcine to evaluate the manipulator. The right and left jugular veins of a pig were punctured five times each through both opened and unopened skin at a puncture angle and speed. A venous placement rate of 80% was obtained with opened skin. A much lower rate of 40% was obtained with unopened skin. One of five attempts in opened skin was unsuccessful, likely because of the stick-slip phenomenon. This system was effective for jugular venous puncture of opened skin. Future studies should focus on puncture conditions that facilitate needle placement, inhibit the stick-slip phenomenon, and minimize needle bending due to the presence of skin.