A Sensorized Needle-Insertion Device for Characterizing Percutaneous Thoracic Tool-Tissue Interactions

Abstract

Tube thoracostomy (TT), where a tube is placed between the lungs and the chest wall to drain air and/or fluids introduced by injury or disease, is a crucial procedure with both routine and emergent applications. It has high complication rates (up to 37.9%) [1], particularly for residents [2] and emergency physicians [3]. Inadver- tent tissue punctures during insertion can cause severe complications, including rare immediate fatality [4]. We propose semi-automating TT tool insertion, as merging the accurate haptic sensing capabilities of a medical robot with the dexterity and perspicacity of a physician could help protect against non-target tissue puncture. To avoid insertional complications, operators must a) position and b) orient tools correctly, and must c) halt insertion immediately upon breaching the parietal pleu- ral membrane. We focus here on preliminaries required for c) and leave a) and b) to future work. We report a prototype sensorized needle-insertion device named NID0 that records manual tool-tissue interactions with ex vivo porcine ribs, a realistic tissue phantom for TT [5], from contact to puncture of the parietal pleura. The acquired dataset showcases tissue characteristics and informs future puncture detection algorithms.