Balter Max L, Chen Alvin I, Maguire Timothy J, Yarmush Martin L
Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854 USA, and also with VascuLogic, LLC, Piscataway, NJ 08854 USA (
Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854 USA, and also with Massachusetts General Hospital, Boston, MA 02108 USA (
IEEE Trans Robot. 2015 Aug;31(4):1044-1053. doi: 10.1109/TRO.2015.2452776.
Accessing the venous bloodstream to deliver fluids or obtain a blood sample is the most common clinical routine practiced in the U.S. Practitioners continue to rely on manual venipuncture techniques, but success rates are heavily dependent on clinician skill and patient physiology. In the U.S., failure rates can be as high as 50% in difficult patients, making venipuncture the leading cause of medical injury. To improve the rate of first-stick success, we have developed a portable autonomous venipuncture device that robotically servos a needle into a suitable vein under image guidance. The device operates in real time, combining near-infrared and ultra-sound imaging, image analysis, and a 7-degree-of-freedom (DOF) robotic system to perform the venipuncture. The robot consists of a 3-DOF gantry to image the patient's peripheral forearm veins and a miniaturized 4-DOF serial arm to guide the cannula into the selected vein under closed-loop control. In this paper, we present the system architecture of the robot and evaluate the accuracy and precision through tracking, free-space positioning, and phantom cannulation experiments. The results demonstrate sub-millimeter accuracy throughout the operating workspace of the manipulator and a high rate of success when cannulating phantom veins in a skin-mimicking tissue model.
在美国，通过静脉血管输送液体或采集血样是最常见的临床操作。从业者仍然依赖手动静脉穿刺技术，但成功率在很大程度上取决于临床医生的技能和患者的生理状况。在美国，对于难穿刺的患者，失败率可能高达50%，这使得静脉穿刺成为医疗伤害的主要原因。为了提高首次穿刺成功率，我们开发了一种便携式自动静脉穿刺设备，该设备在图像引导下通过机器人将针头伺服到合适的静脉中。该设备实时运行，结合近红外和超声成像、图像分析以及一个7自由度（DOF）机器人系统来进行静脉穿刺。该机器人由一个3自由度龙门架用于对患者前臂外周静脉进行成像，以及一个小型化的4自由度串联臂用于在闭环控制下将套管引导到选定的静脉中。在本文中，我们介绍了机器人的系统架构，并通过跟踪、自由空间定位和模拟插管实验评估了其准确性和精确性。结果表明，在机械手的整个操作工作空间内具有亚毫米级的精度，并且在模拟皮肤组织模型中对模拟静脉进行插管时成功率很高。
