Reflectance outperforms force and position in model-free needle puncture detection.

Area of Science:

• Medical Devices
• Surgical Innovation
• Biomedical Engineering

Background:

• Needle thoracostomy is a critical intervention for managing chest over-pressurization.
• High failure rates (up to 94.1%) are attributed to the blind nature of the procedure, relying on tactile feedback.
• Existing instrumented needles using force or position have shown limited success in detecting target space entry.

Purpose of the Study:

• To develop and evaluate a novel instrumented needle system for improved detection of needle entry into the pleural space during simulated procedures.
• To enhance the accuracy and reliability of needle thoracostomy by providing objective sensory feedback.

Main Methods:

• An augmented needle insertion system incorporating an in-bore double-fiber optical setup was developed.
• Simultaneous recording of tissue reflectance, 3D force, torque, position, and orientation during needle insertion into ex vivo porcine ribs.
• Application of model-free puncture detection algorithms to sensor data streams.

Main Results:

• Puncture detection precision significantly improved with optical reflectance measurements compared to force or position alone.
• Reflectance-based detection showed a 3.3-fold increase over force and an 11.6-fold increase over position in identifying needle entry.
• The novel system demonstrated enhanced ability to discern needle puncture events.

Conclusions:

• The integration of optical reflectance sensing offers a substantial improvement in detecting needle entry during simulated thoracostomy procedures.
• This technology has the potential to reduce failure rates and improve patient outcomes for needle thoracostomy.
• Further development and clinical validation of this instrumented needle system are warranted.