Design of a Novel Insertion Training System for Central Venous Catheterization

Area of Science:

• Medical Simulation
• Robotics in Medicine
• Medical Education Technology

Background:

• Central venous catheterization (CVC) is a frequent medical procedure with a high complication rate exceeding 15%.
• Existing CVC simulators lack anatomical variability and objective feedback, impeding efficient skill development.
• There is a need for advanced training systems that provide realistic simulation and performance metrics.

Purpose of the Study:

• To develop and evaluate a novel CVC insertion training system integrated with a haptic robotic trainer.
• To assess the haptic fidelity and accuracy of tool detection within the new simulation system.
• To provide residents with a tool for practicing CVC procedures with realistic feedback and automated performance evaluation.

Main Methods:

• Development of a CVC insertion system featuring a sensorized syringe, custom tissue phantom, and tool detection subsystem.
• Integration of the system with the Advanced Dynamic Haptic Robotic Trainer (DHRT+).
• Conducting five experiments to evaluate haptic fidelity (syringe and tissue) and subcutaneous tool detection accuracy.

Main Results:

• The sensorized syringe accurately simulated clinical aspiration forces and detected arterial/venous flash.
• The custom tissue phantom offered realistic force feedback during ultrasound compression and needle insertion at a lower cost.
• Color sensors accurately verified guidewire and catheter depth, enabling multi-positional insertion practice.

Conclusions:

• The developed CVC insertion training system components effectively enable realistic CVC simulation.
• The system provides accurate measurements for aspiration, guidewire depth, and catheter depth.
• This novel system addresses limitations of current simulators, enhancing CVC skill acquisition through objective feedback and realistic haptics.