Safer fluoroscopy guided femoral access using a passive robotic support with a 3D printed needle and guidewire inserter.

Abstract

Radiation during fluoroscopy guided puncture remains a daily concern for staff. We have designed 11 degree of freedom passive robotic mechanism (7 DOF passive robot and 4 DOF 3D printed needle and guide wire insertion) that keeps manual feel and line of sight while moving hands away from the beam. We tested its effectiveness on operator dose in a controlled swine model. Twelve femoral punctures were completed by one experienced operator. Six were done without the passive robot and six with it. Imaging used a mobile C arm.A diagnostic catheter was used to select both femoral arteries, and the standard Seldinger technique was followed. Real time personal dosimeters recorded per case dose at the fingers, wrist, eyes, left leg, right leg, left arm, and right arm. We also recorded exposure time, access success, and access site events. Navigating hand distance from the source was measured. Dose fell with the robot at every site. Reductions were largest at the fingers and wrist near 80%. Eyes fell by about 42%. The right arm and left leg fell by about 57 and 62%, respectively. The left arm and right leg fell by about 29%. Exposure time averaged 5.1 min without the passive robot and 6.5 min with it. Arterial access success was 100% in both cases. Two access-site complications occurred without the passive robot (one hematoma and one dissection), while one dissection occurred with it. The pattern matches the geometry change created by the passive robot which increases working distance and stabilizes the path while keeping tactile control. The device offers a practical path to safer fluoroscopy guided puncture. Future work will test performance in larger cohorts with multiple operators.