Towards Robotic Transseptal Puncture: A Preliminary Study Investigating the Influence of Puncture Velocity in Minimally Invasive Cardiovascular Surgery

Minimally invasive cardiac surgery (MI CS) has revolutionized cardiovascular interventions. A crucial step during many MI CS targeting the left side of the heart is the transeptal puncture (TP) performed in the fossa ovalis (FO). Performing a manual TP poses challenges, requiring a high level of expertise and a steep learning curve. This has motivated interest in the exploration of robotic transseptal puncture, aiming to improve the accuracy of execution. This study conducts a comprehensive analysis of the impact of puncture speed on TP safety using a robotic implementation system and a specially designed FO simulator. Specifically, a 7 Degree of Freedoms (DoFs). manipulator was used to perform the puncture using the standard transseptal kit commonly used in manual TP. Moreovere, to measure the interaction forces between the needle and the tissue, a load cell was attached to the base of the end effector of the manipulator. The simulator was built and validated against existing models proposed in the literature, successfully replicating the anatomical features and mechanical properties of the fossa ovalis tissue. Experimental results demonstrate that higher puncture velocities are associ-ated with reduced needle shear forces, improving the overall safety of the procedure.