This paper suggests an ultrasound guided needle insertion instrument which can compensate organ motion and deformation in real-time. Surgeons have suffered to find out the precise target position, particularly when the organ has movement caused by involuntary patient motion. The developed instrument can track target motion by image processing and visual servo control. In the experiments, it could correct the insertion path 7.69 times per second for a moving phantom, and the insertion error less than 3mm was obtained. In pig experiments, the needle could be placed in the hepatic portal vein.