Handheld endoscopic manual instrument with articulating tip

Abstract

A handheld surgical device for endoscopic use, particularly endoscopic endonasal and intracranial surgery, is described. The device allows for single hand operation to open or close the tip, articulate the tip in a 360o rotation as well as turn it 180o left to right. Methods of making and using the device in manual and automatic modes are also provided.

Description

HANDHELD ENDOSCOPIC MANUAL INSTRUMENT WITH ARTICULATING TIPCROSS REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. provisional application No. 63 / 686,225, filed August 23, 2024, which is incorporated herein by reference as if fully set forth.TECHNICAL FIELD

[0002] The present disclosure relates to a handheld endoscopic surgical device comprising an opening and closing tip that has additional articulating ability of complete 360° rotation and simultaneous independent distal articulating movement of 180° effectuated with pullies, methods of making and using such device in manual and automatic modes.BACKGROUND OF THE INVENTION

[0003] Endoscopic and laparoscopic tools with articulating tips designed for general surgery have allowed numerous techniques to be developed and pushed minimally invasive surgery further. However, no such instrument is in use in the field of neurosurgery currently. This device attempts to meet this need and allow for use of articulating tip to get more degrees of freedom and allow for more complex motions in small spaces, allowing more refined techniques to be developed. This can allow currently nearly impossible techniques such as endoscopic endonasal suturing to be possible among other more dexterous actions.SUMMARY OF THE INVENTION

[0004] In an aspect, the invention relates to a handheld surgical device for endoscopic use comprising a longitudinal shaft and an articulating tip. The device comprises a rotating body that allows 360 degree rotation. The device also comprises multiple pully mechanisms that allow opening and closing of the tip and its articulation forward or backward in a 180 degree angle motion. The device is configured for manual operation. In particular, the device is configured for single-handed manual operation.

[0005] In aspect, the invention relates to a method of making a handheld surgical device for endoscopic use. The method comprises providing a longitudinal shaft that extends between a first end and a second end; attaching pullies to the longitudinal shaft; and connecting an articulating tip to the longitudinal shaft at the first or the second end through a joint.

[0006] In aspect, the invention relates to a method of assembly a handheld surgical device. The method includes constructing the handheld surgical device from surgical grade material, e.g., steel or polymer.

[0007] In an aspect, the invention relates to a method of moving the device of any one of embodiments described herein through a body part or cavity. The method comprises expanding the longitudinal shaft outwardly into the body part or cavity. The method also comprises engaging the articulating tip within thebody part or cavity to perform a process. The method further comprises retracting the longitudinal shaft backward from the body part or cavity.

[0008] In an aspect, the invention relates to a method of using the handheld surgical device attached to a robotic system. The method comprises acquiring an image of the body part or cavity of a patient. The method also comprises mapping of the body part or cavity of the patient. The method comprises identifying a plurality of target sites in the body part or cavity and designing a treatment. The method further comprises inserting the handheld surgical device in the body part or cavity and automatically performing the treatment procedure by using at least one tip of the handheld surgical device.

[0009] In an aspect, the invention relates to a computer software product. The software product includes a non-transitory computer readable storage medium in which computer program instructions are stored, which instructions, when executed by a computer, cause the computer to perform the steps of: acquiring an image of an image of a body part of a patient and displaying the image on a screen display; identifying a plurality of target sites on the image and designing treatment; inserting a handheld surgical in the body part of the patient; and automatically performing the treatment by using at least one tip of the handheld surgical device.BRIEF DESCRIPTION OF THE DRAWINGS

[0010] The following detailed description of the preferred embodiments will be better understood when read in conjunction with the appended drawings. For the purpose of illustration, there are shown in the drawings embodiments which are presently preferred. It is understood, however, that the invention is not limited to the precise arrangements and instrumentalities shown. In the drawings:

[0011] FIG. 1 is a sagittal or side profile of the handheld surgical device and its elements.

[0012] FIG. 2 is an axial or top-down profile of the handheld surgical device and its elements.

[0013] FIG. 3 is a schematic drawing of an exemplary robotic system compatible with the handheld surgical device according to the embodiments disclosed herein.

[0014] FIG. 4 is a schematic drawing of an exemplary robotic arm attachable to the handheld surgical device according to the embodiments disclosed herein.

[0015] FIG. 5 is a flowchart of the method of making a handheld surgical device according to the embodiments disclosed herein.

[0016] FIG. 6 is a flowchart of the method of using a handheld surgical device coupled with a robotic system.DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0017] Certain terminology is used in the following description for convenience only and is not limiting. Unless stated otherwise, or implicit from context, the following terms and phrases include the meaningsprovided below. Unless explicitly stated otherwise, or apparent from context, the terms and phrases below do not exclude the meaning that the term or phrase has acquired in the art to which it pertains. The definitions are provided to aid in describing particular embodiments, and are not intended to limit the claimed invention, because the scope of the invention is limited only by the claims. Further, unless otherwise required by context, singular terms shall include pluralities and plural terms shall include the singular.

[0018] The singular terms “a,” “an,” and “the” include plural referents unless context clearly indicates otherwise. Similarly, the word “or” is intended to include “and” unless the context clearly indicates otherwise.

[0019] The phrase “at least one” followed by a list of two or more items, such as “A, B, or C,” means any individual one of A, B or C as well as any combination thereof.

[0020] The words "right," "left," "top," and "bottom" designate directions in the drawings to which reference is made.

[0021] Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of this disclosure, suitable methods and materials are described below.

[0022] An embodiment provides a handheld surgical device for endoscopic use. The device may comprise a longitudinal shaft and an articulating tip. The longitudinal shaft may extend between a first end and a second end of the device. The articulating tip may be attached to the longitudinal shaft at the first or the second end through a joint.

[0023] In an embodiment, the articulating tip may be opened. In another embodiment, the articulating tip may be closed.

[0024] In an embodiment, the longitudinal shaft may further comprise pullies. The articulating the tip may be articulated left or right at 180° angle at the joint with pullies.

[0025] In an embodiment, the longitudinal shaft may be configured to rotate 360° along its length wide axis, and rotate the articulated tip.

[0026] In an embodiment, the device may be configured to be operated manually. The device may be configured to be operated with one hand.

[0027] FIG. 1 is a sagittal profile showing the handheld surgical device that can be grasped through finger holes 1 connected to a fixed rigid handle 2 which is attached to main longitudinal inner shaft 5 and attached to movable handle 3 which is connected to main frame of rigid handle 2 and inner shaft 5 via hinge 4. The main inner shaft 5 has another outer shaft 7 threaded on to it with a groove 6 which holds the wider outer shaft 7 and allows for 360 degree rotation around the access of the rigid inner shaft 5. The end of the wider outer shaft 7 is attached to a flexible joint 8 which can be a hinge, spring, or other to allow 180 degree motion of the tip 9 around the distal part of outer shaft 7. The tip 9 may be a grasper, scissor, dissector, forceps, needle driver, vascular clip applier, bipolar cautery or other type of opening and closing tip.

[0028] The tip may be detachable or permanently fixed to the flexible joint 8. The tip opens and closes by articulating on a hinge 10 by the use of opposing forces from attachment points 11, 12 to which strings,ropes, cables, or wires (from here on referred to as cables) 13,15 are attached. The cables are attached to a cut out 14 which is on the movable handle 3. A pulley 16 helps move the inferior cable 15. The superior cable 13 is held in place along the shaft by a thin containment tube or multiple cut outs 17. The inferior cable15 runs inside the shafts 5, 7. Attached to the outer shaft 7 is a hinge 18 to which additional cable connection points 19 and has finger holes 20 on edges which together is the hand control system for lateral movement of the tip. This same control unit can be used to rotate the outer shaft 7 about inner shaft 5. Along outer shaft 7 there are containment tubes or cut outs 21 for cables 22 which are anchored at points 23 to the tip past the flexible joint 8, allowing for forces to be applied moving tip 180 degree motion of the tip 9 around the distal part of outer shaft 7.

[0029] FIG. 2 shows the endoscopic instrument from a top down axial view. The main inner shaft 5 has another outer shaft 7 threaded on to it with a groove 6 which holds the wider shaft and allows for 360 degree rotation around the access of the rigid inner shaft 5. The end of the wider outer shaft 7 is attached to a flexible joint 8 which can be a hinge, spring, or other to allow 180 degree motion of the tip 9 around the distal part of outer shaft 7. The tip 9 may be a grasper, scissor or other type of opening and closing tip. The tip may be detachable or permanently fixed to the flexible joint 8. The tip opens and closes by articulating on a hinge 10 by the use of opposing forces from attachment points 11, 12 to which strings, ropes, cables, or wires (from here on referred to as cables) 13, 15 are attached. The cables are attached to a cut out 14. A pulley16 helps move the inferior cable 15. The pulley is attached to frame 5 via attachment 24. The superior cable 13 is held in place along the shaft by a thin containment tube or multiple cut outs 17. The inferior cable 15 runs inside the shafts 5, 7. Attached to the outer shaft 7 is a hinge 18 to which additional cable connection points 19 and has finger holes 20 on edges which together is the hand control system for lateral movement of the tip. This same control unit can be used to rotate the outer shaft 7 about inner shaft 5. Along outer shaft 7 there are containment tubes or cut outs 21 for cables 22 which are anchored at points 23 to the tip past the flexible joint 8, allowing for forces to be applied moving tip 180 degree motion of the tip 9 around the distal part of outer shaft 7.

[0030] In an embodiment, the tip may be a grasper. The grasper may be a laparoscopic grasper for surgical procedures or an endoscopic graspers used in non-surgical applications. Graspers may be blunt or sharp graspers. Typically, the graspers include the jaws or tips designed with various shapes, sizes, and serrations (or lack thereof) to interact with different types of tissue. The graspers may be atraumatic graspers or traumatic (toothed) graspers.

[0031] The atraumatic graspers are characterized by smooth, blunt, or finely serrated jaws that are designed to minimize tissue damage. The atraumatic graspers may be fenestrated, i.e., having openings in the jaws to allow fluids to pass through and to reduce the surface area contact, thus distributing pressure more evenly. The atraumatic graspers may be non-fenestrated, e.g., having jaws that are solid. The nonfenestrated graspers provide a more continuous, broader surface contact and can be useful for dissectionor pushing tissue. The atraumatic graspers may be used for handling delicate structures such as bowel, bladder, major blood vessels, or thin mesentery where crushing or tearing must be avoided. The atraumatic graspers may be used for gentle retraction to expose the surgical field. For example, the atraumatic graspers may be Babcock graspers (broad, fenestrated, gentle), or DeBakey graspers (long, fine, non-fenestrated serrations).

[0032] The traumatic or toothed graspers feature sharp teeth or prominent serrations on their jaws. The traumatic graspers are designed for securely grasping dense tissue, fascia, or large specimens that are being removed from the body. The teeth of the traumatic graspers provide a very firm grip, which can be essential when significant traction is needed. For example, the traumatic graspers may be Alligator forceps (fine, sharp teeth), some large tissue-grasping forceps.

[0033] The graspers may be any graspers designed for specific applications. The graspers may be dissecting graspers. Dissecting graspers may feature a curved, blunt tip with fine serrations. Many dissecting graspers are monopolar compatible, meaning they can be connected to an electrosurgical unit for cautery, e.g., cutting and sealing tissue with heat. Dissecting graspers may be used for blunt dissection, e.g., separating tissues along natural planes and / or some sharp dissection. The curved tip may allow efficient “hooking” and separation of tissue. Their versatility makes them crucial for mastering precision laparoscopic graspers. The graspers may be Babcock graspers, i.e., a type of atraumatic grasper with distinctive, broad, fenestrated jaws that form a circular shape when closed. The Babcock graspers are designed for holding delicate, tubular structures like bowel, fallopian tubes, or appendix without causing significant crushing injury. The graspers may be Kelly forceps or Crile forceps (Laparoscopic Versions). These forceps resemble their open surgery counterparts, with straight or curved jaws featuring horizontal serrations. These graspers may be used for general grasping, clamping small vessels, or passing sutures.

[0034] The graspers may be right-angle dissectors. The right-angle dissectors features a right-angle bend at the tip, often with a fine, blunt, or serrated jaw. The right-angle dissectors may be used for reaching around structures to dissect or to clamp vessels in tight spaces that are difficult to access directly.

[0035] In an embodiment, the tip may be any type of surgical scissors. The scissors may be bandage scissors. Bandage scissors are used to cut gauze, bandages, and size bandages. Bandage scissors have an angled tip and a blunt bottom tip, and are designed specifically to cut through thin material without cutting the skin. The bandage scissors may be Lister and the Knowles scissors. The Lister scissors are used most for sizing dressings and removing bandages, along with cutting through thicker materials such as plaster, fabric, and umbilical cord. The Lister scissors have lower blade on the jaw that is elongated and the tip holds a flattened blunt nodule, meant to slide between bandages and skin, being conscious of skin safety. This multipurpose feature allows the instrument to be used during cesarean section, opening the uterus while protecting the baby. The Knowles bandage scissors are lightweight, durable, and made to cut through thickmaterials, with a tip on the upper blade, as to protect the patient. The blades are closer in size and shape than the Lister.

[0036] The scissors may be dissecting scissors. The dissecting scissors provide more mechanical leverage than scalpels. The dissecting scissors may be used for making incisions, removing skin, tissue and stitches. The dissecting scissors may have a curved blade and may be useful in protecting incisions during probing. The dissecting scissors may have heavy blades that are meant for cutting thick tissue such as tendons and ligaments. The dissecting scissors may have lighter blades that are used for delicate structures, like eye tissue. The shapes of dissecting scissors may range from straight, angled, or curved. The lightest dissecting scissors, the former with a fine and sharp tip, may be used for meticulous work, and to push tissue aside, rather than pierce it.

[0037] The scissors may be iris scissors. Iris scissors are very small scissors with a very sharp and fine tip. The iris scissors have curved and straight blades depending on the procedure used. The iris scissors may be used during ophthalmic surgery. The iris scissors may be used for removal of fine tissue and suture in many other procedures. For example, these scissors may be used obstetric / gynecological procedures, or dermatologic procedures.

[0038] The scissors may be operating scissors. The operating scissors are general medical scissors that allow for variety in size, and design, depending upon operation.

[0039] The scissors may be stitch scissors. The stitch scissors are used for removing suture. The stitch scissors have a hook shaped tip on one blade that allows for easy entry under the suture, in order to lift and separate from the skin before cutting. The hook may hold the suture to prevent slippage from the blade before it is time for the suture to be cut. The stitch scissor may have straight shanks and may be angled, with serrated jaws.

[0040] The scissors may be tenotomy scissors. The tenotomy scissors may be used in delicate procedures such as ophthalmic surgery, plastic surgery and neurological procedures. The tenotomy scissors may have long handles for a firm grip while getting into small areas. The tenotomy scissors come in a variety of shapes and sizes. Sharp tips render precise dissection, while blunt tips are better for dealing with membranes.

[0041] The scissors may be Metzenbaum scissors. The Metzenbaum scissors have matching ends, but longer handles, with a narrower mid-section. The Metzenbaum scissors are common in organ operations and also in heart operations, and are designed for cutting soft tissue as well as blunt dissection. The blades of the Metzenbaum scissors can be both curved and straight but with the blunt tip. The blades range from 4.5 inches to 14 inches in length. The variety of blades in the Metzenbaum scissors allows for different procedures. The smaller sizes in the Metzenbaum scissors may be suitable for more delicate procedures.

[0042] The scissors may be Pott’s scissors. The Pott’s scissors may be used in vascular and cardiac surgery. The Pott’s scissors specialize in the cutting of delicate pieces. The Pott’s scissors may be usedalongside the number 11 blade or the number 15 blade to get the incision going. These elongated scissors finish the job up with their angled jaws which come in different sizes and angles.

[0043] The scissors may be Mayo scissors. The Mayo scissors come in a variety of sizes, are typically used to cut into fascia, a tri-layered band or sheet of connective tissue fibers between the skin and muscles. The Mayo scissors may have a semi-blunt end. The Mayo scissors may be a straight-bladed Mayo scissor or a curved-bladed Mayo scissor. The straight-bladed Mayo scissors may be used for cutting tissue closer to the surface, as well as cutting sutures, and are referred to as “suture scissors”. The curved-bladed Mayo scissors may be used for deeper penetration than straight bladed scissors. The curved-bladed Mayo scissors may be used to cut through tissues found in the uterus, muscles, breast and foot. When used for dissection, the Mayo scissors are inserted into tissue tips closed at first. They are later opened once inside, to spread out the tissue.

[0044] In an embodiment, the tip may comprise forceps. The forceps may be scissor type forceps. The scissor type forceps resemble scissors because of their shape, and are often called clamps or hemostats by surgeons. These forceps are useful to protect the tissues without tearing them apart while carrying and raising the desired tissue. In conditions where surgeons need to cease the blood flow at once, these forceps play a vital role when there is a need to contract or squeeze the vascular entities such as blood vessels. This allows some spare time for surgeons to finish their remaining procedures gradually. The forceps may be hemostatic type forceps. The hemostatic forceps have a locking ratchet, i.e., a clamping tool that is used widely in many steps of the surgery. These forceps allow surgeons to perform each step of surgery smoothly and non-reluctantly. One of the features of this tool is that it can constrict veins and arteries allowing the surgeons to stop the blood flow. The forceps may be tweezer type forceps The tweezer forceps appear like tweezers and are made into use through the compression made between the user’s forefinger and thumb. The tweezer forceps are also referred to as dressing forceps, tissue forceps, or pick-ups. Tweezer style forceps are typically non-rachet and come with a wide array of tip options including cupped, serrated, diamond-dusted, flat, teeth, or ring. The shape of the tip might be curved, angled, or straight. The forceps may be splinter type forceps. The splinter forceps comprises a magnifying glass of premium quality to provide better visualization by enlarging the operative field. The magnifying glass property allows surgeons to get the hang of dull and restricted areas. The splinter forceps may be used in situations that require precision and caution at the same time. The forceps may be also tissue forceps or ring type forceps. The tissue forceps may be used when grasping the skin layers and flimsy tissues when required. There is a need to hold up the tissues for the skillful surgery with utmost care and that is favorably possible with the use of these forceps. The ring type forceps look like scissors, and may be hinged. These forceps provide a firm hold with the ring holes on the end. These grasping instruments may be curved or angled. The major feature of this tool is that it holds fragile structures firmly without sliding through blades in any direction. The forceps may be thumb forceps. The thumb forceps are known to function on a spring mechanism. The spring mechanism of theseforceps makes them different from the rest as it enables the forceps to take hold and release the desired tissues without distorting or rupturing. There may be other types of forceps based on the function they perform. For example, the forceps may be ophthalmological forceps, and obstetric type forceps.

[0045] In an embodiment, the tip may comprise electrodes to perform bipolar electrocautery. Bipolar electrocautery refers to a surgical technique that utilizes electrical current to generate heat for cutting and coagulating tissue. Bipolar electrocautery confines electrical current between two electrodes typically located at the tips of the specialized instruments, for example, forceps and scissors. Bipolar electrodes come into contact with tissues and produce electrical current that flows between them producing heat that denaturates proteins in the tissue. Bipolar electrocautery effectively seals blood vessels and cut through soft tissues with minimal damage. This procedure may be useful in neurosurgery or laparoscopic surgeries where precision is needed.

[0046] In an embodiment, the tip comprise a needle driver, or a needle holder. The needle driver may comprise jaws that feature precisely machined surfaces that provide secure needle grip without causing damage to the needle shaft or compromising its structural integrity. Professional needle holders utilize tungsten carbide inserts within the jaw faces, creating a non-slip surface that maintains consistent grip pressure throughout extended surgical procedures. The needle holder may also include the locking mechanism. Quality instruments feature smooth, reliable locking systems that engage securely without requiring excessive force, allowing surgeons to maintain precise control while reducing hand fatigue during lengthy procedures. Locking mechanism may be the ratchet system that provides multiple locking positions to accommodate various needle sizes and suture materials, ensuring optimal grip pressure for each specific application. The needle holders may be Mayo-Hegar needle holders, Castroviejo needle holders, Isen-Hegar needle holders, or Barraquer and Mathieu needle holders, or any other needle holders. For example, the flexible Mayo-Hegar needle holders are typically applicable, in general, to surgical interventions. They are featured with a strong, serrated jaw that provides a good hold of needles that come in different dimensions. These needle holders are commonly used in abdominal surgeries and basic surgical procedures. The Castroviejo needle holders are used for surgeries that need delicate operation, are applicable tool for eye and microsurgeries. They have very fine tips for precision and the attachment mechanism that ensures safe needle placement in such complex procedures. The Olsen-Hegar needle holders perform two functions: holding the needle and cutting, which helps a lot to increase the effectiveness of surgical treatments. This double-functioning feature of the instruments is a real plus. Such instruments are thought to be better for circumstances such as cutting a high number of surgical suture needle types during operations. The Barraquer and Mathieu needle holders are designed for special operation cases.

[0047] In an embodiment, the tip may comprise a vascular clip applier. Vascular clip appliers are used in surgical procedures for occluding blood vessels and tissues. The vascular clip appliers may belaparoscopic clip appliers, hemostatic clip appliers, open surgery clip appliers, or any other types commercially available.

[0048] The tip may comprise a retractor. Retractors are used by surgeon professionals to hold an incision or wound open during surgical procedures. The tip may be any other type of opening and closing tip, and may comprise other tools useful in surgeries.

[0049] In an embodiment, the handheld surgical device may be compatible with robotic systems that assist and / or validate operators to expedite surgical procedures. FIG. 3 is a schematic drawing of an exemplary robotic system compatible with the handheld surgical device of any one of the embodiments disclosed herein.

[0050] For example, robotic system 30 may be configured for use in laparoscopic surgeries in human patients. The robotic system may include a robotic arm 40 shown on FIG. 4. The distal end of the robotic arm may be connected to the main shaft of the handheld surgical device through connector 41. The robotic system may comprise a control system 31 configured to control movement of the robotic arm 40 and the handheld surgical device attached thereto. The control system may comprise processor 26 and display 25 (such as a monitor and / or screen). Processor 26 is configured to process the signals from the sensors attached to the tip of the handheld surgical device. Processor 26 may be configured to record signals from sensors over time, maps signals, combine signal information, map and interpolate mapping information. Processor 26 may comprise appropriate signal processing circuits for receiving signals from the handheld surgical device, combined with a robotic system which enables the system observe and regulate the function of the handheld surgical device. The signal processing circuits may receive, amplify, filter and digitize signals from the handheld surgical device. The signals may be generated by sensors. The sensors may be one or more optical sensors, distance sensors, laser scanning sensors, and / or ultrasound sensors.

[0051] The processor may also control other components of the robotic system according to the embodiments described herein. The processor is preferably programmed in software and / or hardware to perform the functions required by the system. The processor may store data for the software in a memory. The software may be downloaded to the processor in electronic form, over a network, or may be provided on tangible media, such as optical, magnetic or other nonvolatile memory media.

[0052] The robotic system may further comprise an imaging system for capturing real-time images of the bodily cavities where the surgery is performed, and a display for presenting images to a physician. The imaging system may comprise CT scan devices or MRI scan devices that may produce CT or MRI scans used for mapping. The processor may store mapping data in a memory. The processor may be coupled to a program operative to produce the visual display of the map by driving a monitor. Map may be an image or an electro-anatomic map of the body cavities or parts. Map may be a 3-D map of the body cavities or parts.

[0053] In an embodiment, the robotic system may create a pre-planned procedure to perform surgery in defined cavities or body parts of a patient using a map of the body cavities or parts. In an embodiment, the robotic system is adapted to project steps of the pre-planned procedure over the real time images.

[0054] In an embodiment, control system 31 may include actuators to operate the robotic arm 40 and the handheld surgical device, and interface 24 to control the actuators.

[0055] An embodiment provides a method of making a handheld surgical device for endoscopic use. FIG. 5 is a flowchart of the method of making a handheld surgical device according to the embodiments disclosed herein. Step S1 of the method may comprise providing a longitudinal shaft that extends between a first end and a second end. Step S2 of the method may include attaching pullies to the longitudinal shaft; and step S3 may include connecting an articulating tip to the longitudinal shaft at the first or the second end through a joint.

[0056] An embodiment provides a method of assembly a handheld surgical device. The device may be constructed from surgical grade material. The surgical grade material may be steel or polymer. The device may be constructed such that main body of rigid handle 2, with main inner shaft 5 and main body of rigid handle 2 being a single piece and with finger hole 1, has a hinge 4 to which movable handle 3 is attached. Additionally pulley 16 may be attached to main body of rigid handle 2 via attachment 24. A groove 6 may be made and another outer shaft 7 may be then threaded on to inner shaft 5 allowing for rotation. A flexible joint 8 may be attached to outer shaft 7 and tip 9 may be attached to flexible joint 8. The tip 9 may be constructed from 2 articulating parts over hinge 10. The opening and closing action of the tip may be controlled by opposing cables 11,12 which may be attached to the tip and then the top cable 12 may be strung across the shaft via containment tube or multiple cut outs 17 to cut out 14 on main body of rigid handle 2 and lower cable 11 may be strung through flexible joint and shaft 5 and 7 to come out underneath or inferiorly to pulley 16 and attached to opposite end of cut out or attachment point 14 of main body. This may allow for the opening closing mechanism to work. The articulating mechanism of the joint may function due to attachment 23 on either side of the tip via cables 22 which may go through cut out or thin tubes on side of instrument 21 and may be attached to control handle which has cable attachment points 19 and may be attached to outer shaft 7 via rotating attachment 18 with finger holes 20 on either side ergonomically placed for single handed operation, allowing independent 180 degree lateral articulation across articulating joint 8 from 360 degree rotation of outer shaft 7 on inner shaft 5. An embodiment provides attachment of any one of tips described herein to flexible joint 8.

[0057] An embodiment provides a method of using the handheld device described herein. The method comprises moving the device through a body cavity. The method may comprise expanding the longitudinal shaft outwardly into the body cavity. The method may further comprise engaging the articulating tip within the body cavity to perform a process; and retracting the longitudinal shaft backward from the body cavity. The body cavity may be intranasal or intracranial cavity.

[0058] An embodiment provides a method of using the handheld surgical device with a single hand. The method comprises using two fingers or palm to open or close the device and index finger and thumb to rotate the device or activate the pullies to articulate the tip for egrasping, suturing, cutting, and other functions.

[0059] An embodiment provides a method of using the handheld surgical device attached to a robotic system. The method may comprise step S4 of acquiring an image of a body part of a patient. Any imaging or visualization procedure may be used for acquiring imaging and may include MRI scanning, CAT scanning, CT scanning. Step S5 of the method may comprise mapping of the body part of the patient. Map may be a 3-D map of the patient body part or a cavity. Step S6 of the method comprises identifying a plurality of target sites in the body part and designing a treatment. The physician may be able to review and modify the designed treatment before performing it. Step S7 of the method comprises inserting the handheld surgical device in the body part and automatically performing the treatment procedure by using at least one tip of the handheld surgical device. The physician may able to intervene in the procedure at any step and resume the manual use of the handheld surgical device.

[0060] Accordingly, the method of using the handheld surgical device may be manual, or may be compatible with active, intermediate or passive robotic systems. In active robotic systems, robots can perform fully autonomous tasks. In intermediate robotic systems, the performance can be shared between robots and physicians. In passive robotic systems, the performance is completely controlled by a physician, and the range of motions of the robotic arm and handheld surgical device is limited.

[0061] An embodiment a computer software product, including a non-transitory computer readable storage medium in which computer program instructions are stored, which instructions, when executed by a computer, cause the computer to perform the steps of: acquiring an image of an image of a body part of a patient and displaying the image on a screen display; identifying a plurality of target sites on the image and designing treatment; inserting a handheld surgical in the body part of the patient; and automatically performing the treatment by using at least one tip of the handheld surgical device.

[0062] It should be understood that many variations are possible based on the disclosure herein. Although features and elements are described above in particular combinations, each feature or element can be used alone without the other features and elements or in various combinations with or without other features and elements.

[0063] The methods provided include implementation in a general purpose computer, a processor, or a processor core. Suitable processors include, by way of example, a general purpose processor, a special purpose processor, a conventional processor, a digital signal processor (DSP), a plurality of microprocessors, one or more microprocessors in association with a DSP core, a controller, a microcontroller, Application Specific Integrated Circuits (ASICs), Field Programmable Gate Arrays (FPGAs) circuits, any other type of integrated circuit (IC), and / or a state machine. Such processors can bemanufactured by configuring a manufacturing process using the results of processed hardware description language (HDL) instructions and other intermediary data including netlists (such instructions capable of being stored on a computer readable media). The results of such processing can be maskworks that are then used in a semiconductor manufacturing process to manufacture a processor which implements the methods described herein.

[0064] The methods or flow charts provided herein can be implemented in a computer program, software, or firmware incorporated in a non-transitory computer-readable storage medium for execution by a general purpose computer or a processor. Examples of non-transitory computer-readable storage mediums include a ROM, a random access memory (RAM), a register, cache memory, semiconductor memory devices, magnetic media such as internal hard disks and removable disks, magneto-optical media, and optical media such as CD-ROM disks, and digital versatile disks (DVDs).

[0065] The following list includes particular embodiments of the present invention. But the list is not limiting and does not exclude alternate embodiments, or embodiments otherwise described herein. Percent identity described in the following embodiments list refers to the identity of the recited sequence along the entire length of the reference sequence.EMBODIMENTS1 . A handheld surgical device for endoscopic use comprising a longitudinal shaft and an articulating tip, wherein the longitudinal shaft extends between a first end and a second end and the articulating tip is attached to the longitudinal shaft at the first or the second end through a joint.2. The handheld surgical device of embodiment 1 , wherein the articulating tip is opened or closed.3. The handheld surgical device one or both embodiments 1 and 2, wherein the articulating tip is selected from the group consisting of: graspers, scissors, forceps, vascular clip appliers, retractors and needle holders.4. The handheld surgical device of any one or more of embodiments 1 - 3, wherein the longitudinal shaft further comprises pullies.5. The handheld surgical device of any one or more of embodiments 1 - 4, wherein articulating the tip is articulated left or right at 180° angle at the joint with pullies.6. The handheld surgical device of any one or more of embodiments 1 - 5, wherein the longitudinal shaft is configured to rotate 360° along its length wide axis, and rotate the articulated tip.7. The handheld surgical device of any one or more of embodiments 1 - 6, wherein the device is configured for operating manually.8. The handheld surgical device of any one or more of embodiments 1 - 7, wherein the device is configured for operating with one hand.9. The handheld surgical device of any one or more of embodiments 1 - 6, wherein the device is configured for operating automatically.10. The handheld surgical device of any one or more of embodiments 1 - 6 and 9, wherein the device is connected to a robotic system for operating automatically.11 . The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 10, wherein the robotic system comprises a robotic arm, a control system, a processor and a display.12. The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 11 , wherein the robotic arm is connected to the main shaft of the handheld surgical device.13. The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 12, wherein the control system is configured to control movement of the robotic arm and the handheld surgical device.14. The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 13, wherein the articulating tip comprises electrodes or sensors.15. The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 14, wherein the processor is configured to record signals from the sensors.16. The handheld surgical device of any one or more of embodiments 1 - 6 and 9 - 15, wherein processor further comprises a software.17. A method of using the handheld surgical device of any one or more of embodiments 1 - 16, through a body cavity comprising: expanding the longitudinal shaft outwardly into the body cavity; engaging the articulating tip within the body cavity to perform a process; and retracting the longitudinal shaft backward from the body cavity.18. The method according to embodiment 17, wherein the body cavity is intranasal or intracranial cavity.19. A method of making a handheld surgical device of any one or more of embodiments 1- 6 for endoscopic use comprising: providing a longitudinal shaft that extends between a first end and a second end; attaching pullies to the longitudinal shaft; and connecting an articulating tip to the longitudinal shaft at the first or the second end through a joint.20. The method of embodiment 19 further comprising connecting the handheld surgical device to a robotic system.21. The method of one or both of embodiments 19 and 20, wherein the robotic system comprises a robotic arm, a control system, a processor and a display.22. The method of any one or more of embodiments 19 - 21 , wherein the robotic arm is connected to the main shaft of the handheld surgical device.23. The method of any one or more of embodiments 19 - 22, wherein the control system controls movement of the robotic arm and the handheld surgical device.24. The method any one or more of embodiments 19 - 23, wherein the articulating tip comprises electrodes or sensors.25. The method any one or more of embodiments 19 - 24, wherein the processor records signals from the sensors.26. The method any one or more of embodiments 19 - 25, wherein processor further comprises a software.27. A method of using the handheld surgical device any one or more of embodiments 1 - 6 and 9 - 16, attached to a robotic system, comprising: acquiring an image of a body part or cavity in a patient; creating a map the body part or the cavity; identifying a plurality of target sites in the body part or the cavity; automatically designing a treatment; and automatically inserting the handheld surgical device in the body part or the cavity and performing the treatment by using the tip the handheld surgical device.28. The method of embodiment 27, wherein the step of acquiring the image is selected from the group of: MRI scanning, CAT scanning, and CT scanning.29. The method of one or both embodiments 27 and 28, wherein treatment is surgery.30. A computer software product, comprising a non-transitory computer readable storage medium in which computer program instructions are stored, which instructions, when executed by a computer, cause the computer to perform the steps of: acquiring an image of an image of a body part or cavity a patient and displaying the image on a screen display; identifying a plurality of target sites on the image and designing treatment; inserting a handheld surgical in the body part of the patient; and automatically performing the treatment by using the tip of the handheld surgical device any one or more of embodiments 1 - 16.

[0066] It is understood, therefore, that this invention is not limited to the particular embodiments disclosed, but is intended to cover all modifications which are within the spirit and scope of the invention as defined by the appended claims; the above description; and / or shown in the attached drawings.

Claims

CLAIMSWhat is claimed is:1 . A handheld surgical device for endoscopic use comprising a longitudinal shaft and an articulating tip, wherein the longitudinal shaft extends between a first end and a second end and the articulating tip is attached to the longitudinal shaft at the first or the second end through a joint.

2. The handheld surgical device of claim 1 , wherein the articulating tip is opened or closed.

3. The handheld surgical device of claim 1 , wherein the articulating tip is selected from the group consisting of: graspers, scissors, forceps, vascular clip appliers, electrodes, sensors, retractors and needle holders.

4. The handheld surgical device of claim 1 , wherein the longitudinal shaft further comprises pullies.

5. The handheld surgical device of claim 1 , wherein articulating the tip is articulated left or right at 180° angle at the joint with pullies.

6. The handheld surgical device of claim 1 , wherein the longitudinal shaft is configured to rotate 360° along its length wide axis, and rotate the articulated tip.

7. The handheld surgical device of claim 1 , wherein the device is configured for operating manually.

8. The handheld surgical device of claim 1 , wherein the device is configured for operating with one hand.

9. The handheld surgical device of claim 1 , wherein the device is configured for operating automatically.

10. The handheld surgical device of claim 9, wherein the device is connected to a robotic system for operating automatically.11 . The handheld surgical device of claim 10, wherein the robotic system comprises a robotic arm, a control system, a processor and a display.

12. The handheld surgical device of claim 11 , wherein the robotic arm is connected to the main shaft of the handheld surgical device.

13. The handheld surgical device of claim 12, wherein the control system is configured to control movement of the robotic arm and the handheld surgical device.

14. The handheld surgical device of claim 11 , wherein the articulating tip comprises electrodes or sensors.

15. The handheld surgical device of claim 14, wherein the processor is configured to record signals from the sensors.

16. The handheld surgical device of claim 11 , wherein processor further comprises a software.

17. A method of using the handheld surgical device of any one of claims 1 - 16 through a body cavity comprising: expanding the longitudinal shaft outwardly into the body cavity; engaging the articulating tip within the body cavity to perform a process; and retracting the longitudinal shaft backward from the body cavity.

18. The method according to claim 8, wherein the body cavity is intranasal or intracranial cavity.

19. A method of making a handheld surgical device of any one of claims 1 - 6 for endoscopic use comprising: providing a longitudinal shaft that extends between a first end and a second end; attaching pullies to the longitudinal shaft; and connecting an articulating tip to the longitudinal shaft at the first or the second end through a joint.

20. The method of claim 19, further comprising connecting the handheld surgical device to a robotic system.21 . The method of claim 20, wherein the robotic system comprises a robotic arm, a control system, a processor and a display.

22. The method of claim 21 , wherein the robotic arm is connected to the longitudinal shaft of the handheld surgical device.

23. The method of claim 22, wherein the control system controls movement of the robotic arm and the handheld surgical device.

24. The method of claim 21 , wherein the articulating tip comprises electrodes or sensors.

25. The method of claim 24, wherein the processor records signals from the sensors.

26. The method of claim 21 , wherein processor further comprises a software.

27. A method of using the handheld surgical device of any one of claims 1 - 6 and 9- 16 attached to a robotic system, comprising: acquiring an image of a body part or cavity in a patient; creating a map the body part or the cavity; identifying a plurality of target sites in the body part or the cavity; automatically designing a treatment; and automatically inserting the handheld surgical device in the body part or the cavity and performing the treatment by using the tip the handheld surgical device.

28. The method of claim 27, wherein the step of acquiring the image is selected from the group of: MRI scanning, CAT scanning, and CT scanning.

29. The method of claim 27, wherein treatment is surgery.

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