Medical probe with improved maneuverability

Abstract

The present invention provides a medical probe comprising a shaft for insertion into a body cavity of a patient and a distal tip assembly. The distal tip assembly is coupled to the distal end of the shaft and comprises a hollow tube having (i) a first opening located at a first section along the longitudinal axis of the hollow tube and having a first size that limits bending of the first section to a first local radius of curvature (LROC); and (ii) a second opening located at a second section along the longitudinal axis of the hollow tube and having a different second size that limits bending of the second section to a different second LROC.

Description

Technical Field

[0001] The present invention relates generally to minimally invasive medical devices, and particularly to techniques for medical probes with improved maneuverability. Background Art

[0002] Various types of medical probes have mechanical designs intended to improve the maneuverability of the probe within the patient's body.

[0003] For example, U.S. Patent Application Publication No. 2017 / 0112669 describes a steerable laser probe that may include a handle and a handle bore, a handle actuating rod, a housing tube, and an optical fiber disposed within the handle bore and the housing tube. The housing tube may include a first housing tube portion and a second housing tube portion, the first housing tube portion having a first stiffness and the second housing tube portion having a second stiffness. The second stiffness may be greater than the first stiffness.

[0004] U.S. Patent Application Publication No. 2011 / 0152880 describes an instrument for performing minimally invasive surgical procedures. The instrument includes an elongated body and a support member disposed within or along the elongated body. The support member is configured to support manipulation, articulation, and angular rotation of the elongated body, provide torque control, and support precise and accurate placement of a distal portion of the elongated body so that complex surgical procedures can be performed using the instrument.

[0005] U.S. Patent Application Publication No. 2014 / 0135736 describes a deflectable catheter comprising an outer member having a proximal portion and a distal portion, an elongated post extending distally from the outer member, and an inner member coaxially positioned with and attached to the post member. The inner member extends distally of the outer member and has a distal tip portion. Summary of the Invention

[0006] Embodiments of the present invention described herein provide a medical probe comprising a shaft for insertion into a body cavity of a patient and a distal tip assembly coupled to the distal end of the shaft and comprising a hollow tube having (i) a first opening located at a first section along a longitudinal axis of the hollow tube and having a first size that limits bending of the first section to a first local radius of curvature (LROC); and (ii) a second opening located at a second, different section along the longitudinal axis of the hollow tube and having a second, different size that limits bending of the second section to a second, different LROC.

[0007] In some embodiments, the first opening comprises a first slit having a first opening angle, and the second opening comprises a second slit having a second opening angle different from the first opening angle. In other embodiments, the first segment is distal to the second segment, the first opening is larger than the second opening, and the first LROC is smaller than the second LROC. In still other embodiments, at least the first segment comprises a first protrusion, at least the first opening comprises a first insert, and the first insert is sized and shaped to fit snugly over the first protrusion.

[0008] In one embodiment, the medical probe includes a control handle mounted at the proximal end of the shaft and configured to bend the first segment to at most a first LROC and the second segment to at most a second LROC. In another embodiment, the medical probe includes a puller wire coupled to the control handle at a first end and to a selected segment of the distal tip assembly at a second end, and the control handle is configured to bend at least one of the first segment and the second segment by pulling the first end of the puller wire. In yet another embodiment, the puller wire comprises an alloy of nickel and titanium.

[0009] In some embodiments, the control handle is configured to bend one of the first and second segments relative to the longitudinal axis while maintaining the other of the first and second segments flush with the shaft.In other embodiments, the cavity comprises an ear, nose and throat (ENT) sinus.

[0010] According to one embodiment of the present invention, there is further provided a method for producing a medical probe, the method comprising providing a shaft for insertion into a body cavity of a patient. A distal end assembly comprising a hollow tube is coupled to the distal end of the shaft. The hollow tube has (i) a first opening located at a first section along the longitudinal axis of the hollow tube and having a first size that limits bending of the first section to a first local radius of curvature (LROC); and (ii) a second opening located at a second, different section along the longitudinal axis of the hollow tube and having a second, different size that limits bending of the second section to a second, different LROC.

[0011] In some embodiments, the method includes forming at least one of the first opening and the second opening using a laser cutting technique.

[0012] The present invention will be more fully understood through the following detailed description of embodiments of the present invention in conjunction with the accompanying drawings, in which: BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 is a schematic illustration of an ENT protocol using an ENT system according to an embodiment of the present invention; and Figure 2A and Figure 2Bis a schematic illustration of a medical probe having a steerable distal tip assembly according to an embodiment of the present invention. DETAILED DESCRIPTION

[0014] Overview

[0015] Various medical procedures require the insertion of medical probes into a patient's organs. Maneuvering the probe into the desired location and proper orientation within branching human organs, such as the sinuses of a patient's ear, nose, and throat (ENT) system, is often challenging. Furthermore, external forces, such as those exerted by the inner surfaces of the patient's nostrils, can complicate the insertion process.

[0016] The embodiments of the present invention described below provide a medical probe having improved maneuverability through the use of a flexible distal tip assembly.

[0017] In some embodiments, a medical probe includes a shaft for insertion into a patient's body cavity (such as the sinus of a patient's ENT system), and a distal end assembly is coupled to the distal end of the shaft. The distal end assembly includes a hollow tube having at least two openings, each of which is located at a different section along the hollow tube. The openings provide the tube with bending capacity. The maximum bending capacity at a given location along the tube is specified by a local radius of curvature (LROC) at that location.

[0018] In some embodiments, a first opening at a first distal-most section of the hollow tube has a given size that limits the bending ability of the distal-most section by a predefined LROC. In some embodiments, a second opening located at a second section along the hollow tube, proximal to the first section, has a size smaller than the given size, thereby generating a LROC greater than the predetermined LROC of the first section. In some embodiments, the hollow tube may include a plurality (e.g., ten) of openings formed along the longitudinal axis of the tube, wherein the size of the openings increases as they approach the distal end of the tube. Thus, the LROC corresponding to the openings decreases as they approach the distal end of the tube.

[0019] In some embodiments, the distal tip assembly includes a control handle mounted at the proximal end of the shaft. The distal tip assembly further includes a puller wire that passes through the longitudinal lumen of the tube and is coupled to the distal-most segment of the hollow tube and the control handle. In some embodiments, during an ENT procedure, a physician can bend one or more segments of the distal tip assembly up to a desired corresponding LROC by pulling or retracting the puller wire.

[0020] The disclosed technology improves the insertion and maneuverability of medical probes in various branch organs, such as ENT, bronchoscopy, or neurological surgery.

[0021] System Description

[0022] Figure 1 is a schematic illustration of an ENT procedure using the ENT system 20 according to an embodiment of the present invention. In some embodiments, the ENT system 20 includes a medical probe, referred to herein as the ENT module 28, that is configured to perform an ENT procedure, such as, but not limited to, treating an infection from one or more sinuses 48 of the patient 22.

[0023] In some embodiments, the ENT module 28 includes a shaft 38 coupled to a distal end that the physician 24 inserts into the nose 26 of the patient 22. The module 28 further includes a handheld device 30 coupled to the proximal end of the shaft 38 and configured to assist the physician 24 in manipulating the distal end of the shaft 38 within the head 41 of the patient 22 (hereinafter referred to as the handheld device). Figure 2A and Figure 2B shown in detail).

[0024] In one embodiment, the system 20 also includes a magnetic position tracking system configured to track the position of one or more position sensors in the head 41. The magnetic position tracking system includes a magnetic field generator 44 and a plurality of position sensors (not shown). The position sensors generate position signals in response to sensing the external magnetic field generated by the magnetic field generator 44, thereby allowing the processor 34 (described in detail below) to estimate the position of each sensor, as will be described below.

[0025] This position sensing method is implemented in various medical applications, such as in the CARTO CT-1000 manufactured by Biosense Webster Inc. (Irvine, Calif.). TM The system is implemented in a CMOS process and is described in detail in U.S. Patents 5,391,199, 6,690,963, 6,484,118, 6,239,724, 6,618,612, and 6,332,089, WO 96 / 05768, and U.S. Patent Application Publication Nos. 2002 / 0065455A1, 2003 / 0120150A1, and 2004 / 0068178A1, the disclosures of which are incorporated herein by reference in their entirety.

[0026] The system 20 also includes a positioning mat 40 comprising a field generator 44 secured to a frame 46. Figure 1 In the exemplary configuration shown, the pad 40 includes five field generators 44, but may alternatively include any other suitable number of generators 44. The pad 40 also includes a pillow (not shown) that is placed under the head 41 of the patient 22 so that the generators 44 are positioned at known locations on the exterior of the head 41.

[0027] In some embodiments, system 20 includes a console 33 including a memory 49 and a driver circuit 42 configured to drive a field generator 44 with appropriate signals via a cable 37 to generate a magnetic field in a predetermined working volume in the space surrounding the head 41 .

[0028] In some embodiments, the console 33 includes a processor 34, typically a general purpose computer, having suitable front-end and interface circuitry for receiving signals from a tool 28 having a plurality of magnetic sensors (not shown) coupled thereto via a cable 32, and for controlling other components of the system 20 described herein.

[0029] In some embodiments, the processor 34 is configured to estimate the position of each position sensor. Based on the estimated position of the sensors, the processor 34 is configured to derive the coordinate system of the ENT tool 28 (hereinafter referred to as Figure 2A and 2B The position, orientation and manipulation curvature radius of the distal end of the device are shown.

[0030] In the context of the present invention and the claims, the terms "bend" and "manipulate" are used interchangeably and refer to the deflection of one or more segments of the ENT tool 28, as will be described below. Figure 2A and Figure 2B Described in detail in .

[0031] In some embodiments, processor 34 is configured to receive, via an interface (not shown), one or more anatomical images, such as computed tomography (CT) images obtained by an external CT system (not shown) depicting corresponding segmented two-dimensional (2D) slices of head 41. The term "segmented" refers to the display of various types of tissue identified in each slice by measuring the tissue's corresponding attenuation in the CT system.

[0032] The console 33 also includes an input device 39 and a user display 36, wherein the input device is used to control the operation of the console, and the user display is configured to display data (e.g., images) received from the processor 34 and / or input inserted by the user using the input device 39 (e.g., by the physician 24).

[0033] In some embodiments, processor 34 is configured to select one or more slices from a CT image, such as image 35, and display the selected slices on user display 36. Figure 1 In the example of , image 35 depicts a cross-sectional anterior view of one or more sinuses 48 of patient 22 .

[0034] For simplicity and clarity, Figure 1Only the elements related to the technology disclosed in the present invention are shown. System 20 typically includes additional modules and elements that are not directly related to the technology disclosed in the present invention and are therefore intentionally omitted. Figure 1 and the corresponding descriptions are omitted.

[0035] The processor 34 can be programmed with software to perform the functions used by the system and store data in the memory 49 to be processed or otherwise used by the software. For example, the software can be downloaded to the processor in electronic form over a network, or the software can be provided on non-transitory tangible media such as optical, magnetic, or electronic storage media. Alternatively, some or all of the functions of the processor 34 can be performed by dedicated or programmable digital hardware components.

[0036] Steerable distal tip assembly made from a single tube

[0037] Figure 2A is a schematic illustration of the ENT module 28 with the steerable distal tip assembly 134 in an extended position, according to an embodiment of the present invention.

[0038] Reference is now made to illustration 80. In some embodiments, the distal tip assembly 134 includes a hollow tube 66 coupled to the distal end of the shaft 38 and generally made from a single piece of any suitable material, such as, but not limited to, a suitable nickel and titanium alloy with high repeatability, such as Nitinol. TM or superelastic nitinol TM .

[0039] In some embodiments, tube 66 is sized and shaped for comfortable insertion through nose 26 into sinuses 48 or any other organ in head 41 of patient 22. Tube 66 is also sized and shaped to allow a medical instrument (such as a sinuplasty balloon, surgical tools, suction or irrigation tools, or any other suitable tool) to subsequently be inserted through lumen 140 of tube 66, as described in detail below.

[0040] In some embodiments, the tube 66 of the distal tip assembly 134 has a plurality of openings, such as openings 77A, 77B, 77C, and 77D, each of which is formed at a corresponding section (also referred to herein as a rib) of the distal tip assembly 134 .

[0041] exist Figure 2A In the example of FIG. 1 , opening 77A is located at the most distal side of distal tip assembly 134 and has the largest size among all openings 77A to 77D. As will be described below Figure 2B As depicted in , the opening size determines the bending limit of the corresponding section of the distal end assembly 134.

[0042] In some embodiments, each of the openings 77A to 77D comprises a slit that may be formed by laser cutting or using any other suitable technique on a section of the circumference of the tube 66. Each of the slits has an opening angle that depends on the width of the slit, as will be described below. Figure 2B As described in .

[0043] In some embodiments, the opening 77A includes an insert 99A that is sized and shaped to fit snugly over the tab 88A of the tube 66. Note that when the distal tip assembly 134 is in the straightened position (also referred to herein as the unbent state), the tab 88A and the insert 99A are generally disengaged from one another, and the opening 77A has a maximum dimension, e.g., along the longitudinal axis 50.

[0044] In some embodiments, openings 77B, 77C, and 77D include respective inserts 99B, 99C, and 99D that are sized and shaped to fit snugly over respective protrusions 88B, 88C, and 88D of tube 66. Note that opening 77D is located most proximal along longitudinal axis 50 and has the smallest size among openings 77A through 77D. In such embodiments, the size of openings 77A through 77D increases progressively as they approach the distal end of tube 66. For example, insert 99A is the largest of all inserts 99B through 99D, and insert 99B is larger than insert 99C, which is larger than insert 99D.

[0045] Similarly, protrusion 88A has a largest dimension among protrusions 88A-88D, and protrusions 88B-88D decrease in size along longitudinal axis 50 toward the proximal end of tube 66 such that protrusion 88D has a smallest dimension among protrusions 88A-88D.

[0046] exist Figure 2A In the example configuration of FIG, tube 66 has ten openings, but in other configurations, tube 66 may have any suitable number of openings, such as 3 to 20 openings of any suitable size or shape. Note that the openings may have similar shapes and different sizes, or different shapes, or any suitable combination thereof.

[0047] In alternative embodiments, the size of the openings can gradually increase from the proximal end to the distal end. For example, opening 77D, insert 99D, and protrusion 88D can be larger than opening 77C, insert 99C, and protrusion 88C, respectively. Similarly, opening 77C, insert 99C, and protrusion 88C can be larger than opening 77A, insert 99A, and protrusion 88A, respectively.

[0048] In other embodiments, the sizes of the openings may vary along the longitudinal axis 50. For example, the opening 77A, insert 99A, and protrusion 88A may be larger than the opening 77B, insert 99B, and protrusion 88B, respectively, but smaller than the sizes of the opening 77C, insert 99C, and protrusion 88C, respectively. In other embodiments, the sizes of the openings, protrusions, and inserts of the tube 66 may have any other suitable distribution along the longitudinal axis 50.

[0049] Now refer back to Figure 2A In some embodiments, the ENT module 28 includes a control handle 128 that is coupled to the Figure 1 , and is mounted at the proximal end of the shaft 38. The control handle 128 is configured to bend and straighten the distal tip assembly 134 relative to the longitudinal axis 50 of the ENT module 28.

[0050] Reference is now made to Inset 70, which is a transverse cross-sectional view BB of the shaft 38. In some embodiments, the shaft 38 is hollow and shaped to define a lumen 140. The ENT module 28 includes a puller wire 130 formed from a suitable nickel and titanium alloy, such as Nitinol. TM ) or other suitable materials or alloys including suitable nickel and titanium (such as Nitinol TM ) or other suitable materials, the pull wire passes through the tube lumen 140 from proximal to distal.

[0051] In some embodiments, the puller wire 130 can be connected to a ring or any other element coupled to a selected segment of the hollow tube 66, such as a distal-most segment, for example, distal to the opening 77A. Figure 2B As described above, the pull wire 130 helps adjust the configuration of the distal portion of the tube 66. In other embodiments, the ENT module 28 may include a ribbon (not shown) instead of or in addition to the pull wire 130. The ribbon may include Nitinol TM Or any other suitable material. The construction of the aforementioned ribbon in the ENT tool is described in detail in U.S. Patent Application Publication No. 2017 / 0325841, which is incorporated herein by reference.

[0052] like Figure 2A As shown, in the unbent state of the tube 66 , each of the openings, and the segments between the openings, are generally flush with their adjacent openings at the circumference of the tube 66 along the axis 50 .

[0053] Reference is now made to illustration 60, which is a cross-sectional view AA of the control handle 128 along the longitudinal axis 50. As described above, the control handle 128 is mounted at the proximal end of the shaft 38. In some embodiments, the control handle 128 is rotatable or rotatable and is configured to control the pull wire 130. As will be described below Figure 2B As described in the foregoing, by rotating the control handle 128 in one direction, the pull wire 130 is pulled, thereby causing the distal end assembly 134 to bend. Conversely, by rotating the control handle 128 in the opposite direction, the pull wire 130 is pulled, thereby causing the tube 66 of the distal end assembly 134 to bend. Figure 2A As shown, the pull wire 130 is not bent and straightened. For example, the proximal end of the pull wire 130 may be coupled to a sliding element 142 that is configured to slide between a proximal position and a distal position. By rotating the control handle 128, the sliding element 142 slides proximally or distally, thereby bending or unbending the tube 66. In some embodiments, the inner surface of the control handle 128 may be formed to form a female thread 144, and the control handle 128 may further include a complementary male thread 146 that engages with the female thread 144. In one embodiment, when the physician 24 (or any other operator of the ENT module 28) rotates the control handle 130, the male thread 146 coupled to the sliding element 142 moves the sliding element proximally or distally along the axis 50 and controls the state of the tube 66 as described above.

[0054] This particular configuration of the distal tip assembly 134 is shown by way of example in order to illustrate certain issues addressed by embodiments of the present invention and to demonstrate the application of these embodiments in enhancing the performance of such medical probes, such as the ENT module 28. However, embodiments of the present invention are by no means limited to this particular type of example configuration for an ENT module, and the principles described herein may be similarly applied to other types of medical probes.

[0055] Controlling the local radius of curvature of the distal tip assembly

[0056] Figure 2B is a schematic illustration of ENT module 28 with distal tip assembly 134 in a manipulated position, according to an embodiment of the present invention.

[0057] Reference is now made to illustration 90 which shows a longitudinal cross-sectional view of the control handle 128. Figure 2A As described above, when the physician 24 rotates the control handle 128, the pull wire 130 is pulled along the axis 50 toward the proximal end of the ENT module 28 and the catheter 66 is manipulated, as shown. Figure 2A In some embodiments, the control handle 128 is further configured to hold the ribbon in place after the aforementioned rotation, thereby maintaining the configuration of the tube 66. For example, as Figure 2B As shown, the engagement of threads 144 and 146 prevents the sliding element from sliding.

[0058] In other embodiments, the control handle 128 may include any other suitable mechanism for preventing undesired slippage of the aforementioned puller wire or ribbon, or any other mechanism suitable for manipulating the distal tip assembly of an ENT tool.

[0059] Referring now to illustration 100, the distal tip assembly 134 is shown in a fully manipulated position. In some embodiments, when the puller wire 130 is pulled proximally along the axis 50, the tube 66 bends and the protrusions of the tube 66 are inserted into their respective inserts. For example, protrusions 88A, 88B, 88C, and 88D are inserted into inserts 99A, 99B, 99C, and 99D, respectively.

[0060] As above Figure 2A As mentioned above, the openings, protrusions, and inserts of tube 66 may have different sizes, for example, gradually increasing in size as they approach the distal end of tube 66. In the example shown in illustration 100, opening 77A, protrusion 88A, and insert 99A are the largest, and opening 77D, protrusion 88D, and insert 99D are the smallest of all the openings, protrusions, and inserts of tube 66.

[0061] As above Figure 2A As described above, each of the openings 77A to 77D has a slit formed on a section of the circumference of the tube 66. When the physician 24 bends the tube 66, the size (eg, width) of the slit determines the opening angle. Figure 2B In the example of FIG. 7 , the slit of the opening 77A is larger than the slit of the opening 77C, and therefore, the opening angle of the opening 77A is larger than the opening angle of the opening 77C. Figure 2A In the unbent state shown, physician 24 has not bent tube 66, and therefore the sections of tube 66 remain flush with each other.

[0062] In some embodiments, the size of the opening's slits and the size of the protrusions and inserts limit the bending of the corresponding segments.The maximum bending capacity at a given location along the tube 66 can be specified by the local radius of curvature (LROC) at that location.

[0063] In such embodiments, larger openings, protrusions, and inserts enable the amount of curvature measured by the smaller LROC to be increased. For example, opening 77A, protrusion 88A, and insert 99A are larger than opening 77C, protrusion 88C, and insert 99C. As shown in inset 100, the RA, which is the LROC for opening 77A, is smaller than the RC, which is the LROC for opening 77C. Note that the term "locally" refers to the arc formed by the curvature of the outer surface of tube 66 at the location of the corresponding opening.

[0064] This configuration means that the remaining openings, inserts, and LROC of tube 66 are sized within the range defined between openings 77A and 77D described above. Note that the above dimensions are provided by way of example, and in other embodiments, the openings, inserts, protrusions, and LROC may have any other suitable dimensions.

[0065] Note that the above LROC represents the LROC at the maximum bend of the tube 66 at each respective section. In some embodiments, the physician 24 can apply less bending to the tube 66 by applying a smaller rotation angle to the control handle 128. In such embodiments, only a portion of the protrusion can be inserted into the respective insert, and the LROC is greater than the fully manipulated LROC shown in the inset 100.

[0066] In some embodiments, when the physician 24 moves the ENT module 28 in the head 41 of the patient 22, at least one section of the tube 66 may be fully steerable and another section may be partially steerable or not steerable at all. For example, the physician 24 may position the distal tip assembly 134 at the sinus ostium 48 (as described above). Figure 1 ), and then only the third distal-most portion of tube 66 is manipulated.

[0067] In this exemplary embodiment, the ostium 48 may secure the sections of the openings 77C and 77D substantially flush with the shaft 38 (as described above). Figure 2A 99B), the physician 24 may partially manipulate a section of the opening 77B (e.g., by inserting only a portion of the protrusion 88B into a corresponding portion of the insert 99B), and fully manipulate a section of the opening 77A to obtain the RA LROC shown in inset 100 (e.g., with the protrusion 88A fully inserted into the insert 99A). In other example embodiments, the physician 24 may partially or fully manipulate any other section or sections of the tube 66 to, for example, Figure 1 The distal tip assembly 134 is manipulated to a desired position in the head 41 by tracking the position of the distal tip assembly 134 in the image 35 shown. Additionally or alternatively, the physician 24 may rotate the ENT module 28 about the longitudinal axis 50, for example by rotating the handheld device 30, to improve maneuverability to reach a desired position on the patient's head 41.

[0068] Although the embodiments described herein are primarily directed to medical probes used in minimally invasive procedures performed on a patient's ear, nose, and throat (ENT), the methods and systems described herein may also be used in other applications such as, but not limited to, bronchoscopy or neurological procedures.

[0069] It should therefore be understood that the embodiments described above are cited by way of example, and that the present invention is not limited to what is specifically shown and described above. On the contrary, the scope of the present invention includes combinations and subcombinations of the various features described above, as well as variations and modifications thereof, which will occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art. The documents incorporated by reference into this patent application are considered an integral part of this application, except that if any term defined in these incorporated documents conflicts with a definition explicitly or implicitly given in this specification, only the definition in this specification shall be considered.

Claims

1. A medical probe comprising: a shaft for insertion into a body cavity of a patient; and a distal tip assembly coupled to the distal end of the shaft and comprising a hollow tube having: (i) a first opening located at a first section along the longitudinal axis of the hollow tube and comprising a first slit having a first width, the first width determining a first opening angle and limiting bending of the first section to a first local radius of curvature, wherein the first section comprises a first protrusion having a first size, and (ii) a second opening located at a second different section along the longitudinal axis of the hollow tube and comprising a second slit having a second different width, the second width determining a second opening angle different from the first opening angle and limiting bending of the second section to a second different local curvature radius, wherein the second section comprises a second protrusion having a second size different from the first size. 2 . The medical probe of claim 1 , wherein the first section is distal to the second section, wherein the first opening is larger than the second opening, and wherein the first local radius of curvature is smaller than the second local radius of curvature.

3. The medical probe of claim 1, wherein at least the first opening comprises a first insert, and wherein the first insert is sized and shaped to fit closely over the first protrusion.

4. The medical probe of claim 1 and comprising a control handle mounted at the proximal end of the shaft and configured to bend the first section up to the first local radius of curvature and the second section up to the second local radius of curvature.

5. The medical probe of claim 4 , and comprising a pull wire coupled to the control handle at a first end and to a selected segment of the distal tip assembly at a second end, and wherein the control handle is configured to bend at least one of the first segment and the second segment by pulling the first end of the pull wire.

6. The medical probe of claim 5, wherein the puller wire comprises an alloy of nickel and titanium. 7 . The medical probe of claim 4 , wherein the control handle is configured to bend one of the first and second segments relative to the longitudinal axis while simultaneously maintaining the other of the first and second segments flush with the shaft.

8. The medical probe of claim 1, wherein the cavity comprises an ENT sinus.

9. A method for manufacturing a medical probe, the method comprising: providing a shaft for insertion into a body cavity of a patient; as well as A distal tip assembly comprising a hollow tube is coupled to the distal end of the shaft, the hollow tube having: (i) a first opening located at a first section along the longitudinal axis of the hollow tube and comprising a first slit having a first width, the first width determining a first opening angle and limiting bending of the first section to a first local radius of curvature, wherein the first section comprises a first protrusion having a first size, and (ii) a second opening located at a second different section along the longitudinal axis of the hollow tube and comprising a second slit having a second different width, the second width determining a second opening angle different from the first opening angle and limiting bending of the second section to a second different local curvature radius, wherein the second section comprises a second protrusion having a second size different from the first size.

10. The method of claim 9, wherein the first section is distal to the second section, wherein the first opening is larger than the second opening, and wherein the first local radius of curvature is smaller than the second local radius of curvature.

11. The method of claim 9, wherein at least the first opening comprises a first insert, and wherein the first insert is sized and shaped to fit snugly over the first protrusion.

12. The method of claim 9, and comprising fitting a control handle at the proximal end of the shaft for bending the first section up to the first local radius of curvature and the second section up to the second local radius of curvature.

13. A method according to claim 12, and including connecting a pull wire to the control handle at a first end, and connecting the pull wire to a selected segment of the distal end assembly at a second end for bending at least one of the first segment and the second segment by pulling the first end of the pull wire.

14. The method of claim 13, wherein the puller wire comprises an alloy of nickel and titanium.

15. The method of claim 9, wherein the cavity comprises an ENT sinus.

16. The method of claim 9, and comprising forming at least one of the first opening and the second opening using a laser cutting technique.

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