Method of making a steerable surgical arm having curvature in different planes

Abstract

A method for manufacturing a tubular body for a maneuverable arm for endoscopic surgery comprises the following steps: providing a hollow metal tube, configuring the hollow metal tube into a tubular body, the tubular body having a first plurality of ribs along a first section of the tubular body, the ribs extending from a first ridge; the tubular body having a second plurality of ribs along a second section of the tubular body, the ribs extending from the second ridge; a) bending the first section of the tubular body; b) heating the bent first section of the tubular body so that the tubular body has a memory of the first bend; c) bending the second section of the tubular body; d) heating the bent second section of the tubular body so that the tubular body has a memory of the second bend; wherein the offset angle between the plane of the first bend and the plane of the second bend is less than 180 degrees.

Description

Technical Field

[0001] The present invention relates to the field of endoscopic surgical instruments, and in particular to a method for manufacturing a micro-manipulator arm for use in surgical operations through an endoscope or near an endoscope. Background Art

[0002] Preferred methods for gastrointestinal (GI) tract surgery include minimally invasive procedures, such as the use of microsurgical instruments to manipulate tissue. An endoscope is proposed, in which two flexible surgical instruments are inserted into its biopsy channel for performing surgical operations on tissue. Each surgical instrument is provided with a manipulable micro-robotic arm at the distal end. In turn, the manipulable arm is provided with an end effector at the distal end. There are many types of end effectors, which can be a pair of surgical forceps, a hot knife, an injection needle, a suturing tool, etc. The end effector determines the purpose of each surgical instrument.

[0003] A transmission tube is fixed to the maneuverable arm to control the bending and extension of the maneuverable arm. When the surgical instrument is installed in the endoscope, the transmission tube passes through the biopsy channel and the maneuverable arm extends slightly from the distal tip of the endoscope.

[0004] The most common flexible endoscopes are manufactured by Olympus TM The diameter of the biopsy channel of some endoscopes manufactured by the US Department of Laboratories is about 3.7 mm. Some other endoscopes have a biopsy channel diameter of 2.8 mm. Therefore, the diameter of the maneuverable arm must be smaller to be able to pass through these biopsy channels.

[0005] During surgery, the surgeon uses a control handle on the proximal end of the endoscope to steer the endoscope inside the body, allowing the distal end of the endoscope, which has a steerable arm, to reach the target tissue. Surgical instruments are disposable and are removed from the endoscope and discarded after surgery.

[0006] The type of maneuverable arm of interest in this application is a curved maneuverable arm made from a continuous piece of nickel-titanium. A wire thread passes through a hollow core within the curved maneuverable arm, with the wire end secured to a point defining the inner surface of the core. The wire thread can be pulled to straighten the curved maneuverable arm.

[0007] Due to their complex structure, the production of manipulable arms is often a manual operation. Typically, a manipulable arm is cut from a small hollow tube, leaving a gap on one side. The cut tube is then bent toward the side without the gap, which opens the gap, and heated. This creates a permanent bend in the manipulable arm. Upon cooling, the manipulable arm is straightened between the maker's fingers. A wire is then threaded through the tube and secured to the distal end of the manipulable arm on the side with the gap. Pulling on the wire closes the gap and straightens the manipulable arm. Further pulling on the wire closes the gap further, bending the manipulable arm in the opposite direction. Releasing the wire returns the manipulable arm to its original bent state. Despite best efforts, the bend often varies from one manipulable arm to another; some arms bend less sharply than others. The problem with a more gradual bend is that it reduces the range of motion of the steerable arm's tip; the surgeon may pull on the wire slightly before the steerable arm is fully extended, and the steerable arm cannot extend any further.

[0008] More importantly, large bending differences will weaken the surgeon's skills in controlling the steerable arm; the surgeon cannot rely entirely on experience to steer each next steerable arm.

[0009] Therefore, it is desirable to provide a steerable arm with reduced bending variation, and a method for producing such a steerable arm. Summary of the Invention

[0010] In a first aspect, the present invention provides a method for manufacturing a tubular body for a manipulatable arm for endoscopic surgery, comprising the following steps: providing a hollow metal tube, configuring the hollow metal tube into a tubular body, the tubular body having a plurality of ribs along at least one side of the tubular body, the ribs extending from a spine; inserting at least one wire rope into the tubular body; bending the tubular body having the wire rope inside; heating the bent tubular body having the bent wire rope inside; causing the tubular body and the wire rope to have a memory of their respective bends.

[0011] In the prior art, the generally straight interior of the wires resists bending of the manipulator arm, resulting in large bend variations between manipulator arms. Heating the wires within the bent hollow tube permanently bends the tube and the wires. The wires no longer resist bending. By bending and heating the manipulator arm after threading multiple wires, the reduction in wire resistance to bending is even more pronounced. This offers the potential to reduce bend variations among manipulator arms, resulting in more consistent product quality.

[0012] Another problem solved by the present invention is that of inconsistent stiffness. Stiffness refers to the strength of the steerable arm to "spring back" when the force pulling it straight is removed.

[0013] Preferably, the method further comprises the step of cutting the metal hollow tube to provide a plurality of rings in series; one edge of each ring defining a rib of the tubular body and the other edge of each ring being part of a ridge.

[0014] Preferably, the method further comprises the steps of: cutting two slits in at least one rib to provide a strip along the rib; pressing the strip toward the inner core of the tubular body to form an eyelet; wherein the step of inserting at least one cord into the tubular body comprises inserting the cord into the eyelet.

[0015] "Eyelets" include any means welded or bonded to the surface of each rib, as well as any means cut from the rib and / or formed from the rib itself by permanently / plastically deforming a portion of the rib itself. Eyelets can be hooks having free, unconnected or endless loops.

[0016] Passing the cord through the eyelet allows the cord to acquire a bend that is as close as possible to the bend of the side of the hollow tube through which the cord is desired to be straightened, which further reduces the variance.

[0017] Preferably, the method further comprises the steps of: making a plurality of eyelets on the plurality of ribs, each eyelet being located on a respective one of the plurality of ribs; the plurality of eyelets being aligned to form a channel within the tubular body; and the step of inserting at least one string into the tubular body comprising inserting the string through the channel.

[0018] Optionally, the method further comprises the step of providing a plurality of perforations of different sizes; wherein the perforations are arranged such that the passage has an increasing diameter along the length of the tubular body.

[0019] In an embodiment with two such channels having enlarged apertures, the channels can be arranged on opposite sides of the inner surface of the tubular body, with one channel arranged along one portion of the length of the tubular body and the other channel arranged along another portion of the length of the tubular body. The larger aperture of each channel can be arranged toward the center of the tubular body so that a single cord can be easily passed through both channels.

[0020] Preferably, the passage is a first passage, and the method further comprises the steps of: forming a plurality of holes in a further plurality of ribs, each hole formed in a respective one of the further plurality of ribs; aligning the plurality of holes to form a second passage; and inserting at least one wire into the tubular body comprises inserting a second wire through the second passage. For embodiments in which two or more wires are heated simultaneously with the tubular body, this feature enables the wires to develop a memory of the bend. Generally, the more unbent wires within the tubular body, the greater the resistance to bending of the tubular body. Therefore, heating multiple wires within the tubular body significantly reduces the likelihood that the wires will straighten to resist bending of the tubular body.

[0021] Optionally, the first and second channels are angularly offset about the axis of the tubular body. This allows the wire in the second channel to be used to bend the tubular body in a different planar direction than the wire in the first channel. The ridges and ribs providing the first channel may be angularly offset from the ridges and ribs providing the second channel.

[0022] Preferably, the method further comprises the steps of: punching holes to form the first passage using a punch having a first size, the first size being adapted to provide holes sized for passage of a wire having a first diameter; and punching holes to form the second passage using another punch having a second size, the second size being adapted to provide holes sized for passage of a wire having a second diameter. The wires can be identified by their diameters, and thus the portion of the maneuverable arm controlled by each wire can also be identified.

[0023] Preferably, the step of pressing the strip toward the inner core of the tubular body to form the holes comprises: punching the strip using a punch having a concave surface; the curvature of the concave surface extending from one slit to the other.

[0024] Preferably, for each rib, cutting of that rib is completed before cutting the next rib along the hollow metal tube.

[0025] Typically, the method further includes the step of connecting an end effector to the distal end of at least one wire. This feature relates to the wire used to operate the end effector, and the wire can also be bent and heated to achieve the curvature of the curved maneuverable arm. Thus, the maneuverable arm can have one wire for straightening the maneuverable arm and another wire for operating the end effector.

[0026] Preferably, the plurality of holes are formed at apexes of the respective ribs.

[0027] In a second aspect, the present invention provides a tubular body of a maneuverable arm for endoscopic surgery, comprising: a plurality of ribs; the ribs extending from a spine; at least one wire passing through the tubular body; wherein the tubular body has a bend in a natural state; and at least one wire has a bend in a natural state that is consistent with the bend of the tubular body.

[0028] Preferably, the tubular body further comprises: at least one translation guide for guiding the movement of a respective one of the at least one wire; said at least one translation guide being located within said tubular body.

[0029] Preferably, said at least one translation guide comprises at least one eyelet formed on the inner surface of said tubular body.

[0030] Preferably, the edge of the at least one eyelet is folded towards the inner core of the tubular body or towards the axis of the hollow tube. This prevents the edge of the eyelet from scratching the cord during its translation.

[0031] In certain embodiments, though not preferred, eyelet can be formed on the outer surface of tubular body.In these embodiments, can use digging warping tool that seam is pulled out.

[0032] Preferably, the tubular body has a plurality of translation guides; and each translation guide corresponds to at least one of a plurality of eyelets; each translation guide is used for a respective wire rope within the tubular body; and the size of the eyelet of each translation guide is different from the size of the eyelet of at least another translation guide; thereby, the wire ropes of different translation guides have different diameters according to the size of the corresponding eyelet.

[0033] Preferably, each of at least one of the plurality of eyelets is formed at the vertex of the respective rib. The eyelets formed at the vertex of the rib can enable the cord to be pulled to bend the tubular body, thereby having a better influence on the moving rib and guiding the movement of the rib more accurately. BRIEF DESCRIPTION OF THE DRAWINGS

[0034] The accompanying drawings illustrate possible arrangements of the present invention, and reference to the accompanying drawings facilitates further description of the present invention, wherein like reference numerals designate like components. Other embodiments of the present invention are possible, and therefore the particularity of the accompanying drawings should not be understood as superseding the generality of the present invention set forth above.

[0035] Figure 1 An apparatus comprising an embodiment of the present invention is shown;

[0036] Figure 2 Two are shown for use with an endoscope. Figure 1 The device shown;

[0037] Figure 3A close-up view of an embodiment of the present invention is shown. Figure 2 a portion shown;

[0038] Figure 4 is a schematic diagram of an embodiment;

[0039] Figure 5 for Figure 4 Operation diagram of an embodiment of the present invention;

[0040] Figure 6 Show Figure 4 The manufacturing method of the embodiment;

[0041] Figure 7 Show Figure 4 A second manufacturing method of an embodiment;

[0042] Figure 8 Show Figure 4 A third manufacturing method of an embodiment;

[0043] Figure 9 Show Figure 4 A portion of a manufacturing method of an embodiment;

[0044] Figure 10(a) to Figure 10(j) Show Figure 4 A portion of a manufacturing method of an embodiment;

[0045] Figure 11 is a set of technical diagrams corresponding to Figure 10(j);

[0046] Figure 12 is a set of technical diagrams corresponding to Figure 10(j);

[0047] Figure 13(a) to Figure 13(h) A manufacturing method of another embodiment is shown;

[0048] Figure 14(a) to Figure 14(d) A manufacturing method of another embodiment is shown;

[0049] Figure 15 Another embodiment is shown;

[0050] Figure 16 A manufacturing method of another embodiment is shown;

[0051] Figure 17 Another embodiment is shown;

[0052] Figure 18 for Figure 17 A perspective view of an embodiment of ; and

[0053] Figure 19 for Figure 17 Another schematic diagram of an embodiment of the present invention. DETAILED DESCRIPTION

[0054] Figure 1 A flexible surgical instrument 100 is shown insertable into an endoscope 200 .

[0055] The flexible surgical instrument 100 includes a transmission tube 107, which constitutes most of the length of the flexible surgical instrument 100. The distal end 103 of the transmission tube 107 is provided with a maneuverable arm 101. The distal end of the maneuverable arm 101 is fixed with a surgical end effector 203 (see FIG. 2 ) that determines the function of the flexible surgical instrument 100. Figure 2 illustrations in ), such as surgical forceps, electric knife, injection needle, suturing tools, etc. Figure 2 An endoscope 200 is shown with two flexible surgical instruments 100 inserted therein.

[0056] Endoscope 200 is an optical instrument that can be inserted into the gastrointestinal (GI) tract through the mouth or anus to provide a view of a target location in the GI tract. Endoscope 200 may include a video display connected to its proximal end, and a light source and a wide-field-of-view camera at its distal end 211. Image transmission from the camera to the video display may be provided by a fiber optic system or a sensor chip system.

[0057] Endoscopes 200 used for GI surgery are typically over 1 meter in length. The most common GI endoscopes 200 have one or two translation channels within their inner core, which can range in diameter from 2.8 mm to 3.7 mm and are commonly referred to as biopsy channels 205 or instrument channels. The biopsy channels 205 have a channel entrance 213 at the proximal end of the endoscope 200 and a channel exit 211 at the distal end of the endoscope 200. Flexible surgical instruments 100 can be inserted into the channel entrances and passed through the biopsy channels 205.

[0058] Figure 2 The endoscope 200 in the embodiment has two biopsy channels 205, one for each of the two flexible surgical instruments 100. The outer diameter of the endoscope 200 with two biopsy channels is typically greater than 1.2 cm.

[0059] Figure 3 for Figure 2 The enlarged view of the middle inset shows an exemplary arrangement of a camera 301 and a light source 303 at the tip of the endoscope 200 or on the cover 201 on the distal end 211 of the endoscope 200. The camera 301 provides a real-time view of the surgical site, the maneuverable arms 101, and the end effector 203 to guide the surgeon in manipulating the maneuverable arms 101. The distal end of one of the maneuverable arms 101 is equipped with surgical forceps as the end effector 203, while the distal end of the other is equipped with a suturing tool.

[0060] Typically, the outer diameter of the transmission tube 107 and the maneuverable arm 101 is 2.7 mm or less to match most biopsy channels 205 provided in commonly available GI endoscopes 200. The length of the maneuverable arm 101 is approximately 3 cm. The length of the transmission tube 107 can be varied according to the design and depends on the length of the endoscope 200 used with the flexible surgical instrument 100. The maneuverable arm 101 can be moved or straightened by pulling on a wire threaded through the transmission tube 107.

[0061] In particular, the end effector wire 109a is connected at one end to the end effector 203 for operating the end effector 203. The main body of the end effector wire 109a extends through the hollow core of the maneuverable arm 101 and the transmission tube 107. The other end of the end effector wire 109a emerges from the proximal end of the transmission tube 107.

[0062] Similarly, a straightening cable 109b is disposed within the inner core of the maneuverable arm 101. The distal end of the straightening cable 109b is connected to a point on the inner surface of the maneuverable arm 101 defining the inner core, and is located near or at the distal end of the maneuverable arm 101. The remaining length of the straightening cable 109b passes through the transfer tube 107 and emerges from the proximal end of the transfer tube 107.

[0063] The maneuverable arm 101 and the portions of the end effector wires 109a and straightening wires 109b within the maneuverable arm 101 are naturally permanently bent. "Permanent" does not mean that the maneuverable arm 101 and wires 109 are rigid and inflexible. Instead, the maneuverable arm 101 is made of a resilient and flexible metal, such as nickel titanium. This allows the maneuverable arm 101 to bend and deform, yet immediately return to its original shape when the bending force is released.

[0064] Pulling the straightening wire 109b, feeding the proximal portion of the straightening wire 109b into the delivery tube, causes the steerable arm 101 to be bent against the curve, which straightens the steerable arm 101. Further pulling may even reverse the curve of the steerable arm 101.

[0065] The ends of the wires 109 extending from the proximal end 105 of the flexible surgical instrument 100 are coupled to an adapter (not shown) located on the outside of the endoscope 200. The adapter includes knobs, pulleys, or levers (not shown) to which the ends of the wires are individually connected. Rotation or translation of each knob, pulley, or lever either pulls on the respective wires or releases tension, depending on the direction of rotation or translation. Pulling on the proximal end of the wires can move or straighten the maneuverable arm 101, or drive the end effector 203. The adapter can be operated manually or automatically by electronic components and software to control the movement of the maneuverable arm 101 and the end effector 203.

[0066] Figure 4The steerable arm 101 is shown without the end effector 203 and without an internal wireless tether, which is a tubular body comprising a spiral chain or a metal ribbon coil. The tubular body 407 comprises a plurality of rings arranged in series, so that the tubular body 407 has an elongated tubular shape.

[0067] In its natural state, the manipulator arm 101 bends, resulting in a tubular body 407 having a convex side 403 and a concave side 401. On the concave side 401, the edges of the rings of the tubular body 407 are brought together, with the edge of each ring abutting the edge of the adjacent ring, thereby preventing compression of the rings on the concave side 401. This provides a ridge 711 on the concave side 401. On the convex side 403, the edges of the rings are spaced apart, forming ribs 709 extending from the ridge 711. When the ridge 711 is bent, the edges of the ribs 709 on the concave side 401 can move closer together or further apart. Thus, a bent manipulator arm 101 can be bent to straighten, or even to the opposite side, reversing the initial bend. However, metal is a resilient material that provides a structural bias in the manipulator arm 101 to restore it to its original bent state when the bending force is removed.

[0068] Figure 5 Three figures are shown schematically illustrating the bending stages of the steerable arm 101. The figures show that the end of the wire 109 used to control the steerable arm 101 passes through the inner core of the steerable arm 101 and is connected to the rib 709 at or near the distal end of the tubular body 407. For clarity, the wire 109 is shown in solid lines, but a skilled reader will understand that the wire 109 is located inside the tubular body 407. The distal end of the wire 109 is fixed to the tubular body 407 by tying a knot, crimping, or any other method that ensures that the wire 109 is always fixed to the inner surface of the tubular body 407.

[0069] The leftmost figure shows the manipulator arm 101 in its natural state, whose shape includes a bend such that the ridge 711 side is concave ( Figure 5 a). The ribs 709 are located on the convex side and are spread out to accommodate the curvature. When the cord 109 is pulled, some of the ribs 709 are pulled closer together, bending and straightening the ridges 711 ( Figure 5 b). Further pulling of the wire 109 pulls the ribs 709 closer together, causing the curvature of the maneuverable arm 101 to reverse, now bending away from the initial curvature direction ( Figure 5 c) Releasing the tension allows the bias to manifest and restores the maneuverable arm 101 to its original curvature. This bias eliminates the need for a second wire to pull the straightened maneuverable arm 101 back to its original curvature. This single-wire method of moving the maneuverable arm 101 in two directions is simpler than a two-wire method, which requires coordinating the pulling of one wire while releasing the other.

[0070] Therefore, the maneuverable arm 101 can move within a plane, from bending in one direction to bending in another direction. This allows the end effector 203 on the maneuverable arm 101 to move toward the tissue to be treated.

[0071] The proximal portion of the straightening cable 109b within the manipulator arm 101, while having a permanent bend that conforms to the bend of the manipulator arm 101, assumes the curvature of the transfer tube 107 when it is pulled into the transfer tube 107. A coupler connecting the manipulator arm and the transfer tube 107 provides the necessary physical influence. When the pulling force is released, the manipulator arm 101 rebounds back to the permanent bend, pulling the proximal portion of the straightening cable 109b back into the manipulator arm 101. The permanent bend of the straightening cable 109b also returns to the manipulator arm 101. Generally, although not necessarily, the elastic force of the straightening cable 109b is lower than the elastic force of the manipulator arm. Similarly, during translation, the end effector cable 109a can conform to the shape of the manipulator arm 101 and the transfer tube 107.

[0072] The overall manufacturing process of the manipulable arm

[0073] Figure 6 One possible overall process for manufacturing the maneuverable arm 101 is shown. In general, the process shown mainly concerns how to manufacture the tubular body 407 and how to thread the wires into the tubular body 407. The manufacture of the end effector 203 is not within the scope of this application.

[0074] First, a hollow metal tube 601 of nickel titanium is cut to produce a tubular body 407. Then, a steel wire 109b is passed through the hollow inner core of the tubular body 407. Optionally, the distal end of the wire 109b is fixed to a position on the inner surface of the tubular body 407. In order to control the distal end of the tubular body 407, the fixing position is preferably close to or located at the distal end of the tubular body 407. The length of the wire 109b is greater than the length of the transmission tube 107. Therefore, the portion of the wire 109b extending out of the tubular body 407 passes through the transmission tube 107, and the excess length is exposed from the proximal end of the transmission tube 107 (not shown). The excess length of the wire 109b can be controlled by a control adapter to which the wire 109b is fixed. In this regard, this wire or any wire with the same purpose is referred to as a straightening wire 109b.

[0075] Also shown is the end effector 203 secured to the distal end of the tubular body 407. In this example, the end effector 203 is a pair of surgical forceps. The end effector 203 is provided with an end effector cord 109a for operating the end effector 203, for example, to close the forceps when pulled. Thus, the end of the end effector cord 109a is connected to the end effector 203 at the distal end, and the cord is long enough to pass through the tubular body 407 and the transmission tube 107, leaving an excess length protruding from the proximal end of the transmission tube 107. This excess length can be manipulated by a control adapter (not shown) to operate the forceps.

[0076] Once the forceps, end effector wire 109a and straightening wire 109b are in place, the entire assembly becomes a manipulable arm and is loaded into a mold. The mold is made of three small metal blocks that can be stacked together. The middle piece 609 is cut to provide an elongated and narrow groove 613 with a bend. The tubular body 407 can be removably placed in the groove 613 with sufficient tightness. There is almost no room or no room for shaking, and the tubular body 407 can maintain the bend firmly and stably. The parts of the wires 109a, 109b outside the tubular body are very long, but only the parts of the wires inside the tubular body 407 bend in the groove 613 together with the tubular body 407.

[0077] The top metal piece 607 and the bottom metal piece 611 are placed on either side of the middle piece 609 to assemble the mold. The mold is then placed in an oven to heat. Optionally, the middle piece 609 has a small channel 615 into which a needle thermometer 617 is inserted to monitor the mold temperature.

[0078] The mold is heated to a temperature above the recrystallization temperature of the tubular material. For nickel titanium, the recrystallization temperature is approximately 500 degrees Celsius. At this temperature, the nickel titanium recrystallizes, releasing the stress in the tubular body 407. This allows the tubular body 407 to permanently remember the bend after cooling. This bend then becomes the permanent shape of the tubular body 407, i.e., the shape of the tubular body 407 in its natural state.

[0079] The material used to make the end effector wires 109a and the straightening wires 109b within the tubular body 407 also undergoes recrystallization and stress relief, and in the process, develops a memory of the same bend. These wires do not necessarily have to be made of nickel titanium. In some embodiments, steel wires are also suitable due to their similar or overlapping recrystallization temperatures with nickel titanium.

[0080] The advantage of the steel cable is that it is elastically flexible, meaning that it can bend with the maneuverable arm 101 and return to a memorized bend. Another advantage is that the steel cable has a relatively low elongation in the relevant use environment. The cables 109a, 109b used to manipulate the maneuverable arm 101 cannot have significant stretchability because, when the cables are pulled, the motion of the maneuverable arm 101 becomes nonlinear, making precise control of the device more challenging.

[0081] At this stage, it should be noted that flexibility refers, in particular, to the ability to bend or straighten; and elasticity refers, in particular, to the ability to return to an earlier or original state.

[0082] Since both the tubular body 407 and the wire are made of elastic material, when the straightening wire 109b is pulled, the tubular body 407 is straightened, but when the tension is released, the tubular body 407 returns to the memorized bend. Similarly, the surgical forceps are designed to close when the end effector wire 109a is pulled, and automatically spring open only when the tension is released.

[0083] In some embodiments not described in detail herein, the materials may be other than nickel titanium and steel. Furthermore, there are many different types of steel. Regardless of the material used, the mold temperature should be higher than the highest recrystallization temperature of all materials used, but not so high as to approach the melting point of any material.

[0084] Figure 7 Another method of heating the tubular body 407 is shown, in which tools such as clamps are used to clamp the ends of the assembled maneuverable arm 101; the maneuverable arm already has the end effector wire 109a and the straightening wire 109b threaded through it. The distance between the tools and the arrangement of the tools are precisely set. The tools are then brought together to form a bend in the middle of the tubular body 407. A heating instrument 713 (such as a heat gun) heats the tubular body 407 and the wires within the tubular body 407 for an appropriate length of time and to an appropriate temperature. The tubular body 407 remains bent while it cools. After cooling, the tubular body 407 and the wires 109b, 109a within the tubular body 407 will have acquired the bend as a permanent part of their shape.

[0085] Figure 8 Show Figure 6 A variation of the method, Figure 8The difference in FIG4 is that, before heat treatment, the end effector wire 109a is passed through the tubular body 407, but the end effector 203 is not fixed to the tubular body 407. The tubular body 407, which has the straightening wire 109b and the end effector wire 109a inside but does not have the end effector 203 fixed thereto, is placed into the groove in the mold and heated. After cooling, the tubular body 407 and the portion of the wire inside the tubular body 407 have acquired a bend. Subsequently, the end effector 203 is fixed to the end effector wire 109a to complete the steerable arm.

[0086] Before being heated and bent, the wire is described as being straight. However, "straight" only refers to being relatively or reasonably straight over the length of the manipulator arm 101 (approximately 3 cm). The straightness of the wire makes it easier to insert the wire into the unbent tubular body 407. However, any metal wire piece one meter long will typically have a gentle bend or slight curve. This gentle bend is not of concern to the present application and is considered straight in the context of the present application.

[0087] When tubular body 407 remains bent, any wires within tubular body 407 will bend with it. By permanently bending the wires within tubular body 407 along with tubular body 407, the tendency of the wires to straighten and resist the bending of tubular body 407 is eliminated. Thus, this embodiment alleviates one of the causes of large variations in the bending of steerable arms in the prior art.

[0088] Furthermore, the curved wire reinforces the curvature of the tubular body 407, which helps the maneuverable arm overcome the transmission friction and return to the curved state more elastically when the straightening wire 109b is released from the pulled state.

[0089] Cutting hollow metal tubes to form tubular bodies

[0090] The tubular body 407 is made of a hollow tube 601 of a superelastic material. Superelastic materials are materials that have the elasticity to undergo large deformation under the action of an external force and immediately return to their pre-deformation shape after the external force is removed. Examples include Nitinol (nickel titanium) and the following non-exhaustive list of alloys: Cu-Zn, Cu-Al-Ni, Au-Cd, Au-Cu-Zn, and In-Tl.

[0091] Preferably, the diameter of tube 601 is small enough to allow the maneuverable arm to be inserted into the biopsy channel of most endoscopes. This typically means a diameter of 2.7 mm or less. Tube 601 is approximately 3 cm long. The transfer tube 107 attached to the maneuverable arm 101 has a similar diameter. Alternatively, the diameter of tube 601 can be suitable for insertion into an external instrument channel attached along the length of an endoscope, which typically has a larger diameter.

[0092] Figure 9 (a) to Figure 9(c) Schematic illustration of how the hollow tube 601 is helically cut at 903 into a helical metal ribbon coil 905 having rings arranged in series, maintaining the elongated shape of the tube 601. The cutting can be accomplished by precision machining, such as laser cutting by equipment such as a laser source 703, a computer numerically controlled (CNC) milling machine, or the like.

[0093] Figure 9 (a) shows a side view of the uncut tube 601. Figure 9 (b) shows the cuts made by the laser along the length of tube 601 and around tube 601. Finally, as Figure 9 As shown in (c), the tube 601 is transformed into a tubular body 407 composed of a metal strip arranged in a series of rings 905. It can also be described as a flat, wide strip arranged in a spiral structure, but it generally maintains a tubular shape. The gaps between the rings 905 are shown exaggerated.

[0094] Figure 9 (a) to Figure 9 The process shown in (c) is an overly simplified example and is only used to illustrate how to spirally cut the tube 601 to form the tubular body 407. Figure 10(a) to Figure 10(j) A more instructive method of cutting tube 601 is shown.

[0095] Figure 10(a) shows that the cutting starts from one end of the tube 601. The horizontal sequence diagram at the top of Figure 10(a) shows how the cutting is done in more detail. Specifically, the horizontal sequence diagram shows that two cuts are required to form the gap 705 under each rib 709. First, a first spiral cut 1009 is cut on the circumference of the tube 601 to define the lower edge of the first rib 709, with "lower" being the direction of the diagram. The first cut is shown with a solid line. The first cut 1009 is an incomplete spiral, surrounding only a large portion of the tube 601 rather than the entire circumference. The starting point of the first cut 1009 is shown to be higher than the tube 601, and the end of the first cut 1009 is shown to be lower than the tube.

[0096] Next, a second spiral cut 1011 is cut into the circumference of tube 601, as shown by the dotted line. The slope of second cut 1011 is less than that of first cut 1009 and is located directly below first cut 1009. Second cut 1011 intersects first cut 1009 at both ends, thereby removing a portion 707 of the tube. This creates a gap 705 between each two adjacent rings.

[0097] The same steps are repeated lower down the tube 601 to form the next ring and gap. Each ring's "second cut" is made at an angle and length that connects to the second cut above it at one end and to the second cut below it at the other end. This creates a continuous spiral cut around the circumference of the tube 601 and along its length.

[0098] Finally, as shown in FIG10( b ), a series of rings separated by gaps are formed on one side of the tube 601. These individual rings are the ribs 709 on the maneuverable arm. The ridge 711 side of the tube 601 is also cut equally along the tube, but without removing any tube material. Each ring on one side of the ridge of the tubular body 407 abuts against an adjacent ring. When the maneuverable arm 101 is bent by pulling the straightening cord 109 b, this abutment prevents the ridge 711 from compressing, while the gaps 705 between the ribs 709 allow the ribs 709 to move closer together, thereby straightening the bent maneuverable arm 101.

[0099] To make a clean cut in any object, the object must have sufficient structural strength to resist overall deformation due to the cutting forces, except in the plane of the cut that bisects the object. However, nickel titanium is a superelastic material and deforms easily. Therefore, to provide a certain degree of structural strength, the tube 601 is cut from one end to the other, cutting the distal end first and then the proximal end. The next rib 709 of the tube 601 is cut only after the previous rib 709 and gap are completed. This leaves as much of the tube 601 as possible uncut to provide structural strength. In contrast, if the tube 601 is cut spirally and continuously along the tube before the gap is cut, the tube 601 may become too weak to maintain its structure when the gap 705 is cut. This may result in an imprecise or inaccurate cut, which may damage the tube 601.

[0100] Finally, all the required ribs 709 and ridges 711 have been formed. The next step is to provide eyelets 715 on the inner surface of the ribs 709. Eyelets 715 are guides for translating the straightening rope 109b. The rows of eyelets together provide a translation channel.

[0101] Preferably, each eyelet 715 is located on the inner surface below the apex of the corresponding rib 709. This ensures that the straightening cable 109b remains as close to the apex of the rib as possible, so that when the tubular body 407 is bent and heated, the bend imparted to the straightening cable 109b aligns with the curve passing through the apex of the rib 709. This reduces mismatched bending between the steerable arm 101 and the straightening cable 109b and further reduces the reaction force to the bending of the steerable arm 101. Furthermore, if the rib 709 is manipulated by its apex, there is a greater influence when closing the rib 709 and straightening the steerable arm.

[0102] In some embodiments, the tube 601 is cut on only one side to provide the gap 705 defining the rib 709. The spiral cut is not performed around the entire circumference. Thus, the side of the tube 601 forming the ridge 711 remains intact and complete, not cut.

[0103] FIG10( c ) is a cross-sectional view of the tubular body 407 as viewed from the proximal end, showing four holes 715 punched out of the circumference of the tubular body 407 toward the inner core.

[0104] In the most basic method, eyelets 715 are formed one by one. Figures 10(d), 10(e), and 10(f) illustrate how a single eyelet 715 is created near the distal end of tube 601 before the first rib 709 is cut into it. Figure 10(e) is a magnified view of the portion of tube 601 being processed in Figure 10(d). First, two slits are cut into tube 601 using a laser. These slits are preferably parallel to the edges of the ribs 709 to be formed. The section of tubing between the two slits forms a strip, with both ends of the strip attached to tube 601. The strip is heated to the recrystallization temperature of the tubing using a suitable heater. Once sufficiently heated, a punch 717 is used to drive the center of the strip into the center of tube 601. The two sides of the strip remain attached to tube 601, and the recessed strip becomes the eyelet 715. After cooling, the eyelet 715 becomes a permanent feature on tube 601.

[0105] In Figure 10(f), the upper left image is a cross-sectional view of the end of tube 601. The figure shows the punch being driven into the circumference of tube 601. The upper right image is a side view of tube 601. The lower image is a perspective view of tube 601 with the punch being driven into it.

[0106] The punch is a block of metal with one end, called a face 719. This face has a rectangular cross-section and is placed on the strip to punch the hole. Preferably, face 719 is not flat, but concave in side view. The edges of concave face 719 cause the sides of the concave strip to bend toward the inner core of tube 601. This reduces the likelihood that sharp edges on eyelet 715 will scratch and interfere with the translation of the pull-line 109b through the eyelet 715, which could affect performance and reduce the product life of the steerable arm 101.

[0107] The preferred method of punching holes one by one is to punch all holes 715 on one side of the tubular body 407 at once, rather than making holes 715 one by one. Punching holes 715 in batches requires first forming the ribs 709. Subsequently, each rib 709 is cut with a laser to form strips on the ribs 709. Then, multiple punches precisely positioned on a batch punching tool can be used to punch holes in all the strips simultaneously.

[0108] FIG10( g ) illustrates a possible large-scale punching tool. The large-scale punching tool comprises a metal die that can be split into two halves 719. Each half 719 is a rectangular metal block with an elongated, straight, narrow groove 721 extending the length of the block. After the ribs 709 and ridges 711 are formed on the tubular body 407, the groove 721 is used to secure the tubular body 407 in place.

[0109] A series of through holes are formed along the base of each groove 721. Each through hole is precisely sized and shaped to allow a punch to extend from the outside of the mold and punch a hole into the strip inside the mold. When the tubular body 407 is placed into the groove 721, the strip on the rib 709 must be aligned with the through hole to ensure accurate punching.

[0110] Punches 717 are mounted on punch blocks 723. Two punch blocks 723 are shown, one for each groove 721. The top punch block 723 has five punches 717, the number and placement of which correspond to the through-holes in the mold half 719 shown above. The bottom punch block 723 also has five punches 717, the number and placement of which correspond to the through-holes in the bottom mold half 719. Any number of punches can be mounted on each punch block 723.

[0111] Once the mold is assembled, the two grooves close together, encasing the tubular body 407. Two punch blocks are then attached to either side of the mold by inserting a punch into the corresponding through-holes. The assembly is then heated in an oven to the recrystallization temperature of the tubing. Once sufficiently heated, the punch is used to impact the punch blocks 723, punching the strip into perforations 715.

[0112] The tubular body 407 is hollow but sufficiently shock resistant so that the strip can be struck. The shock resistance is provided by the walls of the supporting coil structure that are close to the groove 721.

[0113] The mold is then opened and the tubular body 407 is removed, which now has holes 715 on both sides of the tubular body 407 on the inner surface of the ribs 709. The tubular body 407 can now be threaded with the tensioning cord 109b and the end effector cord 109a.

[0114] FIG10(h) shows the straightening cord 109b being inserted. The distal end of the straightening cord 109b is provided with a stopper or knot 1015 that is too large to pass through the eyelets 715, and the proximal end is inserted through the eyelets 715. Once the proximal end of the straightening cord 109b has passed through all the eyelets 715, the straightening cord 109b can be passed through the tubular body 407 until the knot abuts the distal-most eyelet 715 and stops pulling, as shown in FIG10(i). The knot prevents the straightening cord 109b from being pulled out of the eyelets 715. Instead of a knot, the end of the straightening cord 109b can be crimped, welded, or soldered to a point near the distal end of the tube 601, or otherwise secured.

[0115] Figure 10(j) shows the tube 601 subsequently bent into the desired shape and heated with the straightening cord 109b within the eyelet 715, as previously described.

[0116] During surgery, when straightening wire 109b is pulled to straighten steerable arm 101, and when straightening wire 109b is released to restore steerable arm 101 to its original curvature, eyelet 715 acts as a guide to ensure smooth translation of straightening wire 109b.

[0117] Each rib 709 may be provided with an eyelet 715, such that the eyelet 715 forms a translation channel for the tensioning rope 109b. However, in other embodiments, an eyelet 715 may be provided on every other rib 709 (not shown). In other embodiments, a single eyelet may be sufficient for the translation guide.

[0118] In embodiments where the eyelet 715 forms a translational channel for the straightening cable 109b, the eyelet helps the straightening cable 109b to straighten as the ribs close, thereby helping the maneuverable arm 101 to straighten. When the straightening cable 109b is further pulled, the eyelet guides the straightening cable 109b to further translate, helping the straightening cable 109b to bend in the opposite direction as the bending of the maneuverable arm 101 reverses. These bending functions are described above. Figure 5 As shown in Figure 5 These bending functions are further enhanced by providing holes 715 at the apex of each rib. Upon releasing the straightening rope 109b, both the manipulable arm 101 and the straightening rope 109b can be restored to their initial permanent bending state.

[0119] Figure 11 and Figure 12 A technical diagram showing a set of ribs 709 and ridges 711 is shown, in which the content of the diagram in Figure 10(j) is simply repeated.

[0120] Figure 11 The left image in FIG shows an external image of the maneuverable arm 101 from a side view angle, while Figure 11 The right figure in the figure is the corresponding cross-sectional view from the direction marked hh.

[0121] Figure 12 The left picture in the figure is a cross-sectional view in the jj direction, and Figure 12 The right picture in FIG is the corresponding appearance picture of the manipulator arm 101. Figure 11 and Figure 12 As can be seen in FIG, the straightening cord 109b passes through a translation channel defined by a series of eyelets 715 and is secured in place by a knot tied at the distal end of the straightening cord 109b to prevent the straightening cord 109b from slipping out of the eyelets 715.

[0122] Tubular body with different curved sections

[0123] The steerable arm described so far can be straightened and bent in one plane of movement using only one straightening cable 109b within the steerable arm 101. However, in other embodiments, the steerable arm can be made up of different segments, each segment being able to move in a different plane.

[0124] The various segments of the manipulable arm can be designed in a modular manner. FIG13( a ) shows a tubular body 407 cut from a single tube 601, such that the tubular body 407 has two segments 801 and 803. The functions of the two segments 801 and 803 are similar to Figure 4 Two tubular bodies 407 are shown connected in series. The two segments 801 and 803 are coaxial, sharing the same axis, but are angularly offset. The spines and ribs of one segment face one direction, while the spines and ribs of the other segment face a different direction. If the angular offset is 180 degrees, the two segments 801 and 803 can move in the same plane, but in opposite directions.

[0125] The top segment 801 can be driven by a straightening cable 109b fixed to the distal end of the top segment 801, while the bottom segment 803 can be driven by another straightening cable 109b fixed to the distal end of the bottom segment 803, which is located somewhat midway along the tubular body 407.

[0126] However, since the top section 801 extends from the bottom section 803, bending the bottom section 803 allows the top section 801 to swing over a wider range. This allows any end effector 203 fixed to the distal end of the top section 801 to reach a greater range.

[0127] The coaxiality here does not require a straight axis. The axis is the center of the maneuverable arm 101, but it can also be a meandering axis that follows the bending of the maneuverable arm. According to the method, these bends can be permanently obtained by bending the maneuverable arm in two places and then heating the maneuverable arm.

[0128] like Figure 13(b) to Figure 13(d) As shown, the process for cutting the tubular body 407 in FIG13(a) is similar to that described with respect to FIG10 , except that the process now involves cutting the top segment 801 first, followed by cutting the bottom segment 803. First, the top segment of the hollow tube 601 is cut to form the tubular body 407, i.e., the tubular body 407 is formed with a ridge from which ribs extend. Subsequently, a similar cut is made to the bottom segment of the hollow tube 601, but with the tubular body 407 cut in the opposite direction. FIG13(d) shows two series of eyelets 715, each series of eyelets punched into the apex of the rib 709 of a respective segment 801, 803. Each series of eyelets provides a translational passageway for a respective straightening cable 109b.

[0129] The inset in Figure 13(e) shows that the two channels are located on opposite sides of the tubular body 407, 180 degrees apart, and therefore in the same plane of movement. Figure 13(g) is a set of technical drawings that complement the schematic diagrams illustrating the same concept, showing that the ribs 709 and ridges 711 of the top segment 801 and bottom segment 803 are oriented in different directions. A cross-section of the perforations 715 on the inner surface of the apex of the rib 709 can be seen. The mold (not shown) used to heat the tubular body 407 has a groove with two bends, one for each segment, to impart the bend shown in Figure 13(f) to the steerable arm.

[0130] If the two segments 801, 803 are offset by an angle less than 180 degrees, such as shown in the axial view of the tubular body 407 in FIG13(h), where the angular displacement θ is shown, the movement of the two segments 801, 803 will be in different planes. In this case, the tubular body 407 cannot be inserted into the flat groove in the heated mold. To account for the angular offset, the groove (not shown) must have different convexities or inclinations for different segments.

[0131] Alternatively, Figure 7 The heating method described in

[15] can be used to perform separate, sequential heating processes on two segments. First, the top segment 801 is held curved in the plane defined by its ridges 711 and ribs 709 and heat-treated to create a memory of the curve. Then, the bottom segment 803 is held curved in the plane defined by its ridges 711 and ribs 709 and heat-treated. This heating method is useful for maneuverable arms with multiple segments, each moving in a different plane.

[0132] Figure 14(a) to Figure 14(c) An embodiment is shown in which the size and arrangement of the holes in the steerable arm are varied. The holes 715 in the top section 801 and bottom section 803 of the tubular body 407 are located on opposite lateral sides. However, the size of the holes 715 in both sections 801 and 803 increases toward the middle of the tubular body 407. Thus, a single straightening cable 109b can be threaded through the holes in both the top section 801 and the bottom section 803. Prior to heating, the tubular body 407 is held so that the two sections 801 and 803 are bent in opposite orientations. Thereafter, the tubular body 407 permanently acquires the two curved shapes.

[0133] FIG14( d ) shows another variation of the eyelets, wherein the lower set of eyelets are all the same size except for the farthest eyelet, while the upper set of eyelets are also all the same size except for the most proximal eyelet. In this configuration, the smaller eyelets better ensure that the straightening cable 109b passing through the eyelets of the two segments follows the curves of the two segments as closely as possible. The larger eyelet near the middle of the tubular body 407 provides a guide for the straightening cable to pass from one side of the steerable arm to the other.

[0134] Figure 15 Another embodiment is shown, with a manipulable arm 101 having two segments. A corresponding number of straightening cables 109b are provided for the different segments, each straightening cable 109b being attached to the distal end of a corresponding segment and passing through a respective eyelet (not shown) provided in each segment. The distal-most segment shown in the example is not curved in its natural state, but straight, and can alternatively be bent by pulling on cables attached to both sides of the segment. Figure 15 a shows the manipulatable arm 101 in its natural state. Figure 15 b shows the different directions in which each component can move or bend under the action of its respective straightening rope 109b.

[0135] Figure 15 The maneuverable arm 101 in FIG. 1 has four sections 1001, 1003, 1005, and 1007. Below the first distal end 1001 of the maneuverable arm 101a are a second section 1003 and a third section 1005. The first section 1001 and the second section 1003 are axially offset, such that the first section 1001 can bend within a first plane 1012, while the second section 1003 can bend within a second plane 1014 that is angled relative to the first plane 1012. The second section 1003 and the third section 1005 are also axially offset, such that the third section 1005 can bend within a third plane 1013 that is angled relative to the second plane 1014. Thus, the three sections 1001, 1003, and 1005 can move within different planes 1012, 1014, and 1013, providing three degrees of freedom of motion. As shown, the fourth portion 1007, located below the third portion 1005, is a coupler that mates with a corresponding coupler on the transmission tube 107. Preferably, when the transmission tube 107 is twisted at the proximal end of the endoscope, the coupling allows the maneuverable arm 101 to rotate, further increasing the range of motion. The view in Figure 10(c) is from the proximal end of the maneuverable arm.

[0136] Figure 16 The steps for threading a tubular body 407 are shown. The tubular body has three sections, each requiring a straightening cable 109b to bend. As can be seen, eyelets 715 are arranged on different sides of the inner surface of the tubular body 407. A first straightening cable 109b is inserted into a series of eyelets (not shown) defining the translation channel of the most distal section; a second straightening cable 109b is inserted into a series of eyelets (not shown) defining the translation channel of the second most distal section; and a third straightening cable 109b is inserted into a series of eyelets (not shown) defining the translation channel of the most proximal section. In this embodiment, no single cable 109 is threaded through more than one translation channel.

[0137] Subsequently, the distal-most section of the tube 601 is bent and heated, and the first straightening cord 109b is passed through the corresponding eyelet.

[0138] The second distal segment is then bent and heated, and the second straightening cable 109b for the second distal segment is passed through the corresponding eyelet. A portion of the first straightening cable 109b extends from the first segment and passes through the second segment. When translating within the second distal segment, the first straightening cable 109b does not require any eyelet guidance and can simply pass through the inner core of the hollow steerable arm.

[0139] The third distal segment is then bent and heated, the third straightening cable 109b is passed through the corresponding eyelet, and a portion of the first straightening cable 109b and a portion of the second straightening cable 109b are extended through the inner core of the steerable arm in the third segment.

[0140] Figure 17 、 Figure 18 and Figure 19 Various embodiments are shown, including variations of the tubular body 407, in which each rib 709 is rotatably coupled to the next rib 709 via a coupling 1801. One rib 709 may have a male coupling 1701, a circular extrusion, that fits into a corresponding female portion 1703 on the next rib 709, allowing the circular extrusion to rotate within the bracket when the steerable arm is bent. The coupling improves the reliability of the steerable arm 101 by reducing the likelihood of radial expansion of the ring and compressive deformation along the axis of the steerable arm during actuation. The coupling 1801 prevents the ribs from widening or slipping radially, or from twisting axially around the steerable arm. In this embodiment, the ridges are not located on one side of the tubular body, while the ribs extend to the other side. Instead, the ridges are "centrally positioned." The ridges are formed by two rows of couplings 1801, one on each side of the steerable arm. However, the ribs extending from the couplings connect along the tubular body to the next coupling for a threaded connection to the next coupling. Thus, this embodiment remains a continuous structure with no discrete, disconnected parts. Thus, unlike the previous embodiment, the spine is not defined by abutting ribs on the concave side. Instead, the spine is defined by coupling joints 1801, which prevent the ribs from being compressed. These coupling joints 1801 are arranged in two rows along the length of the steerable arm, such that the coupling joints 1801 provide a pivot axis about which the ribs can rotate and the spine can bend to either side. In other words, the ribs and spine are arranged orthogonally relative to the axis of the tube.

[0141] To manufacture the tubular body of this embodiment and provide a permanent bend, the Figure 6 to Figure 10, the only difference being the cutting, now the metal tube 601 must be carved to form the coupling joint and the ribs. As in the previous embodiment, this continuous structure allows the embodiment to be bent with the cord inserted and heated to create a memory of the bend.

[0142] Figure 18 It is a perspective view of the embodiment before heating and bending. As can be seen, the slits are provided on different sides of the tubular body 407 to provide different bending directions or different bending surfaces. Figure 18 The illustration in FIG. 1 is a portion of the tubular body, and the reference numerals indicate coupling joints on opposite sides of the tubular body.

[0143] Figure 19 The corresponding top view 1901, front view 1903, bottom view 1905, and rear view 1907 are shown. The tubular body 407 has cutouts on four orthogonal sides, so that the holes form four different channels on four different sides of the tubular body 407. Straightening cables 109b passing through the channels can be used to bend the tubular body 407 in different planes or directions. As shown in the figure, the holes punched on different sides of the tubular body are of different sizes to accommodate cables of corresponding thicknesses. Therefore, the depth of the punch is determined according to the required hole size. Different cable diameters or thicknesses provide the cables with different tensile strengths, which are matched to the rigidity of each segment of the maneuverable arm.

[0144] The thickness of the wire is selected based on the tensile load requirements of the corresponding maneuverable arm segment. As a general rule, all wires in a maneuverable arm should be as thin as possible to reduce crowding in the transmission body connected to the base of the maneuverable arm. However, different segments of the maneuverable arm require wires with different tensile loads to bend the segment. A wire that is too thin may not have enough tensile strength to bend the stiffer segments without breaking. The force required to bend a segment depends on how much material is removed from the segment and where the material is removed. Therefore, the choice of wire thickness can be estimated based on the design of each segment. In addition, it usually takes more force to bend the closer segments than to bend the distal segments.

[0145] Typically, the end effector wire 109a does not pass through any eyelets, but rather simply passes through the inner core of the tubular body 407, extending between all eyelets. This is because the end effector wire 109a is not used to close the ribs and therefore does not need to translate near the apex of the eyelet. However, in order not to affect the curvature of the tubular body 407, the end effector wire 109a is still permanently bent by heat treatment.

[0146] Therefore, this embodiment includes the following steps:

[0147] 1. Bare hollow tube 601 is laser cut to create ribs 709, ridges 711 and slits for cord guidance.

[0148] 2. Punch (heat) the hollow tube 601 to form the cord guide, i.e., eyelet 715, from the seam.

[0149] 3. The straightening cords 109b used to bend the maneuverable arm 101 are passed through the corresponding punched holes, while the end effector cord 109a is passed through the inner core of the tubular body 407 without passing through any of the eyelets 751. The ends of the straightening cords 109b are attached to the distal ends of their respective segments of the tubular body 407 (e.g., by welding, friction fit, adhesives, or various methods of bonding, or by knots).

[0150] 4. The tubular body 407, end effector 203 and wire 109 are placed into a mold that holds the tubular body 407 in the desired curved shape and heated.

[0151] 5. The curved steerable arm 101 is then attached to the transfer tube (e.g. by welding, although an intermediate flange may also be used to facilitate the connection between the steerable arm and the transfer body). An excess length of wire extending from the proximal end of the steerable arm 101 is threaded through the length of the transfer tube 107.

[0152] Thus, an embodiment includes a method of manufacturing a tubular body 407 of a manipulatable arm 101 for endoscopic surgery, comprising the following steps: 1: providing a hollow metal tube and configuring the hollow metal tube 601 as a tubular body 407 having a plurality of ribs along at least one side of the tubular body 407, with the ribs 709 extending from a spine 711; inserting at least one wire 109a, 109b into the tubular body; bending the tubular body 407 having the wire 109a, 109b inside; heating the bent tubular body 407 having the bent wire 109a, 109b inside; causing the tubular body 107 and the wires 109a, 109b to develop a memory of their respective bends.

[0153] In some embodiments, as Figure 5 As shown schematically, the ridge is located on the side of the tubular body 407 opposite to at least one side; at least one string 109a is inserted. In other embodiments, as Figure 18 As shown, the spine is centrally located and consists of two rows of coupling tabs from which the ribs extend.

[0154] Furthermore, an embodiment also includes a tubular body 407 of a manipulatable arm 101 for endoscopic surgery, comprising: a plurality of ribs 709; the ribs 709 extending from a spine; at least one wire 109a, 109b passing through the tubular body 407; wherein the tubular body 407 has a bend in a natural state; and at least one wire 109a, 109b has a bend in a natural state that corresponds to the bend of the tubular body 407.

[0155] Although the preferred embodiments of the present invention have been described above, those skilled in the art will appreciate that variations or modifications may be made to the details of design, construction or operation without departing from the scope of the present invention.

[0156] For example, although the eyelets 715 are described as recessed strips cut into the ribs 709 of the tubular body 407, the eyelets 715 could be formed by welding or attaching a ring to the inner surface of each rib 709. The difference in the method of making the eyelets 715 does not affect the function of the eyelets 715 in providing a translation guide for the tensioning rope 109a.

[0157] Additionally, in some embodiments, eyelets 715 may be provided on the inner surface of the ridges. Such eyelets allow the tensioning cord 109a to be positioned adjacent to the ridges of one segment so that the cord extends straight to the eyelets of the next segment, which are located on the same side of the tubular body 407 as the ridges.

Claims

1. A method for manufacturing a tubular body of a maneuverable arm for endoscopic surgery, comprising the following steps: providing a hollow metal tube, configuring the hollow metal tube as a tubular body having a first plurality of ribs along a first section of the tubular body, the ribs extending from a first spine; the tubular body having a second plurality of ribs along a second section of the tubular body, the ribs extending from a second spine; a) bending the first section of the tubular body, wherein the first section of the tubular body has a first wire therein; b) heating the first section of the bent tubular body; Make The first cord and the tubular body generate a memory of the first bend; c) bending the second section of the tubular body, the second section of the tubular body having a second cord and corresponding portions of the first cord therein; d) heating the second section of the bent tubular body; Make The second cord, the second section of the tubular body, and the corresponding portion of the first cord remember a second bend; wherein The offset angle between the first curved plane and the second curved plane is less than 180 degrees.

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