Elongated member with coupler to provide radial transition of translating member

Abstract

An apparatus includes a proximal elongate portion, a distal elongate portion, a coupler, a proximal tendon assembly, and a distal tendon assembly. The proximal elongated portion and the distal elongated portion share a central longitudinal axis. A coupler is longitudinally interposed between the proximal elongated portion and the distal elongated portion. The coupler includes a first channel. A proximal tendon assembly extends through the proximal elongate portion. The proximal tendon assembly includes a proximal portion of a tendon positioned at a first radial distance from the central longitudinal axis. A distal tendon assembly extends through the distal elongate portion. The distal tendon assembly includes a distal portion of the tendon positioned at a second radial distance from the central longitudinal axis. A channel for the tendon to pass through the coupler that accommodates repositioning of the tendon from a first radial distance to a second radial distance.

Description

[0001] Priority

[0002] This patent application claims the benefit of U.S. Patent Application No. 18 / 536,619, filed on December 12, 2023, entitled "Elongate Member with Coupler to Provide Radial Transition of Translating Member", which claims the priority of U.S. Patent Application No. 63 / 436,193, filed on December 30, 2022, entitled "Elongate Member with Coupler to Provide Radial Transition of Translating Member", the disclosure of which is incorporated herein by reference. BACKGROUND OF THE INVENTION

[0003] A variety of surgical instruments include an end effector for use in medical treatments and procedures by a medical professional operator, including applications in robotic-assisted surgery. In the case of robotic-assisted surgery, a surgeon can operate a master controller to remotely control the movement of such surgical instruments at the surgical site. The controller can be located at a significant distance from the patient (e.g., across an operating room, in a different room, or in a completely different building from the patient); or very close to the patient in the operating room. The controller can include one or more hand input devices (such as joysticks, exoskeleton gloves, master manipulators) that are coupled to the surgical instrument by servo mechanisms. In one example, servo motors move a manipulator that supports the surgical instrument based on the surgeon's manipulation of the hand input device. During surgery, a surgeon can employ various surgical instruments via a robotic surgical system, including ultrasonic scalpels, surgical staplers, tissue graspers, needle drivers, electrosurgical cautery probes, and the like. Each of these constructs performs a function for the surgeon, such as cutting tissue, coagulating tissue, manipulating a needle, grasping a blood vessel, dissecting tissue, or cauterizing tissue. Robotic-controlled instruments can be introduced into a patient through an incision, through a naturally occurring orifice, or otherwise.

[0004] Although several robotic surgical systems and associated components have been made and used, it is believed that no one prior to the present inventors has made or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0005] Although this specification concludes with claims that particularly point out and distinctly claim this technology, it is believed that the technology will be better understood from the following examples described in conjunction with the accompanying drawings, in which like reference numerals indicate the same elements, and in which:

[0006] Figure 1 A top plan view showing an example of a robotic surgical system used in urological surgery.

[0007] Figure 2 Shows Figure 1 A schematic diagram of different components of the robotic surgical system.

[0008] Figure 3 Shows Figure 1 An enlarged view of other components of the robotic surgical system, including the distal portion of the ureteroscope.

[0009] Figure 4 Shows an example of an elongate member for articulation that can be used with Figure 1 the robotic surgical system. A schematic diagram.

[0010] Figure 5 Shows a cross-sectional end view of the Figure 4 elongate member taken along line 5-5 of Figure 4 the elongate member.

[0011] Figure 6 Shows a cross-sectional end view of the Figure 4 elongate member taken along line 6-6 of Figure 4 the elongate member.

[0012] Figure 7 Shows Figure 4 A perspective view of the connector of the elongate member.

[0013] Figure 8 Shows Figure 7 Another perspective view of the connector.

[0014] Figure 9 Shows Figure 4 A side view of a portion of the elongate member, showing the transition of the tendon assembly along Figure 7 the connector.

[0015] Figure 10 Shows a cross-sectional side view of the Figure 4 elongate member taken along line 10-10 of Figure 4 the elongate member.

[0016] The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be implemented in many other ways, including those not necessarily shown in the drawings. The drawings incorporated in and forming a part of this specification illustrate several aspects of the technology and, together with the description, serve to explain the principles of the technology; however, it should be understood that the technology is not limited to the precise arrangements shown. Detailed Description

[0017] The description of certain examples of the present technology should not be used to limit the scope of the present technology. From the following description, other examples, features, aspects, embodiments, and advantages of the present technology will become apparent to those skilled in the art. The following description is given by way of example, which is one of the best ways contemplated for implementing the present technology. As will be appreciated, the technology described herein can have other different and distinct aspects, all of which do not depart from the present technology. Accordingly, the drawings and description are to be regarded as illustrative in nature rather than restrictive.

[0018] It should also be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein can be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Accordingly, the following teachings, expressions, embodiments, examples, etc. should not be regarded as mutually isolated. Various suitable ways in which the teachings herein can be combined will be apparent to those of ordinary skill in the art in light of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0019] For clarity of the disclosure, the terms "proximal" and "distal" are defined herein relative to the human or robotic operator of the surgical instrument. The term "proximal" refers to an element position that is closer to the human or robotic operator of the surgical instrument and farther from the surgical end effector of the surgical instrument. The term "distal" refers to an element position that is closer to the surgical end effector of the surgical instrument and farther from the human or robotic operator of the surgical instrument. It should also be understood that, for convenience and clarity, spatial terms such as "side", "upward", and "downward" are also used herein with reference to relative position and orientation. For clarity, such terms are used below with reference to views and are not intended to limit the invention described herein.

[0020] Aspects of the present example described herein can be integrated into a robot-enabled medical system that includes a robotic surgical system capable of performing a variety of medical procedures, including both minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopy. In an endoscopy procedure, the robot-enabled medical system is capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.

[0021] In addition to performing a wide range of procedures, robot-enabled medical systems can provide additional beneficial effects, such as enhanced imaging and guidance to assist medical professionals. Additionally, robot-enabled medical systems can provide medical professionals with the ability to perform procedures from an ergonomic position without the need for awkward arm movements and positioning. Additionally, robot-enabled medical systems can provide medical professionals with the ability to perform procedures with improved ease of use such that one or more of the instruments in the robot-enabled medical system can be controlled by a single operator.

[0022] I. Example of a Robot-Enabled Medical System

[0023] Figure 1 An example medical system (100) for performing various medical procedures in accordance with aspects of the present disclosure is shown. The medical system (100) can be used, for example, in endoscopic (e.g., ureteroscopic) procedures. Certain ureteroscopic procedures involve the treatment / removal of kidney stones. Although Figure 1 the system (100) is presented in the context of ureteroscopic procedures, it should be understood that the principles disclosed herein can be implemented in any type of endoscopic (e.g., bronchoscopic, gastrointestinal, etc.) and / or percutaneous procedures.

[0024] The medical system (100) of the present disclosure includes a robotic system (10) (e.g., a mobile robotic cart) that is configured to engage and / or control one or more medical devices (e.g., a ureteroscope (40), a basket system (30), etc.) via one or more robotic arms (12) to perform a direct access procedure on a patient (7). In some configurations, the robotic system (10) and / or control system (50) is configured to receive and / or display images and / or image data representing the internal anatomy of the patient (7) (i.e., the urinary system with a specific depiction of Figure 1 from the endoscope (40).

[0025] It should be understood that the direct access instruments operated by the systems (10, 50) can include any type of medical device or combination of devices, including endoscopes (such as ureteroscopes (40)), catheters (such as steerable or non-steerable catheters), nephroscopes, laparoscopes, basket systems (30), and / or other types of medical devices. The various endoscope-type instruments disclosed herein (such as the endoscope (40) of system (100)) can be configured to navigate within the human anatomy, such as within the natural orifices or lumens of the human anatomy. The terms "endoscope" and "endoscopy" are used herein in their broad and ordinary sense; and can refer to any type of elongated medical device having image generation, viewing, and / or capture capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space of the body. Endoscopes can include (for example) ureteroscopes (for example, for accessing the urinary tract), laparoscopes, nephroscopes (for example, for accessing the kidney), bronchoscopes (for example, for accessing the airway, such as the bronchi), colonoscopes (for example, for accessing the colon), arthroscopes (for example, for accessing joints), cystoscopes (for example, for accessing the bladder), colonoscopes (for example, for accessing the colon and / or rectum), pipelining scopes, etc. In some cases, the endoscope / endoscopy can include a rigid or flexible tube and can be sized to pass within an outer sheath, catheter, introducer, or other lumen-type device, or can be used without such a device.

[0026] The medical system (100) of this example also includes a control system (50), a table (15), and an electromagnetic (EM) field generator (18). The table (15) is configured to hold the patient (7). The EM field generator (18) can be held by one or more of the robotic arms (12) of the robotic system (10) or can be an independent device. As Figures 1 to 2 shown, the control system (50) of this example includes various input / output (I / O) components (258) that are configured to assist a physician (5) or other person in performing a medical procedure. For example, the I / O components (258) can be configured to allow a user to input for controlling / navigating the endoscope (40) and / or the basket system (30) within the patient (7). The I / O components (258) of this example include a controller (55) that is configured to receive user input from an operator; and a display (56) that is configured to present certain information to assist the operator. The controller (55) can take any suitable form, including but not limited to one or more buttons, keys, joysticks, hand-held controllers (such as video game-type controllers), computer mice, touchpads, trackballs, control panels, and / or sensors that capture gestures and finger gestures (such as motion sensors or cameras), touchscreens, etc.

[0027] Also as Figure 2As shown, the control system (50) of the present example includes a communication interface (254) that is operable to provide a communication interface between the control system (50) and the robotic system (10), the basket loading system (30), the endoscope (40), and / or other components. Communication via the communication interface (254) may include data, commands, power, and / or other forms of communication. The communication interface (254) may also be configured to be capable of providing communication via wired, wireless, and / or other modalities. The control system (50) further includes a power interface (259) that can receive power via wires, batteries, and / or any other suitable type of power source to drive the control system (50). The control circuit (251) of the control system (50) can provide signal processing and execute control algorithms to implement the functions of the medical system (100) as described herein.

[0028] The control system (50) may also communicate with the robotic system (10) to receive position data therefrom related to the position of the distal end of the endoscope (40), the entry sheath (90), or the basket device (30). Such position data related to the position of the endoscope (40), the entry sheath (90), or the basket device (30) may be derived using one or more electromagnetic sensors associated with the respective components. Additionally, in some configurations, the control system (50) may communicate with the table (15) to position the table (15) in a particular orientation or otherwise control the table (15). The control system (50) may also communicate with the EM field generator (18) to control the generation of the EM field in the area around the patient (7).

[0029] As described above and as Figures 1 to 2 shown, the robotic system (10) includes a robotic arm (12) that is configured to engage and / or control the endoscope (40) and / or the basket loading system (30) to perform one or more aspects of a procedure. It should be understood that the robotic arm (12) may be coupled to an instrument different from the Figure 1 instrument shown; and in some cases, one or more of the robotic arms (12) may not be utilized or coupled to a medical device. Each robotic arm (12) includes a plurality of arm segments (23) coupled to joints (24) that can provide a plurality of degrees of mobility / freedom. In Figure 1In the example, the robotic system (10) is positioned close to the patient's leg, and the robotic arm (12) is actuated to engage and position the endoscope (40) for entry into an access opening such as the urethra (65) of the patient (7). When the robotic system (10) is properly positioned, the endoscope (40) can be inserted into the patient (7) using the robotic arm (12) by the robot, manually by the physician (5), or a combination thereof. An endoscope drive instrument coupler (11) (e.g., an instrument device manipulator (IDM)) can be attached to the distal portion of one of the arms (12b) to facilitate robotic control / advancement of the endoscope (40). The other of the arms (12c) can include an instrument coupler / manipulator (19) configured to facilitate advancement and operation of the basket device (30). The endoscope (40) can include one or more working channels through which additional tools such as a lithotripter, a basket device, forceps, etc. can be introduced into the treatment site.

[0030] The robotic system (10) can be coupled to any component of the medical system (100), such as the control system (50), the table (15), the EM field generator (18), the endoscope (40), the basket system (30), and / or various types of percutaneous access instruments (e.g., needles, catheters, nephroscopes, etc.). As described above, the robotic system (10) can be communicatively coupled to the control system (50) via the communication interfaces (214, 254). The robotic system (10) also includes a power interface (219) that can receive power via wires, batteries, and / or any other suitable type of power source to drive the robotic system (10). Additionally, the robotic system (10) of this example includes various input / output (I / O) components (218) configured to assist the physician (5) or others in performing a medical procedure. Such I / O components (218) can include any of the various I / O components (258) described herein in the context of the control system (50). In addition to or alternatively, the I / O components (218) of the robotic system (10) can take any suitable form (or can be omitted altogether).

[0031] The robotic system (10) of this example generally includes a column (14), a base (25), and a console (13) located at the top of the column (14). The column (14) can include means for supporting one or more robotic arms (12) (at Figure 2One or more arm supports (17) (also referred to as "brackets") for the deployment shown in the figure are presented. The arm support (17) may include separately configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arm (12) for desired positioning relative to the patient. In some configurations, the arm support (17) may be connected to the column (14) through slots (20) positioned on opposite sides of the column (14) to guide the vertical translation of the arm support (17) along the column (14). The robotic arm (12) of this example generally may include a robotic arm base (21) and an end effector (22) separated by a series of linked arm segments (23), the series of linked arm segments being connected by a series of joints (24), each joint including one or more independent actuators (217). Each actuator (217) may include an independently controllable motor. The I / O component (218) may be positioned at the upper end of the column (14). The console (13) may also include a handle (27) for assisting in maneuvering and stabilizing the robotic system (10).

[0032] The end effector (213) of each robotic arm in the robotic arm (12) may include an Instrument Device Manipulator (IDM) that may be attached using a Mechanism Converter Interface (MCI). In some configurations, the IDM (213) may be removed and replaced with a different type of IDM (213). For example, an IDM (213) of a first type (11) may manipulate an endoscope (40), while an IDM (213) of a second type (19) may manipulate a basket system (30). Another type of IDM (213) may be configured to hold an electromagnetic field generator (18). The MCI may provide a power and control interface (e.g., a connector for transmitting pneumatic pressure, electrical power, electrical signals, and / or optical signals from the robotic arm (12) to the IDM (213)). The IDM (213) may be configured to manipulate medical devices such as an endoscope (40) (e.g., surgical tools / instruments) using techniques including, for example, direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, etc.

[0033] The system (100) may include specific control circuitry configured to perform the specific functions described herein, including the control circuitry (211) of the robotic system (10) and / or the control circuitry (251) of the control system (50). That is, the control circuitry of the system (100) may be the robotic system (10), the control system (50), or some combination thereof. The term "control circuitry" is used herein in its broad and ordinary sense and may refer to any collection of the following: processors, processing circuitry, processing modules / units, chips, dies (e.g., semiconductor dies including one or more active and / or passive devices and / or connectivity circuitry), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuitry, analog circuitry, digital circuitry, and / or any device that manipulates signals based on circuitry and / or hard-coding of operating instructions. The control circuitry referred to herein may also include one or more circuit substrates (e.g., printed circuit boards), conductive traces and vias and / or mounting pads, connectors, and / or components. The control circuitry referred to herein may also include one or more storage devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuitry of a device. Such data storage devices may include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, caches, data storage registers, and / or any device that stores digital information. It should be noted that in instances where the control circuitry includes hardware and / or software state machines, analog circuits, digital circuits, and / or logic circuits, the data storage device / register storing any associated operating instructions may be embedded within or external to the circuit including the state machine, analog circuit, digital circuit, and / or logic circuit.

[0034] The control circuitry (211, 251) may include a computer-readable medium that stores and / or is configured to store hard-coded instructions and / or operating instructions that correspond to at least some of the steps and / or functions illustrated in one or more of the figures herein and / or described herein. In some cases, such computer-readable media may be included in an article of manufacture. The control circuitry (211, 251) may be maintained / set up entirely locally or may be located at least partially remotely (e.g., communicatively coupled indirectly via a local area network and / or a wide area network).

[0035] In some forms, for example, a physician (5) may provide input to a control system (50) and / or a robotic system (10); and in response to this input, control signals may be sent to the robotic system (10) to manipulate an endoscope (40) and / or a catheter basket system (30). The control system (50) may include one or more display devices (56) to provide various information about the procedure. For example, the display (56) may provide information about the endoscope (40) and / or the basket system (30). The control system (50) may receive real-time images captured by the endoscope (40) and display these real-time images via the display (56).

[0036] As Figure 2 shown, the basket device (30) of this example includes a basket (35) formed by one or more wire tines (36) that are disposed within a basket sheath (37) along the length of the basket sheath, where the tines project from the distal end of the sheath (37) to form the basket (35). The tines (36) further extend from the proximal end of the sheath (37) and are slidable within the basket sheath (37). The tines (36) and the sheath (37) may be coupled to respective actuators (75) of a basket cartridge member (32). The basket cartridge (32) may be physically and / or communicatively coupled to a handle portion / component (31) of the basket system (30). The handle component (31) may be configured to assist with basket control manually or via robotic control. The basket system (30) may be powered via a power interface (39) and / or controlled via a control interface (38), and each or both of the power interface and the control interface may interface with a robotic arm / component of the robotic system (10). The basket system (30) may further include one or more sensors (72), such as pressure sensors and / or other force reading sensors, which may be configured to generate signals indicative of forces experienced by / at one or more actuators (75) and / or other couplings of the basket system (30).

[0037] In an exemplary use case, if a patient (7) has a kidney stone (80) located in the kidney (70), a physician may perform a procedure to remove the stone (80) through the urinary tract (65, 60, 63). Specifically, and as Figure 1As shown, a physician may operate a medical system (100) to effect direct entry of an endoscope (40) through the urethra (65) into the urinary tract (65, 60, 63) of a patient (7). The physician (5) may interact with a control system (50) and / or a robotic system (10) to cause / control the robotic system (10) to pass the endoscope (40) from the urethra (65), through the bladder (60), and up the ureter (63) and navigate into the renal pelvis (71) and / or the calyx network of the kidney (70) where a stone (80) is located. The physician (5) may also interact with the control system (50) and / or the robotic system (10) to cause the advancement of a basket device (30) through the working channel of the endoscope (40), where the basket device (30) is configured to facilitate the capture and removal of kidney stones. The control system (50) may provide information associated with the medical device (40) and / or other devices of the system (100), such as real-time endoscopic images captured by the medical device, via a display (56) to assist the physician (5) in navigating / controlling such instrumentation.

[0038] In this example, a ureteral access sheath (90) is positioned within the urinary tract (65, 60, 63) in a region near the kidney (70). The endoscope (40) may pass through the ureteral access sheath (90) to enter the internal anatomy of the kidney (70), as shown. Once at the site of the kidney stone (80) (e.g., within a target calyx (73) of the kidney (70) through which the stone (80) is accessible), the endoscope (40) may be used to deliver / guide the basket device (30) to the target location. Once the stone (80) has been captured within the distal basket portion (35) of the basket device (s), the kidney stone (80) may be extracted from the patient (7) using the ureteral access path utilized.

[0039] Figure 3 An example of an endoscope (440) is shown that may be used as the endoscope (40) described above. The example endoscope (440) includes a working channel (444) for deploying medical devices (e.g., a lithotripter, a basket system (30), forceps, etc.) to a surgical area at the distal end of the endoscope (440) and for flushing and / or aspirating that area. The endoscope (440) may be articulable, such as with respect to at least the distal portion of the endoscope (440), such that the endoscope (440) may be steered within the human anatomy. In some forms, the endoscope (440) is configured to be articulable in, for example, five degrees of freedom, including XYZ coordinate movement, as well as pitch and yaw. In some forms, the endoscope (440) provides six degrees of freedom, including X, Y, and Z coordinate positions, as well as pitch, roll, and yaw. The position sensor of the endoscope (440) may similarly have a similar degree of freedom with respect to the position information generated / provided by the position sensor. As Figure 3As shown, the distal end (442) of the endoscope (440) can be oriented at zero deflection relative to its longitudinal axis (406) (also referred to as the "roll axis").

[0040] In this example, the endoscope (440) can accommodate electrical wires and / or optical fibers to transmit signals to / from the optical components and the distal end (442) of the endoscope (440), and the distal end can include an imaging device (448), such as an optical camera. The imaging device (448) can be used to capture images of the internal anatomical space, such as the target calyces / papillae of the kidney (70). The endoscope (440) can also be configured to accommodate optical fibers to carry light from a proximal light source (such as a light-emitting diode) to the distal end (442) of the endoscope (440). The distal end (442) of the endoscope (440) can include a port for the light source to illuminate the anatomical space when using the imaging device (448). The imaging device (448) can include optical fibers, an optical fiber array, and / or lenses; or light-emitting diodes located at the distal end (442). The optical components of the imaging device (448) move with the distal end (442) of the endoscope (440), such that movement of the distal end (442) of the endoscope (440) causes a change in the image captured by the imaging device (448).

[0041] To capture images along different orientations of the distal end (442), the robotic system (10) can be configured to deflect the distal end (442) along the positive yaw axis (402), negative yaw axis (403), positive pitch axis (404), negative pitch axis (405), or roll axis (406). The distal end (442) or the body (445) of the endoscope (442) can be extended or translated along the longitudinal axis (406), x-axis (408), or y-axis (409). The endoscope (440) can include a reference structure (not shown) to calibrate the position of the endoscope (440). For example, the robotic system (10) and / or the control system (50) can measure the deflection of the endoscope (440) relative to the reference structure. The reference structure can be located, for example, on the proximal end of the endoscope (440) and can include keys, slots, or flanges.

[0042] The robotic arm (12) of the robotic system (10) can be configured to / is capable of being configured to manipulate the endoscope (440) as described above. Such manipulation can be performed by actuating one or more elongate members, such as one or more wire ropes (e.g., wire ropes or push wires), cables, fibers, and / or flexible shafts. For example, the robotic arm (12) can be configured to actuate a plurality of wire ropes (not shown) coupled to the endoscope (440) to deflect the distal end (442) of the endoscope (440). The wire ropes can include any suitable or desired material, such as metallic and non-metallic materials, such as stainless steel, aramid fibers, tungsten, carbon fibers, etc. In some configurations, the endoscope (440) is configured to exhibit non-linear behavior in response to forces applied by the elongate moving members. The non-linear behavior can be based on the stiffness and compressibility of the endoscope (440), as well as the variability of the slack or stiffness between different elongate moving members.

[0043] In some configurations, the endoscope (440) includes at least one sensor that is configured to generate sensor position data and / or send the sensor position data to another device. The sensor position data can indicate the position and / or orientation of the endoscope (440) (e.g., its distal end (442)), and / or can be used to determine / infer the position / orientation of the endoscope (440). For example, the sensor (sometimes referred to as a "position sensor") can include other forms of electromagnetic (EM) sensors having coils or antennas of conductive material. In some configurations, the position sensor is located on the distal end (442) of the endoscope (440), while in other embodiments, the sensor is located at another position on the endoscope (440).

[0044] As Figure 3 shown, the EM field generator (18) is configured to broadcast an alternating EM field 90 that is detected by the EM position sensor of the endoscope (440). The alternating magnetic field (MF) induces a small current in the coil of the EM position sensor, and the small current can be analyzed to determine the distance and / or angle / orientation between the EM position sensor and the EM field generator (18). It should be understood that the endoscope (440) can include other types of sensors, such as shape-sensing optical fibers, accelerometers, gyroscopes, satellite-based positioning sensors (e.g., global positioning system (GPS) sensors), radio frequency transceivers, etc. In this example, the EM position sensor of the endoscope (440) provides sensor data to the control system (50), which then uses the sensor data to determine the position and / or orientation of the endoscope (440).

[0045] In some variations, any of the features and aspects described above may be constructed and operated in accordance with at least some of the teachings of the following patents: U.S. Patent No. 11,737,663, entitled "Target Anatomical Feature Localization," published on August 29, 2023, the disclosure of which is incorporated herein by reference in its entirety; U.S. Publication No. 2021 / 0369384, entitled "Stuck Instrument Management," published on December 2, 2021, the disclosure of which is incorporated herein by reference in its entirety; U.S. Publication No. 2021 / 0401527, entitled "Robotic Medical Systems Including User Interfaces with Graphical Representations of User Input Devices," published on December 30, 2021, the disclosure of which is incorporated herein by reference in its entirety; and / or U.S. Publication No. 2022 / 0096183, entitled "Haptic Feedback for Aligning Robotic Arms," published on March 31, 2022, the disclosure of which is incorporated herein by reference in its entirety.

[0046] II. Example of a Coupler Providing a Radial Transition of a Tendon Assembly

[0047] As described above, the robotic system (10) may include one or more articulating elongate instruments, such as a scope (40), an access sheath (90), a scope (440), a catheter, and / or other types of elongate instruments. Some such articulating elongate instruments may include one or more translation features that drive the articulation. The inclusion of such translation articulation drive features may often be associated with certain design constraints or requirements. For example, it may be desirable to provide a degree of force isolation relative to the translation articulation drive features along certain longitudinal regions of the elongate instrument (e.g., the proximal region) such that actuation of the drive features causes articulation only in another specific longitudinal region of the elongate instrument (e.g., the distal region). It may also be desirable to minimize friction relative to the translation articulation drive features. This friction reduction can be particularly challenging where the translation articulation drive features must traverse multiple elements that move relative to each other (e.g., an array of beads or vertebrae along an articulation joint).

[0048] In an articulating elongate instrument that includes one or more internal working channels for receiving other instruments and has a maximum cross-sectional area constraint, a translational articulation drive feature can ensure a compromise between achieving a suitably sized internal working channel and a suitably sized overall outer diameter. In an elongate instrument having additional features (e.g., one or more cameras and / or illumination features of an endoscope (40), etc.) in a distal portion of the instrument, it may be desirable for the translational articulation drive feature to be positioned to accommodate structures associated with such additional distal features; however, it is not necessary for the translational articulation drive feature to be positioned to accommodate those additional distal features along the proximal portion of the elongate instrument.

[0049] It may also be desirable for the elongate instrument to have a proximal portion that has an architecture that is substantially different from the architecture of the distal portion of the elongate instrument; or even a series of three or more longitudinally staggered portions, each having its own unique architecture. Such different architectures can include those that provide different degrees of flexibility, different kinds of articulation (e.g., single-plane articulation versus bi-plane articulation), a dichotomy between articulation and non-articulation, or other kinds of different architectures. Some such elongate instruments can be ensured to have a translational articulation drive feature that traverses the entire length of the elongate instrument such that the translational articulation drive feature must pass through these longitudinally varying architectures. This can complicate the potential design challenges mentioned above in the context of the translational articulation drive feature.

[0050] Examples of articulating elongate members having a translational articulation drive feature are described below that can easily traverse longitudinally varying architectures along the length of the elongate member with minimal friction and at the same time easily accommodate other structural features in the distal portion of the elongate member without adversely affecting the outer diameter of the elongate member. Specifically, Figure 4An example of an elongate member (500) for articulation that can be used with a robotic surgical system (10) is shown. By way of example only, the elongate member (500) can represent an endoscope (40), an access sheath (90), or a variant of an endoscope (440). Alternatively, the elongate member (500) can be in the form of a catheter and / or any other suitable kind of elongate instrument. The elongate member (500) of the present example includes a proximal portion (510), a distal portion (512), and a coupler (600) that joins the portions (510, 512) together. In the present example, the distal portion (512) is operable to articulate such that a distal end (504) of the elongate member (500) can be deflected laterally away from and toward a central longitudinal axis (LA) (e.g., defined by the proximal portion (510)). Also in the present example, the proximal portion (510) is flexible but not configured to be capable of articulation. In some variants, the elongate member (500) is operable to articulate at one or more different regions along the length of the elongate member (500). For example, the distal portion (512) can include one or more articulation segments, and / or the proximal portion (510) can include one or more articulation segments.

[0051] The proximal portion (510) is coupled to an instrument coupler (11) of the robotic surgical system (10) such that the robotic surgical system (10) is operable to drive the elongate member (500) via the instrument coupler (11). By way of example only, the robotic surgical system (10) is operable to drive the elongate member (500) in translation along the central longitudinal axis (LA), rotation (e.g., rotation about the central longitudinal axis (LA)), articulation, and / or other forms of movement.

[0052] The distal end (504) of the present example can include one or more openings through which one or more additional instruments can access the surgical space or other anatomical regions within a patient's body. The distal end (504) can also include one or more imaging devices, such as the imaging device (448), which can be in the form of one or more cameras, one or more optical fibers with corresponding lenses, etc. The distal end (504) can also include one or more illumination elements, such as one or more integrated light emitting diodes, one or more lenses optically coupled to corresponding optical fibers, etc. In some forms, the distal end (504) includes an end effector that is operable to perform one or more operations on tissue, such as grasping, cutting, suturing, sealing (e.g., via RF energy or ultrasonic energy), anastomosis, etc.

[0053] As Figure 5As shown, the proximal portion (510) includes an outer shaft (502) and an inner shaft (522). The shafts (502, 522) may have any suitable configuration. By way of example only, any one of the shafts (502, 522) may include a flexible laser-cut steel hypotube, a braided structure, or any other suitable type of structure. In some versions, the outer shaft (502) provides primary structural support, while the inner shaft (522) serves as a cushion (e.g., a low-friction coating such as polytetrafluoroethylene, etc.). In some other versions, the inner shaft (522) provides primary structural support, while the outer shaft (502) serves as a cushion (e.g., a low-friction coating such as polytetrafluoroethylene, etc.). As yet another variation, either shaft (502, 522) may include a reflow material, such as polyether block amide (PEBA) and / or any other suitable type of material. Some other versions may provide only a single shaft (502, 522), such that the other shaft (502, 522) is omitted.

[0054] The inner shaft (522) defines an inner lumen (520). The inner lumen (520) is configured to receive other components. By way of example only, the inner lumen may receive coils, Bowden tubes, wires, etc. In this example, the inner lumen receives the working channel (506), which may include a braided shaft and / or any other suitable component. The working channel (506) defines a lumen (508). In some versions, the lumen (508) can slidably receive other instruments. By way of example only, the basket (35) and the basket sheath (37) of the basket device (30) can be advanced distally through the lumen (508) of the working channel (506) in the inner lumen (520). By way of another example, a laser fiber or other instrument can be disposed in the lumen (508) of the working channel (506). Alternatively, a fluid (e.g., a liquid, an aspirate, etc.) can be delivered through the lumen (508) of the working channel (506). The lumen (520) and working channel (506) may extend all the way to the distal end (504), where the lumen (520) may terminate in a distal opening to allow instruments disposed in the working channel (506) to exit distally from the elongated member (500). Although not shown, other features such as electrical wiring, optical fibers, flexible circuits, etc. may extend along at least a portion of the length of the lumen (520) outside of the working channel (506).

[0055] Likewise Figure 5As shown, in the present example, the proximal tendon assembly (530) extends through the lumen (520) outside the working channel (506). In some forms, the proximal tendon assembly (530) is freely disposed within the inner lumen (520). In some other forms, one or more features or techniques are used to maintain the positioning of the proximal tendon assembly (530) along the inner surface of the inner shaft (522) such that the proximal tendon assembly (530) is firmly fixed within the inner lumen (520). In the present example, the elongate member (500) includes four proximal tendon assemblies (530), which are angularly spaced from each other at equal intervals (i.e., at approximately 90 degrees). In some other forms, one to three proximal tendon assemblies (530) are provided; while in other forms, more than four proximal tendon assemblies (530) are provided. Each proximal tendon assembly (530) includes a housing (532) and a tendon (536) slidably disposed within a lumen (534) defined by the housing (532). The housing (532) is configured to deform laterally but not longitudinally compress. By way of example only, the housing (532) can be configured as a coil formed of round or square wire. As another example, the housing (532) can include a number of wires wound into a plurality of adjacent spirals. Alternatively, the housing (532) can take any other suitable form. In some variations, the housing (532) includes a low friction (e.g., polytetrafluoroethylene) lining within the lumen (534).

[0056] Each tendon (536) has a distal end that is firmly fixed at or near the distal end (504) of the elongate member (500) to provide articulation of the distal portion (512). In some other variations, one or more tendons (536) have distal ends that are firmly fixed at a location proximal to the distal portion (512). By way of example only, each tendon (536) can include a pull wire, a drive belt, a single-strand cable, a multi-strand cable, one or more metals, one or more fibers, and / or any other suitable component that is capable of operating to transmit a pulling force along the length of the elongate member (500) to provide articulation of the elongate member (500) with substantially no stretching. Such tendons (536) can also be coupled to the instrument coupler (11) of the robotic surgical system (10) such that the robotic surgical system (10) can be operated to drive the tendon (536) via the instrument coupler (11).

[0057] As Figure 6As shown, the distal portion (512) includes a body (514), a braid assembly (560) and an inner shaft (570). By way of example only, the inner shaft (570) may include a flexible laser-cut steel hypotube, a braided structure, a connecting rod assembly, or any other suitable type of structure. The inner shaft (570) provides a continuation of the inner cavity (520) defined by the inner shaft (522) and as described above. Therefore, the working channel (506) and / or other components (e.g., wires, etc.) provided in the inner cavity (520) in the proximal portion (510) can freely continue to pass through the inner cavity (520) in the distal portion (512). The braid assembly (560) includes a plurality of strands (562) that are wound to form an elongated braided structure extending along the length of the distal portion (512).

[0058] The distal portion (512) of this example also includes a distal tendon assembly (540). As will be described in more detail below, each distal tendon assembly (540) is associated with a corresponding proximal tendon assembly (530) by sharing a common tendon (536). Each distal tendon assembly (540) includes a housing (542) defining a lumen (544), wherein the corresponding tendon (536) is disposed in the lumen (544). By way of example only, the housing (542) can be configured as a tubular body embedded within the wall of the braid assembly (560) (e.g., braided between the inner and outer strands (562) of the braid assembly (560)). Alternatively, the housing (542) can take any other suitable form. In some variations, the housing (542) includes a low-friction (e.g., polytetrafluoroethylene, polyimide, etc.) lining within the lumen (544).

[0059] like Figure 6 As shown, the distal tendon components (540) are braided with the braid component (560) so that each distal tendon component (540) is disposed in a space (564) defined by the strands (562). In some other versions, each distal tendon component (540) is radially interposed between the braid component (560) and the inner shaft (570). In either case, each distal tendon component (540) can extend along a path parallel to the central longitudinal axis (LA) of the distal portion (512). It should also be understood that positioning the distal tendon component (540) within the braid component (560) or otherwise radially outside the inner shaft (570) can maximize the amount of available space within the portion of the lumen (520) extending through the distal portion (512). This may allow the portion of the lumen (520) extending through the distal portion (512) to more easily accommodate components associated with the functionality provided at the distal end (504) (e.g., components of one or more cameras at the distal end (504), mechanical components of a mechanically actuated end effector at the distal end (504), etc.).

[0060] The body (514) of this example is formed around the exterior of the braided component (560). By way of example only, the body (514) can be formed around the exterior of the braided component (560) by a reflow process and / or by any other suitable process. The body (514) can include a reflow material such as polyether block amide (PEBA) and / or any other suitable type of material. At least some of the material for forming the region of the body (514) exterior to the braided component (560) can also reach the region between the braided component (560) and the inner shaft (570), as Figure 6 shown. In cases where the distal tendon assembly (540) would otherwise tend to exert an outwardly directed force on the body (514) (e.g., during bending of the elongate member (500), particularly during driving of joint movement), the braided component (560) can effectively absorb such forces, thereby protecting the body (514) from any damage that the distal tendon assembly (540) might cause to the body (514). In cases where the distal tendon assembly (540) is braided between the inner and outer strands (562) of the braided component (560), the braided component (560) can also maintain the angular position of the distal tendon assembly (540) about the central longitudinal axis (LA).

[0061] The coupler (600) is longitudinally interposed between the proximal portion (510) and the distal portion (512). As Figures 7 to 8 shown, the coupler (600) includes a hollow body (602) that defines a plurality of longitudinally extending channels (610), an array of distal recesses (630), and an array of proximal recesses (620). The hollow configuration of the body (602) allows working channels to be continuously passed from the proximal portion (510) to the distal portion (512) via the coupler (600). The body (602) is formed as a single integral piece from a rigid material (e.g., molded plastic, etc.). In some other configurations, the hollow body (602) is formed as an assembly of components (e.g., stacked disks, etc.).

[0062] The channels (610) are angularly spaced equidistantly from each other (i.e., at approximately 90 degrees) and extend along the entire length of the body (602). Each channel (610) includes a distal portion (614) and a proximal portion (616). Each proximal portion (616) opens through the inner surface (604) of the body (602); while each distal portion (614) does not open through the inner surface (604) of the body (602). A proximally facing shoulder surface (618) is positioned at the transition from the proximal portion (616) to the distal portion (614).

[0063] As Figures 9 to 10As shown (with the working channel (506) omitted for clarity), the coupler (600) is configured to be adjacent to the distal end of the proximal portion (510) and the proximal end of the distal portion (512). Since the body (602) is rigid, the coupler (600) prevents longitudinal movement of the proximal end of the distal portion (512) relative to the distal end of the proximal portion (510). In other words, the coupler (600) provides mechanical grounding between the distal end of the proximal portion (510) and the proximal end of the distal portion (512). Similarly as Figures 9 to 10 shown, the proximal portion (616) of each channel (610) is configured to receive the corresponding housing (532) of each proximal tendon assembly (530); and the distal portion (614) of each channel (610) is configured to receive the corresponding tendon (536). When the housing (532) is assembled in the proximal portion (616) of the channel (610), the distal end (538) of the housing (532) abuts the proximally facing shoulder surface (618). This engagement between the distal end (538) of the housing (532) and the proximally facing shoulder surface (618) provides mechanical grounding between the housing (532), the coupler (600), the distal end of the proximal portion (510) and the proximal end of the distal portion (512).

[0064] As Figure 5 shown, each tendon (536) is positioned along the proximal portion (510) at a first radial distance (R1) from the central longitudinal axis (LA). As Figure 6 shown, each tendon (536) is positioned along the distal portion (512) at a second radial distance (R2) from the central longitudinal axis (LA). The second radial distance (R2) is greater than the first radial distance (R1). Thus, in order to effectively transition the tendon (536) from the proximal portion (510) to the distal portion (512), the channel (610) radially outwardly guides the tendon from the first radial distance (R1) to the second radial distance (R2). This is most clearly seen in Figure 10 . As described above, each proximal portion (616) of each channel (610) opens through the inner surface (604) of the body (602). This allows the distal region of each proximal tendon assembly (530) to bend away from the central longitudinal axis (LA) and pass through the proximal portion of the coupler (600), thereby allowing the distal end (538) of the housing (532) to engage the proximally facing shoulder surface (618); and allowing the tendon (536) to pass through the distal portion (614) of the channel (610).

[0065] Referring back to Figures 7 to 8, the connector (600) of this example includes three distal recesses (630) that are angularly spaced from each other. Similarly, the connector (600) of this example includes three proximal recesses (620) that are angularly spaced from each other. Any other suitable number of recesses (620, 630) may be provided, and the recesses (620, 630) may be provided in any other suitable arrangement. The distal recesses (630) are configured to be able to engage with complementary features (e.g., tabs) at the proximal end of the distal portion (512); and the proximal recesses (620) engage with complementary features (e.g., tabs) at the distal end of the proximal portion (510). In this example, the recesses (620, 630) and the complementary features of the portions (510, 512) are positioned asymmetrically about the central longitudinal axis (LA) such that two of the recesses (620, 630) are angularly spaced 180 degrees from each other in one corner region of the connector (600); and the recesses (620, 630) are angularly spaced 90 degrees from each other in the other corner regions of the connector (600). This relationship can provide a consistent predetermined angular positioning between the connector (600) and the distal portion (512) about the central longitudinal axis (LA). Similarly, the proximal recesses (520) are configured to engage with complementary features at the distal end of the proximal portion (510), thereby providing a consistent predetermined angular positioning between the connector (600) and the proximal portion (510) about the central longitudinal axis (LA). Thus, it should be understood that the connector (600) can be used as an anti-misalignment feature to ensure that the proximal portion (510) and the distal portion (512) are angularly properly aligned with each other about the central longitudinal axis (LA).

[0066] Although three recesses (620) are provided in this example, other variations may include only one recess (620) or more than two recesses (620). The number of complementary features (e.g., tabs, etc.) at the proximal end of the distal portion (512) may vary accordingly. Similarly, although three recesses (630) are provided in this example, other variations may include only one recess (630) or more than two recesses (630). The number of complementary features (e.g., tabs, etc.) at the distal end of the proximal portion (510) may vary accordingly.

[0067] As described above, the body (514) can be formed around the exterior of the braided component (560) through a reflow process using a reflow material such as polyether block amide (PEBA) and / or any other suitable type of material. It should also be understood that the entire length of the elongate member (500) can have an outer layer formed using a reflow material. Such an outer layer can continuously extend along both the portions (510, 512) and the connector (600), thereby providing a smooth and continuous outer surface along the length of the elongate member (500). In some such configurations, the same reflow material (and process) used to form the body (514) can be used to form such an outer layer that continuously extends along both the portions (510, 512) and the connector (600). Alternatively, any other suitable type of component (e.g., wrap, jacket, etc.), material, and process (e.g., heat shrinkage, etc.) can be used to form an outer layer that continuously extends along both the portions (510, 512) and the connector (600).

[0068] Although the above example only includes two portions (510, 512) joined by a single connector (600), other variations can include more than two portions joined by two or more connectors. For example, some variations can include an elongate member having a proximal portion joined to an intermediate portion via a first connector; and an elongate member having a distal portion joined to the intermediate portion via a second connector. In some such variations, the proximal portion can provide flexibility but not articulation; the intermediate portion can provide articulation along only one plane; and the distal portion can provide articulation along two orthogonal planes independent of the articulation of the intermediate portion. As another example of a variation, the proximal portion can provide flexibility but not articulation; the intermediate portion can provide articulation along two orthogonal planes; and the distal portion can provide articulation along two orthogonal planes independent of the articulation of the intermediate portion. Other suitable variations will be apparent to those skilled in the art in view of the teachings herein. In any of these alternative cases, a connector similar to the connector (600) can facilitate the tendon (536) and other longitudinally extending components to continuously traverse such different portions having different architectures and functions.

[0069] While the channels (610) of the connector (600) are parallel to the central longitudinal axis (LA) in this example, in other variations the channels (610) can be oriented differently. For example, in some variations, the channels (610) can have a helical orientation about the central longitudinal axis (LA). Such a helical orientation of the channels (610) can angularly reposition the tendon (536) or other longitudinally extending member from a first angular position about the central longitudinal axis (LA) to a second angular position about the central longitudinal axis (LA) as the tendon (536) or other longitudinally extending member transitions from the proximal portion (510) to the distal portion (512). As described above, some elongated members can include multiple connectors such that this angular repositioning can be provided multiple times along the length of the elongated member, where each connector provides repositioning of its own tendon (536) or other longitudinally extending member.

[0070] While the above example provides the tendon (536) within the lumens (534, 544) of the housings (532, 542), other variations can provide other kinds of components within the lumens (534, 544) of the housings (532, 542). Examples of such other components include but are not limited to wires, irrigation channels, optical fibers, and the like.

[0071] III. Combined Embodiments

[0072] The following embodiments relate to various non-exhaustive ways in which the teachings herein can be combined or applied. It should be understood that the following embodiments are not intended to limit the scope of any claims that may be provided at any time in this patent application or in subsequent filings of this patent application. No disclaimer is intended. The following embodiments are provided merely for illustrative purposes. It is contemplated that the various teachings herein can be arranged and applied in many other ways. It is also contemplated that some variations may omit certain features mentioned in the following embodiments. Accordingly, none of the aspects or features mentioned below should be considered decisive unless expressly so indicated by the inventor or successors in interest to the inventor at a later date. If any claims presented in this patent application or in subsequent filings related to this patent application include additional features beyond those mentioned below, such additional features should not be assumed to have been added for any reason related to patentability.

[0073] Embodiment 1

[0074] An apparatus, comprising: (a) a proximal elongated portion that is flexible; (b) a distal elongated portion that is flexible, the proximal elongated portion and the distal elongated portion sharing a central longitudinal axis; (c) a coupler longitudinally interposed between the proximal elongated portion and the distal elongated portion, the coupler including a first channel; (d) a first proximal tendon assembly extending through the proximal elongated portion, the first proximal tendon assembly including a proximal portion of a first tendon positioned at a first radial distance from the central longitudinal axis; and (e) a first distal tendon assembly extending through the distal elongated portion, the first distal tendon assembly including a distal portion of the first tendon positioned at a second radial distance from the central longitudinal axis; the first tendon passing through the first channel of the coupler; the first channel of the coupler accommodating repositioning of the first tendon from the first radial distance to the second radial distance as the first tendon passes through the first channel of the coupler.

[0075] Embodiment 2

[0076] The apparatus according to embodiment 1, wherein the coupler is configured to provide mechanical grounding between the distal end of the first elongated portion and the proximal end of the second elongated portion.

[0077] Embodiment 3

[0078] The apparatus according to embodiment 2, wherein the coupler abuts the distal end of the first elongated portion and the coupler also abuts the proximal end of the second elongated portion.

[0079] Embodiment 4

[0080] The apparatus according to any one of embodiments 1 to 3, wherein the first tendon assembly is operable to drive articulation of the distal elongated portion.

[0081] Embodiment 5

[0082] The apparatus according to any one of embodiments 1 to 4, wherein the first proximal tendon assembly includes a housing, and the proximal portion of the first tendon is slidably disposed within the housing of the first proximal tendon assembly.

[0083] Embodiment 6

[0084] The apparatus according to embodiment 5, wherein the housing has a distal end, and the distal end of the housing abuts a surface of the coupler.

[0085] Embodiment 7

[0086] The device according to any one of embodiments 5 to 6, wherein the housing includes a coiled tube.

[0087] Embodiment 8

[0088] The device according to any one of embodiments 1 to 7, wherein the proximal elongated portion defines a proximal portion of the lumen.

[0089] Embodiment 9

[0090] The device according to embodiment 8, wherein the first proximal tendon assembly is positioned within the lumen.

[0091] Embodiment 10

[0092] The device according to embodiment 9, wherein the first proximal tendon assembly is movable within the lumen.

[0093] Embodiment 11

[0094] The device according to any one of embodiments 8 to 10, wherein the distal elongated portion defines a distal portion of the lumen.

[0095] Embodiment 12

[0096] The device according to embodiment 11, wherein the lumen extends continuously from the proximal elongated portion to the distal elongated portion via the coupler.

[0097] Embodiment 13

[0098] The device according to any one of embodiments 11 to 12, wherein the first distal tendon assembly is positioned radially outward from the lumen.

[0099] Embodiment 14

[0100] The device according to embodiment 13, wherein the distal elongated portion includes an inner shaft that defines the distal portion of the lumen, and the first distal tendon assembly is positioned radially outward from the inner shaft.

[0101] Embodiment 15

[0102] The device according to embodiment 14, wherein the inner shaft includes a laser-cut Hypotube.

[0103] Embodiment

[0104] The device according to any one or more of embodiments 1 to 15, wherein the distal elongated portion includes a braided component.

[0105] ​

[0106] The device according to embodiment 16, wherein the first distal tendon assembly is interposed between the strands forming the braided component.

[0107] ​

[0108] The device according to any one or more of embodiments 1 to 17, wherein the first distal tendon assembly includes a housing, and the distal portion of the first tendon is slidably disposed in the housing of the first distal tendon assembly.

[0109] ​

[0110] The device according to any one of embodiments 1 to 18, wherein the coupler includes a second channel, and the device further includes: (a) a second proximal tendon assembly that extends through the proximal elongated portion, the second proximal tendon assembly including a proximal portion of a second tendon positioned at the first radial distance from the central longitudinal axis; and (b) a second distal tendon assembly that extends through the distal elongated portion, the second distal tendon assembly including a distal portion of the second tendon positioned at a second radial distance from the central longitudinal axis; the second tendon passes through the second channel of the coupler; when the second tendon passes through the second channel of the coupler, the second channel of the coupler accommodates repositioning of the second tendon from the first radial distance to the second radial distance.

[0111] ​

[0112] The device according to embodiment 19, wherein the first tendon is angularly offset from the second tendon by approximately 90 degrees about the central longitudinal axis.

[0113] ​

[0114] The device according to embodiment 19, wherein the first tendon is angularly offset from the second tendon by approximately 180 degrees about the central longitudinal axis.

[0115] ​

[0116] The device according to any one of embodiments 1 to 21, wherein the coupler includes a set of distal angle alignment features configured to mate with complementary features at the proximal end of the distal elongated portion to provide a predetermined angular alignment of the coupler relative to the distal elongated portion.

[0117] ​

[0118] The device according to any one of embodiments 1 to 22, wherein the coupler includes a set of proximal angle alignment features configured to mate with complementary features at the distal end of the proximal elongated portion to provide a predetermined angular alignment of the coupler relative to the proximal elongated portion.

[0119] ​

[0120] The device according to any one of embodiments 1 to 23, wherein the distal elongated portion includes one or more of the following: one or more cameras, one or more light sources, or one or more sensors.

[0121] ​

[0122] The device according to any one of embodiments 1 to 24, wherein the first channel extends along a path parallel to the central longitudinal axis.

[0123] ​

[0124] A device, comprising: (a) a proximal elongated portion that is flexible; (b) a distal elongated portion that is flexible, the proximal elongated portion and the distal elongated portion sharing a central longitudinal axis; (c) a coupler longitudinally interposed between the proximal elongated portion and the distal elongated portion, the coupler including a plurality of channels; (d) a plurality of proximal tendon assemblies extending through the proximal elongated portion, each proximal tendon assembly of the plurality of proximal tendon assemblies including a proximal portion of a respective tendon positioned at a first radial distance from the central longitudinal axis; and (e) a plurality of distal tendon assemblies extending through the distal elongated portion, each distal tendon assembly of the plurality of distal tendon assemblies including a distal portion of a respective tendon positioned at a second radial distance from the central longitudinal axis; each tendon passing through a respective one of the plurality of channels of the coupler; and each channel of the coupler accommodating repositioning of the respective tendon from the first radial distance to the second radial distance as the respective tendon passes through the first channel of the coupler.

[0125] ​

[0126] A method includes: (a) positioning a plurality of proximal tendon assemblies along a proximal elongate portion, the proximal tendon assemblies being positioned at a first radial distance from a central longitudinal axis defined by the proximal elongate portion; (b) positioning tendons of the plurality of proximal tendon assemblies along respective channels of a coupler that relocates the tendons from the first radial distance from the central longitudinal axis to a second radial distance from the central longitudinal axis; and (c) positioning the tendons along a distal elongate portion, the tendons being positioned at the second radial distance along the distal elongate portion, the coupler being longitudinally interposed between the proximal elongate portion and the distal elongate portion.

[0127] ​

[0128] The method according to embodiment 27, wherein the proximal tendon assemblies further include a plurality of housings, each tendon being slidably disposed in a respective one of the plurality of housings.

[0129] ​

[0130] The method according to embodiment 28, each housing having a distal end, the method further including: abutting the distal end of each housing against a corresponding surface of the coupler, thereby mechanically grounding the housing relative to the coupler.

[0131] ​

[0132] The method according to any one of embodiments 27 to 29, wherein the coupler includes a set of angular alignment features, the method further including: aligning the angular alignment features of the coupler with complementary features of the proximal elongate portion and the distal elongate portion, thereby providing a predetermined angular alignment between the coupler, the proximal elongate portion, and the distal elongate portion.

[0133] ​

[0134] It should be understood that any patent, patent publication, or other published material purported to be incorporated by reference herein, whether in its entirety or in part, is incorporated herein only to the extent that the incorporated material does not conflict with the existing definitions, statements, or other published material set forth in this disclosure. Thus, and to the extent necessary, the explicit disclosure set forth herein supersedes any conflicting material incorporated by reference herein. Any material or portion thereof purported to be incorporated by reference herein that conflicts with the existing definitions, statements, or other published material set forth herein will be incorporated only to the extent that the incorporated material does not create a conflict with the existing published material.

[0135] The forms described above can be designed to be discarded after single use, or they can be designed to be used multiple times. In either case or both cases, these forms can be repaired for reuse after at least one use. Repair can include any combination of the following steps: disassembling the system, instrument, and / or parts thereof, then cleaning or replacing specific parts and subsequently reassembling. Specifically, some forms of the system, instrument, and / or parts thereof can be disassembled, and any number of specific parts or components of the system, instrument, and / or parts thereof can be selectively replaced or removed in any combination. When cleaning and / or replacing specific components, some forms of the system, instrument, and / or parts thereof can be reassembled at a repair facility or by an operator immediately prior to surgery for subsequent use. Those skilled in the art will know that repair of the system, instrument, and / or parts thereof can be carried out for disassembly, cleaning / replacement, and reassembly using a variety of techniques. The use of such techniques and the resulting repaired system, instrument, and / or parts thereof are within the scope of this application.

[0136] By way of example only, the forms described herein can be sterilized before and / or after surgery. In one sterilization technique, the system, instrument, and / or parts thereof are placed in a closed and sealed container (such as a plastic or TYVEK bag). The container and the system, instrument, and / or parts thereof can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation can kill bacteria on the system, instrument, and / or parts thereof and in the container. The sterilized system, instrument, and / or parts thereof can then be stored in a sterile container for later use. Any other techniques known in the art can also be used to sterilize the system, instrument, and / or parts thereof, including but not limited to beta radiation or gamma radiation, ethylene oxide, or steam.

[0137] Various embodiments of the present invention have been shown and described, and further improvements to the methods and systems described herein can be achieved by appropriate modification by those of ordinary skill in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and other modifications will be obvious to those skilled in the art. For example, the embodiments, implementations, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not essential. Therefore, the scope of the present invention should be considered in light of the following claims and should be understood to be not limited to the details of the structures and operations shown and described in the specification and drawings.

Claims

1. An apparatus, comprising: (a) a proximal elongate portion that is flexible; (b) a distal elongate portion that is flexible, the proximal elongate portion and the distal elongate portion sharing a central longitudinal axis; (c) a coupler longitudinally interposed between the proximal elongate portion and the distal elongate portion, the coupler including a first passage; (d) a first proximal tendon assembly extending through the proximal elongate portion, the first proximal tendon assembly including a proximal portion of a first tendon positioned at a first radial distance from the central longitudinal axis; and (e) a first distal tendon assembly extending through the distal elongate portion, the first distal tendon assembly including a distal portion of the first tendon positioned at a second radial distance from the central longitudinal axis; the first tendon passes through the first passage of the coupler; when the first tendon passes through the first passage of the coupler, the first passage of the coupler accommodates repositioning of the first tendon from the first radial distance to the second radial distance.

2. The apparatus according to claim 1, wherein the coupler is configured to provide mechanical ground between a distal end of the first elongate portion and a proximal end of the second elongate portion.

3. The apparatus according to claim 2, wherein the coupler abuts the distal end of the first elongate portion and the coupler also abuts the proximal end of the second elongate portion.

4. The apparatus according to any one of claims 1 to 3, wherein the first tendon assembly is operable to drive articulation of the distal elongate portion.

5. The apparatus according to any one of claims 1 to 4, wherein the first proximal tendon assembly includes a housing, and the proximal portion of the first tendon is slidably disposed within the housing of the first proximal tendon assembly.

6. The apparatus according to claim 5, wherein the housing has a distal end, and the distal end of the housing abuts a surface of the coupler.

7. The apparatus according to any one of claims 5 to 6, wherein the housing includes a coiled tube.

8. The apparatus according to any one of claims 1 to 7, wherein the proximal elongate portion defines a proximal portion of a lumen.

9. The apparatus according to claim 8, wherein the first proximal tendon assembly is positioned within the lumen.

10. The apparatus according to claim 9, wherein the first proximal tendon assembly is movable within the lumen.

11. The apparatus according to any one of claims 8 to 10, wherein the distal elongate portion defines a distal portion of the lumen.

12. The apparatus according to claim 11, wherein the lumen extends continuously from the proximal elongate portion to the distal elongate portion via the coupler.

13. The apparatus according to any one of claims 11 to 12, wherein the first distal tendon assembly is positioned radially outwardly from the lumen.

14. The apparatus of claim 13, the distal elongated portion comprising an inner shaft defining the distal portion of the lumen, the first distal tendon component being positioned radially outward from the inner shaft.

15. The apparatus of claim 14, the inner shaft comprising a laser cut hypotube.

16. The apparatus of any one or more of claims 1 to 15, the distal elongate portion comprising a braid assembly.

17. The apparatus of claim 16, the first distal tendon component being interposed between strands forming the braid component.

18. The apparatus of any one or more of claims 1 to 17, the first distal tendon component comprising a housing, the distal portion of the first tendon being slidably disposed in the housing of the first distal tendon component.

19. The apparatus of any one of claims 1 to 18, wherein the coupling comprises a second passage, the apparatus further comprising: (a) a second proximal tendon component extending through the proximal elongated portion, the second proximal tendon component comprising a proximal portion of a second tendon positioned at the first radial distance from the central longitudinal axis; and (b) a second distal tendon assembly extending through the distal elongated portion, the second distal tendon assembly including a distal tendon assembly positioned about 100 mm from the central longitudinal axis a distal portion of the second tendon at the second radial distance; the second tendon passing through the second passage of the coupler; The second passage of the coupler accommodates repositioning of the second tendon from the first radial distance to the second radial distance as the second tendon passes through the second passage of the coupler.

20. The apparatus of claim 19, the first tendon being angularly offset from the second tendon by approximately 90 degrees about the central longitudinal axis.

21. The apparatus of claim 19, the first tendon being angularly offset from the second tendon by approximately 180 degrees about the central longitudinal axis.

22. According to the device described in any one of claims 1 to 21, the connector includes a set of distal angular alignment features, which are configured to cooperate with complementary features at the proximal end of the distal slender portion to provide a predetermined angular alignment of the connector relative to the distal slender portion.

23. The device according to any one of claims 1 to 22, wherein the connector includes a set of proximal angular alignment features, which are configured to cooperate with complementary features at the distal end of the proximal slender portion to provide a predetermined angular alignment of the connector relative to the proximal slender portion.

24. The apparatus of any one of claims 1 to 23, the distal elongated portion comprising one or more of: one or more cameras, one or more light sources, or one or more sensors.

25. The device according to any one of claims 1 to 24, wherein the first channel extends along a path parallel to the central longitudinal axis.

26. A device comprising: (a) a proximal elongate portion that is flexible; (b) a distal elongate portion that is flexible, the proximal elongate portion and the distal elongate portion sharing a central longitudinal axis; (c) a coupler longitudinally interposed between the proximal elongate portion and the distal elongate portion, the coupler including a plurality of channels; (d) a plurality of proximal tendon assemblies extending through the proximal elongate portion, each proximal tendon assembly of the plurality of proximal tendon assemblies including a proximal portion of a respective tendon positioned at a first radial distance from the central longitudinal axis; and (e) a plurality of distal tendon assemblies extending through the distal elongate portion, each distal tendon assembly of the plurality of distal tendon assemblies including a distal portion of a respective tendon positioned at a second radial distance from the central longitudinal axis; each tendon passes through a respective one of the plurality of channels of the coupler; Each channel of the coupler accommodates repositioning of the respective tendon from the first radial distance to the second radial distance as the respective tendon passes through the first channel of the coupler.

27. A method comprising: (a) positioning a plurality of proximal tendon assemblies along a proximal elongate portion, the proximal tendon assemblies being positioned at a first radial distance from a central longitudinal axis defined by the proximal elongate portion; (b) positioning tendons of the plurality of proximal tendon assemblies along respective channels of a coupler, the coupler repositioning the tendons from the first radial distance from the central longitudinal axis to a second radial distance from the central longitudinal axis; and (c) positioning the tendons along a distal elongate portion, the tendons being positioned at the second radial distance along the distal elongate portion, the coupler being longitudinally interposed between the proximal elongate portion and the distal elongate portion.

28. The method according to claim 27, wherein the proximal tendon assemblies further include a plurality of housings, each tendon being slidably disposed in a respective one of the plurality of housings.

29. The method according to claim 28, each housing having a distal end, the method further comprising: Bringing a distal end of each housing into abutting contact with a corresponding surface of the coupler, thereby mechanically grounding the housing relative to the coupler.

30. The method according to any one of claims 27 to 29, wherein the coupler includes a set of angular alignment features, and the method further comprises: Aligning an angular alignment feature of the coupler with complementary features of the proximal elongate portion and the distal elongate portion, thereby providing a predetermined angular alignment between the coupler, the proximal elongate portion, and the distal elongate portion.

Images