Distributed bending for bendable medical devices

Abstract

To provide a robot apparatus, system and method of use, for steerable medical devices such as endoscopes and catheters that have multiple bendable sections.SOLUTION: A robotic catheter system 100 may comprise a controller 128 and a bendable body having a plurality of steerable segments, where the controller controls actuation of the steerable segments based on an input data. In some embodiments, the input data is at least one of a target bend and a data representation of target bend. In some embodiments, the input data of an operation mode may be selection of a distributed bending mode; in the distributed bending mode, the controller is configured to move the at least one proximal drive wire and the at least one distal drive wire simultaneously.SELECTED DRAWING: Figure 4

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED PATENT APPLICATIONS This application claims priority from U.S. Provisional Patent Application No. 63 / 579,727, filed in the U.S. Patent and Trademark Office on August 30, 2023, the disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THE DISCLOSURE The present disclosure relates to medical devices and, more particularly, to embodiments of steerable medical devices, such as endoscopes and catheters, having multiple bendable sections. [Background technology]

[0003] Endoscopy, bronchoscopy, catheterization, and other medical procedures can facilitate viewing inside the body. During such procedures, flexible medical devices may be inserted into the patient's body and instruments may be passed through the devices to examine or treat areas within the body. Bronchoscopes may be used to view and / or treat a patient's airways. Medical tools, such as cameras and biopsy needles, may be inserted through tool channels in the bronchoscope to target areas within the patient for diagnosis, planning, medical procedures, treatment, etc.

[0004] Some such medical devices are guided through a disposable or limited-use flexible tubular body, often called a sleeve, sheath, or introducer sheath. Some such introducer sheaths or sleeves are robotically controlled. Robotically controlled catheters and endoscopes have a catheter sheath with a steerable distal section and a non-steerable proximal section. The proximal section connects to the working section via an electromechanical connector, and the distal section is sized to be introduced into the patient's anatomy through a natural orifice or small surgical incision. Similar catheters and endoscopes that are insertable into a patient can be operated manually by a user without automated or robotic control. In either case, one or more channels extend along the central lumen of the sheath to allow access for imaging equipment (such as a small camera or fiber optic probe) and / or end effectors (such as a biopsy tool or therapeutic probe) and / or for passing fluids (such as contrast agents or flushing solutions).

[0005] Currently, many commercially available catheters have a single steerable distal section, and the user can direct the bending motion of this steerable distal section. However, new catheters are under development that have three steerable sections at the distal end of the catheter. These steerable distal sections can bend independently, and various operation modes are available. For example, in a tip bending operation mode, the most distal curved section can be bent while the other sections remain unbent, which is particularly useful when navigating the steerable instrument within the lumen. In another mode, only the middle segment is bent (called a targeting mode; or, as this movement resembles a chicken searching for seeds on the ground - more relevantly, a biopsy tool searching for various biopsy sites). Such modes are described, for example, in U.S. Pat. No. 11,096,552, which is incorporated herein by reference in its entirety.

[0006] However, additional modes that optimize the range of motion possible with catheters having multiple distal curved sections (three as exemplified in the aforementioned publications, or two, four, five or more sections) have not been fully explored, and the transitions between the various control modes have not been fully addressed.

[0007] Thus, there is a need for a flexible medical device with multiple distal steerable sections that has multiple control modes and transitions between these various control modes, minimizes variability in the transitions, is user friendly, and provides optimal workflow and ease of use. Summary of the Invention

[0008] Accordingly, it is a broad object of the present disclosure to provide a robotic system, device, and method of use. The robotic system may include: a bendable body having a steerable distal section with a distal bending segment bendable by at least one distal drive wire and a proximal bending segment bendable by at least one proximal drive wire; one or more first actuators configured to drive the distal drive wire; one or more second actuators configured to drive the proximal drive wire; and a controller for controlling the first and second actuators. The controller controls the actuators based on input data of an operation mode and at least one input data of a bending target or a data representation of a bending target. In some embodiments, the input data of the operation mode may be a selection of a distributed bending mode, in which the controller is configured to simultaneously move at least one proximal drive wire and at least one distal drive wire.

[0009] In some embodiments, the operation mode is selected from at least (a) a tip bending mode, (b) a targeting mode, and (c) a distributed bending mode.

[0010] The distal bending mode may be described as the controller being configured to move at least one distal drive wire to bend the distal curved segment towards the bend target or a data representation of the bend target based on the input data. The targeting mode may be described as the controller being configured to move at least one proximal drive wire to bend the proximal curved segment towards the bend target or a data representation of the bend target based on the input data when the bendable body has two curved segments, and the controller being configured to move only at least one drive wire to bend the proximal curved segment relative to the distal curved segment towards the bend target or a data representation of the bend target based on the input data when the bendable body has three or more curved segments. The distributed bending mode may be described as the controller being configured to simultaneously move at least one proximal drive wire and at least one distal drive wire.

[0011] Further features of the present disclosure will become apparent from the following description of illustrative embodiments which refer to the accompanying drawings, in which like structures are indicated with like reference numerals, and in which: [Brief description of the drawings]

[0012] For the purpose of illustrating various aspects of the present disclosure (like numerals denote like elements), the drawings show simplified forms that may be adopted. It should be understood, however, that the present disclosure is not limited to or by the precise arrangements and instrumentalities shown. To assist those skilled in the art in making and using the subject matter herein, reference is made to the accompanying drawings and figures.

[0013] [Figure 1] FIG. 1 illustrates at least one embodiment of an imaging, continuum robotic, or endoscopic device or system according to one or more aspects of the present disclosure. [Diagram 2] FIG. 2 is a schematic diagram illustrating at least one embodiment of an imaging, bendable body, or continuum body robotic device or system in accordance with one or more aspects of the present disclosure. [Diagram 3] 3 illustrates at least one embodiment of a continuum robot and / or medical instrument that can be used with one or more technologies, including autonomous navigation technologies, according to one or more aspects of the present disclosure. Detail A illustrates one guide ring of the bendable body. [Figure 4] FIG. 4 is a schematic diagram illustrating at least one embodiment of an imaging, continuum robot, bendable body, or endoscopic device or system in accordance with one or more aspects of the present disclosure. [Diagram 5] FIG. 5 is a schematic diagram illustrating at least one embodiment of a console or computer that can be used in conjunction with one or more autonomous navigation technologies in accordance with one or more aspects of the present disclosure. [Figure 6] 6(A)-6(C) illustrate one or more principles of tip manipulation of a catheter or continuum robot by actuating one or more curved sections of the continuum robot or bendable body 104 of FIGS. 6(A)-6(C) according to one or more aspects of the present disclosure. [Figure 7] FIG. 7 illustrates the curvature distribution based on the length of the section. [Figure 8] FIG. 8 illustrates a pose having a 90 degree uniform curvature distribution being moved by a 30 degree uniform curvature distribution. [Figure 9] FIG. 9 illustrates the transition to a uniform curvature distribution. [Figure 10] 10(A) and 10(B) illustrate maintaining local angles while turning. [Figure 11] FIG. 11 illustrates possible reactions in poses involving bendable intermediate segments to eliminate crosstalk effects and maintain output direction. [Figure 12] 12(A) and 12(B) illustrate a mode of operation that allows small motion of the intermediate and proximal segments relative to the distal motion.

[0014] Throughout the figures, the same reference numerals and characters, unless otherwise stated, are used to denote like features, elements, components or portions of the illustrated embodiments. Moreover, while the present disclosure will now be described in detail with reference to the figures, it is done so in connection with the illustrated embodiments. It is intended that changes and modifications can be made to the illustrated exemplary embodiments without departing from the true scope and spirit of the present disclosure as defined by the appended claims. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] This disclosure has several embodiments and relies on patents, patent applications and other references for details known to those skilled in the art. Accordingly, wherever a patent, patent application or other reference is cited or repeated in this specification, it is understood to be incorporated by reference in its entirety for all purposes and for the teachings set forth therein.

[0016] In the following paragraphs, certain illustrative embodiments of a robotic medical system configured to use a bendable medical device, and in particular a bendable body, are described. Other embodiments may include alternatives, equivalents, and modifications. In addition, the illustrative embodiments may include certain features, and certain features may not be required for some embodiments of the devices, systems, and methods described herein.

[0017] <Robotic Catheter System> An embodiment of a robotic catheter system 100 is described with reference to Figures 1-4. Figure 1 illustrates a simplified representation of a medical environment, such as an operating room, in which the robotic catheter system 100 may be used. Figure 2 illustrates a functional block diagram of the robotic catheter system 100. Figures 3A-3C illustrate the catheter and bends. Figures 4-5 illustrate a logical block diagram of the robotic catheter system 100. In this example, the system 100 includes a system console 102 (computer cart) operatively connected to a bendable body 104 via a robotic platform 106. The robotic platform 106 includes one or more robotic arms 108 and a linear translation stage 110.

[0018] In FIG. 1 , a user 112 (e.g., a physician) controls the robotic catheter system 100 via a user interface unit (operation unit) to perform an intraluminal procedure on a patient 114 positioned on an operating table 116. The user interface may include at least one of a main display 118 (first user interface unit), a secondary display 120 (second user interface unit), and a handheld controller 124 (third user interface unit). The main display 118 may include, for example, a large display screen attached to the system console 102 or installed on a wall of an operating room, and may be designed as part of the robotic catheter system 100 or may be part of the operating room equipment, for example. Optionally, there is a secondary display 120, which is a small (portable) display device configured to be removably attached to the robotic platform 106. Examples of the secondary display 120 include a portable tablet computer and a mobile communication device (mobile phone).

[0019] The bendable body 104 may be steerable and actuated via an actuator 122. The actuator 103 is removably attached to the linear translation stage 110 of the robotic platform 106. The handheld controller 124 may include a gamepad-like controller with a joystick having a shift lever and / or push buttons. It may be a one-handed or two-handed controller. In one embodiment, the actuator 122 is housed in a housing having the shape of a catheter handle. One or more access ports 126 are provided at or around the catheter handle. The access ports 126 are used for the insertion and / or withdrawal of end effector tools and / or fluids during the performance of an interventional procedure on the patient 114.

[0020] In some embodiments, the handheld controller 124 and / or integrated controller and / or GUI are provided with input means for changing modes and settings. For example, changing between "distal bend" and "proximal bend" can be toggled by pressing a button (or similar digital / on-off method). In some scenarios, the mode will cycle between two (or more) modes each time a 'button' is pressed and released. If there are more than two modes, a method for reversing the direction of cycling can also be included.

[0021] In another scenario, the mode can be switched based on the state of a digital / on-off input means, which may either maintain its state after being changed (i.e. a switch or checkbox) or return to an initial state after being released (i.e. a push button). For example, when the state is off the mode can be 'distal bending' and when the state is on it switches to 'proximal bending'. If there are more than two modes a 'multi-state' input means can be implemented or the mode can be determined based on a combination of multiple input means.

[0022] The amount of bending applied to each section when in distribution mode can also be adjusted using physical or virtual input means. In one scenario, the inclusion of a section in the distribution can be toggled on and off using the method described in the previous paragraph.

[0023] In another scenario, the amount of variance applied to each section can be adjusted. This can be provided using a range input element such as a slider or knob (real or virtual). For example, there can be a virtual slider or number box representing the percentage of the total variance to be applied to the section. Alternatively, the value of this input can represent a reduction in variance. For example, a value representing 25% would result in the corresponding section being allocated 75% of the input bend amount. Similarly, such values ​​can be adjusted using a physical input. Such an input can be analogue, with values ​​within its range corresponding to the percentage (or reduction) of variance for the corresponding section. The input can either maintain its state when changed (i.e. a dial) or return to its starting state when released (i.e. a trigger). A range input element that is a physical device can also be 'adjusted' rather than directly representing a percentage of variance. For example, pressing a button or pressing an analogue stick can increase or decrease the variance value for the corresponding section. The rate of change can be fixed or variable, or it can be related to the value of the input (if it is analogue).

[0024] If there are multiple sections, there can be a dedicated input means for each section. Alternatively, one input means can serve multiple sections. In this scenario, both may be affected in the same way (i.e. both increase or decrease), or vice versa, one may increase and the other decrease (or a combination of each if there are more than two). This input can be a direct mapping, or it can be increment / decrement. If the input is increment / decrement, the rate of increase / decrease can be the same or different. The adjustment of each rate can be changed in the same way as described in the previous paragraph.

[0025] The system console 102 includes a system control 128, a display control 130, and a main display 118. The main display 118 may include conventional display devices such as a liquid crystal display (LCD), an OLED display, a QLED display, or the like. The main display 118 provides a graphic interface unit (GUI) configured to display one or more views. Such views include a live view image 132, an intraoperative image 134, a preoperative image 136, and other procedure information 138. Other views that may be displayed include a model view, a navigation information view, and / or a synthetic view. The live image view 132 may be an image from a camera at the tip of the catheter. This view may also include, for example, information related to the recognition and navigation of the catheter 104. The preoperative image 136 may include 3D or 2D medical images of the patient previously acquired by conventional imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound imaging, and the like. Intraoperative images 134 may include images used in image-guided procedures and may be acquired through fluoroscopy or CT imaging modalities. Intraoperative images 134 may be augmented, synthesized, or correlated with sensor information, camera images, and catheter data.

[0026] In various embodiments in which a catheter tip tracking sensor 140 is used, the sensor may be located at the distal end of the catheter. The catheter tip tracking sensor 140 may be, for example, an electromagnetic (EM) sensor. When an EM sensor is used, a catheter tip position detector 142 is included in the robotic catheter system 100. The catheter tip position detector will include an EM field generator operatively connected to the system controller 128. Electromagnetic sensors suitable for use with bendable bodies are well known and are described, for example, in U.S. Pat. No. 6,201,387 and International Publication WO2020194212A1.

[0027] Similar to FIG. 1, the diagram of FIG. 2 illustrates the robotic catheter system 100 including a system control 128 operatively connected to a display control 130 (connected to a display 118) and a handheld controller 124. The system control 128 is also connected to an actuator 122 via a robotic platform 106 (including a linear translation stage 110). The actuator 122 includes a number of motors 144 that control a number of drive wires 160 that pass through the bendable body 104. One or more access ports 126 may be disposed in the catheter. The catheter includes a proximal section 148 disposed between the actuator and a proximal bending section 152 that actuates the proximal bending section. Three of the six drive wires 160 pass through the distal bending section 156 and actuate this section to enable various movements. Two bendable sections (152 and 156) are shown in this view. Other embodiments described herein can have three bendable sections (see FIG. 3). In some embodiments, a single curved section may be provided, or alternatively, there may be four or more bendable sections in the catheter.

[0028] 3 illustrates an exemplary embodiment of the bendable body 104. The bendable body 104 includes a non-steerable proximal section 148, a steerable distal section 150, and a catheter tip 158. The proximal section 148 and the distal bendable section 150 (including separate sections 152, 154, 156) are joined together by a number of drive wires 160 disposed along the wall of the catheter. The proximal section 148 is configured with a through hole, groove, or conduit for passing the drive wires 160 from the distal section 150 to the actuation portion 122. The distal section 150 is comprised of a number of curved sections including a distal segment 156, an intermediate segment 154, and a proximal segment 152. Each curved section is bent by actuation of at least some of the drive wires 160 (drive members). The position of the catheter may be supported by support wires (support members) (not shown) arranged along the walls of the catheter (see U.S. Patent Application Publication No. 2021 / 0308423). The proximal ends of the drive wires 160 are connected to individual actuators or motors 144 of the actuation portion 122, and the distal ends of the drive wires 160 are selectively secured to anchor members of different bending sections of the distal bendable section 150.

[0029] Each curved section is formed by a number of annular components (rings) with through holes, grooves or conduits along the walls of the rings. The annular components are defined as wire guiding members 162 or anchoring members 164 depending on their function within the catheter. The anchoring members 164 are annular components to which the distal ends of one or more drive wires 160 are attached. The wire guiding members 162 are annular components through which some of the drive wires 160 slide (without being attached to them).

[0030] Detail "A" of FIG. 3 illustrates an exemplary embodiment of an annular component (wire guide member 162 or anchor member 164). Each annular component includes a central opening forming a tool channel 168 and a number of conduits 166 (grooves, subchannels or through holes) spaced equidistantly from the central opening along the annular wall of each annular component. The inside of the annular components may be provided with an inner cover as described in U.S. Patent Application Publication Nos. 2021 / 0369085 and 2022 / 0126060 to provide a smooth inner channel and provide protection. The non-steerable proximal section 148 is a flexible tubular shaft and may be made from an extruded polymeric material. The tubular shaft of the proximal section 148 also has a central opening or tool channel 168 and a number of conduits 166 along the wall of the shaft surrounding the tool channel 168. The tubular shaft and the steerable section 150 may be covered by an outer sheath. In this manner, at least one tool channel 168 formed in the bendable body 104 allows for the passage of imaging equipment and / or end effector tools from the insertion port 126 to the distal end of the bendable body 104 .

[0031] The actuating unit 122 includes one or more servo motors or piezoelectric actuators. The actuating unit 122 bends one or more of the curved sections of the catheter by applying a pushing and / or pulling force to the drive wires 160. As shown in FIG. 3A, each of the three bendable segments of the bendable body 104 has multiple drive wires 160. If each bendable segment is actuated by three drive wires 160, the bendable body 104 has nine drive wires arranged along the wall of the catheter. The actuating unit 122 pushes and pulls at least one of these nine drive wires 160 to bend each bendable segment of the catheter. Forces are applied to the individual drive wires to steer / maneuver the catheter to a desired position. Thus, a segment can be moved by moving at least one of the three drive wires fixed to the segment, and moving at least one drive wire of the segment means that one or more of the drive wires are moved. This can include pulling (or pushing) only one of the drive wires, or pulling one while simultaneously pushing the other.

[0032] The bendable body 104 and the assembled actuation unit 122 are mounted on a linear translation stage 110. The linear translation stage 110 includes a slider and a linear motor, i.e., the linear translation stage 110 is motorized and can be controlled by a system control unit 128 to insert and remove the bendable body 104 into and from a body cavity of a patient.

[0033] Imaging devices 170 that can be inserted through the tool channel 168 include endoscopic cameras (videoscopes) with illumination optics (e.g., fiber optics and LEDs) that illuminate the lumen and / or lesion target of interest within the patient. End effector tools refer to endoscopic surgical instruments such as clamps, forceps, scissors, staplers, ablation or biopsy needles, and other similar tools that function to manipulate a body part (organ or tumor tissue) during examination or surgery. Imaging devices 170 may be what is commonly known as a tip-on-tip camera and may be color or black and white.

[0034] In some embodiments, the catheter tip 158 is fitted with a tracking sensor 140 (e.g., an EM tracking sensor). In this embodiment, the bendable body 104 and the tracking sensor 140 can be tracked by a tip position detector 142. Specifically, the tip position detector 142 detects the position of the tracking sensor 140 and transmits the detected position information to a system controller. 128 to the patient. The system controller 128 receives position information from the tip position detector 142 and continuously records and displays the position of the bendable body 104 with respect to the patient's coordinate system. The system controller 128 controls the actuator 122 and the linear translation stage 110 according to operational commands entered by the user 112 via one or more of the user interfaces (handheld controller 124, the GUI of the main display 118, or buttons on the touch screen of the secondary display 120).

[0035] The robotic medical system described herein includes a bendable body. 104The robot may include a continuum or multi-segment robot configured to form curved shapes in one or more planes by actuating one or more curved sections of a continuum robot. One example of a continuum robot is a snake-shaped catheter and / or endoscopic instrument, as described in applicant's previously published U.S. Patent Nos. 9,144,370, 11,051,892, 11,103,992, 11,278,366, 11,007,641 and U.S. Patent Application Publication Nos. 2019 / 0105468, US 2021 / 0386972, 2021 / 0308423, and 2022 / 0126060, which are incorporated by reference herein for all purposes.

[0036] 4 illustrates that the system control unit 128 executes a software program and controls the display control unit 130 to display a navigation screen (e.g., a live view image 132) on the main display 118 and / or the secondary display 120. The display control unit 130 may include a graphics processing unit (GPU) or a video display controller (VDC).

[0037] 5 illustrates components of the system control unit 128 and / or the display control unit 130. The system control unit 128 and the display control unit 130 may be configured separately. 130 can be configured as a single device. In either case, the system control unit 128 and the display control unit 130 have substantially the same components. Specifically, the system control unit 128 and the display control unit 130 may include a central processing unit (CPU 182) consisting of one or more processors (microprocessors), a random access memory (RAM 184) module, an input / output (I / O 186) interface, a read-only memory (ROM 180), and a data storage device (e.g., a hard disk drive (HDD 188) or a solid-state drive (SSD)).

[0038] The ROM 180 and / or the HDD 188 store operating system (OS) software and software programs necessary for executing the overall functions of the robotic catheter system 100. The RAM 184 is used as a workspace memory. The CPU 182 executes the software programs stored in the RAM 184. The I / O 186, for example, inputs position information to the display control unit 130 and outputs information for displaying a navigation screen to one or more displays (the main display 118 and / or the secondary display 120). In the embodiment described below, the navigation screen is a graphical user interface (GUI) generated by a software program, but may be generated by firmware or a combination of software and firmware.

[0039] The system controller 128 may control the bendable body 104 based on any known kinematic algorithm applicable to a continuum or snake-type catheter robot. For example, the system controller controls the bendable body 104 based on an algorithm known as the follow-the-leader (FTL) algorithm. By applying the FTL algorithm, the distal-most segment 156 of the steerable section 150 is actively controlled using forward kinematic values, and the middle segment 154 and the proximal segment 152 (the following sections) of the bendable body 104 move in a first position in the same way that the distal section moves in a second position at or near the first position.

[0040] The display control unit 130 transmits the position information of the bendable body 104 to the system control unit 128 Alternatively, the display control unit 130 may directly acquire the position information from the tip position detector 142. The bendable body 104 may be a disposable or limited-use catheter device. That is, the bendable body 104 may be detachable from the actuation unit 122 and may be disposable.

[0041] During the procedure, the display controller 130 can generate and output live view images and other views and navigation screens to the main display 118 and / or secondary display 120. The views can optionally be registered with a 3D model of the patient's anatomy (such as the branched structures) and with position information of at least a portion of the catheter (e.g., the position of the catheter tip 158) by executing pre-programmed software routines. Once navigation to the desired target is complete, one or more end effector tools can be inserted through the access port 126 at the proximal end of the catheter and guided through a tool channel 168 in the catheter body to perform an endoluminal procedure from the distal end of the catheter.

[0042] The tools may be medical tools such as endoscopic cameras, forceps, needles, or other biopsy or ablation tools. In one embodiment, the tools may be described as surgical or working tools. The working tools are inserted or removed through the working tool access port 126. In the following embodiments, an embodiment is described in which a bendable body is used to guide the tool to the target. Tools may include endoscopic cameras and end effector tools that can be guided through the bendable body using the same principles. Procedures typically include planning procedures, registration procedures, targeting procedures, and surgical procedures.

[0043] In medical procedures in which the bendable medical device 104 is used, medical images (e.g., from a CT scanner) are often provided to the robotic catheter system 100 preoperatively. A clinical user uses the robotic catheter system 100 to create an anatomical computer model from the images, such as the lung airways of the patient 114. From chest images received from the CT scanner or PACS system, the clinical user can segment the lung airways for a clinical procedure, such as a biopsy. After the robotic catheter system 100 generates a map of the lung airways, the user can also use a navigation software system to create a plan to access the lesion to be biopsied. The plan includes the target lesion and a trajectory (navigation path) through the airways for inserting the distal section 150 of the bendable body 104.

[0044] According to one embodiment, when either inserting or retracting the bendable body 104, the system controller 128 can control the linear translation stage 110 of the robotic platform 106 to move the bendable body 104 in a desired trajectory along the centerline of the lumen (e.g., airway) and subsequently actively control the curved segments. This is similar to known shaft guidance techniques used to control robotically guided catheters or endoscopes to force the flexible shaft of a sheath to stay in a desired trajectory. In one example, when using the robotic catheter system 100, the bendable body 104 is robotically controlled to advance within the lumen. Such control may be via sensors, external images, and / or images from the tip of the bendable body. Sensors may be included to measure actuation force, insertion depth, angulation of user-controlled steerable segments, etc. to obtain trajectory and other information. After a small advance in insertion or retraction distance, the shape of the bendable body 104 is modified by adjusting (actuating) one or more of the curved segments so that the new shape closely matches the desired trajectory. This process is repeated until the target area is reached. The same process can be applied when controlling the bendable body to withdraw the bendable body 104 from the patient, which is similar to the navigation process described, for example, in US 2007 / 0135803, which is incorporated herein by reference for all purposes.

[0045] Further details regarding the actuation of the bendable body robot, including control methods for actuation, are described in Applicant's previous published patent applications US2015 / 0088161, US2018 / 0243900, US2018 / 0311006 and US2019 / 0015978, which are incorporated herein by reference for all purposes.

[0046] <Bending mode> The bendable body 104 can be actuated to bend each segment independently. In one mode of operation, each bendable segment can be fully controlled independently, while other modes can be provided that predefine how the bendable medical device responds to motion commands. For example, in one bending mode, only the middle of the three segments are bent to provide a "cockscomb" motion. In another bending mode, all three bendable segments bend uniformly.

[0047] To provide multiple bending modes, the control algorithm may apply a different function to each curved section to determine the amount and direction of motion to be applied. This function will be based on the input motion provided by the user (or system), but may also take into account any number of other arguments. Some of such optional arguments include the current control mode, the current pose / pose history of each section of the catheter, and the position of the catheter within the anatomy.

[0048] 6(A)-6(C) show exemplary catheter tip manipulation by actuating one or more bending sections of the bendable body 104 in various bending modes. As illustrated in FIG. 6(A), manipulating only the distal-most segment 156 of the steerable section (tip bending mode) changes the position and orientation of the catheter tip 158. On the other hand, manipulating one or more bending sections (152 or 154) other than the distal-most segment affects only the position of the catheter tip 158, and not the orientation of the catheter tip. In FIG. 6(A), the distal segment 156 6B, actuation of the intermediate segment 154 changes the position of the catheter tip 158 from position P1 with an orientation of O1 to position P2 with an orientation of O2, position P3 with an orientation of O3, position P4 with an orientation of O4, etc. In FIG. 6B, actuation of the intermediate segment 154 changes the position of the catheter tip 158 from position P1 with an orientation of O1 to positions P2 and P3 with the same orientation of O1. This mode is also called the cockscomb mode because the tip can move around the target site like a chicken searching for grain.

[0049] It will be appreciated by those skilled in the art that the exemplary catheter tip manipulations shown in Figs. 6(A) and 6(B) can be performed during catheter navigation (i.e., while inserting the catheter through tortuous anatomical structures). In the present disclosure, the exemplary catheter tip manipulations shown in Figs. 6(A) and 6(B) are applied to, i.e., targeting mode. In some examples, this mode is applied after the catheter tip is navigated to a predetermined distance (targeting distance) from the target. In Fig. 6(C), bending is distributed through different curved sections. Actuation of all three segments changes the catheter tip from position P1 with orientation O1 to position P2 with orientation O2 to position P3 with orientation O3, etc. This mode may not be useful when passing through all tortuous anatomical structures, as can be seen by comparing Figs. 6(A) and 6(C), but it may be especially important for tool entry when the tool is too long to bend as tightly as it was used to navigate to the target site.

[0050] For each of these modes, input data is used to move the catheter segments. The input data may come from a user, an automated system (see, e.g., U.S. Provisional Applications Nos. 63 / 513,803 and 63 / 513,794), or a combination thereof. For example, the input data may include a selection of an operation mode, a bend target from a user via a hand controller or GUI. The bend target may be a bend angle, a bend direction, or a combination. This includes both magnitude and direction. In some embodiments, the function applied to the magnitude and the function applied to the direction may be the same or different.

[0051] Alternatively or additionally, the input data may be a data representation of the bend target that is a wire position or other kinematic representation that is a surrogate representation of the bend angle and / or direction, which may be a transformation of a user-defined bend target that is converted into information that the controller uses to control the drive wire.

[0052] The bend goal may be a bend angle (or direction) for the final goal (e.g., bend to the region of interest). In other embodiments, the bend goal is a change in bend angle (or direction).

[0053] Other input instructions may include the current or previous bend angle of each segment and / or a data representation of the current or previous bend angle. This information may be obtained, for example, from a table that stores position information for the procedure.

[0054] Distal bending mode. In this mode, the controller is configured to move at least one distal drive wire toward a bending target, or a data representation of a bending target, based on input data. The bending is at a bending angle and / or direction derived from a previous bending angle and / or previous direction.

[0055] Targeting mode. In this mode, the controller is configured to move at least one proximal drive wire toward a bending target or data representation based on input data. The proximal drive wire is moved if the bendable body has two curved sections. However, if the bendable body has three or more curved sections, the controller is configured to move only the at least one drive wire based on the input data to bend the proximal curved section relative to the distal curved section toward the bending target or data representation of the bending target.

[0056] Distributed bending mode. In this mode, the controller is configured to simultaneously move at least one proximal drive wire and at least one distal drive wire, which allows the proximal curved section to bend at an angle less than the bend angle and the distal curved section to bend at the bend angle. These can be in any ratio, not necessarily less proximal than distal, and neither technically required to be at a "perfect" bend angle / direction.

[0057] <Dispersion bending and dispersion function> The most basic function of distributed bending is a simple proportional amount of the input values. For example, if all curved sections are used to create a uniform curvature, the amount of motion applied to each section will match the percentage of the end effector's position along the entire combined bend length. This can be seen in FIG. 7. Looking at an exemplary end of a bendable body with three curved sections, it can be seen that the proximal curved section 152 is 20 mm long. The middle segment 154 and the distal segment 156 are shown to have a combined length of 30 mm for a total bendable length of 50 mm. Thus, if the bendable body of FIG. 7 is to bend 90 degrees, the angle of the proximal curved section 152 will be 20 mm / 50 mm x 90 degrees = 36 degrees, which is the percentage of the end effector's position along the combined bend length. Since the middle curved segment 154 is 40 mm from the base position and has a total length of 50 mm, the amount of motion applied to the middle curved segment 154 will match the formula 40 mm / 50 mm x 90 degrees = 72 degrees. The distal segment 156 will bend a full 90 degrees.

[0058] figure 7 shows a bendable body with three sections of lengths 20 mm, 20 mm, and 10 mm, but other embodiments can have two, four, or more sections, which may be the same or different lengths. An important consideration for this most basic function of distributed bending is that a proportional amount of the input value remains constant. For example, for a four-section robot with each section being 20 mm long, if the bending target is 60 degrees, the distal segment will bend 15 degrees, the middle segment will bend at 30 degrees and 45 degrees, and the proximal segment will bend at the 60 degrees mentioned above.

[0059] Similarly, tip bending and cockscomb motion (shown in Figures 6(A) and 6(B)) fall into this algorithm when included in the feature. In tip bending mode, the tip receives 100% of the motion and all other sections receive 0% (Figure 6(A)). Similarly, in targeting / cockscomb mode (Figure 6(B)), the middle segment receives 100% of the motion and all other sections receive 0%.

[0060] However, there are some features that are not possible with targeting and cock-comb motion. For example, there are tools that are very stiff in their distal parts. This can limit the amount of local bending that the tip can achieve. (Local bending is the relative pose between the tip and mid-segment). In this scenario, if the user wants to bend the catheter in a direction that the tool forbids, in distributed bending mode, motion can be applied equally to both the tip and mid-segment (Figure 10(B)). Thus, the tip can be reoriented without changing the local pose.

[0061] This simple ratio distribution can also be used to implement functions that are currently not possible in other systems.

[0062] The table below is a simple example of the above example using a catheter with three bendable sections: 10mm, 20mm, and 20mm. [Table 1]

[0063] This dispersion function does not just need to change the amount of motion, but can also affect the direction. This is useful for cock-comb motion. The desired effect of cock-comb motion is to translate the tip position without changing orientation. This is achieved by bending the mid-segment. However, due to the physics of the catheter design, the tip orientation changes slightly as the mid-segment moves. As shown in Figure 11, this type of motion can be countered by adding a bend to the tip to offset the motion resulting from bending the mid-segment. This direction will typically be opposite to the motion of the mid-segment.

[0064] However, the amount of bending applied will depend on the local attitude of the tip. Bending the mid-segment will result in a change in the local attitude of the tip section. As mentioned above, local attitude is the relative attitude between the tip section and the mid-segment. One of the physical phenomena of a three-section catheter is that the output ratio is inversely proportional to its local attitude. That is, for the same drive wire position, the larger the angle of the local attitude, the smaller the output angle. Therefore, the extent to which the tip orientation changes from cockscomb motion will depend on the amount of change in the local attitude. Therefore, the function to counter this unintended tip orientation change needs to use the local attitude in its calculations.

[0065] Finally, applying the same basic ratio variance to the catheter motion from the start of control results in the same ratio variance in the pose of all sections at any point during motion.

[0066] In Figure 8, a catheter with a uniform curvature distribution (90 degrees) is subjected to a distributed motion with a 30 degree curvature distribution. The resulting pose also has a uniform curvature distribution (60 degrees).

[0067] However, the catheter poses before applying any kind of distributed bending motion do not have to be distributed in the same proportion during the motion, i.e., any kind of distributed bending motion algorithm can be applied to any kind of catheter pose (see FIG. 12). They are independent of each other.

[0068] One important implementation of this is during simple navigation: there are scenarios where bending the catheter tip alone is not enough to point the tip in the desired direction, as the catheter tip reaches its physical limit (local pose is too high). In a traditional catheter, when this happens, the stage is driven forward and the FTL algorithm moves the mid-segment towards the tip. This lowers the local pose of the tip section, so that it can continue aiming in previously unreachable directions (i.e. local pose becomes even higher).

[0069] This benefit of moving the middle segment slightly in the direction the tip is trying to aim can be replicated using distributed bending of the present disclosure. This is achieved by applying partial motion to the middle segment (and optionally the proximal segment) to shift the entire bend in the direction the tip is bending. This reduces the amount of local attitude increase that occurs during bending, allowing the tip to bend further than it would otherwise be able to. Again, the amount of bending applied to the middle / proximal segments can vary depending on the local attitude. The greater the local attitude, the greater the benefit from commanding the middle segment to move more. This can also improve FTL efficiency, as local attitude is reduced compared to the absence of distributed bending modes.

[0070] Finally, the function may be fully user defined or may have some parameters defined by the user and may be adjustable (manually or automatically) at any point in time. One scenario where it may be beneficial to vary them "automatically" can be implemented for "cascading bends".

[0071] In another type of distributed bending mode, the bendable device is initially bent with the curvature distribution described above, but when a specified limit is reached, the controller stops the motion of the most proximal section, but continues the motion of the more distal segments. If there are three or more curved sections, this cycle can be repeated for all sections.

[0072] In yet another example, if a tip bending mode is used first, this mode is used until a local attitude limit is reached. When this occurs, any further bending will be applied to both the distal and proximal segments (or the middle segments in a three-section catheter). This sequence can be repeated if the catheter has more than two sections.

[0073] The bending does not have to be limited to a single section at a time, but can be distributed in the manner previously described, but follows the same paradigm of applying motion to other sections after a limit is reached.

[0074] In some embodiments, a constant curvature mode may be used, as described in WO / 2023 / 164047 to Takagi, which describes a bendable body that is bent by a controller configured to switch between a first control for bending a first curved portion and a second control for bending the first and second curved portions such that the curvature of the curved portion is constant. WO / 2023 / 164047 is incorporated herein by reference in its entirety.

[0075] <Transition to derived pose> The user can transition to any dispersion posture from any other posture. When this occurs, the postures of all sections will be adjusted to the desired dispersion based on the posture of the tip. Optionally, the user can apply this transition only to a specific section.

[0076] The user can also choose to revert from the distributed pose to the previous pose (or choose which sections to revert while keeping others). Finally, the user can change the distributed bend ratio from this distributed pose mode (i.e. enter cockscomb mode). The user can also choose to change the current pose to match the new distribution, or to only apply distribution while bending.

[0077] The transition can be applied in stages and the user can stop it at any point during the transition if a more desirable posture requires it.

[0078] When transitioning to the distributed pose, the tip orientation should remain the same, but its position in space may change, which could be addressed manually or automatically by moving the stage position or bending other sections accordingly.

[0079] Additionally, the function for determining the orientation of each section does not have to be based on the orientation of the tip, but may be based on the orientation of any section and / or other information such as target position, etc.

[0080] <Additional distribution features> In some embodiments, the ability to distribute bending through multiple curved sections.

[0081] One feature that improves the maintenance of local pose is the orientation mode as shown in Figures 10(A) and 10(B). The local angles are maintained while the orientation changes. For a three-section robot, the configuration is 100% distal, 100% mid, and 0% proximal. As shown in Figure 10(A), the distal segment is straight with respect to the mid. When a 90 degree bend command is sent, the result is that both the distal and mid segments aim at 90 degrees, but the distal segment is still straight with respect to the mid. In the scenario of Figure 10(B), the distal segment is at +90 degrees with respect to the mid. When a -45 degree bend command is sent, the result is that both the distal and mid segments change their aiming direction to -45 degrees. The distal segment remains bent at +90 degrees with respect to the mid.

[0082] Another feature of distributed bending is related to the cockscomb mode. In standard cockscomb mode, the middle segment bends while the distal and proximal segments do not. However, crosstalk often occurs between the distal and middle segments, and the true final orientation is not accurate. As shown in the example in Figure 11, in a three-section robot, all three sections are straight. A command to bend 90 degrees is sent [S1101], and the middle segment bends 90 degrees. However, the true output shape of the standard cockscomb mode is shown by the bend in

[1102] , where the tip of the distal segment is pulled slightly towards the bending direction of the middle segment. The local angle at the tip is reduced, and the tip no longer points straight ahead. The distributed function shown in step [S1103] bends the distal segment in the opposite direction to the bending of the middle segment ([S1101]) to counteract the pulling of the distal segment due to the bending of the middle segment. This increases the local angle at the tip, and keeps the output direction straight ahead.

[0083] Yet another example of the dispersion feature allows the intermediate and / or proximal segments to be "nudged" towards the tip. Example settings for this mode are as follows: [Table 2]

[0084] This can be used to reduce local angles and increase power. As shown in FIG. 12(A), all sections are straight. When a command to bend +90 degrees is sent, the distal segment bends 90 degrees, the mid segment bends 20% or 18 degrees, and the proximal segment bends 10% or 9 degrees. All bends occur in the direction of the tip bend. This looks different in FIG. 12(B), where all sections are bent to the left and have different angles at the start of the motion. In this case, when a command to bend +90 degrees is sent, the distal segment bends 90 degrees, the mid segment bends 18 degrees, and the proximal segment bends 9 degrees, all in the direction of the tip bend. However, this overall shape of the final curve is what would happen if the tip of the robot were to move as commanded, and other sections are fine-tuned in the direction of the bend to provide a shape that may be particularly useful when navigating and working within a lumen.

[0085] In other embodiments, the amount of fine tuning may be greater (eg, 30% and 15%), less (eg, 10% and 5%), or in a different ratio (eg, 30% and 10%).

[0086] As mentioned above, the robotic medical system described herein includes a bendable body. 104The robot may include a continuum or multi-segment robot configured to form a curved shape in one or more planes by actuating one or more bending sections of the robot. When two or more curved sections are bent, the curvatures in the sections may be in two different planes. In some embodiments, two or more curved sections are bent in the same plane, but with different curvatures. For example, if the distal and proximal sections are bent along a perpendicular plane and the distal end is bent to increase its angle along the same plane, the attitude of the proximal section will be "nudged" in such a way that the bending plane approaches the plane of the distal end (with a slight change in angle). Similarly, the distal and proximal sections may be bent in different directions on the same plane. In this case, when the user instructs the distal end section to bend further, the "nudge" of the proximal section will slightly adjust its bend angle and move it towards the distal end, thus bending it slightly less.

[0087] The present disclosure and / or one or more components of the disclosed devices, systems, and storage media, and / or methods may be used in conjunction with continuum robotic devices, systems, methods, and / or storage media, and / or with endoscopic devices, systems, methods, and / or storage media. Such continuum robotic devices, systems, methods, and / or storage media may be used in conjunction with at least one of the following: U.S. Pat. Nos. 10,687,694, 11,007,641, 11,051,892, 11,096,552, 11278366, 11,504,501, 11,559,190, 11,571,268, and 11,622,828; U.S. Patent Application Publication Nos. 2020 / 0375665, 2021 / 0121051, 2021 No. / 0121162, No. 2021 / 0259521, No. 2021 / 0259790, No. 2021 / 0259794, No. 2021 / 0260339, No. 2021 / 0260767, No. 2021 / 0308423, No. 2 No. 021 / 0362323, No. 2021 / 0369085, No. 2021 / 0369355, No. 2021 / 0369366, No. 2021 / 0386972, No. 2021 / 229277, No. 2022 / 0016394, Nos. 2022 / 0039635, 2022 / 0039784, 2022 / 0040450, 2022 / 0126060, 2022 / 0202273, 2022 / 0202277, 2022 / 0202500, 2022 / 0202501, 2022 / 0202502, 2022 / 0203071, 2023 / 0016761, 2023 / 0201522, 2023 / 0137954 and 2023 / 0 No. 255442, and International Publication Nos. WO2021 / 142272, WO2022 / 031995, WO2022 / 032162, WO / 2023 / 154352, WO / 2023 / 154825, WO / 2023 / 154931, WO / 2023 / 150162, WO / 2023 / 154713, WO / 2023 / 154246 and WO / 2023 / 154931, the disclosures of each of which are incorporated herein by reference in their entirety. Any of the features of the present disclosure may be used in combination with any of the features described in the above patents and applications.

[0088] definition Throughout the figures, wherever possible, unless otherwise stated, the same reference numerals and characters are used to denote like features, elements, components or portions of the illustrated embodiments. Moreover, while the present disclosure will be described in detail with reference to the enclosed figures, it is done so in connection with the illustrated embodiments. It is intended that changes and modifications can be made to the described exemplary embodiments without departing from the true scope of the present disclosure as defined by the appended claims. While the drawings represent some possible configurations and approaches, the drawings are not necessarily to scale and certain features may be exaggerated, omitted or partially cut off in order to more clearly illustrate and explain certain aspects of the present disclosure. The description set forth herein is not intended to be exhaustive or otherwise limit or restrict the scope of the claims to the exact forms and configurations shown in the drawings and disclosed in the following detailed description.

[0089] It will be understood that when an element or component is referred to as "on," "to," "connected to," or "coupled to" another element or component, it may be directly on, to, connected to, or coupled to the other element or component, or there may be intervening elements or components present. In contrast, when an element is referred to as "directly on," "directly connected to," or "directly coupled to" another element or component, there are no intervening elements or components present. When used, the phrase "and / or," when so provided, includes any and all combinations of one or more of the associated listed items.

[0090] For ease of description to describe the relationship of one element or feature to another as shown in the various figures, spatially relative terms such as "below," "below," "lower," "upper," "top," "proximal," "distal," and the like may be used herein. However, it should be understood that the spatially relative terms are intended to encompass various orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, an element described as being "below" or "below" another element or feature would be oriented "above" that other element or feature if the device in the figures were flipped over. Thus, a relative spatial term such as "below" can encompass both an orientation of above and below. The device may be otherwise oriented (rotated 90 degrees or in other directions) and the spatially relative descriptors used herein should be interpreted accordingly. Similarly, the relative spatial terms "proximal" and "distal" may be interchangeable, where applicable.

[0091] As used herein, the term "about" means, for example, within 10%, within 5% or less. In some embodiments, the term "about" can mean within the error of measurement.

[0092] In this specification, terms such as first, second, third, etc. may be used to describe various elements, components, regions, parts, and / or sections. It should be understood that such elements, components, regions, parts, and / or sections should not be limited by these terms. These terms are used only to distinguish one element, component, region, part, or section from another region, part, or section. Thus, a first element, component, region, part, or section described below may be referred to as a second element, component, region, part, or section without departing from the teachings of this specification.

[0093] The terms used herein are for the purpose of describing particular embodiments only and are not intended to be limiting. The use of the terms "a", "an" and "the" and similar referents in the context of describing the present disclosure (particularly in the context of the claims below) are to be construed as including both the singular and the plural, unless otherwise stated herein or unless clearly contradicted by context. The terms "comprise", "have", "include" and "comprise" are to be construed as open-ended terms (i.e., meaning "including, but not limited to"), unless otherwise indicated. Specifically, these terms, when used herein, specify the presence of a stated feature, integer, step, operation, element, component and / or component, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components and / or groups thereof that are not expressly recited. The recitation of ranges of values ​​herein is only intended to serve as a shorthand method for individually referring to the separate values ​​falling within the range, unless otherwise indicated herein, and the separate values ​​are incorporated herein as if individually recited herein. For example, if a range of 10-15 is disclosed, then 11, 12, 13, and 14 are also disclosed. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any examples or exemplary language (e.g., "etc.") provided herein is intended only to more clearly explain the disclosure and does not limit the scope of the disclosure unless otherwise asserted. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the disclosure.

[0094] The present disclosure relates generally to medical devices and illustrates embodiments of a bendable body sheath for guiding a catheter and / or optical probe that can be applied to an imaging device (e.g., an endoscope). The imaging device can image using a miniature camera based on chip-on-tip (COT) technology, or can provide other forms of imaging, such as Spectral Encoded Endoscope (SEE) imaging technology (see, e.g., U.S. Pat. Nos. 10,288,868 and 10,261,223). In some embodiments, the imaging device can include an optical coherence tomography (OCT) device, a spectroscopy device, or a combination of such devices (e.g., a multi-modality imaging probe).

[0095] Embodiments of the present bendable medical devices and portions thereof are described with respect to their position / orientation in three-dimensional space. As used herein, the term "position" refers to the position of an object or portion of an object in three-dimensional space (e.g., three degrees of translational freedom along Cartesian X, Y, Z coordinates), the term "orientation" refers to the rotational configuration of an object or portion of an object (three degrees of rotational freedom - e.g., roll, pitch, yaw), the term "pose" refers to the position of an object or portion of an object in at least one translational degree of freedom and the orientation of an object or portion of an object in at least one rotational degree of freedom (up to six degrees of freedom in total), and the term "shape" refers to a set of attitudes, positions and / or orientations measured along the elongated body of an object. As is known in the medical device art, the terms "proximal" and "distal" are used in reference to the manipulation of the end of an instrument that extends from a user to a surgical or diagnostic site. In this regard, the term "proximal" refers to the portion of the instrument that is closer to the user, and the term "distal" refers to the portion of the instrument that is further from the user and closer to the surgical or diagnostic site.

[0096] As used herein, the term "catheter" generally refers to a flexible, thin, tubular instrument made of medical grade materials designed to be inserted through a narrow opening into a body cavity (e.g., blood vessel) to perform a wide range of medical functions. A catheter may be an imaging device alone or may include tools used in therapeutic and diagnostic procedures. The more specific term "optical catheter" refers to a medical instrument that includes an elongated bundle of one or more flexible, light-conducting fibers with optical imaging capabilities disposed within a protective sheath made of medical grade materials. A specific example of an optical catheter is a fiber optic catheter that includes a sheath, coil, protector, and optical probe. In some applications, a catheter may include a "guide catheter" that functions similarly to a sheath.

[0097] As used herein, the term "endoscope" refers to a rigid or flexible medical instrument that uses light guided by an optical probe to view the inside of a body cavity or organ. A medical procedure in which an endoscope is inserted through a natural orifice is called endoscopy. Specialized endoscopes are generally named for how or where they are used, such as bronchoscopes (mouth), sigmoidoscopes (rectum), cystoscopes (bladder), nephroscopes (kidneys), bronchoscopes (bronchi), pharyngoscopes (pharynx), otoscopes (ears), arthroscopes (joints), laparoscopes (abdomen), and gastrointestinal endoscopes.

[0098] It should be understood that the disclosed methods and compositions can be incorporated in the form of various embodiments, only a few of which are disclosed herein. Variations of such embodiments will become apparent to those skilled in the art upon reading the foregoing description. It is expected and understood that those skilled in the art will adopt such variations as necessary, and it is intended that the disclosure be practiced otherwise than as specifically described herein. Accordingly, this disclosure includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, unless otherwise indicated herein or otherwise clearly contradicted by context, the disclosure includes any combination of the above-described elements in all possible variations thereof.

[0099] Although the present disclosure has been described with reference to exemplary embodiments, it is to be understood that the present disclosure is not limited to the disclosed exemplary embodiments, and the scope of the following claims should be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures and functions.

Claims

1. a bendable body having a steerable distal section with a distal bendable segment bendable by at least one distal drive wire and a proximal bendable segment bendable by at least one proximal drive wire; one or more first actuators configured to drive the distal drive wires; one or more second actuators configured to actuate the proximal drive wires; a controller that controls the first actuator and the second actuator based on input data of an operation mode and at least one input data of a bend target or a data representation of a bend target; A robot system comprising: The operation mode includes at least (a) a tip bending mode, wherein the controller is configured to move the at least one distal drive wire to bend the distal curved segment toward the bend target or the data representation of the bend target based on input data; (b) a targeting mode, in which if the bendable body has two curved segments, the controller is configured to move the at least one proximal drive wire to bend the proximal curved segment towards the bend target or the data representation based on input data, and if the bendable body has three or more curved segments, the controller is configured to move only at least one drive wire to bend the curved segment proximal relative to the distal curved segment towards the bend target or the data representation of the bend target based on input data; (c) a distributed bending mode, wherein the controller is configured to simultaneously move the at least one proximal drive wire and the at least one distal drive wire; Selected from: Robot system.

2. In the distributed bending mode, the controller is configured to move the at least one proximal drive wire and the at least one distal drive wire such that the distal curved segment and the proximal curved segment each bend at a predetermined ratio of the bend angle. The robot system of claim 1 .

3. The predetermined ratio of a curved segment is defined as the length from the proximal end of the steerable distal section to the distal end of the curved segment / the length of the steerable distal section. The robot system according to claim 2 .

4. In the distributed bending mode, the local bending angle of the proximal curved section is smaller than the input data but in the same direction. The robot system of claim 1 .

5. The controller is configured to transition the distal curved segment and the proximal curved segment to a particular bend angle based on input data, the input data further including a previous bend angle. The robot system of claim 1 .

6. the controller is configured to transition the distal curved segment and the proximal curved segment to a particular bend angle such that a resulting bend angle is maintained between a previous mode and a new mode when the controller switches the bend mode. The robot system of claim 1 .

7. the control unit is configured to return the distal curved segment and the proximal curved segment to a previous position. The robot system of claim 1 .

8. the control unit is further configured to direct the bendable body to move in a distal or proximal direction a distance related to a displacement at the distal tip due to movement of the first actuator and the second actuator. The robot system of claim 1 .

9. an intermediate bending segment bendable by at least one intermediate drive wire; Further comprising: In a distributed bending mode, the controller is configured to simultaneously move the at least one proximal drive wire, the at least one intermediate drive wire, and the at least one distal drive wire. The robot system of claim 1 .

10. a plurality of additional bendable segments bendable by a plurality of additional drive wires; Further comprising: When in a distributed bending mode, the controller is configured to simultaneously move the at least one proximal drive wire, the plurality of additional drive wires, and the at least one distal drive wire. The robot system of claim 1 .

11. The input data for the tip bending mode and the targeting mode of operation is provided from an on-off switching element, and the input data for the distributed bending mode of operation is provided from a range input element. The robot system of claim 1 .

12. a bendable body having a steerable distal section with a distal bendable segment bendable by at least one distal drive wire and a proximal bendable segment bendable by at least one proximal drive wire; one or more first actuators configured to drive the distal drive wires; one or more second actuators configured to actuate the proximal drive wires; a controller that controls the first actuator and the second actuator based on input data of an operation mode and at least one input data of a bend target or a data representation of a bend target; A robot system comprising: The input data for the operational mode may be a selection of a distributed bending mode, in which the controller is configured to move the at least one proximal drive wire and the at least one distal drive wire simultaneously. Robot system.

13. In the distributed bending mode, the controller is configured to move the at least one proximal drive wire and the at least one distal drive wire such that the distal curved segment and the proximal curved segment each bend at a predetermined ratio of the bend angle. The robotic system of claim 12.

14. In the distributed bending mode, the local bending angle of the proximal curved section is smaller than the input data but in the same direction. The robotic system of claim 12.

15. The controller is configured to transition the distal curved segment and the proximal curved segment to a particular bend angle based on input data, the input data further including a previous bend angle. The robotic system of claim 12.

16. The input data for the tip bending mode and the targeting mode of operation is provided from an on-off switching element, and the input data for the distributed bending mode of operation is provided from a range input element. The robotic system of claim 12.

17. inserting a bendable body having a steerable distal section and a working channel into a patient, the steerable distal section including a distal curved segment bendable by at least one distal drive wire and a proximal curved segment bendable by at least one proximal drive wire; navigating the steerable distal section to a target point using a tip bending mode of operation using a controller controlling the at least one distal drive wire and the at least one proximal drive wire; changing the operating mode to a distributed operating mode, in which the controller is configured to simultaneously move the at least one proximal drive wire and the at least one distal drive wire to bend the proximal curved segment at an angle less than a current bend angle and to bend the distal curved segment to the current bend angle; inserting a biopsy tool or a camera through the working channel of the bendable body; A surgical method comprising:

18. In the distributed bending mode, the controller is configured to move the at least one proximal drive wire and the at least one distal drive wire such that the distal curved segment and the proximal curved segment each bend at a predetermined ratio of the bend angle, the ratio being a factor of a length of the curved segment relative to a length of the steerable distal section.

18. The surgical method according to claim 17.

19. The predetermined ratio of the curved section is defined as the length from the proximal end of the steerable distal section to the distal end of the curved segment / the length of the steerable distal section.

20. The surgical method of claim 18.

20. The controller is configured to transition the distal curved segment and the proximal curved segment to a particular bend angle based on input data, the input data further including a previous bend angle.

18. The surgical method according to claim 17.

21. the control unit is configured to return the distal curved segment and the proximal curved segment to a previous position.

18. The surgical method according to claim 17.

22. the control unit is further configured to direct the bendable body to move in a distal or proximal direction a distance related to a displacement of the distal tip due to movement of the first actuator and the second actuator.

18. The surgical method according to claim 17.

23. taking a biopsy sample from the patient at the target point. The surgical method according to claim 15.

Images