an elongated member having a coupler for providing radial translation of the translation member;

Abstract

The device includes a proximal elongated portion, a distal elongated 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. The coupler is longitudinally interposed between the proximal elongated portion and the distal elongated portion. The coupler includes a first channel. The proximal tendon assembly extends through the proximal elongated portion. The proximal tendon assembly includes a proximal portion of the tendon positioned a first radial distance from the central longitudinal axis. The distal tendon assembly extends through the distal elongated portion. The distal tendon assembly includes a distal portion of the tendon positioned a second radial distance from the central longitudinal axis. The tendon passes through the channel of the coupler, and the channel accommodates repositioning of the tendon from the first radial distance to the second radial distance.

Description

[Technical Field]

[0001] (Priority) This application claims the benefit of U.S. Patent Application No. 18 / 536,619, filed December 12, 2023, entitled "Elongate Member with Coupler to Provide Radial Transition of Translating Member," which claims priority to U.S. Patent Application No. 63 / 436,193, filed 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 technology]

[0002] Various surgical instruments include end effectors for use in medical treatments and procedures performed by medical personnel, including applications in robotic-assisted surgery. In robotic-assisted surgery, a surgeon may operate a master controller to remotely control the movement of such surgical instruments at the surgical site. The controller may be located a significant distance from the patient (e.g., across the operating room, in a different room, or in a completely different building from the patient) or in close proximity to the patient in the operating room. The controller may include one or more hand input devices (e.g., joysticks, exoskeleton gloves, master manipulators, etc.) coupled to the surgical instruments by servo mechanisms. In one example, servo motors move manipulators supporting the surgical instruments based on the surgeon's manipulation of the hand input devices. During surgery, the surgeon may employ various surgical instruments via the robotic surgical system, including ultrasonic blades, surgical staplers, tissue graspers, needle holders, electrosurgical cautery probes, etc. Each of these structures performs a function for the surgeon, such as cutting tissue, coagulating tissue, manipulating a needle, grasping a blood vessel, dissecting tissue, or cauterizing tissue. Robotically controlled instruments can be introduced into the patient through an incision, through a naturally occurring orifice, or otherwise.

[0003] While several robotic surgical systems and related components have been made and used, it is believed that no one prior to the present inventors has made or used the invention as set forth in the appended claims. [Brief explanation of the drawings]

[0004] While this specification concludes with claims particularly pointing out and distinctly claiming the present technology, the present technology will be better understood from the following description of certain specific embodiments read in conjunction with the accompanying drawings, in which like reference numerals identify the same elements. [Figure 1] FIG. 1 shows a top view of a robotic surgical system being used in a urological procedure. [Figure 2] 2 shows a schematic diagram of various components of the robotic surgical system of FIG. 1. [Figure 3] 10A-B show enlarged views of other components of the robotic surgical system of FIG. 1, including the distal portion of the ureteroscope. [Figure 4] FIG. 2 shows a schematic diagram of one example of an articulating elongate member that may be used with the robotic surgical system of FIG. 1. [Figure 5] 5 shows a cross-sectional end view of the elongated member of FIG. 4 taken along line 5-5 of FIG. 4. [Figure 6] 6 illustrates a cross-sectional end view of the elongate member of FIG. 4 taken along line 6-6 of FIG. 4. [Figure 7] 5 shows a perspective view of the elongate member coupler of FIG. 4. [Figure 8] 8 shows another perspective view of the coupler of FIG. 7. [Figure 9] 8 shows a side view of a portion of the elongate member of FIG. 4 illustrating translation of a tendon assembly along the coupler of FIG. 7. [Figure 10] 10 illustrates a cross-sectional side view of the elongated member of FIG. 4 taken along line 10-10 of FIG. 4.

[0005] The drawings are not intended to be limiting in any manner, and it is contemplated that various embodiments of the technology may be embodied in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings, which are incorporated in and form a part of this specification, illustrate several aspects of the technology and, together with the description, serve to explain the principles of the technology, although it is understood that the technology is not limited to the precise arrangements shown. DETAILED DESCRIPTION OF THE INVENTION

[0006] The following description of certain examples of the present technology should not be used for the purpose of limiting its scope. Other examples, features, aspects, embodiments, and advantages of the present technology will become apparent to those skilled in the art from the following description, which is, by way of example, one of the best modes contemplated for carrying out the present technology. As will be understood, the technology described herein is capable of other different and obvious modes, all without departing from the technology. Therefore, the drawings and descriptions should be regarded as illustrative in nature, and not as restrictive.

[0007] It should be further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Therefore, the teachings, expressions, embodiments, examples, etc. described below should not be considered in isolation from one another. Various suitable ways in which the teachings herein may be combined will be readily apparent to those skilled in the art in light of the teachings herein. Such modifications and variations are intended to be within the scope of the claims.

[0008] For clarity of this disclosure, the terms "proximal" and "distal" are defined herein relative to a human or robotic surgical instrument operator. The term "proximal" refers to the location of an element closer to a human or robotic surgical instrument operator and further from a surgical end effector of the surgical instrument. The term "distal" refers to the location of an element closer to a surgical end effector of the surgical instrument and further from a human or robotic surgical instrument operator. It will also be recognized that for convenience and clarity of exposition, spatial terms such as "side," "upwardly," and "downwardly" are used herein to refer to relative positions and directions. Such terms are used hereinafter with reference to the figures as illustrated for clarity and are not intended to limit the invention described herein.

[0009] Aspects of the present embodiments described herein may be integrated into robotic-enabled medical systems, including robotic surgical systems capable of performing a variety of medical procedures, including both minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopic procedures, such as bronchoscopy, ureteroscopy, and gastroscopy, among other endoscopic procedures.

[0010] In addition to performing a wide range of procedures, robotic-enabled medical systems may offer further advantages, such as enhanced imaging and guidance to assist medical personnel. Additionally, robotic-enabled medical systems may provide medical personnel with the ability to perform procedures from an ergonomic position without requiring awkward arm movements or postures. Still further, robotic-enabled medical systems may provide medical personnel with the ability to perform procedures with improved ease of use, such as when one or more instruments of the robotic-enabled medical system are controlled by a single operator.

[0011] I. Examples of robot-enabled medical systems FIG. 1 illustrates an exemplary medical system 100 for performing various medical procedures in accordance with aspects of the present disclosure. The medical system 100 may be used, for example, in endoscopic (e.g., ureteroscopic) procedures. One particular ureteroscopic procedure involves the treatment / removal of kidney stones. While the system 100 of FIG. 1 is presented in the context of a ureteroscopic procedure, it should be understood that the principles disclosed herein may be implemented in any type of endoscopic (e.g., bronchial, gastrointestinal) and / or percutaneous procedure.

[0012] The medical system 100 of this example includes a robotic system 10 (e.g., a mobile robotic cart) configured to engage and / or control one or more medical instruments (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 variations, the robotic system 10 and / or control system 50 are configured to receive from a scope 40 and / or display images and / or image data representative of the internal anatomy of the patient 7, i.e., the urinary system for the particular depiction of FIG. 1 .

[0013] It should be understood that the direct entry instruments operating through the systems 10, 50 may include any type of medical instrument or combination of instruments, including an endoscope (e.g., ureteroscope 40), a catheter (e.g., steerable or non-steerable catheter), a nephroscope, a laparoscope, a basket system 30, or other types of medical instruments. The various scope-type instruments disclosed herein, such as the scope 40 of the system 100, may be configured to navigate within the human anatomy, such as within a natural orifice or lumen of the human anatomy. The terms "scope" and "endoscope" are used herein in accordance with their broad and ordinary meanings and may refer to any type of elongated medical instrument having imaging, viewing, and / or capture capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space in the body. Scopes may include, for example, ureteroscopes (e.g., for accessing the urinary tract), laparoscopes, nephroscopes (e.g., for accessing the kidneys), bronchoscopes (e.g., for accessing the airways such as the bronchi), colonoscopes (e.g., for accessing the colon), arthroscopes (e.g., for accessing the joints), cystoscopes (e.g., for accessing the bladder), colonoscopes (e.g., for accessing the colon and / or rectum), borescopes, etc. Scopes / endoscopes may, in some cases, comprise a rigid or flexible tube and may be sized to be passed within an outer sheath, catheter, introducer, or other luminal device, or may be used without such a device.

[0014] The medical system 100 of this embodiment further includes a control system 50, a table 15, and an electromagnetic (EM) field generator 18. The table 15 is configured to support a patient 7. The EM field generator 18 may be held by one or more of the robotic arms 12 of the robotic system 10 or may be a stand-alone device. As shown in FIGS. 1-2 , the control system 50 includes various input / output (I / O) components 258 configured to assist a physician 5 or others in performing a medical procedure. For example, the I / O components 258 may be configured to allow user input to control / navigate the scope 40 and / or basket system 30 within the patient 7. The I / O components 258 of this example include a controller 55 configured to receive user input from an operator and a display 56 configured to present certain information to assist the operator. The controller 55 may take any suitable form, including, but not limited to, one or more buttons, keys, joysticks, handheld controllers (e.g., video game-style controllers), computer mice, trackpads, trackballs, control pads, and / or sensors (e.g., motion sensors or cameras) that capture hand and finger gestures, touchscreens, etc.

[0015] As also shown in FIG. 2 , the control system 50 of this example includes a communication interface 254 operable to provide a communication interface between the control system 50 and the robotic system 10, the basket system 30, the scope 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 provide communication via wired, wireless, and / or other modalities. The control system 50 also includes a power interface 259, which may receive power to operate the control system 50 via wires, batteries, and / or any other suitable type of power source. The control circuitry 251 of the control system 50 may provide signal processing and execute control algorithms to achieve the functions of the medical system 100 as described herein.

[0016] The control system 50 may also communicate with the robotic system 10 to receive position data from the robotic system 10 regarding the position of the distal end of the scope 40, the access sheath 90, or the basket device 30. Such position data regarding the position of the scope 40, the access sheath 90, or the basket device 30 may be derived using one or more electromagnetic sensors associated with the respective components. Additionally, in some variations, 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 communicate with the EM field generator 18 to control the generation of the EM field in the area surrounding the patient 7.

[0017] As described above and shown in FIGS. 1-2, the robotic system 10 includes robotic arms 12 configured to engage with and / or control a scope 40 and / or basket system 30 to perform one or more aspects of a procedure. It should be understood that the robotic arms 12 may be coupled to instruments different from those shown in FIG. 1 , and in some scenarios, one or more of the robotic arms 12 may not be utilized or coupled to a medical instrument. Each robotic arm 12 includes multiple arm segments 23 coupled to joints 24 that may provide multiple degrees of movement / freedom. In the example of FIG. 1 , the robotic system 10 is positioned adjacent a patient's leg, and the robotic arms 12 are operable to engage and position the scope 40 for access into an access opening, such as the urethra 65, of the patient 7. Once the robotic system 10 is properly positioned, the scope 40 can be inserted into the patient 7 robotically using the robotic arms 12, manually by the physician 5, or a combination thereof. A scope-driver instrument coupling 11 (i.e., 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 scope 40. Another of the arms 12c can include an instrument coupling / manipulator 19 configured to facilitate advancement and manipulation of the basket device 30. The scope 40 can include one or more working channels through which additional tools, such as a lithotriptor, basket device, forceps, etc., can be introduced into the treatment site.

[0018] The robotic system 10 may 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 scope 40, the basket system 30, and / or any type of percutaneous access device (e.g., needle, catheter, nephroscope, etc.). As described above, the robotic system 10 may be communicatively coupled to the control system 50 via communications interfaces 214, 254. The robotic system 10 also includes a power interface 219, which may receive power for operating the robotic system 10 via wires, batteries, and / or any other suitable type of power source. 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 may include any of the various types of I / O components 258 described herein in the context of control system 50. Additionally, or alternatively, I / O components 218 of robotic system 10 may take any suitable form (or may be omitted entirely).

[0019] The robotic system 10 of this example generally includes a column 14, a base 25, and a console 13 at the top of the column 14. The column 14 may include one or more arm supports 17 (also referred to as "carriages") to support the deployment of one or more robotic arms 12 (three are shown in FIG. 2). The arm supports 17 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arms 12 for more desired positioning relative to the patient. In some variations, the arm supports 17 may be connected to the column 14 through slots 20 located on either side of the column 14 to guide vertical translation of the arm supports 17 along the column 14. The robotic arm 12 of this example generally includes a robotic arm base 21 and an end effector 22 separated by a series of articulated arm segments 23 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. I / O components 218 may be located at the top of the column 14. The console 13 also includes a handle 27 to assist in manipulating and stabilizing the robotic system 10.

[0020] Each end effector (213) of the robotic arm (12) may include an instrument device manipulator (IDM) that may be attached using a mechanism changer interface (MCI). In some variations, the IDMs (213) may be removed and replaced with different types of IDMs (213), e.g., a first type (11) of IDMs (213) may operate a scope (40), while a second type (19) of IDMs (213) may operate a basket system (30). Another type of IDM (213) may be configured to hold an electromagnetic field generator (18). The MCI may include a power and control interface (e.g., connectors for transmitting pneumatic, electrical, and / or optical signals) from the robotic arm (12) to the IDM (213). The IDM (213) may be configured to operate a medical instrument (e.g., a surgical tool / instrument), such as a scope (40), using technologies including, for example, direct drive, harmonic drive, gear drive, belt and pulley drive, magnetic drive, and the like.

[0021] The system 100 may include specific control circuitry configured to perform certain functions described herein, including the control circuitry 211 of the robotic system 10 and the control circuitry 251 of the control system 50. That is, the control circuitry of the system 100 may be part of the robotic system 10, the control system 50, or some combination thereof. The term "control circuitry" is used herein according to its broad and ordinary meaning and may refer to any collection of processors, processing circuits, processing modules / units, chips, dies (e.g., semiconductor dies containing one or more active and / or passive devices and / or connectivity circuits), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuits, analog circuits, digital circuits, and / or any devices that manipulate signals (analog and / or digital) based on hard-coded and / or operational instructions in the circuitry. The control circuitry referred to herein may further include one or more circuit boards (e.g., printed circuit boards), conductive traces and vias, and / or mounting pads, connectors, and / or components. The control circuitry referred to herein may further 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, cache memory, data storage registers, and / or any device that stores digital information. It should be noted that in variations where the control circuitry comprises hardware and / or software state machines, analog circuits, digital circuits, and / or logic circuits, the data storage devices / registers that store any relevant operating instructions may be embedded within or external to the circuitry that comprises the state machines, analog circuits, digital circuits, and / or logic circuits.

[0022] The control circuitry (211, 251) may include computer-readable media that store and / or are configured to store hard-coded and / or operational instructions corresponding to at least some of the steps and / or functions illustrated in one or more of the present figures and / or described herein. Such computer-readable media may, in some cases, be included in an article of manufacture. The control circuitry (211, 251) may be maintained / distributed entirely locally or may be at least partially remotely located (e.g., indirectly communicatively coupled via a local area network and / or wide area network).

[0023] In some variations, for example, the physician 5 may provide input to the control system 50 and / or the robotic system 10, and in response to such input, control signals may be sent to the robotic system 10 to operate the scope 40 and / or the catheter basket system 30. The control system 50 may include one or more display devices 56 to provide various information related to the procedure. For example, the display 56 may provide information related to the scope 40 and / or the basket system 30. For example, the control system 50 may receive real-time images captured by the scope 40 and display the real-time images via the display 56.

[0024] As shown in FIG. 2 , the basket device 30 of this example includes a basket 35 formed from one or more wire tines 36 disposed along its length within a basket sheath 37, with the tines protruding 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 sheath 37 may be coupled to respective actuators 75 of the basket cartridge component 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 be used to assist in basket control, either manually or through robotic control. Basket system 30 may be powered through power interface 39 and / or controlled through control interface 38, each or both of which may interface with a robotic arm / component of robotic system 10. Basket system 30 may further include one or more sensors 72, such as pressure and / or other force reading sensors, which may be configured to generate signals indicative of forces experienced at / by actuator 75 and / or one or more of the other couplings of basket system 30.

[0025] In one example use case, if a patient 7 has a kidney stone 80 located in a kidney 70, a physician may perform a procedure to remove the stone 80 through the ureter 65, 60, 63. Specifically, as shown in FIG. 1 , the physician may operate the medical system 100 to achieve direct entry of the scope 40 into the ureter 65, 60, 63 of the patient 7 via the urethra 65. The physician 5 may interact with the control system 50 and / or the robotic system 10 to control the robotic system 10 to advance and navigate the scope 40 from the urethra 65, through the bladder 60, up the ureter 63, and into the renal pelvis 71 and / or calyx omentum of the kidney 70, where the stone 80 is located. The physician 5 can further interact with the control system 50 and / or the robotic system 10 to effect / control the advancement of the basket device 30 through the working channel of the scope 40, the basket device 30 being configured to facilitate capture and removal of kidney stones. The control system 50 can provide information associated with the medical instrument 40 and / or other instruments of the system 100, such as real-time endoscopic images captured by the medical instrument 40, via the display 56 to assist the physician 5 in navigating / controlling such instruments.

[0026] In this embodiment, a ureteral access sheath 90 is disposed within the ureter 65, 60, 63 to an area near the kidney 70. The shaft 40 can be passed through the ureteral access sheath 90 to access the internal anatomical structures of the kidney 70, as shown. Upon arriving at the site of the kidney stone 80 (e.g., within the target calyx 73 of the kidney 70 where the stone 80 is accessible), the scope 40 can be used to guide / direct the basket device 30 to the target location. Once the stone 80 is captured within the distal basket portion 35 of the basket device 30, the kidney stone 80 can be extracted from the patient 7 using the utilized ureteral access pathway.

[0027] FIG. 3 shows one example of a scope 440 that can be used as the scope 40 described above. The scope 440 of this example includes a working channel 444 for deploying medical instruments (e.g., a lithotriptor, basket system 30, forceps, etc.), irrigation, and / or suction relative to a working area at the distal end of the scope 440. The scope 440 can be articulated, such as relative to at least a distal portion of the scope 440, so that the scope 440 can be maneuvered within the human anatomy. In some variations, the scope 440 is configured to articulate with five degrees of freedom, including, for example, X, Y, and Z coordinate movement, as well as pitch and yaw. In some variations, the scope 440 provides six degrees of freedom, including X, Y, and Z ordinate positions, as well as pitch, roll, and yaw. The position sensors of the scope 440 can similarly have similar degrees of freedom for the position information they generate / provide. As shown in FIG. 3, the tip (442) of the scope (440) can be oriented with zero deflection relative to its longitudinal axis (406) (also referred to as the "roll axis").

[0028] In this example, the scope 440 may house an optical assembly, which may include an imaging device 448, such as an optical camera, and wires and / or optical fibers for transmitting signals to / from the distal end 442 of the scope 440. The imaging device 448 may be used to capture images of an internal anatomical space, such as the target cup / papilla of the kidney 70. The scope 440 may be further configured to house optical fibers for carrying light from a proximally located light source, such as a light-emitting diode, to the distal end 442 of the scope 440. The distal end 442 of the scope 440 may include a port for a light source to illuminate the anatomical space when the imaging device 448 is in use. The imaging device 448 may comprise an optical fiber, a fiber array, and / or a lens, or a light-emitting diode at the distal end 442. The optical components of the imaging device (448) move with the distal end (442) of the scope (440) such that movement of the distal end (442) of the scope (440) results in changes in the image captured by the imaging device (448).

[0029] To capture images at different orientations of the tip 442, the robotic system 10 may be configured to deflect the tip 442 on the positive yaw axis 402, the negative yaw axis 403, the positive pitch axis 404, the negative pitch axis 405, or the roll axis 406. The tip 442 or the body 445 of the scope 442 may extend or translate on the longitudinal axis 406, the x-axis 408, or the y-axis 409. The scope 440 may include a reference structure (not shown) for calibrating the position of the scope 440. For example, the robotic system 10 and / or the control system 50 may measure the deflection of the scope 440 relative to the reference structure. The reference structure may be located on the proximal end of the endoscope 440 and may include, for example, a key, slot, or flange.

[0030] The robotic arm 12 of the robotic system 10 may be configured / configurable to manipulate the scope 440 as described above. Such manipulation may be performed by actuating one or more elongated members, such as one or more pull wires (e.g., pull wires or push wires), cables, fibers, and / or flexible shafts. For example, the robotic arm 12 may be configured to actuate multiple pull wires (not shown) coupled to the scope 440 to deflect the tip 442 of the scope 440. The pull wires may comprise any suitable or desirable material, such as metallic and non-metallic materials, such as stainless steel, aramid fiber, tungsten, carbon fiber, and the like. In some variations, the scope 440 is configured to exhibit nonlinear behavior in response to forces applied by the elongated movement members. The nonlinear behavior may be based on the stiffness and compressibility of the scope 440 and the variability in sag or stiffness between different elongated movement members.

[0031] In some variations, the scope 440 includes at least one sensor configured to generate and / or transmit sensor position data to another device. The sensor position data can indicate the position and / or orientation of the scope 440 (e.g., its distal end 442) and / or can be used to determine / estimate the position / or orientation of the scope 440. For example, the sensor (sometimes referred to as a "position sensor") can include an electromagnetic (EM) sensor having a coil of conductive material or other form of antenna. In some variations, the position sensor is located on the distal end 442 of the scope 440, while in other embodiments, the sensor is located elsewhere on the scope 440.

[0032] As shown in FIG. 3 , the EM field generator 18 is configured to broadcast an alternating EM field 90 that is detected by the EM position sensor of the scope 440. The alternating magnetic field (MF) can induce small currents in the coils of the EM position sensor, which 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 scope 440 may include other types of sensors, such as shape-sensing 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 scope 440 provides sensor data to the control system 50, which is then used to determine the position and / or orientation of the scope 440.

[0033] In some variations, any of the above-described features and aspects may be implemented in accordance with the teachings of 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. Patent Application 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. Patent Application 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. Patent Application Publication No. 2021 / 0401527, entitled "Robotic Medical Systems Including User Interfaces with Graphical Representations of User Input Devices," published on March 31, 2022, the disclosure of which is incorporated herein by reference in its entirety. The present invention may be constructed and operable in accordance with at least some of the teachings of U.S. Patent Application Publication No. 2022 / 0096183, entitled "Ultra-High Performance Computing System for Mobile Devices," which is incorporated herein by reference.

[0034] II. Coupler Embodiments for Providing Radial Translation of Tendon Assembly As described above, the robotic system 10 may include one or more articulating elongate instruments, such as the scope 40, the access sheath 90, the scope 440, a catheter, and / or other types of elongate instruments. Some such articulating elongate instruments may include one or more translational features that drive the articulation. The inclusion of such translational articulation drive features may tend to be associated with certain design constraints or requirements. For example, it may be desirable to provide some degree of force isolation for translational articulation drive features along a particular longitudinal region (e.g., a proximal region) of the elongate instrument so that actuation of the drive feature only causes articulation of another particular longitudinal region (e.g., a distal region) of the elongate instrument. It may also be desirable to minimize friction for translation of the translational articulation drive features. Such friction reduction may be particularly challenging in scenarios where the translational articulation drive features must traverse multiple elements that move relative to one another (e.g., an array of beads or vertebrae along an articulation joint).

[0035] In articulating elongate instruments that include one or more internal working channels for receiving other instruments and have maximum cross-sectional area constraints, translational articulation drive features may justify a compromise between achieving a suitably sized internal working channel and achieving a suitably sized overall outer diameter. In elongate instruments that have additional features at the distal portion of the instrument (e.g., one or more camera and / or lighting features of scope 40), it is desirable for translational articulation drive features to be positioned to accommodate structures associated with such additional distal features, although it may not be necessary for the translational articulation drive features to accommodate those additional distal features along the proximal portion of the elongate instrument.

[0036] It may also be desirable for an elongate instrument to have a proximal portion with a substantially different architecture than the architecture of the distal portion of the elongate instrument, or even a series of three or more longitudinally staggered portions, each with its own unique architecture. Such different architectures may include those providing different degrees of flexibility, different types of articulation (e.g., single-plane articulation vs. bi-plane articulation), a dichotomy of articulation vs. non-articulation, or other types of different architectures. Some such elongate instruments may justify having translational articulation drive features that traverse the entire length of the elongate instrument, such that the translational articulation drive features must traverse these longitudinally varying architectures. This may exacerbate the potential design challenges discussed above in the context of translational articulation drive features.

[0037] The following describes an embodiment of an articulating elongate member having a translational articulation drive feature that can easily traverse longitudinally varying architectures along the length of the elongate member with minimal friction, while also easily accommodating other structural features in the distal portion of the elongate member without adversely affecting the outer diameter of the elongate member. Specifically, FIG. 4 illustrates one embodiment of an articulating elongate member 500 that can be used with the robotic surgical system 10. By way of example only, the elongate member 500 can represent a variation of the scope 40, the access sheath 90, or the scope 440. Alternatively, the elongate member 500 can take the form of a catheter and / or any other suitable type of elongate instrument. The elongate member 500 of this embodiment includes a proximal portion 510, a distal portion 512, and a coupler 600 that joins the portions 510, 512. In this embodiment, the distal portion 512 is operable to articulate such that the distal end 504 of the elongate member 500 can be deflected laterally away from and toward the central longitudinal axis LA (e.g., as defined by the proximal portion 510). Also in this embodiment, the proximal portion 510 is flexible but not configured to articulate. In some variations, 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 may include one or more articulating sections, and / or the proximal portion 510 may include one or more articulating sections.

[0038] Proximal portion 510 is coupled to instrument interface 11 of robotic surgical system 10 such that robotic surgical system 10 is operable to drive elongated member 500 via instrument interface 11. By way of example only, robotic surgical system 10 may be operable to drive translation along central longitudinal axis LA, rotation (e.g., spin about central longitudinal axis LA), articulation, and / or other forms of movement of / by elongated member 500.

[0039] The distal end (504) of this embodiment may include one or more openings through which one or more additional instruments may pass and exit into a surgical space or other anatomical region within a patient. The distal end (504) may also include one or more imaging devices, such as an imaging device (448), which may take the form of one or more cameras, one or more optical fibers with corresponding lenses, etc. The distal end (504) may 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 variations, the distal end (504) includes an end effector operable to perform one or more operations on tissue, such as grasping, cutting, suturing, sealing (e.g., via RF or ultrasonic energy), stapling, etc.

[0040] As shown in FIG. 5 , the catheter 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, either shaft 502, 522 may comprise a flexible laser-cut steel hypotube, a braided structure, or any other suitable type of structure. In some variations, the outer shaft 502 provides primary structural support while the inner shaft 522 functions as a liner (e.g., a low-friction coating such as polytetrafluoroethylene). In some other variations, the inner shaft 522 provides primary structural support while the outer shaft 502 functions as a liner (e.g., a low-friction coating such as polytetrafluoroethylene). As yet another variation, either shaft 502, 522 may comprise a reflow material, such as polyether block amide (PEBA) and / or any other suitable type of material. Some other variations may provide only one single shaft (502, 522) such that the other shafts (502, 522) are omitted.

[0041] The inner shaft (522) defines an inner lumen (520). The inner lumen channel (520) is configured to receive other components. By way of example only, the inner lumen may receive a coil pipe, Bowden tube, electrical wire, or the like. In this embodiment, the inner lumen receives a working channel (506), which may comprise a braided shaft and / or any other suitable component. The working channel (506) defines a lumen (508). In some variations, the lumen (508) slidably receives other instruments. By way of example only, the basket (35) and basket sheath (37) of the basket device (30) may be advanced distally through the lumen (508) of the working channel (506) within the inner lumen (520). By way of further example only, a laser fiber or other instrument may be disposed in the lumen (508) of the working channel (506). Alternatively, fluid (e.g., liquid, suction, etc.) may be communicated through lumen 508 of working channel 506. Inner lumen 520 and working channel 506 may extend all the way to distal end 504, with inner lumen 520 terminating in a distal opening that allows an instrument disposed in working channel 506 to exit distally from elongate member 500. Although not shown, other features, such as electrical wires, optical fibers, flex circuits, etc., may extend along at least a portion of the length of inner lumen 520, outside of working channel 506.

[0042] As also shown in FIG. 5 , the proximal tendon assembly (530) in this example extends through the inner lumen (520) outside the working channel (506). In some variations, the proximal tendon assembly (530) is freely disposed within the inner lumen (520). In some other variations, 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) so that the proximal tendon assembly (530) is rigidly secured within the inner lumen (520). In this example, the elongate member (500) includes four proximal tendon assemblies (530) that are angularly spaced equidistant from one another (i.e., approximately 90 degrees). In some other variations, one to three proximal tendon assemblies (530) are provided, while in other variations, five or more 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 compress longitudinally. By way of example only, the housing (532) may be configured as a coil pipe formed from round or square steel wire. As another example, the housing (532) may include several adjacent helically wound wires. Alternatively, the housing (532) may take any other suitable form. In some variations, the housing (532) includes a low-friction (e.g., polytetrafluoroethylene) lining within the lumen (534).

[0043] Each tendon (536) has a distal end that is rigidly fixed to 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 a distal end that is rigidly fixed at a location proximal to the distal portion (512). By way of example only, each tendon (536) may comprise a pull wire, a drive band, a single-strand cable, a multi-strand cable, one or more metals, one or more fibers, and / or any other suitable component operable to transmit tensile force along the length of the elongate member (500), thereby providing articulation of the elongate member (500) without substantial stretching. Such tendons (536) may also be coupled to the instrument interface (11) of the robotic surgical system (10) such that the robotic surgical system (10) is operable to drive the tendons (536) via the instrument interface (11).

[0044] As shown in FIG. 6 , 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 comprise a flexible laser-cut steel hypotube, a braided structure, a link assembly, or any other suitable type of structure. The inner shaft 570 is defined by the inner shaft 522 and provides a continuation of the inner lumen 520 described above. Thus, the working channel 506 and / or other components (e.g., electrical wires, etc.) disposed in the inner lumen 520 in the proximal portion 510 may freely continue through the inner lumen 520 in the distal portion 512. The braid assembly 560 includes multiple wire strands 562 wound to form an elongated braided structure extending along the length of the distal portion 512.

[0045] The distal portion 512 of this embodiment further includes a distal tendon assembly 540. As 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, with a corresponding tendon 536 disposed in the lumen 544. By way of example only, the housing 542 may be configured as a tubular body embedded within the wall of the braid assembly 560 (e.g., interwoven between the inner and outer wire strands 562 of the braid assembly 560). Alternatively, the housing 542 may 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.

[0046] As shown in FIG. 6 , the distal tendon assemblies (540) are interwoven with the braid assembly (560) such that each distal tendon assembly (540) is disposed in a space (564) defined by the wire strands (562). In some other variations, each distal tendon assembly (540) is radially interposed between the braid assembly (560) and the inner shaft (570). In either scenario, each distal tendon assembly (540) may extend along a path that is parallel to the central longitudinal axis (LA) of the distal portion (512). It should also be understood that positioning the distal tendon assemblies (540) within the braid assembly (560) or otherwise radially outward of the inner shaft (570) may maximize the amount of space available within the portion of the inner lumen (520) that extends through the distal portion (512). This may allow the portion of the inner lumen (520) extending through the distal portion (5012) to more easily accommodate components associated with functions provided at the distal end (504) (e.g., one or more camera components at the distal end (504), mechanical components of a mechanically actuated end effector at the distal end (504), etc.).

[0047] The body 514 in this embodiment is formed around the exterior of the braid assembly 560. By way of example only, the body 514 may be formed around the exterior of the braid assembly 560 by a reflow process and / or any other suitable process. The body 514 may comprise a reflow material, such as polyether block amide (PEBA) and / or any other suitable type of material. At least a portion of the material used to form the region of the body 514 outside the braid assembly 560 may also reach the region between the braid assembly 560 and the inner shaft 570, as shown in FIG. 6 . In scenarios where the distal tendon assembly (540) is prone to exerting outward forces on the body (514) (e.g., during bending of the elongate member (500), particularly during actuated articulation), the braid assembly (560) can effectively absorb such forces, thereby shielding the body (514) from any damage that may be caused to the body (514) by the distal tendon assembly (540). With the distal tendon assembly (540) woven between the inner and outer wire strands (562) of the braid assembly (560), the braid assembly (560) can also maintain the angular position of the distal tendon assembly (540) about the central longitudinal axis (LA).

[0048] The coupler (600) is longitudinally interposed between the proximal portion (510) and the distal portion (512). As shown in FIGS. 7-8, the coupler (600) includes a hollow body (602) defining 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 a working channel to pass continuously through the coupler (600) from the proximal portion (510) to the distal portion (512). The body (602) is formed of a rigid material (e.g., molded plastic, etc.) as a single monolithic piece. In some other variations, the hollow body (602) is formed as an assembly of components (e.g., laminated disks, etc.).

[0049] The channels 610 are angularly spaced equidistant from one another (i.e., 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 entirely through the inner surface 604 of the body 602, while each distal portion 614 does not open entirely through the inner surface 604 of the body 602. A proximally-facing shoulder 618 is located at the transition from the proximal portion 616 to the distal portion 614.

[0050] As shown in Figures 9-10 (with the working channel 506 omitted for clarity), the coupler 600 is configured to abut the distal end of the proximal portion 510 and the proximal end of the distal portion 512. Because 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 a mechanical foundation between the distal end of the proximal portion 510 and the proximal end of the distal portion 512. As also shown in Figures 9-10, the proximal portion (616) of each channel (610) is configured to receive a corresponding housing (532) of each proximal tendon assembly (530), while the distal portion (614) of each channel (610) is configured to receive a corresponding tendon (536). When the housing (532) is mated with 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 a mechanical foundation between the housing (532), the coupler (600), the distal end of the proximal portion (510), and the proximal end of the distal portion (512).

[0051] As shown in FIG. 5, each tendon (536) is positioned a first radial distance R1 from the central longitudinal axis (LA) along the proximal portion (510). As shown in FIG. 6, each tendon (536) is positioned a second radial distance R2 from the central longitudinal axis (LA) along the distal portion (512). The second radial distance R2 is greater than the first radial distance (R1). Thus, to effectively transition the tendons (536) from the proximal portion (510) to the distal portion (512), the channels (610) guide the tendons radially outward from the first radial distance R1 to the second radial distance R2. This is best seen in FIG. 10. As mentioned 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 with the proximally facing shoulder surface (618) and the tendon (536) to enter the distal portion (614) of the channel (610).

[0052] 7-8, the coupler (600) of this embodiment includes three distal recesses (630) angularly spaced apart from one another. Similarly, the coupler (600) of this embodiment includes three proximal recesses (620) angularly spaced apart from one another. 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 engage with complementary features (e.g., tabs) at the proximal end of the distal portion (512), and the proximal portion (620) is configured to engage with complementary features (e.g., tabs) at the distal end of the proximal portion (510). In this embodiment, the recesses (620, 630) and the complementary features of the portions (510, 512) are asymmetrically positioned about the central longitudinal axis (LA) such that two of the recesses (620, 630) are angularly separated from each other by 180 degrees in one angular region of the coupler (600), and the recesses (620, 630) are angularly separated from each other by 90 degrees in another angular region of the coupler (600). This relationship may provide a consistent, predetermined angular positioning between the coupler (600) and the distal portion (512) about the central longitudinal axis (LA). Similarly, the proximal recess (520) is configured to engage a complementary feature at the distal end of the proximal portion (510), thereby providing a consistent, predetermined angular positioning between the coupler (600) and the proximal portion (510) about the central longitudinal axis (LA). It should therefore be appreciated that coupler (600) can function as a poka-yoke feature to ensure that proximal portion (510) and distal portion (512) are properly angularly aligned with one another about central longitudinal axis (LA).

[0053] While three recesses 620 are provided in this example, other variations may include only one recess 620 or more than three recesses 620. The number of complementary features (e.g., tabs, etc.) at the proximal end of distal portion 512 may vary accordingly. Similarly, while three recesses 630 are provided in this example, other variations may include only one recess 630 or more than three recesses 630. The number of complementary features (e.g., tabs, etc.) at the distal end of proximal portion 510 may vary accordingly.

[0054] As mentioned above, the body 514 may be formed around the exterior of the braid assembly 560 by 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 may have an outer layer formed using the reflow material. Such an outer layer may extend continuously along both the sections 510, 512 and the coupler 600, thereby providing a smooth, continuous outer surface along the length of the elongate member 500. In some such variations, the same reflow material (and process) used to form the body 514 may be used to form such an outer layer that extends continuously along both the sections 510, 512 and the coupler 600. Alternatively, any other suitable type of component (e.g., wrap, jacket, etc.), material, and process (e.g., heat shrink, etc.) may be used to form an outer layer that extends continuously along both portions (510, 512) and coupler (600).

[0055] While the above-described embodiment includes only two sections (510, 512) joined by a single coupler (600), other variations may include three or more sections joined by two or more couplers. For example, some variations may include an elongate member having a proximal section joined to an intermediate section via a first coupler and a distal section joined to the intermediate section via a second coupler. In some such variations, the proximal section may provide flexibility but not articulation, the intermediate section may provide articulation along only one plane, and the distal section may provide articulation along two orthogonal planes independent of the articulation of the intermediate section. As another example of a variation, the proximal section may provide flexibility but not articulation, the intermediate section may provide articulation along two orthogonal planes, and the distal section may provide articulation along two orthogonal planes independent of the articulation of the intermediate section. Still other variations will be apparent to those skilled in the art in light of the teachings herein. In any of these alternative scenarios, couplers such as coupler (600) can facilitate the traversal of tendons (536) and other longitudinally extending components that continuously cross such different portions having different architectures and functions.

[0056] Although the channels 610 of the coupler 600 in this embodiment are all parallel to the central longitudinal axis (LA) in this embodiment, the channels 610 may be oriented differently in other variations. For example, in some variations, the channels 610 may have a helical orientation about the central longitudinal axis (LA). Such a helical orientation of the channels 610 may angularly reposition the tendon 536 or other longitudinally extending component 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 component transitions from the proximal portion 510 to the distal portion 512. As noted above, some elongate members may include multiple couplers. This angular repositioning may be provided multiple times along the length of the elongate member, with each coupler providing a unique repositioning of the tendon (536) or other longitudinally extending component.

[0057] While the above-described embodiment provides tendons (536) within the lumens (534, 544) of the housings (532, 542), other variations may provide other types of components within the lumens (534, 544) of the housings (532, 542). Examples of such other components include, but are not limited to, electrical wires, irrigation channels, optical fibers, etc.

[0058] III. Combination Examples The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to limit the scope of any claims that may be presented at any time in this application or any subsequent application related to this application. No disclaimer is intended. The following examples are provided merely for illustrative purposes. It is contemplated that the various teachings herein may be configured and applied in many other ways. It is also contemplated that in some variations, certain features referred to in the following examples may be omitted. Accordingly, none of the aspects or features referred to below should be deemed critical unless later expressly indicated otherwise by the inventors or their successors. If a claim presented in this application or a subsequent application related to this application includes additional features other than those referred to below, those additional features should not be deemed added for any reasons regarding patentability. [Example]

[0059] The device includes: (a) a proximal elongated portion, the proximal elongated portion being flexible; (b) a distal elongated portion, the distal elongated portion being 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; and (d) a first proximal tendon assembly extending through the proximal elongated portion, the first proximal tendon assembly being spaced apart from the central longitudinal axis by a first channel. 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 a second radial distance from the central longitudinal axis, wherein the first tendon passes through a 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. [Example]

[0060] The device of claim 1, wherein the coupler is configured to provide a mechanical foundation between the distal end of the first elongated portion and the proximal end of the second elongated portion. [Example]

[0061] 3. The device of example 2, wherein the coupler abuts a distal end of the first elongated portion, and the coupler further abuts a proximal end of the second elongated portion. [Example]

[0062] The device of any one of Examples 1-3, wherein the first tendon assembly is operable to drive articulation of the distal elongated portion. [Example]

[0063] A device described in any one of Examples 1 to 4, wherein the first proximal tendon assembly comprises a housing, and the proximal portion of the first tendon is slidably disposed within the housing of the first proximal tendon assembly. [Example]

[0064] 6. The device of example 5, wherein the housing has a distal end, the distal end of the housing abutting a surface of the coupler. [Example]

[0065] 7. The apparatus of example 5 or 6, wherein the housing comprises a coil pipe. [Example]

[0066] The device of any one of Examples 1 to 7, wherein the proximal elongated portion defines a proximal portion of the inner lumen. [Example]

[0067] The device of Example 8, wherein the first proximal tendon assembly is positioned in the inner lumen. [Example]

[0068] The device of Example 9, wherein the first proximal tendon assembly is movable within the inner lumen. [Example]

[0069] 11. The device of claim 8, wherein the distal elongated portion defines a distal portion of the inner lumen. [Example]

[0070] 12. The device of example 11, wherein the inner lumen extends continuously from the proximal elongated portion to the distal elongated portion through the coupler. [Example]

[0071] 13. The device of example 11 or 12, wherein the first distal tendon assembly is positioned radially outward from the inner lumen. [Example]

[0072] The device of Example 13, wherein the distal elongated portion includes an inner shaft, the inner shaft defining a distal portion of the inner lumen, and the first distal tendon assembly is positioned radially outward from the inner shaft. [Example]

[0073] The device of example 14, wherein the inner shaft comprises a laser cut hypotube. [Example]

[0074] The device of any one or more of Examples 1-15, wherein the distal elongated portion comprises a braided assembly. [Example]

[0075] The device of Example 16, wherein the first distal tendon assembly is interposed between the strands forming the braided assembly. [Example]

[0076] A device described in any one or more of Examples 1-17, wherein the first distal tendon assembly comprises a housing, and a distal portion of the first tendon is slidably disposed within the housing of the first distal tendon assembly. [Example]

[0077] The device of any one of Examples 1 to 18, wherein the coupler includes a second channel and the device further comprises: (a) a second proximal tendon assembly extending through the proximal elongated portion, the second proximal tendon assembly including a proximal portion of the second tendon positioned a 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 portion of the second tendon positioned a second radial distance from the central longitudinal axis, wherein the second tendon passes through the second channel of the coupler, and the second channel 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 channel of the coupler. [Example]

[0078] 20. The device of Example 19, wherein the first tendon is angularly offset from the second tendon by about 90 degrees about the central longitudinal axis. [Example]

[0079] 20. The device of claim 19, wherein the first tendon is angularly offset from the second tendon by approximately 180 degrees about the central longitudinal axis. [Example]

[0080] A device described in any one of Examples 1 to 21, wherein the coupler includes a set of distal angular 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. [Example]

[0081] A device described in any one of Examples 1 to 22, wherein the coupler includes a set of proximal angular 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. [Example]

[0082] 24. The device of any one of Examples 1 to 23, wherein the distal elongated portion comprises one or more of one or more cameras, one or more light sources, or one or more sensors. [Example]

[0083] The device of any one of Examples 1-24, wherein the first channel extends along a path that is parallel to the central longitudinal axis. [Example]

[0084] The device includes: (a) a proximal elongated portion, the proximal elongated portion being flexible; (b) a distal elongated portion, the distal elongated portion being 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; and (d) a plurality of proximal tendon assemblies extending through the proximal elongated portion, each proximal tendon assembly of the plurality of proximal tendon assemblies positioned 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 a second radial distance from the central longitudinal axis, wherein each tendon passes through a respective channel of a plurality of channels of a coupler, 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 a first channel of the coupler. [Example]

[0085] A method comprising: (a) positioning a plurality of proximal tendon assemblies along a proximal elongated portion, wherein the proximal tendon assemblies are positioned a first radial distance from a central longitudinal axis defined by the proximal elongated portion; (b) positioning tendons of the plurality of proximal tendon assemblies along respective channels of a coupler, wherein the coupler repositions 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 elongated portion, wherein the tendons are positioned a second radial distance along the distal elongated portion, and the coupler is longitudinally interposed between the proximal and distal elongated portions. [Example]

[0086] 28. The method of example 27, wherein the proximal tendon assembly further comprises a plurality of housings, each tendon being slidably disposed within a respective one of the plurality of housings. [Example]

[0087] 29. The method of example 28, wherein each housing has a distal end, and the method further comprises abutting the distal end of each housing against a corresponding surface of the coupler, thereby mechanically grounding the housings to the coupler. [Example]

[0088] The method of any one of Examples 27 to 29, wherein the coupler includes a set of angular alignment features, and the method further includes aligning the angular alignment features of the coupler with complementary features of the proximal elongated portion and the distal elongated portion, thereby providing a predetermined angular alignment between the coupler, the proximal elongated portion, and the distal elongated portion.

[0089] IV. Other It should be understood that all or part of any patent, publication, or other disclosure referred to as being incorporated herein by reference is incorporated herein only to the extent that the incorporated material does not contradict existing definitions, opinions, or other disclosures set forth in this disclosure. As such, and to the extent necessary, the disclosure explicitly set forth herein shall prevail over any conflicting statements incorporated herein by reference. Any material, or portions thereof, that is referred to as being incorporated herein by reference but that contradicts current definitions, opinions, or other disclosures set forth herein shall be incorporated only to the extent that no conflict arises between the incorporated material and the current disclosures.

[0090] The above-described variations may be designed to be disposed of after a single use, or they may be designed to be used multiple times. In either or both cases, the variations may be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the system, device, and / or portions thereof, followed by cleaning or replacement of particular parts, and subsequent reassembly. Specifically, some variations of the system, device, and / or portions thereof may be disassembled, and any number of particular parts or components of the system, device, and / or portions thereof may be selectively replaced or removed in any combination. Upon cleaning and / or replacement of particular parts, some variations of the system, device, and / or portions thereof may be reassembled for subsequent use either at a reconditioning facility or by an operator immediately prior to a procedure. Those skilled in the art will appreciate that a variety of techniques for disassembly, cleaning / replacement, and reassembly may be utilized to recondition a system, device, and / or portions thereof. Use of such techniques, and systems, devices and / or portions thereof reconditioned thereby, are all within the scope of the present application.

[0091] By way of example only, the variations described herein may be sterilized before and / or after a procedure. In one sterilization technique, the system, instruments, and / or portions thereof are placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and system, instruments, and / or portions thereof may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation may kill bacteria on the system, instruments, and / or portions thereof and within the container. The sterilized system, instruments, and / or portions thereof may be stored in the sterile container for later use. The system, instruments, and / or portions thereof may also be sterilized using any other technique known in the art, including, but not limited to, beta or gamma radiation, ethylene oxide, or steam.

[0092] While various embodiments of the present invention have been illustrated and described, further adaptations of the methods and systems described herein may be achieved by appropriate modifications by those skilled in the art without departing from the scope of the present invention. While some of such possible modifications have been mentioned, other modifications will be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, proportions, steps, etc. discussed above are illustrative and not required. Accordingly, it will be understood that the scope of the present invention should be considered in terms of the following claims, and is not limited to the details of structure and operation shown and described in this specification and drawings.

[0093] [Embodiment] (1) A device comprising: (a) a proximal elongate portion, the proximal elongate portion being flexible; (b) a distal elongate portion, the distal elongate portion being flexible, and the proximal elongate portion and the distal elongate 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 a first radial distance from the central longitudinal axis; (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 a second radial distance from the central longitudinal axis; the first tendon passes through the first channel of the coupler; The first channel of the coupler accommodates 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. (2) The device of embodiment 1, wherein the coupler is configured to provide a mechanical foundation between the distal end of the first elongated portion and the proximal end of the second elongated portion. (3) The device described in embodiment 2, wherein the coupler abuts the distal end of the first elongated portion, and the coupler further abuts the proximal end of the second elongated portion. (4) A device described in any one of embodiments 1 to 3, wherein the first tendon assembly is operable to drive articulation of the distal elongated portion. (5) A device described in any one of embodiments 1 to 4, wherein the first proximal tendon assembly comprises a housing, and the proximal portion of the first tendon is slidably disposed within the housing of the first proximal tendon assembly.

[0094] (6) The device of embodiment 5, wherein the housing has a distal end, and the distal end of the housing abuts against a surface of the coupler. (7) The apparatus of any one of embodiments 5 to 6, wherein the housing comprises a coil pipe. (8) The device of any one of embodiments 1 to 7, wherein the proximal elongated portion defines a proximal portion of an inner lumen. (9) The device of embodiment 8, wherein the first proximal tendon assembly is positioned in the inner lumen. (10) The device of embodiment 9, wherein the first proximal tendon assembly is movable within the inner lumen.

[0095] (11) The device of any one of embodiments 8 to 10, wherein the distal elongated portion defines a distal portion of the inner lumen. (12) The device of embodiment 11, wherein the inner lumen extends continuously from the proximal elongated portion to the distal elongated portion through the coupler. (13) The device described in any one of embodiments 11 to 12, wherein the first distal tendon assembly is positioned radially outward from the inner lumen. (14) The device of embodiment 13, wherein the distal elongated portion includes an inner shaft, the inner shaft defining the distal portion of the inner lumen, and the first distal tendon assembly positioned radially outward from the inner shaft. (15) The device of embodiment 14, wherein the inner shaft comprises a laser-cut hypotube.

[0096] (16) The device described in any one or more of embodiments 1 to 15, wherein the distal elongated portion comprises a braided assembly. (17) The device of embodiment 16, wherein the first distal tendon assembly is interposed between strands forming the braided assembly. (18) The device of any one or more of embodiments 1-17, wherein the first distal tendon assembly comprises a housing, and the distal portion of the first tendon is slidably disposed in the housing of the first distal tendon assembly. (19) The coupler includes a second channel, and the device includes: (a) a second proximal tendon assembly extending 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; (b) a second distal tendon assembly extending through the distal elongated portion, the second distal tendon assembly extending with a distal portion of the second tendon positioned at the second radial distance from the central longitudinal axis; the second tendon passes through the second channel of the coupler; An apparatus described in any one of embodiments 1 to 18, wherein the second channel of the coupler is adapted to reposition the second tendon from the first radial distance to the second radial distance as the second tendon passes through the second channel of the coupler. (20) The device of embodiment 19, wherein the first tendon is angularly offset from the second tendon by approximately 90 degrees about the central longitudinal axis.

[0097] (21) The device of embodiment 19, wherein the first tendon is angularly offset from the second tendon by approximately 180 degrees about the central longitudinal axis. (22) The device of any one of claims 1 to 21, wherein the coupler includes a set of distal angular alignment features configured to mate with complementary features at a proximal end of the distal elongated portion to provide a predetermined angular alignment of the coupler relative to the distal elongated portion. (23) The device of any one of embodiments 1 to 22, wherein the coupler includes a set of proximal angular alignment features configured to mate with complementary features at a distal end of the proximal elongated portion to provide a predetermined angular alignment of the coupler relative to the proximal elongated portion. (24) The device described in any one of embodiments 1 to 23, wherein the distal elongated portion includes one or more of one or more cameras, one or more light sources, or one or more sensors. (25) The device described in any one of embodiments 1 to 24, wherein the first channel extends along a path that is parallel to the central longitudinal axis.

[0098] (26) An apparatus comprising: (a) a proximal elongate portion, the proximal elongate portion being flexible; (b) a distal elongate portion, the distal elongate portion being flexible, and the proximal elongate portion and the distal elongate 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 a first radial distance from the central longitudinal axis; (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 a second radial distance from the central longitudinal axis; each tendon passing through a respective one of the plurality of channels of the coupler; each channel of the coupler adapted to reposition a 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 elongated portion, the proximal tendon assemblies being positioned a first radial distance from a central longitudinal axis defined by the proximal elongated 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; (c) positioning the tendon along a distal elongated portion, the tendon being positioned at the second radial distance along the distal elongated portion, the coupler being longitudinally interposed between the proximal elongated portion and the distal elongated portion. (28) The method of embodiment 27, wherein the proximal tendon assembly further comprises a plurality of housings, each tendon being slidably disposed within a respective one of the plurality of housings. (29) The method of embodiment 28, wherein each housing has a distal end, and the method further comprises abutting the distal end of each housing against a corresponding surface of the coupler, thereby mechanically grounding the housing to the coupler. (30) The method of any one of embodiments 27 to 29, wherein the coupler includes a set of angular alignment features, and the method further includes aligning the angular alignment features of the coupler with complementary features of the proximal elongated portion and the distal elongated portion, thereby providing a predetermined angular alignment between the coupler, the proximal elongated portion, and the distal elongated portion.

Claims

1. 1. An apparatus comprising: (a) a proximal elongate portion, the proximal elongate portion being flexible; (b) a distal elongate portion, the distal elongate portion being flexible, and the proximal elongate portion and the distal elongate 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; and (d) at least one proximal tendon assembly extending through the proximal elongated portion, one of the at least one proximal tendon assembly including a proximal portion of a first tendon positioned a first radial distance from the central longitudinal axis; (e) at least one distal tendon assembly extending through the distal elongated portion, one of the at least one distal tendon assembly including a distal portion of the first tendon positioned a second radial distance from the central longitudinal axis; the first tendon passes through the first channel of the coupler; the first channel of the coupler accommodates 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.

2. The device of claim 1 , wherein the coupler is configured to provide a mechanical foundation between a distal end of the proximal elongate portion and a proximal end of the distal elongate portion.

3. The device of claim 1 or 2, wherein the at least one distal tendon assembly is operable to drive articulation of the distal elongated portion.

4. 2. The device of claim 1, wherein the one of the at least one proximal tendon assemblies comprises a housing, the proximal portion of the first tendon being slidably disposed within the housing of the one of the at least one proximal tendon assemblies.

5. The device of claim 1 , wherein the proximal elongated portion defines a proximal portion of an inner lumen.

6. The device of claim 1 , wherein the distal elongated portion comprises a braided assembly.

7. 2. The device of claim 1, wherein the one of the at least one distal tendon assemblies comprises a housing, the distal portion of the first tendon being slidably disposed within the housing of the one of the at least one distal tendon assemblies.

8. the coupler includes a second channel, a second proximal tendon assembly is included in the at least one proximal tendon assembly, the second proximal tendon assembly extends through the proximal elongated portion, the second proximal tendon assembly includes a proximal portion of a second tendon positioned at the first radial distance from the central longitudinal axis; a second distal tendon assembly is included in the at least one distal tendon assembly, the second distal tendon assembly extending through the distal elongated portion, the second distal tendon assembly extending including a distal portion of the second tendon positioned at the second radial distance from the central longitudinal axis; the second tendon passes through the second channel of the coupler; 2. The device of claim 1, wherein the second channel 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 channel of the coupler.

9. 2. The device of claim 1, wherein the coupler includes either a distal set of angular alignment features or a proximal set of angular alignment features, wherein when the coupler includes the distal set of angular alignment features, the distal set of angular alignment features is configured to mate with complementary features at a proximal end of the distal elongated portion to provide a predetermined angular alignment of the coupler relative to the distal elongated portion, and when the coupler includes the proximal set of angular alignment features, the proximal set of angular alignment features is 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.

10. The device of claim 1 , wherein the distal elongated portion includes one or more of one or more cameras, one or more light sources, or one or more sensors.

11. The device of claim 1 , wherein the first channel extends along a path that is parallel to the central longitudinal axis.

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