Surgical Devices

Abstract

A surgical device is provided that can implement a bending mechanism by including a bendable element at the distal end. [Solution] A surgical device (1) is provided, which includes a steerable member that is bendable and includes a plurality of bending segments with channels therein, and a plurality of bending actuation wires that are arranged to pass through the steerable member and bend the steerable member, the steerable member including at least one outwardly opening lumen, and the bending actuation wires passing through the lumens.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of priority from U.S. Provisional Application No. 62 / 292,057, entitled "Surgical Apparatus," filed February 7, 2016, and U.S. Provisional Application No. 62 / 424,273, entitled "Surgical Apparatus," filed November 18, 2016, which are hereby incorporated by reference in their entireties for all purposes.

[0002] The present invention relates to surgical devices and, more particularly, to surgical devices that can implement a bending mechanism by including a bendable element at a distal end. [Background technology]

[0003] Surgical devices used in surgery have different configurations depending on the location of the surgical site and how the surgical site is to be treated. In recent years, various types of surgical instruments using robots have been developed to perform surgery in areas of the surgical site that are difficult to access or perform minimally invasive surgery with existing surgical devices. These surgical devices are configured to move in various directions within the human body by including bendable elements, and they are disclosed in many documents, including U.S. Pat. No. 6,858,005.

[0004] Surgical devices that are bendable at their distal ends are bent by the movement of wires inside them. However, these surgical devices are difficult to finely manipulate and manifest several problems, such as generating backlash when they are bent by wires or restricting the movement of other wires. Also, these surgical devices have many components embedded therein, which are connected to each other in a complex manner, and therefore, it is difficult to miniaturize them. Summary of the Invention

[0005] An embodiment of the present invention can provide a surgical device that includes a steerable member that is bendable and includes a plurality of bending segments with channels therein, and a plurality of bending actuation wires arranged to pass through the steerable member and bend the steerable member, the steerable member including at least one lumen, the bending actuation wires passing through the lumen, and the lumen partially opening outward.

[0006] Other embodiments of the surgical device may further include an end effector disposed at a distal end of the steerable member and an effector actuation wire connected to the end effector for actuating the end effector, at least a portion of the end effector being removably disposed at the distal end of the effector actuation wire.

[0007] A wire termination member may be provided at the distal end of the steerable member for securing the distal ends of the bend actuation wires, and the bend actuation wires may be secured by screwing the wire termination member.

[0008] The surgical device may further include a flexible member comprising a flexible material disposed at a proximal end of the steerable member, and at least one sleeve forming a path for a wire passing through the steerable member or the flexible member, both ends of the sleeve being secured inside the steerable member or the flexible member.

[0009] The screw members may each be mounted on a bending actuation wire such that when the screw members mechanically move in sync with one another, the steerable member bends.

[0010] Hereinafter, a surgical apparatus according to an exemplary embodiment of the present invention will be specifically described with reference to the drawings. Here, the description of the positional relationship between components will be basically performed with reference to the drawings. In the drawings, the structure of the embodiment may be simplified or exaggerated for clarity. Therefore, the present invention is not limited to these exemplary embodiments, and instead, various types of devices may be added, modified, or omitted.

[0011] An exemplary embodiment is described with reference to a surgical device having multiple passageways inside the insert, with various types of surgical instruments located within each passageway, however, it should be noted that the present invention is not limited to this exemplary embodiment and is applicable to a variety of surgical devices, including catheters, endoscopes, and surgical robots that are bendable at their distal ends. [Brief description of the drawings]

[0012] [Figure 1] 1 illustrates a surgical apparatus according to an exemplary embodiment of the present invention; [Diagram 2] FIG. 2 is a cross-sectional view of one of the surgical instruments of FIG. 1. [Figure 3A] 11A-11C are schematic diagrams illustrating slack in wires due to bending of steerable members; [Figure 3B] 11A-11C are schematic diagrams illustrating slack in wires due to bending of steerable members; [Figure 4] 11A-11C are schematic diagrams illustrating slack in wires due to bending of steerable members; [Figure 5A] FIG. 1 illustrates the structure of a bending segment having one directional degree of freedom. [Figure 5B] FIG. 1 illustrates the structure of a bending segment having one directional degree of freedom. [Figure 6A] FIG. 1 illustrates the structure of a bending segment having one directional degree of freedom. [Figure 6B]FIG. 1 illustrates the structure of a bending segment having one directional degree of freedom. [Figure 7A] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 7B] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 8A] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 8B] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 9A] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 9B] FIG. 1 illustrates the structure of a bending segment having two directional degrees of freedom. [Figure 10] 14A-14D illustrate a steerable member using a flexible hinge structure. [Figure 11] FIG. 13 illustrates a steerable member using a flexible spine structure. [Figure 12A] FIG. 1 illustrates a steerable member with lateral support members. [Figure 12B] FIG. 1 illustrates a steerable member with lateral support members. [Figure 12C] FIG. 1 illustrates a steerable member with lateral support members. [Figure 13A] FIG. 1 illustrates a steerable member with lateral support members. [Figure 13B] FIG. 1 illustrates a steerable member with lateral support members. [Figure 13C] FIG. 1 illustrates a steerable member with lateral support members. [Figure 13D] FIG. 1 illustrates a steerable member with lateral support members. [Figure 13E] FIG. 1 illustrates a steerable member with lateral support members. [Figure 14A] FIG. 1 illustrates a steerable member with lateral support members. [Figure 14B]FIG. 1 illustrates a steerable member with lateral support members. [Figure 14C] FIG. 1 illustrates a steerable member with lateral support members. [Figure 15A] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 15B] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 16A] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 16B] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 17A] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 17B] FIG. 1 illustrates a steerable member having connecting segments using a double hinge structure. [Figure 18A] FIG. 13 illustrates a steerable member using a path adjustment member. [Figure 18B] FIG. 13 illustrates a steerable member using a path adjustment member. [Figure 19A] FIG. 13 illustrates a steerable member using a path adjustment member. [Figure 19B] FIG. 13 illustrates a steerable member using a path adjustment member. [Figure 20A] 13A-13C illustrate bending of a steerable member. [Figure 20B] 13A-13C illustrate bending of a steerable member. [Figure 21A] 11A-11C are cross-sectional views illustrating bending of a steerable member according to a modified embodiment; [Figure 21B] 11A-11C are cross-sectional views illustrating bending of a steerable member according to a modified embodiment; [Figure 21C] 11A-11C are cross-sectional views illustrating bending of a steerable member according to a modified embodiment; [Figure 22A]13A-13C are diagrams illustrating a method of fixing a bent actuation wire by a wire termination member. [Figure 22B] 13A-13C are diagrams illustrating a method of fixing a bent actuation wire by a wire termination member. [Figure 22C] 13A-13C are diagrams illustrating a method of fixing a bent actuation wire by a wire termination member. [Diagram 23] FIG. 13 illustrates an example of configuring the end effector as a wire terminating member. [Figure 24] FIG. 2 illustrates the structure of an end effector. [Diagram 25] FIG. 2 illustrates the structure of an end effector. [Figure 26] 1A-1C illustrate various examples of surgical devices with sleeves therein. [Figure 27] 1A-1C illustrate various examples of surgical devices with sleeves therein. [Figure 28] 1A-1C illustrate various examples of surgical devices with sleeves therein. [Figure 29] 1A-1C illustrate various examples of surgical devices with sleeves therein. [Diagram 30] 1A and 1B are diagrams illustrating a connection structure for the end and operating portion of a surgical instrument. [Figure 31A] 13 is a diagram illustrating a schematic configuration of an operating unit for moving a bent actuation wire. FIG. [Figure 31B] 13 is a diagram illustrating a schematic configuration of an operating unit for moving a bent actuation wire. FIG. [Diagram 32] 13 is a diagram illustrating a schematic configuration of an operating unit for moving a bent actuation wire. FIG. [Figure 33A] FIG. 10 is a schematic illustration of the length of a bent actuation wire in an idealized continuous flexible arm before and after bending, showing the length of the bent actuation wire before bending. [Figure 33B]1A-1C are schematic diagrams illustrating the length of a bent actuation wire in an idealized continuous flexible arm before and after bending, showing the length of the bent actuation wire after bending. [Figure 34A] FIG. 2 is a diagram illustrating the length of a bent actuation wire before and after bending in a practical condition, showing the length of the bent actuation wire before bending. [Figure 34B] FIG. 2 is a schematic illustration of the length of a bent actuation wire before and after bending in a practical condition, showing the length of the bent actuation wire after bending. [Diagram 35] 1 illustrates an exemplary bent segment in accordance with an exemplary embodiment of the present invention. [Diagram 36] FIG. 36 illustrates the exemplary tension adjustment member in FIG. 35 in accordance with an exemplary embodiment of the present invention. [Figure 37A] FIG. 37 illustrates the pivoting movement of one of the example tension adjustment members of FIG. 36, showing a front view of the tension adjustment member bent to the left. [Figure 37B] FIG. 37 illustrates the pivoting movement of one of the example tension adjustment members of FIG. 36, showing a front view of the tension adjustment member bent to the right. [Figure 38A] FIG. 37 is a schematic illustrating the exemplary tension adjustment member structure in FIG. 36 improving wire slack, showing the length of a bent actuation wire prior to bending; [Figure 38B] FIG. 37 is a schematic illustrating the improved wire slack achieved by the exemplary tension adjustment member structure in FIG. 36, showing the length of the bent actuation wire after bending. [Figure 39] 13 is a simulation result illustrating the total length change (ΔL) of a bent actuation wire as a function of bend angle θ. [Diagram 40] FIG. 1 is a block diagram illustrating a surgical instrument in accordance with an exemplary embodiment of the present invention. [Diagram 41] 1 is a schematic diagram illustrating a surgical instrument according to an exemplary embodiment of the present invention; [Diagram 42] 1 illustrates a surgical instrument during a bending motion in accordance with an exemplary embodiment of the present invention. [Diagram 43] FIG. 13 is a block diagram illustrating a surgical instrument according to another exemplary embodiment of the present invention. [Diagram 44] 11 is a schematic diagram illustrating a surgical instrument according to another exemplary embodiment of the present invention; [Diagram 45] FIG. 1 is a block diagram illustrating a personalized master controller in accordance with an exemplary embodiment of the present invention. [Figure 46] FIG. 2 is a diagram that illustrates a schematic diagram of a personalized master controller according to an exemplary embodiment of the present invention. [Figure 47] FIG. 2 is a diagram illustrating a control platform and connecting parts according to an exemplary embodiment of the present invention. [Figure 48A] 1A-1C are perspective views illustrating three types of interchangeable grips according to an exemplary embodiment of the present invention, with grip types shown. [Figure 48B] FIG. 1 is a perspective view illustrating one of three types of interchangeable grips according to an exemplary embodiment of the present invention, the tweezers type being shown. [Figure 48C] FIG. 1 is a perspective view illustrating one of three types of interchangeable grips according to an exemplary embodiment of the present invention, the grip being of a laparoscopic hand instrument type. [Figure 49] FIG. 13 is a schematic diagram illustrating a personalized master controller according to another embodiment of the present invention. [Figure 50] A diagram illustrating generally the parts of the control platform of the personalized master controller in FIG. 49 (i.e., the base member, the movable member, and the three parallel kinematic chains). [Figure 51] 50 is an enlarged view of a portion of FIG. 49 showing interchangeable grips attached to a movable member of the control platform in accordance with an exemplary embodiment of the present invention. [Figure 52]50 is an enlarged view of a portion of FIG. 49 showing the replaceable grip being removed from the movable member of the control platform in accordance with an exemplary embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0013] The present invention and its various features and advantageous details are more fully described with reference to non-limiting embodiments, which are illustrated in the accompanying drawings and detailed in the following description. Descriptions of well-known materials, manufacturing techniques, parts, and equipment have been omitted in detail so as not to unnecessarily obscure the invention. It should be understood, however, that the detailed description and specific examples, while indicating preferred embodiments of the invention, are given for purposes of illustration only and not for limitation. Various substitutions, modifications, additions, and / or rearrangements within the spirit and / or scope of the underlying inventive concept will become apparent to those skilled in the art from this disclosure.

[0014] Hereinafter, a surgical apparatus according to an exemplary embodiment of the present invention will be specifically described with reference to the drawings. Here, the description of the positional relationship between components will be basically performed with reference to the drawings. In the drawings, the structures in the embodiment may be simplified or exaggerated for clarity. Therefore, the present invention is not limited to this exemplary embodiment, and instead, various types of devices may be added, modified, or omitted.

[0015] This exemplary embodiment is described with reference to a surgical device having multiple passageways inside the insert, with various types of surgical instruments located within each passageway, however, it should be noted that the present invention is not limited to this exemplary embodiment and is applicable to a variety of surgical devices, including catheters, endoscopes, and surgical robots that are bendable at their distal ends.

[0016] 1 is a diagram illustrating a surgical device according to an exemplary embodiment of the present invention. As illustrated in FIG. 1, the surgical device 1 includes an insertion section 20 provided at a distal end of the surgical device, and an operating section 10 located at a proximal end of the insertion section 20.

[0017] The insert 20 forms the part that is inserted into the surgical site during a surgical procedure. The insert 20 is constructed from a flexible tube in which at least one surgical instrument 30 for use in a surgical procedure is located. The surgical instrument 30 may be selectively located in at least one hollow passage formed inside the insert 20. Alternatively, the surgical instrument 30 may be embedded in the insert 20. The surgical instrument 30 protrudes from the distal end of the insert 20 and may be used in a surgical procedure or may capture an image of the surgical site.

[0018] The surgical device of FIG. 1 includes an insert 20 with four passages, each of which includes four surgical instruments 30. In FIG. 1, two of the four surgical instruments include forceps 31 as end effectors 300 at the distal end. Such surgical instruments can perform various surgical operations by manipulating the forceps. Besides, various other types of surgical elements can also be used, including blades, suture units, needles, and the like. One of the remaining two surgical instruments is an imaging unit 32. The imaging unit 32 can include an optical device, such as an optical fiber, to capture an image of the distal end. The other surgical instrument can be a lumen unit 33 with a working channel therein, through which various instruments can be inserted.

[0019] The surgical instruments 30 protrude from the distal end of the insert 20, and the surgical instruments 30 are configured such that their protruding ends can bend. Bending of the surgical instruments 30 thus makes it possible to perform a surgical procedure in different directions or to take images from different directions. The surgical instruments 30 are able to bend by movement of wires inside them, which will be described in more detail below.

[0020] The operating unit 10 is provided at the proximal end of the insertion unit 20 and is configured to operate the insertion unit 20 and / or the surgical instrument 30. The distal end of the operating unit 10 is connected to the proximal end of the insertion unit 20 and, in this exemplary embodiment, may be detachably connected to the insertion unit 20. At least one driving unit is provided in the operating unit 10. The driving unit 40 is mechanically connected to various types of wire members of the insertion unit 20 and / or the surgical instrument 30, and the driving unit 40 enables various movements of the insertion unit 20 and / or the surgical instrument 30, including bending movements of the surgical instrument 30.

[0021] Hereinafter, the detailed configuration of the above-described surgical apparatus will be described in more detail with reference to the drawings.

[0022] 2 is a cross-sectional view of one of the surgical instruments of FIG. 1. As shown in FIG. 2, the surgical instrument 30 includes a steerable member 100 at a distal end, which is bendable. The steerable member 100 has a plurality of bending segments 110 with hollow channels (not shown), which are connected together. A flexible member 200 including a flexible material is provided at a proximal end of the steerable member 100. The flexible member 200 can be comprised of a hollow tube in which various types of wire members are located that are connected from the distal end of the surgical instrument 30. Optionally, an end effector 300 is provided at the distal end of the steerable member 100, which can be selectively actuated by an effector actuation wire 500.

[0023] Each bending segment 110 of the steerable member 100 is connected to an adjacent bending segment in a manner that allows hinge movement, and is bent by a bending actuation wire 400. The bending actuation wire 400 is positioned in such a manner that it passes through the steerable member 100 and the flexible member 200, with a distal end of the bending actuation wire 400 connected to the steerable member 100, and a proximal end of the bending actuation wire 400 being mechanically connected to the control unit 10. Each bending segment 110 includes a plurality of lumens 112 formed in the length direction, and the bending actuation wire 400 is located within the lumen 112 (FIG. 5A). Thus, when the bending actuation wire 400 is moved by the control unit 10, the plurality of bending segments 110 move in a hinged manner, thus bending the steerable member 100.

[0024] 3 is a diagram that illustrates diagrammatically the slack in a wire due to bending of a steerable member. Let bend segments 110 have a length of L and a width of 2r. Adjacent bend segments 110 are hinged at the midpoint of their opposing sides, which is a distance r from the circumference. Let bend actuation wires 400 be located on two opposing sides of the width of each bend segment and pass midway through the length of each bend segment, which is a distance L from each hinged portion.

[0025] FIG. 3A illustrates the steerable member before bending, and FIG. 3B illustrates the steerable member when bent to a radius of curvature R. In FIG. 3B, the angle of the bend between the two bend segments 110 is indicated by θ. The following equation is for comparing the sum of the lengths of the two wire portions between the two bend segments before bending to the sum of the lengths of the two wire portions after bending. If the lengths of the two wire portions before bending are indicated by L1 and L2, respectively, and the lengths of the two wire portions after bending are indicated by L1' and L2', respectively, the difference ΔL between the two lengths is: TIFF0007628563000001.tif38170

[0026] As can be seen from above, the total length of the two wire portions between the two bend segments after bending is less than that before bending. Therefore, when the wires on both sides are manipulated relative to each other, a slack of ΔL is created between each bend segment. This is because when bending occurs, the amount of change in length of the wire on the other side of the curvature center (L1'-L1) is less than the amount of change in length of the wire near the curvature center (L2-L2'). Therefore, due to bending, backlash is generated, thus making fine adjustment difficult.

[0027] In contrast, in this exemplary embodiment, the bent segment may be configured with various shapes to minimize slack caused by bending. FIG. 4 is a diagram that illustrates wire slack due to the improved bent segment structure. As illustrated in FIG. 4, the improved bent segment 110 is configured such that a portion of the lumen 112 where the bent actuation wire is located is open (see FIG. 5). Here, t indicates the length of the open lumen portion. The wire near the center of curvature has a shorter path due to the open lumen portion, while the wire on the other side of the center of curvature has a path with an extra length added in the corresponding open lumen portion. In this case, the path L2* of the wire near the center of curvature is equal in length to the previous path (L2' in FIG. 3), and the path L1* of the wire on the other side of the center of curvature is longer than the previous path (L1' in FIG. 3). This increase in path length occurs because the sidewall of the open lumen portion opposite the center of curvature (near the center of the bend segment) forms a stumbling portion 114, and the bend actuation wire 400 passing through the path contacts and stumbles against the stumble portion 114 (see FIG. 5). Thus, when bending occurs using the improved bend segment, ΔL is: TIFF0007628563000002.tif59170

[0028] As discussed above, with the improved bend segment 110 configured to reduce the slack length ΔL, the movement of the surgical apparatus 1 can be finely controlled. In general, the length t of the open lumen portion can be 10% or more of the bend segment length L. Depending on the dimensions of the bend segment, the angle of the bend, etc., the amount of reduction in the slack length ΔL will vary, but the slack length ΔL can be reduced by approximately 30% or more.

[0029] The improved bending segment can be designed in various ways. Hereinafter, various exemplary embodiments of the bending segment will be described in detail with reference to Figures 5 to 11.

[0030] Fig. 5 is a diagram illustrating the structure of a bending segment having one degree of freedom. The bending segment 110 shown in Fig. 5 has a body portion with a hollow channel 111 formed therein. A pair of connecting parts 120 is provided at one end of the length of the body portion, and another pair of connecting parts 120 is provided at the opposite end. The connecting parts 120 of each pair are located opposite each other on two opposite sides of the width of the body portion, with the hollow channel 111 halfway between them.

[0031] Each bending segment 110 is hinged to an adjacent bending segment by a connecting part that is linked to the connecting part of the adjacent bending segment. In Figure 5, the connecting parts 120 are connected by pinning them together. Because the hinge shafts of the connecting parts 120 all have the same orientation, the steerable member in Figure 5 has one degree of freedom, in which the steerable member bends left or right (as shown in the drawing).

[0032] Each bend segment 110 includes a pair of lumens 112 in which bend actuation wires are located. The pair of lumens 112 may be formed by penetrating a wall surface of the hollow body, and the pair of lumens 112 are symmetrically disposed about a center of cross section of the bend segment 110 and spaced a predetermined distance from each other.

[0033] As shown in FIG. 5, the lumen of the bent segment 110 is partially open. Specifically, each lumen includes a closed lumen portion 112b and an open lumen portion 112a. In the closed lumen portion 112b, the inside and outside are surrounded by wall surfaces as shown in FIG. 5, and the bent actuation wire moves only inside the lumen due to the sidewall structure. In contrast, in the open lumen portion 112a, at least a portion of its sidewall has an open structure. Therefore, the bent actuation wire located in the open lumen portion 112a can move outside the lumen through the open portion.

[0034] In this exemplary embodiment, the open lumen portion 112a has a structure in which the outer sidewall 113a of the bend segment (which is opposite the center of the cross section of the bend segment) is open. Thus, when bending occurs, the wire 400a near the center of curvature moves to the open portion (outward direction) of the open lumen portion, which allows the bend segment to be connected at a shorter length compared to the closed lumen portion. In contrast, when the sidewall 113b of the open lumen portion (near the center of the cross section of the bend segment) is located opposite the center of curvature, it forms a stumble portion 114, and the wire stumbles against the stumble portion 114. Thus, when bending occurs, the wire 400b on the opposite side of the center of curvature comes into more contact with the bend segment when it stumbles against the stumble portion 114, thereby reducing the slack length.

[0035] In FIG. 5, each lumen 112 of the bend segment 110 is configured such that a closed lumen portion 112b is formed in the middle of the lumen length, and an open lumen portion 112a is located on either side of the closed lumen portion 112b. This is merely an example, and one side of the lumen 112 along the length can form an open lumen portion and the other side can form a closed lumen portion. Alternatively, the open lumen portions of a pair of adjacent bend segments can be symmetrically positioned with respect to the hinge shaft. In this manner, the lumen in which the bend actuation wire is located can be varied such that the wall surface (inner wall surface) 113b closer to the center of the cross section of the bend segment is longer than the wall surface (outer wall surface) 113a opposite the center of the cross section.

[0036] 5 illustrates open lumen portion 112a being longer than closed lumen portion 112b, the present invention is not so limited and can have a variety of configurations depending on the configuration of the bend segment and the angle of the bend. It is noted that an open lumen portion length that is 20% or more of the total lumen length can be advantageous to reduce slack length.

[0037] The connecting parts of the bent segments can be formed in various ways other than pinning the connecting parts together as shown in Figure 5. Figure 6 illustrates examples of different types of connecting parts.

[0038] The bent segments in FIG. 6 each include a pair of connecting parts 120 on one side and a pair of recessed parts 121 on the other side. The connecting parts 110 of the bent segments 110 are received in the recessed parts 121 of the adjacent bent segments and are hinged to the recessed parts 121. The connecting parts 120 in FIG. 6A each consist of a protrusion with a rounded surface, and the recessed parts 121 each are configured to receive the protrusion. Thus, each connecting part 120 moves in a hinged manner when it rotates in the corresponding recessed part 121. The connecting parts 120 in FIG. 6B each consist of a protrusion with a linear edge at the end, and the recessed parts 121 each have a V-shaped notched groove. Thus, the connecting parts 120 can move in a hinged manner, since the area of ​​contact with the recessed parts 121 rotates around the axis of rotation while the connecting parts 120 are in linear contact with the recessed parts 121.

[0039] Fig. 7 is a diagram showing the structure of a bending segment having two degrees of freedom. The bending segments in Fig. 7 are each connected to an adjacent bending segment to enable hinge movement, and are configured such that the hinge shaft h1 connected to the bending segment on one side and the hinge shaft h2 connected to the bending segment on the other side have different orientations. Thus, unlike Figs. 5 and 6, the bending segment 100 in Fig. 7 constitutes a steerable member that can move with more than two degrees of freedom.

[0040] Specifically, each bent segment 110 in Fig. 7 includes a pair of connecting parts 120 on one side of its length and a pair of recessed parts 121 on the other side, facing each other with respect to the center of the bent segment 110, as does the pair of recessed parts 120. As in Fig. 5, the connecting parts 120 each consist of a protrusion with a rounded surface, and the recessed parts 121 are configured to be rotatable and to accommodate the connecting parts.

[0041] 7, in each bent segment 110, the shaft connecting the pair of connecting parts 120 and the shaft running between the pair of recessed parts 121 are orthogonal to each other, i.e., the pair of connecting parts and the pair of recessed parts are positioned at different locations with respect to the cross section of the bent segment 110 (more specifically, the pair of connecting parts and the pair of recessed parts intersect at 90 degrees around the body).

[0042] Thus, the bending segment 110 hinges on the first shaft h1 relative to the adjacent segment on one side, and hinges on the second shaft h2 relative to the adjacent segment on the other side. That is, the connecting parts of the bending segments are configured such that the first hinge shaft and the second hinge shaft are arranged in an alternating manner. Thus, the bending segment of FIG. 7 is capable of moving with two degrees of freedom.

[0043] Each bend segment includes four lumens formed along its length. As shown in Figure 7, each lumen 112 is positioned to pass through a connecting part 120 or a recessed part 121. Thus, the four lumens are positioned where the connecting parts and recessed parts are formed and are spaced at 90 degree intervals around the body.

[0044] Four bending actuation wires 400 are located in the four lumens 112, respectively. Among them, one pair of wires induces bending of one shaft of the steerable member, and the other pair of wires induces bending of the other shaft.

[0045] Each lumen is partially open, as in the above examples. As shown in Fig. 7, a portion of each lumen 112 along its length, where a connecting part 120 or a recessed part 121 is formed, forms a closed lumen portion 112b, and the other portion, where no connecting part 120 or recessed part 121 is formed, forms an open lumen portion 112a. Of course, the closed lumen portion may be centered on the respective lumen, and the open lumen portion may be positioned on either side of the closed lumen portion. Nevertheless, the configuration shown in Fig. 7 offers the advantage of further reducing the slack length.

[0046] 7 illustrates the lumens 112 passing through the connecting part 120 or the recessed part 121, the lumens 112 may also diverge from the connecting part 120 and the recessed part 121. In particular, the connecting parts 120 and the recessed part 121 may be spaced at 90 degree intervals around the side of the body of the bent segment 110 (e.g., around the circumference). Each lumen 112 may be located between the connecting part 120 and the recessed part 121, and in particular may be located at a point that is at 45 degrees relative to the connecting part 120 and the recessed part 121.

[0047] In this case, each lumen 112 may be configured such that a closed lumen portion 112b is formed intermediate the length of the lumen and open lumen portions 112a are formed on either side of the closed lumen portion 112b, as shown in FIG. 8.

[0048] Figures 7 and 8 have been described with respect to the connecting part 120 being composed of a protrusion with a rounded surface, and the recess part 121 receiving the connecting part 120. However, this is merely an example, and as shown in Figure 6B, the connecting part may be composed of a protrusion with linear edges, and the recess part may have a V-shaped notched groove (see Figure 9). Alternatively, rather than each comprising a connecting part and a recess part, as shown in Figure 5, the two connecting parts may be pinned together in a manner that allows hinge movement.

[0049] The exemplary embodiment shown in Figures 7 to 9 requires a connection structure for rotation about one shaft, in which a pair of connection parts is provided on one bending segment and a pair of recess parts is provided on another bending segment, otherwise one connection part and one recess part may be located at one end of one bending segment facing each other with a hollow body part between them, and the connection parts and recess parts of adjacent bending segments may be located oppositely, taking into account the layout of the connection parts and recess parts of bending segments connected to adjacent bending segments.

[0050] Figure 10 illustrates a steerable member using a flexible hinge structure. As shown in Figure 10, bending segments 110 are in the form of disk-like plates and are connected by flexible connecting parts 120 located between the bending segments 110. While the steerable members of Figures 5 to 9 can be bent using the mechanical hinge structures of the connecting parts, the steerable member of Figure 10 can be bent using the elasticity of the material of the connecting parts.

[0051] More specifically, the steerable member of FIG. 10 is composed of a plurality of bending segments 110 and a plurality of connecting parts 120 integrally formed with each other. For example, the steerable member can be manufactured by a molding method using a flexible plastic resin. As shown in FIG. 10, each bending segment 110 and each connecting part 120 has a hollow channel 111 therein. The connecting part 120 is provided between each bending segment 110 and has a wall structure extending radially outward from two opposite sides of the hollow channel. The connecting part 120 (wall structure) is arranged in a direction perpendicular to the direction in which the adjacent connecting parts are arranged. Therefore, the steerable member of FIG. 10 can bend with two degrees of freedom.

[0052] The four lumens 112 in which the bent actuation wires 400 are located are spaced 90 degrees apart. Each lumen 112 is formed at the point where the respective lumen 112 penetrates the outer edge of the connecting part 120. In this case, as in the previous exemplary embodiment, each lumen 112 is a partially open lumen portion 112. As shown in FIG. 11, a closed lumen portion 112b of each lumen is formed at the point where the respective lumen penetrates the connecting part, with an open lumen portion 112a formed on either side of the closed lumen portion 112b through which the bent segment is penetrated. Thus, the steerable member 100 of this exemplary embodiment is able to bend over the connecting part 120 as the bent actuation wires 400 move.

[0053] Fig. 11 illustrates a steerable member using a flexible spine structure. The steerable member 100 of Fig. 11 includes bending segments 110 each made of a disk-shaped plate, and a connecting part 120 using a spine structure to connect the centers of the bending segments. The connecting part 120 may be composed of individual members provided between each bending segment, or may be composed of a single member that passes through multiple bending segments. In this case, the connecting part 120 may include a flexible material and bend when the bending actuation wire 400 moves.

[0054] 10 also includes four lumens 112, each of which is partially open. Specifically, the lumens 112 can include a closed lumen portion 112b formed in the middle of the length of the lumen, and open lumen portions 112a formed on either side of the closed lumen portion 112b.

[0055] In the exemplary embodiment described above, bending segments that can minimize slack are used to prevent backlash caused by bending. The steerable members can be configured in a variety of other ways to prevent backlash.

[0056] 12-14 illustrate a steerable member with lateral support members 130. The lateral support members 130 include an elastic or superelastic material that exerts a restoring force to return to its original shape when its shape is deformed. That is, the steerable member may include at least one lateral support member therein and may be configured to restore the elasticity of the lateral support members to their initial position when the steerable member is bent.

[0057] FIG. 12 is a diagram illustrating the bending characteristics provided by the lateral support members. As illustrated in FIG. 12, when at least one bending actuation wire 400 is pulled by operating the operation portion, the steerable member 100 bends in a corresponding direction. In this case, the steerable member 100 includes at least one lateral support member 130, and the bending actuation wire 400 is operated to cause bending by overcoming the elasticity of the lateral support member 130 (FIG. 12B). Thereafter, when the corresponding bending actuation wire is released from being pulled (FIG. 12C), the steerable member 100 returns to neutral due to the elasticity of the lateral support member 130.

[0058] Conventionally, the bend actuation wire on one side is manipulated to bend in one direction while the bend actuation wire on the other side is manipulated to return to neutral. Thus, slack occurs due to bending, causing backlash. However, by using side support members as shown in FIG. 12, backlash caused by slack in the bend actuation wire can be non-problematic during bending.

[0059] FIG. 13 illustrates various exemplary embodiments of steerable members using lateral support members. As illustrated in FIG. 13, the steerable member 100 can include multiple bending actuation wires 400 and multiple lateral support members 130. The lateral support members 130 can be constructed of various types of structures that can function as lateral springs, such as wire structures or hollow tube structures. The bending segment 110 of the steerable member 100 is configured to bend with two degrees of freedom and can include multiple lumens 112 to allow the bending actuation wires 400 and the lateral support members 130 to pass through the bending segment 110 along the wall surface of the body portion.

[0060] In Fig. 13A-C, multiple bend actuation wires 400 and multiple lateral support members 130 are separately placed. In Fig. 13A and B, four bend actuation wires 400 are arranged at 90 degree intervals around the body of the bend segment 110, and four lateral support members 130 are arranged at 45 degree intervals between each bend actuation wire 400. In this case, as shown in Fig. 13A, four bend actuation wires 400 may be arranged to pass through the connecting parts 120 of the bend segment, and as shown in Fig. 13B, four lateral support members 130 may be arranged to pass through the connecting parts 120 of the bend segment 110. Alternatively, as shown in Fig. 13C, the bend actuation wires 400 and lateral support members 130 may be arranged in pairs along the circumference between the respective connecting part locations, so as not to pass through the connecting parts of the bend segment 110.

[0061] In Fig. 13D and E, the lateral support members 130 have a hollow tube structure, and the bend actuation wires 400 are located inside the lateral support members 130, respectively. The lateral support members 130 and the bend actuation wires 400 may be arranged at 90 degree intervals around the body of the bend segment 110. In Fig. 13D, the lateral support members 130 and the bend actuation wires 400 are arranged to pass through the connecting parts of the bend segment. In Fig. 13E, the lateral support members 130 and the bend actuation wires 400 are located between the respective connecting part locations, so that they do not pass through the connecting parts.

[0062] FIG. 14 illustrates the bending characteristics provided by pre-shaped lateral support members. The lateral support members of FIGS. 12 and 13 have a shape that corresponds to a neutral position of the steerable member. Thus, the steerable member is configured to bend by the bending actuation wires and return to neutral by the lateral support members. In contrast, the lateral support member 130 of FIG. 14 is configured to have a shape that is bent in one direction such that the resiliency of the lateral support member 130 contributes to bending the steerable member to one side.

[0063] In the example, the lateral support member 130 in FIG. 14 is pre-shaped to bend to the left. The steerable member with the lateral support member 130 therein remains bent to the left without any manipulation using the bend actuation wire (FIG. 14A). Also, when the bend actuation wire 400 is moved by a first tension F, the steerable member can be placed in a neutral position (FIG. 14B). The first tension is large enough to be in equilibrium with the moment generated by the elasticity of the lateral support member 130. When the bend actuation wire 400 is moved by a second tension F', the second tension being larger than the first tension, the steerable member can bend to the right (FIG. 14C). In this case, when the tension applied to the bend actuation wire 400 is released by the first tension, the steerable member can move to neutral (FIG. 14B), or when the tension applied to the bend actuation wire is fully released, the steerable member can bend to the left (FIG. 14A).

[0064] In this case, the steerable members are moved to a neutral or initial position by the elasticity of the lateral support members, thereby allowing for backlash-free bending control. Although Figure 14 shows a bending mechanism having one degree of freedom using pre-shaped lateral support members and bending actuation wires, a variety of bending mechanisms using pre-shaped lateral support members can be used.

[0065] In addition, a flexure mechanism using connecting segments that do not cause backlash, as shown in Figures 15 to 17, and the above-mentioned method using lateral support members may be used.

[0066] FIG. 15 is a diagram illustrating the wire path difference caused by bending of the bent segments connected by a connection segment. In the previous exemplary embodiment (e.g., in FIG. 3 to FIG. 9), each bent segment 110 is directly connected to an adjacent bent segment by a connection part 120 provided in the body, and can rotate about one hinge shaft shared between each pair of adjacent bent segments. In contrast, as shown in FIG. 15, a connection segment 140 is provided between each pair of adjacent bent segments 110, and two adjacent bent segments are respectively connected to two ends of the connection segment 140. The connection segment 140 has a double hinge joint structure, which allows two points on the connection segment 140 to be hinged to two different members. Thus, a pair of adjacent bent segments 110 are respectively connected to two ends of the connection segment, and can rotate about different hinge shafts without sharing a hinge shaft.

[0067] Let the distance between the wires on either side of the bend segment 110 be 2r, and the distance between the two hinge shafts of the connection segment be L. The bend segment 110 may be hinged to the connection segment 140 at a point midway between the pair of wires (i.e., at a distance r from each wire).

[0068] FIG. 15A illustrates adjacent bent segments before bending, and FIG. 15B illustrates adjacent bent segments when bent to a radius of curvature R. In FIG. 15B, the angle of the bend between the two bent segments 110 is indicated by θ. It can also be assumed that the angles of the bend θprox and θdistal between the bent segments and the connecting segment generated by the bending are equal. In this case, the following equation is for comparing the sum of the lengths of the two wire portions between the two bent segments before bending with the sum of the lengths of the two wire portions after bending. The lengths of the two wire portions before bending are indicated by L1 and L2, respectively, and the lengths of the two wire portions after bending are indicated by L1' and L2', respectively. TIFF0007628563000003.tif77170

[0069] That is, when the steerable member 100 connected by the connecting segment 140 is bent, the sum of the lengths of the two wire portions before bending (L1+L2) and after bending (L1'+L2') are substantially equal. Thus, any slack caused by bending can be prevented.

[0070] Of course, FIG. 15 assumes that the angles θprox and θdistal of the bend between the flex segment 140 and the connecting segment 110 are equal because the bend occurs in each of the flex segments due to the same wire. However, when the actual bend occurs, the angles of the bend between the connecting segment 140 and the flex segment 110 are in a substantially similar range, but they are slightly different. Thus, the slack length can be minimized compared to a structure in which the two flex segments are connected together on a single hinge shaft.

[0071] Figure 16 is a perspective view illustrating a connector segment and bending segments connected by the connector segment, and Figure 17 is a perspective view illustrating a steerable member including a connector segment.

[0072] As shown in Figure 16, the connection segment 140 is hingedly connected to the first and second bend segments 110a and 110b at different points. The connection segment 140 includes two body portions 141 facing each other. Each body portion 141 includes a first hinge part 142a at one end of its length and a second hinge part 142b at the other end. The first and second bend segments 110a and 110b are connected to the first and second hinge parts 142a and 142b, respectively, such that they move hingedly on different hinge shafts.

[0073] 16, first hinge part 142a and second hinge part 142b are each comprised of a protrusion with a rounded surface, housed in a recess part 121b formed in bending segment 110, and move in a hinged manner. However, this is merely an example, and at least one of the first and second hinge parts may be a recess part for housing a protrusion, or may be connected by other hinge structures, such as pins, etc.

[0074] The connection segment 140 further includes a guide member 143 with a hollow space inside, which connects together the two body parts 141 facing each other. Due to this, the connection segment 130 can form a module. The hollow space of the guide member 143 allows various kinds of wire members, such as bending actuation wires or effector actuation wires, to pass through and also prevents the internal components from falling out during bending. The cross section of the guide member 143 can be similar to the cross section of the bending segment. In this case, the part through which the bending actuation wire passes can be open so as not to restrict the movement of the bending actuation wire.

[0075] The steerable member of FIG. 17 includes multiple connecting segments 140, with adjacent connecting segments 140 configured with mutually orthogonal hinge shafts. Each bending segment 110 has four lumens 112, such that four bending actuation wires 400 are located within the four lumens 112, respectively. Thus, the steerable member 100 is capable of bending with two degrees of freedom. In this case, the bending actuation wires 400 may be located around the body of the bending segment 110 between the respective hinge shaft locations, such that they do not pass through the hinge shafts of the connecting segments 140.

[0076] In another exemplary embodiment, Fig. 18 is a diagram that diagrammatically illustrates the slack of a wire forming a curved path due to bending of a steerable member. While Fig. 3 shows a wire forming a curved straight path when bending occurs, Fig. 18 shows a wire forming a curved path when bending occurs. If the lengths of two wire portions before bending are denoted by L1 and L2, respectively, and the lengths of two wire portions after bending are denoted by L1' and L2', respectively, the relationship between the lengths of the two wire portions is as follows: TIFF0007628563000004.tif41170

[0077] Compared to the wire of Fig. 3, which forms a curved straight path when bending occurs, the wire of Fig. 18, which forms a curved path, can have approximately a 30% reduction in slack length. Using this principle, the bend actuation wire is configured to form a curved path when bending occurs by including a path adjustment member, thereby minimizing slack.

[0078] Fig. 19 is a diagram illustrating a steerable member using a path adjustment member. As shown in Fig. 19, the steerable member 100 includes a plate-like bending segment 110 and a wall-like connecting part 120 located between the bending segments. Also, four lumens 112 are formed through the outer edge of the bending segment 100 and the connecting part 120 (see the description of Fig. 10).

[0079] As shown in FIG. 19B, the bent actuation wires 400 are located inside the pathway adjustment members 150 in their respective lumens, rather than directly in their respective lumens. The pathway adjustment members 150 comprise an elastic material, such as a metal, and bend when the steerable member 100 is bent, thereby forming a curved wire pathway (in this case, the pathway adjustment member's elasticity does not need to be high enough to create a restoring force, as shown in FIG. 13D and E, but sufficient elasticity to form a curved pathway will suffice). Thus, the bent actuation wires 400 according to this exemplary embodiment bend along a curved pathway, rather than along a curved straight pathway, thereby minimizing slack length.

[0080] While this exemplary embodiment has been described in connection with the use of a path adjustment member in conjunction with a steerable member using a flexible hinge structure, the use of a path adjustment member allows for modifications such as placing wires within the steerable member shown in Figures 11-17.

[0081] Figure 20 is a diagram illustrating bending of a steerable member. As shown in Figure 20, in the initial stages of bending, the bending is not uniform throughout the steerable member 100, but is concentrated at the distal end of the steerable member where the bending actuation wires 300 terminate (see Figure 20B). Thus, as the wires move, forces are transferred directly to the distal end of the steerable member, causing the steerable member to bend less at the proximal end.

[0082] Figure 21 is a cross-sectional view of a steerable member according to one exemplary embodiment of the invention. Figures 21A, B, and C show an embodiment for improving bending concentration at the distal end of the steerable member with a geometrically reinforced structure that causes the steerable member to bend more easily at the distal end than at the proximal end.

[0083] Specifically, as shown in Figure 21A, the bending segment 110 has a lumen formed at a predetermined distance from the center of the cross section of the steerable member, and the closer to the proximal end of the steerable member, the farther the lumen in the bending segment is from the center of the cross section of the steerable member. In this case, the moment applied to the steerable member 100 is smaller at the distal end and increases toward the proximal end. Thus, the steerable member 100 bends more easily toward the proximal end.

[0084] In Fig. 21B, the connecting parts 120 may be configured to gradually change shape along the length of the steerable member 100, making the steerable member easier to bend at the proximal end than at the distal end. In an example, the bending characteristics along the length may be adjusted by configuring the connecting parts to have a larger cross-sectional width at the distal end than at the proximal end, as shown in Fig. 21B. Alternatively, aside from adjusting the width of the connecting parts, the connecting parts may be configured with various other manners of shape change, including adjusting the range of movement of the connecting parts with joint structures.

[0085] Also, as shown in FIG. 21C, the distance between the bending segments 110 can vary along the length. Specifically, the connecting parts 120 can be positioned such that the distance between the bending segments is shorter toward the distal end and longer toward the proximal end. In this case, the longer the distance between the bending segments, the easier it is for the steerable member to bend. This results in limited bending near the distal end and improved bending characteristics near the proximal end.

[0086] The steerable member in this configuration has a number of bend actuation wires positioned along the lumen, with the distal end of each bend actuation wire being secured by a wire termination member 410 at the distal end of the steerable member.

[0087] 22 illustrates a method of fixing bend actuation wires with a wire termination member. Because the steerable members and bend actuation wires are very small in size, it is extremely difficult to fix individual bend actuation wires to the distal end of the steerable members. Therefore, this exemplary embodiment uses a wire termination member that can easily fix multiple bend actuation wires.

[0088] As shown in Figure 22, the wire termination member 410 has threads 411 on one side and is threaded onto the distal end of the steerable member 100. The wire termination member also includes a number of holes 412 through which the bend actuation wires pass, the holes 412 being formed in locations that correspond to the lumens in the steerable member. Thus, as shown in Figure 22, the wire termination member can be threaded onto the distal end of the steerable member with the bend actuation wires 400 inserted into the holes of the wire termination member (Figure 22A), thereby facilitating fixation of the bend actuation wires (Figures 22B and C).

[0089] The wire termination member can be a component disposed between the steerable member and the end effector. In this case, the wire termination member can be threaded onto the distal end of the steerable member and the end effector can be connected to the wire termination member. Alternatively, as shown in FIG. 23, the end effector 300 can be used as a wire termination member by fixing the bend actuation wires 400 inside the end effector 300 and threading the end effector 300 directly onto the distal end of the steerable member 100.

[0090] Although FIG. 22 has been described in relation to a steerable member having the configuration shown in FIG. 10, it will be appreciated that the bent actuation wires may be similarly secured when the steerable member has other configurations.

[0091] In the above discussion, various exemplary embodiments of steerable members have been described with reference to Figures 5 to 22. Although the steerable members have been described as components of a surgical device having an end effector, the invention is not so limited. For example, the invention is applicable to bendable steerable members on various types of surgical instruments, such as imaging units or lumen units with working channels.

[0092] Referring back to Figure 2, an end effector 300 is provided at the distal end of the steerable member. As explained above, the end effector 300 may be directly coupled to the distal end of the steerable member 100 or may be coupled thereto through a component such as a wire termination member or the like. The end effector 300 includes various types of surgical elements 311 for use in a surgical procedure. Figure 2 illustrates an end effector including forceps as an example.

[0093] The proximal end of the end effector 300 is connected to an effector actuation wire 500. The effector actuation wire 500 is located in the channel 111 of the steerable member 100 and is mechanically connected to the manipulation portion 10 through the steerable member 100 and the flexible member 200. Thus, the effector actuation wire 500 actuates the end effector 300 when it is moved longitudinally by the manipulation portion 10.

[0094] FIG. 24 is a cross-sectional view that diagrammatically illustrates the operation principle of the end effector. The end effector 300 operates in a first mode (A in FIG. 24) when the effector actuation wire 500 is pulled toward the operating unit 10, and in a second mode (B in FIG. 24) when the effector actuation wire 500 is pulled toward the end effector 300. The first mode involves closing the forceps of the end effector, and the second mode involves opening the forceps. The action of pulling the effector actuation wire 500 toward the operating unit can be easily performed by the driving unit of the operating unit, thereby transmitting a force to the end effector. On the other hand, the action of returning the effector actuation wire 500 toward the end effector 300 may not be properly performed by the driving unit 400. This is because the effector actuation wire has a wire structure. Thus, in this exemplary embodiment, the end effector 400 includes an elastic body portion 341 and is capable of performing a second mode operation by using the elasticity of the elastic body portion 341 to pull the effector actuation wire 500.

[0095] Specifically, as shown in FIG. 24, the effector module of the end effector includes an instrument portion 310 for performing a surgical operation and an actuation portion 320 for actuating the instrument portion 310. The instrument portion 310 is linked to the actuation portion 320, and configured such that the surgical element 311 is opened and closed on both sides by the movement of the actuation portion 320 while the joint 330 of the instrument portion 310 is fixed. The elastic body portion 341 may be located at the proximal end of the actuation portion. When the effector actuation wire 500 is pulled by the operating portion 10, the actuation portion 320 moves backward while pushing the elastic body portion 341, thus closing the surgical element 311 (FIG. 24A). Also, when the force acting on the effector actuation wire 500 is released by the operating section 10, the restoring force of the elastic body 341 moves the actuation portion 320 toward the instrument portion 310, thereby opening the surgical element 311 (FIG. 24B). In this manner, the actuation mechanism of the end effector can be simplified by the use of an elastic body.

[0096] The structure of an end effector using an elastic body can be designed in various ways. FIG. 25 is a diagram illustrating an example of such an end effector. As illustrated in FIG. 25, the end effector 300 can include an effector module 301 and a body portion 340, in which the effector module 301 is attached. The tool portion 310 of the effector module 301 is configured to be exposed at the distal end of the body portion 340, and its actuation portion 320 is housed inside the body portion 340. The joint 330 connecting the tool portion 310 and the actuation portion 320 can be fixed to the body portion 340, and the actuation portion 320 can reciprocate inside the body portion 340. A resilient body portion 341 provided inside the body portion 340 is located rearward of the actuation portion 320, and a proximal end of the actuation portion 320 is connected to an effector actuation wire 500. Thus, the instrument portion 310 can be operated by moving the actuation portion 320 by the effector actuation wire 500 and the resilient body portion 341.

[0097] Also, all or a portion of the end effector 300 may be removably connected to the distal end of the steerable member 100. Thus, various instruments required for a surgical procedure may be selectively fastened and used. In an example, the end effector 300 of FIG. 25 is configured such that the effector module 301 is attachable to or detachable from the distal end of the effector actuation wire 500. The effector module 301 and the distal end of the effector actuation wire 500 may be removably fastened in various manners. For example, according to the exemplary embodiment illustrated in FIG. 25, they may be magnetically fastened together. Thus, at least one of the proximal end of the actuation portion 320 and the distal end of the effector actuation wire 500 may be comprised of a magnetic body that allows for fastening.

[0098] As described above, the surgical instrument according to this exemplary embodiment includes a bendable steerable member 100 and an actuable end effector 300. Additionally, the steerable member 100 and the end effector 300 are moved by a number of wire members, such as the bend actuation wire 400 and the effector actuation wire 500. These wire members are arranged to pass through the steerable member 100 and the flexible member 200. Thus, if the wire members are arranged linearly such that each of the wire members has the shortest path, the movement of the wires may be limited or influenced by the bending of the steerable member or the flexing of the flexible member. Thus, in this exemplary embodiment, at least one sleeve forming a path of travel for the wire members may be provided inside the steerable member or the flexible member. The sleeve is longer than the maximum length of the portion in which it is provided (e.g., the length of that portion when bent or flexed) so that the wire member has a sufficiently long path even when the steerable member is bent or the flexible member is flexed.

[0099] FIG. 26 is a cross-sectional view illustrating the path of the effector actuation wire. As shown in FIG. 26, one end of the effector actuation wire 500 is attached to the proximal end of the end effector 300, and the other end is mechanically connected to the operating section 10 (FIG. 1). One end of a sleeve 600 forming the path of the effector actuation wire 500 is fixed at a suitable location at the distal end of the steerable member 100 or the proximal end of the end effector 300. The other end is fixed at a suitable location at the proximal end of the flexible member 200. In this case, the sleeve 600 is longer than the length of the part where the two ends of the sleeve are fixed (the total length of the steerable member and the flexible member). This excess length added to the sleeve (FIG. 26A) allows more room for the routing of the effector actuation wires 500, even when the steerable member 100 is bent (FIG. 26B). Thus, the movement of the end effector 300 can be decoupled from the bending movement of the steerable member 100, preventing the movement of the end effector 300 from being affected by the bending movement of the steerable member 100.

[0100] 27 is a diagram illustrating the path of the bending actuation wire. As shown in FIG. 27, a sleeve 600 may be provided to accommodate the path of the bending actuation wire 400. In this case, one end of the sleeve 600 is fixed to the proximal end of the steerable member 100 or the distal end of the flexible member 200, and the other end is fixed to the proximal end of the flexible member 200. The sleeve 600 is configured to have an excess length that is added to the linear length of the portion where the sleeve is placed. Thus, the bending of the steerable member 100 will not be affected by the bending of the flexible member 200.

[0101] 28 and 29 are diagrams illustrating the path of the bent actuation wire 400 with two bendable sections. While the previous figures illustrate a configuration in which the steerable member 100 has one bendable section, the steerable member 100 may be divided into a distal steerable section 101 and a proximal steerable section 102, which are capable of bending separately. In this case, the distal steerable section 101 is bent by the distal bend actuation wire 401, and the proximal steerable section 102 is bent by the proximal bend actuation wire 402. One end of the distal bend actuation wire 401 is fixed to the distal end of the distal steerable section 101, passes through a lumen in the distal steerable section 101, and then extends through the hollow channels of the steerable member 100 and the flexible member 200 to the control section 10. Also, one end of the proximal end bending actuation wire 402 is fixed to the distal end of the proximal end steerable portion 102, passes through a lumen in the proximal end steerable portion 102, and then extends through a hollow channel of the flexible member 200 to the operation section 10. In this case, two distal end bending actuation wires 401 and two proximal end bending actuation wires 402 are provided, and each bending portion can have one degree of freedom, or four distal end bending actuation wires 401 and four proximal end bending actuation wires 402 are provided, and each bending portion can have two degrees of freedom.

[0102] As shown in FIG. 28, a sleeve 600 may be provided for routing the distal end bending actuation wire 401. One end of the sleeve 600 may be secured to the proximal end of the distal end steerable portion 101, and the other end may be secured to the proximal end of the flexible member 200. Also, as shown in FIG. 29, a sleeve 600 may be provided for routing the proximal end bending actuation wire 402. One end of the sleeve 600 may be secured to the proximal end of the proximal end steerable portion 102, and the other end may be secured to the proximal end of the flexible member 200. As with the sleeves described above, each sleeve 600 has excess length so that the bending movement of each bending portion can be cut off.

[0103] As explained above, the sleeves 600 described with reference to Figures 26-28 have excess length that is added to the length of the section in which they are placed, and the sleeves 600 can include a resilient material, allowing their shape to change with the movement of the components. Such a sleeve construction allows the movement of each component to be decoupled from the movement of the others, preventing the wire members in the narrow channels from being kinked or damaged by friction.

[0104] 30 is a diagram illustrating a connection structure of the end of the surgical instrument and the operating section. As described above, the surgical instruments 30 are respectively positioned in the passages in the insertion section 20, and the end of the surgical instrument is mechanically connected to the operating section 10. The operating section 10 includes a transmission member 700 corresponding to a plurality of wire members W of the surgical instrument, and a coupler 701 to be fastened to the wire. The wire members W of the surgical instrument each include a proximal end module M at a proximal end, and each proximal end module M is fastened to the corresponding coupler 701. Thus, each wire member can be moved by a respective drive section in the operating section.

[0105] In this case, the insert section 20 and the operating section 10 can be attached to or detached from each other, and the surgical instrument 30 provided in the insert section 20 can also be attached to or detached from the operating section 20. This means that the insert section or the surgical instrument can be cleaned or replaced with a new one. The surgical instrument 30 and the operating section 10 can be detachably fastened in various ways, for example, they can be magnetically fastened together as shown in FIG. 30. Thus, the proximal end of the surgical instrument (specifically, the proximal end module of the bending actuation wire and the effector actuation wire) or the distal end of the operating section (specifically, the coupler of the transmission member) can be composed of a magnetic body and can be attached to or detached from each other by magnetic force.

[0106] 31 and 32 are schematic diagrams illustrating a configuration of the operating section 10 for moving the bent actuation wire 400. The wire member W of the surgical instrument described above is mechanically connected to the driving section 40 of the operating section 10 and moves linearly with the movement of the driving section 40. The driving section can be constructed using various devices such as an actuator, a linear motor, a motor, etc. Also, each wire member can be connected to a different driving section so that each wire member can move separately.

[0107] In this case, a pair of bending actuation wires 400 located opposite each other in the steerable member 100 move in opposite directions when bending occurs. Specifically, when bending occurs, the bending actuation wires near the center of curvature have a shorter path, and the bending actuation wires on the opposite side of the center of curvature have a longer path. Therefore, a pair of wires facing each other can move in opposite directions at the same time by using a single actuator 40. In this case, the operation unit can be designed to be compact by reducing the number of actuators.

[0108] In FIG. 31, the operating unit includes a screw member 41 and a drive unit 40 for rotating the screw member 41. The screw member 41 can be a bidirectional lead screw, meaning that two thread portions with different orientations are formed on a single screw member. Thus, a coupler of a transmission member to be connected to a first bend actuation wire 403 is coupled to the first thread 41a, and a coupler of a transmission member to be connected to a second bend actuation wire 404 is coupled to the second thread 41b. Thus, when the drive unit rotates, the first bend actuation wire 403 and the second bend actuation wire 404 move in opposite directions on a straight line by corresponding distances, respectively, thereby bending the steerable member. Also, the direction of movement of the first bend actuation wire 403 and the second bend actuation wire 404 can be reversed by changing the direction of rotation of the drive unit, thus allowing them to bend in opposite directions.

[0109] In FIG. 32, the operating unit includes a pair of screw members and a drive unit 40 for rotating the screw members. The pair of screw members is composed of a first lead screw 42 with a first thread and a second lead screw 43 with a second thread, the second thread being oriented in an opposite direction to the first thread. The first lead screw 42 and the second lead screw 43 are connected to the drive unit 40 by a gear 44 and rotate in the same direction with the rotation of the drive unit. A first bending actuation wire 403 is mechanically connected to the first lead screw 42, and a second bending actuation wire 404 is mechanically connected to the second lead screw 43. Thus, as in the case of FIG. 31, when the motor rotates, the first and second bending actuation wires are capable of moving in opposite directions, bending the steerable member.

[0110] Although Figures 31 and 32 show the use of screw members as an example to drive the paired bending actuation wires, it will be appreciated that modifications can be made using a variety of link structures.

[0111] 33A and 33B are schematic diagrams illustrating the length of a bend actuation wire in an ideal continuous flexible arm before and after bending. FIG. 33A shows the length of a bend actuation wire in an ideal continuous flexible arm before bending, while FIG. 33B shows the length of a bend actuation wire in an ideal continuous flexible arm being pulled by a wire-driven mechanism A (e.g., a pulley) after bending.

[0112] In an ideal continuous flexible arm, bend actuation wires are positioned on two opposing sides of a wire-driven mechanism A with a width of 2r, where "r" denotes the radius of the wire-driven mechanism A, "L1" and "L2" denote the lengths of the bend actuation wires from both opposing sides of the wire-driven mechanism A to the bend segment (not shown), respectively, before bending, "L1'" and "L2'" denote the lengths of the bend actuation wires from both opposing sides of the wire-driven mechanism A to the bend segment (not shown), respectively, after bending, "L" denotes the length from the center of the wire-driven mechanism A to the bend segment, "R" denotes the radius of curvature when the wire-driven mechanism A is pulled as shown by the arrow, and the angle of the bend by the wire-driven mechanism A is indicated by "θ".

[0113] In an ideal continuous flexible arm as shown in FIG. 33, the total length of the bend actuation wire before and after bending can be expressed as the following equation: Before flexion: L1+L2=2Rθ; After flexion: L1'+L2'=(R+r)θ+(Rr)θ=2Rθ; L1+L2=L1'+L2'

[0114] However, as shown in FIG. 34, which is a diagram that illustrates the length of the bent actuation wire before (shown in FIG. 34A) and after (shown in FIG. 34B) bending in a practical condition. As shown in FIG. 34B, the bent actuation wire is stretched by being pulled (shown as ΔL elongation), resulting in slack B on the released wire, which causes backlash. In this condition, the total length of the bent actuation wire before and after bending can be expressed as the following equation: Before flexion: L1+L2=2Rθ; After bending: L1'+L2'+ΔL elongation=(R+r)θ+(Rr)θ+ΔL elongation=2Rθ+ΔL elongation; L1+L2≠L1'+L2'+ΔL elongation

[0115] In contrast, in this exemplary embodiment, the flexion segment is configured to include a series of intermediate joints with tension adjustment members to minimize slack caused by stretching. FIG. 35 illustrates an exemplary flexion segment according to an exemplary embodiment of the present invention. In FIG. 35, a flexion segment 80 is illustrated to include four intermediate joints 81, 82, 83, 84 arranged along the direction of the longitudinal axis of the flexion segment. Each intermediate joint 81, 82, 83, 84 has a first link portion 811, 821, 831, and 841, and a second link portion 812, 822, 832, and 842, respectively. Each intermediate joint 81, 82, 83, 84 may be interstacked with an adjacent intermediate joint orthogonally, parallel, or at any angle.

[0116] The bending segment 80 further includes a number of lumens 801 passing through respective intermediate joints 81, 82, 83, 84. Accordingly, a like number of bending actuation wires (omitted for clarity) may be correspondingly provided and positioned to pass through each respective lumen 801 and positioned to bend the bending segment 80.

[0117] Each intermediate joint 81, 82, 83, 84 further includes two tension adjustment members 813, 823, 833, and 843 coupled to the first link portion 811, 821, 831, and 841 and the second link portion 812, 822, 832, and 842. Each tension adjustment member 813, 823, 833, and 843 is configured to compensate for elongation of the flex actuation wire as the flex segment bends, thereby changing and maintaining the length of the flex actuation wire at a predetermined length.

[0118] In Figure 36, each The tension adjustment member 813 has two off-axis hinge joints 814 、814’ Each off-axis hinge joint 814 、814’includes a first interfacing half 815, 815' coupled to the first link portion 811 and a second interfacing half 816, 816' coupled to the second link portion 812, the second interfacing half 816, 816' pivoted relative to the first interfacing half 815, 815'. In this exemplary embodiment, each first interfacing half 815, 815' may have a protruding end, while the second interfacing half 816, 816' may have a corresponding recessed end. In another exemplary embodiment, each first interfacing half may instead have a recessed end, while the second interfacing half may have a corresponding protruding end.

[0119] The pivoting motion is achieved by two off-axis hinges 814 depending on the bending orientation. 、814’ 36. FIG. 37 illustrates pivotal movement of one of the tension adjustment members of FIG. 36, with FIG. 37A being a front view of the tension adjustment member bending to the left and FIG. 37B being a front view of the tension adjustment member bending to the right. As shown in FIG. 37A, the intermediate joint bends in a left bending orientation on a left hinge 814 that is offset from the longitudinal axis, whereby only the first interfacing half 815 pivotally moves to the left. Similarly, as shown in FIG. 37B, when the intermediate joint 81 bends to the right, only the first interfacing half 815′ pivotally moves to the right.

[0120]

[00136] Figure 38 is a diagram that illustrates, in schematic form, how wire slack caused by wire stretching is minimized using the tension adjustment member structure of Figure 36. Figure 38A shows the length of the bent actuation wire before the tension adjustment member structure bends, while Figure 38B shows the length of the bent actuation wire after the tension adjustment member structure bends.

[0121] In FIG. 38A and FIG. 38B, "L" indicates the height of the first link portion 811 or the second link portion 812, respectively, along the direction of the central axis of the intermediate joint 81. "L1" indicates the length of the bend actuation wire passing through the lumen between the left side of the first link portion 811 and the second link portion 812 before bending, while "L1'" indicates the length of the bend actuation wire on the left side after bending. "L2" indicates the length of the bend actuation wire passing through the lumen between the right side of the first link portion 811 and the second link portion 812 before bending, while "L2'" indicates the length of the bend actuation wire on the right side after bending. "r" indicates the radius from the central axis of each link portion to the lumen through which the bend actuation wire passes. "R" indicates the radius of curvature when the intermediate joint 81 bends, and the angle of the bend is indicated by "θ". Here, "d" is the distance from the center axis of each link portion to each off-axis hinge joint 814. 、814’ The figure shows the distance to the

[0122] As shown in Figures 38A and 38B, in this exemplary embodiment, if wire elongation is ignored, the total length of the bend actuation wire before and after bending can be expressed as the following equation: L1=L2=L; L1'=2(R+r)sin(θ / 2);L2'=2(Rr)sin(θ / 2); L1 = L2 = L = L' = 2(Rd) tan(θ / 2); L1+L2=4(Rd)tan(θ / 2); L1'+L2'=2(R+r)sin(θ / 2)+2(Rr)sin(θ / 2)=4Rsin(θ / 2); Here, R = L / (2tan(θ / 2)) + d; ΔL=(L1+L2)-(L1'+L2') =2L-4Rsin(θ / 2) =2L-4(L / (2tan(θ / 2))+d)(sin(θ / 2)

[0123] Figure 39 is a simulation result illustrating the total length change (ΔL) of the bend actuation wire as a function of bend angle θ, calculated using Matlab. For example, when L=2, d=0.45, ΔL remains <0 when θ is in the designed range of motion of the joint (0 degrees to 45 degrees). Thus, the slack caused by the stretching of the wire can be compensated for by the ΔL allowed by the off-axis hinge joint.

[0124] Thus, the pivoting movement of the intermediate joint 81 is caused by the hinge 814 which is offset from the longitudinal axis of the intermediate joint 81. 、814’ The length of the bend actuation wire is altered and maintained at a predetermined length in that the stretch of the bend actuation wire is compensated for by the off-axis pivoting motion.

[0125] FIG. 40 is a block diagram illustrating a surgical instrument according to an exemplary embodiment of the present invention. FIG. 41 is a schematic diagram illustrating a surgical instrument according to an exemplary embodiment of the present invention. As shown in FIGS. 40 and 41, a bendable steerable member 100 is provided at the distal end of the surgical instrument 30. The steerable member 100 has a plurality of bend segments 110 with hollow channels (not shown in FIGS. 40 and 41) connected together. Each bend segment 110 includes a plurality of lumens 112 formed along its length. A flexible member 200 comprising a flexible material is provided at the proximal end of the steerable member 100. The flexible member 200 can include a hollow tube in which various types of wire members connected from the distal end of the surgical device 1 are located. Optionally, an end effector 300 is provided at the distal end of the steerable member 100, which may be selectively actuated by an effector actuation wire 500 (see, eg, FIGS. 2, 24-26).

[0126] Each bending segment 110 of the steerable member 100 is connected to an adjacent bending segment in a manner that allows hinge movement and is bent by a bending actuation wire 400 (see, for example, FIG. 2). In this exemplary embodiment, the first bending actuation wire 403a and the second bending actuation wire 403b are located in separate lumens 112 and pass through the steerable member 100 and the flexible member 200, with the distal ends of the first bending actuation wire 403a and the second bending actuation wire 403b being connected to the steerable member 100 and their proximal ends being mechanically connected to the drive member 160. Thus, when the first bending actuation wire 403a and the second bending actuation wire 403b are moved by the drive member 160, the multiple bending segments 110 move in a hinged manner, thus causing a one-degree-of-freedom bending movement of the steerable member 100.

[0127] The driving member 160 includes a first motor 161, a second motor 162, a first motion transmission unit 163, and a second motion transmission unit 164. The first motor 161 is coupled to the first bending actuation wire 403a via the first motion transmission unit 163, and the power from the first motor 161 is transmitted to the first bending actuation wire 403a to actuate the first bending actuation wire 403a. Similarly, the second motor 162 is coupled to the second bending actuation wire 403b via the second motion transmission unit 164, and transmits the power from the second motor 162 to actuate the second bending actuation wire 403b. In this exemplary embodiment, the first motion transmission unit 163 and the second motion transmission unit 164 can be, but are not limited to, a lead screw or a ball screw.

[0128] A tension monitoring member 170 is further provided, including a first sensor 171 and a second sensor 172. The first sensor 171 is coupled to the first motion transmission unit 163 and coupled to the first flexion actuation wire 403a. The first sensor 171 can provide a first feedback signal S1 in response to sensing a change in the tensile force of the first flexion actuation wire 403a between before bending and a desired flexion motion. Similarly, the second sensor 172 is coupled to the second motion transmission unit 164 and the second flexion actuation wire 403b. The second sensor 172 can provide a second feedback signal S2 in response to sensing a change in the tensile force of the second flexion actuation wire 403b between before bending and a desired flexion motion. In this embodiment, the first sensor 171 and the second sensor 172 are, but are not limited to, load cells. A change in the tensile force of the first bending actuation wire 403a or the second bending actuation wire 403b provides a change in an electrical value (e.g., voltage, current, or other parameter), which is calibrated to a load placed on the load cell.

[0129] The drive member 160 and tension monitoring member 170 as described above are further electrically connected to the control member 180. The control member 180 is capable of providing and transmitting a first output signal S3 in response to the first feedback signal S1 to the first motor. Upon receiving the first output signal S3, the first motor 161 will be driven to adjust (i.e., pull or release) the first flexion actuation wire 403a. Similarly, the control member 180 is capable of providing and transmitting a second output signal S4 in response to the second feedback signal S2 to the second motor 162 to adjust the second flexion actuation wire 403b.

[0130] 42 is a diagram illustrating a surgical instrument in a bent state, according to an exemplary embodiment of the present invention. When the first bend actuation wire 403a is actuated (i.e., pulled toward the first motor 161 as shown in FIG. 42) to bend the steerable member 100, the tension of the first bend actuation wire 403a and / or the second bend actuation wire 403b changes for various reasons. For example, the change in length of the second bend actuation wire 403b along the bending direction between before and after bending is smaller than that of the first bend actuation wire 403a. Therefore, the tension of the second bend actuation wire 403b will undergo a change, and a backlash will be generated due to bending, thus making fine adjustment difficult.

[0131] In this exemplary embodiment, the change in tensile force caused by the first bending actuation wire 403a can be measured and monitored by the first sensor 171 and the second sensor 172, respectively, via the voltage change induced by the tensile force. The first feedback signal S1 and the second feedback signal S2 are then provided to the control member 180 in response to the voltage change. After receiving and processing the first feedback signal S1 and the second feedback signal S2, the control member 180 will provide the first output signal S3 and the second output signal S4 to the first motor 161 and the second motor 162, respectively. The first motor 161 then stops moving in response to the first output signal S3, while the second motor 162 releases the second bend actuation wire 403b towards the steerable member 100 until it reaches a predetermined length in response to the second output signal S4, so that the first bend actuation wire 403a and the second bend actuation wire 403b are again maintained under a predetermined tension.

[0132] FIG. 43 is a block diagram illustrating a surgical instrument according to another exemplary embodiment of the present invention. FIG. 44 is a schematic diagram illustrating a surgical instrument according to another exemplary embodiment of the present invention. The end effector 300 may be subjected to various external forces when the end effector 300 is frequently in contact with the body wall, when the end effector 300 generates friction against the body material while being pushed forward along a path in the body, or when the end effector 300 generates a reaction force when the end effector 300 is operated. In conventional surgery, the surgeon feels such external forces by his own fingers. However, in robotic surgery, the surgeon cannot directly feel the external forces, and the surgeon can only guess by his own observation or experience.

[0133] Thus, in this embodiment, the surgical instrument 30 provided herein is capable of functioning with a surgeon station 190 via a communication member 191 .

[0134] The first sensor 171 and the second sensor 172 as described above may be configured to determine whether an external force is applied depending on whether a potential difference between a sensed value and a value when tension is applied to the steerable member 100 during normal operation exceeds a preset threshold ΔVth. When it is determined that an external force is applied, the first sensor 171 and the second sensor 172 will provide a first external force signal S5 and a second external force signal S6, respectively, to the control member 180. The control member 180 will further provide an instruction signal S7 transmitted via the communication member 191 in response to the first external force signal S5 and the second external force signal S6.

[0135] The communication member 191 may be built-in or external to the control member 180. Also, the communication member 191 may use any electrical communication technology in the art. For example, in some embodiments, the communication member 191 may include a wireless transmitter and a wireless receiver (not shown). In other embodiments where the signal is digital or digitized and modulated by the control member 180, the wireless transmitter may be configured in accordance with a standard protocol, for example, Bluetooth. Alternatively, any other suitable configuration of a hardwired transmitter or wireless transmitter, whether standard or proprietary, may be used. Additionally, the wireless transmitter may include an antenna (not shown) extending therefrom to facilitate transmission of the signal to the wireless receiver.

[0136] The surgeon station 190 is adapted to be manually operated by a surgeon and controls the movement of the surgical instrument 30 in response to the surgeon's operation. In this embodiment, the surgeon station 190 is configured to display information related to resistance or vibration in response to an instruction signal S7 to the surgeon station 190. In one embodiment, the control member 180 as described above includes a haptic feedback controller (not shown) and is capable of processing and transmitting the instruction signal S7 in the form of haptic feedback. The haptic feedback may be provided through a variety of forms, for example, through mechanical sensations, including, but not limited to, vibration sensations (e.g., vibration), force sensations (e.g., resistance), and pressure sensations, thermal sensations (high temperature), and / or cryosensations (low temperature). The surgeon station 190 includes a haptic joystick (not shown) and is capable of communicating haptic feedback to the surgeon and informing the surgeon of the external forces.

[0137] In other embodiments, information related to the resistance force or vibration may be shown as graphical or audio information. The surgeon station 190 here may be of various types known in the art, including a user interface for displaying such graphical or audio information. With the surgical instrument 30 provided herein, the external force may be detected and monitored by the tension monitoring member 170, and may be displayed in a visualized form or sensed by haptic feedback. Thus, even in a teleoperation condition, the surgeon may use the master device in the surgeon station in a timely manner against the external force to apply additional force. Also, the accuracy of performing a surgical procedure using the surgical instrument 30 will be increased.

[0138] In a further aspect, the present invention further provides a personalized master controller for use with, inter alia, robotic surgical devices, systems, and methods, such as a robot. In robot-assisted surgery, a surgeon typically operates a master controller to remotely control the motion of a robotic surgical device at a surgical site. The master controller may be separated from the patient by a significant distance (e.g., across an operating room, in a different room, or in a building completely different from the patient). Alternatively, the master controller may be positioned very close to the patient in the operating room. Regardless, the master controller will typically include one or more manual input handles, adapted to move the surgical apparatus 1 as shown in FIG. 1 based on the surgeon's manipulation of the manual input handles. Typically, the manual input handles may be designed to allow smooth motion in six degrees of freedom, which can correspond to three axes of translation and three axes of rotation.

[0139] Moreover, the manual input handle itself may provide degrees of freedom for gripping motions to drive the surgical instrument 30 and perform various surgical operations. For example, a built-in gripping device may further be provided at the proximal end of the manual input handle, which may be lever-operated to allow the operator to mimic the motions of scissors, forceps, or hemostats and control actuation of the surgical instrument 30, for example, to actuate the end effector 300 (see FIG. 1 ) and grip it to move tissue and / or other material at the surgical site. However, such gripping devices may not be interchangeable, and thus operators have no choice but to use a manual input handle equipped with a gripping device with which they may be less familiar. Thus, precision control using a master controller for surgical operations may become more difficult.

[0140] For the reasons outlined above, it would be advantageous to provide improved devices, systems, and methods for robotic surgery, telesurgery, and other teleoperated robotic applications. In an exemplary embodiment, a personalized master controller is provided herein. FIG. 45 is a block diagram illustrating a personalized master controller according to an exemplary embodiment of the present invention. The personalized master controller 9 can be coupled to a processor P (e.g., a computer), which is electrically connected to a surgical apparatus 1. As provided herein, the personalized master controller 9 can include a control platform 90, a connection part 91, and an interchangeable grip 92. As shown in FIG. 45, the control platform 90 can be configured to define and input one or more movement signals and control the movement of the surgical apparatus 1 (e.g., see FIG. 1) via the processor P.

[0141] In some alternative embodiments, the control platform 90 can be a serial manipulator, which includes multiple rigid links connected to joints as described in U.S. Pat. Nos. 7,714,836, 7,411,576, and 6,417,638, which are incorporated herein by reference in their entireties. For example, as shown in FIG. 46, this type of control platform 90 can include a body portion 900 including a base 900a, an input handle 901, and a first plurality of sensors 902. The base 900a can rotate about a first axis A01 having a substantially vertical orientation. The input handle 901 can include a first link 903, a second link 904, and a gimbal structure including an outer gimbal 907 and an inner gimbal 908. The first link 903 is pivoted relative to the body 900 via a first joint 905 that allows the first link 903 to move about a second axis A02, the second axis A02 having an orientation substantially perpendicular to the first axis A01. The second link 904 is pivoted relative to the first link 903 via a second joint 906 that allows the second link 904 to move about a third axis A03, the third axis A03 being substantially parallel to the second axis A02.

[0142] The gimbal structure is mounted on the free end of the second link 904 and includes an outer gimbal 907 and an inner gimbal 908. The outer gimbal 907 is pivotally supported by the second link 904 and allowed to rotate about a fourth axis A04, which is substantially perpendicular to the third axis A03. The inner gimbal 908 is pivotally supported by the outer gimbal 907 and allowed to rotate about a fifth axis A05, which is substantially perpendicular to the fourth axis A04. A connecting part 91 (FIG. 48A) is mounted on the inner gimbal structure 908 and allows an interchangeable grip 92, electrically connected thereto, to rotate about a sixth axis A06.

[0143] The connection part 91 mounted on the inner gimbal structure 908 electrically connects the input handle 901 and the replaceable grip 92. FIG. 47 is a perspective view illustrating the connection part connected to the control platform according to an exemplary embodiment of the present invention. In one embodiment, the connection part 91 can be, but is not limited to, a plug-and-socket type connector. As shown in FIG. 47, in one embodiment, a one-prong plug 911 of the connection part 91 can be coupled to the inner gimbal 908, while a corresponding socket structure 912 can be mounted on the distal end of the replaceable grip 92 (see FIG. 48), and the replaceable grip 92 can be connected on the inner gimbal structure 908 and allowed to rotate about a sixth axis A06, which is substantially perpendicular to the fifth axis A05. Alternatively, in some embodiments, the one-prong plug 911 of the connecting part 91 may be coupled to the distal end 924 of the interchangeable grip 92, while the socket structure 912 may be attached to the inner gimbal 908 (see FIG. 48).

[0144] Thus, the control platform 90 is capable of providing six degrees of freedom movement, including three translational degrees of freedom (X, Y, and Z) and three rotational degrees of freedom (pitch, yaw, and roll), such that the input handle 901 can provide multiple position parameters P1 when it can be translated in the X, Y, and Z directions relative to the control platform 90, either by itself or by the attached interchangeable grip 92, and / or can provide multiple orientation parameters P2 when it can be rotated in pitch, yaw, and roll relative to the control platform 90, either by itself or by the attached interchangeable grip 92.

[0145] In one embodiment, one or more first sensors 902 may be attached to the input handle 901 and configured to generate one or more first movement signals S8 in response to the position parameter P1 and / or orientation parameter P2 described above. The first sensors 902 may be attached, for example, to the first joint 905, the second joint 906, and / or the gimbal structure 907. In some embodiments, the first sensors 902 may be any type of sensor capable of measuring the position parameter P1 and / or orientation parameter P2 based on a condition or change, such as, but not limited to, a position, orientation, force, torque, velocity, acceleration, strain, deformation, magnetic field, angle, and / or light, caused by a movement of the input handle 901 and / or the attached interchangeable grip 92. For example, the first sensor 902 can be a pressure or force sensor, including, but not limited to, a piezoelectric sensor, a simple piezoelectric crystal sensor, a Hall effect sensor, or a resistive strain gauge sensor, all of which can be either standalone or integrated with signal conditioning electronics (Wheatstone bridge, low noise amplifier, A / D converter, etc.) into a sealed module in a single chip or single package. In other embodiments, the first sensor 902 can be, but is not limited to, an angle sensor or a rotation sensor. In certain embodiments, the first sensor 902 can be a Hall effect sensor. As known in the art, a Hall effect sensor can be used in the presence of a corresponding magnet element (not shown) to sense a magnetic field responsive to a position parameter P1 and / or an orientation parameter P2. The first sensor 902 can then generate a first movement signal S8 and control the movement (e.g., roll, translation, or pitch / yaw movement) of the surgical apparatus 1 accordingly.

[0146] FIG. 48 is a perspective view illustrating an interchangeable grip according to an exemplary embodiment of the present invention. In one embodiment, the interchangeable grip 92 provided herein includes a removable handle 921 and can mimic an actual handle from a manual surgical instrument. That is, the interchangeable grip 92 can be the same size and shape and can be squeezable or fixed to provide realism to the surgeon. For example, the two grip levers 922, 923 shown in FIG. 48A can be pivoted at the proximal end of the removable handle 921 to provide a degree of freedom for pinching or grasping motion. Both grip levers 922, 923 can be allowed to move toward each other relative to the removable handle as shown by arrow H to provide a degree of freedom for pinching or grasping motion. Depending on the surgical field, surgeon, or operation, the removable handle 921 and grip levers 922, 923 may be designed to be interchangeable with various types of surgical tools, such as tweezers or laparoscopic hand instruments, as shown in Figures 48B and 48C, respectively, to mimic actual standard surgical handles.

[0147] Also, in some embodiments, the removable handle 921 can be attached to or detached from the socket structure 912 at its distal end 924. The socket structure 912 provided herein can be electrically connected to or detached from the one-prong plug 911 of the connecting part 91 such that the removable handle 921 can be instrumented to accept an associated gripping motion input from the surgeon accordingly, and a corresponding control signal is then generated and transmitted to the surgical apparatus 1 via the control platform 90.

[0148] To sense the gripping movement of the interchangeable grip 92, in one embodiment, the removable handle 921 can define an inner hollow tubular space in which a second sensor 925 is housed and can sense at least one parameter P3 based on a state or change caused by the movement of the grip levers 922, 923, such as (but not limited to) position, orientation, force, torque, velocity, acceleration, strain, deformation, magnetic field, angle, and / or light.

[0149] In some embodiments, the second sensor 925 can be any type of sensor known in the art. For example, the second sensor 925 can be a pressure or force sensor, including but not limited to a piezoelectric sensor, a simple piezoelectric crystal sensor, a Hall effect sensor, or a resistive strain gauge sensor, all of which can be either standalone or integrated with signal conditioning electronics (Wheatstone bridge, low noise amplifier, A / D converter, etc.) into a sealed module in a single chip or single package. In other embodiments, the second sensor 925 can be an angle sensor or a rotation sensor, but is not limited to such. In certain embodiments, the second sensor 925 can be a Hall effect sensor. As known in the art, a Hall effect sensor can be used in the presence of a corresponding magnet element (not shown) to sense a magnetic field, such that the Hall effect sensor can measure the gripping parameters P3 and / or P4 based on the state or change of the magnetic field caused by the movement of the grip levers 922, 923. The Hall effect sensor can then produce a second movement signal S9, which can control the movement of the end effector 300 shown in FIG. 1 (e.g., the opening and closing (gripping) movement of the end effector 300, which can be a gripping device (e.g., jaws or blade)) accordingly.

[0150] FIG. 49 is a diagram that illustrates a personalized master controller according to another exemplary embodiment of the present invention. FIG. 50 is a diagram that illustrates a part of the control platform of the personalized master controller of FIG. 49. In this embodiment, the control platform 90 can be a device that includes a parallel kinematics structure, in particular a Delta parallel kinematics structure device (e.g., as described in U.S. Patent Application Publication No. 2008 / 0223165A1, which is incorporated herein by reference in its entirety). As shown in FIG. 49, the control platform 90 is adapted to provide up to six degrees of freedom (i.e., up to three translational degrees of freedom in the X, Y, and Z directions, and up to three rotational degrees of freedom in the pitch, yaw, and roll orientations), providing position and orientation parameters, respectively.

[0151] In this embodiment, the control platform 90 may include a base member 93, a movable member 94, and three parallel kinematic chains 95 respectively connecting the base member 93 and the movable member 94. Each parallel kinematic chain 95 has a first arm 951 movable in a respective movement plane 950 at a predetermined distance relative to an axis of symmetry (i.e., a centerline perpendicular to the base member 93). Each first arm 951 is coupled to its associated mounting member 96 such that each first arm 951 may be rotated or pivoted relative to the associated mounting member 96 and, therefore, relative to the base member 93.

[0152] A parallel kinematic chain 95 including second arms 952 may be coupled to the movable member 94. Each second arm 952 may be considered as a parallelogram including two linking bars 952a, 952b. At the proximal end of the second arm 952, each linking bar 952a and 952b may be coupled to the movable member 94 by a joint or hinge 97. At the distal end of the second arm 952, each linking bar 952a, 952b is coupled to an end of the associated first arm 951 by a joint or hinge 97. Each second arm 952, and in particular each linking bar 952a, 952b, may have two rotational degrees of freedom at both ends.

[0153] Thus, each kinematic chain 95 connected between the base member 93 and the movable member 94 is moved in a movement space defined by the base member 93, the movable member 94, and the three parallel kinematic chains 95, and can provide up to three translational degrees of freedom (along the X, Y, and Z directions, respectively, as shown in FIG. 50), generating one or more position parameters P1. Further details regarding the Delta parallel kinematic structure device may be found, for example, in U.S. Patent Application Publication No. 2008 / 0223165 A1, which is incorporated herein by reference in its entirety.

[0154] Additionally, up to three rotational degrees of freedom may be provided by a wrist structure 940 coupled to the movable member 94, which includes three pivotable connections 941, 942 and 943, e.g., in the form of pivot joints. Each of the pivotable connections 941, 942 and 943 provides a rotational degree of freedom (yaw, pitch and roll orientations, respectively, in FIG. 51 ) to the movable member 94, thereby generating one or more orientation parameters P2.

[0155] There are multiple first sensors 902, which are provided to detect one or more position parameters P1 and / or orientation parameters P2 caused by the movements of the three parallel kinematic chains 95 and the movable member 94, and subsequently generate a first movement signal S8 in response to the parameters P1 and / or P2. For example, several first sensors 902 can be installed on each mounting member 96, each detecting at least one parameter caused by the movement of the associated first arm 951. Other first sensors 902 can be installed on all or some of the joints or hinges 97, each detecting at least one parameter caused by the movement of the associated second arm 952. Alternatively, three first sensors 902 can be provided on the three pivotable connections 941, 942 and 943, respectively.

[0156] FIG. 51 is an enlarged view of a portion of FIG. 49 showing an interchangeable grip attached to the movable member of the control platform according to an exemplary embodiment. Also, FIG. 52 is an enlarged view of a portion of FIG. 49 showing an interchangeable grip detached from the movable member of the control platform according to an exemplary embodiment. As shown in FIG. 52, the connection part 91 is further mounted on the pivotable connection part 943, such that the connection part 91 can electrically connect the input handle 901 and the interchangeable grip 92. As shown in FIG. 52, in one embodiment, the connection part 91 can include, but is not limited to, a plug-and-socket type connector. For example, the one-prong plug 911 of the connecting part 91 may be connected to the removable handle 921 of the replaceable grip 92 via a screw thread 913, while the corresponding socket structure 912 may be attached to a pivotable connection part 943 such that the replaceable grip can be attached to the pivotable connection part 943 (see FIG. 51) or removed from the pivotable connection part 943 (see FIG. 52) and allowed to rotate about the rotation axis A10 of the pivotable connection part 943.

[0157] As seen above, several exemplary embodiments of surgical apparatuses have been described. However, these exemplary embodiments are merely for illustrative purposes. For example, the surgical instruments described above may be configured as individual surgical apparatuses, or they may be applied to various medical devices, such as lumen units or imaging units with working channels, and surgical apparatuses with end effectors. Moreover, various embodiments of the steerable members may be integrated into or otherwise adapted to various surgical apparatuses, including, but not limited to, catheters, endoscopes, and surgical robots that are bendable at their distal ends.

[0158] As used herein, the terms "comprises," "comprising," "includes," "including," "has," "having," or any other variation thereof, are intended to cover a non-exclusive inclusion. For example, a process, product, article, or apparatus that includes a list of elements is not necessarily limited to only those elements but can include other elements not expressly listed or that are inherent to such process, product, article, or apparatus.

[0159] Moreover, the term "or" as used herein is generally intended to mean "and / or" unless otherwise indicated. For example, condition A or B is satisfied by any one of the following: A is true (or exists) and B is false (or does not exist), A is false (or does not exist) and B is true (or exists), and both A and B are true (or exist). As used herein, terms preceded by "a" or "an" (and "the" when the antecedent is "a" or "an") include both the singular and plural forms of such terms unless expressly indicated otherwise (i.e., unless the reference to "a" or "an" explicitly indicates only the singular or only the plural). Also, as used in the description herein, the meaning of "in" includes "in" and "on" unless the context explicitly dictates otherwise.

[0160] It is also understood that one or more of the elements shown in the drawings / figures may be implemented in a more separate or more integrated manner, or may even be removed or considered as inoperable in certain cases, as would be useful according to a particular application. Additionally, any signal arrows in the drawings / figures should be considered as merely illustrative, and not limiting, unless specifically stated otherwise. The scope of the present disclosure should be determined by the following claims and their legal equivalents.

[0161] In some embodiments, the surgical device includes a steerable member that is bendable and includes a plurality of bending segments with channels therein, and a plurality of bending actuation wires that are arranged to pass through the steerable member and bend the steerable member, the steerable member including at least one lumen, the bending actuation wires passing through the lumen, and the lumen partially opening outward. In some embodiments, the bending segments are hinged to adjacent bending segments. In other embodiments, the connecting parts of each bending segment are pinned to adjacent bending segments. In other embodiments, the connecting parts of each bending segment are received in the recessed parts of the adjacent bending segments and are hinged to the recessed parts. In other embodiments, each connecting part includes a protrusion with a rounded surface, and each recessed part is shaped to receive the respective connecting part, such that the respective connecting part can rotate. In other embodiments, each connecting part includes a protrusion with a linear edge, and each recessed part is shaped like a V-shaped notch, such that the respective connecting part can rotate while in linear contact with the respective recessed part. In alternative embodiments, a pair of connecting parts are provided facing each other on one side of the length of each bending segment, and a pair of recessed parts are provided facing each other on the other side of the length of each bending segment, the pair of connecting parts and the pair of recessed parts being arranged perpendicular to each other to allow bending in two degrees of freedom. In other embodiments, four lumens are formed along the length of each bending segment, each lumen passing through at least a portion of the connecting part or recessed part. In some aspects, each lumen includes a closed lumen portion and an open lumen portion, and the portion of each lumen passing through the connecting part or recessed part forms the closed lumen portion, and the other side of the connecting part or recessed part forms the open lumen portion.In other embodiments, each bend segment has four lumens along its length, each lumen located between the location of the connection part and the location of the recess part along its circumference. In other embodiments, each lumen includes a closed lumen portion and an open lumen portion, the closed lumen portion being formed in the middle of the lumen length, and the open lumen portion being formed on both sides of the closed lumen portion. In some embodiments, the steerable member includes a plurality of plate-like bend segments and a connecting part of flexible material located between the bend segments. In other embodiments, the connecting part is integrally formed between the bend segments and extends outward from two edges of a channel located in the center of the bend segment, the connecting part being formed in a perpendicular direction to the adjacent connecting part. In other embodiments, the bend actuation wire is arranged to pass through the bend segments and the connecting part, and each lumen in which the bend actuation wire is located has a structure in which a portion located in the connecting part forms a closed lumen and a portion formed in the bend segment opens outward. In other embodiments, the connecting part is configured to connect the centers of the adjacent bend segments.

[0162] Some embodiments of the surgical device further include an end effector disposed at a distal end of the steerable member. In some embodiments, the end effector is connected to an effector actuation wire located in a channel of the steerable member such that the end effector can be actuated by moving the effector actuation wire, and at least a portion of the end effector is removably disposed at a distal end of the effector actuation wire. In some embodiments, at least a portion of the end effector is magnetically connected to the distal end of the effector actuation wire. In other embodiments, the end effector includes an effector module including an instrument portion for performing a surgical operation and an actuation portion connected to the effector actuation wire to actuate the instrument portion, and at least one of the proximal end of the effector module or the distal end of the effector actuation wire includes a magnetic body. In some embodiments, the surgical device further includes an effector actuation wire located within the channel of the steerable member and connected to the end effector for actuating the end effector, the end effector further including a resilient body configured to create a resilient force in an opposing direction to a force applied by the effector actuation wire. In other embodiments, the effector actuation wire is configured such that the end effector operates in a first mode when pulled by the effector actuation wire and operates in a second mode while not pulled by the effector actuation wire. In other embodiments, the forceps of the end effector are closed in the first mode and open in the second mode.In some embodiments, the end effector includes an instrument portion for performing a surgical operation, an actuation portion connected to an effector actuation wire to activate the instrument portion, and a body portion forming a path along which the actuation portion reciprocates, with a resilient body located at a proximal end of the actuation portion for applying a resilient force in a direction to push the actuation portion. In other embodiments, the actuation portion and the distal end of the effector actuation wire are configured to be attachable to or detachable from one another. In other embodiments, the actuation portion or at least one of the distal end of the effector actuation wire includes a magnetic body.

[0163] In some embodiments of the surgical device, a wire termination member is provided at the distal end of the steerable member for securing the distal end of the bend actuation wire. In some embodiments, the wire termination member has a thread such that the bend actuation wire is secured by threading the wire termination member into the distal end of the steerable member. In other embodiments, the bend actuation wire is arranged to be secured by being pushed in a wound state between the distal end of the steerable member and the wire termination member. In some embodiments, the wire termination member includes at least one hole, the distal end of the bend actuation wire passes through the at least one hole, and the wire termination member is provided at the distal end of the steerable member. In other embodiments, the hole in the wire termination member is formed at a location corresponding to the lumen in the steerable member. In other embodiments, the surgical device further includes an end effector provided at the distal end of the steerable member, and the wire termination member is the end effector.

[0164] In some embodiments, the surgical device includes a steerable member that is bendable and includes a plurality of bend segments with channels therein, and a plurality of bend actuation wires disposed to pass through the steerable member and bend the steerable member, the steerable member including at least one lumen, the bend actuation wires passing through the lumen, and the surgical device further includes a flexible member disposed at a proximal end of the steerable member, the flexible member including a flexible material, and at least one sleeve that forms a path of travel for the wires passing through the steerable or flexible member, both ends of the sleeve being fixed inside the steerable or flexible member. In some embodiments, the wires include bend actuation wires. In some embodiments, the body of the sleeve is longer than the longest possible path formed between two points where both opposite ends of the sleeve are fixed when the steerable or flexible member is bent, to minimize the effect of bending of the steerable or flexible member on the movement of the wires within the sleeve. In some embodiments, the steerable member and the flexible member have a hollow space for the sleeve to be placed therein. In some embodiments, a second sleeve of the at least one sleeve forms a path for the distal end bend actuation wire, with one end of the second sleeve fixed to the proximal end of the steerable portion of the distal end or the distal end of the steerable portion of the proximal end and the other end fixed to the proximal end of the flexible member. In other embodiments, the second sleeve includes an elastic material such that when the steerable portion of the distal end is bent, the distal end bend actuation wire lies along a curved path. In some embodiments, a third sleeve of the at least one sleeve forms a path for the proximal end bend actuation wire, with one end of the third sleeve fixed to the proximal end of the steerable portion of the proximal end or the distal end of the flexible member and the other end fixed to the proximal end of the flexible member.In other embodiments, the third sleeve comprises a resilient material such that when the proximal end steerable portion is bent, the proximal end bend actuation wire lies along a curved path.

[0165] In some embodiments, the surgical device includes a steerable member that is bendable and includes a plurality of bending segments with channels therein, a plurality of bending actuation wires disposed to pass through the steerable member and bend the steerable member, the steerable member including at least one lumen through which the bending actuation wires pass, and the surgical device includes a flexible member including a flexible material disposed at a proximal end of the steerable member and defining a path along which the bending actuation wires pass, and a manipulation section disposed at the proximal end of the flexible member for actuating the bending actuation wires, the proximal end of the bending actuation wires being attachable to or detachable from the manipulation section. In other embodiments, the proximal end of the bending actuation wires and the proximal end of the effector actuation wire are magnetically and detachably connected to the manipulation section.

[0166] In some embodiments, the surgical device includes a bend actuation wire including a first bend actuation wire and a second bend actuation wire, the second bend actuation wire bending the steerable member in a direction opposite to the first bend actuation wire, and a screw member rotating in the same direction is provided at a proximal end of the first bend actuation wire and a proximal end of the second bend actuation wire, configured to move synchronously with each other in the opposite direction. In some embodiments, the proximal end of the first bend actuation wire is configured to move along a first thread, and the proximal end of the second bend actuation wire is configured to move along a second thread oriented in a direction opposite to the first thread. In other embodiments, the first thread and the second thread are configured to rotate in the same direction by a single drive. In other embodiments, the screw member is a bidirectional lead screw, each having a first and second thread portion formed on a single body portion. In another embodiment, the screw member includes a first lead screw having a first thread and a second lead screw having a second thread, the first lead screw and the second lead screw being configured to move synchronously with one another via gears and to rotate simultaneously via a single drive.

[0167] In some embodiments of the surgical device, the steerable member has a geometry configured to bend more easily at the distal end than at the proximal end. In some embodiments, the bending segment has a geometry configured to bend the steerable member closer to its proximal end. In some embodiments, the bending segment has a lumen formed at a predetermined distance from the center of the cross section of the steerable member, the closer to the proximal end of the steerable member, the farther the lumen in the bending segment is from the center of the cross section of the steerable member. In some embodiments, the steerable member further includes a plurality of connecting parts located between the bending segments, the connecting parts having a geometry configured to bend the steerable member closer to its proximal end. In other embodiments, the connecting parts are configured to have a smaller cross-sectional width toward the proximal end of the steerable member, such that the corresponding part of the steerable member bends more easily. In other embodiments, the connecting parts are configured to increase in diameter along their length toward the proximal end of the steerable member, such that the corresponding part of the steerable member bends more easily.

[0168] In some embodiments, the surgical device includes a bendable steerable member, an end effector at a distal end of the steerable member, and an effector actuation wire disposed to pass through the steerable member and connect to the end effector for actuating the end effector, the end effector including a resilient body portion that creates a resilient force in an opposite direction to a force applied by the effector actuation wire. In some embodiments, the end effector is configured to operate in a first mode when pulled by the effector actuation wire, and configured to operate in a second mode by the resilient force of the resilient body portion while not pulled by the effector actuation wire. In other embodiments, the end effector is actuated such that a surgical element at a distal end is closed in the first mode and open in the second mode. In other embodiments, the end effector further includes an effector module including an instrument portion for performing a surgical operation, an actuation portion connected to the effector actuation wire to actuate the instrument portion, and a body portion forming a path along which the actuation portion reciprocates. In other embodiments, a resilient body portion is located at a proximal end of the actuation portion for applying a resilient force to urge the actuation portion toward the distal end. In some embodiments, the effector module and the distal end of the effector actuation wire are configured to be attachable or detachable from each other. In other embodiments, the effector module and the effector actuation wire are magnetically connected together.

[0169] In some embodiments, the surgical apparatus includes a bendable steerable member, a plurality of bend actuation wires disposed to pass through the steerable member and bend the steerable member, and a wire termination member disposed at a distal end of the steerable member for securing the bend actuation wires, the wire termination member having threads for engaging the distal end of the steerable member such that the bend actuation wires are secured by threading the wire termination member and the steerable member together. In some embodiments, the bend actuation wires are configured to be secured by winding between the distal end of the steerable member and the wire termination member. In other embodiments, the wire termination member includes at least one hole, the distal end of the bend actuation wire passes through the at least one hole, and the wire termination member is disposed at the distal end of the steerable member. In other embodiments, the hole in the wire termination member is formed at a location corresponding to the lumen in the steerable member. In some embodiments, the end effector is disposed on the wire termination member. In some embodiments, the surgical apparatus further includes an end effector disposed at a distal end of the steerable member, the wire terminating member being the end effector.

[0170] In some embodiments, the surgical device includes a bendable steerable member, a first bend actuation wire disposed to pass through the steerable member and bend the steerable member in a first direction, a second bend actuation wire disposed to pass through the steerable member and bend the steerable member in a second direction opposite the first direction, and at least one screw member to which a proximal end of the first bend actuation wire and a proximal end of the second bend actuation wire are coupled, such that the steerable member is bent in the first or second direction by rotating the at least one screw member. In some embodiments, the at least one screw member is disposed to rotate about a longitudinal axis of the first and second bend actuation wires. In some embodiments, the proximal end of the first bend actuation wire and the proximal end of the second bend actuation wire are configured to move synchronously with each other in opposite directions by rotating the at least one screw member. In other embodiments, at least one screw member is configured to rotate in a first rotational direction to move a proximal end of the first bend actuation wire rearward and a proximal end of the second bend actuation wire forward, thereby bending the steerable member in a first direction, and to rotate in a second rotational direction to move the proximal end of the first bend actuation wire forward and a proximal end of the second bend actuation wire rearward, thereby bending the steerable member in a second direction. In some embodiments, the proximal end of the first bend actuation wire is engaged with and moves along the first thread, and the proximal end of the second bend actuation wire is engaged with and moves along the second thread, the second thread being oriented in an opposite direction to the first thread.In other embodiments, the first thread and the second thread are configured to rotate in the same direction and the proximal end of the first bend actuation wire and the proximal end of the second bend actuation wire are configured to move synchronously with one another in opposite directions. In some embodiments, at least one screw member is a bidirectional lead screw having first and second threaded portions formed on a single body.

[0171] In some embodiments, the surgical apparatus includes a bendable steerable member and a plurality of bend actuation wires disposed to pass through a lumen in the steerable member and disposed to bend the steerable member, the steerable member having a geometry configured to cause the steerable member to bend more easily nearer its distal end, hi some embodiments, the geometry is configured to provide a smaller radius of curvature approaching the proximal end of the steerable member.

[0172] In some embodiments, the surgical device includes a steerable member that is bendable and includes a plurality of bend segments with channels therein, a plurality of bend actuation wires that are disposed to pass through the steerable member and are disposed to bend the steerable member, and a lateral support member that includes an elastic material and exerts a restoring force to return the steerable member to an initial position after bending. In some embodiments, the surgical device further includes a plurality of lateral support members, the number of the lateral support members being equal to the number of the bend actuation wires. In some embodiments, the lateral support members are configured to bend in sync with the steerable member with movement of the bend actuation wires, the lateral support members having elasticity, the elasticity being configured to return to its original shape when the force exerted on the bend actuation wires is released, thus returning the steerable member to its initial position. In some embodiments, the shape of the lateral support members prior to bending is linear. In some embodiments, the shape of the lateral support members prior to bending is bent to one side. In other embodiments, the lateral support members are configured in a tubular shape with the bent actuation wires located inside the lateral support members.

[0173] In some embodiments, the surgical device includes a steerable member that is bendable and includes a plurality of bending segments with channels therein and a plurality of connecting segments located between the bending segments, and a plurality of bending actuation wires disposed to pass through the steerable member and bend the steerable member, with two ends of each connecting segment hinged to different bending segments. In some embodiments, each connecting segment includes a pair of body portions forming a portion hinged to the bending segment, and a guide member that ties the pair of body portions together and has a hollow space therein, with the bending actuation wires located in the hollow space. In some embodiments, the bending segment connected to one end of each connecting segment is rotatable about a first hinge shaft, and the bending segment connected to the other end is rotatable about a second hinge shaft, with the first hinge shaft and the second hinge shaft being parallel to each other. In some embodiments, each connection segment is oriented differently than adjacent connection segments to allow the connected bending segments to bend about different axes of rotation and to allow the steerable member to bend with at least two degrees of freedom. In some embodiments, each bending segment includes multiple lumens in which the bending actuation wires are located, the lumens being positioned so that they do not pass through the portions hingedly connected to the connection segments. In some embodiments, the bending segments are rotatably connected to the connection segments, and the hinge shafts about which the bending segments rotate are in the same plane as the ends of the lumens in which the bending actuation wires are located.

[0174] In some embodiments, the surgical apparatus includes a steerable member that is bendable and includes a plurality of bend segments, each bend segment including at least an intermediate joint having a first link portion and a second link portion, the intermediate joint being disposed along a longitudinal axis of the respective bend segment, and a plurality of bend actuation wires disposed to pass through the steerable member to bend the steerable member, the steerable member further including at least one lumen through which the bend actuation wires pass, and the intermediate joint further includes a tension adjustment member coupled to the first link portion and the second link portion and configured to adjust tension in the bend actuation wires by compensating for elongation of the bend actuation wires when the bend segment is bent, thereby changing the length of the bend actuation wires and maintaining them at a predetermined tension. In other embodiments, the first interfacing half has a protruding end and the second interfacing half has a correspondingly recessed end. In other embodiments, the first interfacing half has a recessed end and the second interfacing half has a correspondingly protruding end. In some embodiments, the stretch of the flex actuation wire is compensated for by the two off-axis hinges being offset. In some embodiments, the flex segment includes a series of interstacked intermediate joints.

[0175] In some embodiments, a surgical apparatus includes a steerable member that is bendable and includes a plurality of bending segments and a plurality of lumens; a bend actuation member including a first bend actuation wire and a second bend actuation wire, the first bend actuation wire and the second bend actuation wire arranged to pass separately through their respective lumens, for bending the steerable member; a first sensor coupled to the first bend actuation wire and configured to provide a first feedback signal in response to sensing a change in tension in the first bend actuation wire between before bending and a desired bending motion of the steerable member; and a second sensor coupled to the second bend actuation wire and configured to provide a second feedback signal in response to sensing a change in tension in the second bend actuation wire between before bending and a desired bending motion of the steerable member. a drive member including a first motor coupled to the first bend actuation wire and adapted to actuate the first bend actuation wire, and a second motor coupled to the second bend actuation wire and adapted to actuate the second bend actuation wire, and a control member electrically connected to the tension monitoring member and the drive member, the control member configured to provide a first output signal in response to a first feedback signal, the first motor being driven to adjust a length of the first bend actuation wire to maintain a predetermined tension, and the control member configured to provide a second output signal in response to a second feedback signal, the second motor being driven to adjust a length of the second bend actuation wire to maintain a predetermined tension. In some embodiments, the second bend actuation wire is movable in a direction opposite to the first bend actuation wire.In some embodiments, when the first bending actuation wire is configured to be actuated to bend the steerable member and the second bending actuation wire is configured to be driven by the second motor, the second bending actuation wire is released in response to the second output signal and maintained under a predetermined tension. In some embodiments, the first sensor or the second sensor is a load cell. In some embodiments, the first sensor is further configured to provide a first external force signal in response to sensing an external force applied to the steerable member. In some embodiments, the second sensor is further configured to provide a second external force signal in response to sensing an external force applied to the steerable member. In other embodiments, the control member is further configured to provide an instruction signal in response to the first external force signal or the second external force signal. In other embodiments, the control member further includes a haptic feedback controller, the haptic feedback controller configured to process and convey information in the form of haptic feedback. In other embodiments, the first motion transmission unit or the second motion transmission unit is a lead screw or a ball screw.

[0176] In some embodiments, a personalized master controller for a surgical apparatus includes a control platform configured to define and input one or more movement signals to a surgical robot, the control platform including an input handle translatable in a first plurality of degrees of freedom and providing a plurality of position parameters and / or rotatable in a second plurality of degrees of freedom and providing a plurality of orientation parameters, and a plurality of first sensors coupled to the input handle and configured to generate the first movement signals in response to the position parameters and / or the orientation parameters of the input handle, a connection part attached to the input handle and electrically connected to the input handle, a removable handle electrically connecting the connection part, one or more grip levers pivoted relative to the removable handle, each grip lever movable in a third degree of freedom relative to the removable handle and adapted to provide a gripping movement parameter, and an interchangeable grip including a second sensor coupled to the removable handle and configured to generate a second movement signal to the control platform in response to the gripping movement parameter. In some embodiments, the first plurality of sensors or the second plurality of sensors include a rotary encoder, a Hall effector sensor, an angle sensor, a rotation sensor, or any combination thereof. In some embodiments, the connection part further includes a screw thread coupled to the removable handle and has a first electrical connection terminal. In other embodiments, the removable handle further includes a second electrical connection terminal electrically connected to the first electrical connection terminal. In some embodiments, the replaceable grip includes two grip levers, the two grip levers being correspondingly pivoted relative to the removable handle and allowed to move toward each other relative to the removable handle.

Claims

1. 1. A surgical device comprising: A steerable member including a plurality of bendable flex segments with channels therein, each flex segment including a double hinged joint including a first off-axis hinge joint and a second off-axis hinge joint, the first off-axis hinge joint including a first interfacing half including a first protruding end connected to a first link portion, and a second interfacing half including a first recessed end connected to a second link portion and pivoted about a first fixed pivot point relative to the first interfacing half of the first off-axis hinge joint, the second off-axis hinge joint including a first interfacing half connected to a second link portion, the second interfacing half including a first recessed end connected to the first ... interfacing half of the first off-axis hinge joint, the first interfacing half including a first protruding end connected to the first link portion, the second interfacing half including a first recessed end connected to the first interfacing half of the first off-axis hinge joint, the second interfacing half including a first recessed end connected to the first link portion, the second interfacing half including a first recessed end connected to the first interfacing half of the first off-axis hinge joint, a first interfacing half including a second protruding end connected to said second link portion and a second interfacing half including a second recessed end connected to said second link portion and pivoted about a second fixed pivot point relative to said first interfacing half of said second off-axis hinge joint, said second fixed pivot point being different from said first fixed pivot point, said first protruding end contacting said first recessed end and said second protruding end contacting said second recessed end, and said second protruding end contacting said first recessed end while said second protruding end is spaced apart from said second recessed end, a plurality of bend actuation wires passing through the steerable member and positioned to bend the steerable member, the steerable member including at least one lumen, the bend actuation wires passing through the lumen, the lumen partially opening outward; and an end effector disposed at a distal end of the steerable member; an effector actuation wire located within the channel of the steerable member and connected to the end effector for actuating the end effector; and Including, The end effector includes: an instrument portion for performing a surgical operation; an actuation portion for actuating the instrument portion, a distal end of the actuation portion being connected to the instrument portion and a proximal end of the actuation portion being removably connected to a distal end of the effector actuation wire; a body portion, the actuation portion reciprocating inside the body portion; a resilient body portion located within the body portion at a proximal end of the actuation portion, the resilient body portion applying a resilient force urging the actuation portion toward a distal end of the actuation portion in response to a force applied by the effector actuation wire being pulled toward the proximal end of the effector actuation wire; 13. A surgical device comprising:

2. The surgical apparatus of claim 1, wherein the end effector includes forceps, and the effector actuation wire is configured such that when the end effector is being pulled by the effector actuation wire, the forceps are closed and when the end effector is not being pulled by the effector actuation wire, the forceps are open.

3. The surgical apparatus of claim 1 or 2, wherein at least one of the actuation portion or a distal end of the effector actuation wire includes a magnetic body.

4. A bendable, steerable member including a plurality of bend segments, each bend segment including a channel disposed about and passing through a longitudinal axis of the bend segment, and a body surrounding the channel, the body including a peripheral sidewall extending along the longitudinal axis of the bend segment, each bend segment including a double hinged joint including a first off-axis hinge joint and a second off-axis hinge joint, the first off-axis hinge joint including a first interfacing half including a first protruding end connected to a first link portion, and a second interfacing half including a first recessed end connected to a second link portion and pivoted about a first fixed pivot point relative to the first interfacing half of the first off-axis hinge joint. a steerable member including a first interfacing half including a second protruding end connected to the first link portion and a second interfacing half including a second recessed end connected to the second link portion and pivoted about a second fixed pivot point relative to the first interfacing half of the second off-axis hinge joint, the second fixed pivot point being different from the first fixed pivot point, in a first relative orientation, the first protruding end contacts the first recessed end and the second protruding end contacts the second recessed end, and in a second relative orientation, the first protruding end contacts the first recessed end while the second protruding end is spaced apart from the second recessed end; a plurality of bend actuation wires passing through the steerable member and arranged to bend the steerable member, each bend segment further including a plurality of lumens through which the bend actuation wires pass, each lumen extending through the body of the bend segment in a direction parallel to the longitudinal axis of the bend segment; an end effector disposed at a distal end of the steerable member, a distal instrument portion for performing a surgical procedure; and a proximal actuation portion connected to a distal end of the steerable member, the proximal actuation portion having a resilient body disposed at a proximal end of the proximal actuation portion, the resilient body applying a resilient force urging the proximal actuation portion toward the distal end of the proximal actuation portion; an end effector comprising: an effector actuation wire extending through the channel of each bending segment and removably connected to the proximal actuation portion for actuating the distal instrument portion; 13. A surgical device comprising:

5. The surgical apparatus of claim 4, wherein the end effector is configured to operate to close the distal instrument portion when pulled by the effector actuation wire and to operate to open the distal instrument portion by the elastic force of the elastic body portion while not pulled by the effector actuation wire.

6. The surgical apparatus of claim 4 or 5, wherein the end effector further includes a body portion, the proximal actuation portion reciprocating within the body portion.

7. The surgical apparatus of claim 4 , wherein the proximal actuation portion and the effector actuation wire are magnetically interconnected.

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