Steerable, flexible robotic endoscopic instruments for minimally invasive procedures

Abstract

The probe component (100) includes a base member (110) defining a first bore (112). A first elongated elastic member (120) includes a proximal end (126) secured to the base member (110) and extends from the proximal end to a distal end (128) to define a channel (125) communicating with the first bore (112) and extending along the length of the elastic member. A first tendon (130) has a first end and an opposite second end secured to a portion of the first elongated elastic member (120) adjacent the distal end (128). The first tendon (130) extends into the first channel (125) adjacent the first side (122) of the first elongate elastic member and extends through the first bore (112) to extend outside the first bore. Applying tension to the first tendon (130) causes the first elongate elastic member (120) to bend toward the first side (122).

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Patent Application No. 62 / 813,444, filed March 4, 2019, the entire contents of which are incorporated herein by reference.

[0002] FIELD OF THE INVENTION The present invention relates to endoscopic instruments, and more particularly to steerable probe components. [Background technology]

[0003] Hydrocephalus is a common childhood disorder, occurring at a rate of 0.7 cases per 1,000 in developed countries. The incidence is even higher in developing countries. The disorder results from the accumulation of cerebrospinal fluid (CSF) within the brain, which causes ventricle enlargement and increases intracranial pressure. CSF is thought to be produced in the lateral ventricles and passes through the third, aqueduct, and fourth ventricles before flowing into the cisternal spaces around the craniocervical junction. Obstruction of CSF circulation at the aqueduct connecting the third and fourth ventricles is one of the most common causes of hydrocephalus. Delayed treatment of hydrocephalus can lead to loss of motor function, epilepsy, chronic headache, sensory neurological deficits, and death. The most common treatment for hydrocephalus is a CSF shunt, a procedure in which a silicone tube is implanted between the brain and abdomen to divert CSF. However, 60 years' worth of knowledge about cerebrospinal fluid (CSF) shunts has shown them to be imperfect devices, with shunt obstruction being a leading cause of morbidity and mortality.

[0004] An alternative to cerebrospinal fluid (CSF) shunt placement is endoscopic surgery aimed at removing or bypassing intracerebral obstructions, completely avoiding the need for CSF shunt implantation. One of the most common endoscopic procedures is endoscopic third ventriculostomy (ETV). During ETV surgery, the surgeon first creates an entry point into the ventricle using an endoscope equipped with a high-resolution camera and light source. Then, under direct visualization, a perforation is created in the floor wall of the third ventricle using a rigid instrument passed through the working channel of the endoscope. This perforation allows CSF to bypass the obstruction in the aqueduct and drain into the prepontine cistern, located below the aqueduct. While this procedure has a confirmed success rate of over 80% in infants, it can be difficult to reach the appropriate location in the third ventricle to create the perforation during ETV. The rigid nature of the endoscope requires a linear path from the scalp through the brain parenchyma to the floor of the third ventricle. To avoid bleeding, this straight path must avoid important blood vessels, functional areas, and cranial nerves. This problem is further complicated by the fact that disease progression often results in deformation of brain structures. Due to these constraints, finding the optimal straight path is not always possible.

[0005] Therefore, there is a need for a steerable endoscopic probe assembly that can avoid obstacles. The prior art documents relevant to the invention of this application are as follows (including documents cited in the international phase after the international filing date and documents cited when the application entered the national phase in other countries). (Prior art document) (Patent document) (Patent Document 1) U.S. Patent Application Publication No. 2017 / 0065153 (Patent Document 2) U.S. Patent Application Publication No. 2013 / 0197306 (Patent Document 3) U.S. Patent No. 4,632,110 (Patent Document 4) U.S. Patent No. 6,012,494 (Patent Document 5) U.S. Patent Application Publication No. 2014 / 0379000 (Patent Document 6) U.S. Patent Application Publication No. 2005 / 096694 (Patent Document 7) International Publication No. 2017 / 213491 (Patent Document 8) German Patent Application Publication No. 102009037030 (Patent Document 9) U.S. Patent Application Publication No. 2007 / 021737 (Patent Document 10) U.S. Patent Application Publication No. 2017 / 065153 (Patent Document 11) U.S. Patent No. 6,012,494 Summary of the Invention [Means for solving the problem]

[0006] The shortcomings of the prior art are overcome by the present invention, which in one respect is a probe component including a base member defining a first bore therethrough. A first elongated elastic member has a first side and a second side opposite the first side, the first elongated elastic member including a proximal end secured to the base member and extending from the proximal end to a distal end. The first elongated elastic member defines a first channel in communication with the first bore and extending along the length of the elastic member. A first tendon, a portion of which is disposed within the first channel adjacent the first side of the first elongated elastic member, has a first end and a second end opposite the first end. The second end is an anterior end. Record number a portion of the elongated elastic member adjacent to the distal end thereof; to The first tendon portion passes through the first hole in the base member, such that the first end of the first tendon portion extends outside the first hole. By applying tension to the first tendon portion, the first elongated elastic member is bent toward the first side.

[0007] In another aspect, the present invention is a probe assembly including a base member defining a first bore, a second bore, a third bore, and a fourth bore therethrough. A first elongated resilient member has a first side and a second side opposite the first side. The first elongated resilient member includes a proximal end secured to the base member and extends from the proximal end to a distal end. The first elongated resilient member defines a first passageway aligned with the first bore and extending adjacent the first side along the length of the resilient member. The first elongated resilient member also defines a second passageway aligned with the second bore and extending adjacent the second side along the length of the resilient member. An intermediate rigid member is attached to the distal end of the first elongated resilient member. A second elongated elastic member is attached to the intermediate rigid member on a side opposite to the side to which the first elongated elastic member is attached. The second elongated elastic member has a first side and a second side opposite the first side. The second elongated elastic member defines a third passageway extending along the length of the elastic member adjacent to the first side. The second elongated elastic member also defines a fourth passageway extending along the length of the elastic member adjacent to the second side. A first tendon has a first end and a second end opposite the first end. The second end of the first tendon is anterior. Record number a portion of the elongated elastic member adjacent to the distal end thereof; to The first tendon extends through the first passage of the first elongated elastic member and passes through the first hole in the base member, so that the first end of the first tendon extends outside the first hole. By applying tension to the first tendon, the first elongated elastic member is bent toward the first side. The second tendon has a first end and a second end opposite the first end. The second end of the second tendon is Record number a portion of the elongated elastic member adjacent to the distal end thereof; toThe second tendon extends through the second passage of the first elongated elastic member and through the second hole in the base member, so that the first end of the second tendon extends outside the second hole. By applying tension to the second tendon, the first elongated elastic member is bent toward the second side. The third tendon has a first end and a second end opposite the first end. The second end of the third tendon is anterior. Record number a portion adjacent to the distal end of each of the two elongated elastic members; to The third tendon portion extends through the third passage defined by the second elongated elastic member and the third passage defined by the first elongated elastic member, and passes through the third hole in the base member, so that the first end of the third tendon portion extends outside the third hole. By applying tension to the third tendon portion, the second elongated elastic member is bent toward the first side. The fourth tendon portion has a first end and a second end opposite the first end. The second end of the fourth tendon portion is anterior. Record number a portion adjacent to the distal end of each of the two elongated elastic members; to The fourth tendon extends through the fourth passage of the second elongated elastic member and the fourth passage defined by the first elongated elastic member, and passes through the fourth hole of the base member, so that the first end of the fourth tendon extends outside the fourth hole. Applying tension to the fourth tendon causes the second elongated elastic member to bend toward the second side.

[0008] In yet another aspect, the invention is an instrument for operating a probe assembly, the probe assembly including at least one elastic member for exerting directional control by applying stress to at least one tendon. The instrument is configured for use with an endoscope defining a longitudinal passage therethrough. A housing has an interior structure exposed by retracting a retractable portion of the housing. The housing has one end configured for coupling to the endoscope. At least one input passage is defined by the housing and configured to be aligned with the length of the endoscope. The at least one input passage is configured to receive a portion of the at least one tendon therein, whereby the at least one elastic member is received in the longitudinal passage defined by the endoscope. An actuator assembly is attached to the housing and configured to manipulate the at least one tendon by selectively applying stress to the at least one tendon.

[0009] These and other aspects of the present invention will become apparent from the following description of the preferred embodiments taken in conjunction with the following drawings. It will be apparent to those skilled in the art that various modifications and variations of the present invention may be effected without departing from the spirit and scope of the novel concepts of the present disclosure. [Brief explanation of the drawings]

[0010] The invention is best understood from the following detailed description when read in conjunction with the accompanying drawings, in which: According to common practice, the various elements of the drawings are not drawn to scale. Rather, the dimensions of the various elements have been arbitrarily expanded or reduced for clarity. [Figure 1A] 1A and 1B are schematic diagrams of one representative embodiment of a probe component. [Figure 1B] 1A and 1B are schematic diagrams of one representative embodiment of a probe component. [Figure 2] 2A-2C are schematic diagrams of a second embodiment of a probe component. [Figure 3] FIG. 3 is a schematic diagram of one embodiment of a probe. [Figure 4] 4A and 4B are schematic diagrams of a tubular elastic member having a small circular sawtooth shape. [Figure 5] 5A-5C are schematic diagrams of different crenellation shapes. [Figure 6] FIG. 6 is a schematic diagram of a probe using a tubular elastic member with a small circular sawtooth shape. [Figure 7] 7A-7C are schematic diagrams of the instruments used in the probe. [Figure 8] FIG. 8 is a schematic diagram of an example of the use of a probe in conjunction with an endoscope. [Figure 9] FIG. 9 is a schematic diagram of the probe control housing. [Figure 10] FIG. 10 is a detail of the housing shown in FIG. 9, showing the probe connection. [Figure 11] FIG. 11 shows a detail of the probe coupled to the housing. [Figure 12] FIG. 12 is an exploded view of a schematic diagram of the control device. [Figure 13] FIG. 13 is a schematic diagram of an example of the use of a probe and housing for use with an endoscope. [Figures 14A-14B] 14A-14D are schematic diagrams showing different designs of the probe assembly. [Figure 14C-14D] 14A-14D are schematic diagrams showing different designs of the probe assembly. [Figure 15] FIG. 15 is a micrograph of a small sawtooth-shaped nickel-titanium alloy tube. [Figure 16] FIG. 16 is a photograph of one experimental embodiment of the probe assembly. DETAILED DESCRIPTION OF THE INVENTION

[0011] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention are described in detail below. Referring to the drawings, like reference numerals refer to like parts throughout the drawings. Drawings are not drawn to scale unless expressly stated in the following disclosure. The present disclosure is not limited in any way to the exemplary embodiments and techniques shown in the drawings and the following description. As used in the description and claims of this specification, the following terms have the meanings clearly associated therewith in this specification, unless clearly stated differently in the context: "a," "an," and "the" include plural meanings, and "in" includes "in" and "on."

[0012] The robotically operable steerable probe assembly of the present invention is designed to fit within the small diameter of the working channels of conventional endoscopes (e.g., the MINOP endoscope, available from Acculap Inc., with a 2.2 mm working channel, and the HandyPro endoscope, available from Karl Storz SE & Co. KG, with a 1.3 mm working channel). The probe assembly is also designed for high maneuverability within its workspace, increasing the likelihood of avoiding obstacles. In the operating room, it is often desirable for two surgeons to perform endoscopic procedures: one surgeon to insert and retract the endoscope body, and the other surgeon to manipulate the instruments themselves, including inserting, retracting, and rotating the instruments within the endoscope working channel. Therefore, a robotic solution must include an actuator capable of operating within a small, portable package.

[0013] The robotic probe system of the present invention includes three main components: 1) a proximal articulation section made of an elongated elastic member with high resistance to lateral forces and flexibility; 2) a tendon phase shifting unit that allows the distal tendons to be rerouted, thereby minimizing coupling between the articulation sections; and 3) a distal articulation section made of an elongated elastic member with high flexibility.

[0014] As shown in FIG. 1 , one embodiment of a probe component 100 includes a base member 110 having a first bore 112 therethrough. A first elongated elastic member 120 (also referred to herein as an “articulation member”) extends from the base member 110 and has a first side 122, an opposing second side 124, a proximal end 126, and a distal end 128. The first elongated elastic member 120 defines a channel 125 extending along the first side 122 and aligned with the bore 112. A first tendon 130 passes through the bore 112 and the channel 125 and is secured to the first elongated elastic member 120 near the distal end 128. As shown in FIG. 1B , applying a stress to the first tendon 130 in the direction shown causes the first elongated elastic member 120 to bend inwardly toward the first side 122.

[0015] As shown in FIGS. 2A-2C , the first elongated elastic member 220 can define a first passageway 127 and a second passageway 129 along the second side, and the base member can define a second aperture 113 through which the second tendon portion 132 passes. In this embodiment, the first elongated elastic member 120 can bend both toward the first side 122 and toward the second side 124 by tensioning the tendon portion. In one embodiment, the tendon portion can include a nickel-titanium alloy wire (such as Nitinol) (e.g., part number WSE000450000DG, available from https: / / shop.confluentmedical.com / ). It should be understood that the tendon portion can include other materials, including other types of leads, wires, and cords, depending on the particular application, without departing from the scope of the present invention.

[0016] As shown in FIG. 3 , the probe assembly 300 can include a first elastic elongate member 120a (controlled by tendons 330, 332) and a second elastic elongate member 120b (controlled by tendons 334, 336), separated by an intermediate rigid member 310 configured as a phase-shifting unit. The first elastic elongate member 120a defines a channel 125a, and the second elastic elongate member 120b defines a channel 125b. The probe assembly 300 can be configured in a shape such as an “S” curve, as shown. Additionally, an instrument 330 can be secured to the end of the probe assembly 300 for use in applying the probe assembly (the probe assembly 300 can include passage for electrical leads used to control the instrument 330). In certain embodiments, multiple elastic elongate members can be connected in series and spaced apart by corresponding intermediate rigid members to achieve more complex motion patterns for the probe assembly. The elongate resilient member as illustrated has a substantially tubular shape, but may be tapered along its length or have a variable diameter depending on the particular application. In yet another embodiment, the elongate member may have a non-tubular shape, such as a rectangular beam.

[0017] As shown in FIGS. 4A-4B, the elongated elastic member can include an elastic tubular portion 420 with a first set of small crenulations machined on one side and a second set of small crenulations machined on the other side. In one embodiment, the elastic tubular portion 420 includes a nickel-titanium alloy (it should be understood that the elastic tubular portion 420 can include other materials exhibiting elastic properties depending on the particular application without departing from the scope of the present invention). As shown in FIG. 4B, when one of the tendons 130 is pulled outward, the compression causes adjacent small crenulations to bend, bending the elongated elastic member toward the side of the tendon 130 that is under tension. When the tension is released, the elongated elastic member returns to its original shape due to the superelastic properties of the nickel-titanium alloy. However, this ability to move can also be observed in other materials and is not necessarily limited to nickel-titanium alloys. Furthermore, to reduce component costs, the elastic member can be joined to the non-elastic member by microwelding.

[0018] FIG. 5A shows a crenulated pattern on only one side, allowing for bending in only one direction. FIG. 5B shows an asymmetric crenulated pattern, and FIG. 5C shows a symmetric crenulated pattern, allowing for bending in two directions. FIG. 6 shows a probe assembly 200 with crenulated elastic members 120, 220 (several alternative configurations are shown in FIGS. 14A-14D). Referring to FIG. 6, a portion of intermediate member 310 connecting the joints is shown open to illustrate the phase-shifting paths of tendons 334, 336.

[0019] 7A-7C show different instruments, including a bipolar electrocautery instrument 232, a grasping instrument 234, and a scissors instrument 236. It should be understood that other types of instruments may also be used, including, for example, cutting instruments, basket instruments, loop instruments, and scalpel instruments.

[0020] 8 shows a probe assembly 300 for use during surgery on the brain 11 of a patient 10, the probe assembly being used in conjunction with a rigid endoscope 810. As can be seen in the detail of this figure, the probe assembly 300 is maneuverable to move around an obstacle 12 to reach a target area, and can be further maneuvered to avoid, for example, a tumor.

[0021] As shown in FIG. 9, the controller 800 can employ two (or more) motors 820 that drive gear assemblies 824, which are used to apply (and release) tension to the tendons. A joystick 822, operated by the user, controls the movement of the motors 820. Circuitry 826 is used to transmit control commands from the joystick 822 and a remote computer to the motors 820, thereby providing intuitive user control of the probe assembly. The quick connect assembly shown in FIG. 10 includes a retractable housing portion 804 that exposes an input passageway 830 within which the tendons (130, 132, 134, 136) of the probe assembly 300 are positioned. (One embodiment includes two or more passageways within which two or more probe assemblies can be positioned, thereby allowing two or more instruments to pass through the endoscope.) A probe-side tendon connection 834 engages an actuator-side connection 832, and these connections are operated by a pulley and gear assembly 824. In one embodiment, the quick connect assembly 802 snaps into place with an insertion and twisting motion. In another embodiment, the snap connection may be achieved by magnetic force. This quick connect assembly 802 allows for the removal and pre-positioning of probes with different instruments within the endoscope during surgery. The size of the controller 800, which operates the robotic instrument tip, must be within the range of existing devices used with commercially available endoscopes. Therefore, in an experimental embodiment, the controller module had a diameter of 32 mm and a length of 178.85 mm to accommodate existing product sizes. This controller can be easily coupled to a connection module that interfaces with a MINOP (Minimally Invasive Procedure) neuroendoscope. This connection has a female socket that slides over the endoscope, allowing for fine adjustment of the instrument tip position, and can be secured to the endoscope with a set screw for hands-free operation. The outer sheath of the controller has a window that allows the clinician to rotate the entire motor and robotic assembly along the central axis of the controller.Figure 12 shows an exploded view of yet another embodiment of the controller. In this design, the entire joint is driven by tendons. All tendons are controlled by linear motion, achieved by DC motors with lead screws. Each tendon is routed to a single DC motor through a pulley arrangement, so two motors are used per joint. In designs using two to four motors, the controller has space to accommodate up to four 8 mm diameter DC motors (Maxon Precision Motors, Massachusetts, USA) with 50 mm long, 0.5 mm pitch lead screws. Nuts that hold the tendons are attached to the four lead screws, and these nuts rest on a single central rod. This central rod prevents the nuts from rotating, allowing them to slide along the length of the rod, achieving linear motion. The entire motor and lead screw assembly rests on two bearings on either end of the controller and is located within an inner housing. These bearings therefore allow the housing to rotate along the central axis of the cylindrical assembly, thereby achieving the rotational motion described above. Figure 11 shows this type of probe system, and Figure 13 shows the system in use during surgery.

[0022] In one experimental embodiment, due to the robot's diameter constraints, a flexure joint (a long, elastic member) was created by removing material from a tubular section through machining to form a specific pattern. In one embodiment, a one-way asymmetric notched joint was created by removing material from the tubular section in an asymmetric manner. However, it was found that if all the notches were located on only one side of the tubular section's central axis, the neutral axis of the joint would be shifted toward the distal end. This made the joint susceptible to lateral and other external forces. A two-way symmetric joint did not have this problem, but it was found that the joint lacked high flexibility due to moment arm constraints. To maintain high flexibility in the bending plane while keeping external forces low, a flexure joint known as a two-way asymmetric notched joint was adopted, as shown in Figure 15. In this design, asymmetric notches were created on both sides of the central axis to create a flexible bending segment between the notches. This type of joint has a high ability to withstand axial forces and forces in a plane transverse to the bending plane. This ability of the notched joints to resist lateral forces allows for a routing strategy for the tendons that minimizes inter-articular connections.

[0023] To fabricate the joint used in the experimental embodiment, a 2 mm outer diameter (OD) by 1.43 mm inner diameter (ID) nickel-titanium alloy tubular section was machined on a 3-axis CNC milling machine (Okuma Millac, available from Okuma America Corporation, North Carolina, USA) with a 500 micron diameter, 4-flute end mill (875-TJ -0.020, available from Richards Micro Tool, Massachusetts, USA). The rated cutting speed was 19 m / min, and the feed rate was 4.2 mm / s. In another robot embodiment, the robot joint was machined from a 1.93 mm outer diameter (OD) by 1.49 mm inner diameter (ID) nickel-titanium alloy tubular section. Micromachining of the serrations was performed with a femtosecond laser (WS-Flex Ultra-Short Pulse Laser Workstation, available from Optec, Framley, Belgium). The robotic probe assembly itself contained two joints, each configured to bend along parallel axes in the same plane by driving two tendons. Each joint could bend in either direction in the bending plane by the two tendons. However, the two tendons driving the distal joint were routed together with the tendons driving the proximal joint. The tendons for the distal joint were routed in a plane transverse to the bending plane of the proximal joint. Because the proximal joint had high flexibility in the bending plane but low flexibility in the transverse plane, actuation of the distal tendon achieved deliberate decoupling without significant bending of the proximal joint. The tendon phase-shifting block was a 3D-printed tubular section with a 0.2 mm spiral channel formed within it, allowing the distal tendon to shift phase by 90°, moving from the transverse plane to the bending plane of the distal tendon. With this configuration, we achieved a tendon-driven multi-degree-of-freedom (DoF) system, which realizes decoupling by spring-like joints with direction-dependent flexibility, and also realizes a tendon routing method between successive joints, as shown in Figure 16.

[0024] While certain advantages have been enumerated above, various embodiments may include some, none, or all of the enumerated advantages. Other technical advantages will become apparent to those skilled in the art upon reviewing the drawings and description. While the drawings and description illustrate exemplary embodiments, the principles of the present disclosure may be implemented using any number of technologies, currently known or unknown. Modifications, additions, or omissions may be made to the systems, devices, and methods described herein without departing from the scope of the invention. System and device components may be integrated or separated. The operations of the systems and devices disclosed herein may be implemented with more, fewer, or other components, and the methods described herein may include more, fewer, or other steps. Furthermore, steps may be performed in any suitable order. As used herein, "each" refers to each member of a set or each member of a subset of a set. The following claims and elements thereof are not intended to invoke 35 U.S.C. §112(f) unless the term "means for" or "step for" is expressly used in a particular claim. The above-described embodiments, including the preferred embodiments and best mode of the invention known at the time of filing, are provided as exemplary embodiments only. It will be readily understood that various modifications can be made to the specific embodiments disclosed herein without departing from the scope of the invention. Accordingly, the scope of the present invention is not limited to the specific embodiments described above, but rather is determined by the scope of the following claims.

Claims

1. a probe component configured to be inserted into a proximal end of an endoscope, through a working channel of the endoscope, and beyond a distal end of the endoscope, the probe component having a proximal end and a distal end, the probe component configured to position the distal end of the probe component at a target location beyond the distal end of the endoscope, the probe component comprising: a base member defining a first hole portion passing through the base member and a second hole portion passing through the base member and spaced apart from the first hole portion; a first elongated elastic member having a first side and a second side opposite the first side, the first elongated elastic member including a proximal end secured to the base member and extending from the proximal end to a distal end, the first elongated elastic member defining a first channel in communication with the first aperture and extending along a length of the first elongated elastic member; a second elongated elastic member having a first side and a second side opposite the first side, the second elongated elastic member including a proximal end and extending to a distal end opposite the proximal end, the second elongated elastic member defining a second channel in communication with the first channel and extending along a length of the second elongated elastic member; an intermediate member connecting the articulation portions, the intermediate member connecting the second elongated elastic member and the first elongated elastic member and providing an intermediate channel between the first and second channels; a first tendon having a first end positioned outside the base member, the first tendon having a portion that passes through the first aperture, the first aperture being proximate the first side of the first elongated elastic member, the first tendon having a portion that extends to an opposing second end that is positioned within the first channel of the first elongated elastic member, the second end of the first tendon being secured to a portion of the first elongated elastic member proximate the distal end, the first tendon passing through the first aperture such that the first end of the first tendon extends outside the first aperture, such that application of tension to the first tendon causes the first elongated elastic member to bend toward the first side of the first elongated elastic member; a second tendon having a first end located outside the base member, the second tendon having a portion that passes through the second aperture, the second aperture being proximate the second side of the first elongated elastic member, the second tendon having a portion that extends to an opposing second end that is located within the first channel of the first elongated elastic member, the second end of the second tendon being secured to a portion of the first elongated elastic member proximate the distal end, the second tendon passing through the first channel along the second side of the first elongated elastic member and through the second aperture such that the first end of the second tendon extends outside the second aperture, whereby application of tension to the second tendon causes the first elongated elastic member to bend toward the second side of the first elongated elastic member; and the first elongated elastic member having, along at least a portion of its length, a first plurality of serrations machined into the first side of the first elongated elastic member and a second plurality of serrations machined into the second side of the first elongated elastic member; Probe parts.

2. A probe component as described in claim 1, wherein the first plurality of sawtooth portions are symmetrical to the second plurality of sawtooth portions.

3. 10. The probe assembly of claim 1, wherein the outer diameter of the probe assembly is smaller than the working channel of a rigid endoscope.

4. 2. The probe assembly of claim 1, wherein said first elongated resilient member has a tubular portion including said serrated portion.

5. 2. The probe assembly of claim 1, wherein an instrument attached to the distal end of the probe assembly is positioned at the target location and beyond the distal end of the endoscope.

6. The probe component according to claim 1, further comprising: a third tendon having a first end positioned outside the base member, the third tendon having a portion that passes through a third hole in the base member, the third hole being proximate the first side of the second elongated elastic member, the third tendon having a portion that extends to an opposing second end that is positioned within the second channel of the second elongated elastic member, the second end of the third tendon being secured to a portion of the second elongated elastic member proximate the distal end, the third tendon passing through the third hole such that the first end of the third tendon extends outside the third hole, whereby application of tension to the third tendon causes the second elongated elastic member to bend toward the first side of the second elongated elastic member; The probe component has:

7. 7. The probe assembly of claim 6, wherein the second elongated resilient member has a tubular portion including a plurality of serrations machined into the first side of the second elongated resilient member.

8. 7. The probe assembly of claim 6, wherein at least one of said elongated resilient members has a plurality of bidirectional asymmetrical serrations machined into said first side and said second side; The presence of the bidirectional asymmetric serrations reduces the effect of external forces caused by the operation of applying tension to the tendon while maintaining sufficient flexibility in the bending plane at a high level; the bidirectional asymmetric serrations provide a flexible bending length for each of the elongated elastic members and have a high ability to withstand axial and transverse forces, thereby providing a routing strategy for the tendons that resists lateral forces and minimizes joint connections; Probe parts.

9. The probe component according to claim 6, further comprising: a fourth tendon having a first end positioned outside the base member, the fourth tendon having a portion that passes through a fourth hole in the base member, the fourth hole being proximate the second side of the second elongated elastic member, the fourth tendon having a portion that extends to an opposing second end that is positioned within the second channel of the second elongated elastic member, the second end of the fourth tendon being secured to a portion of the second elongated elastic member proximate the distal end, the fourth tendon passing through the fourth hole such that the first end of the fourth tendon extends outside the fourth hole, whereby application of tension to the fourth tendon causes the second elongated elastic member to bend toward the second side of the second elongated elastic member.

10. 7. The probe component of claim 6, wherein the second elongated resilient member has a tubular portion including a first plurality of serrations machined into the first side of the second elongated resilient member and a second plurality of serrations machined into the second side of the second elongated resilient member.

11. 11. The probe assembly of claim 10, wherein the first plurality of serrations are symmetrical with the second plurality of serrations.

12. 11. The probe assembly of claim 10, wherein the first plurality of serrations are asymmetric with respect to the second plurality of serrations.

13. 10. The probe assembly of claim 9, wherein at least one of the elongated resilient members has a plurality of bidirectional asymmetrical serrations machined into the first side and the second side; The presence of the bidirectional asymmetric serrations reduces the effect of external forces caused by the operation of applying tension to the tendon while maintaining sufficient flexibility in the bending plane at a high level; The bidirectional asymmetric serrations create a flexible bending length in one or both of the elongated elastic members and have a high ability to withstand axial and transverse forces, thereby resisting lateral forces and allowing for a routing strategy for the tendons that minimizes joint connections. Probe parts.

14. 14. The probe assembly of claim 13, wherein the elongated resilient member comprises a nickel-titanium alloy tubular portion; the bidirectional asymmetric sawtooth is micromachined with a femtosecond laser; Probe parts.

15. 7. A probe assembly according to claim 6, wherein each of said elongated elastic members is spaced apart and continuously connected by a plurality of intermediate rigid members and comprises a tubular portion made of nickel-titanium alloy.

16. a probe component configured to be inserted into a proximal end of an endoscope, through a working channel of the endoscope, and beyond a distal end of the endoscope, the probe component having a proximal end and a distal end, the probe component configured to position the distal end of the probe component at a target location beyond the distal end of the endoscope, the probe component comprising: a base member defining a first hole portion and a second hole portion spaced apart from the first hole portion, the base member penetrating the base member; a first elongated elastic member having a first side and a second side opposite the first side, the first elongated elastic member including a proximal end secured to the base member and extending from the proximal end to a distal end, the first elongated elastic member defining a first channel in communication with the first aperture and extending along a length of the first elongated elastic member; a second elongated elastic member having a first side and a second side opposite the first side, the second elongated elastic member including a proximal end and extending to a distal end opposite the proximal end, the second elongated elastic member defining a second channel in communication with the first channel and extending along a length of the second elongated elastic member; an intermediate member connecting the articulation portions, the intermediate member connecting the second elongated elastic member and the first elongated elastic member and providing an intermediate channel between the first channel of the first elongated elastic member and the second channel of the second elongated elastic member; a first tendon portion disposed within the first channel of the first elongated elastic member, threaded through an intermediate member connecting the joint portions, and threaded through the second channel of the second elongated elastic member; a second tendon portion disposed within the first channel of the first elongated elastic member, threaded through an intermediate member connecting the joint portions, and threaded through the second channel of the second elongated elastic member; and and an intermediate member connecting the joint portions shifts the phase of the first tendon portion and the second tendon portion, such that application of tension to at least one of the first tendon portion or the second tendon portion causes the first elongated elastic member to bend along a first plane and the second elongated elastic member to bend along a second plane transverse to the first plane; at least one of the elongated elastic members has a plurality of bidirectional asymmetrical serrations machined into the first side and the second side; The presence of the bidirectional asymmetric serrations reduces the effect of external forces caused by the operation of applying tension to the tendon while maintaining sufficient flexibility in the bending plane at a high level; the bidirectional asymmetric serrations create a flexible bending length in one or both of the first and second elongate elastic members and have a high ability to withstand axial and transverse forces, thereby resisting lateral forces and allowing for a routing scheme for the tendons that minimizes joint connections; the first and second elongated elastic members have tubular portions made of nickel-titanium alloy; The bidirectional asymmetric sawtooth is micromachined with a femtosecond laser. Probe parts.

17. 10. An apparatus for operating a probe assembly, the probe assembly including the probe components of claim 1, the apparatus configured for use with an endoscope defining the working channel as a longitudinal passage therethrough, the apparatus comprising: a housing having an internal structure exposed by retracting a retractable portion of the housing, the housing having one end configured to couple to an endoscope; at least one input passage defined by the housing and configured to receive a portion of the probe assembly therein, such that the probe assembly is received within the longitudinal passage defined by the endoscope; and an actuator assembly attached to the housing and configured to operate the probe assembly by selectively stressing the tendons of the probe components; An apparatus having:

18. 18. The apparatus of claim 17, further comprising: a quick connect assembly having a probe tendon connection, the quick connect assembly being connectable to the actuator assembly and attached to the probe assembly; the actuator assembly has an actuator tendon connection; the tendon of the probe component is connected to the probe tendon connection part; the actuator tendon connection is complementary to the probe tendon connection such that when the quick connect assembly is snapped into place on the actuator assembly, the actuator tendon connection engages the probe tendon connection, such that actuator assembly induced movement applied to the actuator tendon connection results in corresponding movement at the probe tendon connection, resulting in manipulation of the tendons of the probe component; Device.

19. 18. The apparatus of claim 17, further comprising: The apparatus comprises at least one joystick configured to provide intuitive control input to the probe assembly.

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