Bendable tube for use in surgical devices

Abstract

Disclosed herein is a tube for use in a surgical device that is at least partially inserted into a human or animal body, and a method for manufacturing such a tube. A tube according to the present disclosure extends from a proximal end to a distal end of the tube and includes a plurality of bendable segments. Each of the bendable segments includes three proximal openings, three central openings, and three distal openings in a wall of the tube. The central openings are disposed along the circumference of the tube and are separated from one another by a central connecting portion of the wall. The central connecting portions are displaced from one another by 105°-135° along the circumference of the tube. The proximal openings are disposed proximal to the central openings, and each of the proximal openings is adjacent to a respective one of the central connecting portions. The distal openings are disposed distal to the central openings, and each of the distal openings is adjacent to a respective one of the central connecting portions.

Description

[Technical Field]

[0001] FIELD OF THE DISCLOSURE The present disclosure is in the field of medical technology. In particular, the present disclosure relates to bendable tubes for use in surgical devices such as endoscopes that are at least partially inserted into the human or animal body, and methods of manufacturing such tubes. [Background technology]

[0002] An endoscope is a surgical device that can be used to access (e.g., view or remove) or treat tissue within a patient's body by inserting one or more medical tools into the body through an incision or bodily opening. The endoscope can include an interface / control unit and an insertion tube coupled to the interface / control unit. The insertion tube is configured to be inserted into the patient's body and can include one or more conduits for providing access to the tissue within the body. The one or more conduits can be configured, for example, to receive medical tools and / or fluids and to direct the medical tools and fluids, respectively, to the tissue of interest.

[0003] The insertion tube may be bendable to facilitate insertion into a patient's body. To this end, the insertion tube may include, for example, one or more passive and / or active bendable sections (also referred to as passive and active bending sections, respectively). Passive bendable sections may be formed, for example, from bendable or flexible materials or structures, while active bendable sections may include, for example, one or more joints that can articulate to actively bend the insertion tube.

[0004] While being bendable, the insertion tube must also exhibit sufficient rigidity, for example, to allow a physician to push and rotate the insertion tube within the patient's body and / or to prevent plastic deformation when the insertion tube is bent. To achieve this, the insertion tube may be formed, for example, of a rigid or semi-rigid material, or may be made bendable by providing multiple small openings in the insertion tube wall to reduce the insertion tube's rigidity, as disclosed, for example, in U.S. Patent Application Publication No. 2021 / 0393111. Furthermore, while openings in the insertion tube wall can provide flexibility, the openings can also reduce the insertion tube's torsional rigidity. This can result in, for example, insufficient transmission of torque or rotational motion along the tube. Furthermore, the openings can make the insertion tube more susceptible to plastic deformation at small bending radii. Similar problems can occur with actively bendable sections. Meeting these conflicting requirements can result in complex structures that are difficult, time-consuming, and therefore costly to manufacture. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] U.S. Patent Application Publication No. 2021 / 0393111 Summary of the Invention

[0006] It is therefore an object of the present disclosure to provide a tube for use in a surgical device, such as an endoscope, that is bendable while also providing sufficient torsional stiffness and resistance to plastic deformation.

[0007] This object is achieved by a tube for use in a surgical device according to claim 1 and a method for manufacturing a tube for use in a surgical device according to claim 29. Examples thereof are detailed in the dependent claims.

[0008] The tube according to the present disclosure is configured for use in a surgical device that is at least partially inserted into a human or animal body. The tube extends from the proximal end to the distal end of the tube and includes (i.e., including, but not limited to) a plurality of bendable segments. Each of the bendable segments includes three proximal openings, three central openings, and three distal openings in the wall of the tube. The central openings are disposed around the circumference of the tube and are separated from one another by central connecting portions in the wall. The central connecting portions are displaced from one another by 105° to 135° around the circumference of the tube. The three proximal openings are disposed proximal to the central opening, each adjacent to a respective one of the central connecting portions. The three distal openings are disposed distal to the central opening, each adjacent to a respective one of the central connecting portions.

[0009] As used herein, the term "proximal" can refer to an element, feature, or location along the length of the tube that is closer to a physician or other medical practitioner (e.g., closer to the interface / controls of the surgical device) during use of the surgical device, while the term "distal" can refer to an element, feature, or location along the length of the tube that is closer to the location of tissue to be examined or treated within a patient's body during use of the surgical device (e.g., farther from the interface / controls of the surgical device). The direction from the proximal end to the distal end of the tube may hereinafter also be referred to as the longitudinal or axial direction. A direction along the circumference of the tube (e.g., parallel to the surface, e.g., outer surface, of the tube and perpendicular to the longitudinal direction) may also be referred to as the circumferential or azimuthal direction. A direction perpendicular to the surface, e.g., outer surface, of the tube (e.g., perpendicular to the longitudinal and circumferential directions) may also be referred to as the radial direction. The longitudinal, circumferential, and radial directions may define, for example, a cylindrical coordinate system. Depending on the condition or configuration of the tube, the orientation of these directions may change along the length of the tube, for example, as a result of bending of the tube.

[0010] The plurality of bendable segments may include, for example, 2 to 1000 bendable segments, and in some examples, 20 to 500 bendable segments. The bendable segments may be positioned along the length of the tube, for example, in one or more portions of the tube as described in more detail below, for example, in one or more passive bending sections positioned between the proximal end of the tube and an active bending section located at the distal end of the tube.

[0011] Each of the proximal, central, and distal openings may extend through the wall of the tube, for example, from the inner surface of the wall facing the interior of the tube to the outer surface of the wall facing the exterior of the tube. In some examples, the tube may include one or more additional layers disposed on the inside and / or outside of the wall, such as, for example, a sleeve or cover surrounding the outer surface of the wall. Thus, the openings do not necessarily provide a fluid connection between the interior and exterior of the tube, but may be at least partially covered on the inside and / or outside of the wall.

[0012] The central connectors are portions of the wall disposed between adjacent central openings, e.g., portions of the wall remaining when openings are formed (e.g., cut) in the wall. The central connectors are displaced from one another by a displacement angle of 105° to 135°, in some cases 115° to 125°, and in one example 118° to 122° (e.g., 120°) around the circumference of the tube (along the circumferential direction). Accordingly, the central openings may also be displaced from one another by a displacement angle of 105° to 135°, in some cases 115° to 125°, and in one example 118° to 122° (e.g., 120°) around the circumference of the tube. The displacement angle may be, for example, the azimuthal angle enclosed by a triangle formed by the centers (e.g., center of gravity) of two adjacent central connectors (or central openings) and the center of the tube (e.g., a point along the central axis of the tube at each location along the length of the tube). In other words, the distance between the centers of two adjacent central connecting portions (or central openings) may be about 29.1% to 37.5%, in some instances about 31.9% to about 34.7%, and in one instance about 32.8% to about 33.9% (e.g., 1 / 3) of the circumference of the tube in each bendable segment.

[0013] The proximal opening is disposed proximally of the central opening (e.g., between the central opening and the proximal end of the tube). The distal opening is disposed distally of the central opening (e.g., between the central opening and the distal end of the tube). The proximal and distal openings are disposed adjacent to a respective one of the central connecting portions, e.g., such that each of the central connecting portions is disposed ("sandwiched") between the proximal and distal openings. Some or all of the proximal and / or distal openings can be aligned with their respective central connecting portions, e.g., such that the centers of the proximal (or distal) openings are aligned with the centers of the respective central connecting portions (e.g., located at the same or substantially the same orientation).

[0014] At least some of the bendable segments (e.g., at least some of the bendable segments among the plurality of segments), and in some instances all of the bendable segments, may be arranged in pairs along the length of the tube, and the distance between the bendable segments of each pair may be smaller than the distance between the respective pair and an adjacent pair. The distance between the bendable segments of each pair may be, for example, less than 50%, preferably less than 25%, and in one example, less than 15% of the distance between the respective pair and an adjacent pair. The distance between the bendable segments of a pair may be, for example, the distance between the distal opening of the proximal bendable segment of each pair and the proximal opening of the distal bendable segment of each pair. The distance between a pair and an adjacent pair may be, for example, the distance between the proximal opening of the proximal bendable segment of a pair and the distal opening of the distal bendable segment of an adjacent pair, or the distance between the distal opening of the distal bendable segment of a pair and the proximal opening of the proximal bendable segment of an adjacent pair.

[0015] Additionally or alternatively, the distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment of two adjacent bendable segments (e.g., for at least two adjacent bendable segments, and in some examples for some or any two adjacent bendable segments) of the plurality of bendable segments may be 50% to 200%, preferably 80% to 120%, and in one example 90% to 110% of the distance between the proximal opening and the central opening of the distal bendable segment, and / or 50% to 200%, preferably 80% to 120%, and in one example 90% to 110% of the distance between the central opening and the distal opening of the proximal bendable segment. In other words, the distance between adjacent bendable segments (e.g., between the proximal and distal bendable segments of a segment pair) may be similar to or equal to the distance between the proximal opening and the central opening and / or the distance between the central opening and the distal opening of one or both of the adjacent bendable segments.

[0016] The proximal openings of the distal bendable segments and the distal openings of the proximal bendable segments of two adjacent bendable segments can overlap along the circumference of the tube to form a spring segment therebetween (e.g., six spring segments arranged along the circumference of the tube, each extending between a respective proximal connection portion of the distal bendable segment and a respective distal connection portion of the proximal bendable segment). Each of the spring segments can be configured to deform (e.g., stretch and / or bend) when the tube bends. The deformation of the spring segment can be associated with, for example, opening (e.g., increasing cross-sectional area) or closing (e.g., decreasing cross-sectional area) the respective proximal and distal openings. Additionally or alternatively, each of the spring segments can be configured to provide a restoring force, which can, for example, oppose bending or tilting of the respective bendable segments relative to each other (e.g., urging the tube toward a straight / unbent configuration). Providing spring segments between adjacent bendable segments can increase the flexibility of the tube.

[0017] The length of the spring segments along the circumferential direction may be, for example, 5% to 16%, in some examples 10% to 16%, and in one example 13% to 16% of the circumference of the tube between each bendable segment. Increasing the length of the spring segments may increase the flexibility of the tube. The width of the spring segments along the longitudinal direction may be uniform or approximately uniform along their length. In other examples, for one or more spring segments, and in some examples all spring segments, the width at the center of each spring segment may be smaller than the width at one or both ends of each spring segment. The width at the center of each spring segment may be, for example, 50% to 95%, in some examples 60% to 90%, and in one example 65% to 80% of the width at one or both ends of each spring segment. The width of the spring segments may affect the flexibility of the tube and may be adjusted to adjust the flexibility, for example, increasing flexibility by reducing the width of a spring segment. Increasing the width of the spring segments at their ends compared to their middles can improve the guidance of torsional and / or bending forces on the respective spring segments.

[0018] In some examples, some or all of the bendable segments may be arranged as a contiguous group of bendable segments. The distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment of any two adjacent bendable segments in a contiguous group of bendable segments may be similar or equivalent to the distance between the proximal opening and the central opening of the distal bendable segment and / or the distance between the central opening and the distal opening of the proximal bendable segment. For example, the distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment of any two adjacent bendable segments in a contiguous group of bendable segments may be 50% to 200%, in some examples 80% to 120%, of the distance between the proximal opening and the central opening of the distal bendable segment, and / or 50% to 200%, in some examples 80% to 120%, of the distance between the proximal opening and the central opening of the distal bendable segment. This may allow, for example, for the provision of spring segments both within and between bendable segments.

[0019] Adjacent bendable segments of the plurality of bendable segments can be rotated relative to one another along the circumferential direction, for example, such that the central connecting portions of adjacent bendable segments are displaced relative to one another along the circumference of the pipe. The central connecting portions of adjacent bendable segments can be displaced, for example, by 52.5° to 67.5°, in some instances 57.5° to 62.5°, and in one instance 59° to 61° (e.g., 60°) along the circumference of the pipe. Adjacent bendable segments can be rotated relative to one another, particularly such that the center of a central opening of one of the adjacent bendable segments is aligned with the central connecting portion of the other of the adjacent bendable segments, for example, such that the center of each central opening is displaced from its respective central connecting portion along the circumference of the pipe by less than 5°, preferably less than 2°, in one instance less than 1°, and in one instance less than 0.5°. Circumferential displacement of adjacent bendable segments can, in some instances, result in more uniform bending characteristics for the tube, for example, by providing six primary bending directions / planes defined by the centers of the openings rather than three primary bending directions / planes.

[0020] In some examples, the proximal opening, central opening, and distal opening may all have the same size and / or shape, e.g., the same length along the circumferential direction and the same width along the longitudinal direction. In other examples, the proximal opening and / or distal opening may have a different size and / or shape, particularly a different width, than the central opening. For example, the proximal opening and / or distal opening may be a slit. As used herein, "slit" may refer to an opening having a large aspect ratio (e.g., length to width), for example, the aspect ratio of a slit may be greater than 10:1, in some examples greater than 20:1, in some examples greater than 50:1, and in some examples greater than 100:1. The width of the central opening along the longitudinal direction may be at least 5 times, and in some examples at least 10 times, the width of the proximal opening and / or distal opening. In other examples, the central opening may be a slit. In this case, the width of the proximal and / or distal openings along the longitudinal direction may be, for example, at least 5 times, and in some instances at least 10 times, the width of the central opening.

[0021] The proximal openings may be separated from one another by proximal connecting portions of the wall, e.g., portions of the wall that remain between the proximal openings when forming (e.g., cutting) the proximal openings. The distal openings may be separated from one another by distal connecting portions of the wall, e.g., portions of the wall that remain between the distal openings when forming (e.g., cutting) the distal openings.

[0022] The circumferential length of the proximal connecting portion and / or the distal connecting portion may be similar to or equal to the length of the central connecting portion, for example, 25% to 200%, and in some instances, 30% to 100% of the length of the central connecting portion. In some instances, the circumferential length of the proximal connecting portion and / or the distal connecting portion may be smaller than the length of the central connecting portion, for example, 30% to 95%, and in some instances, 50% to 80% of the length of the central connecting portion. The length of the proximal connecting portion and / or the distal connecting portion may be small relative to the circumference of the tube within each bendable segment, for example, 10% or less, and in some instances, 5% or less of the circumference of the tube within each bendable segment. Additionally or alternatively, the length of the central connecting portion may be small relative to the circumference of the tube within each bendable segment, for example, 15% or less, in some instances, 10% or less, and in some instances, 8% or less of the circumference of the tube within each bendable segment. By shortening the length of the proximal, central, and / or distal connecting portions, the length of the spring segments adjacent to each connecting portion can be increased, thereby increasing the flexibility of the tube. By lengthening the length of the proximal, central, and / or distal connecting portions, the torsional stiffness of the tube can be increased.

[0023] Furthermore, some or all of the bendable segments (e.g., at least some of the bendable segments of the plurality of segments) may each include one or more additional sets of openings in addition to the proximal, central, and distal openings. For example, some or all of the bendable segments may include a fourth set of openings, which may be located either proximal to the proximal opening or distal to the distal opening. The fourth set of openings may include three fourth openings, each of which may be adjacent to a respective one of the proximal and distal connecting portions, for example. In one example, the inner two sets of openings (e.g., the central and proximal openings when the fourth opening is located proximal to the proximal opening) may be slits. The width of the openings of the outermost two sets of openings along the longitudinal direction (i.e., the distal and fourth openings in the above example) may be at least five times, and in some examples at least ten times, the width of the openings in the inner two sets of openings. A bendable segment with four sets of openings, for example, can provide improved torque transmission for a given stiffness / flexibility of the tube.

[0024] The proximal and / or distal openings of some or all of the bendable segments (e.g., at least some of the bendable segments) can overlap the central opening of the respective bendable segments along the circumferential direction to form spring segments therebetween. For example, all of the proximal openings can overlap two central openings separated by their respective proximal connecting portions. This can form a set of six spring segments arranged around the circumference of the tube between the proximal and central openings. Additionally or alternatively, a set of six spring segments can be formed between the central and distal openings. The spring segments can be similar, e.g., particularly with respect to their length and / or width, to the spring segments described above with respect to the spring segments between adjacent bendable segments. In some examples, for one or more of these spring segments, the longitudinal width at the center of each spring segment is smaller than the width of each spring segment at one or both ends of each spring segment, e.g., as described above with respect to the spring segments between adjacent bendable segments. The length, width, and shape of the spring segments can be adjusted to tailor the flexibility of the tube as described above for the spring segments between adjacent bendable segments.

[0025] The longitudinal width of some or all of the central openings may be uniform or nearly uniform along their lengths. The central openings may have, for example, a rectangular shape, with rounded corners. Additionally or alternatively, some or all of the central openings (e.g., two or more of the central openings) may each include a narrow central portion in the center of the respective central opening. The narrow central portion may have a longitudinal width smaller than the width of adjacent portions of the central opening on either side of the central portion. The longitudinal width of the narrow central portion may be smaller than the maximum width of each central opening, for example, 20% to 90%, and in some instances, 40% to 70% of the maximum width of each central opening. The narrow central portion may be configured, for example, by contacting the sidewalls of the central openings with each other, thereby limiting longitudinal compression of each central opening. The narrow central portion may be configured, for example, to limit longitudinal compression of each central opening to the width of the respective central portion.

[0026] Additionally or alternatively, for some or all of the central openings (e.g., two or more of the central openings), the width along the longitudinal direction at the center of each central opening may be smaller than the width at one or both ends of the central opening, and may be 20% to 90%, and in some instances, 40% to 70%, of the width at one or both ends. In other instances, the width at one or both ends of each central opening may be larger than the width at the center, for example, as described below. The width at the end of a central opening may be measured, for example, at 5% and 95%, respectively, and in some instances, at 10% and 90%, respectively, of the length of each central opening, or may be defined as the maximum width at the end, and the end may include, for example, the outermost 5% or in some instances the outermost 10% of the length of each central opening. In some instances, the end may include no more than the outermost 5% or, in some instances, no more than the outermost 10% of the length of each central opening. In some examples, each of the ends may include rounded corners, and the width of the end may be measured, for example, at the innermost edge of the rounded corners.

[0027] Some or all of the central openings (e.g., two or more of the central openings) may each include a wider intermediate portion disposed between the central portion and each end portion of the respective central opening. The width of the wider intermediate portion along the longitudinal direction may be greater than the width of the central portion and may be greater than the width of the end portions. For example, the width of the central portion and / or the width of the end portions may be 20% to 90%, and in some instances, 40% to 70%, of the width of the intermediate portion. The width of the wider intermediate portion may constitute the maximum width of each opening. In some instances, the width of one or both end portions of each central opening may be smaller than the width of the central portion, and may be, for example, 40% to 90%, and in one example, 40% to 70% of the width of the central portion.

[0028] In some examples, some or all of the proximal openings (e.g., two or more of the proximal openings) and / or some or all of the distal openings (e.g., two or more of the distal openings) may be shaped as described above with respect to the central opening, particularly in examples where the central opening is slit-shaped, but also in other examples where the central opening includes, for example, a narrow central portion and / or a wider middle portion. One or both of the proximal and distal openings may include, for example, a narrow central portion and / or a wider middle portion.

[0029] In some examples, the bendable segments may be arranged in two or more sections along the length of the tube, in some examples, three or more sections, in some examples, four or more sections, and in some examples, five or more sections. The sections may be adjacent to one another or may be spaced apart such that the distance between sections is substantially greater than the distance between bendable segments within a section. In some examples, the sections may differ in the density of the bendable segments, which may be characterized, for example, by the number of bendable segments per unit length of the tube and / or the inverse of the distance between adjacent bendable segments or pairs of bendable segments in each section. For example, the density of the bendable segments in each of two or more sections may be different from the density of the bendable segments in at least one other section, and in some examples, all other sections. The density of the bendable segments / the distance between adjacent bendable segments or pairs may be used as a parameter for adjusting the stiffness of each section.

[0030] The tube may include, for example, a first portion and a second portion (the first and second portions being included in the two or more portions), where the density of the bendable segments in the first portion is different from the density of the bendable segments in the second portion. The density of the bendable segments in the second portion may be, for example, at least 5%, in some instances at least 10%, and in one instance at least 20% greater than the density in the first portion, e.g., to provide slightly different stiffnesses for the portions. In other instances, the density of the bendable segments in the second portion may be at least 50%, in some instances at least 100%, and in one instance at least 150% greater than the density of the first portion, e.g., to provide substantially different stiffnesses for the portions.

[0031] Additionally or alternatively, the two or more sections may differ in how the bendable segments are arranged. For example, the bendable segments in at least one of the two or more sections, e.g., the second section, may be arranged as a contiguous group of bendable segments, and the distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment of any two adjacent bendable segments in the contiguous group of bendable segments may be similar or equivalent to the distance between the proximal opening and the central opening of the distal bendable segment and / or the distance between the central opening and the distal opening of the proximal bendable segment. For example, the distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment may be 50% to 200%, and in some examples 80% to 120%, of the distance between the proximal opening and the central opening of the distal bendable segment, and / or 50% to 200%, and in some examples 80% to 120%, of the distance between the proximal opening and the central opening of the distal bendable segment and / or 50% to 200%, and in some examples 80% to 120%, of the distance between the central opening and the distal opening of the proximal bendable segment. This can allow, for example, to provide spring segments both within and between bendable segments.

[0032] The bendable segments in at least one of the two or more sections, e.g., the first section, may be arranged in pairs along the longitudinal direction, e.g., the distance between each pair of bendable segments may be less than 50%, in some instances less than 25%, and in some instances less than 15% of the distance between the respective pair and the adjacent pair. In some instances, the bendable segments in one or more other sections, e.g., the second section, may also be arranged in pairs, but with, e.g., different distances between adjacent pairs. In other instances, the bendable segments in both the first section and the second section may be arranged as respective contiguous groups of bendable segments as described above, but with, e.g., different distances between adjacent bendable segments. The distance between adjacent pairs may be used, for example, as a parameter for adjusting the density and therefore stiffness of each section.

[0033] The two or more sections may include one or more, and in some instances, two or more, additional sections in addition to the first and second sections. In other words, the tube may include three or more sections, the three or more sections including the first and second sections. The density of the bendable segments in each of the additional sections may be different from the density of the bendable segments in at least one other section, and in some instances, all other sections of the two or more sections, e.g., different from the density of the bendable segments in the first section and / or the second section. In some instances, the bendable segments in some or all of the additional sections may also be arranged in pairs as described above and / or in respective contiguous groups as described above.

[0034] In addition to or instead of the density of bendable portions and / or the arrangement of bendable portions, two or more portions may differ in one or more parameters related to the arrangement and / or shape of openings within a bendable segment and / or within a pair of bendable segments. For example, each of the two or more portions may differ from at least one other portion, and in some instances, all other portions, in one or more of these parameters. The bendable segments in a first portion may differ from the bendable segments in a second portion and / or from the bendable segments in some or all of the one or more additional portions, for example, in one or more of the following: (1) the distance between the proximal opening and the central opening and / or the distance between the central opening and the distal opening, e.g., the width of the spring segment formed between the proximal opening and the central opening and / or the central opening and the distal opening; (2) the distance between the bendable segments in a pair of bendable segments, e.g., the width of the spring segment formed between the bendable segments of the pair; (3) the length of the proximal connecting portion between the proximal opening and / or the length of the distal connecting portion between the distal opening; and (4) the length of the central connecting portion between the central openings. Additionally or alternatively, the sections may differ in other parameters related to the placement and / or shape of the opening, for example, the width of one or more of the narrow central section, intermediate section, and ends of the central opening.

[0035] In some examples, the tube may further include an active bending section having multiple annular or tubular elements pivotally connected to one another by multiple joints. Each of the joints may, for example, pivotally connect a respective proximal element to a respective distal element. The joints may, for example, be hinges that allow articulation or rotation about a single axis of rotation. In some examples, adjacent elements of the active bending section may be connected by a pair of joints located on opposite sides of the tube, for example, rotated 180° relative to one another along the circumference. Additionally, the tube may include means for articulating the joints, for example, one or more control wires as commonly known in the art. The active bending section may be located between the multiple bendable segments and the distal end of the tube, for example, at or adjacent to the distal end of the tube.

[0036] In some examples, some or all of the joints each include a distal contact surface on the proximal element for the respective joint configured to slidably engage a proximal contact surface on the distal element for the respective joint. A reference protrusion may be disposed on one of the proximal and distal contact surfaces (e.g., the first contact surface). Additionally or alternatively, a reference notch may be disposed on the other of the proximal and distal contact surfaces (e.g., the second contact surface). In other words, at least one of the reference protrusion and the reference notch is disposed on at least one of the proximal and distal contact surfaces. At least one of the reference protrusion and the reference notch (i.e., the reference protrusion and / or the reference notch) may be disposed such that the force required to pivot the proximal and distal elements relative to each other is greater when the joint is in a reference position (e.g., a first articulation angle) than when the joint is in a second position (e.g., a second articulation angle) different from the reference position. This may allow, for example, for the joint to be biased towards a reference position such that the joint is preferably in the reference position when, for example, no tension is applied to the active bending portion.

[0037] At least one of the reference protrusion and the reference notch (i.e., the reference protrusion and / or the reference notch) may be positioned to, for example, generate less friction within the joint in the reference position than in the second position. For example, as the joint moves from the reference position to the second position, the overlap or contact area between the proximal and distal contact surfaces (e.g., the surface area of ​​the proximal contact surface in contact with the distal contact surface) increases.

[0038] Additionally or alternatively, at least one of the reference protrusion and the reference notch (i.e., the reference protrusion and / or the reference notch) may be positioned such that the length of the tube increases when the joint moves from the reference position to the second position. In one example, the reference protrusion is positioned on one of the proximal and distal contact surfaces, and the reference notch is positioned on the other of the proximal and distal contact surfaces. In the reference position, the reference protrusion may be positioned at least partially within the reference notch. In the second position, the reference protrusion may be positioned outside the reference notch. This may result in an increase in the length of the tube when the joint moves from the reference position to the second position. Therefore, a greater force may be required to pivot the proximal and distal elements relative to each other in the reference position than in the second position because the reference protrusion must be moved out of the reference notch.

[0039] In some examples, the proximal and distal elements are parallel to one another when the joint is in a reference position, e.g., such that the articulation angle between the proximal and distal elements is zero or substantially zero. The outer surfaces of the proximal and distal elements may be coplanar and parallel to one another in the reference position (e.g., such that corresponding portions of the tube are straight or substantially straight). In other examples, the proximal and distal elements may be positioned at a non-zero articulation angle in the reference position, e.g., such that corresponding portions of the tube are bent at a predetermined bend radius.

[0040] Some or all of the joints may include a pair of arcuate proximal brackets, each on a distal element associated with the respective joint, each extending along a circular arc. Additionally or alternatively, some or all of the joints may include a pair of arcuate distal brackets, each on a proximal element associated with the respective joint, each extending along a respective circular arc. The proximal and / or distal brackets may extend along an arc having a central angle of, for example, at least 30°, in some instances at least 60°, in one instance at least 90°, in one instance at least 120°, and / or no greater than 170°, in some instances no greater than 150°, and in one instance no greater than 120°.

[0041] Each of the proximal brackets may be configured to slidably engage with a corresponding recess in the proximal element and / or one of the distal brackets. Additionally or alternatively, each of the distal brackets may be configured to slidably engage with a corresponding recess in the distal element and / or one of the proximal brackets. The proximal and / or distal brackets may be configured to slidably engage with the corresponding recess such that, for example, one of the respective brackets moves further into the recess when the joint is articulated in a first direction, while the other of the respective brackets moves further out of the recess when the joint is articulated in the first direction, and vice versa. Similarly, the proximal and / or distal brackets may be configured to slidably engage with corresponding brackets ("mating brackets") such that, for example, when the joint is articulated in a first direction, the overlap and / or contact area between one of the respective brackets and the corresponding mating bracket increases, while when the joint is articulated in a second direction, the overlap and / or contact area between the other of the respective brackets and the corresponding mating bracket decreases, and vice versa. Providing proximal and / or distal brackets can, in some instances, increase the robustness of the joint, and thus, for example, the joint can be configured to transmit and / or withstand greater bending and / or torsional forces.

[0042] The proximal bracket or the distal bracket can form a circular joint socket (e.g., a circular or substantially circular recess or notch) configured to receive a corresponding joint head (e.g., a circular or substantially circular protrusion or pin) of each of the distal and proximal elements. In some examples, the reference protrusion can be disposed on a surface of one (e.g., the first) of the joint socket and the joint head. Additionally or alternatively, the reference notch can be disposed on a surface of the other (e.g., the second) of the joint socket and the joint head. In other words, at least one of the reference protrusion and the reference notch can be disposed on a surface of at least one of the joint socket and the joint head. For example, the reference protrusion can be disposed on a surface of the joint head and the reference notch can be disposed on a surface of the joint socket, or vice versa.

[0043] An active bending section according to any one of the above examples can also be used without a bendable segment according to the present disclosure, for example, in a tube having different bendable segments or in a tube without a passive bending section and / or bendable segments. Accordingly, the present disclosure further provides a tube for use in a surgical device at least partially inserted into a human or animal body, the tube including an active bending section having a plurality of annular or tubular elements pivotally connected to one another by a plurality of joints, some or all of the joints each including a distal contact surface on the proximal element configured to slidably engage a proximal contact surface on the distal element, and reference protrusions and / or reference notches disposed on the proximal and / or distal contact surfaces such that the force required to pivot the proximal and distal elements relative to one another is greater when the joint is in a reference position than when the joint is in a second position different from the reference position. The joints in the active bending section can be embodied, for example, as described above. The tube can further include any of the features of a tube according to any of the examples of the present disclosure described herein.

[0044] A tube according to the present disclosure may be a tube configured for use in an endoscope, such as, for example, but not limited to, a bronchoscope, sinusoscope, nasopharyngoscope, laryngoscope, laryngoscope, laparoscope, gastroscope, duodenoscope, colonoscope, echoscope, hysteroscope, cystoscope, uroscope, urethroscope, cardioscope, and arthroscope. The length and / or diameter of the tube may be selected accordingly. The tube may be, for example, an insertion tube for use in an endoscope or a portion of an insertion tube for use in an endoscope. In one example, the tube is a hypotube for use in an endoscope. The hypotube may be configured, for example, to be surrounded or wrapped by a tubular sleeve or cover to form the insertion tube, and the sleeve or cover may cover the opening of the bendable segment. The hypotube may form, for example, a frame or skeleton of the insertion tube configured to provide dimensional stability to the insertion tube. In addition to or instead of an endoscope, the tube may be configured for use in other surgical devices that are at least partially inserted into a human or animal body, such as, for example, a catheter or portion thereof. A tube according to the present disclosure may be a tube configured for use in a guide instrument for guiding a treatment tool or optical guide into a patient's body, such as during laparoscopic surgery.

[0045] The present disclosure further provides a surgical device, particularly an endoscope, for insertion at least partially into a human or animal body, comprising a tube according to any one of the examples described herein. The tube may be, for example, an insertion tube or part thereof, particularly a hypotube, of an endoscope. The endoscope may further include an interface / control unit coupled to the tube.

[0046] The present disclosure further provides a method for manufacturing a tube for use in a surgical device at least partially inserted into a human or animal body. The method includes providing a tubular member and forming a plurality of bendable segments in the tubular member. Each bendable segment is formed by (1) forming three central openings in the wall of the tubular member, the openings being displaced from one another along the circumference of the tubular member by 29% to 38% of the circumference of the tubular member and separated from one another by a central connecting portion in the wall; (2) forming three first openings in the wall on a first side of the central opening, each opening adjacent to a respective one of the central connecting portions; and (3) forming three second openings in the wall on a second side opposite the first side of the central opening, each opening adjacent to a respective one of the central connecting portions. The numbering above is for clarity only and does not imply a particular order of execution of the method. The method may be performed in any order, and portions thereof may be performed at least partially simultaneously, so long as it is technically feasible.

[0047] The present method can be used, for example, to manufacture a tube according to any one of the examples described herein, for example, to form bendable segments and openings in the arrangements and shapes described herein. The first opening can be formed, for example, proximal to the central opening and can correspond to a proximal opening of a tube according to the present disclosure. The second opening can be formed, for example, distal to the central opening and can correspond to a distal opening of a tube according to the present disclosure. The method can further include forming additional openings in the tubular component, for example, the fourth set of openings described above. Furthermore, the method can include forming one or more active bending sections described herein, for example, within the tubular component or as a separate section connected or attached to the tubular component. The one or more active bending sections can be formed, for example, using any one of the techniques for forming bendable segments described herein.

[0048] The tubular component may comprise (i.e., includes, but is not limited to) a rigid or semi-rigid material, particularly a metal such as stainless steel, titanium, or a nickel-titanium alloy such as Nitinol. In some examples, the tubular component may be made of (i.e., may not include other materials) a rigid or semi-rigid material, particularly a metal such as stainless steel, titanium, or a nickel-titanium alloy such as Nitinol. Additionally or alternatively, the tubular component may comprise a plastic. In some examples, the tubular component may be made of a plastic.

[0049] The openings may be formed by cutting the wall of the tubular component, particularly by laser cutting. However, the method is not limited to a particular machining process or technique for forming the openings, and the openings may be formed by other means, for example, using any suitable computer numerically controlled (CNC) machining technique, such as drilling and / or milling.

[0050] The central openings are formed to be displaced from one another around the circumference of the tubular component by 29% to 38% of the circumference of the tubular component in each bendable segment (e.g., corresponding to an angular displacement of about 105° to about 135° relative to the center of the tube), in some instances 31% to 35%, and in one instance 32.8% to 33.9% (e.g., 1 / 3) of the circumference of the tubular component. The displacement of the central openings may be measured, for example, between the centers (e.g., center of gravity) of the respective central openings. The central openings may be particularly formed such that the central connecting portions between the central openings are displaced as described above for tubes according to the present disclosure.

[0051] In some examples, the first openings and / or second openings in some or all of the bendable segments are slits formed by laser cutting. In other words, the method may include laser cutting slits as the first openings and second openings. Additionally or alternatively, the central openings in some or all of the bendable segments may be slits formed by laser cutting. The width of each opening / slit along the length of the tubular component may correspond to the cutting width of the laser cut. The cutting width may be, for example, 10 μm to 50 μm, and in some examples, 20 μm to 40 μm.

[0052] By providing three central openings arranged around the circumference of the tube, the present disclosure allows for the formation of tubes for use in surgical devices that are bendable while exhibiting a sufficient degree of torsional rigidity and resistance to plastic deformation. The three central connecting portions of the tube wall separating the central openings are arranged in a three-fold or near-three-fold symmetry about the center or axis of the tube, providing three approximately equidistant points for direct force transmission across each bendable segment. This allows for efficient torque transmission along the length of the tube, for example, from the proximal end to the distal end, while reducing torsional and / or bending stresses in the bendable segments. Spring segments can be formed between the central opening and each of the proximal and distal openings, connecting the central connecting portions to the proximal and distal connecting portions. When the tube is bent, the spring segments can deform and absorb stress, thereby providing relief to other load points.

[0053] The bendable segments of the present disclosure can reduce the effect of inter-segment distance on the torsional stiffness of the tube, thus allowing for sufficient flexibility to be provided by adding / reducing inter-segment distances without significantly affecting torsional stiffness. Furthermore, the proposed design provides multiple parameters regarding the size, shape, and placement of the openings, which can be adjusted to control the mechanical properties of the tube as desired for each surgical device or intended application, as detailed above. The bendable segments of the present disclosure can be easily manufactured and can achieve a good compromise between processing time / cost, flexibility, and torsional stiffness of the tube, which can be flexibly adjusted according to each requirement. For example, the number of bendable segments can be reduced and / or the shape of the openings can be simplified (e.g., by increasing the radius of curvature associated with the openings) to enable faster processing during manufacturing.

[0054] The present disclosure and examples thereof are described in detail below with reference to the drawings, which show the following schematic diagrams: [Brief explanation of the drawings]

[0055] [Figure 1] 1 illustrates an endoscope according to an example of the present disclosure. [Figure 2a] 1 shows a tube for use in a surgical device according to one example of the present disclosure. [Figure 2b] 2b shows a bendable segment of the tube of FIG. 2a according to an example of the present disclosure. [Figure 3a] 10 illustrates a bendable segment of tubing for use in a surgical device including a centrally narrowed opening according to another example of the present disclosure. [Figure 3b] A paired arrangement of bendable segments as in FIG. 3 a on a tube for use in a surgical device according to one example of the present disclosure. [Figure 4] FIG. 1 is a perspective view of a tube for use in a surgical device having spaced apart bendable segments according to an example of the present disclosure; [Figure 5a]10 illustrates a paired arrangement of bendable segments of tubing for use in a surgical device having a narrowed central portion according to another example of the present disclosure. [Figure 5b] 10 illustrates a paired arrangement of bendable segments of tubing for use in a surgical device having a widened midsection according to one example of the present disclosure. [Figure 6a] 1 shows a tube for use in a surgical device having a bendable segment with a central slit according to an example of the present disclosure. [Figure 6b] 1 shows a tube for use in a surgical device having a bendable segment with four sets of openings according to one example of the present disclosure. [Figure 7] 1 illustrates a tube for use in a surgical device according to one example of the present disclosure, the tube including a plurality of passive bending sections with bendable segments and an active bending section. [Figure 8a] Bendable segment in distal passive bending section of tube of FIG. 7. [Figure 8b] Bendable segment in the central passive bending section of the tube of FIG. [Figure 8c] Bendable segment in the proximal passive bending section of the tube of FIG. [Figure 9a] Pipe elements and joints in the active bending of the pipe in Figure 7 . [Figure 9b] Pipe elements and joints in the active bending of the pipe in Figure 7 . [Figure 9c] Figure 7. Joint interface of the joint in the active bending section of the tube. [Figure 10] 10 is a flowchart of a method of manufacturing a tube for use in a surgical device according to an example of the present disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0056] 1 shows a schematic diagram (not to scale) of a surgical device 100 according to one example of the present disclosure. In the example of FIG. 1, the surgical device 100 is an endoscope that includes an interface / control unit 102 having a connector 104 and one or more ports 106.

[0057] Connector 104 is configured to connect or attach tube 200 to interface / control unit 102, which may be removably connected or attached in some examples. Tube 200 may be a tube according to any one of the examples described herein, such as tube 200 of FIG. 2a or tube 700 of FIG. 7. Tube 200 has a proximal end 200A and a distal end 200B and extends from proximal end 200A to distal end 200B, with proximal end 200A adjacent to interface / control unit 102 (e.g., connected to or attached to interface / control unit 102 via connector 104) and distal end 200B facing away from interface / control unit 102. Direction X from proximal end 200A to distal end 200B may hereinafter be referred to as the longitudinal direction, axial direction, or X direction. The direction φ along the circumference of the tube (eg, parallel to the surface of the tube and perpendicular to the longitudinal direction X) may hereinafter be referred to as the circumferential direction, the azimuthal direction, or the φ direction.

[0058] The one or more ports 106 may include one or more fluid ports in communication with the interior of the tube 200, e.g., via the connector 104, e.g., in communication with a conduit (not shown) formed by or disposed within the tube 200. Additionally or alternatively, the one or more ports 106 may include one or more light guiding ports, each configured to receive and / or provide coupling to a light guide (not shown) disposed within the tube 200, e.g., in a channel formed by or within a conduit disposed within the tube 200. The interface / control unit 102 may further include one or more electrical contacts (not shown), e.g., to provide electrical connection to the interior of the tube 200, to the distal end 200B of the tube 200, and / or to a distal tip (not shown) of the endoscope 100, which may be disposed at or connected to the distal end 200B of the tube 200. Additionally, the interface / control unit 106 may include means for actuating an active bending portion (not shown) of the tube 200, such as the active bending portion 700-V of FIG. 7, and may include, for example, one or more control knobs (not shown) that may be configured to apply tension to one or more control wires (not shown) coupled to the active bending portion.

[0059] The interface / control section 102 may be embodied as a single unit as shown in FIG. 1, or may be embodied as two or more separate units, e.g., a control section and an interface section, where the control section may be connected to the proximal end 200A of the tube 200, e.g., via a connector 104, and the interface section may be connected to the control section, e.g., via a flexible tube or umbilical cord.

[0060] FIG. 2a shows a schematic diagram (not to scale) of a tube 200 for use in a surgical device according to one example of the present disclosure. The tube 200 may be configured for use in the endoscope 100 of FIG. 1, for example. In FIG. 2a, the tube 200 is shown cut open along the longitudinal X direction and with its wall 202 flattened out so that the entire circumference (360° circumferentially) of the tube 200 is visible. Typically, for example, during use, the wall 202 would be rolled up circumferentially such that the left edge of the wall 202 of FIG. 2a is connected to the right edge of the wall 202, thereby forming a tubular structure similar to the tube of FIG. 4, described below, for example.

[0061] The tube 200 can have, for example, an elliptical cross-section, particularly a circular cross-section, such that the tube 200 is cylindrical. The length and diameter of the tube 200 can be selected to suit the type of endoscope in which the tube 200 is to be used. The tube 200 can have a length of, for example, 20 cm to 200 cm, and in some examples, 50 cm to 150 cm. The outer diameter of the tube 200 can be, for example, 1 mm to 20 mm, and in some examples, 2 mm to 10 mm. The tube 200 can comprise (i.e., includes, but is not limited to) a rigid or semi-rigid material, particularly a metal such as stainless steel. In one example, the tube 200 is made of (i.e., does not include other materials) a rigid or semi-rigid material, particularly a metal such as stainless steel. The tube 200 can be, for example, a hypotube for the endoscope 100. In another example, the tube 200 can be an insertion tube for the endoscope 100. The insertion tube may further include a sleeve or cover (not shown) surrounding a surface of the wall 202, such as the inner and / or outer surface of the wall 202 (in other words, in some examples, the wall 202 may form the hypotube of the insertion tube), and the sleeve or cover may include a flexible material such as plastic or rubber. In one example, the sleeve or cover may be constructed of a flexible material such as plastic or rubber.

[0062] The tube 200 includes a plurality of bendable segments 204A, 204B, each of which includes three sets of openings in a wall 202 of the tube 200: three central openings 206, three proximal openings 210A proximal to the central openings 206 (i.e., between the central openings 206 and the proximal end 200A), and three distal openings 210B distal to the central openings 206 (i.e., between the central openings 206 and the distal end 200B). The openings in each set (proximal, central, and distal) are arranged around the circumference of the tube 200 and are separated from one another by a proximal connecting portion 212A, a central connecting portion 208, and a distal connecting portion 212B of the wall 202, respectively. The proximal opening 210A, the central opening 206, and the distal opening 210B may be perpendicular to the longitudinal direction, i.e., extend parallel to the circumferential direction.

[0063] In the example of FIG. 2a, the connection portions for each pair are displaced from one another by a displacement angle of 120° around the circumference of the tube 200, e.g., such that the length / displacement L between the centers of two adjacent central connection portions is equal to 1 / 3 of the circumference of the tube 200. In other examples, the displacement angle may deviate slightly from 120°, e.g., between 105° and 135°, and in some examples, between 118° and 122°. The pair of proximal openings 210A and the pair of distal openings 210B are rotated (or displaced) relative to the pair of central openings 206 by half the displacement angle (corresponding to a circumferential displacement of H=L / 2; see FIG. 3b), e.g., 60°, so that each of the proximal openings 210A and each of the distal openings 210B are adjacent to a respective one of the central connection portions 208. In the example of FIG. 1, the center of each of the proximal openings 210A and each of the distal openings 210B coincides with the center of the respective central connecting portion 208 along the circumferential direction.

[0064] 2a, the plurality of bendable segments 204A, 204B includes two sets of bendable segments: a first set of bendable segments 204A and a second set of bendable segments 204B. The second set of bendable segments 204B are rotated (or displaced) relative to the first set of bendable segments 204A by half the displacement angle, e.g., 60°. Thus, the center of the central opening 206 of the second set of bendable segments 204B is aligned with the central connecting portion 208 of the first set of bendable segments 204A, and vice versa. The center of the proximal opening 210A of the second set of bendable segments 204B is aligned with the distal connecting portion 212B of the first set of bendable segments 204A, and vice versa. The center of the distal opening 210B of the second set of bendable segments 204B is aligned with the proximal connecting portion 212A of the first set of bendable segments 204A, and vice versa. Except for being rotated, the bendable segments 204A, 204B may be identical in some examples.

[0065] The two sets of bendable segments 204A, 204B are arranged such that each bendable segment 204A of the first set is spaced a distance F from a distally adjacent bendable segment 204B of the second set distal to the respective bendable segment 204A and a distance G from a proximally adjacent bendable segment 204B of the second set proximally to the respective bendable segment 204A. In some examples, the distances F and G may be equal or approximately equal as shown in FIG. 2a, i.e., the bendable segments 204A, 204B may be spaced equidistant. In other examples, the distances F and G may be different, and the bendable segments 204A, 204B may be arranged in pairs, for example, as described in more detail below with reference to FIGS. 3b, 8b, and 8c.

[0066] FIG. 2b shows an enlarged view (not to scale) of bendable segment 204A of tube 200 corresponding to the dotted rectangle in FIG. 2a according to one example of the present disclosure. Each central connecting portion 208 has a length A1 along the circumferential direction φ, and each proximal connecting portion 212A and distal connecting portion 212B has a length A2 along the circumferential direction. Length A1 may be, for example, 3% to 10%, and in some instances, 4% to 8%, of the circumference of tube 200. Length A2 may be less than length A1, for example, 2% to 5% of the circumference of tube 200.

[0067] 2b, central opening 206 has a rectangular shape with a uniform or substantially uniform width C along longitudinal direction X, and the corners of central opening 206 may be rounded. Width C may be, for example, 1% to 5%, and in some instances 2% to 3%, of the circumference of tube 200. In some instances, width C is 0.05 mm to 1 mm, in one instance 0.1 mm to 0.5 mm, and in one instance 0.2 mm to 0.3 mm.

[0068] The proximal openings 210A and the distal openings 210B are narrow slits with a large aspect ratio. For example, the length of each of the proximal openings 210A and the distal openings 210B in the circumferential direction may be 50 to 200 times, and in one example, 100 to 200 times, the width of the respective opening in the longitudinal direction. The width of each of the proximal openings 210A and the distal openings 210B may be less than 20% of the width C, and in some examples, less than 10%, for example, 0.01 mm to 0.05 mm. The length of the central opening 206 in the circumferential direction may be, for example, 5 to 15 times, and in one example, 8 to 12 times the width C.

[0069] The lengths of the proximal opening 210A and the distal opening 210B are substantially greater than the length A1 of the central connecting portion 208, e.g., 3 to 10 times greater than the length A1. The proximal opening 210A and the distal opening 210B thus circumferentially overlap the central opening 206, forming a narrow spring segment 214 therebetween. Each of the spring segments 214 has a longitudinal width D corresponding to the distance between the central opening 206 and each of the proximal opening 210A and the distal opening 210B. The width D is selected to be sufficiently small so that the spring segment 214 can deform (e.g., elongate and / or bend) during tube bending that may be associated with the openings opening and closing along the longitudinal direction. The width D may be smaller than the width C of the central opening 206, e.g., 30% to 90% of the width C. In some examples, the width D is between 0.05 mm and 0.5 mm, and in one example, between 0.1 mm and 0.25 mm.

[0070] FIG. 3a shows an enlarged view of bendable segments 204A / B according to another example of the present disclosure that can also be used in a tube, such as the tube 200 of FIG. 2a, in addition to or instead of the bendable segment 204A of FIG. 2b.

[0071] The bendable segments 204A / b of FIG. 3a differ from the bendable segments of FIG. 2b in that the central opening 206 does not have a uniform width in the longitudinal direction X, but rather has a "butterfly-like" shape with a narrow central portion 206C disposed between a pair of intermediate portions 206B and a pair of end portions 206A. The width C2 of the narrow central portion 206A is smaller than the width C1 of the end portions 206A and smaller than the width C3 of the intermediate portion 206B. In the example of FIG. 3a, the width C2 is 40% to 60%, e.g., 50%, of the width C1. The width C1 may be slightly smaller than the width C3, e.g., 80% to 95% of the width C3. The width C3 may be the maximum width of the central opening 206. End 206A of central opening 206 may include a rounded corner having a radius of curvature B, which may be, for example, 0.02 mm to 0.3 mm, and in one example, 0.05 mm to 0.1 mm. The rounded corner can, in some examples, reduce bending and torsional stresses near end 206A. Width C1 of end 206A may be measured, for example, at the innermost edge of the rounded corner. In some examples, central opening 206 may be mirror-symmetrical with respect to a plane extending parallel to longitudinal direction X and through the center of central opening 206.

[0072] In the example of FIG. 2b, the proximal opening 210A and the distal opening are curved. The central portion of the proximal opening 210A adjacent to the central connecting portion 208 is closer to the proximal end of the tube than the end of the proximal opening 210A adjacent to the proximal connecting portion 212A. The central portion of the distal opening 210B adjacent to the central connecting portion 208 is closer to the distal end of the tube than the end of the distal opening 210B adjacent to the distal connecting portion 212B. In some examples, each of the proximal opening 210A and / or the distal opening 210B may be mirror-symmetrical with respect to a plane parallel to the longitudinal direction X and extending through the center of the respective opening. Additionally or alternatively, the proximal opening 210A may be mirror-symmetrical with the distal opening 210B with respect to a plane perpendicular to the longitudinal direction.

[0073] The central opening 206 and the proximal and distal openings 210A and 210B are shaped so that the width of the spring segment 214 formed therebetween varies along its length. The width D3 at the center of the spring segment 214 is smaller than the width D1 at the ends adjacent the proximal / distal connecting portions 212A and 212B and smaller than the width D2 at the ends adjacent the central connecting portion 208. The width D3 may be, for example, 70% to 85% of the width D1 and / or the width D2. In some examples, the width D1 may be smaller than the width D2, for example, 80% to 90% of the width D2. The length E of the spring segment 214 along the circumferential direction may be, for example, 10% to 16% of the circumference of the tube, and in one example, 12% to 15%.

[0074] Figure 3b shows two adjacent bendable segments 204A, 204B similar to Figure 3a, with the proximal bendable segment 204A rotated (or displaced) relative to the distal bendable segment 204B in the same manner as described above for the tube 200 of Figure 2a. The central connecting portion 208 of the proximal bendable segment 204A is displaced by a distance / displacement H relative to the central connecting portion 208 of the distal bendable segment 204A. The distance H can correspond to half the distance / displacement L between adjacent central connecting portions 208 of one of the bendable segments 204A, 204B, for example, with reference to Figure 2a, and can be, for example, 1 / 6 of the circumference of the tube (corresponding to a 60° rotation).

[0075] The bendable segments 204A, 204B are arranged as pairs of bendable segments, for example, such that the distance F between the two bendable segments 204A, 204B of the pair is much smaller than the distance G between the pair and the other bendable segments, as shown, for example, in Figures 8b and 8c. In the example of Figure 3b, the distance F between the distal opening 210B of the proximal bendable segment 204A and the proximal opening 210A of the distal bendable segment 204B is similar (e.g., 80% to 120%) to the distance D between the central opening 206 and each of the proximal and distal openings 210A and 210B, thus forming an additional set of spring segments 216 between the bendable segments of the pair.

[0076] 3a, spring segments 216 have a width D6 at their centers that is smaller than the widths (widths D4 and D5) at the ends of distal bendable segment 204B adjacent proximal connecting portion 212A and proximal bendable segment 204A adjacent distal connecting portion 212B. The ratio of widths D4 to D6 can be within the ranges described above for the ratios of widths D1 to D3, for example. In some examples, width D4 can be similar to width D1 (e.g., 80% to 120% of width D1), width D5 can be similar to width D2 (e.g., 80% to 120% of width D2), and width D6 can be similar to width D3 (e.g., 80% to 120% of width D3).

[0077] FIG. 4 shows a perspective view of a tube 200 according to one example of the present disclosure, cut perpendicular to the longitudinal X direction for illustrative purposes. The tube 200 includes multiple bendable segments 204A, 204B having narrow central portions similar to the bendable segments 204A / B of FIG. 3a, two of which are visible in FIG. 4. The bendable segments 204A, 204B are rotated relative to each other along the circumferential direction, similar to that described above with reference to FIGS. 2a and 3b. In contrast to FIG. 3b, the bendable segments 204A, 204B are spaced apart from each other such that the distance between the pair is much greater than the distance between the central opening 206 of one of the bendable segments 204A, 204B and the proximal and distal openings, respectively. In this case, a spring segment cannot be formed between bendable segment 204A and bendable segment 204B because the width of the wall portion between bendable segment 204A and bendable segment 204B may be too large to allow significant deformation of this wall portion.

[0078] 5a and 5b show further examples of bendable segments 204A, 204B according to the present disclosure, which differ from the bendable segments of FIGS. 3a, 3b in the shape of the central opening 206 and / or the proximal and distal openings 206.

[0079] In the example of FIG. 5a, the central opening 206 has a "snowboard-like" shape with a narrow central portion 206C disposed between a pair of intermediate portions 206B and a pair of end portions 206A. The width C2 of the narrow central portion 206C is smaller than the width C1 of the end portions 206A and the width C3 of the central portion, for example, as described above with respect to FIG. 3a. In contrast to the example of FIG. 3a, the width C1 may be substantially equal to the width C3 or may be slightly larger than the width C3. The width C1 may be, for example, 95% to 120% of C3, and in one example, 100% to 110%.

[0080] In the example of FIG. 5b, the central opening 206 has a "double diamond" shape, with a pair of wide intermediate portions 206B each disposed between a narrow central portion 206C and a respective tapered end portion 206A. The width C2 of the narrow central portion 206C may be, for example, 60% to 70% of the width C3 of the wide intermediate portion 206B. The width C1 of the tapered end portion is substantially equal to or smaller than width C2. Width C1 may be, for example, 40% to 70% of width C2. In one example, the ratio of width C2 to width C3 is similar to the ratio of width C1 to width C2 (e.g., 80% to 120%).

[0081] 6a and 6b show a further example of a tube 200 including multiple bendable segments 204A, 204B according to examples of the present disclosure, where the tube 200 is shown cut open along the longitudinal direction X as in FIG. 2a to expand the walls 200.

[0082] Tube 200 of Figure 6a is similar to the tube of Figure 2a, except that in this example, central opening 206 is a narrow slit similar to the proximal and distal openings of Figure 2a, while proximal and distal openings 210A, 210B are wider openings similar to the central opening of Figure 2a. The width of proximal and distal openings 210A, 210B along the length may be, for example, at least five times, and in some instances at least ten times, the width of central opening 206.

[0083] In the example of FIG. 6b, each of the bendable segments 204A, 204B includes four sets of openings: two inner sets of openings and two outer sets of openings located proximal and distal to the inner sets of openings. The openings in each set are rotated circumferentially so that they are adjacent (e.g., aligned) with the connecting portions between adjacent sets of openings. In the example of FIG. 6b, the inner two sets of openings are narrow slits with much smaller longitudinal widths than the outer two sets of openings. A bendable segment such as that of FIG. 6b can, for example, provide improved torque transmission for a given stiffness / flexibility of the tube 200. A bendable segment such as that of FIG. 6b can be obtained, for example, by providing three fourth openings 600 proximal to the proximal opening 210A, each fourth opening 600 located adjacent to a respective proximal connecting portion 212A and separated from each other by fourth connecting portions 602. Alternatively, the fourth opening 600 may be provided distal to the distal opening 210B adjacent each of the distal connecting portions 212B.

[0084] 7 illustrates a tube 700 for use in a surgical device, such as the endoscope 100 of FIG. 1 , according to another example of the present disclosure. The tube 700 extends along a longitudinal direction X from a proximal end 700A, which may be connected or attached to, for example, the connector 104 of the endoscope 100, to a distal end 700B. The tube 700 includes five sections 700-I, 700-II, 700-III, 700-IV, and 700-V disposed between the proximal end 700A and the distal end 700B, each of which may exhibit a different degree of stiffness / flexibility.

[0085] 7, tube 700 includes rigid portion 700-I disposed at proximal end 700A. Rigid portion 700-I may not include a bendable segment, for example, to ensure a robust connection to connector 104. The length of rigid portion 700-I along the longitudinal direction may be, for example, 1% to 10%, and in some examples, 2% to 6%, e.g., 4%, of the total length of tube 700. In one example, the total length of tube 700 is 50 cm to 100 cm, and the length of rigid portion 700-I is 1 cm to 5 cm.

[0086] Tube 700 further includes three passive bending sections disposed between rigid section 700-I and distal end 700B: proximal passive bending section 700-II, central passive bending section 700-III, and distal passive bending section 700-IV. Sections 700-II through 700-IV may each exhibit different degrees of stiffness / flexibility, e.g., stiffness increases from section 700-II to section 700-IV. In other words, section 700-II may be stiffer (less flexible) than section 700-III distal to section 700-II, which in turn may be stiffer (less flexible) than section 700-IV distal to section 700-III. The length of section 700-II along the longitudinal direction may be, for example, 20% to 70% of the overall length of tube 700, and in some instances, 30% to 50%, e.g., 40%. The length of portion 700-III along the longitudinal direction may be, for example, 20% to 70%, and in some instances 30% to 50%, such as 40%, of the total length of tube 700. In some instances, the length of portion 700-III may be similar to the length of portion 700-II (e.g., 80% to 120%). The length of portion 700-IV along the longitudinal direction may be substantially smaller than the lengths of portions 700-II and 700-III. The length of portion 700-IV may be, for example, 1% to 10%, and in some instances 2% to 5%, such as 3%, of the total length of tube 700. In one example, the length of portion 700-II is 20 cm to 40 cm, the length of portion 700-III is 20 cm to 40 cm, and the length of portion 700-IV is 1 cm to 4 cm.

[0087] A portion of the distal passive curve section 700-IV is shown in Figure 8a, a portion of the central passive curve section 700-III is shown in Figure 8b, and a portion of the proximal passive curve section 700-II is shown in Figure 8c.

[0088] Each of the passive curve sections 700-II through 700-IV includes multiple bendable segments 204A, 204B disposed along the length of the respective section. To achieve different degrees of stiffness, the density of the bendable segments (e.g., the number of bendable segments 204A, 204B per unit length of the tube 700) varies between sections 700-II through 700-IV, with the density of bendable segments in the distal passive curve section 700-IV being higher than the density in the central passive curve section 700-III, which in turn is higher than the density in the proximal passive curve section 700-II.

[0089] In the distal passive bending section 700-IV, the bendable segments 204A, 204B are arranged as a continuous group of bendable segments, with both the distance F between the bendable segment 204A and the distal adjacent bendable segment 204B and the distance G between the bendable segment 204A and the proximal adjacent bendable segment 204B (see FIG. 2a) being similar to the distance D between the central opening 206 in the bendable segments 204A, 204B and the proximal and distal openings 210A, 210B. In this manner, a continuous arrangement of spring segments can be formed, achieving high flexibility in the section 700-IV. The distal passive bending section 700-IV can include, for example, 5 to 20 bendable segments, and in one example, 10 to 15 bendable segments.

[0090] In the central passive bending section 700-III and the proximal passive bending section 700-II, the bendable segments 204A, 204B are arranged in pairs. The distance F between the bendable segment 204A and the distally adjacent bendable segment 204B is similar to the distance D between the central opening 206 and the proximal and distal openings 210A, 210B in the bendable segments 204A, 204B, respectively. Therefore, an additional set of spring segments is formed between the pair of bendable segments 204A. On the other hand, the distance G between the bendable segment 204A and the proximally adjacent bendable segment 204B is much greater than the distance F. Therefore, the density of the bendable segments is less than that in the distal passive bending section 700-IV, and no additional spring segments are formed between the pair. For example, the distance G in the sections 700-II, 700-III may be 5 to 10 times, and in one example, 8 to 12 times, the distance F in the respective sections. To achieve greater flexibility in the central passive bending portion 700-III, the distance G may in some instances be smaller in the central passive bending portion 700-III than in the proximal passive bending portion 700-II. The distance G in portion 700-II may be, for example, 100% to 150%, and in one example, 105% to 120%, of the distance G in portion 700-III. Each of portions 700-II and 700-III may include, for example, 50 to 150, and in one example, 75 to 100 bendable segments.

[0091] In addition to, or instead of, density, portions 700-II through 700-IV may differ from one another in one or more parameters characterizing the placement and / or shape of openings in bendable segments and / or pairs of bendable segments to achieve different degrees of stiffness. For example, the length A1 of central connecting portion 208 may be greater in portion 700-III than in portion 700-IV and / or greater in portion 700-II than in portion 700-III. The length A2 of proximal and / or distal connecting portions 212A, 212B may be greater in portion 700-III than in portion 700-IV and / or greater in portion 700-II than in portion 700-III. A distance D (corresponding to the width of the spring segment 214) between the central opening 206 and each of the proximal and distal openings 210A, 210B may be greater in portion 700-III than in portion 700-IV and / or may be greater in portion 700-II than in portion 700-III. A distance F (corresponding to the width of the spring segment 216) between the bendable segments 204A, 204B of a bendable segment pair may be greater in portion 700-III than in portion 700-IV and / or may be greater in portion 700-II than in portion 700-III.

[0092] In other examples, tube 700 may include more or fewer passive curves than the example of Figure 7, such as, for example, only two passive curves or four passive curves. For example, proximal and middle passive curves 700-II, 700-III may instead be embodied as a single passive curve having a uniform density of bendable segments.

[0093] Additionally, tube 700 includes an active bending section 700-V, a portion of which is shown in FIGS. 9a and 9b. Active bending section 700-V is disposed between distal passive bending section 700-IV and distal end 700B of tube 700. The length of active bending section 700-V may be, for example, 4% to 10%, and in some instances 6% to 8%, of the overall length of tube 700, such as 2 cm to 5 cm in one example. Active bending section 700-V includes multiple annular or tubular elements 702A, 702B pivotally connected to one another by multiple joints 704, thereby forming a linear chain or sequence of elements articulatable relative to one another. Each joint 704 connects two adjacent elements, i.e., a respective proximal element 702A and a respective distal element 702B, to one another. While Figure 9a illustrates a joint 704 with the proximal and distal elements 702A, 702B associated with the joint 704 separated for illustrative purposes, Figure 9b illustrates the joint 704 with the proximal and distal elements 702A, 702B positioned as in active bending section 700-V of tube 700 in Figure 7 during normal use. In the example of Figures 9a and 9b, adjacent elements 702A, 702B are connected to one another by a pair of joints 704 positioned on opposite sides (e.g., 180° around) of tube 700. Figure 9c illustrates an enlarged view of one of the joints 704 corresponding to the dashed rectangle in Figure 9b. The joint 704 can be actuated (e.g., articulated), for example, by one or more control wires, as commonly known in the art. For example, a flap positioned midway between joints 704 on elements 702A, 702B may be bent inward into the interior of tube 700, and openings or notches in the flap may provide guide channels through which respective control wires may be placed.

[0094] Each joint 704 includes a distal contact surface 706B on a respective proximal element 702A (i.e., the proximal element 702A for the respective joint) and a proximal contact surface 706A on a respective distal element 702B (i.e., the distal element 702B for the respective joint). In the example of Figures 9a, 9b, the proximal contact surface 706A is formed by a surface of a joint head 708A (e.g., a circular joint head having the shape of a circular segment as shown in Figures 9a, 9b) protruding from the distal element 702B of the joint 704, e.g., by a side surface of the joint head 708A extending in a radial direction corresponding to the direction of view in Figures 9a, 9b. The distal contact surface 706B is formed by an edge or rim, e.g., a radially extending side surface or wall, of a joint socket 708B (e.g., a circular joint socket having the shape of a circular segment as shown in Figures 9a, 9b) within the proximal element 702A of the joint 704. The joint socket 708B is configured to receive the joint head 708A such that the proximal and distal contact surfaces 706A, 706B slidably engage one another and the joint head 708A can rotate within the joint socket 708B.

[0095] Each joint 704 further includes a pair of arcuate proximal brackets 710A protruding from a respective distal element 702B and a pair of corresponding recesses 712A in the respective proximal element 702A, each of the recesses 712A configured to slidably receive a respective one of the proximal brackets 710A. Furthermore, each joint 704 further includes a pair of arcuate distal brackets 710B protruding from a respective proximal element 702A and a pair of corresponding recesses 712B in the respective distal element 702B, each of the recesses 712B configured to receive a respective one of the distal brackets 710A. In this manner, a dual-joint structure is formed in each joint 704, which can increase the robustness of the joint 704 with respect to bending and / or torsional forces.

[0096] 9a and 9b, the joints 704 on elements 702A and 702B are aligned with each other along the circumferential direction and are positioned on opposite sides of tube 700 to, for example, allow articulation or bending of portion 700-V in a single plane / direction. In other examples, the joints on opposite sides of elements 702A and 702B may be rotated 90° relative to each other along the circumferential direction, for example, so that the proximal joint head 708A, proximal bracket 710A, and proximal recess 712B of each element are positioned between the distal joint socket 708B, distal bracket 710B, and distal recess 712A of each element. This allows articulation or bending of portion 700-V in two orthogonal planes / directions.

[0097] Each of the joints 704 includes a reference protrusion 714A disposed on a proximal contact surface 706A, e.g., at the tip of a joint head 708A, and a corresponding reference notch 714B disposed on a distal contact surface 706B configured to receive the reference protrusion 714A, as shown in Figure 9c. The reference protrusion 714A and the reference notch 714B cooperate to define a reference position for the respective joint 704, which in the example of Figures 9a-9c corresponds to a linear configuration in which the respective proximal and distal elements 702A, 702B are parallel to one another (e.g., corresponding to an articulation angle of 0°) as shown in Figures 9a-9b.

[0098] The reference protrusion 714A and the reference notch 714B are configured such that the length of the tube 700 increases when the respective joint moves from a reference position to a second position (e.g., corresponding to a non-zero articulation angle) corresponding to a bent configuration in which the respective proximal and distal elements 702A, 702B are tilted relative to one another. For example, as the joint 704 rotates away from the reference position, the tip of the reference protrusion 714A can contact and press against a portion of the distal contact surface 706B adjacent the reference notch 714B, thereby increasing the spacing between the respective proximal and distal elements 702A, 702B and, therefore, the length of the tube 700. As a result, the force required to pivot the proximal and distal elements relative to one another is greater when the joint is in the reference position (0° articulation angle, reference protrusion 714A is within reference notch 714B) than when the joint is in the second position (non-zero articulation angle; reference protrusion 714A is outside reference notch 714B). This can, for example, ensure that joint 704 is preferably positioned in a reference configuration and can, for example, prevent elements of portion 700-V from being positioned in a zigzag pattern when portion 700-V is not under tension.

[0099] FIG. 10 shows a flowchart of a method 1000 for manufacturing a tube for use in a surgical device that is at least partially inserted into a human or animal body according to one example of the present disclosure. Method 1000 can be used, for example, to manufacture tube 700 of FIG. 7 , which is used as a non-limiting example for illustrative purposes below. However, this is in no way intended to be limiting, and method 1000 may be used to manufacture other tubes for use in surgical devices, particularly other tubes according to any of the examples of the present disclosure described herein, such as tube 200 of FIG. 2 a. Furthermore, method 1000 is not limited to the order of execution shown in the flowchart of FIG. 10. So long as it is technically feasible, method 1000 may be performed in any order, and portions thereof, such as some or all of steps 1004A-C and 1006, may be performed at least partially simultaneously.

[0100] In step 1002, a tubular component is provided. The tubular component may be, for example, a cylindrical tube having a length and diameter that may be selected depending on the type and application of the surgical device in which the tube 700 will be used. The tubular component may have a length of, for example, 20 cm to 200 cm, and in some instances, 50 cm to 150 cm. The outer diameter of the tubular component may be, for example, 1 mm to 20 mm, in some instances, 2 mm to 10 mm, and in one instance, 2.5 mm to 5.5 mm. The tubular component may comprise (i.e., includes, but is not limited to) a rigid or semi-rigid material, particularly a metal such as stainless steel. In one example, the tubular component is made of (i.e., does not include) a rigid or semi-rigid material, particularly a metal such as stainless steel. The wall thickness of the tubular component may be selected depending on the material used and the intended application, and may be, for example, 0.05 mm to 1 mm, and in some instances, 0.1 mm to 0.3 mm. The tubular component may be formed as a single, continuous piece of material.

[0101] In step 1004, a plurality of bendable segments 204A, 204B are formed in the tubular component by forming three central openings 206 (step 1004A), three first openings 210A on a first side of the central opening 206 (step 1004B), and three second openings 210B on a second side opposite the first side of the central opening 206 (step 1004C) in the wall of the tubular component.

[0102] The central openings 206 are displaced from one another around the circumference of the tubular component by 29% to 38%, and in one example, 32.8% to 33.9% (e.g., 1 / 3) of the circumference of the tubular component in each bendable segment. The central openings 206 are formed such that a central connecting portion 208 of the wall of the tube 700 remains between the central openings 206. The central openings 206 may be formed in any shape, size, and / or arrangement as described above with reference to Figures 2a-8c, for example.

[0103] The first openings 210A are formed adjacent to respective ones of the central connecting portions 208. The first openings 210A may be formed, for example, proximal to the central opening 206 and thus may correspond to the proximal openings in the examples described above. The first openings 210A may be formed, for example, with a shape, size, and / or arrangement as described above with respect to the proximal openings in FIGS. 2a-8c.

[0104] Second openings 210B are also formed opposite the first openings 210B and adjacent to each one of the central connecting portions 208. The second openings 210B may be formed, for example, distal to the central opening 206 and thus may correspond to the distal openings in the examples described above. The second openings 210B may be formed, for example, with a shape, size, and / or arrangement as described above with respect to the distal openings in Figures 2a-8c.

[0105] The openings 206, 210A, 210B may be formed sequentially or at least partially simultaneously. Each of the openings 206, 210A, 210B may be formed by cutting the wall of the tubular component, for example, by laser cutting. Some or all of the openings 206, 210A, 210B may be formed as slits, such as the first / proximal opening 210A and the second / distal opening 210B in the example of FIG. 2a, or the central opening 206 in the example of FIG. 6a. In some examples, the width of the slit may correspond to the cutting width of the laser cut, which may be, for example, 10 μm to 50 μm, and in one example, 20 μm to 40 μm. The cutting width of the laser cut may be determined, for example, by the focal diameter or width of the laser beam used to perform the cut.

[0106] Bendable segments 206A, 206B may be formed in one or more portions of the tubular component, for example, as described above with reference to Figure 7. In some examples, step 1004 may include forming additional openings in some or all of the bendable segments, for example, a fourth set of openings as in the example of Figure 6b.

[0107] The method 1000 may further include forming an active curved section, such as section 700-V of tube 700, including a plurality of annular or tubular elements 702A, 702B pivotally connected to one another by a plurality of joints 704. The elements 702A, 702B and joints 704 of the active curved section 700-V may also be formed from the same tubular part from which the bendable segments 204A, 204B are formed, among other things. For example, the elements 702A, 702B may be cut from the tubular part, for example, by laser cutting. The elements 702A, 702B may be formed to have a shape as described above with reference to FIGS. 9a-9c, for example, by cutting along the periphery or edge of each element 702A, 702B.

[0108] The examples of the present disclosure disclosed herein merely constitute specific examples for illustrative purposes. The present invention can be embodied in various ways and with many modifications without altering its basic underlying characteristics. Accordingly, the present invention is defined solely by the claims set forth below. [Explanation of symbols]

[0109] 100 Surgical Devices / Endoscopes 102 Interface / Control Unit 104 Connector 106 port 200 tubes 200A proximal end 200B distal end 202 Wall 204A First Type / First Set of Bendable Segments 204B Second Type / Set of Bendable Segments 206 Central opening 206A End of central opening 206 206B Middle portion of central opening 206 206C: Central portion of central opening 206 208 Central connection part 210A First Opening / Proximal Opening 210B Second Opening / Distal Opening 212A Proximal Connection Part 212B Distal connection part 214,216 Spring segments 600 Fourth Opening 602 Fourth connecting part 700 tubes 700A proximal end 700B Distal End 700-I Rigid part 700-II Proximal Passive Curve 700-III Central Passive Bending Section 700-IV Distal Passive Curve 700-V Active Curve 702A Proximal Element 702B Distal Element 704 Joint 706A Proximal Contact Surface 706B Distal contact surface 708A Joint Head 708B Joint Socket 710A Proximal Bracket 710B Distal Bracket 712A Recess for proximal bracket 710A 712B Recess for distal bracket 710B 714A Reference protrusion 714B Reference Notch 1000 Tube manufacturing method 1002 preparing a tubular part 1004 Forming a bendable segment 1004A forming a central opening 1004B forming a proximal opening 1004C forming a distal opening 1006 Step of forming active bending portion X Longitudinal direction φ Circumferential direction A1 Length of central connection A2 Length of proximal / distal connection B Radius of curvature at the end of the central opening C, C1, C2, C3 Width of central opening D Distance between the central opening and the proximal / distal opening D, D1, D2, D3 Width of spring segment 214 D4, D5, D6, F Width of spring segment 216 E Length of spring segments 214, 216 F,G Distance between adjacent bendable segments L Displacement of adjacent central connection parts

Claims

1. A tube (200, 700) for use in an endoscope (100) for insertion at least partially into a human or animal body, said tube (200, 700) extending from a proximal end (200A, 700A) to a distal end (200B, 700B) of said tube (200, 700), said tube (200, 700) comprising a plurality of bendable segments (204A, 204B), each of said bendable segments (204A, 204B) comprising: three central openings (206) in the wall (202) of the pipe (200), the central openings (206) being arranged around the circumference of the pipe (200) and separated from one another by central connecting portions (208) of the wall (200), the central connecting portions (208) being displaced from one another by 105° to 135° along the circumference of the pipe (200); three proximal openings (210A) in the wall (202) disposed proximally of the central opening (206), each adjacent a respective one of the central connecting portions (208); three distal openings (210B) in the wall (202) disposed distally of the central opening (206), each adjacent a respective one of the central connecting portions (208); The tube (200, 700) is an insertion tube or hypotube for use in the endoscope (100). tube (200, 700).

2. 2. The pipe (200, 700) of claim 1, wherein at least some of the bendable segments (204A, 204B) are arranged in pairs along the longitudinal direction (X) of the pipe (200, 700), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 50% of the distance (G) between each pair and an adjacent pair.

3. A tube (200, 700) as described in claim 2, wherein the distance (F) is less than 25% of the distance (G) between each pair and an adjacent pair.

4. 3. The tube (200, 700) of claim 2, wherein a distance (F) between the distal opening (210B) of a proximal bendable segment (204A) and the proximal opening (210A) of a distal bendable segment (204B) of two adjacent bendable segments of the plurality of bendable segments (204A, 204B) is 50% to 200% of a distance (D) between the proximal opening (210A) and the central opening (206) of the distal bendable segment (204B), or 50% to 200% of a distance (D) between the central opening (206) and the distal opening (212B) of the proximal bendable segment (204A).

5. 5. The tube (200, 700) of claim 4, wherein the proximal opening (210A) of the distal bendable segment (204B) and the distal opening (210B) of the proximal bendable segment (204A) overlap along the circumferential direction (φ) of the tube (200, 700) to form a spring segment (216) therebetween.

6. A pipe (200, 700) as described in claim 5, wherein for one or more of the spring segments (216), the width (D6) along the longitudinal direction (X) at the center of each of the spring segments (216) is smaller than the width (D4, D5) of each of the spring segments (216) at one or both ends of each of the spring segments (216).

7. 5. The tube of claim 4, wherein at least some of the bendable segments are arranged as a contiguous group of bendable segments, and wherein the distance (F) between the distal opening (210B) of the proximal bendable segment (204A) and the proximal opening (210A) of the distal bendable segment (204B) of any two adjacent bendable segments in the contiguous group of bendable segments is 50% to 200% of the distance (D) between the proximal opening (210A) and the central opening (206) of the distal bendable segment (204B), or 50% to 200% of the distance (D) between the central opening (206) of the proximal bendable segment (204A) and the distal opening (210B).

8. 6. The pipe (200, 700) of claim 5, wherein adjacent bendable segments (204A, 204B) of the plurality of bendable segments (204A, 204B) are rotated relative to each other along the circumferential direction (φ), and a center of the central opening (206) of one bendable segment (204A) of the adjacent bendable segments (204A, 204B) is aligned with the central connecting portion (208) of the other bendable segment (204B) of the adjacent bendable segments (204A, 204B).

9. 3. The tube (200, 700) of claim 2, wherein the proximal opening (210A) or the distal opening (210B) is a slit, and the width (C) of the central opening (206) along the longitudinal direction (X) is at least five times the width of the slit.

10. A tube (200, 700) as described in claim 9, wherein the width (C) is at least 10 times larger than the width of the slit.

11. 6. The tube (200, 700) of claim 5, wherein the proximal openings (210A) are separated from each other by a proximal connecting portion (212A) of the wall (202), and the distal openings (210B) are separated from each other by a distal connecting portion (212B) of the wall (202).

12. The tube (200, 700) of claim 11, wherein the length (A2) of the proximal connecting portion (212A) or the length (A2) of the distal connecting portion (212B) along the circumferential direction (φ) is 25% to 200% of the length (A1) of the central connecting portion (208).

13. The tube (200, 700) of claim 11, wherein the length (A2) of the proximal connecting portion (212A) or the length (A2) of the distal connecting portion (212B) along the circumferential direction (φ) is 30% to 100% of the length (A1) of the central connecting portion (208).

14. 13. The tube (200, 700) of claim 12, wherein the length (A2) of the proximal connection portion (212A) or the length (A2) of the distal connection portion (212B) is less than or equal to 10% of the circumference of the tube (200, 700) at the respective bendable segments (204A, 204B).

15. 13. The tube (200, 700) of claim 12, wherein the length (A2) of the proximal connection portion (212A) or the length (A2) of the distal connection portion (212B) is 5% or less of the circumference of the tube (200, 700) at the respective bendable segments (204A, 204B).

16. 12. The tube (200, 700) of claim 11, wherein some or all of the bendable segments (204A, 204B) each further comprise a fourth set of openings, the fourth set of openings including three fourth openings (600) positioned proximally of the proximal opening (210A) and each adjacent to a respective one of the proximal connecting portions (212A) or positioned distally of the distal opening (210B) and each adjacent to a respective one of the distal connecting portions (212B).

17. 6. The tube of claim 5, wherein the proximal opening (210A) or the distal opening (210B) of some or all of the bendable segments (204A, 204B) overlaps with the central opening (206) of the respective bendable segment (204A, 204B) along the circumferential direction (φ) to form a spring segment (214) therebetween, and wherein for one or more of the spring segments (214), a width (D3) along the longitudinal direction (X) at the center of the respective spring segment (214) is smaller than a width (D1, D2) of the respective spring segment (214) at one or both ends of the respective spring segment (214).

18. 3. The tube (200, 700) of claim 2, wherein some or all of the central openings (206), some or all of the proximal openings (210A), or some or all of the distal openings (210B) each have a narrow central portion (206C) in the center of the respective openings (206, 210A, 210B), and the narrow central portion (206C) has a width (C2) along the longitudinal direction (X) that is 20% to 90% of the maximum width of the respective openings (206, 210A, 210B).

19. A tube (200, 700) as described in claim 18, wherein the width (C2) is 40% to 70% of the maximum width of each opening (206, 210A, 210B).

20. 19. The tube (200, 700) of claim 18, wherein the width (C2) of part or all of the central opening (206), the width of part or all of the proximal opening (210A), or the width of part or all of the distal opening (210B) along the longitudinal direction (X) is 20% to 90% of the width (C1) of one or both ends (206A) of each opening (206, 210A, 210B) at the center of each opening (206, 210A, 210B).

21. 19. The tube (200, 700) of claim 18, wherein the width (C2) of part or all of the central opening (206), the width of part or all of the proximal opening (210A), or the width of part or all of the distal opening (210B) along the longitudinal direction (X) is 40% to 70% of the width (C1) of one or both ends (206A) of each opening (206, 210A, 210B) at the center of each opening (206, 210A, 210B).

22. 19. The tube (200, 700) of claim 18, wherein some or all of the central openings (206), some or all of the proximal openings (210A), or some or all of the distal openings (210B) each comprise a wider intermediate portion (206B) disposed between the central portion (206C) and the respective end portion (206A) of the respective openings (206, 210A, 210B), and wherein a width (C3) of the wider intermediate portion (206B) along the longitudinal direction (X) is greater than the width (C2) of the central portion (206C) and greater than the width (C1) of the end portion (206A).

23. 23. The pipe (200, 700) of claim 22, wherein the width (C1) of one or both ends (206A) of each opening (206, 210A, 210B) is 40% to 90% of the width (C2) of the central portion (206C).

24. The tube (200, 700) of claim 12, wherein the tube (200, 700) comprises a first portion (700-II) and a second portion (700-III, 700-IV), and the density of the bendable segments in the first portion (700-II) is different from the density of the bendable segments in the second portion (700-III, 700-IV).

25. 25. The tube of claim 24, wherein the bendable segments in the second portion are arranged as a contiguous group of bendable segments, and wherein a distance between the distal opening of the proximal bendable segment and the proximal opening of the distal bendable segment of any two adjacent bendable segments in the contiguous group of bendable segments is between 50% and 200% of a distance between the proximal opening and the central opening of the distal bendable segment, or between 50% and 200% of a distance between the central opening and the distal opening of the proximal bendable segment.

26. 25. The pipe (200, 700) of claim 24, wherein the bendable segments (204A, 204B) in the first portion (700-II) are arranged in pairs along the longitudinal direction (X), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 50% of the distance (G) between the respective pair and an adjacent pair.

27. ​​A tube (200, 700) as described in claim 26, wherein the distance (F) is less than 25% of the distance (G).

28. the bendable segments (204A, 204B) in the second portion (700-III) are arranged in pairs along the longitudinal direction (X), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 50% of the distance (G) between the respective pair and an adjacent pair; or The tube (200, 700) comprises one or more additional portions (700-III) in which bendable segments (204A, 204B) are arranged in pairs along the longitudinal direction (X), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 50% of the distance (G) between the respective pair and an adjacent pair, and the density of the bendable segments in each of the one or more additional portions (700-III) is different from the density of the bendable segments in at least the first portion (700-II) or the second portion (700-IV).

27. The tube (200, 700) of claim 26.

29. the bendable segments (204A, 204B) in the second portion (700-III) are arranged in pairs along the longitudinal direction (X), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 25% of the distance (G) between the respective pair and an adjacent pair; or The tube (200, 700) comprises one or more additional portions (700-III) in which bendable segments (204A, 204B) are arranged in pairs along the longitudinal direction (X), and the distance (F) between the bendable segments (204A, 204B) of each pair is less than 25% of the distance (G) between the respective pair and an adjacent pair, and the density of the bendable segments in each of the one or more additional portions (700-III) is different from the density of the bendable segments in at least the first portion (700-II) or the second portion (700-IV).

27. The tube (200, 700) of claim 26.

30. The bendable segments (204A, 204B) in the first portion (700-II) are connected to the bendable segments (204A, 204B) in the second portion (700-III, 700-IV) or to the bendable segments (204A, 204B) in some or all of the one or more additional portions (700-III) by: the distance (D) between the proximal opening (210A) and the central opening (206) or the distance (D) between the central opening (206) and the distal opening (210A); the distance (F) between the bendable segments (204A, 204B) in the pair of bendable segments; the length (A2) of the proximal connecting portion (212A) between the proximal openings (210A) or the length (A2) of the distal connecting portion (212B) between the distal openings (210B); and The length (A1) of the central connecting portion (208) between the central openings (206) 30. The tube (200, 700) of claim 29, differing in one or more of:

31. The tube (200, 700) of claim 1, further comprising an active bending section (700-V) having a plurality of annular or tubular elements (702A, 702B) pivotally connected to one another by a plurality of joints (704).

32. Some or all of the joints (704) each comprise a distal contact surface (706B) on the proximal element (702A) for the respective joint (704) configured to slidably engage a proximal contact surface (706A) on the distal element (702B) for the respective joint (704), and a reference protrusion (714A) is disposed on one of the proximal contact surface (706A) and the distal contact surface (706B), or a reference protrusion (714A) is disposed on the proximal contact surface (706A) and the distal contact surface (706B).

32. The tube of claim 31, wherein a reference notch is disposed on the other of the position contact surfaces, and wherein the reference protrusion or the reference notch is disposed such that a force required to pivot the proximal and distal elements relative to one another is greater when the joint is in a reference position than when the joint is in a second position different from the reference position.

33. 33. The tube (200, 700) of claim 32, wherein the reference protrusion (714A) or the reference notch (714B) is positioned such that the length of the tube (200, 700) increases when the joint (704) moves from the reference position to the second position.

34. 33. The tube (200, 700) of claim 32, wherein the proximal element (702A) and the distal element (702B) are parallel to one another when the respective joints (704) are in the reference position.

35. Some or all of the joints (704) each have: a pair of arcuate proximal brackets (710A) on the distal element (702B) for said respective joint (704), each extending along an arc; or a pair of arcuate distal brackets (710B) on the proximal element (702A) for each said joint (704), each extending along a respective arc; Equipped with Each of the proximal brackets (710A) is configured to slidably engage with a corresponding recess (712A) in the proximal element (702A) or one of the distal brackets (710B), or each of the distal brackets (710B) is configured to slidably engage with a corresponding recess (712B) in the distal element (702B) or one of the proximal brackets (710A).

33. The tube (200, 700) of claim 32.

36. 36. The pipe (200, 700) of claim 35, wherein the proximal bracket (710A) or the distal bracket (710B) forms a circular joint socket (708B) configured to receive a corresponding joint head (708A) on the distal element (702B) and the proximal element (702A), respectively, and the reference protrusion (714A) is located on a surface of one of the joint socket (708B) and the joint head (708A), or the reference notch (714B) is located on a surface of the other of the joint socket (708B) and the joint head (708A).

37. A method (1000) for manufacturing a tube (200, 700) that is an insertion tube or hypotube for use in an endoscope (100) that is at least partially inserted into a human or animal body, the method comprising: providing a tubular member; and forming a plurality of bendable segments (204A, 204B) in the tubular member, each of the bendable segments (204A, 204B) comprising: forming three central openings (206) in the wall (202) of said tubular component, the openings being displaced from one another along the circumference of said tubular component by 29% to 38% of the circumference of said tubular component and separated from one another by a central connecting portion (208) of said wall (202); forming three first openings (210A) in the wall (202) on a first side of the central opening (206), each opening being formed adjacent a respective one of the central connecting portions (208); and forming three second openings (210B) in the wall (202) on a second side opposite the first side of the central opening (206), each of the second openings (210B) being formed adjacent to a respective one of the central connecting portions (208); The method (1000) is formed by:

38. 38. The method (1000) of claim 37, wherein the first opening (210A) and the second opening (210B) are slits formed by laser cutting, and a width of the first and second openings (210A, 210B) along the longitudinal direction (X) of the tubular part corresponds to a cutting width of the laser cutting, the cutting width being between 10 μm and 50 μm.

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