Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/005—Flexible endoscopes
  • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
  • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/00147—Holding or positioning arrangements
  • A61B1/00149—Holding or positioning arrangements using articulated arms
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
  • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
  • A61B2017/003—Steerable
  • A61B2017/00305—Constructional details of the flexible means
  • A61B2017/00314—Separate linked members
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
  • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
  • A61B2017/003—Steerable
  • A61B2017/00318—Steering mechanisms
  • A61B2017/00323—Cables or rods
  • A61B2017/00327—Cables or rods with actuating members moving in opposite directions

Definitions

• the present invention relates to articulated arms comprising tubular structures that include bendable sections comprising concatenated annular members.
• Articulated arms comprising tubular structures having longitudinal, i.e., axially- oriented, channels for passage therethrough of cables and wires have been introduced.
• the tubular structures include concatenated annular members formed with corresponding projections and recesses to facilitate pivoting of the annular members and bending of bendable portions of the tubular structures.
• the projections and recesses have used naive, symmetrical designs that cause the interaction between them to suffer from backlash and/or slippage, and to be hindered by excessive friction between neighboring members, all of these potentially affecting the pivoting precision of the articulated arms.
• annular members that reduce or eliminate or reduce the impacts of the drawbacks of the known designs.
• an articulated arm comprises a tubular structure that includes a bendable section comprising a plurality of concatenated annular members.
• Each annular member comprises a first pair of axial projections and a corresponding first pair of recesses axially aligned therewith; each projection is shaped to include an apex point defining a vertex of a convex-angle portion of the projection, and each corresponding recess is shaped to surround a volume having an apex point defining a vertex of a concave-angle portion of the recess.
• the plurality of annular members is arranged in the bendable section such that for each pair of consecutive annular members, the projections of a first annular member are pivotably engaged with corresponding recesses of a second annular member.
• a pivoting of the first and second annular members relative to each other so as to bend the bendable section includes a pivoting of the respective concave-angle portions of the corresponding recesses of the second annular member about the respective apex points of the projections of the first annular member.
• the apex points of the projections of the first annular member can be in direct contact with the respective vertices of the concave-angle portions of the corresponding recesses of the second annular member when the articulated arm is in an assembled and operative state.
• the apex points of the projections can be in direct contact with the respective vertices of the concave-angle portions when the respective concaveangle portions pivot about the respective apex points of the projections.
• the convex angles of the convex-angle portions of the projections can be smaller than respective conjugate angles of the concave angles of the concave-angle portions of the corresponding recesses.
• the axial projections of the first pair of axial projections can be diametrically opposed from each other.
• the projections can be respectively devoid of axes of symmetry. In some embodiments, the recesses can be respectively devoid of axes of symmetry.
• the pivoting of the first and second annular members relative to each other can be substantially without backlash. In some embodiments, the pivoting of the first and second annular members relative to each other can be substantially without friction in the recesses.
• each annular member can comprise a second pair of axial projections and a corresponding second pair of recesses axially aligned therewith, wherein, for each pair of consecutive annular members, the second-pair projections of the first annular member are slidably engaged with corresponding second-pair recesses of the second annular member to form respective guiding arrangements, a first guiding arrangement being effective to define a pivot limit of the first and second annular members in a direction of the flexing.
• the pivoting of the first and second annular members relative to each other is not limited by a pivot limit of the pivoting of the concave-angle portions of the corresponding recesses of the second annular member about the respective apex points of the projections of the first annular member.
• the axial projections of the second pair of axial projections can be diametrically opposed from each other.
• the axial projections of the first and second pairs of axial projections can be distributed evenly around the respective circumferences of each annular member.
• the articulated arm can comprise a first bendable section comprising a respective plurality of concatenated annular members having a first diameter, and a second bendable section comprising a respective plurality of concatenated annular members having a second diameter that is different than the first diameter.
• the pivoting of the first and second annular members relative to each other can include a maximum relative pivoting of at least 5°, or at least 6°, or at least 7°. In some such embodiments, it can be that the maximum relative pivoting is no more than 12°, or no more than 10°, or no more than 8°.
• bending either one of the first or second bendable sections can include bending the respective bendable section by at least 150°, or at least 180°. In some embodiments, bending at least one of the first and second bendable sections can include bending the respective bendable section by at least 210°.
• the plurality of annular members is arranged in the bendable section such that for each pair of consecutive annular members, the one or more pivot-projections of a first annular member are pivotably engaged with the one or more corresponding pivot-recesses of a second annular member.
• a pivoting of the first and second annular members relative to each other so as to bend the bendable section includes a pivoting of the respective concave-angle portions of the one or more corresponding pivotrecesses of the second annular member about the respective apex points of the one or more pivot-projections of the first annular member.
• the one or more axial pivot-projections can include exactly one pivot-projection, and/or the one or more corresponding recesses can include exactly one corresponding pivot- recess, and/or the exactly one pivot-projection of the first annular member can be pivotably engaged with the exactly one corresponding pivot-recess of the second annular member.
• the apex points of the pivot-projections can be in direct contact with the respective vertices of the concave-angle portions when the respective concave-angle portions pivot about the respective apex points of the pivot-projections.
• the pivot-projections can be respectively devoid of axes of symmetry. In some embodiments, the pivot-recesses can be respectively devoid of axes of symmetry.
• the pivoting of the first and second annular members relative to each other can be substantially without backlash. In some embodiments, the pivoting of the first and second annular members relative to each other can be substantially without friction in the pivot-recesses.
• the different-diameter annular members 10 of the two bendable portions 99 are proportionally dimensioned, i.e., the smaller-diameter member 10 of the different-diameter annular members 10 is a proportionately ‘shrunken’ version of the larger-diameter member 10 of the two.
• Fig. 2A shows an example of a bendable portion 99 according to embodiments.
• the bendable portion 99 comprises n annular members 10 and two end elements 150A, 150B and arranged .
• the number n can be any integer according to the length requirements of the bendable portion 99, of the tubular section 40, or of the articulated arm 100. In some embodiments, the number n is based on or related to the maximum bend required for a bendable portion 99 divided by the maximum pivot angle of one annular member 10 relative to another. For example, if a bendable portion 99 will be required to double back on itself, i.e., bend through at least 180°, and the maximum pivot angle of adjacent or consecutive annular members 10 is 7.8°, then n can be made equal to 23, 24, 25 or more.
• the maximum pivot angle of adjacent or consecutive annular members 10 is at least 5°, or at least 6°, or at least 7°, and the maximum pivoting angle is not more than 12°, or not more than 10°, or not more than 8°.
• any bendable section can be flexed by at least 150°, or at least 180°.
• the two bending portions 99 can have different minimum aggregate bending angles, e.g., where a first bending portion 99 can be flexed by at least 180° and a second bending portion 99 can be flexed by at least 210°
• the different-diameter annular members 10 of the two bendable portions 99 of Fig. 1 are configured to flex the respective bendable portions 99 to have a central longitudinal axis with a radius of not more than 20 mm, or not more than 15 mm, or not more than 13 mm.
• the respective axes of the two bending portions 99 have the same minimum radius when flexed to a respective maximum extent as in, for example, Fig. 2C.
• the annular members 10 are shaped to enable pivoting of annular members 10 relative to each other. As can be seen in Fig. 2B, the annular members 10 are narrower on one side (the ‘upper side’ in the view shown in Fig. 2B), i.e., around a first portion of the circumference, than on the other side (the Tower side’ in Fig. 2B). The shape of the annular members 10 leaves a large gap 51 when the bendable portion is not bent, e.g., gap 511-2 between annular member 101 and annular member IO2, or gap 512-3 between annular member IO2 and annular member IO3 on the ‘upper side’.
• gap 52 e.g., gap 521-2 between annular member 101 and annular member IO2, or gap 522-3 between annular member IO2 and annular member IO3, is substantially smaller in the unbent state of the bendable portion 99.
• Fig. 2C shows a bendable portion 99 in a fully bent (flexed) state, such that every pair of consecutive annular members 10/, 10;+/ out of the plurality of annular members 101 .. 10 « can be pivoted relative to each other in the direction(s) shown by arrows 975 and 976 in Fig. 2C, to at least partly close the gaps 51, and open up the gaps 52.
• the annular members 10/, 10;+/ pivot the projection of annular member 10; pivots within the corresponding recess of the annular members 10;+/.
• all of the annular members 10 of the bendable portion 99 are shown as being pivoted so as to achieve a total bend of more than 210°.
• Fig. 2D shows a side view of multiple annular members 10 of a bendable portion 99 in perspective view, in which it can be seen that each annular member 10 is shaped to include a pair of axially extending projections 15, and a corresponding pair of axially oriented recesses 16.
• the first annular member 101 in Fig. 2D includes projections 15IA and 15IB
• the second annular member IO2 includes projections 152A and 152B.
• the projections 15;A and 15;A of an annular member 10 are diametrically opposed from each other, and the corresponding recesses 16;A and 156;A are diametrically opposed from each other.
• respective projections 15;A are axially aligned with and pivotably engaged with corresponding recesses 16;A, while respective projections 15® are axially aligned with and pivotably engaged with corresponding recesses 16®.
• individual concatenated annular members 10 cannot be non- destructively separated from each other.
• the respective shapes of the projections 15 and recesses 16, e.g., in combination with . selection of a construction material of sufficient rigidity are selected so as to be effective to prevent non- destructive separation of concatenated annular members 10 with a longitudinal force or twisting force.
• the process of selecting a suitable design of axial projections 15 and recesses 16, along with selecting a suitable construction material for the annular members 10, can consist of a separation analysis and/or physical test to check whether the design of the axial projections 15 and recesses 16 is sufficiently robust, and whether the material is not overly pliable, so as not to allow forced but non-destructive separation of concatenated annular members 10. Further, the protrusions axial projections 15 and recesses 16 are shaped so as not to allow separation of concatenated annular members 10 by lateral sliding.
• Figs. 3A and 3B show elevation views of an annular member 10, with Fig. 3 A showing the side having axial projections 15 and Fig,. 3B showing the side having axial recesses 16.
• the axial projections 15 and recesses 16 have substantially the same radial thickness of the annular member 10, which means that each of the projections 15 and recesses 16 is wider, i.e., circumferentially longer, on the outside of the annular member 10 than on the inside.
• the left-side projection 15L of Fig. 3A would not be able to slide laterally out of the left-side recess 16L of Fig. 3B, and separation of the annular members 10 would be prevented by the narrowing of the left-side recess 16L at point ®.
• Figs. 4, 5 and 6, disclose certain structural and functional attributes of the axial projections 15 and corresponding recesses 16 of annular members 10 according to embodiments.
• the projection 15 of the annular member 10 is shaped to include an apex point 45.
• the apex point 45 defines a vertex of a convex-angle portion 19 of the projection 15 defined at the apex point 45 by convex angle a.
• the convex- angle portion 19 can have a different shape, i.e., include a differently shaped portion of the projection 15 including the apex point 45 and the rays extending therefrom (e.g., Ais and Bis in Fig. 5).
• the corresponding recess 16 is shaped to surround a volume having an apex point 46.
• the apex point 46 defines both a vertex of a convex-angle volume defined at the apex point 46 by convex angle P, and a vertex of a concave-angle portion 18 partly circumscribing the recess 16 that subsumes the convex-angle volume and that is defined at the apex point 46 by concave angle P’.
• the concave-angle portion 18 ‘of the recess 16’ meaning ‘partly circumscribing the recess 16’, that is shown in Fig.
• the concave-angle portion 18 can have a different shape, i.e., include a differently shaped portion of the annular member 10 partly circumscribing the recess 16 and including the apex point 46 and the rays extending therefrom (e.g., A and B in Fig. 5).
• the convex angle a of the convex-angle portion of the projection is the convex angle a of the convex-angle portion of the projection
• end members 150 of a bendable portion 99 may include projections 15 and/or recesses 16 to link to, i.e., be pivotably engaged with, the first or last annular member 10 in a concatenated plurality annular members 10.
• Fig. 5 schematically illustrates the lack of symmetry in projections 15 and recesses
• Axes 20015 that could serve as axes of symmetry are shown as attempting to bisect the projection 15.
• One axis 200is passes through the apex point 45 and is parallel to a longitudinal axis (not shown) of the bendable portion 99 and of the linked annular members 10.
• a second axis 20015 passes through the apex point 45 and the center of the narrow (‘stem’) portion of the projection 15.
• the line segments and chords Ais, Bis, Cis, and Dis making up the profile of the convex-angle portion of the projection 15 on both sides of the ‘bisecting’ axes do not exhibit any symmetry -Ais, for example, is longer than Bis, and Dis is longer and more curved than Cis.
• Axes 20016 that could serve as axes of symmetry are shown as attempting to bisect the recess 15.
• One axis 20016 passes through the apex point 46 and is parallel to a longitudinal axis (not shown) of the bendable portion 99 and of the linked annular members 10.
• a second axis 20016 passes through the apex point 46 and the center of the narrow portion of the recess 16.
• the line segments and chords Ai6, Bi6, Ci6, and Dn> making up the profile of the concave-angle portion circumscribing the recess 16 on both sides of the ‘bisecting’ axes do not exhibit any symmetry - Ai6, for example, is longer than Bn, and Dn> is longer and more curved than Ci6.
• the pivoting of the one of more recesses 16 of a given annular member 10 about corresponding projections 15 of a neighboring annular member 10 optimally takes place when the apex points 45 of the convex-angle portions 19 are in direct contact with the corresponding concave-angle portions 18 at their respective apex points 46.
• slack is removed between the annular members 10 in order to produce direct contact between consecutive annular members 10.
• such direct contact ensures that the apex points 45, 46 combine to form a pivot point.
• the concave-angle portion 18 of the recess 16 thus pivots precisely about the apex point 45 of the convex-angle portion 19 of the projection 15.
• an axial force can be applied, e.g., a force indicated by arrow 205 in Fig. 6.
• pivoting of the first and second annular members 101, IO2 relative to each other is substantially without backlash or slippage that might be induced in design where pivoting occurs with slack between projection 15 and recess 16, i.e., at the apex points 45, 46.
• the force 205 is effective to drive the apex point 45 of the convex-angle portion 19 of the projection 15 to come into contact with the apex point 46 of the corresponding concave-angle portions 18 of the recess 16.
• a cable (not shown) passes through each of one or more axially-oriented and axially-aligned holes 43 in the annular members 10 of a bendable portion 99.
• Fig. 7A shows the first and second annular members 101, IO2 of Fig. 6, with the apex point 45i of the convex-angle portion 19 of the projection 15i of the first annular member 101 being in contact with the apex point 46i of the concave-angle portion I82 of the recess I62 of the second annular member IO2 (reference numbers 46i and I81 are not shown in Fig. 7A due to lack of space).
• Figs. 7B and 7C illustrate the pivoting of the respective concave-angle portion I82 of the corresponding recess I62 of the second annular member IO2 about the respective apex point 45i of the projection 15 of the first annular member 101.
• expressing that recesses 16 and respective 46 of respective concave-angle portion 18 pivot about apexes 45 of projections 15 is equivalent to expressing that apexes 45 of projections 15 pivot within recesses 16, as all ‘pivoting’ is relative, and neither the projections 15 nor the recesses 16 are fixed in space.
• the pivoting comprises about 5° of pivot.
• the pivoting comprises about 11 0 of pivot.
• the maximum pivot range can be larger or smaller than 11 0 of pivot.
• the maximum pivot range is determined by other design elements, such as the design of guiding projections and recesses as discussed hereinbelow with respect to Figs. 10A, 10B, 11, 12 and 13.
• the pivoting range shown in Fig. 7C can be constrained and the projection line segment B15 (see Fig. 5) does not contact the recess line segment n> to fully close the gap 53 between Bis and Bi6.

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• 2024
  • 2024-03-25 EP EP24778457.2A patent/EP4687622A1/de active Pending
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