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WO2025026670A1 - Tube pliable à compensation de longueur de parcours de fils de direction - Google Patents

Tube pliable à compensation de longueur de parcours de fils de direction Download PDF

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Publication number
WO2025026670A1
WO2025026670A1 PCT/EP2024/069397 EP2024069397W WO2025026670A1 WO 2025026670 A1 WO2025026670 A1 WO 2025026670A1 EP 2024069397 W EP2024069397 W EP 2024069397W WO 2025026670 A1 WO2025026670 A1 WO 2025026670A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
tangential
longitudinal
steerable
steering
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/EP2024/069397
Other languages
English (en)
Inventor
Mattheus Hendrik Louis THISSEN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Fortimedix Assets II BV
Original Assignee
Fortimedix Assets II BV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Fortimedix Assets II BV filed Critical Fortimedix Assets II BV
Publication of WO2025026670A1 publication Critical patent/WO2025026670A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
    • 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
    • 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
    • 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
    • A61B1/0057—Constructional details of force transmission elements, e.g. control wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0138—Tip steering devices having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils

Definitions

  • the invention relates to a bendable tube with path length compensation of steering wires.
  • the invention also relates to a bendable tube with an improved elastic hinge.
  • the invention also relates to an invasive instrument such as an endoscope comprising such a bendable tube.
  • Transformation of surgical interventions that require large incisions for exposing a target area into minimal invasive surgical interventions, i.e. requiring only natural orifices or small incisions for establishing access to the target area, is a well-known and ongoing process.
  • an operator such as a physician, requires an access device that is arranged for introducing and guiding invasive instruments into the human or animal body via an access port of that body.
  • the access port is preferably provided by a single small incision in the skin and underlying tissue.
  • a natural orifice of the body can be used as an entrance.
  • the access device preferably enables the operator to control one or more degrees of freedom that the invasive instruments offer. In this way, the operator can perform required actions at the target area in the human or animal body in an ergonomic and accurate manner with a reduced risk of clashing of the instruments used.
  • Surgical invasive instruments and endoscopes are well-known in the art. Both the invasive instruments and endoscopes can comprise a steerable tube that enhances its navigation and steering capabilities.
  • a steerable tube may comprise a proximal end part including at least one flexible zone, a distal end part including at least one flexible zone, and an intermediate part, wherein the steerable tube further comprises a steering arrangement that is adapted for translating a deflection of at least a part of the proximal end part relative to the intermediate part into a related deflection of at least a part of the distal end part.
  • the distal flexible zone may be steered by a robotic system arranged at the proximal end of the steerable instrument.
  • Steerable invasive instruments may comprise a handle that is arranged at the proximal end part of the steerable tube for steering the tube and/or for manipulating a tool that is arranged at the distal end part of the steerable tube.
  • a tool can for example be a camera, a manual manipulator, e.g. a pair of scissors, forceps, or manipulators using an energy source, e.g. an electrical, ultrasonic or optical energy source.
  • such a steerable tube may comprise a number of co-axially arranged cylindrical elements including an outer cylindrical element, an inner cylindrical element and one or more intermediate cylindrical elements depending on the number of flexible zones in the proximal and distal end parts of the tube and the desired implementation of the steering members of the steering arrangement, i.e. all steering members can be arranged in a single intermediate cylindrical element or the steering members are divided in different sets and each set of steering members is arranged, at least in part, in a different or the same intermediate cylindrical element.
  • the steering arrangement comprises conventional steering cables with, for instance, sub 1 mm diameters as steering members, wherein the steering cables are arranged between related flexible zones at the proximal and distal end parts of the tube.
  • Other steering units at the proximal end like ball shaped steering units or robot driven steering units, may be applied instead.
  • each of the intermediate cylindrical elements including the steering wires can be fabricated either by using a suitable material addition technique, such as injection molding or plating, or by starting from a tube and then using a suitable material removal technique, such as laser cutting, photochemical etching, deep pressing, conventional chipping techniques such as drilling or milling or high-pressure waterjet cutting systems.
  • a suitable material addition technique such as injection molding or plating
  • a suitable material removal technique such as laser cutting, photochemical etching, deep pressing, conventional chipping techniques such as drilling or milling or high-pressure waterjet cutting systems.
  • Steering wires manufactured in that way are, then, implemented as longitudinal strips resulting from the tube material, and can be used as pulling/pushing wires.
  • laser cutting is very advantageous as it allows a very accurate and clean removal of material under reasonable economic conditions.
  • the inner and outer cylindrical elements may be manufactured from tubes too. These tubes should be flexible at locations where the distal end, and possibly the proximal end too, of the instrument is bendable. Also at other locations where the instrument should be flexible, the inner and outer cylindrical elements should be flexible. This can be implemented by providing the inner and outer cylindrical elements with hinges at these flexible locations. Such hinges may result from (laser) cutting predetermined patterns in the tube. Many different patterns are known from the prior art. Which pattern to use depends on design requirements at the location concerned including but not limited to the required bending angle, bending flexibility, longitudinal stiffness, and radial stiffness.
  • Figure 1A shows a body of a tube shaped instrument 1 having a first steering wire 16(1) running from one end to the opposing end on one side of the body in a straight fashion, as well as a second steering wire 16(2) running from one end to the opposing end on the other side, i.e. 180 degrees rotated locations, of the body in a straight fashion. Steering wires are running in parallel.
  • the tube 1 has a central axis of symmetry 29.
  • the body of tube 1 has a length L. In the unbent status of figure 1A, both steering wires 16(1) and 16(2) also have a length L inside the body.
  • FIG. 13 Figure IB shows tube 1 in a bent position, here in a 180 degrees curve.
  • the length of axis 29 inside the body remains the same.
  • a portion of steering wire 16(1) located at the inner side of the curve now extends from the body by an offset of +AL whereas a portion of steering wire 16(2) located at the outer side of the curve now extends inside the body by an offset of -AL.
  • steering wire 16(1) is pushed outside the body and steering wire 16(2) is pulled inside the body. Since steering wires 16(1), 16(2) are attached to the tip of the instrument, this causes one or more of the above mentioned problems, e.g., undesired deflection of the tip.
  • the force isolation elements are isolating axial loads of the invasive instrument from the bendable body portion which axial loads are caused by pulling/pushing the steering wires in order to deflect the deflectable tip portion. Because the steering wires are spiraling in at least a part of the body section, they can compensate at least some of the path length differences when the body section bends. Moreover, because the longitudinal force isolation elements are running through the body portion in a parallel fashion to the steering wires, they are spiraling as well, resulting in at least some path length compensation for the longitudinal force isolation elements in the body portion themselves too.
  • the invention relates to an improved hinge structure as claimed in independent claim 17.
  • Figures 1 A and IB show schematic drawings to introduce some of the problems dealt with by a first aspect of the invention.
  • FIGS. 2A and 2B show a schematic solution of the prior art to the problem shown in figures 1A, IB.
  • Figures 3 A and 3B show prior art tubes of a steerable instrument having steering wires made from a tube wall.
  • Figure 4 shows a schematic perspective view of a tube having steering wires made from a tube wall.
  • Figure 5A shows a schematic perspective view of an alternative tube having steering wires made from a tube wall.
  • Figure 5B shows an enlarged view of a distal portion of the tube shown in figure 5A.
  • Figure 5C shows a schematic cross sectional view of some components of a proximal portion of the steerable instrument.
  • Figures 5D-5F show embodiments of force isolation elements.
  • Figure 5G shows a prior art embodiment of a tube with steering wires separated by spacer wires extending from the proximal end to the distal end of the tube.
  • Figure 5H shows an embodiment of a tube with uninterrupted spacer wires.
  • Figure 6 shows an example of an inner tube which can be used inside the tube shown in figures 4, 5A, 5B and 5C.
  • Figure 7 shows an example of a tip and body portion of an outer tube which can be used outside the tube shown in figures 4, 5A, 5B and 5C.
  • Figure 8 shows a hinge structure according to the prior art.
  • Figures 9-12C show portions of hinge structure embodiments according to a second aspect of the invention.
  • the present invention is, in an embodiment, implemented with tubes provided with suitable cutting patterns, also called “cylindrical elements” hereinafter.
  • the basic technology of such tubes is, e.g., described in EP 2 273 911 Bl.
  • Figure 3 A shows an exploded view of three cylindrical members forming an instrument according to EP 2 273 911 Bl.
  • the instrument 202 is composed of three coaxial cylindrical members: an inner member 204, an intermediate member 206 and an outer member 208.
  • the inner cylindrical member 204 is composed of a first rigid, steerable end part 210, which is the part normally used at an operating location which may be difficult to reach, e.g., inside the human body, a first flexible part 212, an intermediate rigid part 214, a second flexible part 216 and a second, steering rigid end part 218.
  • the steerable end part 210 is located at a distal end of the instrument.
  • the steering rigid end part is located at a proximal end of the instrument.
  • the outer cylindrical member 208 is in the same way composed of a first, steerable rigid part 201, a flexible part 203, an intermediate rigid part 205, a second flexible part 207 and a second, steering rigid part 209.
  • the flexible parts of cylindrical members 204, 208 are also called “hinges” in the art.
  • the length of the different parts of the cylindrical members 208 and 212 are substantially the same so that when the cylindrical member 204 is inserted into the cylindrical member 208, steerable end parts 210 and 201, flexible parts 212 and 203, rigid parts 214 and 205, flexible parts 216 and 207, and rigid steering end parts 218 and 209 are aligned with each other, respectively.
  • the intermediate cylindrical member 206 also has a first, steerable rigid end part 240 and a second, steering rigid end part 242 which in the assembled condition are located between the corresponding rigid steerable end parts 210, 201 and the rigid steering end parts 218, 209, respectively, of the two other cylindrical members 204, 208.
  • Components 216, 218, 242, 207, 209 and the portion of 211 that is axially aligned with components 216 and 207 together form a steering unit 244 of the steerable instrument.
  • Components 210, 212, 240, 201, 203 and the portion of 211 that is axially aligned with components 212 and 203 together form a steerable - or deflectable - portion 248 of the steerable instrument.
  • the portion in between steering unit 244 and steerable portion 248 is a body portion 246.
  • the rigid steering end parts 218, 242, 209 of the three cylindrical members may be attached to each other.
  • the steerable end parts 210, 240, 201 may be attached to one another.
  • the steering end parts 218, 242, 209 are located at a proximal end of the invasive instrument whereas the steerable end parts 210, 240, 201 are located at a distal end of the invasive instrument.
  • Figure 3B which is also known from EP 2 273 911 Bl, shows an unrolled view of a part of an alternative embodiment of the intermediate cylindrical member of the instrument of figure 3 A.
  • the intermediate cylindrical member of figure 3B is formed by a number of steering wires 16(i) wherein each steering wire 16(i) is composed of three portions 222, 224 and 226, co-existing with the first flexible portion, the intermediate rigid portion and the second flexible portion, respectively.
  • each pair of adjacent longitudinal elements 220 is very close to each other in the tangential direction so that in fact only a narrow gap is present there between just sufficient to allow independent movement of each longitudinal element.
  • each longitudinal element consists of a relatively small and flexible strip 228, 230 as seen in circumferential direction, so that there is a substantial gap between each pair of adjacent strips, and each strip 228, 230 is provided with a number of cams 232, extending in circumferential direction and almost bridging completely the gap to the next strip.
  • the examples of the cylindrical elements shown in figures 3 A, 3B can be manufactured entirely by cutting suitable cutting patterns in tubes, e.g., by laser cutting.
  • the steering wires 16(i) are strips manufactured from the wall of cylindrical element 206.
  • FIG. 48 They show the basic technology used in the cylindrical elements of the present invention too.
  • Other examples of - steerable invasive -instruments manufactured by (laser) cutting suitable patterns in cylindrical elements can, e.g., be derived from W02009112060, WO2009127236, WO2012128618, WO2012173478, W02014011049, WO2015084174, W02016089202, W02017010883, WO2017014624, W02017082720, WO2017213491, W02018067004, W02019009710, W02020080938, W02020214027, W02020218920, W02020218921, WO2022260518, WO2023287286, and WO2023287289.
  • Such other examples may relate to instruments having more than one steerable end part and/or having a flexible, instead of a rigid intermediate part.
  • FIG. 4 shows an example of a tube 306 implementing the solution of figures 3A, 3B.
  • the figure shows a distal portion at the distal end of tube 306.
  • the shown implementation has a ring-shaped end portion 300.
  • 1 4 but I may have any other suitable value.
  • the four steering wires 16(i) are equidistantly divided over the circumference of tube 306. All steering wires 16(i) are attached to ring-shaped end portion 300, e.g., by cutting them from the same wall of tube 306 as ring-shaped end portion 300. Note that there may be more steering wires or portions thereof in tube 306, e.g., some extending to further deflectable zones at the distal end.
  • the distal portion has a deflectable tip section 301 that can be deflected by suitable longitudinal movements of the four steering wires 16(i).
  • adjacent steering wires 16(i) are separated by spacers 304(i), respectively.
  • Spacer 304(i) is located between steering wires 16(i) and 16(i+ 1) as seen in the circumferential direction.
  • Each spacer 304(i) may be made from the wall of tube 306 by providing the wall material between adjacent steering wires 16(i) with a suitable cutting pattern such that the resulting spacers 304(i) keep adjacent steering wires 16(i) at a desired tangential distance and at the same time have enough flexibility to allow deflection of the deflectable tip section 301.
  • the flexibility depends on the used cutting pattern. A cutting pattern that may be used is explained hereinafter with reference number 316(i) (cf. figure 5B).
  • Proximal to deflectable tip section 301 tube 306 has a body section 309 with three sub body sections 303, 305, 307.
  • sub body section 303 adjacent to deflectable tip section 301, all steering wires 16(i) are straight and running in parallel to one another and to central axis 29.
  • sub body section 305 adjacent to sub body section 303, all steering wires 16(i) are spiraling 180 degrees about central axis 29 in a parallel fashion.
  • Sub body section 307 extends proximally from sub body section 305. In sub body section 307 all steering wires 16(i) are straight and running in parallel to one another and to central axis 29.
  • all steering wires 16(i) may have an equal thickness and width. However, depending on the design thicknesses and/or widths of all steering wires 16(i) may differ per section 301, 303, 305, 307, provided they are flexible along the entire tip and body section length.
  • the position of sub body section 305 in which steering wires 16(i) are spiraling 180 degrees can be selected in dependence on the application of tube 306, i.e., knowledge of a curved channel in which tube 306 will be inserted. If the body section 309 is bent due to inserting tube 306 in a curved channel path length differences of wires 16(i) in sub body sections 303, 305, 307 caused by the bending are compensated due to the spiraling in sub body portion 305, as explained with reference to figures 2 A, 2B.
  • the tube 306 shown in figure 4 may have more than one sub body section 305 in which steering wires 16(i) are spiraling 180 degrees. They may be consecutive to one another or may be divided by sub body sections in which steering wires 16(i) are running straight in parallel to central axis 29 like in sub body section 307. The size of the pitch of the 180 degrees spiral depends on the application.
  • steering wires 16(i) are spiraling in the entire body section 309, i.e., sub body sections 303, 307 are absent.
  • the total spiraling in body section 309 between the distal end and the proximal end is an integer number of times 180 degrees.
  • body section 309 is connected or attached to a steering section - shown in figure 5C with reference number 354.
  • a steering section 354 is configured to move steering wires 16(i) in the longitudinal direction of the instrument such that together they may deflect deflectable tip section 301.
  • steering section 354 may be equipped with a bendable portion configured to translate a bending action into such movement of steering wires 16(i), as is known in the art, e.g. as shown in figures 3 A, 3B.
  • longitudinal movement of steering wires 16(i) may be controlled by directly controlling the longitudinal movement of steering wires 16(i) on an individual level, e.g. by means of a robotic steering section, as is also known in the art.
  • Figures 5A, 5B, 5C, 5D, 6 and 7 show an embodiment of a first aspect of the invention.
  • Figure 5 A shows an inner tube 330 coaxially surrounded by an intermediate tube 312.
  • An outer tube 340 - of which an example of the distal end and body section is shown in figure 7 - may be provided coaxially arranged with inner tube 330 and intermediate tube 312.
  • Figure 5B shows an enlarged view of an example of the distal end and body section of intermediate tube 312.
  • Figure 5C shows some components at the proximal end of the instrument in a cross sectional view.
  • Figure 6 shows an enlarged view of an example of the distal end and body section of inner tube 330.
  • Intermediate tube 312 of the embodiment of figure 5A again has a deflectable tip section 301 and a flexible body section 309 proximally from deflectable tip section 301.
  • the four steering wires 16(i) are equidistantly divided over the circumference of intermediate tube 312. All steering wires 16(i) are attached to ring-shaped end portion 314, e.g., by cutting them from the same wall of tube 312 as ring-shaped end portion 314.
  • the deflectable tip section 301 can be deflected by the four steering wires 16(i) in all directions in 3D space.
  • adjacent steering wires 16(i) are separated by spacers 316(i), respectively.
  • Spacer 316(i) is located between steering wires 16(i) and 16(i+l) as seen in the circumferential direction.
  • Each spacer 316(i) may be made from the wall of intermediate tube 312 by providing the wall material between adjacent steering wires 16(i) with a suitable cutting pattern such that the resulting spacers 316(i) keep adjacent steering wires 16(i) at a desired tangential distance and at the same time have enough flexibility to allow deflection of the deflectable tip section 301.
  • the flexibility depends on the used cutting pattern.
  • a cutting pattern of spacers 316(i) that may be used is explained hereinafter with reference to figure 5B.
  • spacers 316(i) have a spring shape design. In the tangential direction of tube 312 each spacer 316(i) extends from one steering wire 16(i) to adjacent steering wire 16(i+ 1) and has a tangential cross section equal to the tangential cross section of tube 312. In an embodiment, spacers 316(i) are not attached to steering wires 16(i). In the axial direction of tube 312 spacers 316(i) have a regular repetitive pattern like a block wave pattern, as shown. At its distal end, each spacer 316(i) may be attached to ring-shaped end portion 314. However, the repetitive pattern may be different, and more like a sinus wave pattern.
  • Such a repetitive pattern can be easily made by providing the wall of tube 312 with a suitable cutting pattern.
  • Such spacers 316(i) with a block wave pattern have the advantage of providing tip section 301 with a high flexibility in all directions and, at the same time, a high rigidity against torque because they fill up a lot of space between adjacent steering wires 16(i).
  • body section 309 adjacent to deflectable tip section 301, all steering wires 16(i) are running in parallel to one another in a continuous spiraling fashion.
  • steering wires 16(i) are spiraling an integer number of times 180 degrees in order to compensate path length differences between them inside body section 309 once body section 309 bends.
  • the total amount of spiraling depends on the design requirements: e.g., one may wish to have another amount of spiraling in order to deflect the tip section in a certain plane different from a plane of bending a steering section at the proximal end. Then, the spiraling may not fully compensate path length differences in the body section due to bending of the body section.
  • that may be compensated for by e.g. a Bowden cable arrangement at the proximal end of the instrument, e.g., one as explained and shown in WO2022260518A1.
  • all steering wires 16(i) may have an equal thickness and width. However, depending on the design thicknesses and/or widths of all steering wires 16(i) may differ per section 301, 309 provided they are flexible along the entire body section length.
  • tube 312 is provided with solid fill spacers 318(i) of which, in an embodiment, the distal end is attached to one of the spacers 316(i).
  • Each solid fill spacer 318(i) is located between adjacent steering wires 16(i) and 16(i+ 1) and is, in an embodiment, attached to spacer 316(i) inside deflectable tip section 301.
  • Solid fill spacer 318(i) is designed to keep adjacent steering wires 16(i), 16(i+l) apart from one another in body section 309 at a desired tangential distance.
  • Reference number 319(i) refers to a location on solid fill spacer 318(i) where a portion 350(i) of an outer tube 340 and/or of inner tube 330 is attached to solid fill spacer 318(i) (cf. hereinafter with reference to figure 7).
  • a pair of spacers 320a(i), 320b(i) extends in the body section 309 from solid fill spacer 318(i) in the proximal direction of tube 312.
  • the notation “ 16(i), 16(i+l)” includes the adjacent pair “16(1), 16(1)”.
  • Each longitudinal force isolation element 322(k) is, at its distal end, attached to solid fill spacer 318(i).
  • longitudinal force isolation element 322(k) may extend into solid fill spacer 318(i) by providing solid fill spacer 318(i) with two longitudinal slits. This provides body section 309 with more flexibility in the area of solid fill spacers 318(i).
  • an embodiment is shown having the same number of longitudinal force isolation elements as the number of steering wires 16(i). However, that is not strictly necessary. E.g., there may be more or less than one longitudinal force isolation element 322(k) between two adjacent steering wires 16(i). Each longitudinal force isolation element 322(k) is shown to have equal tangential distances to adjacently located steering wires 16(i), 16(i+l ). This is not strictly necessary.
  • Spacer pairs 320a(i), 320b(i) are designed to keep adjacent steering wires at a predetermined distance from one another together with the material of longitudinal force isolation element 322(k) and still allow bending of body section 309. Spacer pairs 320a(i), 320b(i) may be made from the wall of tube 306 by providing the wall with a suitable cutting pattern 310.
  • cutting pattern 310 may comprise a plurality of slit sets in which each slit set comprises a few parallel slits extending tangentially from a first side of one spacer of the spacer pair 320a(i), 320b(i) towards but not entirely until a second side of that one spacer, as well as a few more parallel slits extending tangentially from the second side of the one spacer of the spacer pair 320a(i), 320b(i) towards but not entirely until the first side of that one spacer.
  • the flexibility of body section 309 may be less than the flexibility of deflectable tip section 301.
  • To provide tube 306 with more rigidity against torque spacer pairs 320(i) may be provided with one or more through holes 324, each one designed to receive a radially bent lip from inner tube 330 and/or from outer tube 340.
  • Figure 7 shows such lips 352 in outer tube 340. Once a lip 352 is bent into through hole 324 spacer pairs 320a(i), 320b(i) will have less room for tangential and axial movement relative to inner tube 330 or outer tube 340 from which lip 352 extends.
  • spacer pairs 320a(i), 320b(i) relative to inner tube 330 and/or outer tube 340 are blocked as much as possible by these lips 352, whereas axial movement of spacer pairs 320a(i), 320b(i) relative to inner tube 330 and outer tube 340 is allowed until a certain maximum amount.
  • longitudinal force isolation elements 322(k) are not attached to adjacent spacer pairs 320a(i), 320b(i) which are also not attached to adjacent steering wires 16(i).
  • longitudinal force isolation elements 322(k) may have an equal thickness and width as steering wires 16(i). Together with steering wires 16(i) and spacer pairs 320a(i), 320b(i) they should provide body section 309 with the required flexibility in order to allow inserting into a curved channel.
  • Each longitudinal force isolation element 322(k) has a proximal end located at the proximal end of the body section 309. Proximal ends of longitudinal force isolation elements 322(k) are each attached to at least one of a proximal portion of outer tube 340 or a proximal portion of inner tube 330.
  • FIG 5C shows a schematic longitudinal cross section of the proximal end of a bendable body portion 356 of the invasive instrument.
  • the invasive instrument comprises inner tube 330, intermediate tube 312 and outer tube 340.
  • the cross section of figure 5C shows two opposite longitudinal force isolation elements 322(1), 322(3), respectively.
  • attachments 326(k) for all longitudinal force isolation elements 322(k) may be made by (laser) melting or any other suitable method.
  • Steering wires 16(i) are extending proximally from the proximal end of body portion 356 to a steering unit 354 of the invasive instrument, which steering unit 354 is schematically indicated as a box in figure 5C.
  • a steering unit 354 may be implemented as a proximal bendable unit, like the steering unit 244 schematically shown in figure 3A or as a robotic instrument.
  • the steering wires 16(i) may be configured such that they can be easily coupled with or decoupled from a suitable driving mechanism of a manually operable steering handle or a robotic instrument, e.g., one as shown in W02020218920, W020202 18921 or NL2030160B1.
  • Steering unit 354 may be configured to translate a bending action or longitudinal action of one or more driving mechanisms into longitudinal movement of steering wires 16(i).
  • FIG. 72 shows a portion of inner tube 330 at the distal side of the instrument.
  • Inner tube 330 has a ring-shaped end section 332, a flexible tip section 334 proximal from ring-shaped end section 332, a rigid, ring-shaped section 336 proximal from flexible tip section 334 and a bendable body section 338 proximal from ring-shaped section 336.
  • ring-shaped end section 332 is axially aligned with ring-shaped end portion 3144
  • flexible tip section 334 is axially aligned with deflectable tip section 301
  • rigid, ring-shaped section 336 is axially aligned with solid fill spacers 318(i)
  • bendable body section 338 is axially aligned with flexible spacer pairs 320a(i), 320b(i).
  • the flexibility of flexible tip section 334 may be higher than the flexibility of bendable body section 338.
  • Flexible tip section 334 is provided with a desired flexibility by making a suitable cutting pattern in inner tube 330.
  • This may be any cutting pattern known in the art or still to be developed.
  • Bendable body section 338 is provided with a desired flexibility by making a suitable cutting pattern in inner tube 330.
  • This may be any cutting pattern known in the art or still to be developed.
  • An example may be the cutting pattern as shown with reference number 360 in figure 7 and as explained in detail with reference to hinges 407(j ) in figures 9-12C.
  • Rigid, ring-shaped section 336 may be attached to all solid fill spacers 318(i) in intermediate tube 312.
  • Figure 7 shows a portion 358 of the invasive instrument with coaxially arranged inner tube 330, intermediate tube 312 and outer tube 340.
  • the figure shows details of outer tube 340.
  • the figure also shows tip portion 358 and body portion 356.
  • the body portion 356, at its proximal end, is connected or attached to steering unit 354 (cf. figure 5C) or configured to be coupled to steering unit 354.
  • Outer tube 340 has a ring-shaped end section 342, a flexible tip section 344 proximal from ring-shaped end section 342, a rigid, ring-shaped section 346 proximal from flexible tip section 344 and a bendable body section 348 proximal from ring-shaped section 346.
  • ring-shaped end section 342 is axially aligned with ring-shaped end sections 314 and 332
  • flexible tip section 344 is axially aligned with flexible tip section 334 and deflectable tip section 301
  • rigid, ring-shaped section 346 is axially aligned with ring-shape section 336 and solid fill spacers 318(i)
  • bendable body section 348 is axially aligned with bendable body section 338 and flexible spacer pairs 320a(i), 320b(i).
  • the flexibility of flexible tip section 344 may be higher than the flexibility of bendable body section 348.
  • Flexible tip section 344 is provided with a desired flexibility by making a suitable cutting pattern in outer tube 340.
  • This may be any cutting pattern known in the art or still to be developed.
  • An example may be the cutting pattern shown with reference number 360 in figure 7 and as explained in detail with reference to hinges 407(j ) in figures 9-12C.
  • Bendable body section 348 is provided with a desired flexibility by making a suitable cutting pattern in outer tube 340. This may be any cutting pattern known in the art or still to be developed. It may be the same cutting pattern as applied in flexible tip section 344.
  • Rigid, ring-shaped section 346 may be attached to all solid fill spacers 318(i) in intermediate tube 312 at locations 350(j). I.e., each one of solid fill spacers 318(i) in intermediate tube 312 is attached to at least one of ring-shaped section 336 of inner tube 330 or ring-shaped section 346 of outer tube 340. This may be done by (laser) welding or any other known attachment technique. To that end, outer tube 340 may have small lips at locations 350(j ) which may be melted by a laser beam such that molten lip material is welded to the solid fill spacers 318(i).
  • FIG. 7 also shows that body section 348 is provided with one or more lips 352. Once intermediate tube 312 (and possibly also inner tube 330) each one of these lips 352 is bent inwards such each one is inserted in one of the through holes 324 in spacer pairs 320a(i), 320b(i). Once being inside these through holes 324 they will limit tangential and axial movement of spacer pairs 320a(i), 320b(i) relative to outer tube 340.
  • force isolation elements 322(k) may themselves be provided with through holes 325, as shown in figure 5D, through which lips of inner tube 330 and/or outer tube 340 are inserted, like lips 352 shown in figure 7. Then, tangential movement of force isolation elements 322(k) relative to inner tube 330 and/or outer tube 340 is blocked as much as possible by these lips, whereas axial movement of force isolation elements 322(k) relative to inner tube 330 and outer tube 340 is allowed until a certain maximum amount.
  • such through holes 325 are configured such as to provide force isolation elements 322(k) with a certain required flexibility to allow body section 309 to be bendable and yet with enough longitudinal stiffness. I.e., a desired flexibility of the force isolation elements 322(k) can be achieved by a suitable choice of the axial length and/or the tangential width of the through holes 325.
  • Figure 5E shows an alternative to the embodiment of figure 5D in which the through holes have the form of long slots 325, such that one can also say that the force isolation element 322(k) is split into two parallel force isolation sub-elements 322(k,l) and 322(k,2) which are attached to one another by one or more small bridges 323 extending in a tangential direction, or a small angle thereto.
  • the length of the slots 325 may all be equal. However, they may be designed differently such that the bending stiffness of the body section of the instrument differs in dependence on the axial location.
  • bending stiffness of the body shown in figure 5E will, at all locations, strongly depend on those portions 322(k, 1), 322(k,2), 323 of force isolation elements of which the tangential direction extends at a small angle relative to the bending direction. Those portions 322(k,l), 322(k,2), 323 of force isolation elements that do not bend at all or bend in a direction at an angle closer to 90 degrees relative to the bending direction of the instrument will influence the bending stiffness much less provided the thickness of the force isolation elements is less than their width.
  • the actual bending stiffness of an axial location of the body section depends on if there is a slot 325 or a bridge 323 on that axial location. If there is a bridge 323, the bending stiffness is larger than if there is a slot 325.
  • a force isolation 322(k) may be split into more than two force isolation sub-elements.
  • the bending stiffness of the body section depends on the widths wl, w2 - as measured in the tangential direction - of the two parallel force isolation sub-elements 322(k,l), 322(k,2), cf. figure 5E.
  • These individual widths wl, w2 may be equal but may also be different.
  • these widths wl, w2 may vary in dependence on the position as measured in the axial direction.
  • the actual bending stiffness also depends on the thickness of the force isolation elements 322(k,l), 322(k,2).
  • the bending stiffness of force isolation element 322(k) at axial locations of slots 325 depends on (wl+w2+w3) / 3-w3 / 3, where wl is the width of force isolation sub-element 322(k,l) and w2 is the width of force isolation sub-element 322(k,2) and w3 is the width of the slot or bridge.
  • the bending stiffness of force isolation element 322(k) at axial locations of bridges 323 depends on (wl+w2+w3) / 3, where wl is the width of force isolation sub-element 322(k,l), w2 is the width of force isolation subelement 322(k,2), and w3 is the width of bridge 323.
  • FIG. 90 An alternative to the design of figure 5D is shown in figure 5F. Instead of being attached to one another by one or more bridges 323, in the embodiment of figure 5E the two adjacent force isolation sub-elements 522(k,l), 522(k,2) are separated by one or more spacer elements 327. Consecutive spacer elements 327 may be altematingly attached to one of the two force isolation sub-elements 322(k,l), 322(k,2) and only touching the other one. Slots 325 are again present between consecutive spacer elements 327.
  • the bending stiffness of force isolation element 322(k) at axial locations of slots 325 depends on l 3 + w2 3, where wl is the width of force isolation subelement 322(k,l) and w2 is the width of force isolation sub-element 322(k,2).
  • the bending stiffness of force isolation element 322(k) at axial locations of a spacer element 327 attached to force isolation sub-element 322(k,l) or 322(k,2), respectively depends on w 2 ⁇ 3 +(wl+w 3) ⁇ 3 or l 3+( 2+ 3) 3, respectively, where wl is the width of force isolation subelement 322(k,l), 2 is the width of force isolation sub-element 322(k,2), and w3 is the width of spacer element 327. So, at axial locations of spacer elements 327, the force isolation element 322(k) of the embodiment of figure 5F has a lower bending stiffness than the force isolation element 322(k) of figure 5E.
  • spacer pairs 320a(i), 320b(i) there are no spacer pairs 320a(i), 320b(i). I.e., one or both of the spacer pairs 320a(i), 320b(i) may be left out and force isolation elements 322(k) may be designed to act also as tangential spacers between adjacent steering wires 16(i).
  • Tangential movement of these force isolation elements 322(k,l), 322(k,2) acting as tangential spacers may be blocked relative to a tube inside and/or outside the tube in which the force isolation elements 322(k,l), 322(k,2) are manufactured, e.g., by bending one or more lips 352 from such outer and/or inner tube inside slots 325.
  • Such lips 352 may have a same width - as seen in the tangential direction - as slots 325 such that they are clamped in slots 325 after being bent into them. They may also be slightly less wide than slot 325 such as to allow such lips 352 to slide inside slot 325 in an axial direction which may be necessary when path length variations inside body section 309 occur.
  • FIG. 5G shows a prior art steerable tube as known from W02009/098244.
  • the figure shows a tube 500 having a distal end (left) and a proximal end (right).
  • the tube has a plurality of steering wires 502(i) cut from the tube 500 and extending from the proximal end to the distal end.
  • each steering wire 502(i) is attached to a proximal ring 508p by a flexible steering wire portion 504(i).
  • each steering wire 502(i) is attached to a distal ring 508d by a flexible steering wire portion 506(i).
  • Adjacent steering wires 502(i) are separated by a spacer element having a distal spacer element portion 510d, middle spacer element portion 510m, and a proximal spacer element portion 510p.
  • the distal and proximal spacer element portions 510d and 510p, respectively, are attached to distal ring 508d and proximal ring 508p, respectively.
  • the middle spacer element portion 510m is bend-resistive meaning it cannot or can hardly bend. Both distal and proximal spacer element portions 510d and 51 Op have a wavy pattern.
  • the present invention makes it possible to implement spacers between adjacent steering wires 16(i) as an uninterrupted wire in instruments with a flexible body section that should be guided through a tortuous path, e.g. through blood vessels or intestines in a (human) body.
  • a tortuous path e.g. through blood vessels or intestines in a (human) body.
  • path length variations in the body section can be compensated for.
  • at least a 360 degrees spiral is needed to compensate the length difference for bending a passive shaft with a continuous radius over its full length. Controlling the degree of spiralisation can be used to control the instrument bending characteristics.
  • the spiraling as measured between the distal end and the proximal end is a multiple of 360 degrees or a multiple of at least 180 degrees if one only wants to compensate the length difference in one plane.
  • FIG 5H An implementation is shown in figure 5H which is identical to figure 5E be it that an “s” has been added to all reference numbers relating to the force isolation elements: they are no longer attached at their both ends to a tube inside and/or outside the tube shown in figure 5H - note that they may still be attached to such an inner and/or outer tube but only at one end. So, they don’t function as force isolation elements anymore but only as uninterrupted spacer wires 322s(k) between adjacent steering wires 16(i).
  • Such uninterrupted spacer wires 322(k) may be split in two or more spacer sub-wires 322s(k,l), 322s(k,2) separated by one or more slots 325s and attached by one or more bridges 323s, as shown in figure 5H.
  • spacer sub-wires 322s(k,l) may be split in two or more spacer sub-wires 322s(k,l), 322s(k,2) separated by one or more slots 325s and attached by one or more bridges 323s, as shown in figure 5H.
  • other implementations are possible, e.g. the one shown in figure 5F.
  • spacer wires 322s(k) can also be applied between other elements than steering wires 16(i). I.e., such spacer wires 322s(k) can be applied between a first portion of the tube 306 and a second portion of the tube 306.
  • the first portion may be a steering wire 16(i) but may also be a control wire manufactured from the tube 306 by a suitable cutting (or other material removing) pattern and configured to control a function of the instrument of which the tube 306 is a part, like a lock/unlock function or any other function as explained in detail in WO2023/287289 of the present applicant.
  • figure 5H may be defined as follows:
  • a steerable tube (312) comprising a deflectable tip section (301) at a distal side and a bendable body section (309) proximal from the deflectable tip section (301), one or more steering wires (16(i)) configured to deflect the deflectable tip section (301) and spiraling in a circumferential direction of the steerable instrument in at least a portion of the flexible body section (309), and one or more spacer wires (322s(k)) providing a tangential spacer function between a first portion of the tube (312) and a second portion of the tube (312), the one or more spacer wires (322s(k)) extending in at least the entire bendable body section (309) and spiraling in the flexible body section (309) like the one or more steering wires (16(i)).
  • FIG. 5 A, 5B, 5C, 5D, 6 and 7 is based on a continuous spiraling of all steering wires a positive integer number of times 180 degrees about intermediate tube 312.
  • a discrete system may be used like the one shown in figure 4 in which the body section is divided in sub-body sections and the 180 degrees spiraling is only applied in some of the sub-body sections whereas the other sub-body sections comprise straight steering wires running in parallel to one another and to the central axis.
  • the total amount of spiraling may differ from a positive integer number of times 180 degrees about intermediate tube 312, e.g., when there are specific requirements as to the plane in which the tip section should be deflected.
  • the path length compensation may not be perfect but may be compensated for by implementing an extra Bowden cable arrangement for both the steering wires 16(i) and the force isolation elements 322(k), e.g., at the proximal end of the instrument, as schematically indicated with a box 355 in figure 5C.
  • One may, e.g., apply one of the Bowden cable arrangements as shown and explained in WO2022260518A1.
  • an extra “coil pipe” or Bowden cable section proximal to the proximal end of the body section may be applied, as schematically indicated with reference number 355 in figure 5C.
  • Bowden cable section 355 is drawn inside steering section 354, however, it can, alternatively, be present between the proximal end of body section 356 and steering section 354. Examples of such coil pipe or Bowden cable sections entirely manufactured by (laser) cutting components from tubes are disclosed in WO2022260518A1.
  • the embodiment of figures 5 A, 5B, 5C, 5D, 6 and 7 shows three tubes in which all components are made by making suitable cutting patterns in them.
  • the invention is not limited to applications with three tubes.
  • the instrument may have more tubes.
  • Steering wires 16(i) may have mutually connected or attached separate portions made from the tube material of two or more such tubes, as explained in WO2017213491.
  • the instrument may have other longitudinal elements made from the tube material and configured to perform another function than steering the tip or isolating forces, e.g., to lock or unlock a curvature of a portion of the body portion, as explained in WO2023287289.
  • the invasive instrument is shown with one deflectable tip portion, the invention is not restricted to this. I.e., the invasive instrument may have multiple deflectable tip portions.
  • All tubes 330, 312, 340 may have one of a circular, oval, elliptical or rectangular cross section.
  • All tubes 330, 312, 340 may, at least in part, be made of at least one of the following set of materials: a biocompatible polymeric material, including polyurethane, polyethylene or polypropylene, stainless steel, cobalt-chromium, shape memory alloy such as Nitinol®, plastic, polymer, composites, or other curable material.
  • a biocompatible polymeric material including polyurethane, polyethylene or polypropylene, stainless steel, cobalt-chromium, shape memory alloy such as Nitinol®, plastic, polymer, composites, or other curable material.
  • components of the tubes result from a material removal technique applied on a wall of the at least one tube 312 to make suitable cutting patterns, including at least one of photochemical etching, deep pressing, chipping techniques, laser cutting or water cutting.
  • the material removal means can be a laser beam that melts and evaporates material or a waterjet cutting beam and this beam can have a width of 0.01 to 2.00 mm, more typically for this application, between 0.015 and 0.04mm.
  • the wall thickness of tubes depend on their application.
  • the wall thickness may be in a range of 0.03-2.0 mm, preferably 0.03-1.0 mm, more preferably 0.05-0.5 mm, and most preferably 0.08-0.4 mm.
  • the diameter of the tubes depend on their application.
  • the diameter may be in a range of 0.5-20 mm, preferably 0.5-10 mm, more preferably 0.5-6 mm.
  • the radial play between adjacent tubes may be in range of 0.01 - 0.3 mm.
  • the invention relates to a steerable instrument with a deflectable tip portion (358) at a distal side and a bendable body portion (356) proximal from the tip portion (358), the steerable instrument including at least one tube (312) and at least one of an inner tube (330) inside the at least one tube (312) or an outer tube (340) outside the at least one tube (312), one or more steering wires (16(i)) in the at least one tube (312), the at least one tube (312) including a deflectable tip section (301) in the deflectable tip portion (358) and a bendable body section (309) in the bendable body portion (356), the one or more steering wires (16(i)) spiraling in a circumferential direction of the steerable instrument in at least a portion of the flexible body section (309), the steerable instrument also including one or more longitudinal force isolation elements (322(k)) in the at least one tube (312), the longitudinal force isolation elements (322(k)) being arranged in parallel to the one or
  • the one or more steering wires (16(i)) may be spiraling 180 degrees in the circumferential direction of the steerable instrument in at least one portion of the flexible body section (309) in order to provide path length compensation caused by bending of the at least one portion of the flexible body section (309).
  • the one or more steering wires (16(i)) may be spiraling a number of times 180 degrees in the circumferential direction of the steerable instrument in an equal number of portions of the flexible body section (309) in order to provide path length compensation caused by bending of one or more of the number of portions of the flexible body section (309).
  • the one or more steering wires (16(i)) may be spiraling in a continuous fashion along the entire flexible body section (309).
  • multiple steering wires (16(i)) may be arranged at equidistant locations in the tangential direction of the at least one tube (312) in a parallel fashion, whereas the at least one tube may have multiple longitudinal force isolation elements (322(k)), at least one longitudinal force isolation element (322(k)) being located between two adjacent steering wires (16(i), 16(i+l)).
  • Each longitudinal force isolation element (322(k)) may be attached to a spacer (318(i)) configured to keep two adjacent steering wires (16(i)) at a desired tangential distance and if the steerable instrument includes the outer tube (340), the distal end of each longitudinal force isolation element (322(k)) is attached to the outer tube (340) via an attachment of the spacer (318(i)) to the outer tube (340), or if the steerable instrument includes the inner tube (330), the distal end of each longitudinal force isolation element (322(k)) is attached to the inner tube (330) via an attachment of the spacer (318(i)) to the inner tube (330), or if the steerable instrument includes the inner tube (330) and the outer tube (340), the distal end of each longitudinal force isolation element (322(k)) is attached to at least one of the inner tube (330) or the outer tube (340) via an attachment of the spacer (318(i)) to at least one of the inner tube (330) or the outer tube (
  • [ 122 ] There may be one longitudinal force isolation element (322(k)) arranged between and at equal distances from two adjacent steering wires (16(i), 16(i+l)).
  • a pair of flexile spacers may be provided between two adjacent steering wires (16(i), 16(i+l)) proximally from the spacer (318(i), a first one of the pair of flexile spacers (320a(i), 320b(i)) being located between the single longitudinal force isolation element (322(k)) and a first one of the two adjacent steering wires (16(i), 16(i+l )) and a second one of the pair of flexile spacers (320a(i), 320b(i)) being located between the single longitudinal force isolation element (322(k)) and a second one of the two adjacent steering wires (16(i), 16(i+l)).
  • the at least one tube (312) may include a ring-shaped end portion (314) at its distal end to which the one or more steering wires (16(i)) are attached.
  • At least one of the longitudinal force isolation elements (322(k)) may be provided with through holes (325), a lip extending from either the inner tube (330) or the outer tube (340), respectively, through the through holes (325), the lips and through holes (325) being configured to block tangential movement but allow axial movement of the longitudinal force isolation elements (322(k)) relative to the inner tube (330) or outer tube (340), respectively.
  • the tip section of the at least one tube (312) may include a spacer (316(i)) between each two adjacent steering wires (16(i), 16(i+l)), each spacer (316(i)) having the form of a regular wave pattern like a block wave or sine wave pattern.
  • the steerable instrument may have a Bowden cable section (355) at a proximal side of a proximal end of the body section (356) to compensate offsets in path length differences of the steering wires (16(i)).
  • the invention relates to a hinge structure, i.e., the one shown with reference number 360 in figure 7.
  • a hinge structure i.e., the one shown with reference number 360 in figure 7.
  • first figure 8 will be described which is a copy of figure 9 of WO2018067004.
  • FIG. 8 shows a hinge structure 402 in a tube 400.
  • the hinge structure 402 is shown to have two identical hinges 401(1), 401(2) be it that these identical hinges 401(1), 401(2) are rotated 90 degrees in the tangential direction of tube 400.
  • Like reference numbers without the “(l)”or “(2)” refer to the same components of the respective hinges 401(1), 401(2).
  • Hinge 401(1) is made by a cutting pattern in tube 400.
  • the cutting pattern defines a distal, i.e. left hand, side and a proximal, i.e. right hand, side of hinge 401(1).
  • the distal side and proximal side are connected to one another by two identical longitudinal bridges, one being shown with reference number 404(1). The other one is not visible in figure 8 but located 180 degrees rotated in the tangential direction of tube 400 relative to longitudinal bridge 404(1).
  • Longitudinal bridge 404(1) is a strip made in the wall material of tube 400 by two parallel longitudinal slits 406(1), 408(2) extending in the longitudinal direction of tube 400.
  • the two parallel longitudinal slits 406(1), 408(2) have the same length.
  • Longitudinal bridge 404(1) has a center of rotation 426(1).
  • a first tangential slit 410(1) extends from longitudinal slit 406(1) in a first tangential direction of tube 400.
  • First tangential slit 410(1) is connected to longitudinal slit 406(1) at a center location of longitudinal slit 406(1).
  • First tangential slit 410(1) covers a tangential range of less than 180 degrees.
  • First tangential slit 410(1) is interrupted by a first lip shaped portion 412(1) of the distal side of hinge 401(1).
  • First lip shaped portion 412(1) extends into the longitudinal direction of tube 400 in a first opening 414(1) in the proximal side of hinge 401(1).
  • First lip shaped portion 412(1) and opening 414(1) are separated by a small slit 428(1) such that the outside surface of first lip shaped portion 412(1) matches the inside surface of first opening 414(1), and first lip shaped portion 412(1) can move freely inside first opening 414(1).
  • a second tangential slit 418(1) extends from longitudinal slit 408(1) in a second tangential direction of tube 400.
  • the second tangential direction is opposite to the first tangential direction.
  • Second tangential slit 410(1) is connected to longitudinal slit 408(1) at a center location of longitudinal slit 408(1).
  • Second tangential slit 418(1) covers a tangential range of less than 180 degrees.
  • Second tangential slit 418(1) is interrupted by a lip shaped portion 420(1) of the distal side of hinge 401(1). Lip shaped portion 420(1) extends into the longitudinal direction of tube 400 in an opening 422(1) in the proximal side of hinge 401(1).
  • Lip shaped portion 420(1) and opening 422(1) are separated by a small slit 430(1) such that the outside surface of lip shaped portion 420(1) matches the inside surface of opening 422(1), and lip shaped portion 420(1) can move freely inside opening 422(1).
  • Lip shaped portion 412(1) has a first curved side extending along a portion of a first circle Cl having its center coinciding with center of rotation 426(1) of longitudinal bridge 404(1).
  • Lip shaped portion 412(1) has a second curved side, opposite to the first curved side, extending along a portion of a second circle C2 having its center coinciding with center of rotation 426(1) of longitudinal bridge 404(1) as well.
  • Lip shaped portion 420(1) has a third curved side extending along a portion of first circle Cl and a fourth curved side, opposite to the third curved side, extending along a portion of second circle C2.
  • Longitudinal bridge 404(1), longitudinal slits 406(1), 408(1), tangential slits 410(1), 418(1), lip shaped portion 412(1), 420(1), and openings 414(1), 422(1) define a first cutting pattern in tube 400.
  • a second cutting pattern, identical to the first cutting pattern, is present on 180 degrees rotated locations in tube 400.
  • Figure 8 shows an end portion of a tangential slit 416(1) of the second cutting pattern which corresponds to tangential slit 418(1) of the first cutting pattern, and an end portion of a tangential slit 424(1) of the second cutting pattern which corresponds to tangential slit 410(1) of the first cutting pattern.
  • tangential slits 416(1) and 424(1) extend in the tangential direction over a length shorter than 180 degrees.
  • Tangential slit 410(1) of the first cutting pattern and tangential slit 416(1) of the second cutting pattern do not coincide in any location but are overlapping in the tangential direction such that a tangential bridge 403(1) extending in the tangential direction is present between them.
  • Tangential bridge 403(1) is at one end attached to the distal side of hinge 401(1) and at its other end attached to the proximal side of hinge 401(1).
  • Tangential slit 418(1) of the first cutting pattern and tangential slit 424(1) of the second cutting pattern do not coincide in any location but are overlapping in the tangential direction such that a tangential bridge 405(1) extending in the tangential direction is present between them.
  • Tangential bridge 405(1) is at one end attached to the distal side of hinge 401(1) and at its other end attached to the proximal side of hinge 401(1).
  • the first and second cutting patterns allow bending of tube 400 by rotating the distal and proximal sides of hinge 401(1) in opposite directions in a first plane perpendicular to a virtual line through center of rotation 426(1) of longitudinal bridge 404(1) and the center of the longitudinal bridge of the second cutting pattern on the opposite side of tube 400.
  • Lip shaped portions 412(1), 420(1) inside openings 414(1), 422(1) - and their non-visible counterparts of the second cutting pattern - block relative tangential rotation between the distal side and proximal side of hinge 401(1) after a certain minimum amount of relative tangential rotation as allowed by the slit between lip shaped portions 412(1) and 420(1), respectively, and openings 414(1) and 422(1), respectively.
  • lip shaped portions 412(1), 420(1) and their non-visible counterparts of the second cutting pattern further counteract potential damaging effects of torsional forces.
  • FIG. 8 shows some components of hinge 401(2) which is identical to hinge 401(1) be it 90 degrees rotated relative to hinge 401(1).
  • Tube 400 has a distal portion located at the distal side of hinge 401(2) and a proximal portion located at the proximal side of hinge 401(2).
  • Hinge 401(2) also has two opposite longitudinal bridges with respective centers. Therefore, hinge 401(2) allows rotation of these distal and proximal portions relative to one another in a second plane which is perpendicular to a virtual line through these two centers of these two longitudinal bridges.
  • the second plane is perpendicular to the above mentioned first plane, allowing the hinge structure 402 comprising hinges 401(1), 401(2) to be bent in three dimensions.
  • Hinge structure 402 as shown may be repeated multiple times in tube 400 such that tube 400 can bend in three dimensions along a longer length of tube 400.
  • Lip shaped portions 412(1), 420(1), 412(2), and 420(2) should have a certain size, especially in the longitudinal direction, to be effective and not to be damaged themselves too easily due to torsional forces. Therefore, they may limit further miniaturization of tubes 400.
  • the present aspect of the invention addresses this problem, as explained with reference to figures 9-12C.
  • FIG 9 which shows a side view of a first hinge 407(1) of a hinge structure 360 of the invention
  • the same reference numbers as used in earlier figures have been used to refer to the same components.
  • this hinge structure may be applied in any bendable tube and not only in a device shown in figures 1 A-7.
  • Such a bendable tube may, e.g., be part of any type of bendable invasive instrument e.g. for endoscopic applications.
  • Such bendable invasive instruments may have one or more deflectable tips which can be deflected by a suitable steering section 354 at the proximal end.
  • Steering wires may be strips resulting from making suitable cutting patterns in one or more coaxial tubes or may be cables. They may be straight or spiraling in the instrument.
  • tangential slit 410(1) comprises tangential slit portions 410a(l), 410b(l), and tangential slit 418(1) comprises tangential slit portions 418a(l), 418b(l).
  • Tangential slit portions 410a(l), 410b(l) are connected to one another and have respective ends 409(1), 419(1). Tangential slit portions 410a(l), 410b(l) extend from end 409(1) to end 419(1) partly surrounding the tube 400 in tangential direction E.
  • tangential slit portion 410a(l) is tapering towards end 409(1), and tangential slit portion 410b(l) is tapering towards end 419(1).
  • tangential slit portions 410a(l), 410b(l) may have a single width along their lengths, which may be the same for both.
  • Tangential slit portions 418a(l), 418b(l) are connected to one another and have respective ends 411(1), 413(1). Tangential slit portions 418a(l), 418b(l) extend from end 411(1) to the end 413(1) partly surrounding the tube in tangential direction F. In an embodiment, tangential slit portion 418a(l) is tapering towards end 411(1), and tangential slit portion 418b(l) is tapering towards end 413(1).
  • the tapering of tangential slit portion 410a(l) may be equal to the tapering of tangential slit portion 418a(l) and the tapering of tangential slit portion 410b(l) may be equal to the tapering of tangential slit portion 418b(l).
  • tangential slit portions 418a(l), 418b(l) may have a single width along their lengths, which may be the same for both and the same as the ones of those of tangential slit portions 410a(l), 410b(l).
  • the tangential direction E and the tangential direction F are opposite directions.
  • the end 409(1) and the end 411(1) are located on a same circumference in a plane perpendicular to the central axis 29 which extends in the longitudinal direction of the tube 400.
  • the end 409(1) and the end 411(1) are arranged facing each other.
  • End 409(1) coincides with the center location of longitudinal slit 406(1) and end 411(1) coincides with the center location of longitudinal slit 408(1) which both extend longitudinally along the tube 400 such that they define longitudinal sides of longitudinal bridge 404(1). Ends 409(1) and 411(1), respectively, may coincide with another portion of longitudinal slits 406(1) and 408(1), respectively.
  • both longitudinal slits 406(1) and 408(1) may be curved in opposite directions such that longitudinal bridge 404(1) has a smallest width t at a certain location which may be in the center of the total length of longitudinal bridge 404(1).
  • Width t may have a value between 0.05-0.3mm.
  • Longitudinal slit 406(1) has a length LB1 which may have a value between 0.3-4mm.
  • Longitudinal slit 408(1) has a length LB2 which may have a value between 0.3- 4mm.
  • Length LB1 may be equal to length LB2.
  • the shape of longitudinal slit 406(1) may coincide with a portion of a first circle CB1 having a first radius of 0.5-10mm.
  • the shape of longitudinal slit 408(1) may coincide with a portion of a second circle CB2 having a second radius of 0.5-10mm.
  • the radius of second circle CB2 may be equal to the radius of first circle CB1.
  • the values provided here for width /, lengths LB1 and LB2, and radius of CB1 and CB2 may be applicable for tube instruments with a radius between l-15mm and a wall thickness between 0.08-2mm.
  • longitudinal bridge 404(1) has a better defined center of rotation 426(1) in its center about which portions of tube 400 located at longitudinally opposite sides of bridge 404(1) may bend than if longitudinal bridge 404(1) has an equal width along its length, thus providing the instrument with more accuracy in movement.
  • the tangential directions E and F are located in a plane perpendicular to central axis 29 of the tube 400.
  • direction E may form an angle with such a plane.
  • the tangential direction F may also form an angle with such a plane. These angles may be between -20° and + 20°, or - 10° and +10° degrees, more preferably between -8° and +8° degrees. They may have the same value.
  • Tangential slit portions 410a(l) and 410b(l) are located at longitudinally shifted positions and, respectively, connected at opposite ends of a longitudinal channel 425(1) which is extending in the longitudinal direction of the instrument 400 such as to form a tangential shoulder structure.
  • Side walls of longitudinal channel 425(1) are defined by walls 442(1), 440(1) which are extending in the longitudinal direction of the instrument between tangential slit portions 410a(l), 410b(l).
  • walls 442(1), 440(1) are straight. However, they may have a curvature coinciding with a portion of a circle having center of rotation 426(1) as its center to align movement during rotation of the hinge with the center of rotation 426(1).
  • walls 442(1), 440(1) are partly overlapping as seen in the tangential direction of the instrument. The amount of overlap may be between 0.05 - 3mm.
  • Tangential slit portions 418a(l) and 418b(l) are located at longitudinally shifted positions and, respectively, connected at opposite ends of a longitudinal channel 427(1) which is extending in the longitudinal direction of the instrument 400 such as to form a tangential shoulder structure.
  • Side walls of longitudinal channel 427(1) are defined by walls 446(1), 444(1) which are extending in the longitudinal direction of the instrument between tangential slit portions 418a(l), 418b(l).
  • walls 446(1), 444(1) are straight. However, they may have a curvature coinciding with a portion of a circle having center of rotation 426(1) as its center to align movement during rotation of the hinge with the center of rotation 426(1). In the non-bent position of the distal and proximal sides of the hinge, walls 446(1), 444(1) are partly overlapping as seen in the tangential direction of the instrument. The amount of overlap may be between 0.05 - 3mm.
  • the instrument 400 may be rotated in its tangential direction, e.g., by providing a rotational force to the proximal end of the instrument 400. Then, the instrument may be located inside a channel, e.g., intestines of a living being, a blood vessel, or esophagus or the like. Rotating the instrument inside such a channel may cause friction between the channel wall and the instrument 400 resulting in torsion forces on the instrument.
  • a channel e.g., intestines of a living being, a blood vessel, or esophagus or the like. Rotating the instrument inside such a channel may cause friction between the channel wall and the instrument 400 resulting in torsion forces on the instrument.
  • a hinge structure as shown in figures 9 and 10 limits torsion response loss because, during rotation, wall 442(1) may abut wall 440(1), and wall 446(1) may abut wall 444(1) which will limit (or block) a possible rotation difference between the distal and proximal sides of hinge 407(1) shown in these figures to a certain maximum.
  • the hinge provides extra torsion stiffness due to the walls 442(1), 440(1), 446(1), and 444(1).
  • Figure 10 shows a 3D view on tube 400 such that one can also look inside tube 400.
  • first hinge 407(1) shown in figure 9 can be seen in figure 10.
  • figure 10 shows a second hinge 407(2) which is identical to the one shown in figure 9 be it that the second one is rotated 90 degrees in the tangential direction, causing the total hinge structure to be bendable in all directions, as will be evident to persons skilled in the art.
  • the individual features of first hinge 407(1) as shown in figure 9 are indicated with the same reference numbers.
  • the features of second hinge 407(2) shown in figure 10 are shown with the same reference numbers but having the indicator “(2)” instead of “(1)” affixed to it.
  • first hinge 407(1) has tangential slit portions 424a(l), 424b(l) and tangential slit portions 416a(l), 416b(l).
  • Tangential slit portions 424a(l), 424b(l) have an end 423(1) and an end 415(1).
  • Tangential slit portions 424a(l), 424b(l) extend from end 423(1) to end 415(1) partly surrounding the tube in a tangential direction H (cf. figure 9).
  • Tangential slit portions 416a(l), 416b(l) have an end 421(1) and an end 417(1). Tangential slit portions 416a(l), 416b(l) extend from end 421(1) to end 417(1) partly surrounding the tube in a tangential direction G (cf. figure 9).
  • the tangential direction H and the tangential direction G are opposite directions.
  • the end 423(1) and the end 421(1) are located at the same plane perpendicular to the central axis 29 mentioned above on which ends 409(1) and 411(1) are located. End 423(1) and end 421(1) are arranged facing each other.
  • End 423(1) coincides with a center location of a longitudinal slit 452(1) and end 421(1) coincides with a center location of a longitudinal slit 448(1) which both extend longitudinally along the tube 400 such that they define longitudinal sides of a longitudinal bridge 450(1).
  • longitudinal slits 452(1) and 448(1) may be curved in opposite directions such that longitudinal bridge 450(1) has a smallest width t at a certain location which may be in the middle of the total length of longitudinal bridge 450(1). Width t may have a value between 0.05-0.3mm.
  • Slit 452(1) has a length LB3 which may have a value between 0.3-4mm.
  • Slit 448(1) has a length LB4 which may have a value between 0.3-4mm.
  • Length LB3 may be equal to length LB4.
  • all lengths LB1, LB2, LB3, and LB4 may be equal.
  • the shape of slit 452(1) may coincide with a portion of a third circle CB3 having a third radius of 0.5-10mm.
  • the shape of slit 448(1) may coincide with a portion of a fourth circle CB4 having a fourth radius of 0.5-10mm.
  • the radius of fourth circle CB4 may be equal to the radius of third circle CB3.
  • the radius of all circles CB1, CB2, CB3, and CB4 may be equal.
  • the values provided here for width /, lengths LB3 and LB4, and radius of CB3 and CB4 may be applicable for tube instruments with a radius between l-15mm and a wall thickness between 0.08- 2mm.
  • longitudinal bridge 450(1) has a better center of rotation 458(1) in its center about which portions of tube 400 located at longitudinally opposite sides of bridge 450(1) may bend than if longitudinal bridge 450(1) would have an equal width along its entire length, providing the instrument with more accuracy in movement.
  • Tangential slit portions 424a(l) and 424b(l) are located at longitudinally shifted positions and, respectively, connected at opposite ends of a longitudinal channel 429(1) which is extending in the longitudinal direction of the instrument 400 such as to form a tangential shoulder structure.
  • Side walls of longitudinal channel 429(1) are defined by walls 454(1), 456(1) which are extending in the longitudinal direction of the instrument between tangential slit portions 424a(l), 424b(l).
  • walls 454(1), 456(1) are straight. However, they may have a curvature coinciding with a portion of a circle having center of rotation 458(1) of longitudinal bridge 450(1) as its center to align movement during bending of the hinge with the center of rotation 458(1).
  • walls 454(1), 456(1) are partly overlapping as seen in the tangential direction of the instrument. The amount of overlap may be between 0.05 - 3mm.
  • Tangential slit portions 416a(l) and 416b(l) are located at longitudinally shifted positions and, respectively, connected at opposite ends of a longitudinal channel 431(1) which is extending in the longitudinal direction of the instrument 400 such as to form a tangential shoulder structure.
  • Side walls of longitudinal channel 431(1) are defined by walls 462(1), 464(1) which are extending in the longitudinal direction of the instrument between tangential slit portions 416a(l), 416b(l).
  • walls 462(1), 464(1) are straight. However, they may have a curvature coinciding with a portion of a circle having center of rotation 458(1) as its center to align movement during bending of the hinge with the center of rotation 458(1). In the non-bend position of the two opposite sides of the hinge, walls 462(1), 464(1) are partly overlapping as seen in the tangential direction of the instrument. The amount of overlap may be between 0.05 - 3mm.
  • the instrument 400 may be rotated in its tangential direction, e.g., by providing a rotational force to the proximal end of the instrument. Then, the instrument may be located inside a channel, e.g., intestines of a living being, a blood vessel, or esophagus or the like. Rotating the instrument inside such a channel may cause friction between the channel walls and the instrument resulting in torsion forces on the instrument.
  • a channel e.g., intestines of a living being, a blood vessel, or esophagus or the like. Rotating the instrument inside such a channel may cause friction between the channel walls and the instrument resulting in torsion forces on the instrument.
  • Hinge structures as shown in figures 9 and 10 can better cope with increased torsion forces because, during rotation, wall 454(1) may abut wall 456(1), and wall 462(1) may abut wall 464(1) which will limit (or block) any possible rotation difference between distal and proximal sides of the hinge shown in these figures to a certain maximum.
  • the hinge structure shown in these figures provides extra torsion stiffness due to the walls 454(1), 456(1), 462(1), and 464(1).
  • the tangential directions G and H are in the above mentioned plane perpendicular to the central axis of the tube 400.
  • direction G may form an angle with such a plane.
  • the tangential direction H may also form an angle with such a plane. These angles may be between -10° and +10° degrees, more preferably between -8° and +8° degrees. They may have the same value.
  • Longitudinal bridges 404(1) and 450(1) are, preferably, located on locations on tube 400 rotated 180 degrees away from each other on the circumference, thus allowing tube 400 to bend about a virtual line through centers of rotation 426(1) and 458(1).
  • tangential slit portion 410b(l) and tangential slit portion 416b(l) overlap circumferentially, i.e. a part of tangential slit portion 410b(l) is located adjacent to a part of tangential slit portion 416b(l) as seen in a longitudinal direction, however, without these parts engaging one another.
  • a tangential bridge 403(1) is present between these parts of tangential slit portion 410b(l) and tangential slit portion 416b(l). The ends of tangential bridge 403(1) are attached to the distal side and to the proximal side of hinge 407(1), respectively.
  • tangential bridge 403(1) has a constant width BW(1) (seen in the longitudinal direction of the instrument). This width may be 0.05-0.3mm. Tangential bridge 403(1) may have a length equal to a value between 20-45% of the tube circumference.
  • tangential slit portion 418b(l) and tangential slit portion 424b(l) overlap circumferentially, i.e. a part of tangential slit portion 418b(l) is located adjacent to a part of tangential slit portion 424b(l) as seen in a longitudinal direction, however, without these parts engaging one another.
  • a tangential bridge 405(1) is present between these parts of tangential slit portion 418b(l) and tangential slit portion 424b(l). The ends of tangential bridge 405(1) are attached to the distal side and to the proximal side of hinge 407(1), respectively.
  • tangential bridge 405(1) has a constant width BW(2) (seen in the longitudinal direction of the instrument). This width may be 0.05-0.3mm and may be the same as the width of tangential bridge 403(1). Tangential bridge 405(1) may have a length equal to a value between 20-45% of the tube circumference. The lengths of tangential bridges 403(1) and 405(1) may be equal.
  • the channels defined by the side walls 442(j)/440(j), 446(j)/444(j), 454(j)/456(j), and 462(j)/464(j) have a certain width defined by, e.g., the width of a laser beam used to make all slit patterns in the tube 400, if a laser is used.
  • the width of these channels define a maximum tangential play between adjacent sides of each hinge when they rotate relative to one another in the tangential direction. There is a desire to keep this width as small as possible to reduce such play.
  • Figures 12A, 12B and 12C show ways of reducing this width of these channels.
  • Figure 12A is identical to figure 9 apart from the following.
  • a fracture element 480(1) When manufacturing the slit pattern in tube 400 opposing side walls 442(1), 440(1) are still attached to one another by means of a fracture element 480(1).
  • a fracture element 482(1) when manufacturing the slit pattern in tube 400 opposing side walls 446(1), 444(1) are still attached to one another by means of a fracture element 482(1).
  • Figure 12B shows an example of a fracture element 482(1) in enlarged shape.
  • the manufacturing process of making the slit pattern renders fracture element 482(1) such that it has a wider portion 484(1) and a smaller portion 488(1).
  • wider portion 484(1) is attached to side wall 446(1) and smaller portion 488(1) is attached to side wall 444(1), whereas wider portion 484(1) is attached to smaller portion 488(1).
  • a first reason to manufacture such a fracture element 482(1) is to keep different opposite portions of the tube-like element 400 which are separated by slits still attached to one another which makes maneuverability of the tube 400 much easier, e.g. when it has to be inserted into another tube or another tube has to inserted into it.
  • a second reason is, however, that one can use such fracture elements to reduce play between such opposite portions.
  • Fracture element 482(1) is designed such that when these forces Fl and F2 are above a certain threshold force smaller portion 488(1) will fracture while wider portion 484(1) will remain intact and the material of the hinge to which wider portion 484(1) is attached only deforms elastically but not plastically and also the material of the hinge to which smaller portion 488(1) is attached only deforms elastically but not plastically by the forces Fl and F2. Also wider portion 484(1) may only deform elastically but not plastically by these forces but that is not necessary.
  • fracture element 482(1) equally applies to fracture element 480(1).
  • similar or identical play reducing fracture elements can be applied between all opposite side walls 454(j)/456(j), and 462(j)/464(j).
  • Figure 12C shows an alternative fracture element 490(1) to fracture element 482(1) of figure 12B.
  • side wall 444(1) is divided into two portions: a first side wall portion 444a(l) located in the tangential extension of tangential slit 418a(l) and a second side wall portion 444b(l) defining the side wall of longitudinal channel 427(1) between tangential slits 418a(l) and 418(b(l).
  • the tangential distance between second side wall portion 444b(l) and side wall 446(1) is indicated with width wl. Width wl depends on the used manufacturing method, e.g., the size of a laser beam.
  • the tangential distance between second side wall portion 444a(l) and side wall 446(1) is indicated with width w3 wherein w3 may be as small as 0 mm. Width wl > w3.
  • a small fracture element or melt element 490(1) is kept between a transition area between first side wall portion 444a(l) and second side wall portion 444b(l).
  • fracture element 490(1) When element 490(1) is implemented as fracture element, this fracture element will be fractured by bending hinge 407(1) with a certain predetermined bending force.
  • fracture element 490(1) is designed such that when the bending force, schematically indicated with Fl and F2, is above a certain threshold force a reaction force as caused by the bending force inside the fracture element will cause fracture of fracture element 490(1) while the material of the side walls to which they are attached will remain intact because this material may only deform elastically but not plastically. Fracturing may also be caused by fatigue, i.e., by bending hinge 407(1) multiple times with a force less than this threshold force but strong enough to eventually rupture fracture element 490(1). This method causes less tension in material of tube 400 attached to fracture element 490(1).
  • melt element 490(1) When element 490(1) is implemented as melt element, this melt element will be destroyed by melting them later in the manufacturing process.
  • tube 400 in which hinge 407(1) is manufactured is inserted inside another tube having holes in its structure which are aligned with respective melt elements. Then, an energy beam, e.g. a laser beam, is directed through such holes to the melt elements 490(1) of which the energy is so high that it destroys the melt elements but does not or hardly not destroy the side walls to which the melt elements are attached.
  • an energy beam e.g. a laser beam
  • Fracture elements like fracture element 490(1) can be applied between all opposite side walls 440(j)/442(j), 454(j)/456(j), and 462(j)/464(j). If so, after all these fracture elements are fractured, or destroyed by melting, and all hinges 407(j) are unbent - tube 400 is 100% straight - then, there is no tangential play reduction yet. However, in practice, most of the times the invasive instrument may be inserted in a curved channel, e.g., in a human body, causing many if not most of hinges 407(j) to be bent more or less. In the bent condition, at least some of the first side wall portions 444a(l) (and their equivalents at respective other locations) will be moved opposite side wall 446(1) (and their respective equivalents at other locations) and actual play will be reduced from wl to w3.
  • the tubes of the invasive instrument may have a circular cross section.
  • the tubes may, however, have another suitable cross section.
  • the tubes may have an oval or elliptical or rectangular cross section, tube
  • the tubes may be formed using a suitable biocompatible polymeric material, such as polyurethane, polyethylene, polypropylene or other biocompatible polymers.
  • the tubes may be made of any other suitable material and/or in any other suitable way.
  • Other suitable materials may be stainless steel, cobalt-chromium, shape memory alloy, such as Nitinol®, plastic, polymer, composites or other curable material.
  • the circumferential, longitudinal slits and other slits may be made by means of any known material removal technique such as photochemical etching, deep pressing, chipping techniques, however, preferably by laser or water cutting. All slits are open both to the outside and inside of the tubes.
  • the longitudinal slits, the circumferential slits and the U-shaped slits may have any suitable length and width, as required by the envisaged application.
  • the longitudinal slits, the circumferential slits and the U-shaped slits of an intermediate tube may have the same or different lengths and/or widths.
  • the length is between 25 and 50%, more preferably between 30 and 45%, and most preferably between 35 and 40% of the external circumference of the tube-like member.
  • the circumferential slits may have any suitable width.
  • the circumferential slits of the same tube-like member may have the same width or different widths.
  • the circumferential slits may be narrower next to their ending points and wider in their central part.
  • the longitudinal slits and the inclined slits may have also any suitable length and width, as required by the envisaged application.
  • the longitudinal slits and the inclined slits of a tube-like member may have the same or different lengths and/or widths.
  • Variations in bending and torsion fidelity along the length of the tubelike member can be achieved by varying the durometer rating of materials that are used to mold the different segments. Also, the flexibility of the tube-like member may be varied by changing the dimensions and locations of the circumferential slits, longitudinal slits and inclined slits and/or by varying the angles between the circumferential slits and the radial circumference.
  • Tube 400 may have one of a circular, oval, elliptical or rectangular cross section.
  • Tube 400 may, at least in part, be made of at least one of the following set of materials: a biocompatible polymeric material, including polyurethane, polyethylene or polypropylene, stainless steel, cobalt-chromium, shape memory alloy such as Nitinol®, plastic, polymer, composites, or other curable material.
  • a biocompatible polymeric material including polyurethane, polyethylene or polypropylene, stainless steel, cobalt-chromium, shape memory alloy such as Nitinol®, plastic, polymer, composites, or other curable material.
  • the cutting patterns of hinges 407(j) result from a material removal technique applied on a wall of tube 400, including at least one of photochemical etching, deep pressing, chipping techniques, laser cutting or water cutting.
  • the material removal means can be a laser beam that melts and evaporates material or a waterjet cutting beam and this beam can have a width of 0.01 to 2.00 mm, more typically for this application, between 0.015 and 0.04mm.
  • the wall thickness of tubes depend on their application.
  • the wall thickness may be in a range of 0.03-2.0 mm, preferably 0.03-1.0 mm, more preferably 0.05-0.5 mm, and most preferably 0.08-0.4 mm.
  • the diameter of the tubes depend on their application.
  • the diameter may be in a range of 0.5-20 mm, preferably 0.5-10 mm, more preferably 0.5-6 mm.
  • the radial play between adjacent tubes may be in range of 0.01 - 0.3 mm.
  • the first longitudinal bridge (404(j)) may have a first center of rotation (426(j )) and the second longitudinal bridge (450(j )) may have a second center of rotation (458(j )), each hinge (407(j )) being able to bend about a virtual line through the first center of rotation (426(j )) and the second center of rotation (458(j )), each one of the first longitudinally extending wall (440(j)), the second longitudinally extending wall (442(j)), third longitudinally extending wall (444(j)) and the fourth longitudinally extending wall (446(j )) being formed as a portion of a respective circle having its center in the first center of rotation (426(j )), and each one of fifth longitudinally extending wall (454(j )), the sixth longitudinally extending wall (456(j )), seventh longitudinally extending wall (462(j )) and the eighth longitudinally extending wall (444(j)) being formed as a portion of a respective circle having
  • the first cutting pattern may have two longitudinal slits (406(j), 408(j )) extending in the longitudinal direction and forming two longitudinal sides of the first longitudinal bridge (404(j)), and the second cutting pattern may have two further longitudinal slits (448(j), 452(j )) extending in the longitudinal direction and forming two longitudinal sides of the second longitudinal bridge (450(j)).
  • the two longitudinal slits (406(j), 408(j )) may be curved such that the first longitudinal bridge (404(j)) has a first width increasing to its ends.
  • the two further longitudinal slits (448(j), 452(j )) may be curved such that the second longitudinal bridge (404(j)) has a second width increasing to its ends.
  • the first tangential slit (410a(j), 41 Ob(j )) may extend from a center (409(j )) of one of the two longitudinal slits (406(j), 408(j )) and the second tangential slit (418a(j), 418b(j )) may extend from a center (41 l(j)) of the other one of the two longitudinal slits (406(j), 408(j )).
  • the third tangential slit (424a(j), 424b(j)) may extend from a center (423(j )) of one of the two further longitudinal slits (448(j), 452(j )) and the fourth tangential slit (416a(j), 416b(j )) extends from a center (421 (j )) of the other one of the two further longitudinal slits (448(j), 452(j )).
  • One of the two first tangential slit portions (410a(j), 41 Ob(j )) and one of the two fourth tangential slit portions (416a(j), 416b(j )) may be, at least partly, tangentially overlapping such as to form a first tangential bridge (403 (j )) between them, the first tangential bridge (403 (j )) having one end attached to the proximal hinge side and an other end to the distal hinge side.
  • One of the two second tangential slit portions (418a(j), 418b(j)) and one of the two third tangential slit portions (424a(j), 424b(j)) may be, at least partly, tangentially overlapping such as to form a second tangential bridge (405(j )) between them, the second tangential bridge (405(j )) having one end attached to the proximal hinge side and an other end to the distal hinge side.
  • the two first tangential slit portions (410a(j), 41 Ob(j )) and the third two tangential slit portions (424a(j), 424b(j)) may be oriented forming a first angle with a plane perpendicular to a center axis of the tube (400), the first angle being between -10° and +10° degrees, more preferably between -8° and +8° degrees.
  • the two second tangential slit portions (418a(j), 418b(j)) and the two fourth tangential slit portions (416a(j), 416b(j )) may be oriented forming a second angle with a plane perpendicular to a center axis of the tube (400), the second angle being between -10° and +10° degrees, more preferably between - 8° and +8° degrees.
  • the tube may include at least one of the following features: the first longitudinally extending wall (440(j)) and the second longitudinally extending wall (442(j)) have portions of a fractured first fracture element (480(j )) such as to reduce play between them, the third longitudinally extending wall (444(j )) and the fourth longitudinally extending wall (446(j )) have portions of a fractured second fracture element (482(j )) such as to reduce play between them, the fifth longitudinally extending wall (454(j )) and the sixth longitudinally extending wall (456(j )) have portions of a fractured third fracture element such as to reduce play between them, or the seventh longitudinally extending wall (462(j )) and the eighth longitudinally extending wall (444(j )) have portions of a fractured fourth fracture element such as to reduce play between them.

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Abstract

Un tube déformable (312) comporte une section d'extrémité déformable (301) et une section de corps pliable (309). Le tube déformable comporte un ou plusieurs fils de direction (16(i)) disposés en spirale dans la section de corps (309) afin de compenser des différences de longueur de parcours se produisant dans la section de corps (309) lorsque la section de corps (309) est pliée. Afin d'isoler des charges axiales dans la section de corps (309), le tube déformable (312) est pourvu d'un ou de plusieurs éléments d'isolation de force longitudinale (322(k)) dans la section de corps (309), qui s'étendent parallèlement au ou aux fils de direction (16(i)). Les éléments d'isolation de force (322(k)) sont fixés aux deux extrémités à un tube externe (340) et/ou à un tube interne (330).
PCT/EP2024/069397 2023-07-28 2024-07-09 Tube pliable à compensation de longueur de parcours de fils de direction Pending WO2025026670A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2035502 2023-07-28
NL2035502A NL2035502B1 (en) 2023-07-28 2023-07-28 Bendable tube with path length compensation of steering wires

Publications (1)

Publication Number Publication Date
WO2025026670A1 true WO2025026670A1 (fr) 2025-02-06

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Application Number Title Priority Date Filing Date
PCT/EP2024/069397 Pending WO2025026670A1 (fr) 2023-07-28 2024-07-09 Tube pliable à compensation de longueur de parcours de fils de direction

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NL (1) NL2035502B1 (fr)
WO (1) WO2025026670A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12490886B2 (en) 2019-04-08 2025-12-09 Fortimedix Assets Ii B.V. Steerable instrument comprising a detachable part

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