GUIDE TUBE CONTROL OF MINIMALLY INVASIVE SURGICAL INSTRUMENTS

1 . A surgical apparatus comprising:

a guide tube comprising an actively flexible distal portion;

a surgical instrument comprising an end effector at a distal end of the surgical instrument; and

a telemanipulative control system;

wherein the surgical instrument extends through the guide tube; and

wherein, in response to signals generated by the control system, the actively flexible distal segment of the guide tube moves the end effector in at least two orientation degrees of freedom without substantially changing the position of the end effector.

2 . (canceled)

3 . The apparatus of claim 1:

wherein the end effector rolls with reference to a longitudinal axis of the guide tube in response to rolling the surgical instrument within the guide tube.

4 . The apparatus of claim 1:

wherein the end effector surges with reference to a longitudinal axis of the guide tube in response to surging the surgical instrument within the guide tube.

5 . The apparatus of claim 1:

wherein the distal segment of the guide tube comprises a bend sensor.

6 . (canceled)

7 . The apparatus of claim 1:

wherein the surgical instrument is releasably secured in the guide tube to allow motion of the guide tube to surge, roll, or surge and roll the end effector with reference to a longitudinal axis of the guide tube.

8 . The apparatus of claim 1:

wherein the distal segment of the guide tube comprises a mechanical limit that establishes a minimum radius of curvature that prevents binding an operation of the surgical instrument or end effector.

9 . The apparatus of claim 1:

wherein the control system establishes a minimum radius of curvature for the distal segment of the guide tube that prevents binding an operation of the surgical instrument or end effector.

10 . The apparatus of claim 1:

wherein the length of a cable that extends through the distal segment of the guide tube and that operates the end effector remains essentially constant as the distal segment of the guide tube moves.

11 . The apparatus of claim 1:

wherein the guide tube comprises a flexible proximal segment adjacent the distal segment; and

wherein the proximal segment is sufficiently stiff so that the proximal segment maintains shape as the distal portion moves the end effector when the end effector is grasping tissue.

12 . The apparatus of claim 11:

wherein the proximal segment is active and lockable.

13 . The apparatus of claim 11:

wherein the proximal segment is servo lockable.

14 . The apparatus of claim 11:

wherein the proximal segment is passive and lockable.

15 . The apparatus of claim 1 further comprising:

a secondary guide tube;

wherein the guide tube comprises a flexible proximal portion; and

wherein the telemanipulation control system inserts at least part of the flexible proximal segment and at least part of the flexible distal segment of the guide tube past a distal end of the secondary guide tube.

16 - 30 . (canceled)

31 . The surgical apparatus of claim 1:

wherein a longitudinal axis is defined between proximal and distal ends of the guide tube; and

wherein the two orientation degrees of freedom comprise pitch and yaw with reference to the longitudinal axis of the guide tube.

32 . The surgical apparatus of claim 1:

wherein the actively flexible distal segment of the guide tube moves the end effector with a moment sufficient to manipulate tissue.

33 . A surgical apparatus comprising:

a guide tube comprising a distal end, a first flexible portion, and a second flexible portion adjacent the first flexible portion, wherein the first flexible portion is at the distal end of the guide tube;

a surgical instrument comprising a distal end and an end effector at the distal end of the surgical instrument; and

a telemanipulation control system;

wherein the surgical instrument extends through the guide tube; and

wherein, in response to signals generated by the control system, the first flexible portion of the guide tube changes an orientation of the end effector while the second flexible portion of the guide tube remains substantially rigid.

34 . The surgical apparatus of claim 33:

wherein a longitudinal axis is defined between proximal and distal ends of the guide tube; and

wherein, in response to signals generated by the control system, the first flexible portion of the guide tube changes the orientation of the end effector in pitch and yaw with reference to the longitudinal axis of the guide tube.

35 . A surgical apparatus comprising:

a first primary guide tube, wherein the first primary guide tube comprises a first flexible portion and a second flexible portion, and wherein the first flexible portion of the first primary guide tube is at a distal end of the first primary guide tube;

a second primary guide tube, wherein the second primary guide tube comprises a first flexible portion and a second flexible portion, and wherein the first flexible portion of the second primary guide tube is at a distal end of the second primary guide tube;

a secondary guide tube, wherein the first and the second primary guide tubes extend lengthwise through the secondary guide tube;

a first surgical instrument that extends lengthwise through the first primary guide tube, wherein a distal end effector of the first surgical instrument extends beyond the distal end of the first primary guide tube;

a second surgical instrument that extends lengthwise through the second primary guide tube, wherein a distal end effector of the second surgical instrument extends beyond the distal end of the second primary guide tube;

wherein the first flexible portion of the first primary guide tube actively changes an orientation of the end effector of the first surgical instrument; and

wherein the first flexible portion of the second primary guide tube actively changes an orientation of the end effector of the second surgical instrument.

36 . A surgical apparatus comprising:

a guide tube comprising an actively flexible distal portion; and

a surgical instrument comprising a passively flexible distal portion and an end effector at the distal end of the passively flexible distal portion;

wherein the surgical instrument extends through the guide tube such that the passively flexible distal portion of the surgical instrument is generally aligned with the actively flexible distal portion of the guide tube, and such that the end effector is beyond the actively flexible distal portion of the guide tube.

37 . The surgical apparatus of claim 36:

wherein the guide tube comprises a second actively flexible portion adjacent to the actively flexible distal portion.

38 . The surgical apparatus of claim 36:

wherein the guide tube comprises a passively flexible portion adjacent to the actively flexible distal portion.

39 . The apparatus of claim 1:

wherein the surgical instrument is releasably secured in the guide.

40 . The apparatus of claim 1:

wherein a longitudinal axis is defined between proximal and distal ends of the guide tube; and

wherein, in response to second signals generated by the control system, the guide tube moves the end effector in a surge degree of freedom by translating along the longitudinal axis.