SURGICAL APPARATUS
The disclosure provides a surgical apparatus comprising: a steerable member that is bendable and comprises a plurality of bending segments with channels therein; and a plurality of bending actuation wires that are arranged to pass through the steerable member and cause the steerable member to bend, the steerable member comprising at least one outwardly opening lumen through which the bending actuation wires pass.
1 . A method of performing endoluminal surgery comprising the steps of:
providing an endoluminal surgery apparatus comprising a bendable endoscope having a proximal end and a distal end, at least one robotic arm including a distal end, a proximal end, and at least one conduit therein extending between the proximal and distal end, at least one robotic positioner operatively coupled to the proximal end of the at least one robotic arm, a first sheath surrounding at least a portion of the at least one robotic arm and including a proximal end and a distal end, the distal end of the endoscope and the distal end of the at least one sheath coupled to a distal coupler to form a distal end of the endoluminal surgical apparatus;
inserting the distal end of the endoluminal surgical apparatus through a natural body orifice with at least a portion of the at least one robotic arm, including the distal end thereof, disposed within the first sheath;
navigating the endoluminal surgery apparatus to a desired surgical site within a body cavity by steering the bendable endoscope, while maintaining at least a portion of the at least one robotic arm, including the distal end thereof, disposed within the first sheath;
providing at least one steering wire extending through the conduit of the robot arm from at least the proximal end thereof to a location adjacent to, but spaced from, the distal end thereof, whereby selective tensioning of the at least one wire causes bending of the at least one robotic arm adjacent to the distal end thereof;
releasing the tension of the at least one wire during the navigating of the endoluminal surgery apparatus to a desired surgical site within a body cavity, and thereby cause the arms to be sufficiently flexible to bend together with the endoscope,
advancing the arms from the sheaths at the surgical site while tensioning the at least one wire; and
performing a surgical task at the surgical site.
2 . The method of claim 1 , further comprising at least one intermediate coupler located between the distal and proximal ends of the endoscope and the at least one sheath.
3 . The method of claim 2 , wherein the at least one intermediate coupler includes at least a first opening and a second opening therethrough, and the endoscope is connected to the at least one intermediate coupler in the first opening.
4 . The method of claim 1 , further comprising:
after navigating the endoluminal surgery apparatus to a desired surgical site within a body cavity, fixing the endoscope and first sheath to restrict movement of the distal ends thereof against movement with respect to the surgical site.
5 . The method of claim 1 , further comprising:
a positioning member, comprising a base, a moveable member moveable with respect to the base, and
wherein the first sheath is secured to the moveable member.
6 . The method of claim 5 , further comprising during the navigating of the endoluminal surgery apparatus to a desired surgical site within a body cavity, moving the first sheath by moving the moveable member at least one of linearly and rotationally with respect to the base.
7 . The method of claim 5 , wherein the at least one robotic positioner is mounted within the moveable member.
8 . The method of claim 7 , further comprising moving the distal end of the robot arm by moving the robotic positioner with respect to the moveable member.
9 . The method of claim 8 , wherein the distal end of the at least one robotic arm comprises a steerable member and an end effector, wherein the at least one wire is connected to the steerable member.
10 . The method of claim 8 , wherein the distal end of the at least one robotic arm comprises a steerable member and an end effector, wherein the at least one wire is moveable to actuate movement of the end effector.
11 . The method of claim 10 , wherein selective tensioning of the at least one wire causes bending of the robotic arm concentrated at the distal end of the steerable member where a bending actuation wire is attached.
12 . The method of claim 8 wherein the steerable member comprises a plurality of bending segments have a first plurality of lumens formed at a distance from the center of a cross-section of the steerable member, and closer to the proximal end of the steerable member, the more distant the lumens in the bending segments are from the center of the cross-section of the steerable member.
13 . The method of claim 12 , wherein for the same movement of the at least one wire within the first plurality of lumens causes the movement of the bending segments of the steerable member adjacent to the distal end of the steerable member to be less than the movement of the bending segments adjacent to the proximal end of the steerable member.
14 . The method of claim 12 wherein the bending segments have a larger sectional width at the distal end of the steerable member than at the proximal end of the steerable member.
15 . The method of claim 12 wherein the bending segments are positioned such that the distance between the bending segments decreases toward the distal end of the steerable member and increases toward the proximal end of the steerable member.
16 . The method of claim 13 wherein the bending segments have a larger sectional width at the distal end of the steerable member than at the proximal end of the steerable member.
17 . The method of claim 13 wherein the bending segments are positioned such that the distance between the bending segments decreases toward the distal end of the steerable member and increases toward the proximal end of the steerable member.
18 . The method of claim 1 wherein a tension-regulating member is a double-hinged joint comprising two off-axis hinge joints spaced from one another from an intermediate center, the two off-axis hinge joints comprising a first hinge and a second hinge, with each off-axis hinge joint comprising a first interfacing half coupled to a first link portion and a second interfacing half coupled to a second link portion and correspondingly pivotable with respect to the first interfacing half.
19 . The method of claim 18 wherein, an intermediate joint bends in a bending orientation along the second hinge of the off-axis hinge joint, which second hinge is offset from the intermediate center, whereby the first interfacing half pivotally moves only along the second hinge.
20 . The method of claim 18 wherein, an intermediate joint bends in a bending orientation along the first hinge of the off-axis hinge joint, which first hinge is offset from the intermediate center whereby the first interfacing half pivotally moves only along the first hinge.