Insertion tube with deflectable tip
Apparatus described herein includes a tube, shaped to define a tube lumen and including a distal portion that has a plurality of articulated sections. The apparatus further includes a ribbon that passes longitudinally through the tube lumen and is connected to a distalmost one of the articulated sections, and a control handle disposed at a proximal end of the tube, the control handle being configured to flex the distal portion of the tube by pulling the ribbon. Other embodiments are also described.
1. A method, comprising:
(a) by pulling a ribbon, flexing a distal portion of a tube, wherein a proximal portion of the tube defines a longitudinal axis, wherein pulling the ribbon comprises rotating a rotary actuator in a first angular direction about the longitudinal axis, wherein the ribbon is positioned to traverse an exterior wall of the tube distal to the rotary actuator, wherein the rotary actuator remains in a fixed position on the longitudinal axis upon rotating the rotary actuator in the first angular direction; and
(b) subsequently, while the distal portion of the tube is flexed, passing a tool longitudinally through a lumen of the tube and into an interior portion of a body of a subject.
2. The method according to claim 1 , wherein the interior portion of the body of the subject includes a sinus of the subject.
3. The method according to claim 1 , wherein the rotary actuator comprises a dial.
4. The method according to claim 1 , wherein the distal portion of the tube includes a plurality of articulated sections, the ribbon being coupled to a distalmost one of the articulated sections.
5. The method according to claim 4 , wherein flexing the distal portion of the tube comprises flexing the distal portion of the tube by causing at least one of the articulated sections to swivel with respect to another one of the articulated sections.
6. The method according to claim 4 , wherein at least one pair of the articulated sections includes: a first articulated section, shaped to define two grooves; and a second articulated section, comprising two protrusions configured to swivelingly fit within the grooves such that one of the first articulated section and the second articulated section swivels with respect to the other one of the first articulated section and the second articulated section, as the ribbon is pulled.
7. The method according to claim 1 , wherein the ribbon has a curved cross-section.
8. The method according to claim 1 , wherein the ribbon is at a distal end of a control tube that runs longitudinally within the tube lumen proximally to the distal portion of the tube, and wherein pulling the ribbon comprises pulling the ribbon by pulling the control tube.
9. The method according to claim 4 , wherein the articulated sections are configured such that:
(i) a first circumferential region of each articulated section defines a gap with the corresponding first circumferential region of each adjacent articulated section when the distal portion of the tube is in a straight configuration, and
(ii) the first circumferential region of each articulation section is flush with the corresponding first circumferential region of each adjacent articulated section when the distal portion of the tube is in a flexed configuration.
10. The method according to claim 9 , wherein the gap is V-shaped.
11. The method according to claim 4 , wherein the articulated sections are configured such that:
(i) a first circumferential region of each articulated section is flush with the corresponding first circumferential region of each adjacent articulated section when the distal portion of the tube is in a straight configuration, and
(ii) the first circumferential region of each articulation section defines a gap with the corresponding first circumferential region of each adjacent articulated section when the distal portion of the tube is in a flexed configuration.
12. The method according to claim 11 , wherein the articulated sections are further configured such that:
(i) a second circumferential region of each articulated section defines a gap with the corresponding second circumferential region of each adjacent articulated section when the distal portion of the tube is in a straight configuration, and
(ii) the second circumferential region of each articulation section is flush with the corresponding second circumferential region of each adjacent articulated section when the distal portion of the tube is in a flexed configuration.
13. The method according to claim 1 , wherein the tool comprises a camera.
14. The method according to claim 1 , wherein the tool comprises a balloon catheter.
15. The method according to claim 1 , wherein the tool comprises a guidewire.
16. A method, comprising:
(a) rotating a rotary actuator about a longitudinal axis defined by a proximal portion of a tube, wherein rotating the rotary actuator drives a linear actuator longitudinally relative to the tube and the rotary actuator, wherein the rotary actuator drives the linear actuator longitudinally along an exterior portion of the tube distal to the rotary actuator, wherein the linear movement of the linear actuator causes a distal portion of the tube to flex laterally away from the longitudinal axis;
(b) inserting the distal portion of the tube into a nasal cavity of a patient; and
(c) advancing a tool through a lumen of the tube to thereby position a distal portion of the tool in the nasal cavity of the patient, wherein at least a portion of the advanced tool is disposed in the flexed distal portion of the tube.
17. The method according to claim 16 , wherein the linear actuator comprises a ribbon.
18. The method according to claim 16 , wherein advancing the tool comprises positioning the distal portion of the tool in a paranasal sinus of the patient.
19. The method according to claim 16 , wherein rotating a rotary actuator is performed before inserting the distal portion of the tube into the nasal cavity of the patient.
20. A method, comprising:
(a) rotating a rotary actuator about a longitudinal axis defined by a proximal portion of a tube, wherein rotating the rotary actuator drives a linear actuator along the longitudinal axis in a distal direction relative to the rotary actuator, wherein the linear actuator transitions from an exterior position of the tube to an interior position of the tube through an opening defined by the tube, wherein the opening is located distal to the rotary actuator, wherein the linear movement of the linear actuator causes a distal portion of the tube to flex laterally away from the longitudinal axis;
(b) after rotating the rotary actuator, inserting the distal portion of the tube into a nasal cavity of a patient while the distal portion is in a flexed state; and
(c) advancing a guidewire or balloon catheter through a lumen of the tube to thereby position a distal portion of the guidewire or balloon catheter in the nasal cavity of the patient, wherein at least a portion of the advanced guidewire or balloon catheter is disposed in the flexed distal portion of the tube.