Abstract: An instrument includes, a lumen, a handpiece affixed to the proximal end of the lumen and including an actuator, a proximal articulable segment, the proximal end of the proximal articulable segment pivotably attached to the distal end of the lumen via a proximal hinge pin extending in a direction generally perpendicular to a longitudinal axis of the lumen, an actuation cable extending from the actuator through the lumen and into the proximal articulable segment, and a cable router comprising a proximal pulley assembly rotatable about the proximal hinge pin, wherein the cable is wrapped about the proximal pulley assembly.

Abstract: Devices, apparatus, and methods for catheter-based repair of cardiac valves, including transcatheter-mitral-valve-cerclage annuloplasty and transcatheter-mitral-valve reapposition. In particular, a target and capture device is provided for guiding a cerclage traversal catheter system through a cerclage trajectory, particularly through a reentry site of the cerclage trajectory. The target and capture device provides the user with a target through which the cerclage traversal catheter system must be guided, particularly under imaging guidance, so as to properly traverse the cerclage trajectory at any desired location, particularly at a reentry site. The target and capture device can, further, ensnare and externalize the cerclage traversal catheter system.

Abstract: A circular stapler apparatus for stapling tissue has a circular stapling head operable to drive staples toward an anvil to form the staples in a circular array. The anvil includes an anvil head, a proximal shaft extending proximally from the anvil head and having a proximal end disposed in a first plane, and a first pivot connecting the anvil head to the proximal shaft. The first pivot is operable to be disposed in a second plane that is laterally offset from the first plane. The anvil is configured to rotate via movement through multiple pivot points. The anvil may be configured to rotate to a position in which a portion of the anvil head is disposed below the first pivot and between the first pivot and the proximal shaft such that the anvil head is acutely angled with respect to a longitudinal axis of the proximal shaft.

Abstract: A tacker for applying a rotary tack, including a drive shaft coupled to a trigger assembly, wherein operating the trigger assembly causes rotation of the drive shaft, a distal portion of the drive shaft passing into an articulated arm that holds rotary tacks, wherein upon operation of the trigger assembly, the drive shaft rotates to cause deployment of the tacks distally out of the articulated arm, and wherein the drive shaft includes a cable on which are located a plurality of axially spaced drive links that transfer rotational motion of the drive shaft to rotation of the tacks.

Abstract: A borescope includes a plurality of bending parts, a plurality of lens barrels, a plurality of joint parts, an objective lens device, a plurality of reflectors, a plurality of relay lenses, and a camera mount. The plurality of lens barrels are connected via the plurality of bending parts with predetermined bend angles, respectively. Rotation angles of the plurality of bending parts are changeable via the plurality of joint parts relative to the plurality of lens barrels. The objective lens device has an objective lens and is detachably provided at a front end side of the plurality of lens barrels. The plurality of reflectors are respectively disposed in the plurality of bending parts. The plurality of relay lenses are respectively disposed in the plurality of lens barrels. The camera mount is provided at a rear end side of the plurality of lens barrels.

Abstract: An actuator includes an inner element coupled to an outer element by a linear-motion bearing that provides a single degree of translational movement of the inner element with respect to the outer element along a longitudinal axis. The inner element includes a permanent magnet and the outer element includes a conductive winding with a first coil wound in first direction around a first pole of the permanent magnet and a second coil wound in a second direction around a second pole of the permanent magnet.

Abstract: A catheter includes a proximal portion and a distal portion, the distal portion including an arcuate portion. The catheter further includes a rotating portion, the rotating portion connecting the proximal portion and distal portion, the rotating portion including a first piece and a second piece, wherein the first piece and second piece create a snap fit. Methods of using the catheter include threading the inserted catheter through the vasculature and allowing the distal portion to freely rotate about an axis defined by the rotating portion responsive to any tortuosity in the vasculature.

Abstract: A steerable multi-linked device. The device includes a first multi-linked mechanism and a second multi-linked mechanism. The first mechanism defines a first plurality of grooves. The second mechanism defines a second plurality of grooves. The first and second pluralities of grooves cooperate to define at least two working ports along a length of the device. At least one of the first and second mechanisms are steerable.

Abstract: Disclosed is an articulation mechanism for a surgical instrument including a housing defining a longitudinal axis. The housing has a first slot extending at least partially through the housing and a second slot extending at least partially through the housing offset from the first slot. The articulation mechanism further includes a first bar member which is adapted for insertion into the first slot. The articulation mechanism further includes a second bar member which is adapted for insertion into the second slot. Each bar member is rotatable within its respective slot to articulate a cable. Each end portion of each bar member includes a pulley inserted into a channel of the end portion which is adapted for the engagement with a cable.

Abstract: An instrument having a flexible and elongated body includes at least a lumen and a flex member disposed within the lumen. The flex member may be capable of providing steering control to a first portion of the elongate body while providing load bearing support to a second portion of the elongate body. A pull wire may be disposed within the flex member, and at least a distal portion of the pull wire may be coupled to the elongate body and a proximal portion of the pull wire may be operatively coupled to a control unit. The control unit may be coupled to a proximal portion of the elongate body. In addition, a control member may be operatively coupled to the control unit such that a distal portion of the control member may be positioned near a proximal portion of the flex member. The control member may be configured to support the flex member and control the movement or displacement of the flex member.

Abstract: This invention is directed to a flexible device, a first elongate member configured to move the flexible device in a first direction, and a second elongate member configured to move the flexible device in a second direction. The flexible device can include a plurality of articulation links, wherein at least one of the plurality of articulation links can include a body configured to receive the first elongate member and the second elongate member. A cinching element may engage the first elongate member to substantially limit movement between the plurality of articulation links when a tensile force is applied to the first elongate member and may disengage the first elongate member to permit movement between the plurality of articulation links when a tensile force is applied to the second elongate member.

Abstract: An endoscope comprising, in a part of an insertion portion having flexibility, a bending portion formed by covering an outermost circumference with a covering rubber. Respective end portions of the covering rubber being tightly bound to a rigid portion near the bending portion with a thread and fixed by applying an adhesive. In at least one end portion of both fixed end portions of the covering rubber, hardness of at least a portion in a range from an end portion in a center portion side of a portion tightly bound with the thread to an end portion in a center portion side of a portion to which the adhesive is applied is set higher than hardness in a center portion of the covering rubber.

Abstract: The current invention presents an extensible and guidable apparatus and methods to evaluate tubular or cavitary structure. The apparatus has a power, control and display unit and a flexible tubular device having a proximal end and a distal end. A stretchable conduit and a plurality of extensible channels run longitudinally inside the flexible tubular device. The flexible tubular device comprises a non-extensible tubular shaft and a reversibly extensible tubular shaft, connected longitudinally in tandem. The reversibly extensible tubular shaft comprises a plurality of reversible extension segments and is controllably longitudinally extensible and bendable by changes in pressure and volume of a medium in said reversible extension segments. Said tubular device is directionally bendable at the distal end by selective negative changes in pressure in said distal end. Said tubular device obtains visual information of target area and material samples, and is capable of manipulation of the target area.

Abstract: A sheath apparatus includes, a plurality of node rings configured to be tilted with respect to each other, each node ring defining a substantially cylindrical wall and having at least one hole passing through said cylindrical wall, the plurality of node rings being arranged next to each other along a linear axis such that consecutive node rings contact each other at a contact plane; a manipulating wire going through the holes in said stacked node rings; and a position restoring component configured to restore said stacked node rings from a tilted position to an original position, wherein said position restoring component is located inside or outside of the stacked node rings.

Abstract: A rotation mechanism (rotating device) that can be easily accessed by the surgeon's finger to rotate an endoscope or similar instrument. The rotation mechanism is a device/component with a “starfish” configuration, which can be attached to the endoscope/arthroscope just distal to the eyepiece (or to an alternate attachment to a camera). The starfish component has a plurality of projections that extend radially from the endoscope axis, and beyond the diameter of the mechanism on the camera head that grasps the arthroscope eyecup. The projections can be easily accessed by the surgeon's finger to rotate the endoscope.

Abstract: The invention provides articulating mechanisms, and flexible members and flexible segments that can form such articulating mechanisms. The mechanisms are useful, for example, for remote steering, guidance and/or manipulation of various instruments and tools at a targeted location. The mechanisms, members or segments include links connected by flexible hinges. The proximal and distal ends of the mechanisms are connected by at least one set of cables in such a fashion that a proximal active flexible segment forms a discrete pair with a distal active flexible segment. Movement of active flexible segments at the proximal end of the mechanism results in a corresponding, relative movement of segments at the distal end of the mechanism. This configuration allows each flexible segment pair to move independently of one another and also permits the articulating mechanism to undergo complex movements and adopt complex configurations.

Abstract: Featured are systems, devices and apparatuses for use in minimally invasive surgical, diagnostic or therapeutic methods and/or techniques, in particular methods and/or techniques for a mammalian throat. In particular embodiments, a dexterity apparatus including one or more dexterity devices is featured, where each of the dexterity devices comprises surgical tools and each is configured and arranged with end-tip dexterity for enhanced manipulation. A portion of the dexterity devices is snake like, which is re-configurable (i.e., can be bent) so as to in effect maneuver the surgical tool and put the tool in a desired position with respect to the surgical site. Another portion of the dexterity device includes the surgical tool thereby providing the capability of performing surgical actions such as sewing, gripping, soft tissue manipulation, cutting and suction of saliva, blood and other materials from the surgical site.

Abstract: The invention provides an articulating mechanism useful, for example, for remote manipulation of various surgical instruments and diagnostic tools within, or to, regions of the body. Movement of segments at the proximal end of the mechanism results in a corresponding, relative movement of segments at the distal end of the mechanism. The proximal and distal segments are connected by a set of cables in such a fashion that each proximal segment forms a discrete pair with a distal segment. This configuration allows each segment pair to move independently of one another and also permits the articulating mechanism to undergo complex movements and adopt complex configurations. The articulating mechanisms may also be combined in such a way to remotely mimic finger movements for manipulation of an object or body tissue.

Abstract: A shaft element for an endoscopic instrument includes a first, proximal shaft segment and a second, distal shaft segment, such that the second shaft segment is connected with the first shaft segment by three connecting elements, such that the connecting elements each include a first two-axis joint, such that the first joints form a triangle and such that the first connecting element is connected with the first shaft segment in such a way that it cannot slide with respect to the latter in a longitudinal direction, and a second and third connecting elements can each be slid with respect to the first shaft segment in a longitudinal direction independently of one another. The invention also relates to an endoscopic instrument, in particular an endoscope with such a shaft segment.

Abstract: A medical apparatus includes a distal end portion provided at a distal end of an insertion portion that has functions of performing inspection, treatment or observation, a bending portion provided with first and second ends and configured so as to bend in two or more directions by connecting the first end to the distal end portion and connecting a plurality of bending pieces, a bending portion operation unit provided in an operation section connected to a proximal end of the insertion portion that causes the bending portion to perform bending operation and a neutral position restoring elastic member fixed to the first end side and the second end side that generates elasticity for causing the bending portion to restore to a neutral position.

Abstract: A highly articulated robotic probe (HARP) is comprised of a first mechanism and a second mechanism, one or both of which can be steered in desired directions. Each mechanism can alternate between being rigid and limp. In limp mode the mechanism is highly flexible. When one mechanism is limp, the other is rigid. The limp mechanism is then pushed or pulled along the rigid mechanism. The limp mechanism is made rigid, thereby assuming the shape of the rigid mechanism. The rigid mechanism is made limp and the process repeats. These innovations allow the device to drive anywhere in three dimensions. The device can “remember” its previous configurations, and can go anywhere in a body or other structure (e.g. jet engine). When used in medical applications, once the device arrives at a desired location, the inner core mechanism can be removed and another functional device such as a scalpel, clamp or other tool slid through the rigid sleeve to perform.

Abstract: An articulated device may include a first steerable multi-linked mechanism and a second steerable multi-linked mechanism. The second steerable multi-linked mechanism may include a first link, a plurality of intermediate links and a second link movably coupled to a second one of the intermediate links. A first one of the intermediate links may be movably coupled to the first link. The articulated device may include a camera located within at least a portion of the second link and a protective shield connected to a distal end of the second link. The protective shield may surround at least a portion of the camera.

Abstract: A highly articulated robotic probe comprises an outer sleeve and an inner core. The outer sleeve and inner core include a plurality of links. The links of the outer sleeve and inner core are configured to pivot relative to one another. Various characteristics of the links determine the overall pivot angle of the articulated probe. Each of the plurality of links may have one or more channels. The channels form a semi-continuous passage from link to link and are configured to receive an elongated member such as an inner core, tool or cable. One or more cables may be used to control the outer links of the outer sleeve and the inner links of the inner core. Various characteristics of the cables determine the overall performance of the articulated probe.

Abstract: A surgical instrument extends through a guide tube and exits at an intermediate position of the guide tube. The instrument includes a parallel motion mechanism that changes the position of a distal end of the surgical instrument without changing the orientation of the distal end. An image capture component is at the distal end of the guide tube, and a joint allows the image capture component to move while the intermediate position remains stationary. The configuration allows a cross section of the guide tube to be oblong. In some aspects, a joint for the image capture component is placed between exit ports for surgical instruments, which allows the guide tube cross section to be further reduced.

Abstract: Included are a bending tube; slits; wire guides; an outer coat member; and hole portions that are formed between particular slits in a distal end region that is forward from a central region on an outer circumference of a cylindrical member, each of the hole portions being communicated with any one of the slits, the wire guides covered by the outer coat member being respectively fixed to the hole portions while being attached to the cylindrical member from an outside thereof.

Abstract: A path-following robot, such as for creating a path to a target surgical site, includes a series of interconnected elements including a lead element at one end thereof, and a plurality of actuators each operably coupled to one of the plurality of elements. Each actuator is capable of effecting rotational and spherical motion of one element with respect to another element. The actuators are arranged to receive commands which individually control the relative position of one element compared with another element, where a position of the lead element determines a path and corresponding positions for all subsequent elements to create a path-following motion.

Abstract: An actuatable joint is disclosed having a transmission member, for example a ring gear, associated with a member of a joint and rotatable about a longitudinal axis through the member. In particular a two degree of freedom actuatable joint is disclosed comprising tendon driven joint arrangements having a transmission member disposed around or inside a body of the joint arrangement, to provide transmission of a force from a driving means to two tendons actuating a rotational degree of freedom of the joint arrangement. Further disclosed is a segmented device, for example an endoscope, comprising a plurality of such joints, for example to define a flexible and steerable conduit for an instrument.

Abstract: A joint-ring for an endoscope-bending-tube that fits with and is fixed to a rigid-member on a distal end side, the joint-ring being formed by plastically deforming a tube-material, the joint-ring including a joint-ring-convex portion provided in the tube-material before the plastic deformation, configured to fit with distal end rigid concave portions of the distal end rigid-member to perform positioning, and protrudingly provided to the distal end side, a plastically deformed shape portion provided in the joint-ring such that an axial direction position thereof overlaps the joint-ring-convex-portion and formed by force of stretching along a circumferential surface in the plastic deformation, and joint-ring-convex-portions provided in the tube-material before the plastic deformation near both sides in the circumferential direction of the joint-ring-convex-portion to interrupt the force of stretching along the circumferential surface to keep the force from reaching the joint-ring-convex-portion to thereby preve

Abstract: An element for transmitting pushing and pulling forces as well as torque having a straight configuration and a bent configuration comprises a base plate, an end plate and bellows arranged between the base plate and the end plate. The base plate and the end plate are connected with a connecting element. A plurality of washers is arranged within the bellows, the washers having a tronconical shape at at least one of their major surfaces. The washers are in mutual contact with each other or with the base plate or the end plate respectively, both in the straight configuration and the bent configuration, such that element can transmit pushing and pulling forces both in the straight configuration and the bent configuration without substantially changing the length of the element.

Abstract: Each of the first hinge portions includes a first central planar portion, and first both-sides planar portion, and each of second hinge portions includes a second central planar portion, and second both-sides planar portion which is arranged on the same plane as the first both-sides planar portion. At least one of each first hinge portion and each second hinge portion includes/include an axial step portion which is provided between the first central planar portion and the first both-sides planar portion and/or between the second central planar portion and the second both-sides planar portion over the entire length of the nodal ring in the longitudinal direction and allows/allow the first central planar portion to be arranged to an outer peripheral side than the second central planar portion by a distance corresponding to a wall thickness of the nodal ring.

Abstract: In an instrument for laparoscopic surgery, with an operating handle, a rectilinear first shaft section connected to the operating handle, a flexible second shaft section arranged at the distal end of the first shaft section and having an end part located at the distal tip of the second shaft section, wherein the second shaft section can be moved from a rectilinear extension position to a curved position in a predetermined plane of curvature with the aid of a tensioning means engaging on the end part, provision is made for a flexible connecting means to extend between the first shaft section and the end part, and the flexible connecting means has a restoring function with which the flexible second shaft section can be restored automatically to a rectilinear or predetermined extension position.

Abstract: Provided is a manufacturing method of a bending module that forms a plurality of joint members by press-processing sheet material, with each joint member having a joint member body, a connection protrusion and a wire guide protrusion having a wire guide hole formed at one side corner of the joint member body, and connection protrusion is formed at another side corner of the joint member body. The wire guide protrusions are folded with respect to the joint member bodies; a joint member assembly is formed by arranging the plurality of joint members in parallel and connecting neighboring connection members to connect the joint members together; the joint member assembly are bent to a ring shape; and each joint member is connect to each other by welding corners thereof.

Abstract: An endoscope includes a distal rigid portion, a bending portion comprising a first bending portion and a second bending portion and a flexible tube portion. The endoscope further includes an operation wire, a wire guide member, a bending operation portion. The endoscope further includes a regulation wire, the regulation wire being longer than the bending portion, the regulation wire being inserted through the first bending portion and the second bending portion, the regulation wire being provided to face the operation wire in the diametrical direction of the bending portion, the regulation wire regulating the bending of the bending portion so that the second bending portion is bent in a direction opposite to the bending direction of the first bending portion and the bending portion is bent in an S-shape when the first bending portion is bent.

Abstract: An instrument includes, a lumen, a handpiece affixed to the proximal end of the lumen and including an actuator, a proximal articulable segment, the proximal end of the proximal articulable segment pivotably attached to the distal end of the lumen, an actuation cable extending from the actuator through the lumen and into the proximal articulable segment, and a cable router having a proximal knuckle assembly having a proximal segment knuckle affixed to the proximal end of the proximal articulable segment, a lumen knuckle affixed to the distal end of the lumen, and a proximal hinge pin knuckle positioned about the proximal hinge pin, wherein the cable is bent against the proximal segment knuckle, the lumen knuckle and the proximal hinge pin knuckle when the proximal articulable segment is generally parallel with the lumen.

Abstract: A surgical instrument includes a housing having an elongated member assembly extending from the housing. The elongated member has a first portion and a second portion. The second portion is movably coupled to the first portion by a cable that facilitates the relative movement of the first portion and the second portion.

Abstract: A wire-operated selective compliance mobile platform (100), in particular for endoscopic surgery devices, obtains a perfect and precise mobility and thus it allows to handle, in the most effective way, the supported instruments, and comprises a mobile surface (1), a connecting base (2) apt to be connected to a flexible tubular duct (4) for endoscopic uses, a plurality of supporting elements (3), apt to permit the motion of said mobile surface (1) relative to said base (2), characterized in that said supporting elements (3) have at least a selective compliance turning pair (31) and a number of joints (32, 34) so as to provide a predetermined number of degrees of freedom to said platform (100), neither determining any over-constraining, nor forcing the system to be deformed in unselected directions, each supporting element (3) being operated by moving means (51, 52) so as to move said mobile surface (1).

Abstract: A steerable endoscope has an elongated body with a selectively steerable distal portion and an automatically controlled proximal portion. The endoscope body is inserted into a patient and the selectively steerable distal portion is used to select a desired path within the patient's body. When the endoscope body is advanced, an electronic motion controller operates the automatically controlled proximal portion to assume the selected curve of the selectively steerable distal portion. Another desired path is selected with the selectively steerable distal portion and the endoscope body is advanced again. As the endoscope body is further advanced, the selected curves propagate proximally along the endoscope body, and when the endoscope body is withdrawn proximally, the selected curves propagate distally along the endoscope body. This creates a serpentine motion in the endoscope body that allows it to negotiate tortuous curves along a desired path through, around, and between organs within the body.

Abstract: An endoscope deflection section frame including a plurality of rings and rivets. Each ring has front ears and rear ears with rivet holes through the ears. The rivets are located in the rivet holes to thereby pivotably connect the rings to one another. Each rivet includes a head at an interior side of an inner one of the ears and an opposite end at an exterior side of an outer one of the ears. The opposite end is welded to the outer ear.

Abstract: A steerable endoscope has an elongated body with a selectively steerable distal portion and an automatically controlled proximal portion. The endoscope body is inserted into a patient and the selectively steerable distal portion is used to select a desired path within the patient's body. When the endoscope body is advanced, an electronic motion controller operates the automatically controlled proximal portion to assume the selected curve of the selectively steerable distal portion. Another desired path is selected with the selectively steerable distal portion and the endoscope body is advanced again. As the endoscope body is further advanced, the selected curves propagate proximally along the endoscope body, and when the endoscope body is withdrawn proximally, the selected curves propagate distally along the endoscope body. This creates a serpentine motion in the endoscope body that allows it to negotiate tortuous curves along a desired path through, around, and between organs within the body.

Abstract: An endoscope includes a curving operation portion which performs a curving operation of a curving portion by rotating around a pivot shaft in a first rotation direction and in a second rotation direction opposite to the first rotation direction from a neutral position where the curving portion is in a non-curved neutral state, a first operation wire which is pulled by the curving operation in the curving operation portion to curve the curving portion in the second curving direction, and a second operation wire which is pulled by the curving operation in the curving operation portion to curve the curving portion in the first curving direction. The endoscope includes a wire crossing portion in which the second operation wire crosses the first operation wire, and a movement regulating portion which regulates the movement of the wire crossing portion from within the operation portion into the insertion portion.

Abstract: A multijointed bending mechanism having a first bending piece, a second bending piece connected to the first bending piece so as to be rotatable around a first rotation shaft, a third bending piece connected to the second bending piece so as to be rotatable around a second rotation shaft, at least two first wires connected to the first bending piece to rotate the first bending piece and at least two second wires connected to the second bending piece to rotate the second bending piece. The second wires are disposed inwards of the first wires with respect to a vertical direction of the first and second rotation shafts.

Abstract: A sheath apparatus includes, a plurality of node rings configured to be tilted with respect to each other, each node ring defining a substantially cylindrical wall and having at least one hole passing through said cylindrical wall, the plurality of node rings being arranged next to each other along a linear axis such that consecutive node rings contact each other at a contact plane; a manipulating wire going through the holes in said stacked node rings; and a position restoring component configured to restore said stacked node rings from a tilted position to an original position, wherein said position restoring component is located inside or outside of the stacked node rings.

Abstract: An endoscope includes an endoscope insertion portion having a bendable bending portion and a bending mechanism configured to bend the bending portion. The bending mechanism includes a pulley, at least one annular member, a pulling member, and a pulling operation member. The pulley is rotatably driven. The annular member is formed into a C-shape with a cut-out, and can be elastically deformed. The annular member is externally fitted to the pulley with a gap. The pulling member has an intermediate portion wound around the annular member. The distal end portion of the pulling member is connected to the bending portion, and the proximal end portion of the pulling member is connected to the pulling operation member which pulls the pulling member. The width direction position at the winding start position of the pulling member wound around the annular member is made different from the width direction position at the winding end position of the pulling member.

Abstract: A self-propelled device for locomotion through a lumen, comprising a set of serially arranged inflatable chambers, and incorporating a number of novel aspects. To enable easy insertion and use, the rigidity of the device is increased by means of rigid inserts in the balloons, or by use of stiff springs between segments. The working channel can be attached to the distal chamber of the device, such that it is pulled from the leading end of the device during inflation, rather than being pulled from the trailing end of the device during deflation. Lumen wall inspection or treatment facilities are enabled by means of a camera or treatment arm mounted between two distally positioned balloons, the device is able to provide observation capabilities to the lumen wall, yet without becoming excessively dirty by exposure to the front end of the device, as in prior art camera units.

Abstract: The present invention relates, generally, to controlling a steerable instrument having an elongate body. More particularly, the present invention relates to a system and method for sensing the shape of a steerable instrument and controlling the steerable instrument in response to a control signal from a user input device and a shape signal corresponding to the sensed shape of at least a portion of the steerable instrument. The present invention also relates to a system for sensing the shape of a flexible instrument with an optical shape sensor.

Abstract: An apparatus including an outer articulated tube member, the outer articulated tube member having a first tubular section and a second tubular section. The apparatus further including an inner articulated tube member positioned within the outer articulated tube member, the inner articulated tube member having a first tubular section and a second tubular section. The first tubular section and the second tubular section of at least one of the outer articulated tube member and the inner articulated tube member are movable with respect to one another in a first configuration and fixed with respect to one another in a second configuration.

Abstract: A medical device for multiple bends, includes a distal-side traction member which is inserted through the distal-side bending portion and the proximal-side bending portion, which is configured to bend the distal-side bending portion in the bending orientation, and which includes a distal-side fixing portion fixed to the distal end of the distal-side bending portion in the axial direction, and a proximal-side traction member which is inserted through the proximal-side bending portion, which is configured to bend the proximal-side bending portion in the bending orientation, and which includes a proximal-side fixing portion fixed to the distal end of the proximal-side bending portion in the axial direction. The proximal-side fixing portion is disposed at substantially the same position as the distal-side fixing portion in a circumferential direction.

Abstract: In at least one embodiment of the present invention, an access sheath for positioning in a patient's body is provided. The access sheath comprises an elongated member having a proximal portion extending to a distal portion and a plurality of lumens formed therethrough including a working lumen and a first additional lumen. The first additional lumen is configured to receive an optical system or an irrigation system. The proximal portion has a stiffening section that includes a first coil and one of a braiding and a second coil which are disposed about the working lumen in concentric relationship with each other. The distal portion has a tip and a first deflection section and a second deflection section. The first deflection section is proximal to the tip and distal to the second deflection section. The first deflection section is configured to be actuated to bend at a first angle to position the tip. The second deflection section is configured to bend at a second angle to reposition the tip.

Abstract: A medical device for multiple bends, includes a distal-side traction member which is inserted through the distal-side bending portion and the proximal-side bending portion, which is configured to bend the distal-side bending portion in the bending orientation, and which includes a distal-side fixing portion fixed to the distal end of the distal-side bending portion in the axial direction, and a proximal-side traction member which is inserted through the proximal-side bending portion, which is configured to bend the proximal-side bending portion in the bending orientation, and which includes a proximal-side fixing portion fixed to the distal end of the proximal-side bending portion in the axial direction. The proximal-side fixing portion is disposed at substantially the same position as the distal-side fixing portion in a circumferential direction.

Abstract: An insertion portion includes a holding member that holds an observation portion, and a tubular bending portion. A small-diameter portion of the holding member is fitted into an inside surface of a distal end side portion of the bending portion. A hole portion is provided in the bending portion. A concave portion is provided at the small-diameter portion. A screw member penetrates the hole portion by screw-fastening, and a distal end side thereof is housed in the concave portion. A diameter of the concave portion is larger than an outside diameter of the screw member. A length obtained by adding a depth of the concave portion and a thickness of the distal end side portion of the bending portion is greater than an axial direction length of the screw member. The screw member is held in a non-contacting state with respect to the concave portion in the hole portion.