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: 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: Articulation joints for use in connection with a surgical instrument that has a portion that must be passed through a trocar or similar structure and then articulated relative to another portion of the instrument received within the trocar. Various embodiments of the articulation joint include at least one flexible driven member to articulate the surgical implement relative to the handle assembly of the instrument.

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 medical manipulator which includes: a plurality of arms formed in a cylindrical shape a distal end portion of which is made of a rigid member having a bending portion capable of bending; an insertion portion made of a rigid member having a plurality of channels in which base ends of the plurality of arms are connected to a distal end of the insertion portion so as to connect lumens of the arms to the plurality of channels; a photographic device provided at the distal end of the insertion portion; an operation portion that operates the bending portion; and a transmission member that connects the bending portion and the operation portion, in which the bending portion has: a first bending portion that is capable of bending in a predetermined direction by an operation of the operation portion, and a second bending portion provided in a base end than the first bending portion that is capable of fixing the plurality of arms in a bent state so as to mutually separate, and the transmission portion has: a first regi

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: 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 bending portion includes: a bending piece set in which a plurality of bending pieces are continuously provided by forming a convex portion on a first bending piece and a concave portion on a second bending piece by cutting a rigid pipe, the convex portion and the concave portion forming an engagement portion that pivotably couples adjacent bending pieces to each other, wherein a first engagement portion includes: a first convex portion formed on the first bending piece and including a first peripheral portion serving as a first pivoting surface; and a first concave portion formed on the second bending piece and including a first inner circumferential portion on which the first peripheral portion slides, and the first engagement portion has, in the first peripheral portion, a tapered surface having an outer diameter that becomes smaller from a bending piece inner surface side toward a bending piece outer surface side.

Abstract: An elongate robotic arm comprising articulated segments and a channel that extends along the longitudinal axis of the arm and contains a stiffening member which includes a sensor for measuring the shape of the arm. Using the central channel for this purpose improves the ease and accuracy of shape measurement.

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 drive system for controlling movement of an elongate member includes a base unit having a first rotatable knob and a second rotatable knob, a follower assembly including a follower slidably coupled to a guide rail, a longitudinal movement wire, and a rotational movement wire. The follower includes a longitudinal movement pulley, a rotational movement pulley, and an alignment element structured to receive an elongate member such that the elongate member is attachable thereto. The longitudinal movement wire operably couples the first rotatable knob to the longitudinal movement pulley such that rotation of the first knob drives the follower in a longitudinal direction along the guide rail. The rotational movement wire operably couples the second rotatable knob to the rotational movement pulley such that rotation of the second knob rotates the alignment element and attached elongate member.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device. In one embodiment, methods and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting. In other embodiments, a single cable actuator is provided and is movable between a first position, in which it is effective to rotate an end effector without actuating (i.e., closing and firing) the end effector, and a second position, in which it is effective to actuate the end effector without rotating the end effector. In other aspects, methods and devices are provided for moving a flexible neck formed on a distal end of an accessory channel for use with an endoscope.

Abstract: A steerable, tendon-driven endoscope is described herein. The endoscope has an elongated body with a manually or selectively steerable distal portion and an automatically controlled, segmented proximal portion. The steerable distal portion and the segment of the controllable portion are actuated by at least two tendons. As the endoscope is advanced, the user maneuvers the distal portion, and a motion controller actuates tendons in the segmented proximal portion so that the proximal portion assumes the selected curve of the selectively steerable distal portion. By this method the selected curves are propagated along the endoscope body so that the endoscope largely conforms to the pathway selected. When the endoscope is withdrawn proximally, the selected curves can propagate distally along the endoscope body. This allows the endoscope to negotiate tortuous curves along a desired path through or around and between organs within the body.

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: A surgical instrument is inserted through a guide tube. The surgical instrument exits at an intermediate position of the guide tube and is oriented to be substantially parallel to the guide tube's longitudinal axis as it exits. A stereoscopic image capture component is on the guide tube between the intermediate position and the guide tube's distal end. The image capture component's field of view is generally perpendicular to the guide tube's longitudinal axis. The guide tube is jointed to allow the image capture component to be moved. The surgical instruments and the guide tube are telemanipulatively controlled.

Abstract: Two surgical instruments are inserted through a guide tube. The surgical instruments exit at an intermediate position of the guide tube and are oriented to be substantially parallel to the guide tube's longitudinal axis as they exit. A stereoscopic image capture component is on the guide tube between the intermediate position and the guide tube's distal end. The image capture component's field of view is generally perpendicular to the guide tube's longitudinal axis. The surgical instruments and the guide tube are telemanipulatively controlled.

Abstract: The invention is related to a medical device for conducting a medical examination and/or intervention within a human or animal body the medical device (1) comprising an elongate body (2) which is designed for introduction into an orifice (15) of the human or animal body the elongate body (2) comprising a distal end (3), which is on the front side of the elongate body during introduction into the orifice (15), of the human or animal body and a proximal end (4) on the opposite side, wherein the elongate body is a hollow body comprising a reception chamber (8) in its interior, which reception chamber (8) is arranged for reception of a human finger (9), characterised in that one or more guiding elements (5, 21) for guiding a medical examination and/or intervention component (6) are located on or in the elongate body and at least one image gathering device (7), which is arranged for gathering of images in front of the distal end (3) of the elongate body (2), is arranged on or in the elongate body (2).

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: An endoscopic imaging system includes a reusable control cabinet having a number of actuators that control the orientation of a lightweight endoscope that is connectable thereto. The endoscope is used with a single patient and is then disposed. The endoscope includes an illumination mechanism, an image sensor and an elongate shaft having one or more lumens located therein. A polymeric articulation joint at the distal end of the endoscope allows the distal end to be oriented by the control cabinet. The endoscope is coated with a hydrophilic coating that reduces its coefficient of friction and because it is lightweight, requires less force to advance it to a desired location within a patient.

Abstract: The medical treatment endoscope according to the present invention includes a sheath having a flexibility; at least one arm member having a bending part that projects out from a front end of the sheath and performs bending actions; an open/close mechanism which directs the arm member from a direction along a central axis of the sheath to a direction deviated from the central axis of the sheath, and from a direction deviated from the central axis of the sheath to a direction along the central axis of the sheath; and a viewing device and an illuminating member that are disposed to the front end side of the sheath.

Abstract: Some embodiments provided herein relate to a device for endoscopy. The device includes a first segment of endoscopic tube, a second segment of endoscopic tube, and at least one positional sensor configured to determine a relative orientation of the first segment to the second segment. Some embodiments provided herein relate to mapping information (such as images) along a specific path and/or length of an endoscopic probe.

Abstract: A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: Systems and methods for articulating an elongate articulatable body which is adapted to be delivered within a body cavity. Particularly, systems and methods for enhancing an articulating force on the elongate body without increasing an actuation force applied by an actuator.

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 video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.

Abstract: A flexible endoscope part including an operation member pulling operated to curve a flexible part, a plurality of joint rings connected substantially coaxially to be pivot-able in relation to each other, each the joint rings have an opening part and an engagement part, and an operation-member receiving unit which is inserted into the opening part from outside to inside in the radial direction of the joint ring, is formed by performing bending process on an elastic wire material, is protruded into inside of the joint ring, wherein the operation-member insertion part forms a coil shape which extends in an insertion direction of the operation member.

Abstract: An articulating mechanism for use in a medical device, such as an endoscope or a catheter, includes a series of stacked links disposed adjacent to one another and movable with respect to each other. Each link includes a front face tapered to a pair of pivot points and a rear face defining a wedge shaped recess for receiving the pivot points of the adjacent link. Pull-wires provide tension and hold the staked links together while also allowing for controlled bending of the distal portion by movement of one or more of the pull-wires.

Abstract: A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: A clip device 1 that has a coil-shaped tubular body 6 that is inserted through a curvable treatment instrument insertion channel of an endoscope, the tubular body 6 includes a proximal side coil (first coil) 10 that has a spring constant per unit length of 15 N/mm to 500 N/mm and is disposed on the proximal end side of the tubular body 6; and a distal end side coil 11 that is connected to the distal end of the proximal side coil 10, has a greater inner diameter than the inner diameter of the proximal side coil 10, has a spring constant per unit length of 15 N/mm to 500 N/mm, and has a spring constant that differs from the spring constant of the proximal side coil 10, with the ratio of the spring constants of the proximal side coil 10 and the distal end side coil 11 is greater than 1.0 and less than or equal to 2.0.

Abstract: Methods and apparatus for accessing and treating regions of the body are disclosed herein. Using an endoscopic device having an automatically controllable proximal portion and a selectively steerable distal portion, the device generally may be advanced into the body through an opening. The distal portion is selectively steered to assume a selected curve along a desired path within the body which avoids contact with tissue while the proximal portion is automatically controlled to assume the selected curve of the distal portion. The endoscopic device can then be used for accessing various regions of the body which are typically difficult to access and treat through conventional surgical techniques because the device is unconstrained by “straight-line” requirements. Various applications can include accessing regions of the brain, thoracic cavity, including regions within the heart, peritoneal cavity, etc., which are difficult to reach using conventional surgical procedures.

Abstract: A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: An articulating mechanism for use in a medical device, such as an endoscope or a catheter, includes a series of stacked links disposed adjacent to one another and movable with respect to each other. Each link includes a front face tapered to a pair of pivot points and a rear face defining a wedge shaped recess for receiving the pivot points of the adjacent link. Pull-wires provide tension and hold the staked links together while also allowing for controlled bending of the distal portion by movement of one or more of the pull-wires.

Abstract: An endoscope includes an insertion portion including a bending portion configured to bend in four directions, and a flexible tube portion provided so as to be continuous with the bending portion, wherein the bending portion includes a first bending region and a second bending region, and wherein the flexible tube portion comprises inside, four first guide pipes each including a distal end fixed to a distal end of the first bending region and a proximal end fixed to a bending portion operation device, and three second guide pipes each including a distal end fixed to a distal end of the second bending region and a proximal end fixed to a bending portion bent shape switching device.

Abstract: A system for releasably attaching a steerable disposable multi-linked device to a durable device may include a disposable portion and a durable portion. The disposable portion may include a connecting member connected to the disposable portion and the durable portion and a steerable multi-linked device. The steerable multi-linked device may include a first link, a plurality of intermediate links, a second link movably coupled to a second one of the intermediate links, and a cable which passes through the first link and intermediate links and extends beyond a first end of the first link. A first one of the intermediate links may be movably coupled to the first link. The durable portion may include an axial member which defines an opening therethrough and a feeder mechanism.

Abstract: The medical treatment endoscope according to the present invention includes a sheath having a flexibility; at least one arm member having a bending part that projects out from a front end of the sheath and performs bending actions; an open/close mechanism which directs the arm member from a direction along a central axis of the sheath to a direction deviated from the central axis of the sheath, and from a direction deviated from the central axis of the sheath to a direction along the central axis of the sheath; and a viewing device and an illuminating member that are disposed to the front end side of the sheath.

Abstract: An endoscope includes a manipulation unit, and an insertion unit which is disposed in continuation to the manipulation unit. The insertion unit contains a bending portion which has a plurality of articulation wheels coupled in succession, two adjacent ones of the articulation wheels being coupled by a shaft member so as to be relatively turnable around the shaft member which crosses the center axis of the bending portion, the bending portion being bent in such a way that a wire which leads to the manipulation unit via the plurality of articulation wheels is tractively manipulated. The shaft member has a guide part formed with an insertional hole through which the wire is inserted, and at least the guide part of the shaft member is turnable around the center axis of the shaft member, to both the two articulation wheels coupled by the shaft member.

Abstract: A video endoscope system includes a reusable control cabinet and an endoscope that is connectable thereto. The endoscope may be used with a single patient and then disposed. The endoscope includes an illumination mechanism, an image sensor, and an elongate shaft having one or more lumens located therein. An articulation joint at the distal end of the endoscope allows the distal end to be oriented by the actuators in the control cabinet or actuators in a control handle of the endoscope. Fluidics, electrical, navigation, image, display and data entry controls are integrated into the system along with other accessories.

Abstract: An endoscope insertion portion includes an image pick-up assembly including an image pick-up unit and an image pick-up cable provided in order from the distal end portion to the proximal end side wherein the outer diameter of the image pick-up unit is larger than the outer diameter of the image pick-up cable, and a channel assembly arranged side by side with the image pick-up assembly and including a thin outer diameter portion and a thick outer diameter portion provided in order from the distal end portion to the proximal end side wherein a distal end portion of the thick outer diameter portion is arranged on more proximal end side than a proximal end portion of the image pick-up unit.

Abstract: An instrument guide device comprises an elongated guide shaft having proximal and distal ends and including an instrument lumen for receiving therethrough a manually operated instrument having an instrument shaft. A distal bendable member is disposed at the distal end of the guide shaft and a proximal bendable member is disposed at the proximal end of the guide shaft. Actuation means extends between the distal and proximal bendable members and provides a bending of the distal bendable member controlled from the proximal bendable member. The proximal bendable member is controlled from the manually operated instrument to cause a corresponding bending of said distal bendable member. A locking mechanism has locked and unlocked positions and includes a ball and socket arrangement disposed about the proximal bendable member and a cinch member for locking the ball and socket arrangement.

Abstract: An endoscope includes an active bending portion provided in an insertion portion and bendable according to a bending operation, the active bending portion including bending pieces adjacent to each other and pivotably connected together via a plurality of rotation shafts, the rotation shafts being located at positions differing by 90° in a circumferential direction J of the bending pieces, and a passive bending portion provided closer to the proximal end side than the active bending portion and passively bendable when an external force is applied thereto, the passive bending portion including bending pieces adjacent to each other and pivotably connected together via a plurality of rotation shafts, the rotation shafts being located at positions differing by 60° in the circumferential direction J.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device configured to be introduced into a body. In one embodiment, a surgical device is provided including a cannulated elongate shaft having a distal working end with a flexible steering platform. The flexible steering platform can includes a plurality of axially aligned links and a plurality of flexible connector elements. Adjacent links can be connected using at least two of the connector elements such that flexing one or more connector elements can bend the steering platform in one or more directions. The surgical device's shaft can be configured to receive a flexible surgical instrument therein such that a working end of the surgical instrument can be received within the steering platform, thereby allowing movement of the surgical instrument's working end to be controlled through movement of the steering platform.

Abstract: With a method for manufacturing a bendable tube, which is preferably envisaged for an endoscopic instrument, first a tube is separated into several tube sections in a manner such that adjacent tube sections engage into one another with a positive fit in the axis direction of the tube. After the separation of the tube into several tube sections, one envisages peripherally arranging means for providing a positive fit transversely to the axis direction of the tube, on the regions of the tube sections, which are situated in engagement with one another.

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: A slender insertion section of the endoscope has an endoscope distal-end portion, a tubular body and a bending portion, all extending along the longitudinal axis of the insertion section. The bending portion is arranged between the distal-end portion and the tubular body. The insertion section has an inner component. The bending portion has an annular ring assembly composed of a plurality of annular rings arranged side by side. Each annular ring has a ring body, a pair of bulging portion that face at one end face of the ring body, and a plurality of projections which the inner component can move. The most distal annular ring of the annular ring assembly supports one end of a wire. The wire passes through the annular rings and has its other end coupled to an operation section of the endoscope.

Abstract: A surgical instrument having a surgical unit which operates on an operating portion in a body cavity, an accommodation portion capable of accommodating the surgical unit. The surgical instrument having movement manipulation mechanism connected to the surgical unit for moving the surgical unit to a position at which the surgical unit is accommodated in the accommodation portion and to a position at which the surgical unit is exposed from the accommodation portion along the inside of the accommodation portion.

Abstract: A flexible segment system including: a first link; a first flexible hinge integral to the first link; and a second link integral to and continuing from the first flexible hinge.

Abstract: In one aspect, the present invention is an articulation joint for use in a low cost medical device such as an endoscope intended for a single use. In one embodiment, the articulation joint comprises a plurality of interconnected segments. In another embodiment, the articulation joint comprises an elongated tubular body. In another aspect, the present invention provides methods of manufacturing an articulation joint for use in a medical device.

Abstract: An apparatus having an elongate hollow metal body extending along a longitudinal axis is disclosed. The hollow body defines a central opening and has a predetermined wall thickness. A pattern of laser cut slits is formed into the body. The slits define a plurality of articulatable elements. The plurality of articulatable elements enable active articulation of the body in a first plane and passive deflection in planes orthogonal to the first plane.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. A positively positionable multi-disk wrist mechanism includes a plurality of disks or vertebrae stacked in series. Each vertebra is configured to rotate in pitch or in yaw with respect to each neighboring vertebra. Actuation cables are used to manipulate and control movement of the vertebrae. In specific embodiments, some of the cables are distal cables that extend from a proximal vertebra through one or more intermediate vertebrae to a distal vertebra, while the remaining cables are medial cables that extend from the proximal vertebra to one or more of the intermediate vertebrae. The cables are actuated by a pivoted plate cable actuator mechanism.