Endoluminal surgical tool with small bend radius steering section

Abstract

An endoluminal surgical instrument has first and second steering controls on a handle. A flexible shaft attached to the handle has a distal steerable end including a first link and a second link separated by a plurality of intermediate links. First and second steering elements, such as pairs of steering wires, are linked to first and second steering controls and to the first and second links. One or more of the links is pivotable through an angle of at least 30 degrees relative to an adjoining link. The set back position of the second steering elements from the first steering elements, and the pivoting capability of the links allows the steerable end to be steered into a small bend radius. This makes the instrument highly maneuverable for use in endoluminal surgery, such as incision-less surgery of the stomach.

1 . An endoluminal surgical instrument, comprising:
 a handle;   first and second steering controls on the handle;   a flexible shaft attached to the handle;   the flexible shaft having a distal steerable end including a distal link and a proximal link spaced proximally apart from the distal link by a plurality of intermediate links; and   a first pair of steering wires passing through the proximal link and attached to the distal link; and   a second pair of steering wires attached to the proximal link, and with all of the steering wires substantially equally radially spaced apart.   
     
     
         2 . The surgical instrument of  claim 1  further comprising an end tip on a distal end of the flexible shaft and with a distal link adjacent to the end tip. 
     
     
         3 . The surgical instrument of  claim 2  with the end tip attached onto the distal link. 
     
     
         4 . The surgical instrument of  claim 1  comprising 2-10 intermediate links. 
     
     
         5 . The surgical instrument of  claim 2  comprising two or more lumens extending from the handle to the end tip. 
     
     
         6 . The surgical instrument of  claim 1  with one or more of the links pivotal through an angle of at least 30 degrees relative to an adjoining pivotally attached link. 
     
     
         7 . An endoluminal surgical instrument, comprising:
 a handle;   left/right and up/down steering controls on the handle;   a flexible shaft, with a proximal end of the flexible shaft attached to the handle;   the flexible shaft having a distal steerable end including a distal link spaced apart from a proximal link by a plurality of intermediate links, with substantially each intermediate link pivotal through an angle of at least  30  degrees relative to an adjoining intermediate link;   an end tip attached onto the distal link;   two or more lumens extending through the flexible shaft from the handle to the end tip;   left and right steering wires extending distally from the left/right steering control to the proximal link, with the left steering wire attached to a left side of the proximal link and with the right steering wire attached to a right side of the proximal link; and   up and down steering wires extending distally from the up/down steering control, passing through or by the proximal link, and terminating at the distal link, with the up steering wire attached to a top of the distal link and with the down steering wire attached to a bottom of the distal link, and with all of the steering wires equally radially spaced apart.