US7090683B2 — Flexible instrument

Claim 1

Independent Claim 153 words

A robotic medical system comprising: a flexible instrument having proximal and distal ends with at least one flexible segment extending with direct passage in a lumen of the human body, the at least one flexible segment being controllably bendable so as to locate the distal end of the flexible instrument at an internal target site; a tool operatively connected to the distal end of the flexible instrument for performing a procedure; a master station including an input device; a slave station including a receiver for the flexible instrument for controlling through the receiver at least one degree-of-freedom of the flexible instrument; and an electrical controller coupled between the master station and the slave station operated in accordance with a computer algorithm that receives a command from said input device and for controlling the at least one degree-of-freedom of the flexible instrument so as to respond in accordance with action at the input device.

Claim 2

Dependent Claim 153 words

A robotic medical system comprising: a flexible instrument having proximal and distal ends with at least one flexible segment extending with direct passage in a lumen of the human body, the at least one flexible segment being controllably bendable so as to locate the distal end of the flexible instrument at an internal target site; a tool operatively connected to the distal end of the flexible instrument for performing a procedure; a master station including an input device; a slave station including a receiver for the flexible instrument for controlling through the receiver at least one degree-of-freedom of the flexible instrument; and an electrical controller coupled between the master station and the slave station operated in accordance with a computer algorithm that receives a command from said input device and for controlling the at least one degree-of-freedom of the flexible instrument so as to respond in accordance with action at the input device.

Claim 3

Dependent Claim 20 words

The system of claim 1 , further comprising a mechanically drivable mechanism intercoupled with the tool via the flexible instrument.

Claim 4

Dependent Claim 43 words

The system of claim 1 , further comprising at least one mechanical cable extending along the flexible instrument between the proximal and distal ends and at least a second mechanical cable extending between a drive unit controlled from said controller and said receiver.

Claim 5

Dependent Claim 30 words

The system of claim 3 , wherein the controller activates the at least one mechanical cable to effect flexure of the flexible instrument at the at least one flexible segment.

Claim 6

Dependent Claim 19 words

The system of claim 1 , including a viewing shaft disposed separate from a shaft of the flexible instrument.

Claim 7

Dependent Claim 25 words

The system of claim 5 , wherein the flexible instrument shaft is guidable to the target site alongside of and outside of said viewing shaft.

Claim 8

Dependent Claim 18 words

The system of claim 6 , wherein the flexible instrument shaft is disposed in a flexible guide shaft.

Claim 9

Dependent Claim 33 words

The system of claim 1 , further comprising a cable terminating at a point more distal than a first flexible segment, the cable capable of being pulled to bend the first flexible segment.

Claim 10

Dependent Claim 27 words

The system of claim 2 , wherein the mechanically drivable mechanism comprises a first control element for controlling the bending of the at least one flexible segment.

Claim 11

Dependent Claim 33 words

The system of claim 9 , wherein the flexible instrument comprises an outer shaft and an inner shaft and further including a second control element that controls the rotation of the outer shaft.

Claim 12

Dependent Claim 33 words

The system of claim 10 , further including a third control element that controls the rotation of the inner shaft, said first, second and third control elements being disposed in a single row.

Claim 13

Dependent Claim 20 words

The system of claim 2 , further comprising a drive unit coupled intermediate the controller and the mechanically drivable mechanism.

Claim 14

Independent Claim 124 words

A method of remotely controlling a flexible instrument, comprising: providing a flexible instrument shaft having a distal end supporting a tool, the shaft further including at least one controlled flexible segment about the distal end capable of controlled bending for positioning the tool to an operative site; inserting the shaft into an anatomic lumen, the flexible shaft adapted to conform to the configuration of the anatomic lumen and being unsupported within any viewing endoscope; mechanically driving, via a drive unit, a cabling system extending through the shaft; and activating the at least one controlled flexible segment by operating the drive unit, so as to effect bending of the at least one flexible segment and thereby effect positioning of the tool to the operative site.

Claim 15

Independent Claim 124 words

A method of remotely controlling a flexible instrument, comprising: providing a flexible instrument shaft having a distal end supporting a tool, the shaft further including at least one controlled flexible segment about the distal end capable of controlled bending for positioning the tool to an operative site; inserting the shaft into an anatomic lumen, the flexible shaft adapted to conform to the configuration of the anatomic lumen and being unsupported within any viewing endoscope; mechanically driving, via a drive unit, a cabling system extending through the shaft; and activating the at least one controlled flexible segment by operating the drive unit, so as to effect bending of the at least one flexible segment and thereby effect positioning of the tool to the operative site.

Claim 16

Dependent Claim 18 words

The method of claim 13 , wherein the step of inserting the shaft comprises providing a percutaneous access.

Claim 17

Dependent Claim 21 words

The method of claim 13 , wherein said step of inserting the shaft comprises providing access through a natural body orifice.

Claim 18

Dependent Claim 127 words

A flexible instrument system comprising: a flexible shaft having a proximal end and a distal end, the distal end operatively connected to a tool, the shaft being insertable into an anatomic lumen of a subject so as to dispose the tool at an operative site; a mechanically drivable mechanism disposed at the proximal end of the shaft, the mechanically drivable mechanism capable of operating said tool via at least one flexible segment positioned along the shaft; a mechanical receiver supported from a fixed position adjacent the subject, for receiving and supporting the shaft via the mechanically drivable mechanism in a position to maintain the tool at the operative site; a computation system for receiving electrical control signals received from a user input device for controlling the shaft.

Claim 19

Dependent Claim 127 words

A flexible instrument system comprising: a flexible shaft having a proximal end and a distal end, the distal end operatively connected to a tool, the shaft being insertable into an anatomic lumen of a subject so as to dispose the tool at an operative site; a mechanically drivable mechanism disposed at the proximal end of the shaft, the mechanically drivable mechanism capable of operating said tool via at least one flexible segment positioned along the shaft; a mechanical receiver supported from a fixed position adjacent the subject, for receiving and supporting the shaft via the mechanically drivable mechanism in a position to maintain the tool at the operative site; a computation system for receiving electrical control signals received from a user input device for controlling the shaft.

Claim 20

Dependent Claim 24 words

The system of claim 16 , wherein the flexible shaft is controllable to a greater number of degrees-of-freedom than the degrees-of-freedom of the receiver.

Claim 21

Dependent Claim 16 words

The system of claim 17 , wherein the receiver is controllable to at least one degree-of-freedom.

Claim 22

Dependent Claim 31 words

The system of claim 18 , wherein the shaft is controllable to at least two degrees-of-freedom including remote control of the at least one flexible segment from said user input device.

Claim 23

Dependent Claim 35 words

The system of claim 16 , including a tendon between the tool and mechanically drivable mechanism and wherein the tool, the shaft, the tendon and the mechanically drivable mechanism are disposable as a single unit.

Claim 24

Dependent Claim 44 words

The system of claim 16 , further comprising a drive unit intercoupled between the computation system and the shaft, for converting electrical control signals into mechanical actuations, and wherein said at least one flexible segment extends from said mechanically drivable mechanism to said tool.

Claim 25

Dependent Claim 67 words

The system of claim 21 , wherein the drive unit is drivably intercoupled with the shaft, the drive unit being disposed at a first location which is remote from a second location at which the shaft is disposed and further including at least a first cable between the mechanically drivable mechanism and the tool and at least a second cable between the drive unit and the receiver.

Claim 26

Dependent Claim 24 words

The system of claim 21 , wherein the drive unit has separate cables that couples to and controls both the shaft and the receiver.

Claim 27

Dependent Claim 26 words

The system of claim 21 , wherein the receiver is readily drivably engageable with and disengageable from the mechanically drivable mechanism via a mechanical interface mechanism.

Claim 28

Dependent Claim 19 words

The system of claim 16 , wherein the shaft is controllably bendable at the at least one flexible segment.

Claim 29

Dependent Claim 28 words

The system of claim 16 , wherein the shaft is an inner shaft, the system further comprising a flexible guide shaft for receiving and guiding the inner shaft.

Claim 30

Dependent Claim 160 words

A flexible instrument system, comprising: a medical implement having sufficient flexibility along a length thereof so as to readily flex and conform to a pathway in an anatomic vessel as the implement is inserted therein, and an endoscopic viewing implement disposed alongside of and separate from said medical implement, the medical implement comprising: a tool for performing a medical procedure; a flexible shaft having proximal and distal ends and supporting the tool at its distal end, the shaft being insertable into a subject so as to dispose the tool at an operative site via controlled bending of at least one flexible segment positioned along the shaft; and a mechanically drivable mechanism disposed at the proximal end of the shaft; and a drive unit intercoupled with the medical implement and including; at least a first cable intercoupled with the tool; and at least a second cable intercoupled with the shaft for controlling a bend at the at least one flexible segment.

Claim 31

Dependent Claim 160 words

A flexible instrument system, comprising: a medical implement having sufficient flexibility along a length thereof so as to readily flex and conform to a pathway in an anatomic vessel as the implement is inserted therein, and an endoscopic viewing implement disposed alongside of and separate from said medical implement, the medical implement comprising: a tool for performing a medical procedure; a flexible shaft having proximal and distal ends and supporting the tool at its distal end, the shaft being insertable into a subject so as to dispose the tool at an operative site via controlled bending of at least one flexible segment positioned along the shaft; and a mechanically drivable mechanism disposed at the proximal end of the shaft; and a drive unit intercoupled with the medical implement and including; at least a first cable intercoupled with the tool; and at least a second cable intercoupled with the shaft for controlling a bend at the at least one flexible segment.

Claim 32

Dependent Claim 33 words

The system of claim 27 , wherein the system is remotely controlled through a user input device controllable by a user, and a computation system for receiving user input from the input device.

Claim 33

Dependent Claim 27 words

The system of claim 27 , wherein the tool, the shaft and the mechanically drivable mechanism of the medical implement are all disposable as a single unit.

Claim 34

Dependent Claim 146 words

A flexible instrument system comprising: a drive unit, for controlling operation of a medical implement; a mechanical actuation system extending from the drive unit to the medical implement; a flexible guide shaft having proximal and distal ends with at least one segment thereof extending through a lumen of a subject; and a flexible viewing shaft separate from said flexible guide shaft, extending through said lumen to a target site and associated with a remotely disposed display for viewing the target site; the medical implement comprising; a flexible shaft having proximal and distal ends, the flexible shaft being insertable into a subject through said flexible guide shaft so as to dispose the distal end at an operative site, the shaft further comprising at least one controlled flexible segment for actuating a controlled bend; and a mechanically drivable mechanism disposed at a proximal end of the flexible shaft.

Claim 35

Dependent Claim 146 words

A flexible instrument system comprising: a drive unit, for controlling operation of a medical implement; a mechanical actuation system extending from the drive unit to the medical implement; a flexible guide shaft having proximal and distal ends with at least one segment thereof extending through a lumen of a subject; and a flexible viewing shaft separate from said flexible guide shaft, extending through said lumen to a target site and associated with a remotely disposed display for viewing the target site; the medical implement comprising; a flexible shaft having proximal and distal ends, the flexible shaft being insertable into a subject through said flexible guide shaft so as to dispose the distal end at an operative site, the shaft further comprising at least one controlled flexible segment for actuating a controlled bend; and a mechanically drivable mechanism disposed at a proximal end of the flexible shaft.

Claim 36

Dependent Claim 66 words

The system of claim 30 , wherein the mechanical actuation system comprises a cable extending between the mechanically drivable mechanism and the at least one flexible segment, the cable being axially movable under control of the drive unit to provide the bending at the at least one flexible segment, and a second cable that interconnects the drive unit and a receiver for the mechanically drivable mechanism.

Claim 37

Dependent Claim 43 words

The system of claim 30 , wherein the medical implement further comprises a tool for performing a medical procedure and disposed at the distal end of the flexible shaft and said flexible shaft is disposed alongside and outside of said flexible viewing shaft.

Claim 38

Dependent Claim 40 words

The system of claim 32 , wherein the mechanical actuation system is a first mechanical actuation system, the system further comprising a second mechanical actuation system extending between the drive unit and the tool for controlling operation of the tool.

Claim 39

Dependent Claim 35 words

The system of claim 33 , wherein the second mechanical actuation system comprises a cable extending between the mechanically drivable mechanism and the tool, the cable being axially movable to control operation of the tool.

Claim 40

Dependent Claim 66 words

The system of claim 30 , wherein the system is remotely controlled and further comprising an electrical controller intercoupled with the drive unit for establishing electrical control signals convertible to mechanical actuations for controlling the medical implement, and a user input device coupled to the controller, said implement flexible shaft being inherently and sufficiently deformable and extending entirely from the distal to the proximal ends thereof.

Claim 41

Dependent Claim 25 words

The system of claim 30 , wherein the flexible shaft and mechanically drivable mechanism of the medical implement are all disposable as a single unit.

Claim 42

Dependent Claim 71 words

The system of claim 30 , wherein the drive unit is drivably coupled with the medical implement, the drive unit being disposed at a first location which is remote from a second location at which the medical implement is disposed, and wherein said mechanical actuation system includes a first cable set between the drive unit and a receiver and a second cable set between the mechanically drivable mechanism and the tool.

Claim 43

Dependent Claim 34 words

The system of claim 30 , further comprising a receiver for engaging the mechanically drivable mechanism, the receiver and mechanically drivable mechanism having respective laterally facing engagement surfaces that interlock to couple drive therebetween.

Claim 44

Dependent Claim 16 words

The system of claim 38 , wherein the laterally facing engagement surfaces are each substantially flat.

Claim 45

Dependent Claim 29 words

The system of claim 38 , wherein the receiver and the mechanically drivable mechanism have respective rotatable members are adapted to mate with each other to transfer drive therebetween.

Claim 46

Dependent Claim 26 words

The system of claim 40 , wherein one of the rotatable members includes a blade which interlocks with a receiving slot of a mating rotatable member.

Claim 47

Dependent Claim 32 words

The system of claim 40 , further comprising at least one cable associated with each rotatable member and a cam associated with each rotatable member for tensioning the at least one cable.

Claim 48

Dependent Claim 23 words

The system of claim 40 , wherein the receiver and the mechanically drivable mechanism carry respective gears adapted to rotate the flexible shaft.

Claim 49

Dependent Claim 27 words

The system of claim 40 , including a carriage supporting the receiver and the mechanically drivable mechanism for transition in a direction axial of the flexible shaft.

Claim 50

Dependent Claim 196 words

A robotic medical system comprising: a flexible guide shaft having proximal and distal ends with at least one segment thereof extending through a lumen of a subject; a flexible instrument shaft extending through the flexible guide shaft and having at least one flexible segment thereof that is remotely controllably bendable so as to locate a distal end of the flexible instrument shaft at an internal target site of the subject; a tool carried at the distal end of the flexible instrument shaft for performing a procedure at the internal target site; a flexible viewing shaft, having a distal end separate from said flexible instrument shaft, extending to the target site and associated with a remotely disposed display for viewing the target site; a master station including an input device; a slave station including a receiver upon which the flexible instrument shaft is mounted and for controlling movement of said flexible instrument shaft; and an electrical controller coupled between the master station and the slave station operated in accordance with a command from said input device and for controlling at least one degree-of-freedom of the flexible instrument shaft so as to replicate action at the input device.

Claim 51

Dependent Claim 196 words

A robotic medical system comprising: a flexible guide shaft having proximal and distal ends with at least one segment thereof extending through a lumen of a subject; a flexible instrument shaft extending through the flexible guide shaft and having at least one flexible segment thereof that is remotely controllably bendable so as to locate a distal end of the flexible instrument shaft at an internal target site of the subject; a tool carried at the distal end of the flexible instrument shaft for performing a procedure at the internal target site; a flexible viewing shaft, having a distal end separate from said flexible instrument shaft, extending to the target site and associated with a remotely disposed display for viewing the target site; a master station including an input device; a slave station including a receiver upon which the flexible instrument shaft is mounted and for controlling movement of said flexible instrument shaft; and an electrical controller coupled between the master station and the slave station operated in accordance with a command from said input device and for controlling at least one degree-of-freedom of the flexible instrument shaft so as to replicate action at the input device.

Claim 52

Dependent Claim 40 words

The system of claim 45 , further comprising a mechanically drivable mechanism intercoupled with the tool via the flexible instrument, and wherein said controller controls three dimensional motion of the instrument to replicate three dimensional action at the input device.

Claim 53

Dependent Claim 15 words

The system of claim 45 , wherein said flexible instrument comprises a single flexible shaft.

Claim 54

Dependent Claim 15 words

The system of claim 47 wherein the flexible instrument comprises inner and outer coaxial shafts.

Claim 55

Dependent Claim 163 words

A flexible instrument system comprising: a flexible instrument shaft having a proximal end and a distal end, the distal end supporting a tool, the shaft being insertable into a subject through a body lumen so as to dispose the tool at an operative site of a subject; a mechanically drivable mechanism disposed at the proximal end of the shaft, the mechanically drivable mechanism capable of operating said tool via at least one flexible segment positioned along the shaft; a flexible viewing shaft, having a distal end separate from said flexible instrument shaft, extending to the target site and associated with a remotely disposed display for viewing the target site; a receiver for receiving and supporting the flexible instrument shaft via the mechanically drivable mechanism in a manner to position the tool at the operative site; a computation system for receiving electrical control signals received from a remote user input device for controlling said at least one flexible segment of the flexible instrument shaft.

Claim 56

Dependent Claim 163 words

A flexible instrument system comprising: a flexible instrument shaft having a proximal end and a distal end, the distal end supporting a tool, the shaft being insertable into a subject through a body lumen so as to dispose the tool at an operative site of a subject; a mechanically drivable mechanism disposed at the proximal end of the shaft, the mechanically drivable mechanism capable of operating said tool via at least one flexible segment positioned along the shaft; a flexible viewing shaft, having a distal end separate from said flexible instrument shaft, extending to the target site and associated with a remotely disposed display for viewing the target site; a receiver for receiving and supporting the flexible instrument shaft via the mechanically drivable mechanism in a manner to position the tool at the operative site; a computation system for receiving electrical control signals received from a remote user input device for controlling said at least one flexible segment of the flexible instrument shaft.

Claim 57

Dependent Claim 18 words

The system of claim 49 wherein the flexible instrument shaft is disposed alongside of said flexible viewing shaft.

Claim 58

Dependent Claim 22 words

The system of claim 49 , wherein the tool, the shaft and the mechanically drivable mechanism are disposable as a single unit.

Claim 59

Dependent Claim 72 words

The system of claim 49 , further comprising a drive unit intercoupled between the computation system and the shaft, for converting electrical control signals into mechanical actuations, so as to replicate at the instrument shaft actions taken at the user input device, at least a first tendon operatively interconnected between the drive unit and the receiver, and at least a second tendon operatively interconnected between the mechanically drivable mechanism and the tool.

Claim 60

Dependent Claim 38 words

The system of claim 52 , wherein the drive unit is drivably intercoupled with the shaft, the drive unit being disposed at a first location which is remote from a second location at which the shaft is disposed.

Claim 61

Dependent Claim 20 words

The system of claim 52 , wherein the drive unit couples to and controls both the shaft and the receiver.

Claim 62

Dependent Claim 26 words

The system of claim 52 , wherein the receiver is a mechanical receiver and is readily drivably engageable with and disengageable from the mechanically drivable mechanism.

Claim 63

Dependent Claim 29 words

The system of claim 49 , wherein said computation system controls the flexible shaft in three dimensions so as to replicate three dimensional motion at the user input device.

Claim 64

Dependent Claim 28 words

The system of claim 49 , wherein the shaft is an inner shaft, the system further comprising a flexible guide shaft for receiving and guiding the inner shaft.

Claim 65

Dependent Claim 134 words

A flexible instrument system comprising: a drive unit, for controlling operation of a medical implement; a mechanical actuation system extending from the drive unit; and the medical implement having sufficient flexibility to conform to a pathway in an anatomic vessel as the implement is inserted therein, the medical implement consisting only of; a flexible shaft having proximal and distal ends, the flexible shaft being insertable into a subject so as to dispose the distal end at an operative site, the shaft further comprising at least one controlled flexible segment for actuating a controlled bend for controlling the disposition of a working end of said flexible shaft; the working end; and a mechanically drivable mechanism disposed at a proximal end of the flexible shaft operable from said mechanical actuation system to actuate the controlled bend.

Claim 66

Dependent Claim 134 words

A flexible instrument system comprising: a drive unit, for controlling operation of a medical implement; a mechanical actuation system extending from the drive unit; and the medical implement having sufficient flexibility to conform to a pathway in an anatomic vessel as the implement is inserted therein, the medical implement consisting only of; a flexible shaft having proximal and distal ends, the flexible shaft being insertable into a subject so as to dispose the distal end at an operative site, the shaft further comprising at least one controlled flexible segment for actuating a controlled bend for controlling the disposition of a working end of said flexible shaft; the working end; and a mechanically drivable mechanism disposed at a proximal end of the flexible shaft operable from said mechanical actuation system to actuate the controlled bend.

Claim 67

Dependent Claim 15 words

The system of claim 58 further including a guide shaft for receiving the flexible shaft.

Claim 68

Dependent Claim 16 words

The system of claim 58 wherein the flexible shaft is in direct contact within the pathway.

Claim 69

Dependent Claim 302 words

A remotely controllable flexible instrument system for performing a medical procedure on a subject, comprising: an instrument shaft having proximal and distal ends, the shaft being insertable into an anatomic lumen of a subject so as to dispose the distal end of the instrument shaft at an internal target site; a shaft mount coupled to the instrument shaft at the proximal end of the instrument shaft; a drive unit drivably coupled to the shaft mount; said instrument shaft comprising an elongated flexible instrument shaft that supports a medical procedure member for performing the medical procedure at the internal target site; a flexible instrument guide shaft for receiving therethrough said flexible instrument shaft and constructed and arranged so that some length of the guide shaft supports the flexible instrument shaft adjacent the internal target site; said flexible instrument shaft constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to control the distal end of the flexible instrument shaft at the internal target site; an elongated flexible endoscopic viewing member having means for viewing the target site and coupled with a remotely disposed display for depicting the internal target site; said elongated flexible endoscopic viewing member, having a distal end being disposed alongside of and separate from said flexible instrument shaft; and a remote user interface at which a user may manipulate an input device, and an electrical controller for receiving commands from the user interface and transmitting signals to the drive unit for controlling movement of said tool to replicate input device manipulations by the user; said electrical controller further including a command processing program for controlling said at least one remotely controllable flexible segment and movement of the medical procedure member in accordance with manipulations of the input device by the user.

Claim 70

Dependent Claim 302 words

A remotely controllable flexible instrument system for performing a medical procedure on a subject, comprising: an instrument shaft having proximal and distal ends, the shaft being insertable into an anatomic lumen of a subject so as to dispose the distal end of the instrument shaft at an internal target site; a shaft mount coupled to the instrument shaft at the proximal end of the instrument shaft; a drive unit drivably coupled to the shaft mount; said instrument shaft comprising an elongated flexible instrument shaft that supports a medical procedure member for performing the medical procedure at the internal target site; a flexible instrument guide shaft for receiving therethrough said flexible instrument shaft and constructed and arranged so that some length of the guide shaft supports the flexible instrument shaft adjacent the internal target site; said flexible instrument shaft constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to control the distal end of the flexible instrument shaft at the internal target site; an elongated flexible endoscopic viewing member having means for viewing the target site and coupled with a remotely disposed display for depicting the internal target site; said elongated flexible endoscopic viewing member, having a distal end being disposed alongside of and separate from said flexible instrument shaft; and a remote user interface at which a user may manipulate an input device, and an electrical controller for receiving commands from the user interface and transmitting signals to the drive unit for controlling movement of said tool to replicate input device manipulations by the user; said electrical controller further including a command processing program for controlling said at least one remotely controllable flexible segment and movement of the medical procedure member in accordance with manipulations of the input device by the user.

Claim 71

Dependent Claim 14 words

The system of claim 61 wherein said endoscopic viewing member comprises a viewing shaft.

Claim 72

Dependent Claim 28 words

The system of claim 61 wherein the guide shaft is inserted into the anatomic lumen and is in direct contact with the walls that define the anatomic lumen.

Claim 73

Dependent Claim 23 words

The system of claim 61 wherein the elongated flexible instrument shaft is deformable along a length from the shaft mount to the tool.

Claim 74

Dependent Claim 24 words

The system of claim 61 wherein the shaft, shaft mount and medical procedure member are constructed and arranged as a single piece disposable unit.

Claim 75

Dependent Claim 35 words

The system of claim 61 further comprising a receiver intercoupled with the drive unit, the shaft mount being readily removably mountable on the receiver for drivable intercoupling of the shaft mount with the drive unit.

Claim 76

Dependent Claim 47 words

The system of claim 61 wherein the shaft mount and the receiver are engageable and disengageable from each other and further including a first tendon set between the drive unit and the receiver and a second tendon set between the shaft mount and the medical procedure member.

Claim 77

Dependent Claim 22 words

The system of claim 67 wherein the drive unit is engageable with and disengageable from the receiver, the drive unit being portable.

Claim 78

Dependent Claim 14 words

The system of claim 61 wherein the instrument has multiple remote controllably flexible segments.

Claim 79

Dependent Claim 28 words

The system of claim 61 wherein the electrical controller controls the instrument shaft in three dimensions in accordance with and corresponding to manipulations at the remote user interface.

Claim 80

Dependent Claim 230 words

A remotely controllable instrument system comprising: a user interface at which a user may manipulate an input device; an instrument used in performing a medical procedure at a target site of a subject; said instrument including an elongated shaft having a tool mounted at a distal end thereof; a viewing endoscope shaft that is inserted into the subject for viewing the target site; an electrical controller for receiving commands from said user interface; a drive unit intercoupling the electrical controller and the instrument for controlling the instrument in accordance with input device manipulations; said instrument shaft being constructed and arranged so that its physical properties make at least some length thereof inherently and sufficiently deformable so as to enable it to readily pass atraumatically into an anatomic lumen of the subject; said instrument shaft being further constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to locate the distal end of the flexible shaft at the internal target site; and a drive unit drivably coupled to said instrument for operating said tool through said instrument shaft; said drive unit being operable from the input device at said user interface so as to control operation of said tool at said target site to replicate input device manipulations; said instrument shaft being guidable to said target site alongside of said endoscope shaft.

Claim 81

Dependent Claim 230 words

A remotely controllable instrument system comprising: a user interface at which a user may manipulate an input device; an instrument used in performing a medical procedure at a target site of a subject; said instrument including an elongated shaft having a tool mounted at a distal end thereof; a viewing endoscope shaft that is inserted into the subject for viewing the target site; an electrical controller for receiving commands from said user interface; a drive unit intercoupling the electrical controller and the instrument for controlling the instrument in accordance with input device manipulations; said instrument shaft being constructed and arranged so that its physical properties make at least some length thereof inherently and sufficiently deformable so as to enable it to readily pass atraumatically into an anatomic lumen of the subject; said instrument shaft being further constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to locate the distal end of the flexible shaft at the internal target site; and a drive unit drivably coupled to said instrument for operating said tool through said instrument shaft; said drive unit being operable from the input device at said user interface so as to control operation of said tool at said target site to replicate input device manipulations; said instrument shaft being guidable to said target site alongside of said endoscope shaft.

Claim 82

Dependent Claim 27 words

The system of claim 71 including a cable pathway extending from the drive unit to the flexible segment, for actuation of controlled bending via the drive unit.

Claim 83

Dependent Claim 26 words

The system of claim 72 including another cable pathway extending from the drive unit to the tool, for actuation of the tool via the drive unit.

Claim 84

Dependent Claim 18 words

The system of claim 71 wherein said instrument shaft is controlled in three dimensions from said user interface.

Claim 85

Dependent Claim 22 words

The system of claim 71 wherein said instrument shaft is disposed separate from and controlled independent of operation of said endoscope shaft.

Claim 86

Independent Claim 161 words

A method of performing a medical procedure comprising the steps of: providing an elongated flexible instrument member having a distal end supporting a tool, and further including at least one controlled flexible segment capable of controlled bending for positioning the tool to an operative site; inserting the elongated flexible instrument member through a guide tube into an anatomic lumen, the flexible instrument member and guide tube adapted to conform to the configuration of the anatomic lumen; mechanically driving, via an electromechanical drive unit, a cabling system that couples with the elongated flexible instrument member; detecting and displaying a visualization of the operative site discernable by a user; and activating the at least one controlled flexible segment by operating the drive unit from a remote user interface, so as to effect bending of the at least one flexible segment and thereby effect positioning of the tool at the operative site; said detecting and displaying step being controlled independent of said activating step.

Claim 87

Independent Claim 161 words

A method of performing a medical procedure comprising the steps of: providing an elongated flexible instrument member having a distal end supporting a tool, and further including at least one controlled flexible segment capable of controlled bending for positioning the tool to an operative site; inserting the elongated flexible instrument member through a guide tube into an anatomic lumen, the flexible instrument member and guide tube adapted to conform to the configuration of the anatomic lumen; mechanically driving, via an electromechanical drive unit, a cabling system that couples with the elongated flexible instrument member; detecting and displaying a visualization of the operative site discernable by a user; and activating the at least one controlled flexible segment by operating the drive unit from a remote user interface, so as to effect bending of the at least one flexible segment and thereby effect positioning of the tool at the operative site; said detecting and displaying step being controlled independent of said activating step.

Claim 88

Dependent Claim 18 words

The method of claim 76 wherein said detecting and displaying step is motionally decoupled from said activating step.

Claim 89

Dependent Claim 33 words

The method of claim 76 wherein said detecting and displaying step includes detection by one or means selected from the following, ultrasound (echocardiography, Doppler ultrasound), angiography, electrophysiology, radiology or magnet resonance imaging (MRI).

Claim 90

Dependent Claim 17 words

The method of claim 76 wherein said detecting and displaying step includes detection by a viewing endoscope.

Claim 91

Dependent Claim 26 words

The method of claim 76 wherein said tool is operated with multiple degrees of freedom, all of which are controlled through said elongated flexible instrument member.

Claim 92

Dependent Claim 19 words

The method of claim 76 wherein said detecting and displaying step is controlled entirely independent of said activating step.

Claim 93

Dependent Claim 241 words

A remotely controllable instrument system comprising: a user interface at which a user may manipulate an input device; an instrument used in performing a medical procedure at a target site of a subject; said instrument including an elongated shaft having a proximal end and a working distal end thereof; an electrical controller for receiving commands from said user interface; a drive unit intercoupling the electrical controller and the instrument for controlling the instrument in accordance with input device manipulations; said instrument shaft being constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to locate the distal end of the flexible shaft at the internal target site; and a drive unit drivably coupled to said instrument for operating said tool through said instrument shaft; said drive unit being operable from the input device at said user interface so as to control operation of said tool at said target site to replicate input device manipulations; at least one elongate element extending between proximal and working ends of said instrument shaft; an instrument coupler positioned at the proximal end of the instrument shaft; and at least one rotatable body mounted at said instrument coupler and to which said at least one elongate element is connected so that selective displacement of the rotatable body causes the selective pulling of the said at least one elongate element to control the bending motion of said flexible segment.

Claim 94

Dependent Claim 241 words

A remotely controllable instrument system comprising: a user interface at which a user may manipulate an input device; an instrument used in performing a medical procedure at a target site of a subject; said instrument including an elongated shaft having a proximal end and a working distal end thereof; an electrical controller for receiving commands from said user interface; a drive unit intercoupling the electrical controller and the instrument for controlling the instrument in accordance with input device manipulations; said instrument shaft being constructed and arranged having at least one remotely controllable flexible segment disposed therealong and being controllably bendable so as to locate the distal end of the flexible shaft at the internal target site; and a drive unit drivably coupled to said instrument for operating said tool through said instrument shaft; said drive unit being operable from the input device at said user interface so as to control operation of said tool at said target site to replicate input device manipulations; at least one elongate element extending between proximal and working ends of said instrument shaft; an instrument coupler positioned at the proximal end of the instrument shaft; and at least one rotatable body mounted at said instrument coupler and to which said at least one elongate element is connected so that selective displacement of the rotatable body causes the selective pulling of the said at least one elongate element to control the bending motion of said flexible segment.

Claim 95

Dependent Claim 29 words

The system of claim 82 wherein said drive unit includes a drive coupler releasably engageable with the instrument coupler for transferring drive from the drive unit to the instrument.

Claim 96

Dependent Claim 36 words

The system of claim 83 including a cable pathway extending from the drive unit to the tool, and a tool at the working end, said cable pathway for actuation of the tool via the drive unit.

Claim 97

Dependent Claim 24 words

The system of claim 84 wherein said drive unit includes a drive coupler that includes a drive wheel member engagable with the rotatable body.

Claim 98

Dependent Claim 17 words

The system of claim 85 wherein another rotatable body and associated drive wheel member control said tool.

Claim 99

Dependent Claim 29 words

The system of claim 86 including another elongated element and associated rotatable body for controlling said tool, said another elongated element extending through the center of said flexible segment.

Annuity Stage	Window Opens	Payment Deadline	Surcharge Period Until	Estimated Fee	Status
3.5 Years (Year 4)	2009-08-14	2010-02-13	2010-08-15	$2000.00	Window Closed / Lapsed
7.5 Years (Year 8)	2013-08-14	2014-02-13	2014-08-15	$3760.00	Window Closed / Lapsed
11.5 Years (Year 12)	2017-08-14	2018-02-13	2018-08-15	$7700.00	Window Closed / Lapsed

Flexible instrument

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