# US 12,213,649 B2 · Steerable instrument comprising a cylindrical diameter adaptation section > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,213,649 B2 - Document ID: US12213649B2 - Status: Granted - Kind: B2 - Application number: 17/965,870 - Filed: 2022-10-14 - Published: 2023-02-02 - Granted: 2025-02-04 - Earliest claimed: 2016-06-06 - Assignees: Fortimedix Assets II B.V. - Applicants: Fortimedix Assets II B.V. - Inventors: Mattheus Hendrik Louis Thissen - Web page: https://patentgrep.com/patent/US12213649B2 ## CPC - A61B 1/0055: {Constructional details of insertion parts, e.g. vertebral elements} - A61B 1/0011: {Manufacturing of endoscope parts} - A61B 1/0057: {Constructional details of force transmission elements, e.g. control wires} - A61B 1/008: Articulations - A61B 1/00071: {Insertion part of the endoscope body (A61B1/0055 takes precedence)} - A61B 1/0052: {Constructional details of control elements, e.g. handles} - A61B 17/29: Forceps for use in minimally invasive surgery - A61B 2017/00309: {Cut-outs or slits} - A61B 2017/00318: {Steering mechanisms} - A61B 2017/00323: {Cables or rods} - A61B 2017/2905: {flexible} - A61B 2017/2906: {Multiple forceps} - A61B 2017/2908: {Multiple segments connected by articulations} - A61B 2017/291: {the position of the handle being adjustable with respect to the shaft} - A61M 25/0138: {having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract A steerable instrument for endoscopic and/or invasive type of applications, such as in surgery, which has an elongated tubular body having a proximal end part with a first actuation flexible zone having a first diameter and a distal end part having a first distal flexible zone having a second diameter that is different from the first diameter. A cylindrical diameter adaptation section is arranged to connect the proximal end part to the distal end part such that a flexion in a radial direction relative to a longitudinal center axis of the longitudinal tubular body of the first actuation flexible zone results in an amplified or attenuated flexion of the first distal flexible zone. ## Claims ### Claim 1 A steerable instrument for at least one of endoscopic and invasive type of applications, the instrument comprising an elongated tubular body having at least a first actuation zone at a proximal side of the steerable instrument and at least a first bendable zone at a distal side of the steerable instrument, the first actuation zone being configured to control bending of the first bendable zone by means of a plurality of longitudinal steering elements, the steerable instrument having a cylindrical diameter adaptation section located proximally from the first bendable zone and comprising a first side and a second side, wherein the longitudinal steering elements comprise at least a first set of one or more longitudinal steering elements and a second set of one or more longitudinal steering elements, said one or more longitudinal steering elements of the first set of longitudinal steering elements are defined by longitudinal slits provided in a wall of a first cylindrical tube and are located at a first distance from an axis of symmetry at said first side as well as within said cylindrical diameter adaptation section, the first cylindrical tube having a first radius equal to said first distance, said one or more longitudinal steering elements of the second set of longitudinal steering elements are defined by longitudinal slits provided in a wall of a second cylindrical tube and are located at a second distance from said axis of symmetry at said second side as well as within said cylindrical diameter adaptation section, said second distance being different from said first distance, the second cylindrical tube having a second radius equal to said second distance, each longitudinal steering element of the first set of one or more steering longitudinal steering elements is overlapping with one longitudinal steering element of the second set of one or more longitudinal steering elements within said cylindrical diameter adaptation section in an area of overlap as seen in a radial direction from said axis of symmetry, and each longitudinal steering element of the first set of one or more longitudinal steering elements is connected and/or attached to one longitudinal steering element of the second set of one or more longitudinal steering elements in the area of overlap, such that a movement of each longitudinal steering element of the first set of one or more longitudinal steering elements in a longitudinal direction of said steerable instrument results in a same movement of said one longitudinal steering element of the second set of one or more longitudinal steering elements to which it is connected and/or attached in said longitudinal direction. ### Claim 2 (depends on 1) The steerable instrument according to claim 1, wherein said first actuation zone is flexible and configured to control deflecting of said first bendable zone by deflecting said first actuation zone about a first angle relative to said axis of symmetry such that said first bendable zone is deflected about a second angle which is different from said first angle. ### Claim 3 (depends on 1) The steerable instrument according to claim 1, wherein said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements is attached to a flexible longitudinal steering element which is defined by slits provided in the wall of said second cylindrical tube and located outside said cylindrical diameter adaptation section and inside said first actuation zone. ### Claim 4 (depends on 1) The steerable instrument according to claim 1, wherein said steerable instrument comprises a third cylindrical tube having a third radius between said first radius and second radius and being located between said first cylindrical tube and said second cylindrical tube, the third cylindrical tube having one or more open spaces in said cylindrical diameter adaptation section, each open space being configured to allow said one of said one or more longitudinal steering elements of the first set of longitudinal steering elements to be connected or attached to, or both connected and attached to said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements. ### Claim 5 (depends on 4) The steerable instrument according to claim 4, wherein said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements is attached to a flexible longitudinal steering element which is defined by slits provided in the wall of said second cylindrical tube and located outside said cylindrical diameter adaptation section and inside said first actuation zone, and said third cylindrical tube is provided with a flexible portion inside said first actuation zone. ### Claim 6 (depends on 4) The steerable instrument according to claim 4, wherein a sliding island is provided in each said open space, each sliding island being at least one of connected to and attached to both said one of said one or more longitudinal steering elements of the first set of longitudinal steering elements and to said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements, and each sliding island having a longitudinal size which is smaller than a longitudinal size of said open space. ### Claim 7 (depends on 4) The steerable instrument according to claim 4, wherein said one of said one or more longitudinal steering elements of the first set of longitudinal steering elements and said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements are at least one of connected and attached to each other through said open space by means of a lip. ### Claim 8 (depends on 1) The steerable instrument according to claim 1, wherein said one of said one or more longitudinal steering elements of the first set of longitudinal steering elements and said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements are attached to one another by means of at least one of a welding process and gluing. ### Claim 9 (depends on 1) The steerable instrument according to claim 1, wherein said one of said one or more longitudinal steering elements of the first set of longitudinal steering elements and said one of said one or more longitudinal steering elements of the second set of longitudinal steering elements are connected to one another by means of a mechanical connection. ### Claim 10 (depends on 1) The steerable instrument according to claim 1, wherein said elongated tubular body has a second actuation zone at said proximal side of the steerable instrument and a second bendable zone at said distal side of the steerable instrument, said second actuation zone being configured to control bending of said second bendable zone by means of an other plurality of longitudinal steering elements. ### Claim 11 (depends on 1) The steerable instrument according to claim 1, wherein each one of the first cylindrical tube and second cylindrical tube has a thickness in a range of 0.1-2.0 mm. ### Claim 12 (depends on 4) The steerable instrument according to claim 4, wherein the third cylindrical tube has a thickness in a range of 0.1-2.0 mm. ### Claim 13 (depends on 1) The steerable instrument according to claim 1, wherein the longitudinal slits defining the first set of longitudinal steering elements and the longitudinal slits defining the second set of longitudinal steering elements have a width in a range of 5-50 μm. ### Claim 14 (depends on 6) A method of producing a steerable instrument for endoscopic and/or invasive type of applications according to claim 6, the method comprising: providing said first cylindrical tube, providing said third cylindrical tube, said third cylindrical tube comprising rigid, portions attached to one another by connection elements, said portions and connection elements defining an open space, said at least one sliding island being attached to at least one of said connection elements and said rigid, portions by means of one or more break islands, inserting said first cylindrical tube into said third cylindrical tube, aligning said at least one sliding island with said at least one of said one or more longitudinal elements of said first cylindrical tube, at least one of connecting and attaching said at least one sliding island to said at least one of said one or more longitudinal elements of said first cylindrical tube, providing said second cylindrical tube and inserting said first cylindrical tube and said third cylindrical tube into said second cylindrical tube, aligning said at least one sliding island with said at least one of said one or more longitudinal elements of said second cylindrical tube, at least one of connecting and attaching said at least one sliding island to said at least one of said one or more longitudinal elements of said second cylindrical tube, breaking off said one or more break islands by moving said at least one sliding island in said open space such that said at least one sliding island can freely move in said open space. ### Claim 15 (depends on 14) The method according to claim 14, wherein said action of breaking off said one or more break islands by moving said at least one sliding island in said open space such that said at least one sliding island can freely move in said open space is performed by moving said at least one of said one or more longitudinal elements of said first cylindrical tube and said at least one of said one or more longitudinal elements of said second cylindrical tube relative to said third cylindrical tube.