Methods and apparatus to shape flexible entry guides for minimally invasive surgery

A method for a surgical procedure, the method comprising:

• inserting a first steering device into a first lumen at a first end of a flexible entry guide tube;
• inserting the flexible entry guide tube into a body cavity through an opening;
• steering a second end of the flexible entry guide tube towards a first surgical site within the body cavity using the first steering device;
• and
• locking the shape of the flexible entry guide tube in place within the body cavity with the second end located near the surgical site to guide surgical tools into the surgical site.

An apparatus for surgical procedures, the apparatus comprising:

• a flexible entry guide tube having one or more lumens extending along its length from a proximal end to substantially at or near a distal end;
• a first tool insertable into a first instrument lumen;
• and
• a first locking device adapted to couple a portion of the first tool to a portion of the flexible entry guide tube within the first instrument lumen to deter axial motion of the first tool along the length of the flexible entry guide tube.

A method for a surgical procedure, the method comprising:

• inserting a first substantially rigid removable stiffening rod into a first lumen within a flexible entry guide;
• stiffening a first portion of the entry guide with the first substantially rigid removable stiffening rod;
• and
• steering the flexible entry guide towards a surgical site.

A surgical apparatus comprising:

• an entry guide tube having a plurality of lumens defined between a proximal end and a distal end;
• and
• a first device configured to be inserted into a first lumens, wherein the first device comprises a first steerable flexible portion;
• wherein if the first steerable flexible portion of the first device is within the first lumen, then the first steerable flexible portion shapes an adjacent portion of the entry guide tube;
• and
• wherein if the first steerable flexible portion extends out of the first lumens beyond the distal end of the entry guide tube, then the first steerable flexible portion is used to conduct a surgical operation.

A method for a surgical procedure, the method comprising:

• inserting a distal end of a flexible entry guide through an opening of a body, the flexible entry guide including one or more lumens to receive tools;
• operating controls at a console to remotely control one or more actuators;
• and
• steering the flexible entry guide towards a surgical site in response to the remote control of the one or more actuators.

A flexible entry guide system for a surgical procedure, the system comprising:

• a flexible entry guide having a proximal end and a distal end, the flexible entry guide including
• a plurality of vertebrae pivotally coupled together to allow the entry guide to flex, each of the plurality of vertebrae having one or more lumen openings axially aligned together to form one or more lumens along the length of the flexible entry guide;
• a plurality of steering cables routed from a proximal end of the entry guide through a plurality of axially aligned cable openings in the vertebrae to one or more steering points of the entry guide;
• and
• a plurality of actuators coupled to ends of the plurality of steering cables, the plurality of actuators under remote control of a first control system to steer the flexible entry guide within a body.

A surgical apparatus for a surgical procedure, the apparatus comprising:

• a flexible entry guide tube having a plurality of lumens between a proximal end and a distal end;
• a plurality of tools insertable into the plurality of lumens, each of the plurality of tools including
• a steerable portion extendable beyond the distal end of the flexible entry guide tube, and
• a sensor to sense a shape of all or a portion of the tool;
• wherein the shape of each of the plurality of tools is controlled in response to the shape of each respective tool sensed by each sensor.

A method for a surgical procedure, the method comprising:

• inserting a plurality of instruments into a respective plurality of lumens in a flexible entry guide and coupling portions of the plurality of instruments to lumen walls in the respective plurality of lumens of the flexible entry guide;
• pushing and/or pulling the plurality of instruments having portions coupled to the lumen walls to steer the flexible entry guide to a surgical site of a body;
• and
• rigidizing the flexible entry guide to maintain its shape and position in the body near the surgical site to perform the surgical procedure.