This review article provides a comprehensive overview and classification of the joint types used in the steerable tips of minimally invasive surgical instruments. The review was carried out with the objective to pinpoint the essence of the joints' fundamental mechanical design and to provide a qualitative comparison of their strengths and weaknesses with respect to a number of straightforward criteria. Besides researching the ASME scientific literature, the entire Espacenet patent database was searched using the keywords endo* or lapar* or surg* in title and steer* or articu* or deflect* in title or abstract. The extensive scope of the patent results was further limited to World (WO), United States (US), and European (EP) patents only as well as to the period of the last decade, 2003–2013, with a few exceptions predating this period. Overall, more than 840 patents were reviewed and categorized on the basis of the joints' mechanical design and supplemented with the scientific papers. A number of joint categories and subcategories were identified. At the fundamental level the joints can be differentiated as planar and spatial, where the spatial are further split as perpendicular mirrored and revolved. Based on the means of establishing rotational motion, the joint types can be discriminated as rolling, sliding, the combination of rolling and sliding, and bending. Lastly, the rolling and sliding categories can be further split with regard to the phenomenon or feature used for transferring the rotational motion, i.e., friction, teeth, belts, curved features, and hinges. In general, the most favored joint types were identified as the sliding and the bending joint categories overall. Nevertheless, it was recognized that no single fundamental joint type can be considered as ideal and that novel and preferably more superior joint configurations can be generated by combining several fundamental categories together.

References

References
1.
Braga
,
M.
,
Vignali
,
A.
,
Gianotti
,
L.
,
Zuliani
,
W.
,
Radaelli
,
G.
,
Gruarin
,
P.
,
Dellabona
,
P.
, and
Carlo
,
V. D.
,
2002
, “
Laparoscopic Versus Open Colorectal Surgery: A Randomized Trial on Short-Term Outcome
,”
Ann. Surg.
,
236
(
6
), pp.
759
767
.10.1097/00000658-200212000-00008
2.
Breedveld
,
P.
,
Stassen
,
H. G.
,
Meijer
,
D. W.
, and
Jakimowicz
,
J. J.
,
1999
, “
Manipulation in Laparoscopic Surgery: Overview of Impeding Effects and Supporting Aids
,”
J. Laparoendosc. Adv. Surg. Tech. A
,
9
(
6
), pp.
469
480
.10.1089/lap.1999.9.469
3.
Khoorjestan
,
S. M.
,
Najarian
,
S.
,
Simforoosh
,
N.
, and
Farkoush
,
S. H.
,
2010
, “
Design and Modeling of a Novel Flexible Surgical Instrument Applicable in Minimally Invasive Surgery
,”
Int. J. Nat. Eng. Sci.
,
4
(
1
), pp.
53
60
.
4.
Minor
,
M.
, and
Mukherjee
,
R.
,
1999
, “
A Mechanism for Dexterous End-Effector Placement During Minimally Invasive Surgery
,”
ASME J. Mech. Des.
,
121
(
4
), pp.
472
479
.10.1115/1.2829485
5.
Velanovich
,
V.
,
2000
, “
Laparoscopic vs. Open Surgery
,”
Surg. Endosc.
,
14
(
1
), pp.
16
21
.10.1007/s004649900003
6.
Arrow Medical,
2012
, “
Bruder Traditional Laparoscopic Instruments
,” Arrow Medical Supply Inc., Libertyville, IL, http://www.arrowmedical.com/sites/default/files/5MM%20LAP%20DISSECTOR,%20GRASPER,%20BIOPSY%20FORCEPS%20%26%20SCISSORS.pdf
7.
Breedveld
,
P.
,
2010
, “
Steerable Laparoscopic Cable-Ring Forceps
,”
ASME J. Med. Dev.
,
4
(
2
), p.
027518
.10.1115/1.3443169
8.
Breedveld
,
P.
,
Stassen
,
H. G.
,
Meijer
,
D. W.
, and
Stassen
,
L. P. S.
,
1999
, “
Theoretical Background and Conceptual Solution for Depth Perception and Eye-Hand Coordination Problems in Laparoscopic Surgery
,”
Min. lnvasive Ther. Allied Technol.
,
8
(
4
), pp.
227
234
.10.3109/13645709909153166
9.
Breedveld
,
P.
,
Scheltes
,
J. S.
,
Blom
,
E. M.
, and
Verheij
,
J. E. I.
,
2005
, “
A New, Easily Miniaturized Steerable Endoscope
,”
IEEE Eng. Med. Biol. Mag.
,
24
(
6
), pp.
40
47
.10.1109/MEMB.2005.1549729
10.
Jelínek
,
F.
,
Pessers
,
R.
, and
Breedveld
,
P.
,
2014
, “
DragonFlex Smart Steerable Laparoscopic Instrument
,”
ASME J. Med. Dev.
,
8
(
1
), p.
015001
.10.1115/1.4026153
11.
Catherine
,
J.
,
Rotinat-Libersa
,
C.
, and
Micaelli
,
A.
,
2011
, “
Comparative Review of Endoscopic Devices Articulations Technologies Developed for Minimally Invasive Medical Procedures
,”
Appl. Bionics Biomech.
,
8
(
2
), pp.
151
171
.10.3233/ABB-2011-0018
12.
Fan
,
C.
,
Dodou
,
D.
, and
Breedveld
,
P.
,
2013
, “
Review of Manual Control Methods for Handheld Maneuverable Instruments
,”
Minimally Invasive Ther. Allied Technol.
,
22
(
3
), pp.
127
135
.10.3109/13645706.2012.733709
13.
Cepolina
,
F.
, and
Michelini
,
R. C.
,
2004
, “
Review of Robotic Fixtures for Minimally Invasive Surgery
,”
Int. J. Med. Rob. Comput. Assist. Surg.
,
1
(
1
), pp.
43
63
.10.1002/rcs.5
14.
Cole
,
D.
,
Harris
,
M. L.
,
Castro
,
C. E.
,
Stewart
,
J. S.
,
Crews
,
S. T.
, and
Balbierz
,
D. J.
,
2009
, “
Overtube Introducer for Use in Endoscopic Bariatric Surgery
,” U.S. Patent No. 2009/0030284.
15.
Parihar
,
S. K.
,
Miller
,
M. C.
, and
Worrell
,
B. C.
,
2013
, “
Robotically Controlled Surgical Instrument
,” U.S. Patent No. 2013/0211397.
16.
Parrott
,
D. A.
,
Krupp
,
B. T.
,
Gillum
,
C. L.
,
Matice
,
C. J.
, and
Mingione
,
L. P.
,
2012
, “
Articulating Laparoscopic Surgical Instruments
,” WO Patent No. 2012/058213.
17.
Blase
,
B.
,
2012
, “
Articulated Section of a Shaft for an Endoscopic Instrument
,” EP Patent No. 2,438,844.
18.
Kleyman
,
G.
, and
Taylor
,
E.
,
2012
, “
Articulating Laparoscopic Surgical Access Instrument
,” U.S. Patent No. 2012/0296169.
19.
Nai
,
T. Y.
,
Herder
,
J. L.
, and
Tuijthof
,
G. J. M.
,
2011
, “
Steerable Mechanical Joint for High Load Transmission in Minimally Invasive Instruments
,”
ASME J. Med. Dev.
,
5
(
3
), p.
034503
.10.1115/1.4004649
20.
Bakos
,
G. J.
,
2013
, “
Steerable Surgical Access Devices and Methods
,” U.S. Patent No. 8,348,834.
21.
Banik
,
M. S.
,
Boulais
,
D. R.
,
Couvillon
,
L. A.
,
Chin
,
A. C. C.
,
Anderson
,
F. J.
,
Macnamara
,
F. T.
,
Fantone
,
S. D.
,
Braunstein
,
D. J.
,
Orband
,
D. G.
,
Saber
,
M.
,
Hunter
,
I. W.
,
Coppola
,
P. A.
,
Kirouac
,
A. P.
,
Clark
,
R. J.
,
Wiesman
,
R. M.
,
Mason
,
T. J.
,
Mehta
,
N. R.
, and
Greaves
,
A. E. R.
,
2013
, “
Articulation Joint
,” EP Patent No. 2,617,350.
22.
Cooper
,
T. G.
,
Wallace
,
D. T.
,
Chang
,
S.
,
Anderson
,
S. C.
,
Williams
,
D.
, and
Manzo
,
S.
,
2012
, “
Surgical Tool Having Positively Positionable Tendon-Actuated Multi-Disk Wrist Joint
,” U.S. Patent No. 2012/0220831.
23.
Malkowski
,
J. T.
,
2013
, “
Surgical Articulation Assembly
,” U.S. Patent No. 2013/0178838.
24.
Malkowski
,
J. T.
, and
Hathaway
,
P.
,
2012
, “
Surgical Articulation Assembly
,” U.S. Patent No. 2012/0310220.
25.
Fiorini
,
P.
,
Reppele
,
L.
, and
Morselli
,
M.
,
2012
, “
Robotic Surgical Utensil
,” EP Patent No. 2,415,418.
26.
Madhani
,
A. J.
, and
Salisbury
,
J. K.
,
2013
, “
Articulated Surgical Instrument for Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity
,” U.S. Patent No. 2013/0110131.
27.
Allred
,
J. B.
, and
Bingham
,
R.
,
1989
, “
Endoscope Steering Section
,” U.S. Patent No. 4,796,607.
28.
Breedveld
,
P.
,
Herder
,
J. L.
, and
Tomiyama
,
T.
,
2011
, “
Teaching Creativity in Mechanical Design
,” 4th World Conference on Design Research (IASDR2011), Delft, The Netherlands, Oct. 31–Nov. 4.
29.
Braun
,
M.
,
2012
, “
Surgical Instrument Comprising an Instrument Handle and Zero Point Adjustment
,” U.S. Patent No. 8,267,958.
30.
Frede
,
T.
,
Hammady
,
A.
,
Klein
,
J.
,
Teber
,
D.
,
Inaki
,
N.
,
Waseda
,
M.
,
Buess
,
G.
, and
Rassweiler
,
J.
,
2007
, “
The Radius Surgical System—A New Device for Complex Minimally Invasive Procedures in Urology?
,”
Eur. Urol.
,
51
(
4
), pp.
1015
1022
.10.1016/j.eururo.2006.11.046
31.
Kerver
,
L.
,
Tang
,
B.
,
Ho
,
F.
, and
Nordell
,
B.
,
2012
, “
Method and Apparatus for Articulating the Wrist of a Laparoscopic Grasping Instrument
,” EP Patent No. 2,240,095.
32.
Marczyk
,
S.
,
Pribanic
,
R.
,
Farascioni
,
D.
,
Taylor
,
E. J.
, and
Hathaway
,
P.
,
2013
, “
Endoscopic Vessel Sealer and Divider Having a Flexible Articulating Shaft
,” U.S. Patent No. 2013/0274741.
33.
Padget
,
M.
,
Skinlo
,
D.
,
Weisel
,
T.
, and
Chu
,
L.
,
2013
, “
Medical Device With Articulating Shaft
,” EP Patent No. 1,786,335.
34.
Stone
,
K. T.
,
Walters
,
T. M.
, and
Kaiser
,
R. A.
,
2007
, “
Steerable Suture Passing Device
,” U.S. Patent No. 2007/0038230.
35.
Stroup
,
D. K.
, and
Deptala
,
A.
,
2013
, “
Wrist Assembly for Articulating Laparoscopic Surgical Instruments
,” WO Patent No. 2013/154700.
36.
Worrell
,
B. C.
,
Bourdeaux
,
C. P.
,
Conlon
,
S. P.
,
Knight
,
G.
,
Miller
,
M. C.
,
Schieb
,
C. J.
,
Shelton
,
F. E.
,
Strobl
,
G. S.
,
Swayze
,
J. S.
,
Trees
,
G. A.
,
Voegele
,
A. C.
,
Black
,
C. S.
, and
Avimukta
,
K. B.
,
2012
, “
Articulation Joint Features for Articulating Surgical Device
,” WO Patent No. 2012/040445.
37.
Brunnen
,
R. D.
, and
Simon
,
T. J.
,
2010
, “
Flexible Section of an Insertion Tube of an Endoscope and Method of Manufacturing Thereof
,” U.S. Patent No. 7,766,821.
38.
Dawoodjee
,
A. E.
,
2013
, “
Flexible Laparoscopic Device
,” WO Patent No. 2013/119817.
39.
Tseng
,
H. T.
,
2012
, “
Flexible Tubular Interlocking Structure for a Handheld Endoscope
,” U.S. Patent No. 2012/0190924.
40.
Agarwal
,
S. K.
,
Chatzigeorgiou
,
D.
,
Petrzelka
,
J. E.
,
Menon
,
M. C.
,
Lustrino
,
M.
,
Slocum
,
A. H.
, and
Stefanov-Wagner
,
C. J.
,
2011
, “
An Articulating Tool for Endoscopic Screw Delivery
,”
ASME J. Med. Dev.
,
5
(
1
), p.
011004
.10.1115/1.4003435
41.
Brock
,
D. L.
, and
Lee
,
W.
,
2011
, “
Surgical Instrument
,” EP Patent No. 1,176,921.
42.
Doyle
,
M. C.
, and
Caputo
,
J.
,
2012
, “
Hand-Actuated Articulating Surgical Tool
,” EP Patent No. 2,005,914.
43.
Hirzel
,
D. L.
,
2013
, “
Urethrovesical Anastomosis Suturing Method Using Articulating Laparoscopic Device
,” U.S. Patent No. 8,460,320.
44.
Jacobs
,
M.
,
Armenteros
,
J. R.
,
Barker
,
G.
, and
French
,
C. K.
,
2011
, “
Surgical Clamp and Surgical Clamp Installation Tool
,” U.S. Patent No. 2011/0190791.
45.
Kortenbach
,
J. A.
,
Gottlieb
,
S.
,
Smith
,
K. W.
,
Slater
,
C. R.
, and
Bales
,
T. O.
,
2003
, “
Rotatable and Deflectable Biopsy Forceps
,” U.S. Patent No. 2003/0195432.
46.
Krzyzanowski
,
J.
,
2013
, “
End Effector Assembly With Increased Clamping Force for a Surgical Instrument
,” U.S. Patent No. 8,394,120.
47.
Marczyk
,
S.
, “
Surgical Stapling Apparatus With Powered Articulation
,” U.S. Patent No. 2012/0298718.
48.
Nicholas
,
D. A.
,
Aranyi
,
E.
,
Zvenyatsky
,
B.
,
Matula
,
P. A.
,
Remiszewski
,
S. H.
,
Green
,
D. T.
, and
Bolanos
,
H.
,
2007
, “
Articulating Endoscopic Surgical Apparatus
,” U.S. Patent No. 2007/0162072.
49.
Ouchi
,
T.
,
2010
, “
Treatment Tools for Endoscope
,” U.S. Patent No. 7,857,749.
50.
Scheib
,
C. J.
,
Jaworek
,
G. S.
, and
Hall
,
S. G.
,
2013
, “
Articulatable Surgical Instrument Comprising a Firing Drive
,” U.S. Patent No. 2013/0270322.
51.
Goldfarb
,
M. A.
, and
Goldfarb
,
E.
,
2012
, “
Articulated Surgical Probe and Method for Use
,” U.S. Patent No. 2012/0116398.
52.
Joshi
,
S.
,
Boulnois
,
J.-L.
,
Woolfson
,
S. B.
,
LePage
,
A. A.
, and
Delvin
,
C.
,
2012
, “
Articulable Surgical Instrument
,” EP Patent No. 2,415,403.
53.
Marescaux
,
J. F. B.
,
Melanson
,
J. S.
,
Dallemagne
,
B.
,
Leroy
,
J.
,
Mutter
,
D. R. D.
,
Barry
,
J. P.
,
Storz
,
S.
, and
Leonhard
,
M.
,
2012
, “
Articulating Endoscope Instrument
,” U.S. Patent No. 8,137,263.
54.
Menn
,
P.
,
2012
, “
Articulating Steerable Clip Applier for Laparoscopic Procedures
,” U.S. Patent No. 2012/0265220.
55.
Saadat
,
V.
, and
Peh
,
R.-F.
,
2011
, “
Apparatus and Methods for Performing Transluminal Gastrointestinal Procedures
,” U.S. Patent No. 2011/0196392.
56.
Hegeman
,
D. E.
,
Danitz
,
D. J.
,
Hinman
,
C. D.
, and
Alvord
,
L. J.
,
2012
, “
Tool With Articulation Lock
,” U.S. Patent No. 2012/0095451.
57.
Saadat
,
V.
,
Rothe
,
C. A.
,
Ewers
,
R. C.
,
Maahs
,
T. D.
, and
Michlitsch
,
K. J.
,
2006
, “
Endoluminal Tool Deployment System
,” U.S. Patent No. 2006/0178560.
58.
Heimberger
,
R.
,
2010
, “
Bendable Tube and Method for its Manufacture
,” EP Patent No. 0,764,423.
59.
Ananthanarayanan
,
A.
,
Gupta
,
S. K.
,
Ehrlich
,
L.
, and
Desai
,
J. P.
,
2011
, “
Design of Revolute Joints for In-Mold Assembly Using Insert Molding
,”
ASME J. Mech. Des.
,
133
(
12
), p.
121010
.10.1115/1.4005327
60.
Aust
,
G. M.
, and
Taylor
,
T. E.
,
2006
, “
Surgical Instrument
,” U.S. Patent No. RE39,152.
61.
Belson
,
A.
,
Frey
,
P. D.
,
McElhaney
,
C. W. H.
,
Milroy
,
J. C.
,
Ohline
,
R. M.
, and
Tartaglia
,
J. M.
,
2011
, “
Steerable Segmented Endoscope and Method of Insertion
,” U.S. Patent No. 2011/0065993.
62.
Danitz
,
D. J.
,
2006
, “
Articulating Mechanism Comprising Pairs of Link Components Connected by Cables and Which Can be Easily Assembled
,” WO Patent No. 2006/057699.
63.
Harris
,
A. N.
,
Thompson
,
J. R.
, and
Rone
,
R. J.
,
2011
, “
Articulating Surgical Hand Tool
,” WO Patent 2011/053735.
64.
Hassoun
,
B.
,
2012
, “
Surgical Instrument
,” U.S. Patent No. 2012/0316560.
65.
Jeong
,
C. W.
, and
Kim
,
H. T.
,
2012
, “
Minimally Invasive Surgical Instrument Having a Bent Shaft
,” WO Patent No. 2012/128591.
66.
Lee
,
W.
,
Chamorro
,
A.
,
Ailinger
,
R.
, and
Meglan
,
D.
,
2010
, “
Robotically Controlled Surgical Instruments
,” U.S. Patent No. 7,699,835.
67.
Lin
,
W.-T.
, and
Chan
,
C.-C.
,
2010
, “
Four-Dimensional Tip Deflection Device for Endoscope
,” U.S. Patent No. 2010/0036202.
68.
Mitchell
,
S.
,
Ewers
,
R. C.
, and
Maahs
,
T. D.
,
2012
, “
Endoluminal Surgical Tool With Small Bend Radius Steering Section
,” U.S. Patent No. 2012/0238952.
69.
Oku
,
M.
,
2013
, “
Tube Assembly For Endoscope and Attaching Method
,” U.S. Patent No. 0245376.
70.
Awtar
,
S.
,
Geiger
,
J.
,
Trutna
,
T. T.
,
Nielsen
,
J. M.
, and
Abani
,
R.
,
2010
, “
FlexDex™: A Minimally Invasive Surgical Tool With Enhanced Dexterity and Intuitive Control
,”
ASME J. Med. Dev.
,
4
(
3
), p.
035003
.10.1115/1.4002234
71.
Steege
,
A. T. C.
,
2013
, “
Surgical Tool
,” WO Patent No. 2013/009699.
72.
Milani
,
M.
,
Fiorini
,
P.
, and
Reppele
,
L.
,
2011
, “
Instrument for Robotic Surgery
,” EP Patent No. 2,364,825.
73.
Wallace
,
D. T.
,
Anderson
,
C. S.
, and
Manzo
,
S.
,
2012
, “
Platform Link Wrist Mechanism
,” EP Patent No. 1,408,846.
74.
Castro
,
M. S.
, and
Flaherty
,
J. C.
,
2012
, “
Articulating Surgical Tools and Tool Sheaths, and Methods of Deploying the Same
,” WO Patent No. 2012/138834.
75.
Danitz
,
D. J.
, and
Gold
,
A.
,
2010
, “
Articulating Endoscopes
,” U.S. Patent No. 2010/0261964.
76.
Hinman
,
C. D.
, and
Danitz
,
D. J.
,
2013
, “
Link Systems and Articulation Mechanisms for Remote Manipulation of Surgical or Diagnostic Tools
,” U.S. Patent No. 2013/0218141.
77.
Jeong
,
C. W.
,
Sin
,
C. C.
,
Kim
,
S. R.
, and
Kim
,
H. T.
,
2013
, “
Minimally Invasive Surgical Instrument Having Detachable End Effector
,” WO Patent No. 2013/036024.
78.
Lange
,
G.
,
2003
, “
Endoscopic Surgical Instrument for Rotational Manipulation
,” U.S. Patent No. 6,666,854.
79.
Lee
,
W.
,
Chamorro
,
A.
,
Fortier
,
R. C.
, and
Cerier
,
J. C.
,
2012
, “
Surgical Instrument
,” U.S. Patent No. 2012/0253324.
80.
Malkowski
,
J. T.
,
Cabrera
,
R.
,
Fortier
,
R.
,
Ziegler
,
A.
,
Cruz
,
A.
,
Stellon
,
G. A.
, and
Evans
,
S.
,
2011
, “
Articulating Surgical Device
,” U.S. Patent No. 2011/0184459.
81.
Seow
,
C. M.
,
Chin
,
W. J.
,
Nelson
,
C. A.
,
Nakamura
,
A.
,
Farritor
,
S. M.
, and
Oleynikov
,
D.
,
2013
, “
Articulated Manipulator With Multiple Instruments for Natural Orifice Transluminal Endoscopic Surgery
,”
ASME J. Med. Dev.
,
7
(
4
), p.
041004
.10.1115/1.4025183
82.
Park
,
H. Y.
,
Kim
,
Y. J.
,
Kim
,
J. H.
, and
Lee
,
Y. B.
,
2013
, “
Link Unit, Arm Module, and Surgical Apparatus Including the Same
,” U.S. Patent No. 2013/0199327.
83.
Zirps
,
C. T.
, and
Rebh
,
W. R.
,
2012
, “
Surgical Instrument
,” EP Patent No. 0,987,986.
84.
Hallbeck
,
S. M.
,
Riggle
,
J.
,
Laveaga
,
A. D.
, and
Kaufman
,
J.
,
2013
, “
Laparoscopic Devices and Methods of Using
,” WO Patent No. 2013/116692.
85.
Boury
,
H. N.
,
1999
, “
Selectively Manipulable Catheter
,” U.S. Patent No. 5,916,147.
86.
Chong
,
E.
,
2008
, “
A Catheter Steering Device
,” U.S. Patent No. 2008/0319418.
87.
Erhard
,
M.
,
2005
, “
Laparoscopic Instrument
,” EP Patent No. 1,584,293.
88.
Griffiths
,
J. R.
,
2013
, “
System and Method for an Articulating Distal End of an Endoscopic Medical Device
,” U.S. Patent No. 2013/0150831.
89.
Knodel
,
B. D.
,
Thompson
,
B.
,
Manoux
,
P. R.
, and
White
,
N. H.
,
2012
, “
Method for Treating Tissue With an Articulated Surgical Instrument
,” U.S. Patent No. 2012/0061446.
90.
Kovac
,
T. J.
, and
Wei
,
M. F.
,
2003
, “
Endoscopic Surgical Instrument for Rotational Manipulation
,” U.S. Patent No. 6,663,641.
91.
Lenker
,
J. A.
, and
Pool
,
S. L.
,
2013
, “
Steerable Endoluminal Punch
,” WO Patent No. 2013/158354.
92.
Lyons
,
E.
,
Rose-Innes
,
D. J.
, and
Brewer
,
R. J.
,
2012
, “
Surgical Instrument
,” U.S. Patent No. 8,241,320.
93.
Verbeek
,
M. A. E.
,
2012
, “
Steerable Tube, Endoscopic Instrument and Endoscope Comprising Such a Tube, and an Assembly
,” WO Patent No. 2012/173478.
94.
Viola
,
F. J.
,
2013
, “
Surgical Stapler Having an Articulation Mechanism
,” U.S. Patent No. 2013/0032627.
95.
Shelton
,
F. E.
, and
Ortiz
,
M. S.
,
2013
, “
Articulatable Surgical Device With Rotary Driven Cutting Member
,” U.S. Patent No. 2013/0197556.
96.
Breedveld
,
P.
, and
Hirose
,
S.
,
2004
, “
Design of Steerable Endoscopes to Improve the Visual Perception of Depth During Laparoscopic Surgery
,”
ASME J. Mech. Des.
,
126
(
1
), pp.
2
5
.10.1115/1.1637658
97.
Cooper
,
T. G.
, and
Anderson
,
S. C.
,
2013
, “
Flexible Wrist for Surgical Tool
,” U.S. Patent No. 2013/0096540.
98.
Danitz
,
D. J.
, and
Hinman
,
C. D.
,
2011
, “
Articulating Sheath for Flexible Instruments
,” EP Patent No. 2,335,558.
99.
Harder
,
H. E.
,
Jensen
,
H.-I.
, and
Speitling
,
A. W.
,
2003
, “
An Elongate Element for Transmitting Forces
,” EP Patent No. 0,889,252.
100.
Hermann
,
R.
,
Hegemann
,
O.
, and
Lutze
,
T.
,
2013
, “
Surgical Instrument
,” U.S. Patent No. 8,382,742.
101.
Lee
,
W.
,
Chamorro
,
A.
, and
Lee
,
W.
,
2011
, “
Surgical Instrument
,” U.S. Patent No. 8,029,531.
102.
Lin
,
W.-T.
,
2013
, “
Two-Way Endoscope Steering Mechanism and Four-Way Endoscope Steering Mechanism
,” U.S. Patent No. 2013/0158355.
103.
Wallace
,
D. T.
,
Moll
,
F. H.
,
Younge
,
R. G.
,
Martin
,
K. M.
,
Stahler
,
G. J.
,
Moore
,
D. F.
,
Adams
,
D. T.
,
Zinn
,
M. R.
, and
Niemeyer
,
G. D.
,
2013
, “
Robotic Catheter System
,” U.S. Patent No. 8,409,136.
104.
Dewaele
,
F.
,
Mabilde
,
C.
, and
Blanckaert
,
B.
,
2013
, “
Steerable Tube
,” EP Patent No. 2,259,710.
105.
Burgner
,
J.
,
Swaney
,
P. J.
,
Bruns
,
T. L.
,
Clark
,
M. S.
,
Rucker
,
D. C.
,
Burdette
,
E. C.
, and
Webster
,
R. J.
,
2012
, “
An Autoclavable Steerable Cannula Manual Deployment Device: Design and Accuracy Analysis
,”
ASME J. Med. Dev.
,
6
(
4
), p.
041007
.10.1115/1.4007944
106.
Hendrick
,
R. J.
,
Lathrop
,
R. A.
,
Schneider
,
J. S.
, and
Webster
,
I. I. I. R. J.
,
2013
, “
Design of an Endonasal Graft Placement Tool for Repair of Skull Base Defects
,”
ASME J. Med. Dev.
,
7
(
2
), p.
020916
.10.1115/1.4024328
107.
Yen
,
P.-L.
,
Chu
,
Y.-J.
,
Hu
,
R.-H.
,
Yeh
,
C.-C.
, and
Luo
,
R. C.
,
2013
, “
An Automatic Object Tracking Steerable Endoscope
,”
ASME J. Med. Dev.
,
7
(
3
), p.
030921
.10.1115/1.4024522
108.
Zhang
,
J.
, and
Simaan
,
N.
,
2013
, “
Design of Underactuated Steerable Electrode Arrays for Optimal Insertions
,”
ASME J. Mech. Rob.
,
5
(
1
), p.
011008
.10.1115/1.4007005
109.
Breedveld
,
P.
, and
Scheltes
,
J. S.
,
2008
, “
Instrument for Fine-Mechanical or Surgical Applications
,” U.S. Patent No. 2008/0234545.
110.
Melsky
,
G.
,
2005
, “
Irrigation and Aspiration Device
,” U.S. Patent No. 2005/0119614.
111.
Miller
,
A. J.
,
2012
, “
Steerable Endoluminal Devices and Methods
,” BioCardia, Inc., U.S. Patent No. 2012/0123327.
112.
Nardeo
,
M.
,
2003
, “
Steerable Medical Catheter With Bendable Encapsulated Metal Spring Tip Fused to Polymeric Shaft
,” U.S. Patent No. 6,530,897.
113.
Pilvisto
,
T.
,
2005
, “
Endoscope-Type Device, Especially for Emergency Intubation
,” U.S. Patent No. 6,887,195.
114.
Stefanchik
,
D.
, and
Ghabrial
,
R. M.
,
2008
, “
Methods for Stabilizing and Positioning an Endoscope and Surgical Procedures
,” U.S. Patent No. 2008/0021277.
You do not currently have access to this content.