An instrument having a flexible and elongated body includes at least a lumen and a flex member disposed within the lumen. The flex member may be capable of providing steering control to a first portion of the elongate body while providing load bearing support to a second portion of the elongate body. A pull wire may be disposed within the flex member, and at least a distal portion of the pull wire may be coupled to the elongate body and a proximal portion of the pull wire may be operatively coupled to a control unit. The control unit may be coupled to a proximal portion of the elongate body. In addition, a control member may be operatively coupled to the control unit such that a distal portion of the control member may be positioned near a proximal portion of the flex member. The control member may be configured to support the flex member and control the movement or displacement of the flex member. Furthermore, the flex member may be configured to selectively decouple articulation or steering forces of a first portion of the elongate body away from a second portion of the elongate body; thereby, preventing compression of the second portion of the elongate body while maintaining elasticity or flexibility of the second portion of the elongate body.

The present invention provides a variable stiffness catheter comprising a pneumatic actuator lumen system that allows manipulation of shape and curvature at one or more locations along the catheter.

An articulated tip part for an endoscope, and an endoscope, including segments including a distal end segment having an outer wall defining an inner spacing adapted to accommodate a camera assembly therein and a proximal wall having a proximal surface, the distal end segment having an outer surface, wherein adjacent of the segments are interconnected by at least one hinge member to enable bending of the articulated tip part; and an insertion guide adapted to guide a steering wire and including an entry provided in the outer surface of the distal end segment, the insertion guide also including an exit fluidly coupled with and leading to the inner spacing of the distal end segment, whereby an end of a steering wire can be guided into the inner spacing of the distal end segment via the entry of the insertion guide.

A device including a sheath having a proximal end, a distal end, and a lumen extending through the sheath from the proximal end to the distal end, wherein the sheath is biased to a released position; a pull wire extending along the sheath and being coupled to the sheath at the distal end, wherein the pull wire and the sheath are configured to cooperate such that pulling the pull wire toward the proximal end causes the distal end to assume an active position, and such that release of the pull wire causes the distal end to return to the released position; and a control portion coupled to the proximal end of the sheath and to the pull wire, wherein the control portion includes a control element operable to selectively pull the pull wire toward the proximal end of the sheath or to release the pull wire.

The disclosure provides for a variable stiffness catheter. The catheter may include an inner layer forming an inner lumen, a middle layer surrounding the inner layer, and an outer layer surrounding the middle layer. The middle layer may include an annular lumen and a plurality of strings within the annular lumen, and the plurality of strings may be connected to the inner layer. Applying a vacuum and evacuating the annular lumen of the middle layer alters a frictional force between the inner layer and the outer layer and thereby changes the catheter's flexural rigidity.

Several embodiments of the present invention are generally directed to medical visualization systems that comprise combinations of disposable and resuable components, such as catheters, functional handles, hubs, optical devices, etc. Other embodiments of the present invention are generally directed to features and aspects of an in-vivo visualization system that comprises an endoscope having a working channel through which a catheter having viewing capabilities is routed. the catheter may obtain viewing capabilities by being constructed as a vision catheter or by having a fiberscope or other viewing device selectively routed through one of its channels. The catheter is preferably of the steerable type so that the distal end of the catheter may be steered from its proximal end as it is advanced with the body. A suitable use for the in-vivo visualization system includes but is not limited to diagnosis and/or treatment of the duodenum, and particularly the biliary tree.

An endoluminal punch and introducer sheath are described wherein the endoluminal punch comprises a guidewire lumen through which a user is capable of placing a guidewire. The endoluminal punch system further comprises a mechanism affixed to the hub which is capable of controlling the axial positioning of the guidewire relative to the endoluminal punch distal end. The control mechanism can be released so that the endoluminal punch can be removed from a patient while retaining the guidewire in place within the patient. The endoluminal punch introducer, including a sheath and dilator, can comprise energy emitting electrodes or transducers for cutting larger size holes in stubborn (friable, scarred, or fibrotic) tissue. In other embodiments, the endoluminal punch can comprise a guidewire or stylet, wherein the guidewire or stylet is capable of emitting energy to cut through tissue.

A steerable instrument has an actuator at a proximal side and a bendable zone at a distal side. The actuator controls bending of the flexible zone by means of one or more longitudinal elements. The instrument has a first cylindrical element, a second cylindrical element and a third cylindrical element. The second cylindrical element has a zone with a longitudinal element portion with a first height in a radial direction of the instrument. Radial spacers are located at mutual sides of the longitudinal element portion, which have, at least locally, a second height in the radial direction larger than the first height.

The teachings herein relate to devices for insertion into a cavity, opening or other passageway that requires the bending of the device to conform to a curved or even tortuous shape of the path. The devices include axial support components for translating forces for moving the device forward in the path. The axial support components preferably include adjacent components capable of rocking for tilting the device in one or more directions. The device preferably includes one or more lateral support components for limiting any lateral motion of an axial support component relative to an adjacent axial support component.

The present invention discloses a steerable guidewire and a method for manufacturing the same, and a steerable catheter and a method for manufacturing the same. According to an aspect of the present invention, a steerable guidewire, which is inserted into a catheter and guides the catheter to a desired blood vessel, may include: a steerable tip part that can be bent in at least two stages due to a stimulus from the outside and that is steered in a predetermined direction; and a non-steerable tip part that is not steerable. The steerable tip part may include: a first steerable tip part having a first length and bent in a first angle with respect to the non-steerable tip part; and a second steerable tip part having one end connected to the first steerable tip part, having a second length, and bent and steered into a second angle with respect to the non-steerable tip part. The first steerable tip part may be positioned farther from the non-steerable tip part than the second steerable tip part. The first length of the first steerable tip part may be smaller than a sum of lengths of steerable tip parts other than the first steerable tip part, and the first angle may be steered so as to be larger than the second angle.