Review Article

Classification of Joints Used in Steerable Instruments for Minimally Invasive Surgery—A Review of the State of the Art

[+] Author and Article Information
Filip Jelínek

BioMechanical Engineering Department,
Faculty Mechanical, Maritime
and Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: f.jelinek@tudelft.nl

Ewout A. Arkenbout

BioMechanical Engineering Department,
Faculty Mechanical, Maritime
and Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: e.a.arkenbout@tudelft.nl

Paul W. J. Henselmans

BioMechanical Engineering Department,
Faculty Mechanical, Maritime
and Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: p.w.j.henselmans@tudelft.nl

Rob Pessers

Research and Development Group,
Stork Food & Dairy Systems B.V.,
Deccaweg 32,
Amsterdam 1042 AD, The Netherlands
e-mail: rob.pessers@sfds.eu

Paul Breedveld

BioMechanical Engineering Department,
Faculty Mechanical, Maritime
and Materials Engineering,
Delft University of Technology,
Mekelweg 2,
Delft 2628 CD, The Netherlands
e-mail: p.breedveld@tudelft.nl

Manuscript received December 26, 2013; final manuscript received September 19, 2014; published online November 14, 2014. Assoc. Editor: John LaDisa.

J. Med. Devices 9(1), 010801 (Mar 01, 2015) (11 pages) Paper No: MED-13-1304; doi: 10.1115/1.4028649 History: Received December 26, 2013; Revised September 19, 2014; Online November 14, 2014

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.

Copyright © 2015 by ASME
Your Session has timed out. Please sign back in to continue.


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. [CrossRef] [PubMed]
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. [CrossRef] [PubMed]
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.
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. [CrossRef]
Velanovich, V., 2000, “Laparoscopic vs. Open Surgery,” Surg. Endosc., 14(1), pp. 16–21. [CrossRef] [PubMed]
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
Breedveld, P., 2010, “Steerable Laparoscopic Cable-Ring Forceps,” ASME J. Med. Dev., 4(2), p. 027518. [CrossRef]
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. [CrossRef]
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. [CrossRef] [PubMed]
Jelínek, F., Pessers, R., and Breedveld, P., 2014, “DragonFlex Smart Steerable Laparoscopic Instrument,” ASME J. Med. Dev., 8(1), p. 015001. [CrossRef]
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. [CrossRef]
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. [CrossRef]
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. [CrossRef]
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.
Parihar, S. K., Miller, M. C., and Worrell, B. C., 2013, “Robotically Controlled Surgical Instrument,” U.S. Patent No. 2013/0211397.
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.
Blase, B., 2012, “Articulated Section of a Shaft for an Endoscopic Instrument,” EP Patent No. 2,438,844.
Kleyman, G., and Taylor, E., 2012, “Articulating Laparoscopic Surgical Access Instrument,” U.S. Patent No. 2012/0296169.
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. [CrossRef]
Bakos, G. J., 2013, “Steerable Surgical Access Devices and Methods,” U.S. Patent No. 8,348,834.
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.
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.
Malkowski, J. T., 2013, “Surgical Articulation Assembly,” U.S. Patent No. 2013/0178838.
Malkowski, J. T., and Hathaway, P., 2012, “Surgical Articulation Assembly,” U.S. Patent No. 2012/0310220.
Fiorini, P., Reppele, L., and Morselli, M., 2012, “Robotic Surgical Utensil,” EP Patent No. 2,415,418.
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.
Allred, J. B., and Bingham, R., 1989, “Endoscope Steering Section,” U.S. Patent No. 4,796,607.
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.
Braun, M., 2012, “Surgical Instrument Comprising an Instrument Handle and Zero Point Adjustment,” U.S. Patent No. 8,267,958.
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. [CrossRef] [PubMed]
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.
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.
Padget, M., Skinlo, D., Weisel, T., and Chu, L., 2013, “Medical Device With Articulating Shaft,” EP Patent No. 1,786,335.
Stone, K. T., Walters, T. M., and Kaiser, R. A., 2007, “Steerable Suture Passing Device,” U.S. Patent No. 2007/0038230.
Stroup, D. K., and Deptala, A., 2013, “Wrist Assembly for Articulating Laparoscopic Surgical Instruments,” WO Patent No. 2013/154700.
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.
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.
Dawoodjee, A. E., 2013, “Flexible Laparoscopic Device,” WO Patent No. 2013/119817.
Tseng, H. T., 2012, “Flexible Tubular Interlocking Structure for a Handheld Endoscope,” U.S. Patent No. 2012/0190924.
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. [CrossRef]
Brock, D. L., and Lee, W., 2011, “Surgical Instrument,” EP Patent No. 1,176,921.
Doyle, M. C., and Caputo, J., 2012, “Hand-Actuated Articulating Surgical Tool,” EP Patent No. 2,005,914.
Hirzel, D. L., 2013, “Urethrovesical Anastomosis Suturing Method Using Articulating Laparoscopic Device,” U.S. Patent No. 8,460,320.
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.
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.
Krzyzanowski, J., 2013, “End Effector Assembly With Increased Clamping Force for a Surgical Instrument,” U.S. Patent No. 8,394,120.
Marczyk, S., “Surgical Stapling Apparatus With Powered Articulation,” U.S. Patent No. 2012/0298718.
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.
Ouchi, T., 2010, “Treatment Tools for Endoscope,” U.S. Patent No. 7,857,749.
Scheib, C. J., Jaworek, G. S., and Hall, S. G., 2013, “Articulatable Surgical Instrument Comprising a Firing Drive,” U.S. Patent No. 2013/0270322.
Goldfarb, M. A., and Goldfarb, E., 2012, “Articulated Surgical Probe and Method for Use,” U.S. Patent No. 2012/0116398.
Joshi, S., Boulnois, J.-L., Woolfson, S. B., LePage, A. A., and Delvin, C., 2012, “Articulable Surgical Instrument,” EP Patent No. 2,415,403.
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.
Menn, P., 2012, “Articulating Steerable Clip Applier for Laparoscopic Procedures,” U.S. Patent No. 2012/0265220.
Saadat, V., and Peh, R.-F., 2011, “Apparatus and Methods for Performing Transluminal Gastrointestinal Procedures,” U.S. Patent No. 2011/0196392.
Hegeman, D. E., Danitz, D. J., Hinman, C. D., and Alvord, L. J., 2012, “Tool With Articulation Lock,” U.S. Patent No. 2012/0095451.
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.
Heimberger, R., 2010, “Bendable Tube and Method for its Manufacture,” EP Patent No. 0,764,423.
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. [CrossRef]
Aust, G. M., and Taylor, T. E., 2006, “Surgical Instrument,” U.S. Patent No. RE39,152.
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.
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.
Harris, A. N., Thompson, J. R., and Rone, R. J., 2011, “Articulating Surgical Hand Tool,” WO Patent 2011/053735.
Hassoun, B., 2012, “Surgical Instrument,” U.S. Patent No. 2012/0316560.
Jeong, C. W., and Kim, H. T., 2012, “Minimally Invasive Surgical Instrument Having a Bent Shaft,” WO Patent No. 2012/128591.
Lee, W., Chamorro, A., Ailinger, R., and Meglan, D., 2010, “Robotically Controlled Surgical Instruments,” U.S. Patent No. 7,699,835.
Lin, W.-T., and Chan, C.-C., 2010, “Four-Dimensional Tip Deflection Device for Endoscope,” U.S. Patent No. 2010/0036202.
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.
Oku, M., 2013, “Tube Assembly For Endoscope and Attaching Method,” U.S. Patent No. 0245376.
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. [CrossRef]
Steege, A. T. C., 2013, “Surgical Tool,” WO Patent No. 2013/009699.
Milani, M., Fiorini, P., and Reppele, L., 2011, “Instrument for Robotic Surgery,” EP Patent No. 2,364,825.
Wallace, D. T., Anderson, C. S., and Manzo, S., 2012, “Platform Link Wrist Mechanism,” EP Patent No. 1,408,846.
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.
Danitz, D. J., and Gold, A., 2010, “Articulating Endoscopes,” U.S. Patent No. 2010/0261964.
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.
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.
Lange, G., 2003, “Endoscopic Surgical Instrument for Rotational Manipulation,” U.S. Patent No. 6,666,854.
Lee, W., Chamorro, A., Fortier, R. C., and Cerier, J. C., 2012, “Surgical Instrument,” U.S. Patent No. 2012/0253324.
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.
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. [CrossRef]
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.
Zirps, C. T., and Rebh, W. R., 2012, “Surgical Instrument,” EP Patent No. 0,987,986.
Hallbeck, S. M., Riggle, J., Laveaga, A. D., and Kaufman, J., 2013, “Laparoscopic Devices and Methods of Using,” WO Patent No. 2013/116692.
Boury, H. N., 1999, “Selectively Manipulable Catheter,” U.S. Patent No. 5,916,147.
Chong, E., 2008, “A Catheter Steering Device,” U.S. Patent No. 2008/0319418.
Erhard, M., 2005, “Laparoscopic Instrument,” EP Patent No. 1,584,293.
Griffiths, J. R., 2013, “System and Method for an Articulating Distal End of an Endoscopic Medical Device,” U.S. Patent No. 2013/0150831.
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.
Kovac, T. J., and Wei, M. F., 2003, “Endoscopic Surgical Instrument for Rotational Manipulation,” U.S. Patent No. 6,663,641.
Lenker, J. A., and Pool, S. L., 2013, “Steerable Endoluminal Punch,” WO Patent No. 2013/158354.
Lyons, E., Rose-Innes, D. J., and Brewer, R. J., 2012, “Surgical Instrument,” U.S. Patent No. 8,241,320.
Verbeek, M. A. E., 2012, “Steerable Tube, Endoscopic Instrument and Endoscope Comprising Such a Tube, and an Assembly,” WO Patent No. 2012/173478.
Viola, F. J., 2013, “Surgical Stapler Having an Articulation Mechanism,” U.S. Patent No. 2013/0032627.
Shelton, F. E., and Ortiz, M. S., 2013, “Articulatable Surgical Device With Rotary Driven Cutting Member,” U.S. Patent No. 2013/0197556.
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. [CrossRef]
Cooper, T. G., and Anderson, S. C., 2013, “Flexible Wrist for Surgical Tool,” U.S. Patent No. 2013/0096540.
Danitz, D. J., and Hinman, C. D., 2011, “Articulating Sheath for Flexible Instruments,” EP Patent No. 2,335,558.
Harder, H. E., Jensen, H.-I., and Speitling, A. W., 2003, “An Elongate Element for Transmitting Forces,” EP Patent No. 0,889,252.
Hermann, R., Hegemann, O., and Lutze, T., 2013, “Surgical Instrument,” U.S. Patent No. 8,382,742.
Lee, W., Chamorro, A., and Lee, W., 2011, “Surgical Instrument,” U.S. Patent No. 8,029,531.
Lin, W.-T., 2013, “Two-Way Endoscope Steering Mechanism and Four-Way Endoscope Steering Mechanism,” U.S. Patent No. 2013/0158355.
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.
Dewaele, F., Mabilde, C., and Blanckaert, B., 2013, “Steerable Tube,” EP Patent No. 2,259,710.
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. [CrossRef]
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. [CrossRef]
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. [CrossRef]
Zhang, J., and Simaan, N., 2013, “Design of Underactuated Steerable Electrode Arrays for Optimal Insertions,” ASME J. Mech. Rob., 5(1), p. 011008. [CrossRef]
Breedveld, P., and Scheltes, J. S., 2008, “Instrument for Fine-Mechanical or Surgical Applications,” U.S. Patent No. 2008/0234545.
Melsky, G., 2005, “Irrigation and Aspiration Device,” U.S. Patent No. 2005/0119614.
Miller, A. J., 2012, “Steerable Endoluminal Devices and Methods,” BioCardia, Inc., U.S. Patent No. 2012/0123327.
Nardeo, M., 2003, “Steerable Medical Catheter With Bendable Encapsulated Metal Spring Tip Fused to Polymeric Shaft,” U.S. Patent No. 6,530,897.
Pilvisto, T., 2005, “Endoscope-Type Device, Especially for Emergency Intubation,” U.S. Patent No. 6,887,195.
Stefanchik, D., and Ghabrial, R. M., 2008, “Methods for Stabilizing and Positioning an Endoscope and Surgical Procedures,” U.S. Patent No. 2008/0021277.


Grahic Jump Location
Fig. 1

(a) Rigid [6] and steerable [7] laparoscopic instruments; (b) rigid instrument DOF [8]; (c) additional steerable tip DOF. Adopted from Ref. [10].

Grahic Jump Location
Fig. 2

Graphical summary of the joint type classification, listing all the relevant up-to-date patents for each joint type category. Additional descriptors (C, L, RP, S) highlight various differing joint configurations within several joint type categories.

Grahic Jump Location
Fig. 3

Overview of the rolling joint types adopted from the patents by (a) Parrott et al. [16], (b) Blase [17], (c) Banik et al. [21], (d) Cooper et al. [22], (e) Madhani and Salisbury [26], and (f) Allred and Bingham [27]

Grahic Jump Location
Fig. 4

Overview of the sliding curved joint types adopted from the patents by (a) Stroup and Deptala [35], (b) Tseng [39], (c) Hegeman et al. [56], (d) Marczyk et al. [32], (e) Malkowski et al. [80], and (f) Banik et al. [21]

Grahic Jump Location
Fig. 5

Overview of the sliding hinged joint types adopted from the patents by (a) Brock and Lee [41], (b) Saadat and Peh [55], (c) Jeong and Kim [65], (d) Steege [71], and (e) Wallace et al. [73]

Grahic Jump Location
Fig. 6

Overview of the rolling sliding joint types adopted from the patents by (a) Menn [54], (b) Saadat et al. [57], (c) Heimberger [58], and (d) Boury [85]

Grahic Jump Location
Fig. 7

Overview of the bending flexure joint types adopted from the patents by (a) Stone et al. [34], (b) Shelton and Ortiz [95], (c) Cooper and Anderson [97], (d) Dewaele et al. [104], (e) Lee et al. [66], and (f) Breedveld and Scheltes [109]




Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In