# Patent

## Title
Steerable laser probe

## Abstract

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, an actuation control of the handle, a housing tube having a housing tube distal end and a housing tube proximal end, a first housing tube portion having a first stiffness, a second housing tube portion having a second stiffness, an optic fiber disposed within an inner portion of the handle and the housing tube, and a cable disposed within the housing tube and the actuation control. A rotation of the actuation control may be configured to gradually curve the housing tube and the optic fiber. A rotation of the actuation control may be configured to gradually straighten the housing tube and the optic fiber.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This Application claims the benefit of U.S. Provisional Application No. 61/704,527, filed Sep. 23, 2012.


FIELD OF THE INVENTION
The present disclosure relates to a surgical instrument, and, more particularly, to a steerable laser probe.
BACKGROUND OF THE INVENTION
A wide variety of ophthalmic procedures require a laser energy source. For example, ophthalmic surgeons may use laser photocoagulation to treat proliferative retinopathy. Proliferative retinopathy is a condition characterized by the development of abnormal blood vessels in the retina that grow into the vitreous humor. Ophthalmic surgeons may treat this condition by energizing a laser to cauterize portions of the retina to prevent the abnormal blood vessels from growing and hemorrhaging.
In order to increase the chances of a successful laser photocoagulation procedure, it is important that a surgeon is able aim the laser at a plurality of targets within the eye, e.g., by guiding or moving the laser from a first target to a second target within the eye. It is also important that the surgeon is able to easily control a movement of the laser. For example, the surgeon must be able to easily direct a laser beam by steering the beam to a first position aimed at a first target, guide the laser beam from the first position to a second position aimed at a second target, and hold the laser beam in the second position. Accordingly, there is a need for a surgical laser probe that can be easily guided to a plurality of targets within the eye.
BRIEF SUMMARY OF THE INVENTION
The present disclosure presents a steerable laser probe. In one or more embodiments, a steerable laser probe may comprise a handle having a handle distal end and a handle proximal end, an actuation control of the handle, a housing tube having a housing tube distal end and a housing tube proximal end, a first housing tube portion having a first stiffness, a second housing tube portion having a second stiffness, an optic fiber disposed within an inner portion of the handle and the housing tube, and a cable disposed within the housing tube and the actuation control. Illustratively, a rotation of the actuation control may be configured to gradually curve the housing tube. In one or more embodiments, a gradual curving of the housing tube may be configured to gradually curve the optic fiber. Illustratively, a rotation of the actuation control may be configured to gradually straighten the housing tube. In one or more embodiments, a gradual straightening of the housing tube may be configured to gradually straighten the optic fiber.



BRIEF DESCRIPTION OF THE DRAWINGS
The above and further advantages of the present invention may be better understood by referring to the following description in conjunction with the accompanying drawings in which like reference numerals indicate identical or functionally similar elements:
FIGS. 1A and 1B are schematic diagrams illustrating an actuation control;
FIGS. 2A and 2B are schematic diagrams illustrating an exploded view of a handle assembly;
FIGS. 3A and 3B are schematic diagrams illustrating a handle;
FIGS. 4A, 4B, and 4C are schematic diagrams illustrating a housing tube;
FIG. 5 is a schematic diagram illustrating an exploded view of a steerable laser probe assembly;
FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating a gradual curving of an optic fiber;
FIGS. 7A, 7B, 7C, 7D, and 7E are schematic diagrams illustrating a gradual straightening of an optic fiber.



DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT
FIGS. 1A and 1B are schematic diagrams illustrating an actuation control 100. FIG. 1A illustrates a side view of an actuation control 100. Illustratively, actuation control 100 may comprise an actuation control distal end 101, an actuation control proximal end 102, an actuation control anterior end 103, and an actuation control posterior end 104. FIG. 1B illustrates a cross-sectional view of an actuation control 100. In one or more embodiments, actuation control 100 may comprise a fixation pin guide 110, a cable housing 120, and an actuation chamber 130. Illustratively, actuation control 100 may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials.
FIGS. 2A and 2B are schematic diagrams illustrating an exploded view of a handle assembly 200. FIG. 2A illustrates a side view of a handle assembly 200. In one or more embodiments, handle assembly 200 may comprise a handle end cap 205 having a handle end cap distal end 206 and a handle end cap proximal end 207, an actuation control mount 210 having an actuation control mount distal end 211 and an actuation control mount proximal end 212, an actuation control 100, a fixation pin 215, a handle base 220 having a handle base distal end 221 and a handle base proximal end 222, and a handle end cap interface 225. Illustratively, actuation control 100 may be disposed within actuation control mount 210. In one or more embodiments, fixation pin 215 may be configured to fix actuation control 100 within actuation control mount 210, e.g., fixation pin 215 may be disposed within a portion of actuation control mount 210 and within a portion of actuation control 100. Illustratively, fixation pin 215 may be disposed within actuation control mount 210 and fixation pin guide 110. In one or more embodiments, actuation control 100 may be rotated about fixation pin 215, e.g., a surgeon may rotate actuation control 100 within actuation control mount 210 by applying a force to a portion of actuation control 100.
FIG. 2B illustrates a cross-sectional view of a handle assembly 200. Illustratively, handle assembly 200 may comprise a handle inner portion 240, an auto-fixing component housing 245, and a housing tube housing 250. In one or more embodiments, actuation control 100 may be oriented wherein a portion of actuation chamber 130 may be disposed within a portion of handle inner portion 240. Illustratively, handle end cap 205, actuation control mount 210, and handle base 220 may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials.
FIGS. 3A and 3B are schematic diagrams illustrating a handle 300. FIG. 3A illustrates a side view of a handle 300. Illustratively, handle 300 may comprise a handle distal end 301 and a handle proximal end 302. In one or more embodiments, handle distal end 301 may comprise a portion of handle base 220, e.g., handle distal end 301 may comprise handle base distal end 221. Illustratively, handle proximal end 302 may comprise a portion of end cap 205, e.g., handle proximal end 302 may comprise handle end cap proximal end 207.
FIG. 3B illustrates a cross-sectional view of a handle 300. In one or more embodiments, actuation control mount 210 may be disposed within handle end cap 205 and handle base 220. Illustratively, actuation control mount 210 may be disposed within handle end cap 205 and handle base 220 wherein a portion of actuation control 100 may be adjacent to a portion of auto-fixing component housing 245. In one or more embodiments, a portion of handle base 220 may be disposed within a portion of handle end cap 205, e.g., handle base proximal end 222 may be disposed within handle end cap 205. In one or more embodiments, a portion of handle base 220 may be disposed within handle end cap 205 wherein handle end cap interface 225 may be configured to interface with a portion of handle end cap 205, e.g., handle end cap interface 225 may be configured to interface with handle end cap distal end 206. Illustratively, a portion of handle base 220 may be fixed within handle end cap 205, e.g., by an adhesive or any suitable fixation means. In one or more embodiments, a portion of handle base 220 may be fixed within handle end cap 205 by a press fit, a setscrew, a weld, etc. Illustratively, handle base 220 and handle end cap 205 may be manufactured as a single unit.
FIGS. 4A, 4B, and 4C are schematic diagrams illustrating a housing tube 400. In one or more embodiments, housing tube 400 may comprise a housing tube distal end 401 and a housing tube proximal end 402. Housing tube 400 may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. Illustratively, housing tube 400 may be manufactured with dimensions configured for microsurgical procedures, e.g., ophthalmic surgical procedures. FIG. 4A illustrates a housing tube 400 oriented to illustrate a first housing tube portion 420. Illustratively, first housing tube portion 420 may have a first stiffness. FIG. 4B illustrates a housing tube 400 oriented to illustrate a second housing tube portion 430. Illustratively, second housing tube portion 430 may have a second stiffness. In one or more embodiments, the second stiffness may be greater than the first stiffness. Illustratively, first housing tube portion 420 may comprise a first material having a first stiffness. In one or more embodiments, second housing tube portion 430 may comprise a second material having a second stiffness. Illustratively, the second stiffness may be greater than the first stiffness.
In one or more embodiments, housing tube 400 may comprise a non-uniform inner diameter or a non-uniform outer diameter, e.g., to vary a stiffness of one or more portions of housing tube 400. Illustratively, a first housing tube portion 420 may comprise a first inner diameter of housing tube 400 and a second housing tube portion 430 may comprise a second inner diameter of housing tube 400. In one or more embodiments, the first inner diameter of housing tube 400 may be larger than the second inner diameter of housing tube 400. Illustratively, a first housing tube portion 420 may comprise a first outer diameter of housing tube 400 and a second housing tube portion 430 may comprise a second outer diameter of housing tube 400. In one or more embodiments, the first outer diameter of housing tube 400 may be smaller than the second outer diameter of housing tube 400.
In one or more embodiments, first housing tube portion 420 may comprise one or more apertures configured to produce a first stiffness of first housing tube portion 420. Illustratively, second housing tube portion 430 may comprise a solid portion of housing tube 400 having a second stiffness. In one or more embodiments, the second stiffness may be greater than the first stiffness. Illustratively, first housing tube portion 420 may comprise one or more apertures configured to produce a first stiffness of first housing tube portion 420. In one or more embodiments, second housing tube portion 430 may comprise one or more apertures configured to produce a second stiffness of second housing tube portion 430. Illustratively, the second stiffness may be greater than the first stiffness.
In one or more embodiments, first housing tube portion 420 may comprise a plurality of slits configured to separate one or more solid portions of housing tube 400. Illustratively, a plurality of slits may be cut, e.g., laser cut, into first housing tube portion 420. In one or more embodiments, first housing tube portion 420 may comprise a plurality of slits configured to minimize a force of friction between housing tube 400 and a cannula, e.g., as housing tube 400 is inserted into the cannula or as housing tube 400 is extracted from the cannula. For example, each slit of the plurality of slits may comprise one or more arches configured to minimize a force of friction between housing tube 400 and a cannula.
FIG. 4C illustrates an angled view of housing tube 400. Illustratively, an optic fiber 450 may be disposed within housing tube 400. In one or more embodiments, optic fiber 450 may comprise an optic fiber distal end 451 and an optic fiber proximal end 452. Illustratively, optic fiber 450 may be configured to transmit light, e.g., laser light, illumination light, etc. In one or more embodiments, optic fiber 450 may be disposed within housing tube 400 wherein optic fiber distal end 451 may be adjacent to housing tube distal end 401. Illustratively, optic fiber 450 may be disposed within housing tube 400 wherein a portion of optic fiber 450 may be adjacent to a portion of first housing tube portion 420. In one or more embodiments, a portion of optic fiber 450 may be fixed to an inner portion of housing tube 400, e.g., by an adhesive or any suitable fixation means.
Illustratively, a cable 410 may be disposed in housing tube 400. In one or more embodiments, a cable 410 may comprise a cable distal end 411 and a cable proximal end 412. Illustratively, cable 410 may be disposed in housing tube 400 wherein cable distal end 411 may be adjacent to housing tube distal end 401. In one or more embodiments, cable 410 may be disposed in housing tube 400 wherein a portion of cable 410 may be adjacent to a portion of first housing tube portion 420. Illustratively, a portion of cable 410 may be fixed to a portion of housing tube 400, e.g., cable distal end 411 may be fixed to a portion of housing tube 400. In one or more embodiments, a portion of cable 410 may be fixed to a portion of housing tube 400, e.g., by an adhesive or any suitable fixation means. Illustratively, a portion of cable 410 may be fixed to a portion of housing tube 400 by a weld, a press fit, a loop, a tie, etc.
FIG. 5 is a schematic diagram illustrating an exploded view of a steerable laser probe assembly 500. In one or more embodiments, a steerable laser probe assembly 500 may comprise a handle 300 having a handle distal end 301 and a handle proximal end 302, a housing tube 400 having a housing tube distal end 401 and a housing tube proximal end 402, a cable 410 having a cable distal end 411 and a cable proximal end 412, an optic fiber 450 having an optic fiber distal end 451 and an optic fiber proximal end 452, an auto-fixing component 520 having an auto-fixing component distal end 521 and an auto-fixing component proximal end 522, and a light source interface 510. Illustratively, light source interface 510 may be configured to interface with optic fiber 450, e.g., at optic fiber proximal end 452. In one or more embodiments, light source interface 510 may comprise a standard light source connecter, e.g., an SMA connector.
Illustratively, a portion of housing tube 400 may be disposed within a portion of handle 300, e.g., housing tube proximal end 402 may be disposed within a portion of handle 300. In one or more embodiments, a portion of housing tube 400 may be disposed within a portion of handle base 220, e.g., housing tube proximal end 402 may be disposed in housing tube housing 250. Illustratively, a portion of housing tube 400 may be fixed within a portion of handle 300, e.g., housing tube proximal end 402 may be fixed within housing tube housing 250. In one or more embodiments, a portion of housing tube 400 may be fixed within housing tube housing 250, e.g., by an adhesive or any suitable fixation means. For example, a portion of housing tube 400 may be fixed within housing tube housing 250 by a press fit, a set screw, etc.
Illustratively, optic fiber 450 may be disposed within handle inner portion 240, actuation chamber 130, housing tube housing 250, and housing tube 400. In one or more embodiments, optic fiber 450 may be disposed within housing tube 400 wherein optic fiber distal end 451 may be adjacent to housing tube distal end 401. Illustratively, a portion of optic fiber 450 may be fixed to a portion of housing tube 400, e.g., by an adhesive or any suitable fixation means. In one or more embodiments, cable 410 may be disposed within cable housing 120, actuation chamber 130, handle inner portion 240, housing tube housing 250, and housing tube 400. Illustratively, cable 410 may be disposed within housing tube 400 wherein cable distal end 411 may be adjacent to housing tube distal end 401. In one or more embodiments, cable 410 may be disposed within housing tube 400 wherein a portion of cable 410 may be adjacent to a portion of first housing tube portion 420. Illustratively, a portion of cable 410 may be fixed to a portion of housing tube 400, e.g., by an adhesive or any suitable fixation means. For example, a portion of cable 410 may be fixed to a portion of housing tube 400 by a weld, a press fit, a loop, a tie, etc. In one or more embodiments, a portion of cable 410 may be fixed within cable housing 120, e.g., by an adhesive or any suitable fixation means. For example, a portion of cable 410 may be fixed within cable housing 120 by a weld, a press fit, a loop, a tie, etc. Illustratively, a first portion of cable 410 may be fixed to a portion of housing tube 400 and a second portion of cable 410 may be fixed within cable housing 120. In one or more embodiments, cable distal end 411 may be fixed to a portion of housing tube 400. Illustratively, cable proximal end 412 may be fixed within cable housing 120.
In one or more embodiments, a surgeon may rotate actuation control 100 within handle inner portion 240, e.g., by applying a force to a portion of actuation control 100. Illustratively, actuation chamber 130 may be configured to prevent a contact between a portion of actuation control 100 and a portion of optic fiber 450, e.g., due to a rotation of actuation control 100. In one or more embodiments, a geometry of actuation chamber 130 may be configured to prevent a contact between a portion of actuation control 100 and a portion of optic fiber 450, e.g., due to a rotation of actuation control. Illustratively, a surgeon may rotate actuation control 100 about fixation pin 215, e.g., by applying a force to a portion of actuation control 100. In one or more embodiments, a rotation of actuation control 100 may be configured to retract cable 410 relative to housing tube 400. Illustratively, a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of housing tube 400, e.g., a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to first housing tube portion 420. In one or more embodiments, an application of a force to a portion of housing tube 400 may be configured to compress a portion of housing tube 400, e.g., an application of a force to a portion of housing tube 400 may be configured to compress first housing tube portion 420. Illustratively, a compression of a portion of housing tube 400 may be configured to cause housing tube 400 to gradually curve. In one or more embodiments, a gradual curving of housing tube 400 may be configured to gradually curve optic fiber 450. Illustratively, a rotation of actuation control 100 may be configured to gradually curve optic fiber 450.
In one or more embodiments, a rotation of actuation control 100 may be configured to extend cable 410 relative to housing tube 400. Illustratively, an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to a portion of housing tube 400, e.g., an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to first housing tube portion 420. In one or more embodiments, a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of housing tube 400, e.g., a reduction of a force applied to a portion of housing tube 400 may be configured to decompress first housing tube portion 420. Illustratively, a decompression of a portion of housing tube 400 may be configured to cause housing tube 400 to gradually straighten. In one or more embodiments, a gradual straightening of housing tube 400 may be configured to gradually straighten optic fiber 450. Illustratively, a rotation of actuation control 100 may be configured to gradually straighten optic fiber 450.
In one or more embodiments, auto-fixing component 520 may be disposed within auto-fixing component housing 245. Illustratively, auto-fixing component 520 may be fixed within auto-fixing component housing 245, e.g., by an adhesive or any suitable fixation means. In one or more embodiments, auto-fixing component 520 may be disposed within auto-fixing component housing 245 wherein a portion of auto-fixing component 520 may be adjacent to a portion of actuation control 100. Illustratively, auto-fixing component 520 may be configured to produce a magnetic field, e.g., auto-fixing component 520 may comprise a permanent magnet. In one or more embodiments, auto-fixing component 520 may comprise a ferromagnetic material, e.g., auto-fixing component 520 may comprise a ferrimagnetic material. Illustratively, actuation control 100 may be configured to produce a magnetic field, e.g., actuation control 100 may comprise a permanent magnetic. In one or more embodiments, actuation control 100 may comprise a ferromagnetic material, e.g., actuation control 100 may comprise a ferrimagnetic material.
Illustratively, auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a rotational position within handle inner portion 240, e.g., a magnetic force attracting actuation control 100 to auto-fixing component 520 may be configured to hold actuation control 100 fixed in a rotational position within handle inner portion 240. In one or more embodiments, actuation control 100 may be configured to temporarily fix actuation control 100 in a rotational position within handle inner portion 240, e.g., a magnetic force attracting auto-fixing component 520 to actuation control 100 may be configured to temporarily hold actuation control 100 fixed in a rotational position within handle inner portion 240. Illustratively, both auto-fixing component 520 and actuation control 100 may be configured to temporarily fix actuation control 100 in a rotational position within handle inner portion 240, e.g., auto-fixing component 520 and actuation control 100 may both comprise permanent magnets having poles oriented to attract auto-fixing component 520 to actuation control 100 and to attract actuation control 100 to auto-fixing component 520.
In one or more embodiments, a surgeon may actuate actuation control 100 within handle inner portion 240, e.g., by applying a force to a portion of actuation control 100 until actuation control 100 is in a first desired rotational position within handle inner portion 240. Illustratively, the surgeon may then remove the force applied to actuation control 100 and perform a portion of a surgical procedure, e.g., actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in the first desired rotational position within handle inner portion 240. In one or more embodiments, the surgeon may actuate actuation control 100 within handle inner portion 240, e.g., by applying a force to a portion of actuation control 100 until actuation control 100 is in a second desired rotational position within handle inner portion 240. Illustratively, the surgeon may then remove the force applied to actuation control 100 and perform a portion of a surgical procedure, e.g., actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in the second desired rotational position within handle inner portion 240. In one or more embodiments, the surgeon may actuate actuation control 100 within handle inner portion 240, e.g., by applying a force to a portion of actuation control 100 until actuation control 100 is in a third desired rotational position within handle inner portion 240. Illustratively, the surgeon may then remove the force applied to actuation control 100 and perform a portion of a surgical procedure, e.g., actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in the third desired rotational position within handle inner portion 240. In one or more embodiments, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in any desired rotational position within handle inner portion 240.
FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating a gradual curving of an optic fiber 450. FIG. 6A illustrates a straight optic fiber 600. In one or more embodiments, optic fiber 450 may comprise a straight optic fiber 600, e.g., when cable 410 is fully extended relative to housing tube 400. For example, optic fiber 450 may comprise a straight optic fiber 600, e.g., when first housing tube portion 420 is fully decompressed. Illustratively, a line tangent to optic fiber distal end 451 may be parallel to a line tangent to housing tube proximal end 402, e.g., when optic fiber 450 comprises a straight optic fiber 600. In one or more embodiments, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a first fixed rotational position within handle inner portion 240. Illustratively, optic fiber 450 may comprise a straight optic fiber 600, e.g., when actuation control 100 is fixed in the first fixed rotational position within handle inner portion 240.
FIG. 6B illustrates an optic fiber in a first curved position 610. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually curve optic fiber 450 from a straight optic fiber 600 to an optic fiber in a first curved position 610. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to retract cable 410 relative to housing tube 400. In one or more embodiments, a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of housing tube 400, e.g., a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of first housing tube portion 420. Illustratively, an application of a force to a portion of housing tube 400 may be configured to compress a portion of housing tube 400, e.g., an application of a force to a portion of housing tube 400 may be configured to compress a portion of first housing tube portion 420. In one or more embodiments, a compression of a portion of housing tube 400 may be configured to gradually curve housing tube 400. Illustratively, a gradual curving of housing tube 400 may be configured to gradually curve optic fiber 450, e.g., from a straight optic fiber 600 to an optic fiber in a first curved position 610. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a first angle, e.g., when optic fiber 450 comprises an optic fiber in a first curved position 610. In one or more embodiments, the first angle may comprise any angle greater than zero degrees. For example, the first angle may comprise a 45 degree angle. Illustratively, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a second fixed rotational position within handle inner portion 240. In one or more embodiments, optic fiber 450 may comprise an optic fiber in a first curved position 610, e.g., when actuation control 100 is fixed in the second fixed rotational position within handle inner portion 240.
FIG. 6C illustrates an optic fiber in a second curved position 620. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be is configured to gradually curve optic fiber 450 from an optic fiber in a first curved position 610 to an optic fiber in a second curved position 620. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to retract cable 410 relative to housing tube 400. In one or more embodiments, a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of housing tube 400, e.g., a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of first housing tube portion 420. Illustratively, an application of a force to a portion of housing tube 400 may be configured to compress a portion of housing tube 400, e.g., an application of a force to a portion of housing tube 400 may be configured to compress a portion of first housing tube portion 420. In one or more embodiments, a compression of a portion of housing tube 400 may be configured to gradually curve housing tube 400. Illustratively, a gradual curving of housing tube 400 may be configured to gradually curve optic fiber 450, e.g., from an optic fiber in a first curved position 610 to an optic fiber in a second curved position 620. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a second angle, e.g., when optic fiber 450 comprises an optic fiber in a second curved position 620. In one or more embodiments, the second angle may comprise any angle greater than the first angle. For example, the second angle may comprise a 90 degree angle. Illustratively, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a third fixed rotational position within handle inner portion 240. In one or more embodiments, optic fiber 450 may comprise an optic fiber in a second curved position 620, e.g., when actuation control 100 is fixed in the third fixed rotational position within handle inner portion 240.
FIG. 6D illustrates an optic fiber in a third curved position 630. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually curve optic fiber 450 from an optic fiber in a second curved position 620 to an optic fiber in a third curved position 630. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to retract cable 410 relative to housing tube 400. In one or more embodiments, a refraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of housing tube 400, e.g., a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of first housing tube portion 420. Illustratively, an application of a force to a portion of housing tube 400 may be configured to compress a portion of housing tube 400, e.g., an application of a force to a portion of housing tube 400 may be configured to compress a portion of first housing tube portion 420. In one or more embodiments, a compression of a portion of housing tube 400 may be configured to gradually curve housing tube 400. Illustratively, a gradual curving of housing tube 400 may be configured to gradually curve optic fiber 450, e.g., from an optic fiber in a second curved position 620 to an optic fiber in a third curved position 630. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a third angle, e.g., when optic fiber 450 comprises an optic fiber in a third curved position 630. In one or more embodiments, the third angle may comprise any angle greater than the second angle. For example, the third angle may comprise a 135 degree angle. Illustratively, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a fourth fixed rotational position within handle inner portion 240. In one or more embodiments, optic fiber 450 may comprise an optic fiber in a third curved position 630, e.g., when actuation control 100 is fixed in the fourth fixed rotational position within handle inner portion 240.
FIG. 6E illustrates an optic fiber in a fourth curved position 640. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually curve optic fiber 450 from an optic fiber in a third curved position 630 to an optic fiber in a fourth curved position 640. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to retract cable 410 relative to housing tube 400. In one or more embodiments, a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of housing tube 400, e.g., a retraction of cable 410 relative to housing tube 400 may be configured to apply a force to a portion of first housing tube portion 420. Illustratively, an application of a force to a portion of housing tube 400 may be configured to compress a portion of housing tube 400, e.g., an application of a force to a portion of housing tube 400 may be configured to compress a portion of first housing tube portion 420. In one or more embodiments, a compression of a portion of housing tube 400 may be configured to gradually curve housing tube 400. Illustratively, a gradual curving of housing tube 400 may be configured to gradually curve optic fiber 450, e.g., from an optic fiber in a third curved position 630 to an optic fiber in a fourth curved position 640. In one or more embodiments, a line tangent to optic fiber distal end 451 may be parallel to a line tangent to housing tube proximal end 402, e.g., when optic fiber 450 comprises an optic fiber in a fourth curved position 640. Illustratively, actuation control 100 and auto-fixing component 520 may be configured to temporarily fix actuation control 100 in a fifth fixed rotational position within handle inner portion 240. In one or more embodiments, optic fiber 450 may comprise an optic fiber in a fourth curved position 640, e.g., when actuation control 100 is fixed in the fifth fixed rotational position within handle inner portion 240.
In one or more embodiments, one or more properties of a steerable laser probe may be adjusted to attain one or more desired steerable laser probe features. Illustratively, a distance that housing tube distal end 401 extends from handle distal end 301 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. In one or more embodiments, a stiffness of first housing tube portion 420 or a stiffness of second housing tube portion 430 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. Illustratively, a material comprising first housing tube portion 420 or a material comprising second housing tube portion 430 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position.
In one or more embodiments, a number of apertures in housing tube 400 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. Illustratively, a location of one or more apertures in housing tube 400 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. In one or more embodiments, a geometry of one or more apertures in housing tube 400 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. Illustratively, a geometry of one or more apertures in housing tube 400 may be uniform, e.g., each aperture of the one or more apertures may have a same geometry. In one or more embodiments, a geometry of one or more apertures in housing tube 400 may be non-uniform, e.g., a first aperture in housing is tube 400 may have a first geometry and a second aperture in housing tube 400 may have a second geometry. Illustratively, a geometry or location of one or more apertures in housing tube 400 may be optimized to evenly distribute an applied force. For example, a geometry or location of one or more apertures in housing tube 400 may be optimized to evenly distribute a force applied to first housing tube portion 420.
Illustratively, a stiffness of first housing tube portion 420 or a stiffness of second housing tube portion 430 may be adjusted to vary a bend radius of housing tube 400. In one or more embodiments, a stiffness of first housing tube portion 420 or a stiffness of second housing tube portion 430 may be adjusted to vary a radius of curvature of housing tube 400, e.g., when housing tube 400 is in a particular curved position. Illustratively, a number of apertures in housing tube 400 may be adjusted to vary a bend radius of housing tube 400. In one or more embodiments, a number of apertures in housing tube 400 may be adjusted to vary a radius of curvature of housing tube 400, e.g., when housing tube 400 is in a particular curved position. Illustratively, a location or a geometry of one or more apertures in housing tube 400 may be adjusted to vary a bend radius of housing tube 400. In one or more embodiments, a location or a geometry of one or more apertures in housing tube 400 may be adjusted to vary a radius of curvature of housing tube 400, e.g., when housing tube 400 is in a particular curved position.
In one or more embodiments, at least a portion of optic fiber 450 may be enclosed in an optic fiber sleeve configured to, e.g., protect optic fiber 450, vary a stiffness of optic fiber 450, vary an optical property of optic fiber 450, etc. Illustratively, optic fiber 450 may comprise a buffer, a cladding disposed in the buffer, and a core disposed in the cladding. In one or more embodiments, at least a portion of optic fiber 450 may comprise a buffer configured to protect an optical property of optic fiber 450. Illustratively, at least a portion of optic fiber 450 may comprise a buffer configured to protect an optical layer of optic fiber 450, e.g., the buffer may protect an optical layer of a curved portion of optic fiber 450. In one or more embodiments, at least a portion of optic fiber 450 may comprise a polyimide buffer configured to protect an optical property of optic fiber 450. For example, at least a portion of optic fiber 450 may comprise a Kapton buffer configured to protect an optical property of optic fiber 450.
In one or more embodiments, a location wherein cable 410 may be fixed to housing tube 400 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. For example, a portion of cable 410 may be fixed to an outer portion of housing tube 400. Illustratively, cable 410 may be fixed to housing tube 400 at a plurality of fixation points, e.g., to vary one or more properties of a steerable laser probe. In one or more embodiments, a length of cable 410 may be adjusted to vary an amount of rotation of actuation control 100 configured to curve housing tube 400 to a particular curved position. Illustratively, a steerable laser probe may comprise one or more redundant cables 410. In one or more embodiments, one or more redundant cables 410 may be configured to maintain a particular curved position of housing tube 400, e.g., in the event that cable 410 breaks or fails. Illustratively, one or more redundant cables 410 may be configured to maintain a particular curved position of housing tube 400, e.g., in the event that a cable 410 fixation means fails. In one or more embodiments, one or more redundant cables 410 may be configured to maintain a particular curved position of housing tube 400, e.g., in the event that cable 410 is no longer configured to maintain the particular curved position of housing tube 400. Illustratively, one or more redundant cables 410 may be configured to maintain a particular curved position of housing tube 400 wherein cable 410 is also configured to maintain the particular curved position of housing tube 400.
In one or more embodiments, housing tube 400 may comprise an access window configured to allow access to a portion cable 410. Illustratively, cable 410 may be fixed to a portion of housing tube 400, e.g., by looping a portion of cable 410 through an aperture in housing tube 400. In one or more embodiments, cable 410 may be fixed to a portion of housing tube 400, e.g., by a purely mechanical means. For example, cable 410 may be fixed to a portion of housing tube 400 in a manner other than by an adhesive, a weld, etc. Illustratively, cable 410 may be fixed to a portion of housing tube 400 wherein a portion of cable 410 is configured to fail at a first applied failure force and a fixation means that fixes a portion of cable 410 to a portion of housing tube 400 is configured to fail at a second applied failure force. In one or more embodiments, the second applied failure force may be greater than the first applied failure force.
Illustratively, an arrangement of a portion of cable 410, e.g., an arrangement of a portion of cable 410 between cable distal end 411 and cable proximal end 412, may be adjusted to attain one or more desired steerable laser probe features. In one or more embodiments, an arrangement of a portion of cable 410 may be configured to cause a rotation of actuation control 100, e.g., a rotation of actuation control 100 due to force vector applied to actuation control anterior end 103 and directed towards handle distal end 301 and away from handle proximal end 302, to retract cable 410 relative to housing tube 400. Illustratively, an arrangement of a portion of cable 410 may be configured to cause a rotation of actuation control 100, e.g., a rotation of actuation control 100 due to force vector applied to actuation control anterior end 103 and directed towards handle proximal end 302 and away from handle distal end 301, to extend cable 410 relative to housing tube 400. In one or more embodiments, cable 410 may be disposed within actuation chamber 130, e.g., cable 410 may ingress actuation chamber 130 at actuation control distal end 101, and then disposed within cable housing 120. Illustratively, cable 410 may be disposed within actuation chamber 130, e.g., cable 410 may be disposed over actuation control posterior end 104 and ingress actuation chamber 130 at actuation control proximal end 102, and then disposed within cable housing 120. In one or more embodiments, cable 410 may not be disposed within actuation chamber 130, e.g., cable 410 may be disposed over actuation control posterior end 104 and actuation control proximal end 102, and then disposed within cable housing 120.
Illustratively, an arrangement of a portion of cable 410 may be configured to cause a rotation of actuation control 100, e.g., a rotation of actuation control 100 due to force vector applied to actuation control anterior end 103 and directed towards handle proximal end 302 and away from handle distal end 301, to retract cable 410 relative to housing tube 400. In one or more embodiments, an arrangement of a portion of cable 410 may be configured to cause a rotation of actuation control 100, e.g., a rotation of actuation control 100 due to force vector applied to actuation control anterior end 103 and directed towards handle distal end 301 and away from handle proximal end 302, to extend cable 410 relative to housing tube 400. For example, cable 410 may be disposed over a portion of actuation control 100 between actuation control distal end 101 and actuation control anterior end 103, and then disposed within cable housing 120.
Illustratively, a steerable laser probe may be configured to indicate, e.g., to a surgeon, a direction that optic fiber 450 may curve, e.g., due to a rotation of actuation control 100 within handle inner portion 240. In one or more embodiments, a portion of a steerable laser probe, e.g., handle 300, may be marked in a manner configured to indicate a direction that optic fiber 450 may curve. For example, a portion of housing tube 400 may comprise a mark configured to indicate a direction that optic fiber 450 may curve. Illustratively, housing tube 400 may comprise a slight curve, e.g., a curve less than 7.5 degrees, when cable 410 is fully extended relative to housing tube 400. For example, housing tube 400 may comprise a slight curve, e.g., a curve greater than 7.5 degrees, when cable 410 is fully extended relative to housing tube 400. In one or more embodiments, housing tube 400 may comprise a slight curve configured to indicate a direction that optic fiber 450 may curve, e.g., due to a rotation of actuation control 100 within handle inner portion 240.
FIGS. 7A, 7B, 7C, 7D, and 7E are schematic diagrams illustrating a gradual straightening of an optic fiber 450. FIG. 7A illustrates a fully curved optic fiber 700. In one or more embodiments, optic fiber 450 may comprise a fully curved optic fiber 700, e.g., when cable 410 is fully retracted relative to housing tube 400. For example, optic fiber 450 may comprise a fully curved optic fiber 700, e.g., when first housing tube portion 420 is fully compressed. In one or more embodiments, a line tangent to optic fiber distal end 451 may be parallel to a line tangent to housing tube proximal end 402, e.g., when optic fiber 450 comprises a fully curved optic fiber 700.
FIG. 7B illustrates an optic fiber in a first partially straightened position 710. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually straighten optic fiber 450 from a fully curved optic fiber 700 to an optic fiber in a first partially straightened position 710. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to extend cable 410 relative to housing tube 400. In one or more embodiments, an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to housing tube 400, e.g., an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to a portion of first housing tube portion 420. Illustratively, a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of housing tube 400, e.g., a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of first housing tube portion 420. In one or more embodiments, a decompression of a portion of housing tube 400 may be configured to gradually straighten housing tube 400. Illustratively, a gradual straightening of housing tube 400 may be configured to gradually straighten optic fiber 450, e.g., from a fully curved optic fiber 700 to an optic fiber in a first partially straightened position 710. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a first partially straightened angle, e.g., when optic fiber 450 comprises an optic fiber in a first partially straightened position 710. Illustratively, the first partially straightened angle may comprise any angle less than 180 degrees. For example, the first partially straightened angle may comprise a 135 degree angle.
FIG. 7C illustrates an optic fiber in a second partially straightened position 720. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually straighten optic fiber 450 from an optic fiber in a first partially straightened position 710 to an optic fiber in a second partially straightened position 720. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to extend cable 410 relative to housing tube 400. In one or more embodiments, an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to housing tube 400, e.g., an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to a portion of first housing tube portion 420. Illustratively, a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of housing tube 400, e.g., a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of first housing tube portion 420. In one or more embodiments, a decompression of a portion of housing tube 400 may be configured to gradually straighten housing tube 400. Illustratively, a gradual straightening of housing tube 400 may be configured to gradually straighten optic fiber 450, e.g., from an optic fiber in a first partially straightened position 710 to an optic fiber in a second partially straightened position 720. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a second partially straightened angle, e.g., when optic fiber 450 comprises an optic fiber in a second partially straightened position 720. Illustratively, the second partially straightened angle may comprise any angle less than the first partially straightened angle. For example, the second partially straightened angle may comprise a 90 degree angle.
FIG. 7D illustrates an optic fiber in a third partially straightened position 730. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually straighten optic fiber 450 from an optic fiber in a second partially straightened position 720 to an optic fiber in a third partially straightened position 730. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to extend cable 410 relative to housing tube 400. In one or more embodiments, an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to housing tube 400, e.g., an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to a portion of first housing tube portion 420. Illustratively, a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of housing tube 400, e.g., a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of first housing tube portion 420. In one or more embodiments, a decompression of a portion of housing tube 400 may be configured to gradually straighten housing tube 400. Illustratively, a gradual straightening of housing tube 400 may be configured to gradually straighten optic fiber 450, e.g., from an optic fiber in a second partially straightened position 720 to an optic fiber in a third partially straightened position 730. In one or more embodiments, a line tangent to optic fiber distal end 451 may intersect a line tangent to housing tube proximal end 402 at a third partially straightened angle, e.g., when optic fiber 450 comprises an optic fiber in a third partially straightened position 730. Illustratively, the third partially straightened angle may comprise any angle less than the second partially straightened angle. For example, the third partially straightened angle may comprise a 45 degree angle.
FIG. 7E illustrates an optic fiber in a fully straightened position 740. In one or more embodiments, a rotation of actuation control 100 within handle inner portion 240 may be configured to gradually straighten optic fiber 450 from an optic fiber in a third partially straightened position 730 to an optic fiber in a fully straightened position 740. Illustratively, a rotation of actuation control 100 within handle inner portion 240 may be configured to extend cable 410 relative to housing tube 400. In one or more embodiments, an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to housing tube 400, e.g., an extension of cable 410 relative to housing tube 400 may be configured to reduce a force applied to a portion of first housing tube portion 420. Illustratively, a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of housing tube 400, e.g., a reduction of a force applied to a portion of housing tube 400 may be configured to decompress a portion of first housing tube portion 420. In one or more embodiments, a decompression of a portion of housing tube 400 may be configured to gradually straighten housing tube 400. Illustratively, a gradual straightening of housing tube 400 may be configured to gradually straighten optic fiber 450, e.g., from an optic fiber in a third partially straightned position 730 to an optic fiber in a fully straightened position 740. In one or more embodiments, a line tangent to optic fiber distal end 451 may be parallel to a line tangent to housing tube proximal end 402, e.g., when optic fiber 450 comprises an optic fiber in a fully straightened position 740.
Illustratively, a surgeon may aim optic fiber distal end 451 at any of a plurality of targets within an eye, e.g., to perform a photocoagulation procedure, to illuminate a surgical target site, etc. In one or more embodiments, a surgeon may aim optic fiber distal end 451 at any target within a particular transverse plane of the inner eye by, e.g., rotating handle 300 to orient housing tube 400 in an orientation configured to cause a curvature of housing tube 400 within the particular transverse plane of the inner eye and varying an amount of rotation of actuation control 100 within handle inner portion 240. Illustratively, a surgeon may aim optic fiber distal end 451 at any target within a particular sagittal plane of the inner eye by, e.g., rotating handle 300 to orient housing tube 400 in an orientation configured to cause a curvature of housing tube 400 within the particular sagittal plane of the inner eye and varying an amount of rotation of actuation control 100 within handle inner portion 240. In one or more embodiments, a surgeon may aim optic fiber distal end 451 at any target within a particular frontal plane of the inner eye by, e.g., varying an amount of rotation of actuation control 100 within handle inner portion 240 to orient a line tangent to optic fiber distal end 451 wherein the line tangent to optic fiber distal end 451 is within the particular frontal plane of the inner eye and rotating handle 300. Illustratively, a surgeon may aim optic fiber distal end 451 at any target located outside of the particular transverse plane, the particular sagittal plane, and the particular frontal plane of the inner eye, e.g., by varying a rotational orientation of handle 300 and varying an amount of rotation of actuation control 100 within handle inner portion 240. In one or more embodiments, a surgeon may aim optic fiber distal end 451 at any target of a plurality of targets within an eye, e.g., without increasing a length of a portion of a steerable laser probe within the eye. Illustratively, a surgeon may aim optic fiber distal end 451 at any target of a plurality of targets within an eye, e.g., without decreasing a length of a portion of a steerable laser probe within the eye.
The foregoing description has been directed to particular embodiments of this invention. It will be apparent; however, that other variations and modifications may be made to the described embodiments, with the attainment of some or all of their advantages. Specifically, it should be noted that the principles of the present invention may be implemented in any system. Furthermore, while this description has been written in terms of a surgical instrument, the teachings of the present invention are equally suitable to any systems where the functionality may be employed. Therefore, it is the object of the appended claims to cover all such variations and modifications as come within the true spirit and scope of the invention.

## Claims

1. An instrument comprising:
a handle having a handle distal end and a handle proximal end;
a handle end cap of the handle having a handle end cap distal end and a handle end cap proximal end;
a handle base of the handle having a handle base distal end and a handle base proximal end;
an actuation control mount of the handle having an actuation control mount distal end and an actuation control mount proximal end wherein the actuation control mount distal end is disposed in the handle base and wherein the actuation control mount proximal end is disposed in the handle end cap;
an actuation control of the handle, the actuation control disposed within the actuation control mount;
a fixation pin disposed in a portion of the actuation control and the actuation control mount wherein an application of a force to a portion of the actuation control is configured to rotate the actuation control about the fixation pin;
an actuation chamber of the actuation control;
a single housing tube having a housing tube distal end and a housing tube proximal end, the housing tube having dimensions configured to perform microsurgical procedures;
a first housing tube portion of the housing tube, the first housing tube portion having a first stiffness and having a plurality of slits wherein each slit of the plurality of slits has an arch
a second housing tube portion of the housing tube, the second housing tube portion having a second stiffness wherein the second stiffness is greater than the first stiffness;
an optic fiber having an optic fiber distal end and an optic fiber proximal end, the optic fiber disposed in the housing tube, an inner portion of the handle, and the actuation chamber of the actuation control; and
a cable having a cable distal end and a cable proximal end, the cable disposed in the housing tube and the inner portion of the handle wherein the cable distal end is adjacent to the housing tube distal end and wherein a portion of the cable is fixed to a portion of the housing tube wherein a rotation of the actuation control about the fixation pin in a first direction is configured to gradually curve the optic fiber.

2. The instrument of claim 1 wherein the rotation of the actuation control about the fixation pin in the first direction is configured to retract the cable relative to the housing tube.

3. The instrument of claim 1 wherein a rotation of the actuation control about the fixation pin in a second direction is configured to gradually straighten the optic fiber.

4. The instrument of claim 3 wherein the rotation of the actuation control about the fixation pin in the second direction is configured to extend the cable relative to the housing tube.

5. The instrument of claim 1 further comprising:
an auto-fixing component of the handle, the auto-fixing component disposed within an auto-fixing component housing of the handle wherein at least a portion of the auto-fixing component is adjacent to at least a portion of the actuation control.

6. The instrument of claim 5 wherein the auto-fixing component and the actuation control are configured to temporarily fix the actuation control in a first rotational position about the fixation pin.

7. The instrument of claim 6 wherein the auto-fixing component and the actuation control are configured to temporarily fix the optic fiber in a first curved position wherein a line tangent to the optic fiber distal end intersects a line tangent to the housing tube proximal end at a first angle.

8. The instrument of claim 7 wherein the auto-fixing component and the actuation control are configured to temporarily fix the actuation control in a second rotational position about the fixation pin.

9. The instrument of claim 8 wherein the auto-fixing component and the actuation control are configured to temporarily fix the optic fiber in a second curved position wherein the line tangent to the optic fiber distal end intersects the line tangent to the housing tube proximal end at a second angle.

10. The instrument of claim 9 wherein the auto-fixing component and the actuation control are configured to temporarily fix the actuation control in a third rotational position about the fixation pin.

11. The instrument of claim 10 wherein the auto-fixing component and the actuation control are configured to temporarily fix the optic fiber in a third curved position wherein the line tangent to the to the optic fiber distal end intersects the line tangent to the housing tube proximal end at a third angle.

12. The instrument of claim 5 wherein at least a portion of the auto-fixing component comprises a permanent magnet.

13. The instrument of claim 12 wherein at least a portion of the actuation control comprises a permanent magnet.

14. The instrument of claim 1 wherein the cable proximal end is disposed within a cable housing of the actuation control.

15. The instrument of claim 14 wherein the cable proximal end is fixed within the cable housing of the actuation control.

16. The instrument of claim 1 further comprising:
a plurality of apertures of the first housing tube portion.

17. The instrument of claim 1 wherein the plurality of slits are configured to minimize a force of friction between the housing tube and a cannula.