Abstract
The article investigates how the difficulties caused by the flexibility of the endoscope shaft could be solved and to provide a categorized overview of designs that potentially provide a solution. The following are discussed: paradoxical problem of flexible endoscopy; NOTES or hybrid endoscopy surgery; design challenges; shaft-guidance: guiding principles; virtual track guidance; physical track guidance; shaft-guidance: rigidity control; material stiffening; structural stiffening; and hybrid stiffening.
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