Development of structured fabric-based endoscopic guiding sheath with tunable diameter and stiffness functions.

Flexible surgical instruments with multiple degrees of freedom or continuum surgical instruments demonstrate significant advantages in Natural Orifice Transluminal Endoscopic Surgery (NOTES), particularly when navigating the complex anatomical pathways of the human gastrointestinal tract. However, conventional endoscopic instruments with fixed diameters and stiffness profiles risk exerting excessive mechanical stress on esophageal tissues, with clinical studies documenting mucosal tears and hemorrhagic complications in up to 15% of transgastric cholecystectomy procedures. To address these limitations, we developed a structured fabric-based guiding sheath featuring dynamic diameter modulation and tunable stiffness.