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Various methods have been proposed to reinforce the structural stiffnesses of hyper-redundant manipulators. However, the safety, rapid response, space efficiency, and cost-effectiveness of these methods should be considered for use in actual clinical environments, such as the gastrointestinal tract. This study proposed a method to minimize the positional changes of the overtube end tip due to external forces using only auxiliary tendons in the optimized path without additional mechanical structures. Overall, the proposed method involved moving the overtube to the target lesion through the main driving tendon and applying tension to the auxiliary tendons to reinforce the structural stiffness. The complete system was analyzed in terms of energy, and the sigmoidal auxiliary tendons were verified to effectively reinforce the structural stiffness of the overtube consisting of rolling joints. In addition, the design guidelines of the overtube for actual endoscopic surgery were proposed considering hollowness, retroflexion, and high structural stiffness. The positional changes due to external forces were confirmed to be reduced by 60% over the entire workspace.<\/jats:p>","DOI":"10.1089\/soro.2021.0148","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T17:28:21Z","timestamp":1656437301000},"page":"234-245","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Sigmoidal Auxiliary Tendon-Driven Mechanism Reinforcing Structural Stiffness of Hyper-Redundant Manipulator for Endoscopic Surgery"],"prefix":"10.1177","volume":"10","author":[{"given":"Hansoul","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Min","family":"You","sequence":"additional","affiliation":[{"name":"Robotics Program, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minho","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Robotics Engineering, Daegu Kyeongbuk Institute of Science and Technology (DIGIST), Daegu, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki-Uk","family":"Kyung","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Soo","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea."},{"name":"EasyEndo Surgical Inc., Daejeon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/cas.12829"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(05)00291-0"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-009-0724-8"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.11.014"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2012.45.4.375"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.04.192"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-018-2066-y"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2078"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.1749"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.1819"},{"key":"e_1_3_4_13_2","first-page":"150","volume-title":"a new robotic surgical system for GI surgery","author":"Vrielink TJO","unstructured":"Vrielink TJO, , Zhao M, , Darzi A, et al. 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