A medical device comprises a handle comprises an actuator. A shaft extends distally from the handle. A first shaft segment extends proximally from the handle and has a proximal end and a distal end. A second shaft segment has a proximal end and a distal end and is pivotably supported with respect to the distal end of the first shaft segment at a position offset from a longitudinal axis of the shaft in a first offset direction. A third shaft segment has a proximal end and a distal end and is pivotably supported with respect to the distal end of the second shaft segment at a position offset from the longitudinal axis of the shaft in a second offset direction different from the first offset direction. A first member extends through at least a portion of the first shaft segment and is operatively associated with the actuator. A second member extends through at least a portion of the second shaft segment. The second member has a proximal end pivotably supported with respect to the distal end of the first member and a distal end pivotably supported with respect to the third shaft segment. The actuator is operative to provide substantially simultaneous compound articulation of the second and third shaft segments.