End tool of surgical instrument and surgical instrument comprising same for electrocautery

Abstract

To provide a surgical instrument for electrocautery comprising an end tool that can be rotated in two or more directions and operates to intuitively match the operation of a manipulation part.SOLUTION: The present invention relates to, in a surgical instrument 10 which is mounted on a robotic arm or is manually operable for use in laparoscopic surgery or other various surgeries, an end tool of a surgical instrument comprising an end tool 100, and a surgical instrument for electrocautery comprising the same, wherein the end tool can be rotated in two or more directions and operates to intuitively match the operation of a manipulation part 200.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to an end tool for a surgical instrument and an electrosurgical instrument equipped with the same. Specifically, in a surgical instrument that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various surgeries, the end tool of the surgical instrument is rotatable in two or more directions and operates in a manner that intuitively matches the operation of the operation unit, and an electrosurgical instrument equipped with the same.

Background Art

[0002] Surgery often requires the cutting and joining of body tissues including organs, muscle tissues, connective tissues, and blood vessels. For centuries, sharp blades and sutures have been used for cutting and joining. However, during surgery, bleeding occurs when cutting body tissues, especially relatively highly vascularized tissues. Therefore, doctors have needed surgical instruments and methods to delay or reduce bleeding during surgery.

[0003] In recent years, electrosurgical instruments that use electrical energy have become available for performing certain surgical operations. For example, in surgical instruments such as graspers, scissors, forceps, blades, needles, hooks, etc., electrosurgical instruments including one or more electrodes formed to supply electrical energy have been developed. The electrical energy supplied through the electrodes can be used for coagulation, joining, or cutting of the patient's body tissues. In particular, when using electrical energy, cutting and hemostasis can also be performed simultaneously.

[0004] Electrosurgical instruments are typically classified into two types: monopolar and bipolar. In a monopolar electrosurgical instrument, electrical energy of a specific polarity is supplied to one or more electrodes of the instrument, and electricity of the other polarity is electrically connected to the patient. In a bipolar electrosurgical instrument, one or more electrodes are electrically connected to a first-polarity electrical energy source, and one or more electrodes are electrically connected to a second-polarity electrical energy source opposite to the first polarity.

[0005] The background art described above is technical information that the inventor possessed for the derivation of the present invention or acquired during the derivation process of the present invention, and is not necessarily prior art publicly disclosed to the general public before the filing of the present invention.

Summary of the Invention

Problems to be Solved by the Invention

[0006] An object of the present invention is to provide an electrosurgical instrument for laparoscopic surgery or various surgeries, which can be attached to a robotic arm or manually operable, and has an end tool that can rotate in two or more directions and operates in an intuitive manner consistent with the operation of the operation unit.

Means for Solving the Problems

[0007] One embodiment of the present invention is an end tool of a surgical instrument, including a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis that is substantially the same as or parallel to the first axis and is formed at a certain interval from the first jaw pulley, a blade that moves between a proximal portion and a distal portion of the first jaw, a blade assembly at least partially formed between the first jaw pulley and the second jaw pulley, and a blade wire that is at least partially in contact with the blade assembly and transmits a driving force required for the movement of the blade to the blade.

[0008] According to an embodiment of the present invention, in an end tool of a surgical instrument, there are provided a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis that is substantially the same as or parallel to the first axis and is formed at a certain interval from the first jaw pulley, a blade that moves between a proximal portion and a distal portion of the first jaw, a blade assembly at least partially formed between the first jaw pulley and the second jaw pulley, and a blade wire that is at least partially in contact with the blade assembly and transmits a driving force required for the movement of the blade to the blade.

[0009] In the present invention, an end tool hub is further included, which includes a first pulley coupling portion and a second pulley coupling portion formed to face each other, and a guide portion for connecting the first pulley coupling portion and the second pulley coupling portion. The first pulley is disposed adjacent to the first pulley coupling portion of the end tool hub, the second pulley is disposed adjacent to the second pulley coupling portion of the end tool hub, and at least a part of the blade assembly is formed between the first pulley and the second pulley.

[0010] In the present invention, the blade assembly includes a blade pulley, and the blade pulley is disposed between the first pulley and the second pulley.

[0011] In the present invention, the first shaft is sequentially inserted through the first pulley coupling portion, the first pulley, the blade pulley, the second pulley, and the second pulley coupling portion.

[0012] In the present invention, the first pulley, the blade pulley, and the second pulley are sequentially stacked and formed within the end tool hub.

[0013] In the present invention, the first pulley, the blade pulley, and the second pulley are formed to be rotatable independently of each other.

[0014] In the present invention, a blade auxiliary pulley disposed between the blade pulley and the guide portion is further included.

[0015] In the present invention, the blade wire is located on a common internal tangent line of the blade pulley and the blade auxiliary pulley, and the rotation angle of the blade pulley is enlarged by the blade auxiliary pulley.

[0016] In the present invention, in the guide portion, a region adjacent to the first jog pulley, the blade pulley, and the second jog pulley is formed to be curved such that its cross section has a predetermined curvature.

[0017] In the present invention, the blade wire is located on a common internal tangent line of the blade pulley and the guide portion, and the rotation angle of the blade pulley is enlarged by the guide portion.

[0018] In the present invention, the blade assembly includes a blade pulley, and the blade pulley is disposed between the first jog pulley and the second jog pulley.

[0019] In the present invention, the blade wire is connected to the blade pulley, the blade pulley is connected to the blade, and when the blade pulley rotates by the blade wire, the blade connected to the blade pulley moves between the proximal portion and the distal portion of the first jo.

[0020] In the present invention, the blade assembly further includes a blade link connected to the blade pulley and the blade, and transmitting the rotation of the blade pulley to the blade.

[0021] In the present invention, a first electrode is formed on a surface of the first jo facing the second jo, and a second electrode is formed on a surface of the second jo facing the first jo.

[0022] In the present invention, while current flows through the first electrode and the second electrode, cauterization of tissue is performed.

[0023] In the present invention, when the cauterization is completed, the blade wire moves, and accordingly, the blade moves from the proximal portion side to the distal portion side of the first jo while cutting the tissue.

[0024] In the present invention, when the blade is located at the proximal portion of the first joe, at least a part of the blade is accommodated in the first joe, and the blade is moved toward the second joe side by the blade wire.

[0025] In the present invention, the blade is characterized in that it is drawn out of the first joe while moving toward the distal portion side of the first joe.

[0026] In the present invention, a pair of end tool first joe pitch main pulleys formed on one side of the first joe pulley and rotatable about a second axis forming a predetermined angle with the first axis, and a pair of end tool second joe pitch main pulleys formed on one side of the second joe pulley and rotatable about an axis substantially the same as or parallel to the second axis are further included.

[0027] In the present invention, the end tool is characterized in that it is formed so as to be capable of yaw rotation about the first axis and at the same time capable of pitch rotation about the second axis.

[0028] In the present invention, a first joe wire at least partly wound around the first joe pulley and the pair of end tool first joe pitch main pulleys, and a second joe wire at least partly wound around the second joe pulley and the pair of end tool second joe pitch main pulleys are further included.

[0029] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis, a blade pulley formed to be rotatable about an axis substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley or the second jaw pulley, and one or more blades connected to the blade pulley and moving between a proximal end and a distal end of the first jaw in response to rotation of the blade pulley.

[0030] In the present invention, it further includes a blade link connected to the blade pulley and the blade for transmitting the rotation of the blade pulley to the blade.

[0031] In the present invention, it is characterized in that the rotational movement of the blade pulley is converted into the positional movement of the blade by the blade link.

[0032] In the present invention, one end of the blade link is coupled to the blade pulley, the other end of the blade link is coupled to the blade, and when the blade pulley rotates in a certain direction, the blade link coupled to the blade pulley moves the blade while moving in the direction of the proximal end or the distal end of the first jaw.

[0033] In the present invention, the first jaw is characterized in that a blade receiving portion for receiving at least a part of the blade and the blade link is formed.

[0034] In the present invention, the blade is characterized in that it moves along the blade receiving portion of the first jaw.

[0035] In the present invention, the second jaw is characterized in that a slit is formed which can accommodate at least a part of the blade drawn out from the first jaw.

[0036] In the present invention, when the blade pulley rotates in any one direction, the blade moves to the proximal side of the first jaw, and when the blade pulley rotates in the other direction, the blade moves to the distal side of the first jaw.

[0037] In the present invention, a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis forming a predetermined angle with the first axis, and a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis are included.

[0038] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction about the second axis, the blade pulley rotates together with the first jaw pulley and the second jaw pulley.

[0039] In the present invention, a blade second auxiliary pulley disposed on one side of the blade pulley is further included.

[0040] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction about the first axis, the blade pulley rotates together with the first jaw pulley and the second jaw pulley.

[0041] In the present invention, when the first jaw pulley and the second jaw pulley rotate in different directions about the first axis, the blade pulley rotates together with either one of the first jaw pulley or the second jaw pulley.

[0042] In the present invention, while the blade pulley rotates about the first axis by the blade wire, the first jog pulley and the second jog pulley cannot rotate.

[0043] In the present invention, a first electrode is formed on a surface of the first jog facing the second jog, and a second electrode is formed on a surface of the second jog facing the first jog.

[0044] In the present invention, while current flows through the first electrode and the second electrode, cauterization of tissue is performed.

[0045] In the present invention, when the cauterization is completed, the blade pulley rotates, and accordingly, the blade moves from the first position to the second position while cutting the tissue.

[0046] In the present invention, the first jog pulley, the blade pulley, and the second jog pulley are sequentially laminated and formed.

[0047] In the present invention, the blade pulley is formed between the first jog pulley and the second jog pulley.

[0048] In the present invention, the first jog pulley, the blade pulley, and the second jog pulley are formed to be rotatable independently of each other.

[0049] In the present invention, a plurality of serrated portions are formed on an edge portion of the blade.

[0050] In the present invention, it further includes a first jog wire at least partially wound around the first jog pulley and a second jog wire at least partially wound around the second jog pulley.

[0051] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw and a second jaw that can rotate independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a first jaw wire at least partially wound around the first jaw pulley, a second jaw pulley coupled to the second jaw and formed to be rotatable about the first axis, a second jaw wire at least partially wound around the second jaw pulley, a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis forming a predetermined angle with the first axis, a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or in balance with the second axis, a blade pulley formed to be rotatable about the first axis and disposed between the first jaw pulley and the second jaw pulley, a blade wire at least partially wound around the blade pulley, and a blade connected to the blade pulley and at least partially received in the first jaw and moving toward the second jaw side in response to rotation of the blade pulley.

[0052] In the present invention, it further includes a blade link respectively connected to the blade pulley and the blade for transmitting the rotation of the blade pulley to the blade.

[0053] In the present invention, it is characterized in that the rotational movement of the blade pulley is converted into the positional movement of the blade by the blade link.

[0054] In the present invention, when the blade pulley rotates, the blade link coupled to the blade pulley moves, and when the blade link moves, the blade coupled to the blade link moves.

[0055] In the present invention, the first jaw is characterized in that a blade accommodating portion for accommodating at least a part of the blade and the blade link is formed.

[0056] In the present invention, the blade is characterized by moving along the blade housing portion of the first jaw.

[0057] In the present invention, the second jaw is characterized in that a slit capable of accommodating at least a part of the blade drawn out from the first jaw is formed therein.

[0058] The present invention further includes a first guide portion formed on the first jaw and a second guide portion formed on the blade, and the movement path of the blade is guided by the first guide portion and the second guide portion.

[0059] In the present invention, a groove-shaped first guide portion is formed on the first jaw.

[0060] A protruding second guide portion is formed on the blade. When the second guide portion is fitted to the first guide portion and the second guide portion moves along the first guide portion, the blade moves between the distal portion and the proximal portion of the first jaw.

[0061] In the present invention, the groove-shaped first guide portion is formed so as to be bent one or more times.

[0062] In the present invention, the first guide portion is formed to be inclined to a certain extent in a predetermined section. When the blade passes through the inclined region of the first guide portion, the blade moves in the direction of the distal portion of the first jaw and at the same time moves in the direction of protruding from the inside to the outside of the first jaw.

[0063] In the present invention, after the blade passes through the inclined region of the first guide portion, the blade linearly moves in the direction of the distal portion of the first jaw.

[0064] In the present invention, the blade moves between a first position and a second position in response to the rotation of the blade pulley.

[0065] In the present invention, the first position is a position where the blade is housed within the first jaw, and the second position is a position where at least a part of the blade protrudes outside the first jaw.

[0066] In the present invention, when the blade is in the first position, the blade does not protrude outside the first jaw.

[0067] In the present invention, the blade is drawn out to the outside of the first jaw while moving toward the distal end side of the first jaw.

[0068] In the present invention, the blade is formed in a four-bar link shape in which four links are connected to each other.

[0069] In the present invention, the blade includes an edge portion and a first link formed to face the edge portion, and when the blade pulley rotates, the edge portion and the first link move in opposite directions to each other.

[0070] In the present invention, the blade is directly connected to the blade pulley.

[0071] In the present invention, when the blade pulley rotates, the blade rotates with it and moves in a direction of a jaw other than the jaw in which the blade is housed.

[0072] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis, a blade pulley formed to be rotatable about the first axis and disposed adjacent to the first jaw pulley and the second jaw pulley, a plurality of blades that move between a proximal end and a distal end of the first jaw in response to rotation of the blade pulley, and a blade link connected to the blade pulley and the plurality of blades respectively, for transmitting rotation of the blade pulley to the plurality of blades.

[0073] In the present invention, it is characterized in that the movement trajectories of the plurality of blades are substantially the same.

[0074] In the present invention, the plurality of blades include a first blade and a second blade, at least a part of which is accommodated in the first jaw and are disposed adjacent to each other.

[0075] In the present invention, when the blade pulley rotates, the first blade and the second blade perform a rotational movement with respect to the first jaw.

[0076] In the present invention, when the blade link is located at the proximal end or the distal end of the first jaw, the first blade and the second blade are drawn into the first jaw.

[0077] In the present invention, when the blade link is located between the proximal end and the distal end of the first jaw, at least a part of each of the first blade and the second blade is drawn out from the first jaw.

[0078] In the present invention, it is characterized in that the movement trajectories of the plurality of blades are formed to be different from each other.

[0079] In the present invention, it is characterized in that at least a part of the movement trajectories of the blades arranged adjacent to each other overlap.

[0080] In the present invention, the plurality of blades include a first blade, a second blade, and a third blade, at least a part of which is accommodated in the first jaw and arranged adjacent to each other, and the first blade, the second blade, and the third blade are sequentially arranged from the proximal part to the distal part of the first jaw.

[0081] In the present invention, the first blade is fixedly coupled to the blade link and moves integrally with the blade link.

[0082] In the present invention, when the blade pulley rotates, the first blade moves substantially linearly.

[0083] In the present invention, when the blade pulley rotates, the second blade rotates with respect to the first jaw.

[0084] In the present invention, the second blade is axially coupled to the first jaw, and when the blade link moves, the second blade rotates with respect to the first jaw.

[0085] In the present invention, it further includes a first guide portion formed on the first jaw and a second guide portion formed on the third blade, and the movement path of the third blade is guided by the first guide portion and the second guide portion.

[0086] In the present invention, a groove-shaped first guide portion is formed in the first jaw, a protruding second guide portion is formed in the third blade, and when the second guide portion is fitted into the first guide portion, the third blade moves between the distal portion and the proximal portion of the first jaw as the second guide portion moves along the first guide portion.

[0087] In the present invention, when the blade link is located at the proximal portion of the first jaw, at least a part of the first blade is pulled out from the first jaw to the outside, and the second blade and the third blade are pulled into the first jaw.

[0088] In the present invention, when the blade link is located at the distal portion of the first jaw, at least a part of each of the first blade and the third blade is pulled out from the first jaw to the outside, and the second blade is pulled into the first jaw.

[0089] In the present invention, the rotational movement of the blade pulley is converted into the positional movement of the plurality of blades by the blade link.

[0090] In the present invention, a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis forming a predetermined angle with the first axis, and a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis are further included.

[0091] In the present invention, the end tool is formed so as to be capable of yaw rotation about the first axis and at the same time capable of pitch rotation about the second axis.

[0092] In the present invention, it further includes a first jaw wire at least partially wound around the first jaw pulley, a second jaw wire at least partially wound around the second jaw pulley, and a blade wire at least partially wound around the blade pulley.

[0093] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw (jaw) and a second jaw (jaw) that can rotate independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a first jaw wire at least partially wound around the first jaw pulley, a second jaw coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis, a second jaw pulley, a second jaw wire at least partially wound around the second jaw pulley, a blade pulley formed to be rotatable about the first axis and disposed adjacent to the first jaw pulley and the second jaw pulley, a blade wire at least partially wound around the blade pulley, a blade that moves between a proximal end and a distal end of the first jaw in response to rotation of the blade pulley, and a blade link assembly including a plurality of blade links and connected to the blade pulley and the blade to transmit rotation of the blade pulley to the blade.

[0094] In the present invention, when the blade pulley rotates, the blade moves while the length of the blade link assembly changes.

[0095] In the present invention, the rotational movement of the blade pulley is converted into a linear movement of the blade by the blade link assembly.

[0096] In the present invention, at least a part of the blade is located within the first jaw, and at least a part of the blade is located within the second jaw.

[0097] In the present invention, at least a part of the plurality of blade links rotate about a predetermined axis of rotation when the blade pulley rotates, and at the same time, linearly move between the proximal portion and the distal portion of the first joe.

[0098] In the present invention, the plurality of blade links are arranged so as to repeatedly cross in an X shape.

[0099] In the present invention, when the blade pulley rotates, the blade link assembly is compressed or pulled.

[0100] In the present invention, it further includes a first guide portion formed on the first joe and a second guide portion formed on the blade, and the movement path of the blade is guided by the first guide portion and the second guide portion.

[0101] In the present invention, it further includes a first link guide portion formed on the first joe and a second link guide portion formed on the blade link assembly, and the movement path of the blade link assembly is guided by the first link guide portion and the second link guide portion.

[0102] In the present invention, while the blade link assembly moves along the first link guide portion, the blade connected to the blade link assembly moves linearly.

[0103] In the present invention, the blade link assembly includes a first blade link connected to the blade pulley, a second blade link axially coupled to the first joe and connected to the first blade link, and a third blade link connected to the second blade link and the blade.

[0104] In the present invention, the first blade is coupled to a region between both ends of the second blade link.

[0105] In the present invention, a pair of end tool first jog pitch main pulleys are formed on one side of the first jog pulley and are rotatable about a second axis that forms a predetermined angle with the first axis, and a pair of end tool second jog pitch main pulleys are formed on one side of the second jog pulley and are rotatable about an axis that is substantially the same as or parallel to the second axis.

[0106] In the present invention, the end tool is characterized in that it is formed so as to be capable of yaw rotation about the first axis and at the same time capable of pitch rotation about the second axis.

[0107] According to an embodiment of the present invention, an end tool including a first jaw and a second jaw that are each rotatably formed and are rotatable in two or more directions, an operation unit that controls the rotation of the end tool in the two or more directions, a first jaw wire connected to the operation unit and transmitting the rotation of the operation unit to the first jaw, and a second jaw wire connected to the operation unit and transmitting the rotation of the operation unit to the second jaw. A connection unit that extends in a first direction (X-axis), has the end tool coupled to one end and the operation unit coupled to the other end to connect the operation unit and the end tool. The end tool includes a first electrode coupled to the first jaw, a second electrode coupled to the second jaw and formed to face the first jaw, a first jaw pulley coupled to the first jaw and rotatable about the first axis, a second jaw pulley coupled to the second jaw and rotatable about an axis that is substantially the same as or parallel to the first axis, and a blade pulley rotatable about an axis that is substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley or the second jaw pulley. And a blade connected to the blade pulley and moving between a proximal portion and a distal portion of the first jaw in response to the rotation of the blade pulley.

[0108] In the present invention, at least a part of the operation unit is formed to extend toward the end tool side.

[0109] In the present invention, when the operation unit is rotated in each of the two or more directions, the end tool rotates in a direction substantially the same as the operation direction of the operation unit.

[0110] In the present invention, the formation direction of the end tool at one end of the connection part and the formation direction of the operation unit at the other end of the connection part are in the same direction with respect to the extension axis (X axis) of the connection part.

[0111] In the present invention, the operation unit is formed to extend in a direction away from the user who holds the electrosurgical instrument.

[0112] In the present invention, the end of the operation unit is formed on the end tool side such that the end of the finger of the user who holds the operation unit faces the end tool.

[0113] In the present invention, the connection part includes a bent part formed so as to be bent one or more times while connecting the end tool and the operation unit.

[0114] In the present invention, the bent part is formed to have a substantially semi-circular cross section, and is formed such that the formation direction of the operation unit at the end of the bent part and the formation direction of the end tool at the position where the connection part and the end tool are connected are substantially the same.

[0115] In the present invention, at least a part of the operation unit is formed to be accommodated in the bent part in at least any one operating state of the operation unit.

[0116] In the present invention, it further includes an end tool joe auxiliary pulley formed on one side of the first joe pulley and the second joe pulley and rotatably formed about a second axis.

[0117] In the present invention, by the end tool joe auxiliary pulley, two strands of the first joe wire wound around the first joe pulley are arranged on one side with reference to a plane perpendicular to the second axis and passing through the first axis, and by the end tool joe auxiliary pulley, two strands of the second joe wire wound around the second joe pulley are arranged on the other side with reference to a plane perpendicular to the second axis and passing through the first axis.

[0118] In the present invention, either one of the first joe wires wound around the first joe pulley is formed to pass between the first joe pulley and the end tool joe auxiliary pulley, and either one of the second joe wires wound around the second joe pulley is formed to pass between the second joe pulley and the end tool joe auxiliary pulley.

[0119] In the present invention, the first joe wire is located on the internal tangent line between the first joe pulley and the end tool joe auxiliary pulley, and the second joe wire is located on the internal tangent line between the first joe pulley and the end tool joe auxiliary pulley.

[0120] In the present invention, it further includes a blade link connected to the blade pulley and the blade for transmitting the rotation of the blade pulley to the blade.

[0121] In the present invention, it is characterized in that the rotational movement of the blade pulley is converted into the positional movement of the blade by the blade link.

[0122] In the present invention, the first jog pulley and the second jog pulley are formed at a certain interval, and the blade pulley is formed between the first jog pulley and the second jog pulley.

[0123] In the present invention, the first jog pulley, the blade pulley, and the second jog pulley are sequentially laminated and formed.

[0124] In the present invention, while current flows through the first electrode and the second electrode, ablation of tissue is performed.

[0125] In the present invention, when the ablation is completed, the blade pulley rotates, and accordingly, the blade cuts the tissue while moving between the proximal portion and the distal portion of the first jaw.

[0126] In the present invention, a pair of end tool first jog pitch main pulleys formed on one side of the first jog pulley and rotatable about a second axis forming a predetermined angle with the first axis, and a pair of end tool second jog pitch main pulleys formed on one side of the second jog pulley and rotatable about an axis substantially the same as or parallel to the second axis are included.

[0127] In the present invention, the end tool is formed such that it can yaw-rotate about the first axis and at the same time can pitch-rotate about the second axis.

[0128] In the present invention, when the first jog pulley and the second jog pulley rotate in the same direction about the second axis, the blade pulley rotates together with the first jog pulley and the second jog pulley.

[0129] In the present invention, when the first pulley and the second pulley rotate in the same direction about the first axis, the blade pulley is characterized by rotating together with the first pulley and the second pulley.

[0130] In the present invention, when the first pulley and the second pulley rotate in different directions about the first axis, the blade pulley is characterized by rotating together with either one of the first pulley or the second pulley.

[0131] In the present invention, while the blade pulley rotates about the first axis by a blade wire, the first pulley and the second pulley are characterized by being unable to rotate.

[0132] According to an embodiment of the present invention, a step of disposing tissue between a first jaw and a second jaw of an end tool of an electrosurgical instrument, a first jaw pulley to which the first jaw is coupled and a second jaw pulley to which the second jaw is coupled rotate in opposite directions about a first axis, and the first jaw and the second jaw are closed, a current flows through a first electrode connected to the first jaw and a second electrode connected to the second jaw, and the tissue between the first jaw and the second jaw is cauterized, and a step of cutting the tissue while a blade of a blade assembly having at least a part disposed between the first jaw pulley and the second jaw pulley moves from a proximal portion to a distal portion side of the first jaw.

[0133] In the present invention, the blade assembly further includes a blade pulley at least partially disposed between the first joe pulley and the second joe pulley, and a blade link connecting the blade pulley and the blade. The step of cutting the tissue includes rotating the blade pulley, moving the blade link coupled to the blade pulley from the proximal portion to the distal portion side of the first joe in response to the rotation of the blade pulley, and moving the blade coupled to the blade link from the proximal portion to the distal portion side of the first joe in response to the movement of the blade link.

[0134] In the present invention, it is characterized in that the rotational movement of the blade pulley is converted into the positional movement of the blade by the blade link.

[0135] In the present invention, it further includes a blade wire coupled to the blade pulley and rotating the blade pulley, and the step of cutting the tissue is performed by the rotation of the blade pulley by the blade wire.

[0136] In the present invention, the first joe pulley and the second joe pulley are formed at a certain interval, and the blade pulley is formed between the first joe pulley and the second joe pulley.

[0137] In the present invention, the first joe pulley, the blade pulley and the second joe pulley are sequentially laminated and formed.

[0138] In the present invention, the end tool further includes a pair of end tool first joe pitch main pulleys formed on one side of the first joe pulley and rotatable about a second axis forming a predetermined angle with the first axis, and a pair of end tool second joe pitch main pulleys formed on one side of the second joe pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0139] In the present invention, the end tool is formed such that it can rotate in yaw about the first axis and simultaneously can rotate in pitch about the second axis.

[0140] In the present invention, when the first jow wire or the second jow wire causes the first jow pulley or the second jow pulley to rotate about the first axis or the second axis, the blade pulley rotates together with the first jow pulley or the second jow pulley, and while the blade pulley is being rotated by the blade wire, the first jow pulley and the second jow pulley cannot rotate.

[0141] In the present invention, when the blade pulley rotates in one direction, the blade moves from the proximal portion to the distal portion of the first joe, and when the blade pulley rotates in the other direction, the blade moves from the distal portion to the proximal portion of the first joe.

[0142] In the present invention, the step of cutting the tissue is characterized in that it is performed while the blade moves from the first joe toward the second joe side.

[0143] In the present invention, it further includes a blade wire that is at least partially in contact with the blade assembly and transmits the driving force required for the movement of the blade to the blade, and the step of cutting the tissue is characterized in that it is performed by the movement of the blade by the blade wire.

[0144] Other aspects, features, and advantages other than those described above will become apparent from the following drawings, claims, and detailed description of the invention.

Effect of the Invention

[0145] According to the present invention as described above, since the operation direction of the operation unit by the surgeon and the operation direction of the end tool are intuitively the same direction, the convenience for the operator is improved, and effects such as the accuracy, reliability, and speed of the surgery can be obtained.

Brief Description of the Drawings

[0146]

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[0147] The present invention can be subjected to various transformations and can have various embodiments. Specific embodiments are illustrated in the drawings and will be described in detail herein. However, this is not intended to limit the present invention to the specific embodiments, and it should be understood that the present invention includes all transformations, equivalents, and alternatives included within the spirit and technical scope of the present invention. When it is determined that a specific description of related known technologies may impede the gist of the present invention in explaining the present invention, the detailed description thereof will be omitted.

[0148] Terms such as first, second, etc. can be used to describe various components, but the components should not be limited by the terms. The terms are used only for the purpose of distinguishing one component from another.

[0149] The terms used in this application are merely for describing specific embodiments and are not intended to limit the present invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In this application, terms such as "including" or "having" are used to specify the existence of features, numbers, steps, operations, components, parts, or combinations thereof described herein, and it should be understood that they do not preclude the existence or addition of one or more other features, numbers, steps, operations, components, parts, or combinations thereof in advance.

[0150] Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. When describing with reference to the accompanying drawings, the same or corresponding components will be given the same drawing numbers, and redundant descriptions thereof will be omitted.

[0151] In addition, when describing various embodiments of the present invention, it should be understood that each embodiment does not need to be interpreted or implemented independently, and the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments described individually.

[0152] The instrument for electrocautery surgery according to the present invention is characterized in that when the operation part is rotated in any one direction for at least one or more of the pitch, yaw, and actuation operations, the end tool rotates in the same direction as the operation direction of the operation part intuitively.

[0153] FIG. 1a is a conceptual diagram of the pitch operation of a conventional surgical instrument, and FIG. 1b is a conceptual diagram of the yaw operation.

[0154] Referring to FIG. 1a, when performing the pitch operation of a conventional surgical instrument, the end tool 120a is formed in front of the rotation center 121a of the end tool, and the operation part 110a is formed behind the rotation center 111a of the operation part. When the operation part 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operation part 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. On the other hand, referring to FIG. 1b, when performing the yaw operation of a conventional surgical instrument, the end tool 120a is formed in front of the rotation center 121a of the end tool, and the operation part 110a is formed behind the rotation center 111a of the operation part. When the operation part 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operation part 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. In this case, from the perspective of the user's left - right direction, when the user moves the operation part 110a to the left, the end tool 120a moves to the right, and when the user moves the operation part 110a to the right, the end tool 120a moves to the left. As a result, since the operation direction of the user and the movement direction of the end tool are opposite, it can cause user errors, and there is a problem that the user's operation is not easy.

[0155] FIG. 1c is a conceptual diagram of the pitch operation of another conventional surgical instrument, and FIG. 1d is a conceptual diagram of the yaw operation.

[0156] Referring to FIG. 1c, some of the conventional surgical instruments are formed in a mirror-symmetric form. When performing a pitch operation, with the end tool 120b formed in front of the rotation center 121b of the end tool and the operation part 110b formed behind the rotation center 111b of the operation part, when the operation part 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operation part 110b is rotated counterclockwise, the end tool 120b is formed to rotate clockwise. In this case, from the perspective of the rotation directions of the operation part and the end tool, the rotation direction in which the user rotates the operation part 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there is a possibility of causing confusion in the operation direction for the user, the movement of the joint is not intuitive, and there is a problem that mistakes may occur. Also, referring to FIG. 1d, when performing a yaw operation, with the end tool 120b formed in front of the rotation center 121b of the end tool and the operation part 110b formed behind the rotation center 111b of the operation part, when the operation part 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operation part 110b is rotated counterclockwise, the end tool 120b is formed to rotate clockwise. In this case, from the perspective of the rotation directions of the operation part and the end tool, the rotation direction in which the user rotates the operation part 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there is a possibility of causing confusion in the operation direction for the user, the movement of the joint is not intuitive, and there is a problem that mistakes may occur. Thus, in the pitch or yaw operation of the user of the conventional surgical instrument, the operation direction of the user and the movement direction of the end tool do not match each other in either one of the rotation direction perspective or the left-right direction perspective. This is because in the joint configuration of the conventional surgical instrument, the configurations of the end tool and the operation part are different from each other. That is, the end tool is formed in front of the rotation center of the end tool, while the operation part is formed behind the rotation center of the operation part.To solve such problems, the surgical instrument according to an embodiment of the present invention shown in FIGS. 1e and 1f forms the end tool 120c in front of the rotation center 121c of the end tool, and also forms the operation part 110c in front of the rotation center 111c of the operation part, and is characterized in that the operations of the operation part 110c and the end tool 120c are intuitively consistent. Expressing such characteristics in another way, unlike the existing examples with a configuration where the operation part approaches the user side (i.e., moves away from the end tool) with respect to its own joint as shown in FIGS. 1a, 1b, 1c, and 1d, the surgical instrument according to an embodiment of the present invention shown in FIGS. 1e and 1f is formed such that at least a part of the operation part approaches the end tool (from its own joint) with respect to its own joint at a certain moment or more during the operation process.

[0157] In other words, in the case of conventional surgical instruments such as FIGS. 1a, 1b, 1c, and 1d, while the end tool is located in front of its own rotation center, the operation part is formed behind its own rotation center. Due to the operation of the operation part that moves the rear part while the front part is fixed, the end tool with the front part fixed and the rear part moving will be moved. Therefore, structurally, it is a non-intuitive and inconsistent structure. As a result, there are inconsistencies in the operation of the operation part and the movement of the end tool, from the perspective of the left-right direction or the rotation direction, which may cause confusion to the user, making it difficult to perform the operation of the operation part intuitively and quickly, and there is a problem that it may induce mistakes. In contrast, for the surgical instrument according to an embodiment of the present invention, since both the end tool and the operation part move based on the rotation center formed at the rear, it can be said that the operations are intuitively consistent with each other structurally. In other words, since the moving part of the end tool moves based on the rotation center formed at the rear, the moving part of the operation part also moves based on the corresponding rotation center formed at the rear. Therefore, it can be said that the operations are intuitively consistent with each other structurally. As a result, the user can operate the end tool direction intuitively and quickly, and there is an advantage that the possibility of mistakes occurring is significantly reduced. Hereinafter, the specific mechanism that enables such a function will be described.

[0158] <First Embodiment of an Instrument for Electrocoagulation Surgery> FIG. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention, and FIG. 3 is a side view of the electrocautery surgical instrument of FIG. 2. FIGS. 4 and 5 are perspective views showing the end tool of the electrocautery surgical instrument of FIG. 2, FIG. 6 is an exploded perspective view showing the end tool of the electrocautery surgical instrument of FIG. 2, and FIGS. 7 and 8 are bottom perspective views showing the end tool of the electrocautery surgical instrument of FIG. 2. FIGS. 9 and 10 are side views showing the end tool of the electrocautery surgical instrument of FIG. 2, FIG. 11 is a perspective view showing a guide member of the end tool of the electrocautery surgical instrument of FIG. 2, FIG. 12 is a perspective view showing an end tool hub of the end tool of the electrocautery surgical instrument of FIG. 2, and FIGS. 13 to 14 are plan views showing the end tool of the electrocautery surgical instrument of FIG. 2.

[0159] First, referring to FIGS. 2 and 3, an electrocautery surgical instrument 10 according to a first embodiment of the present invention includes an end tool 100, an operation unit 200, a power transmission unit 300, and a connection unit 400.

[0160] Here, the connecting portion 400 is formed in a hollow shaft shape and can accommodate one or more wires and electric wires inside. An operation portion 200 is coupled to one end of the connecting portion 400, and an end tool 100 is coupled to the other end. The connecting portion 400 can serve to connect the operation portion 200 and the end tool 100. Here, the connecting portion 400 of the electrosurgical instrument 10 according to the first embodiment of the present invention includes a straight portion 401 and a bent portion 402. The straight portion 401 is formed on the side coupled to the end tool 100, and the bent portion 402 is formed on the side coupled to the operation portion 200, which is a feature. By thus forming the end portion of the connecting portion 400 on the operation portion 200 side to be bent, the pitch operation portion 201, the yaw operation portion 202, and the actuation operation portion 203 are formed on the extension line of the end tool 100 or adjacent to the extension line. Stated from another aspect, it can also be explained that at least a part of the pitch operation portion 201 and the yaw operation portion 202 are accommodated in the recess formed by the bent portion 402. Due to such a shape of the bent portion 402, the shapes and operations of the operation portion 200 and the end tool 100 can more intuitively coincide.

[0161] On the other hand, the plane on which the bent portion 402 is formed can be a pitch plane, that is, substantially the same plane as the XZ plane in FIG. 2. Thus, by forming the bent portion 402 on substantially the same plane as the XZ plane, interference between the operation portions can be reduced. Of course, for the intuitive operation of the end tool and the operation portion, configurations in other forms are also possible, not just the XZ plane.

[0162] On one hand, a connector 410 can be formed at the bending part 402. The connector 410 can be connected to an external power source (not shown), and the connector 410 is connected to the joe 103 via electric wires 411 and 412, and can transmit the electrical energy supplied from the external power source (not shown) to the joe 103. Here, the connector 410 can be of a bipolar type with two electrodes formed, or the connector can be of a monopolar type with one electrode formed.

[0163] The operation unit 200 is formed at one end of the connection unit 400 and is provided with an interface that can be directly manipulated by a doctor, for example, in the shape of forceps, a stick, a lever, etc. When the doctor manipulates this, the end tool 100 connected to the interface and inserted into the body of the surgical patient performs a predetermined operation to perform the surgery. Here, FIG. 2 shows that the operation unit 200 is formed in a handle shape that can be rotated with fingers pinched, but the idea of the present invention is not limited to this, and it can be said that various forms of operation units that are connected to the end tool 100 and can operate the end tool 100 are possible.

[0164] The end tool 100 is formed at the other end of the connection unit 400, is inserted into the surgical site, and performs operations necessary for the surgery. As an example of such an end tool 100, a pair of joes 103 for performing a grip operation as shown in FIG. 2 can be used. However, the idea of the present invention is not limited to this, and various devices for surgery can be used as the end tool 100. For example, a configuration such as monopolar cautery can also be used as the end tool. Such an end tool 100 is connected by the operation unit 200 and the power transmission unit 300, and by transmitting the driving force of the operation unit 200 via the power transmission unit 300, it performs operations necessary for the surgery, such as grip, cutting, and suturing operations.

[0165] Here, the end tool 100 of the electrosurgical instrument 10 according to the first embodiment of the present invention is formed to be rotatable in at least one or more directions. For example, the end tool 100 can be formed to perform a pitch motion about the Y-axis in FIG. 2 and perform a yaw motion and an actuation motion about the Z-axis in FIG. 2.

[0166] Here, each of the pitch, yaw, and actuation operations used in the present invention is defined as follows.

[0167] First, the pitch operation means a motion in which the end tool 100 rotates in the vertical direction with respect to the extending direction of the connection part 400 (the X-axis direction in FIG. 2), that is, a motion of rotating about the Y-axis in FIG. 2. In other words, it means a motion in which the end tool 100 formed to extend from the connection part 400 in the extending direction of the connection part 400 (the X-axis direction in FIG. 2) rotates up and down about the Y-axis with respect to the connection part 400.

[0168] Next, the yaw operation means a motion in which the end tool 100 rotates in the left-right direction with respect to the extending direction of the connection part 400 (the X-axis direction in FIG. 2), that is, a motion of rotating about the Z-axis in FIG. 2. In other words, it means a motion in which the end tool 100 formed to extend from the connection part 400 in the extending direction of the connection part 400 (the X-axis direction in FIG. 2) rotates left and right about the Z-axis with respect to the connection part 400. That is, it means a motion in which the two jaws 103 formed on the end tool 100 rotate in the same direction about the Z-axis.

[0169] On the other hand, the actuation operation means that the end tool 100 rotates about the same rotation axis as the yaw operation, but the two jaws 103 rotate in opposite directions to each other while the jaws close or open. That is, it means a motion in which the two jaws 103 formed on the end tool 100 rotate in opposite directions about the Z-axis.

[0170] The power transmission unit 300 connects the operation unit 200 and the end tool 100 and serves to transmit the driving force of the operation unit 200 to the end tool 100, and may include a plurality of wires, pulleys, links, joints, gears, and the like.

[0171] The end tool 100, operation unit 200, power transmission unit 300, etc. of the electrosurgical instrument 10 shown in FIG. 2 will be described later.

[0172] (Intuitive Drive) Hereinafter, the intuitive driving of the electrosurgical instrument 10 of the present invention will be described.

[0173] First, while holding the first handle 204 with the palm of the hand, the user can perform a pitch operation by rotating the first handle 204 about the Y axis (i.e., the rotation axis 246 in FIG. 25), and perform a yaw operation by rotating the first handle 204 about the Z axis (i.e., the rotation axis 243 in FIG. 25). Further, the user can perform an actuation operation by operating the actuation operation unit 203 with the thumb and index finger inserted into the ring-shaped first actuation extension 252 and / or the second actuation extension 257 formed at one end of the actuation operation unit 203.

[0174] Here, the electrocautery surgical instrument 10 according to the first embodiment of the present invention is characterized in that when the operation unit 200 is rotated in a certain direction with respect to the connection unit 400, the end tool 100 rotates in the same direction as the operation direction of the operation unit 200 intuitively. In other words, when the first handle 204 of the operation unit 200 is rotated in a certain direction, the end tool 100 also rotates in the same direction as the certain direction intuitively to perform a pitch motion or a yaw motion. Here, it can be additionally explained that the intuitively same direction means that the moving direction of the finger of the user holding the operation unit 200 and the moving direction of the end portion of the end tool 100 form substantially the same direction. Of course, the same direction here does not necessarily mean a direction that completely coincides on the three-dimensional coordinate. For example, it can be understood that when the user's finger moves to the left, the end portion of the end tool also moves to the left, and when the user's finger moves downward, the end portion of the end tool 100 also moves downward, to such an extent of identity.

[0175] For this purpose, the electrosurgical instrument 10 according to the first embodiment of the present invention is characterized in that the operation unit 200 and the end tool 100 are formed in the same direction with respect to a plane perpendicular to the extension axis (X-axis) of the connection part 400. That is, when viewed with reference to the YZ plane of FIG. 2, the operation unit 200 is formed to extend in the +X-axis direction, and at the same time, the end tool 100 is also formed to extend in the +X-axis direction. In other words, it can be said that the formation direction of the end tool 100 at one end of the connection part 400 and the formation direction of the operation unit 200 at the other end of the connection part 400 are the same direction with reference to the YZ plane. Also, in other words, it can be said that the operation unit 200 is formed in a direction away from the body of the user who holds it, that is, in the direction in which the end tool 100 is formed. That is, the first handle 204, the first actuation operation unit 251, the second actuation operation unit 256, etc., which the user holds and moves for actuation operation, yaw operation, and pitch operation, are formed such that the moving parts for performing each operation extend in the +X-axis direction from the rotation center of each joint for the operation. As a result, the operation unit 200 can be configured in the same way as the moving part of the end tool 100 extends in the +X-axis direction from the rotation center of each joint for the operation, and as described with reference to FIG. 1, the operation direction of the user and the operation direction of the end tool will coincide in both the rotational direction and the left-right direction viewpoints. As a result, the same operation can be performed intuitively.

[0176] Specifically, in the case of a conventional surgical instrument, the direction in which the user operates the operation unit and the actual operating direction of the end tool are different from each other and do not coincide intuitively. Therefore, it is not easy to perform an intuitive operation from the perspective of the surgeon, and it takes a long time to become proficient in moving the end tool in the desired direction. In some cases, there is a problem that a malfunction may occur and damage may be caused to the patient.

[0177] To solve such problems, in the electrosurgical instrument 10 according to the first embodiment of the present invention, the operation direction of the operation unit 200 and the operation direction of the end tool 100 are made to be intuitively in the same direction. For this purpose, like the end tool 100, the operation unit 200 has a portion that actually moves for the actuation operation, yaw operation, and pitch operation extending in the +X-axis direction from the rotation center of the corresponding joint of each operation. This is a characteristic of the present invention.

[0178] Hereinafter, the end tool 100, operation unit 200, power transmission unit 300, etc. of the electrosurgical instrument 10 shown in FIG. 2 will be described in more detail.

[0179] (Power Transmission Section) Hereinafter, the power transmission unit 300 of the electrosurgical instrument 10 shown in FIG. 2 will be described in more detail.

[0180] Referring to FIGS. 2 to 25 and the like, the power transmission unit 300 of the electrosurgical instrument 10 according to an embodiment of the present invention can include wires 301, 302, 303, 304, 305, 306, 307, and 308.

[0181] Here, the wire 301 and the wire 305 can serve as a pair of first jaw wires. The wire 302 and the wire 306 can serve as a pair of second jaw wires. Here, the components including the wire 301 and the wire 305 as the first jaw wires and the wire 302 and the wire 306 as the second jaw wires can be referred to as jaw wires. Also, the wire 303 and the wire 304 can serve as a pair of pitch wires. Further, the wire 307 and the wire 308 can serve as a pair of blade wires.

[0182] In addition, the power transmission unit 300 of the electrocautery surgical instrument 10 according to an embodiment of the present invention may include fastening members 321, 323, 324, 326, 327, and 329 that are coupled to respective ends of each wire to couple the wire and the pulley. Here, each fastening member can be in various forms such as ball-shaped, tube-shaped, etc., as required.

[0183] Here, on the end tool 100 side, the fastening member 321 serves as a pitch wire end tool fastening member, the fastening member 323 serves as a first jaw wire end tool fastening member, the fastening member 326 serves as a second jaw wire end tool fastening member, and the fastening member 329 can serve as a blade wire end tool fastening member.

[0184] On the operation unit 200 side, the fastening member 324 can serve as a first jaw wire operation unit fastening member, and the fastening member 327 can serve as a second jaw wire operation unit fastening member. Although not shown in the figure, a pitch wire operation unit fastening member and a blade wire operation unit fastening member can be further formed on the operation unit 200 side.

[0185] The connection relationship between the wire, the fastening member, and the pulley will be described in detail as follows.

[0186] First, the wire 301 and the wire 305, which are the first jaw wires, can be a single wire. A fastening member 323, which is a first jaw wire end tool fastening member, is sandwiched at the midpoint of the single wire that is the first jaw wire. After pressing (crimping) and fixing this fastening member 323, both sides of the first jaw wire centered on the fastening member 323 can be referred to as the wire 301 and the wire 305, respectively.

[0187] Alternatively, the wire 301 and the wire 305, which are the first jaw wires, can be formed of separate wires, and the wire 301 and the wire 305 can also be connected by the fastening member 323.

[0188] And by coupling this fastening member 323 to the pulley 111, the wires 301 and 305 can be fixedly coupled to the pulley 111. As a result, the pulley 111 can rotate according to whether the wires 301 and 305 are pulled or loosened.

[0189] On the other hand, the end portions on the opposite side of the position where the fastening member 323 is fastened by the wires 301 and 305 can be coupled with the first jaw wire operation part fastening member 324.

[0190] And by coupling the first jaw wire operation part fastening member 324 to the pulley 210 in this way, the wires 301 and 305 can be fixedly coupled to the pulley 210. As a result, when the pulley 210 rotates by a motor or manual force, the wires 301 and 305 are pulled or loosened, and the pulley 111 of the end tool 100 can rotate.

[0191] Similarly, the wires 302 and 306, which are the second jaw wires, are respectively coupled with the fastening member 326, which is the second jaw wire end tool fastening member, and the second jaw wire operation part fastening member 327. And the fastening member 326 is coupled to the pulley 121, and the second jaw wire operation part fastening member 327 is coupled to the pulley 220. As a result, when the pulley 220 rotates by a motor or manual force, the wires 302 and 306 are pulled or loosened, and the pulley 121 of the end tool 100 can rotate.

[0192] Similarly, wire 303 and wire 304, which are pitch wires, are respectively coupled to a fastening member 321, which is a pitch wire end tool fastening member, and a pitch wire operation part fastening member (not shown). Then, the fastening member 321 is coupled to the pulley 131, and the pitch wire operation part fastening member (not shown) is coupled to the pulley 231. As a result, when the pulley 231 rotates by a motor or manual force, the wires 303 and 304 are pulled or loosened, enabling the pulley 131 of the end tool 100 to rotate.

[0193] Similarly, wire 307 and wire 308, which are blade wires, are respectively coupled to a fastening member 329, which is a blade wire end tool fastening member, and a blade wire operation part fastening member (not shown). Then, the fastening member 329 is coupled to the blade pulley 161, and the blade wire operation part fastening member (not shown) is coupled to a pulley (see 269 in FIG. 29). As a result, when the pulley 269 rotates by a motor or manual force, the wires 307 and 308 are pulled or loosened, enabling the blade pulley 161 of the end tool 100 to rotate.

[0194] (End Tool) Hereinafter, the end tool 100 of the electrocautery surgical instrument 10 in FIG. 2 will be described in more detail.

[0195] FIGS. 4 and 5 are perspective views showing the end tool of the electrocautery surgical instrument in FIG. 2, FIG. 6 is an exploded perspective view showing the end tool of the electrocautery surgical instrument in FIG. 2, and FIGS. 7 and 8 are bottom perspective views showing the end tool of the electrocautery surgical instrument in FIG. 2. Also, FIGS. 9 and 10 are side views showing the end tool of the electrocautery surgical instrument in FIG. 2, and FIGS. 13 to 14 are plan views showing the end tool of the electrocautery surgical instrument in FIG. 2.

[0196] Here, FIG. 4 shows a state where the end tool hub 180 and the pitch hub 107 are coupled, and FIG. 5 shows a state where the end tool hub 180 is removed. FIG. 7 shows a state where the first jaw 101 and the second jaw 102 are removed, and FIG. 8 shows a state where the first jaw 101, the second jaw 102, and the blade 171 are removed. On the other hand, FIG. 13 is a view centered on the wire, and FIG. 14 is a view centered on the pulley.

[0197] Referring to FIGS. 4 to 13, an end tool 100 according to a first embodiment of the present invention includes a pair of jaws for performing a grip operation, that is, a first jaw 101 and a second jaw 102. Here, each of the first jaw 101 and the second jaw 102, or a component including the first jaw 101 and the second jaw 102 can be referred to as a jaw 103.

[0198] Further, the end tool 100 can include pulleys 111, 112, 113, 114, 115, and 116 related to the rotational movement of the first jaw 101. Further, pulleys 121, 122, 123, 124, 125, and 126 related to the rotational movement of the second jaw 102 can be included.

[0199] Here, although the figure shows that the first jaw 101 and the pulley 111 are integrally formed, the idea of the present invention is not limited thereto, and the first jaw 101 and the pulley 111 can also be formed from separate members and coupled. Further, although the figure shows that the second jaw 102 and the pulley 121 are integrally formed, the idea of the present invention is not limited thereto, and the second jaw 102 and the pulley 121 can also be formed from separate members and coupled.

[0200] Here, although the figure shows that the opposing pulleys are formed parallel to each other, it can be said that the spirit of the present invention is not limited thereto, and each pulley can be formed in various ways at positions and sizes suitable for the configuration of the end tool.

[0201] Further, the end tool 100 of the first embodiment of the present invention can include an end tool hub 180 and a pitch hub 107.

[0202] The end tool hub 180 can accommodate at least a part of a pulley 111 and a pulley 121 that are axially coupled to the rotary shafts 141 and 142, which will be described later, and through which the rotary shafts 141 and 142 are inserted. Further, the end tool hub 180 can accommodate at least a part of a pulley 112 and a pulley 122 that are axially coupled to the rotary shaft 142 inside.

[0203] Specifically, referring to FIG. 12, the end tool hub 180 includes a first jo pulley coupling portion 181, a second jo pulley coupling portion 182, a guide portion 183, and a pitch pulley coupling portion 185.

[0204] Specifically, the first jo pulley coupling portion 181 and the second jo pulley coupling portion 182 are formed to face each other, and the pulley 111, the pulley 121, and the blade pulley 161 are accommodated therein. Further, through holes are formed in the first jo pulley coupling portion 181 and the second jo pulley coupling portion 182, respectively, and the rotary shaft 141 passes through the first jo pulley coupling portion 181, the pulley 111, the blade pulley 161, the pulley 121, and the second jo pulley coupling portion 182 to axially couple them.

[0205] The first jo pulley coupling portion 181 and the second jo pulley coupling portion 182 are connected by the guide portion 183. That is, the first jo pulley coupling portion 181 and the second jo pulley coupling portion 182 that are parallel to each other are coupled by the guide portion 183 formed in a direction substantially perpendicular thereto, and the first jo pulley coupling portion 181, the second jo pulley coupling portion 182, and the guide portion 183 are generally in a "C" shape, and the pulley 111, the pulley 121, and the blade pulley 161 are accommodated therein.

[0206] Here, the pulley 111, which is the first jump pulley, is disposed adjacent to the first jump pulley coupling portion 181 of the end tool hub 180, and the pulley 121, which is the second jump pulley, is disposed adjacent to the second jump pulley coupling portion 182 of the end tool hub 180, and a blade assembly accommodating portion 177 can be formed between the first jump pulley coupling portion 181 and the second jump pulley coupling portion 182. And at least a part of a blade assembly 170 described later can be formed within the blade assembly accommodating portion 177. In other words, it can also be expressed that at least a part of the blade pulley 161 and the blade link 173 of the blade assembly 170 are disposed between the first jump pulley coupling portion 181 and the second jump pulley coupling portion 182. Thus, by disposing the blade assembly 170 including the blade 171 between the pulley 111, which is the first jump pulley, and the pulley 121, which is the second jump pulley, it is possible to execute a cutting operation using the blade 171 together with the pitch operation and the yaw operation of the end tool 100, which is a feature of the present invention. This will be described in more detail later.

[0207] On the other hand, at one end of the end tool hub 180, a pulley 131 that serves as an end tool pitch pulley can be formed. As shown in FIG. 4, the pulley 131 can be formed integrally with the end tool hub 180. That is, one end of the end tool hub 180 can be formed in a disc shape like a pulley, and a groove around which a wire can be wound can also be formed on its outer peripheral surface. Alternatively, the pulley 131 can be formed as a member separate from the end tool hub 180 and can also be coupled to the end tool hub 180. The above-described wires 303 and 304 are coupled to the pulley 131 that serves as an end tool pitch pulley, and this pulley 131 performs a pitch operation while rotating around the rotation axis 143.

[0208] The pitch hub 107 has the rotary shafts 143 and 144, which will be described later, penetrating and inserted therethrough, and can be axially coupled to the end tool hub 180 and the pulley 131 by the rotary shaft 143. Therefore, the end tool hub 180 and the pulley 131 can be formed rotatable relative to the pitch hub 107 about the rotary shaft 143.

[0209] In addition, the pitch hub 107 can accommodate at least a part of the pulleys 113, 114, 123, and 124 axially coupled to the rotary shaft 143 therein. Further, the pitch hub 107 can accommodate at least a part of the pulleys 115, 116, 125, and 126 axially coupled to the rotary shaft 144 therein.

[0210] Moreover, the end tool 100 of the first embodiment of the present invention can include the rotary shafts 141, 142, 143, and 144. As described above, the rotary shafts 141 and 142 can penetrate and be inserted into the end tool hub 180, and the rotary shafts 143 and 144 can penetrate and be inserted into the pitch hub 107.

[0211] The rotary shafts 141, 142, 143, and 144 can be sequentially arranged in the direction from the distal end 104 to the proximal end 105 of the end tool 100. Therefore, in order from the distal end 104, the rotary shaft 141 can also be referred to as the first pin, the rotary shaft 142 as the second pin, the rotary shaft 143 as the third pin, and the rotary shaft 144 as the fourth pin.

[0212] Here, the rotary shaft 141 can function as an end tool joint pulley rotary shaft, the rotary shaft 142 can function as an end tool joint auxiliary pulley rotary shaft, the rotary shaft 143 can function as an end tool pitch rotary shaft, and the rotary shaft 144 can function as an end tool pitch auxiliary rotary shaft of the end tool 100.

[0213] One or more pulleys can be fitted to each of the rotation axes 141, 142, 143, 144, which will be described in detail below.

[0214] The pulley 111 functions as the end tool first jaw pulley, and the pulley 121 functions as the end tool second jaw pulley. The pulley 111 can also be referred to as the first jaw pulley, and the pulley 121 can also be referred to as the second jaw pulley. These two components can also be collectively referred to as the end tool jaw pulley or simply the jaw pulley.

[0215] The pulleys 111 and 121, which are end tool jaw pulleys, are formed to face each other and are rotatable independently of each other about the rotation axis 141, which is the end tool jaw pulley rotation axis. At this time, the pulleys 111 and 121 are formed with a certain interval therebetween, and a blade assembly accommodating portion 177 can be formed therebetween. Then, at least a part of the blade assembly 170 described later can be disposed in the blade assembly accommodating portion 177.

[0216] Here, in the figure, the pulleys 111 and 121 are formed to rotate about one rotation axis 141, but it goes without saying that each end tool jaw pulley can be formed to rotate about a different axis. Here, the first jaw 101 is fixedly coupled to the pulley 111 and rotates together with the pulley 111, and the second jaw 102 can be fixedly coupled to the pulley 121 and rotate together with the pulley 121. In response to the rotation of the pulleys 111 and 121, the yaw operation and the actuation operation of the end tool 100 are performed. That is, when the pulleys 111 and 121 rotate in the same direction about the rotation axis 141, the yaw operation is executed, and when the pulleys 111 and 121 rotate in opposite directions about the rotation axis, the actuation operation is executed.

[0217] Here, the first jaw 101 and the pulley 111 can be formed as separate members and coupled to each other, or the first jaw 101 and the pulley 111 can be integrally formed. Similarly, the second jaw 102 and the pulley 121 can be formed as separate members and coupled to each other, or the second jaw 102 and the pulley 121 can be integrally formed.

[0218] The pulley 112 functions as an end tool first jaw auxiliary pulley, and the pulley 122 functions as an end tool second jaw auxiliary pulley. These two components can also be collectively referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0219] Specifically, the pulleys 112 and 122, which are end tool jaw auxiliary pulleys, can be additionally provided on one side of the pulleys 111 and 121. That is, the auxiliary pulley 112 can be disposed between the pulley 111 and the pulley 113 / pulley 114. Also, the auxiliary pulley 122 can be disposed between the pulley 121 and the pulley 123 / pulley 124. The pulleys 112 and 122 can be formed to be rotatable independently of each other about the rotation axis 142. Here, in the figure, the pulleys 112 and 122 are shown as being formed to rotate about one rotation axis 142, but it goes without saying that each of the pulleys 112 and 122 can be formed to be rotatable about a separate axis. Such auxiliary pulleys will be described in more detail later.

[0220] The pulleys 113 and 114 function as end tool first jaw pitch main pulleys, and the pulleys 123 and 124 function as end tool second jaw pitch main pulleys. These two components can also be collectively referred to as end tool jaw pitch main pulleys.

[0221] Pulley 115 and pulley 116 function as end tool first jo pitch sub-pulleys, and pulley 125 and pulley 126 function as end tool second jo pitch sub-pulleys. These two components can also be collectively referred to as end tool jo pitch sub-pulleys.

[0222] Hereinafter, the components related to the rotation of pulley 111 will be described.

[0223] Pulley 113 and pulley 114 function as end tool first jo pitch main pulleys. That is, they function as the main rotation pulleys for the pitch operation of the first jo 101. Here, wire 301, which is the first jo wire, is wound around pulley 113, and wire 305, which is the first jo wire, is wound around pulley 114.

[0224] Pulley 115 and pulley 116 function as end tool first jo pitch sub-pulleys. That is, they function as the sub-rotation pulleys for the pitch operation of the first jo 101. Here, wire 301, which is the first jo wire, is wound around pulley 115, and wire 305, which is the first jo wire, is wound around pulley 116.

[0225] Here, on one side of pulley 111 and pulley 112, pulley 113 and pulley 114 are arranged to face each other. Here, pulley 113 and pulley 114 are formed to be rotatable independently of each other about the rotation axis 143, which is the end tool pitch rotation axis. Also, on one side of each of pulley 113 and pulley 114, pulley 115 and pulley 116 are arranged to face each other. Here, pulley 115 and pulley 116 are formed to be rotatable independently of each other about the rotation axis 144, which is the end tool pitch auxiliary rotation axis. Here, the figure shows that pulley 113, pulley 115, pulley 114, and pulley 116 are all formed to be rotatable about the Y-axis direction, but the idea of the present invention is not limited to this, and the rotation axes of the respective pulleys can be formed in various directions according to their configurations.

[0226] The wire 301, which is the first joist wire, is sequentially wound so as to be in contact with at least a part of the pulleys 115, 113, and 111. And the wire 305 connected to the wire 301 by the fastening member 323 is sequentially wound so as to be in contact with at least a part of the pulleys 111, 112, 114, and 116.

[0227] In other words, the wire 301 and the wire 305, which are the first joist wires, are sequentially wound so as to be in contact with at least a part of the pulleys 115, 113, 111, 112, 114, and 116, and the wire 301 and the wire 305 are formed so as to be able to move along the pulleys while rotating the pulleys.

[0228] Therefore, when the wire 301 is pulled in the direction of the arrow 301 in FIG. 13, the fastening member 323 to which the wire 301 is coupled and the pulley 111 coupled thereto will rotate in the direction of the arrow L in FIG. 13. Conversely, when the wire 305 is pulled in the direction of the arrow 305 in FIG. 6, the fastening member 323 to which the wire 305 is coupled and the pulley 111 coupled thereto will rotate in the direction of the arrow R in FIG. 6.

[0229] Hereinafter, the pulleys 112 and 122 that serve as auxiliary pulleys will be described in more detail.

[0230] The pulleys 112 and 122 can serve to expand the rotation angles of the first joist 101 and the second joist 102 respectively by contacting the wire 305, which is the first joist wire, and the wire 302, which is the second joist wire, and changing the arrangement paths of the wire 305 and the wire 302 to a certain extent.

[0231] That is, when the auxiliary pulleys are not arranged, each of the first jaw and the second jaw could only rotate up to a right angle. However, in one embodiment of the present invention, by additionally providing pulley 112 and pulley 122 which are auxiliary pulleys, the effect that the maximum rotation angle increases by θ when viewed from FIG. 14 can be obtained. Thereby, in a state where the two jaws of the end tool 100 are yaw-rotated together by 90° in the L direction, an operation in which the two jaws must be opened for an actuation operation is enabled. This is because the second jaw 102 can rotate by an additional angle θ as in FIG. 14. Similarly, the actuation operation is also possible in a state where the two jaws are yaw-rotated in the R direction. In other words, it has a feature that the range of yaw rotation in which the actuation operation is possible can be expanded via pulley 112 and pulley 122.

[0232] To explain this in more detail, it is as follows.

[0233] When the auxiliary pulleys are not arranged, since the first jaw wire is fixedly coupled to the end tool first jaw pulley and the second jaw wire is fixedly coupled to the end tool second jaw pulley, the end tool first jaw pulley and the end tool second jaw pulley can only rotate up to 90° respectively. In this case, when the first jaw and the second jaw perform the actuation operation in a state where they are located on the 90° line, the first jaw can be opened, but the second jaw cannot rotate more than 90°. Therefore, there was a problem that the actuation operation could not be performed smoothly when the first jaw and the second jaw were performing a yaw operation by a certain angle or more.

[0234] To solve such problems, in the case of the electrocautery surgical instrument 10 of the present invention, auxiliary pulleys 112 and 122 are additionally arranged on one side of the pulleys 111 and 121. By arranging the pulleys 112 and 122 in this way and changing the arrangement paths of the wire 305 which is the first joystick wire and the wire 302 which is the second joystick wire to a certain extent, the tangential directions of the wire 305 and the wire 302 are changed. Accordingly, the fastening member 322 that couples the wire 302 and the pulley 121 can rotate up to the N line in FIG. 14. That is, the fastening member 326 which is the coupling part between the wire 302 and the pulley 121 can rotate until it is positioned on the common internal tangent of the pulley 121 and the pulley 122. Similarly, the fastening member 323 which is the coupling part between the wire 305 and the pulley 111 can rotate until it is positioned on the common internal tangent of the pulley 111 and the pulley 112, and the rotation range in the R direction can be expanded.

[0235] In other words, by the pulley 112, the wires 301 and 305 which are two strands of the first joystick wire wound around the pulley 111 are perpendicular to the Y axis and are arranged on either side with reference to the plane passing through the X axis. At the same time, by the pulley 122, the wires 302 and 306 which are two strands of the second joystick wire wound around the pulley 121 are perpendicular to the Y axis and are arranged on the other side with reference to the plane passing through the X axis.

[0236] In other words, the pulleys 113 and 114 are perpendicular to the Y axis and are arranged on either side with reference to the plane passing through the X axis, and the pulleys 123 and 124 are perpendicular to the Y axis and are arranged on the other side with reference to the plane passing through the X axis.

[0237] In other words, the wire 305 is positioned on the internal tangent of the pulley 111 and the pulley 112, and the rotation angle of the pulley 111 is expanded by the pulley 112. Also, the wire 302 is positioned on the internal tangent of the pulley 121 and the pulley 122, and the rotation angle of the pulley 121 is expanded by the pulley 122.

[0238] According to the present invention as described above, by increasing the rotation radii of Joe 101 and Joe 102, it is possible to obtain the effect of expanding the yaw operation range in which normal opening and closing actuation operations can be performed.

[0239] Next, the components related to the rotation of pulley 121 will be described.

[0240] Pulleys 123 and 124 function as end tool second joe pitch main pulleys. That is, they function as the main rotation pulleys for the pitch operation of the second joe 102. Here, the wire 306, which is the second joe wire, is wound around pulley 123, and the wire 302, which is the second joe wire, is wound around pulley 124.

[0241] Pulleys 125 and 126 function as end tool second joe pitch sub-pulleys. That is, they function as the sub-rotation pulleys for the pitch operation of the second joe 102. Here, the wire 306, which is the second joe wire, is wound around pulley 125, and the wire 302, which is the second joe wire, is wound around pulley 126.

[0242] On one side of pulley 121, pulleys 123 and 124 are arranged to face each other. Here, pulleys 123 and 124 are formed to be rotatable independently of each other about the rotation axis 143, which is the end tool pitch rotation axis. Also, on one side of each of pulleys 123 and 124, pulleys 125 and 126 are arranged to face each other. Here, pulleys 125 and 126 are formed to be rotatable independently of each other about the rotation axis 144, which is the end tool pitch auxiliary rotation axis. Here, although the figure shows that pulleys 123, 125, 124, and 126 are all formed to be rotatable about the Y-axis direction, the idea of the present invention is not limited to this, and the rotation axes of the respective pulleys can be formed in various directions so as to suit their configurations.

[0243] The wire 306, which is the second joist wire, is sequentially wound so as to be in contact with at least a part of the pulleys 125, 123, and 121. And the wire 302 connected to the wire 306 by the fastening member 326 is sequentially wound so as to be in contact with at least a part of the pulleys 121, 122, 124, and 126.

[0244] In other words, the wire 306 and the wire 302, which are the second joist wires, are sequentially wound so as to be in contact with at least a part of the pulleys 125, 123, 121, 122, 124, and 116, and the wire 306 and the wire 302 are formed so as to be able to move along the pulleys while rotating the pulleys.

[0245] Therefore, when the wire 306 is pulled in the direction of the arrow 306 in FIG. 13, the fastening member 322 to which the wire 306 is coupled and the pulley 121 coupled thereto will rotate in the direction of the arrow R in FIG. 13. Conversely, when the wire 302 is pulled in the direction of the arrow 302 in FIG. 13, the fastening member 326 to which the wire 302 is coupled and the pulley 121 coupled thereto will rotate in the direction of the arrow L in FIG. 13.

[0246] Hereinafter, the pitch motion of the present invention will be described in more detail.

[0247] On one hand, when wire 301 is pulled toward the arrow 301 side in FIG. 13 and at the same time wire 305 is pulled toward the arrow 305 side in FIG. 13 (i.e., when both strands of the first joe wire are fully pulled), as shown in FIG. 5, since wires 301 and 305 are wound below pulleys 113 and 114 that are rotatable about the rotation axis 143 which is the end tool pitch rotation axis, end tool hub 180 to which pulleys 111 and 111 to which wires 301 and 305 are fixedly coupled are coupled rotates counterclockwise together about the rotation axis 143 as a whole. As a result, end tool 100 performs a pitch motion while rotating downward. At this time, since the second joe 102 and wires 302 and 306 fixedly coupled thereto are wound above pulleys 123 and 124 that are rotatable about the rotation axis 143, wires 302 and 306 are unwound in directions opposite to 302 and 306, respectively.

[0248] Conversely, when wire 302 is pulled toward the arrow 302 side in FIG. 13 and at the same time wire 306 is pulled toward the arrow 306 in FIG. 13, as shown in FIG. 5, since wires 302 and 306 are wound above pulleys 123 and 124 that are rotatable about the rotation axis 143 which is the end tool pitch rotation axis, end tool hub 180 to which pulleys 121 and 121 to which wires 302 and 306 are fixedly coupled are coupled rotates clockwise together about the rotation axis 143 as a whole. As a result, end tool 100 performs a pitch motion while rotating upward. At this time, since the first joe 101 and wires 301 and 305 fixedly coupled thereto are wound below pulleys 113 and 114 that are rotatable about the rotation axis 143, wires 302 and 306 move in directions opposite to 301 and 305, respectively.

[0249] On the one hand, the end tool 100 of the electrocautery surgical instrument 10 of the present invention further includes a pulley 131 which is an end tool pitch pulley. The operation unit 200 further includes pulleys 231 and 232 which are operation unit pitch pulleys. The power transmission unit 300 can further include wires 303 and 304 which are pitch wires. Specifically, the pulley 131 of the end tool 100 is rotatable about a rotation axis 143 which is an end tool pitch rotation axis, and can be formed integrally with (or fixedly coupled to) the end tool hub 180. Also, the wires 303 and 304 can serve to connect the pulley 131 of the end tool 100 with the pulleys 231 and 232 of the operation unit 200.

[0250] Therefore, when the pulleys 231 and 232 of the operation unit 200 rotate, the rotation of the pulleys 231 and 232 is transmitted to the pulley 131 of the end tool 100 via the wires 303 and 304, causing the pulley 131 to rotate together. As a result, the end tool 100 performs a pitch motion while rotating.

[0251] That is, the electrocautery surgical instrument 10 according to the first embodiment of the present invention includes the pulley 131 of the end tool 100, the pulleys 231 and 232 of the operation unit 200, and the wires 303 and 304 of the power transmission unit 300 for power transmission for the pitch motion, so that the driving force of the pitch operation of the operation unit 200 can be more completely transmitted to the end tool 100, thereby improving the operation reliability.

[0252] Here, the diameters of pulleys 113, 114, 123, and 124, which are end tool joint pitch main pulleys, and the diameter of pulley 131, which is an end tool pitch pulley, may be the same as each other, or may be different from each other. At this time, the ratio of the diameter of the end tool joint pitch main pulley to the diameter of the end tool pitch pulley can be the same as the ratio of the diameter of the operation part pitch pulley to the diameter of the operation part pitch main pulley of the operation part 200 described later. This will be described in detail later.

[0253] (Blade Pulley Related Components) Hereinafter, the blade pulley 161 of the end tool 100 of the electrocautery surgical instrument 10 in FIG. 2 will be described in more detail.

[0254] FIGS. 15, 16, and 17 are side views showing the cutting operation of the end tool of the electrocautery surgical instrument in FIG. 2, and are views when the jaw is in the neutral position. Here, FIGS. 15, 16, and 17 are views in which some components not related to the blade and the blade pulley are removed.

[0255] Referring to FIGS. 6 to 8, FIGS. 15 to 17, etc., the end tool 100 of the first embodiment of the present invention can include a blade pulley 161, a blade auxiliary pulley 162, a pulley 163, a pulley 164, a pulley 165, and a pulley 166 related to the linear / rotary motion of the blade 171.

[0256] The blade pulley 161 is formed to face the pulleys 111 and 121, which are end tool joint pulleys, and is formed to be rotatable independently of each other about the rotary shaft 141, which is the end tool joint pulley rotary shaft. Here, in the figure, the blade pulley 161 is shown to be disposed between the pulley 111 and the pulley 121, but the idea of the present invention is not limited to this, and the blade pulley 161 can be disposed at various positions adjacent to the pulley 111 or the pulley 121.

[0257] Here, one feature of the present invention is that the blade pulley 161, the pulley 111, and the pulley 121 are formed to rotate substantially about the same axis. By forming the blade pulley 161, the pulley 111, and the pulley 121 to rotate about the same axis in this way, it becomes possible to perform pitch motion / yaw motion / actuation operation and at the same time perform a cutting operation using the blade 171. This will be described in more detail later. However, although in the figure the blade pulley 161, the pulley 111, and the pulley 121 are formed to rotate about one rotation axis 141 here, it goes without saying that each joe pulley can be formed to be rotatable about another axis that is concentric with each other.

[0258] In other words, it can also be expressed as a structure in which the pulley 111 which is the first joe pulley, the blade pulley 161, and the pulley 121 which is the second joe pulley are sequentially laminated along the rotation axis 141. Or, it can also be expressed as a structure in which the blade pulley 161 is arranged between the pulley 111 and the pulley 121 which oppose each other. Here, the pulley 111 which is the first joe pulley, the blade pulley 161, and the pulley 121 which is the second joe pulley can be formed to be rotatable independently of each other.

[0259] The blade auxiliary pulley 162 can be additionally provided on one side of the blade pulley 161. In other words, the blade auxiliary pulley 162 can be arranged between the blade pulley 161 and the pulley 163 / pulley 164. The blade auxiliary pulley 162 can be formed to be rotatable independently of the pulley 112 and the pulley 122 about the rotation axis 142. Here, although in the figure the blade auxiliary pulley 162, the pulley 112, and the pulley 122 are formed to rotate about one rotation axis 142, it goes without saying that the blade auxiliary pulley 162, the pulley 112, and the pulley 122 can each be formed to be rotatable about a different axis. Such a blade auxiliary pulley will be described in more detail later.

[0260] Pulley 163 and pulley 164 function as blade pitch main pulleys, and pulley 165 and pulley 166 can function as blade pitch sub-pulleys.

[0261] Hereinafter, components related to the rotation of blade pulley 161 will be described.

[0262] Pulley 163 and pulley 164 function as blade pitch main pulleys. Here, wire 307, which is a blade wire, is wound around pulley 163, and wire 308, which is a blade wire, is wound around pulley 164.

[0263] Pulley 165 and pulley 166 function as blade pitch sub-pulleys. Here, wire 307, which is a blade wire, is wound around pulley 165, and wire 308, which is a blade wire, is wound around pulley 166.

[0264] Here, on one side of blade pulley 161 and blade auxiliary pulley 162, pulley 163 and pulley 164 are arranged to face each other. Here, pulley 163 and pulley 164 are formed to be rotatable independently of each other about a rotation axis 143, which is an end tool pitch rotation axis. Also, on each side of pulley 163 and pulley 164, pulley 165 and pulley 166 are arranged to face each other. Here, pulley 165 and pulley 166 are formed to be rotatable independently of each other about a rotation axis 144, which is an end tool pitch auxiliary rotation axis. Here, the figure shows that pulley 163, pulley 165, pulley 164, and pulley 166 are all formed to be rotatable about the Y-axis direction, but the idea of the present invention is not limited to this, and the rotation axes of the respective pulleys can be formed in various directions so as to be suitable for their configurations.

[0265] As described above, the rotation axes 141, 142, 143, and 144 can be sequentially arranged in the direction from the distal end 104 to the proximal end 105 of the end tool 100. Accordingly, the blade pulley 161, the blade auxiliary pulley 162, the pulleys 163 / pulleys 164, and the pulleys 165 / pulleys 166 can be sequentially arranged while facing from the distal end 104 to the proximal end 105 of the end tool 100.

[0266] The wire 307, which is a blade wire, is sequentially wound so as to be in contact with at least a part of the pulleys 165, 163, the blade auxiliary pulley 162, and the blade pulley 161. And the wire 308 connected to the wire 307 by the fastening member 329 is sequentially wound so as to be in contact with at least a part of the blade pulley 161, the blade auxiliary pulley 162, the pulley 164, and the pulley 166.

[0267] In other words, the wire 307 and the wire 308, which are blade wires, are sequentially wound so as to be in contact with at least a part of the pulleys 165, 163, the blade auxiliary pulley 162, the blade pulley 161, the blade auxiliary pulley 162, the pulley 164, and the pulley 166, and the wire 307 and the wire 308 are formed to move along the pulleys while rotating the pulleys.

[0268] Therefore, when the wire 307 is pulled, the fastening member 329 to which the wire 307 is coupled and the blade pulley 161 coupled thereto will rotate in one direction. Conversely, when the wire 308 is pulled, the fastening member 329 to which the wire 308 is coupled and the blade pulley 161 coupled thereto will rotate in the opposite direction.

[0269] Hereinafter, the blade auxiliary pulley 162 will be described in more detail.

[0270] The blade auxiliary pulley 162 can play a role in expanding the rotation angle of the blade pulley 161 by contacting the wires 307 and 308 which are blade wires and changing the arrangement paths of the wires 307 and 308 to a certain extent.

[0271] That is, when the blade auxiliary pulley is not arranged, the blade pulley can only rotate up to a right angle. However, in one embodiment of the present invention, by additionally providing the blade auxiliary pulley 162 which is an auxiliary pulley, the effect that the maximum rotation angle increases by θ in both directions can be obtained. This enables the blade pulley 161 to rotate to linearly move the blade 171 for the cutting operation in a state where the two jaws of the end tool 100 are yaw-rotated together by 90°. In other words, it has the characteristic that the range of yaw rotation enabling the cutting operation can be expanded via the blade auxiliary pulley 162.

[0272] To explain this in more detail, it is as follows.

[0273] In the case of the electrosurgical instrument 10 of the present invention, the blade auxiliary pulley 162 is additionally arranged on one side of the blade pulley 161. By arranging the blade auxiliary pulley 162 in this way and changing the arrangement paths of the wires 307 and 308 which are blade wires to a certain extent, the tangential directions of the wires 307 and 308 are changed, and thus the rotation angle of the fastening member 329 that couples the wires 307 and 308 with the blade pulley 161 is increased. That is, the fastening member 329 which is the coupling part of the wires 307 and 308 and the blade pulley 161 can rotate until it is located on the common internal tangent of the blade pulley 161 and the blade auxiliary pulley 162.

[0274] In other words, the wires 307 and 308 are located on the internal tangent of the blade pulley 161 and the blade auxiliary pulley 162, and the rotation angle of the blade pulley 161 is expanded by the blade auxiliary pulley 162.

[0275] According to the present invention, by increasing the radius of rotation of the blade pulley 161, it is possible to obtain the effect of expanding the pitching operation range in which a normal cutting operation can be performed.

[0276] (Coagulation and Cutting Related Components) Subsequently, referring to FIGS. 4 to 17 and the like, an end tool 100 according to the first embodiment of the present invention can include a first jaw 101, a second jaw 102, a first electrode 151, a second electrode 152, a blade pulley 161, a blade 171, and a blade link 173 in order to perform cautery and cutting operations.

[0277] Here, components such as the blade pulley 161, the blade 171, and the blade link 173 related to the driving of the blade can be collectively referred to as a blade assembly 170. One embodiment of the present invention is characterized in that by arranging a blade assembly 170 including a blade 171 between a pulley 111 which is a first jaw pulley and a pulley 121 which is a second jaw pulley, it becomes possible to execute a cutting operation using the blade 171 together with the pitching operation and the yawing operation of the end tool 100. This will be described in more detail.

[0278] The first jaw 101 can include a guide member 101a and a case 101c.

[0279] As shown in FIG. 11 and the like, the guide member 101a can form a blade housing portion 101d and a first guide portion 101e. The guide member 101a can be coupled to the pulley 111 and can be formed to guide the movement path of the blade 171. As an example, the guide member 101a can be formed in two long rod shapes facing each other, and inside the guide member 101a, a blade housing portion 101d capable of housing at least a part of the blade 171 and the blade link 173 described later can be formed. The blade housing portion 101d can be formed long along the direction from the proximal portion 101g to the distal portion 101f of the first jaw 101. The entire blade 171 can be housed in the blade housing portion 101d, or at least a part of the blade 171 can protrude outside the blade housing portion 101d. In other words, it can be considered that the blade 171 moves along the blade housing portion 101d while cutting the tissue. This will be described in more detail later.

[0280] Also, a first guide portion 101e for guiding the movement of the blade 171 can be formed on the guide member 101a of the first jaw 101. Here, the first guide portion 101e can be formed on both inner side walls of the guide member 101a that forms the blade housing portion 101d. Here, the first guide portion 101e can be formed in a groove shape along the movement path of the blade 171. Then, in a state where the second guide portion 171c of the blade 171 formed in a protrusion shape is fitted into the groove-shaped first guide portion 101e, as the second guide portion 171c moves along the first guide portion 101e, the blade 171 moves with respect to the first jaw 101.

[0281] Here, the first guide portion 101e can be formed to be foldable one or more times. For example, as shown in FIG. 15 and the like, the first guide portion 101e can be formed in a form bent at a predetermined angle (about 120° in the figure). At this time, the proximal side of the first guide portion 101e can be formed to be inclined to a certain extent, and the distal side of the first guide portion 101e can also be formed parallel to the X-axis direction.

[0282] Therefore, when the blade 171 passes through the inclined region of the first guide portion 101e, it can be expressed that the blade 171 moves from the proximal portion 101g to the distal portion 101f side of the first joe 101 and at the same time moves in a direction protruding from the inside to the outside of the first joe 101. And when the blade 171 passes through the parallel region of the first guide portion 101e, it can be expressed that the blade 171 linearly moves from the proximal portion 101g to the distal portion 101f side of the first joe 101.

[0283] In other words, it can be said that the movement path of the blade 171 is determined by the shape of the first guide portion 101e.

[0284] Note that in the figure, the first guide portion 101e is shown as being integrally formed with the guide member 101a as a component of the first joe 101, but the idea of the present invention is not limited to this, and it can be said that the first guide portion 101e can be formed of a member different from the guide member 101a and coupled to the guide member 101a.

[0285] On the other hand, in the figure, the two groove-like shapes included in the first guide portion 101e are shown as being the same as each other, but the idea of the present invention is not limited to this, and a plurality of groove-like shapes included in the first guide portion 101e can be formed to be different from each other. By adjusting the plurality of groove-like shapes included in the first guide portion 101e in this way, the movement path of the blade 171 can be changed to a certain extent.

[0286] In addition, the first jaw 101 can further include a case 101c. This case 101c is formed to cover the upper part of the first jaw 101, and can prevent the blade housing portion 101d, the first guide portion 101e, and the blade 171 housed therein from being exposed to the outside.

[0287] On the other hand, a first electrode 151 can be formed on the surface of the first jaw 101 that faces the second jaw 102. And a second electrode 152 can be formed on the surface of the second jaw 102 that faces the first jaw 101.

[0288] At this time, a slit 151a can be formed in the first electrode 151, and at least a part of the blade 171 can protrude outside the first jaw 101 and the first electrode 151 through this slit 151a.

[0289] Also, a slit 152a can be formed in the second electrode 152. And at least a part of the blade 171 protruding outside the first jaw 101 can pass through this slit 152a and be housed in the second jaw 102.

[0290] On the other hand, although not shown in the figure, a slit can be further formed in the second jaw 102 to accommodate at least a part of the blade 171 drawn out from the first jaw 101. By forming a slit (not shown) in the second jaw 102 in this way, the blade 171 can be drawn out from the first jaw 101 and cutting can be performed in a state where the first jaw 101 and the second jaw 102 are closed.

[0291] On the other hand, although not shown in the figure, a spacer (not shown) can be formed on at least one of the first jaw 101 or the second jaw 102 to space the first electrode 151 and the second electrode 152 so that they do not come into direct contact. This spacer (not shown) can include an insulating material such as ceramic.

[0292] On the other hand, although not shown in the figure, one or more sensors (not shown) can be further formed on at least one of the first jaw 101 or the second jaw 102. This sensor (not shown) positions tissue between the first jaw 101 and the second jaw 102, and can be formed to measure at least a part of current, voltage, resistance, impedance, and temperature while current flows between the first electrode 151 and the second electrode 152 and cauterization is performed.

[0293] Alternatively, without separately providing a sensor, monitoring and control thereof can be directly performed on at least a part of current, voltage, resistance, impedance, and temperature by a generator (not shown) that supplies power to the electrodes.

[0294] The blade pulley 161 is axially coupled to the rotary shaft 141 and is formed to be rotatable about the rotary shaft 141. This blade pulley 161 is disposed between the pulley 111 which is the end tool first jaw pulley and the pulley 121 which is the end tool second jaw pulley. Here, the pulley 111, the pulley 121, and the blade pulley 161 can be formed to be rotatable independently of each other.

[0295] The blade 171 can include a main body portion 171a, an edge portion 171b, and one or more second guide portions 171c.

[0296] An edge portion 171b that is sharply formed to cut tissue is formed in a region of the main body portion 171a. At least a part of this edge portion 171b is drawn out of the first jaw 101, and the tissue disposed between the first jaw 101 and the second jaw 102 can be cut.

[0297] On the other hand, one or more second guide portions 171c can be formed in other regions of the main body portion 171a. For example, the second guide portion 171c is formed in a protruding shape, and in a state where the second guide portion 171c is fitted into the groove-shaped first guide portion 101e, when the second guide portion 171c moves along the first guide portion 101e, the blade 171 moves with respect to the first jaw 101. Also, a blade link 173 described later can be axially coupled to the second guide portion 171c.

[0298] On the other hand, although not shown in the figure, it can be said that the first guide portion 101e of the first jaw 101 can be formed in a protruding shape, and the second guide portion 171c of the blade 171 can be formed in a groove shape.

[0299] The blade link 173 connects the blade pulley 161 and the blade 171, and serves to transmit the rotation of the blade pulley 161 to the blade 171 so that the blade 171 moves along the direction from the proximal portion 101g to the distal portion 101f of the first jaw 101. The blade link 173 can be formed in a long bar shape, and either one end of the blade link 173 can be connected to the blade pulley 161, and the other end can be connected to the blade 171.

[0300] As an example, through holes are formed at both ends of the blade link 173, and these through holes can be respectively fitted into the protruding portion 161a formed on one surface of the blade pulley 161 and the second guide portion 171c formed on the blade 171. In other words, at the same time that either one end of the blade link 173 is axially coupled to the blade pulley 161, the other end of the blade link 173 is axially coupled to the blade 171.

[0301] When the blade pulley 161 rotates about the rotation axis 141 in this state, the rotational movement of the blade pulley 161 is transmitted to the blade 171 by the blade link 173 coupled to the blade pulley 161. Then, due to the transmitted rotational movement of the blade pulley 161, the position of the blade 171 changes, and the blade 171 can be withdrawn from the first jaw 101 while moving along the direction from the proximal portion 101g to the distal portion 101f of the first jaw 101, or drawn into the inside of the first jaw 101.

[0302] That is, the blade link 173, the first guide portion 101e of the first jaw 101, and the second guide portion 171c of the blade 171 are coupled to form a kind of power transmission mechanism. When the blade pulley 161 rotates, the blade 171 connected thereto moves between the first position and the second position.

[0303] Here, the end tool 100 of the electrosurgical instrument 10 according to an embodiment of the present invention is characterized in that it includes a blade pulley 161 disposed between the pulley 111 and the pulley 121 and a blade 171 connected to the blade pulley 161 and moving between a first position and a second position in response to the rotation of the blade pulley 161. In other words, it can also be expressed that the blade 171 moves between the distal end 101f and the proximal end 101g of the first jaw 101 in response to the rotation of the blade pulley 161. And by providing the blade pulley 161 and the blade 171 in this way, it is characterized in that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation movement enables cauterization and cutting. More specifically, it is as follows.

[0304] So far, various types of electrosurgical instruments have been developed. Among them, a vessel resector called an Advanced Energy Device or a vessel sealer has an added sensing function compared to the conventional bipolar cautery method. It supplies power of different polarities to two electrodes, and after denaturing blood vessels with the heat generated thereby to stop bleeding, it cuts the portion where bleeding has been stopped with a blade. At this time, it measures the impedance of the tissue (or blood vessel) while current is flowing to measure whether cauterization has been completed. When cauterization is completed, it automatically interrupts the current supply and then cuts the tissue using a blade.

[0305] In the case of such a bipolar vessel resector, a blade for cutting tissue after cauterization must be essentially provided. Since such a blade must additionally be provided with an instrument for linear reciprocating motion as an end tool, in most cases, joint motions such as pitch / yaw motion are impossible.

[0306] On the other hand, there was an attempt to implement joint motion using a flexible joint in which a plurality of joints were connected in a bipolar vessel resector. In this case, however, there was a problem that the rotation angle was limited and accurate operation control of the end tool was difficult to perform.

[0307] On the other hand, in contrast to this, in the case of a method of performing hemostasis and cutting using ultrasonic vibration, it was impossible to have joints themselves due to the physical characteristics of ultrasonic waves.

[0308] To solve such problems, the end tool 100 of the electrosurgical instrument 10 according to an embodiment of the present invention is characterized in that it includes a blade pulley 161 disposed between a pulley 111 and a pulley 121 and a blade 171 connected to the blade pulley 161 and moving between a first position and a second position in response to the rotation of the blade pulley 161. And by providing the blade pulley 161 and the blade 171 in this way, in a bipolar surgical instrument for tissue cauterization and cutting, it is characterized in that pitch / yaw / actuation movement is enabled by a pulley / wire system.

[0309] FIG. 15 is a diagram showing a state where the blade pulley 161 and the blade 171 are located at the first position, and FIG. 17 is a diagram showing a state where the blade pulley 161 and the blade 171 are located at the second position. FIG. 16 is a diagram showing a state where the blade pulley 161 and the blade 171 are moving from the first position to the second position. On the other hand, FIG. 18 is a diagram showing a state before the first jaw 101 and the second jaw 102 are opened to cut tissue, FIG. 19 is a diagram showing a state where the first jaw 101 and the second jaw 102 are closed to cauterize and cut tissue, and FIG. 20 is a diagram showing a state where the first jaw 101 and the second jaw 102 are opened again after the cutting of the tissue is completed. And FIG. 21 is a perspective view of a cross section along AA of FIG. 19, and FIG. 22 is a front view of a cross section along AA of FIG. 19.

[0310] In other words, as shown in FIG. 19, it can also be expressed that the cutting operation of FIGS. 15 to 17 is performed in a state where the first jaw 101 and the second jaw 102 are closed, and the tissue between the first jaw 101 and the second jaw 102 is cut.

[0311] Here, the first position shown in FIG. 15 can be defined as a state where the blade 171 is completely retracted into the first jaw 101. Alternatively, it can also be defined as a state where the second guide portion 171c of the blade 171 is located at one end of any of the groove-shaped first guide portions 101e, specifically, the end portion on the side adjacent to the blade pulley 161.

[0312] On the other hand, the second position shown in FIG. 17 can be defined as a state where the blade 171 is maximally drawn out from the first jaw 101 to the outside. Alternatively, it can also be defined as a state where the second guide portion 171c of the blade 171 is located at the other end of the groove-shaped first guide portion 101e, specifically, the end portion located on the distal portion 104 side of the end tool 100.

[0313] First, as shown in FIG. 18, with the first jaw 101 and the second jaw 102 in an open state, after positioning the tissue to be cut between the first jaw 101 and the second jaw 102, an actuation operation is performed to close the first jaw 101 and the second jaw 102 as shown in FIG. 19.

[0314] Next, with the blade pulley 161 and the blade 171 in the first position as shown in FIG. 15, currents of different polarities are passed through the first electrode 151 and the second electrode 152 to cauterize the tissue between the first jaw 101 and the second jaw 102. At this time, a generator (not shown) that supplies power to the electrodes monitors at least a part of the current, voltage, resistance, impedance, and temperature, and the power supply can be interrupted when the cauterization is completed.

[0315] When the blade pulley 161 rotates in the direction of arrow A in FIGS. 16 and 17 in the state where the cauterization is thus completed, the blade link 173 coupled to the blade pulley 161 moves in the direction of arrow B in FIGS. 16 and 17 and sequentially reaches the positions in FIGS. 16 and 17. Then, the blade 171 coupled to the blade link 173 moves from the first position of the proximal portion 101g of the first jaw 101 to the second position side of the distal portion 101f of the first jaw 101.

[0316] That is, when the blade pulley 161 rotates in the direction of arrow A in the state where the protruding second guide portion 171c is fitted into the groove-shaped first guide portion 101e, the blade link 173 coupled to the blade pulley 161 pushes the blade 171 in the direction of arrow B, whereby the blade 171 moves along the first guide portion 101e as a whole.

[0317] At this time, since the groove-shaped first guide portion 101e is formed to be inclined to a certain extent in a certain section, the blade 171 linearly moves in the direction of the distal portion 104 of the end tool 100 (that is, moves in the X-axis direction) and at the same time linearly moves in the direction of protruding from the inside to the outside of the first jaw 101 to a certain extent (that is, moves in the Y-axis direction).

[0318] In this way, while the blade 171 simultaneously moves in the X-axis direction and the Y-axis direction, the tissue between the first jaw 101 and the second jaw 102 is cut.

[0319] However, here, the linear motion of the blade 171 does not mean only a complete straight line. Even if the middle part of the straight line is bent by a predetermined angle or there is a section having a gentle curvature in a certain section and it is not a complete straight line, it should be understood that it means a motion that can cut the tissue while being a linear motion as a whole.

[0320] Also, as described above, it can be said that the plurality of groove shapes included in the first guide portion 101e can be formed differently from each other, and thus it is also possible to give a certain degree of change to the linear motion of the blade 171.

[0321] When the blade pulley 161 continues to rotate in the direction of arrow A and reaches the position shown in FIG. 17, the blade pulley 161 and the blade 171 are located at the second position and cannot move any further.

[0322] On the other hand, when the blade pulley 161 rotates in the direction opposite to arrow A in this state, the blade link 173 coupled to the blade pulley 161 also moves generally in the direction opposite to arrow B and returns to the first position.

[0323] Finally, as shown in FIG. 20, when the first jaw 101 and the second jaw 102 are opened again, it can be confirmed that the tissue between the first jaw 101 and the second jaw 102 has been cut.

[0324] According to such a present invention, it is possible to obtain an effect that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation motion can perform cauterization and cutting.

[0325] (Operation Section) FIGS. 23 and 24 are perspective views showing the operation portion of the surgical instrument of FIG. 2. FIG. 25 is a diagram simply showing only the configuration of the pulleys and wires constituting the joints of the electrocautery surgical instrument shown in FIG. 2.

[0326] Referring to FIGS. 2 to 25, the operation unit 200 of the electrocautery surgical instrument 10 according to the first embodiment of the present invention includes a first handle 204 that can be gripped by a user, an actuation operation unit 203 that controls the actuation movement of the end tool 100, a yaw operation unit 202 that controls the yaw movement of the end tool 100, and a pitch operation unit 201 that controls the pitch movement of the end tool 100. Here, it can be understood that FIGS. 23 and 24 show only the components related to the pitch / yaw / actuation movement of the electrocautery surgical instrument 10.

[0327] Further, the operation unit 200 of the electrocautery surgical instrument 10 further includes a blade operation unit 260 that controls the movement of the blade of the end tool 100 to perform cutting, and a cautery operation unit 270 that controls the supply of electrical energy to the first electrode 151 and the second electrode 152 of the end tool 100 to perform cautery.

[0328] The operation unit 200 can include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 related to the rotational movement of the first jaw 101. Further, it can include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 related to the rotational movement of the second jaw 102. Further, the operation unit 200 can include pulleys 231, 232, 233, and 234 related to the pitch movement. Further, it can include a pulley 235 that is an intermediate pulley disposed at various locations of the bent portion 402 of the connection unit 400.

[0329] Here, although the figure shows that the opposing pulleys are formed parallel to each other, it can be said that the spirit of the present invention is not limited thereto, and each pulley can be formed in various ways at positions and sizes suitable for the configuration of the operation unit.

[0330] In addition, the operation unit 200 of the first embodiment of the present invention can include a rotation shaft 241, a rotation shaft 242, a rotation shaft 243, a rotation shaft 244, a rotation shaft 245, and a rotation shaft 246. Here, the rotation shaft 241 functions as an operation unit first jo actuator rotation shaft, and the rotation shaft 242 can function as an operation unit second jo actuator rotation shaft. Then, the rotation shaft 243 functions as an operation unit yaw main rotation shaft, and the rotation shaft 244 can function as an operation unit yaw sub rotation shaft. Then, the rotation shaft 245 functions as an operation unit pitch sub rotation shaft, and the rotation shaft 246 can function as an operation unit pitch main rotation shaft.

[0331] The rotation shafts 241 / rotation shafts 242, rotation shaft 243, rotation shaft 244, rotation shaft 245, and rotation shaft 246 can be sequentially arranged in the direction from the distal end 205 to the proximal end 206 of the operation unit 200.

[0332] One or more pulleys can be fitted to each of such rotation shafts 241, 242, 243, 244, 245, 246, which will be described in detail later.

[0333] The pulley 210 functions as an operation unit first jo actuator pulley, and the pulley 220 functions as an operation unit second jo actuator pulley. These components can also be collectively referred to as operation unit actuator pulleys.

[0334] The pulleys 211 and 212 function as operation unit first jo yaw main pulleys, and the pulleys 221 and 222 function as operation unit second jo yaw main pulleys. These components can also be collectively referred to as operation unit yaw main pulleys.

[0335] The pulleys 213 and 214 function as operation unit first jo yaw sub pulleys, and the pulleys 223 and 224 function as operation unit second jo yaw sub pulleys. These components can also be collectively referred to as operation unit yaw sub pulleys.

[0336] The pulleys 215 and 216 function as the operation unit first jog pitch sub-pulleys, and the pulleys 225 and 226 function as the operation unit second jog pitch sub-pulleys. These components can also be collectively referred to as the operation unit pitch sub-pulleys.

[0337] The pulleys 217 and 218 function as the operation unit first jog pitch main pulleys, and the pulleys 227 and 228 function as the operation unit second jog pitch main pulleys. These components can also be collectively referred to as the operation unit pitch main pulleys.

[0338] The pulleys 231 and 232 function as the operation unit pitch wire main pulleys, and the pulleys 233 and 234 function as the operation unit pitch wire sub-pulleys.

[0339] When classifying the above components from the perspective of the operation unit for each motion (pitch / yaw / actuation), it is as follows.

[0340] The pitch operation unit 201 that controls the pitch motion of the end effector 100 can include the pulleys 215, 216, 217, 218, 225, 226, 227, 228, 231, 232, and 234. Also, the pitch operation unit 201 can include the rotating shafts 245 and 246. Further, the pitch operation unit 201 can further include the pitch frame 208.

[0341] The yaw operation unit 202 that controls the yaw motion of the end effector 100 can include the pulleys 211, 212, 213, 214, 221, 222, 223, and 224. Also, the yaw operation unit 202 can include the rotating shafts 243 and 244. Further, the yaw operation unit 202 can further include the yaw frame 207.

[0342] The actuation operation unit 203 that controls the actuation movement of the end tool 100 can include a pulley 210, a pulley 220, a rotating shaft 241, and a rotating shaft 242. Further, the actuation operation unit 203 can further include a first actuation operation unit 251 and a second actuation operation unit 256.

[0343] Hereinafter, each component of the operation unit 200 will be described in more detail.

[0344] The first handle 204 is formed so that it can be gripped by the user's hand, and in particular, it can be formed so that the user can wrap and grasp the first handle 204 with their palm. An actuation operation unit 203 and a yaw operation unit 202 are formed on the first handle 204, and a pitch operation unit 201 is formed on one side of the yaw operation unit 202. The other end of the pitch operation unit 201 is connected to the bent portion 402 of the connection unit 400.

[0345] The actuation operation unit 203 includes a first actuation operation unit 251 and a second actuation operation unit 256. The first actuation operation unit 251 includes a rotating shaft 241, a pulley 210, a first actuation extension 252, and a first actuation gear 253. The second actuation operation unit 256 includes a rotating shaft 242, a pulley 220, a second actuation extension 257, and a second actuation gear 258. Here, the ends of the first actuation extension 252 and the second actuation extension 257 are formed in a ring shape and can operate as a second handle.

[0346] Here, the rotation shafts 241 and 242, which are the actuation rotation shafts, can be formed to make a predetermined angle with the XY plane in which the connection part 400 is formed. For example, the rotation shafts 241 and 242 can be formed in a direction parallel to the Z axis. In this state, when the pitch operation part 201 or the yaw operation part 202 rotates, the coordinate system of the actuation operation part 203 can change relatively. Of course, the idea of the present invention is not limited to this. By ergonomic design, the rotation shafts 241 and 242 can be formed in various directions so as to suit the structure of the hand of the user who grips the actuation operation part 203.

[0347] On the other hand, the pulley 210, the first actuation extension part 252, and the first actuation gear 253 can be fixedly coupled to each other and formed to be rotatable together about the rotation shaft 241. Here, the pulley 210 can be composed of one pulley or can be composed of two pulleys fixedly coupled to each other.

[0348] Similarly, the pulley 220, the second actuation extension part 257, and the second actuation gear 258 can be fixedly coupled to each other and formed to be rotatable together about the rotation shaft 242. Here, the pulley 220 can be composed of one pulley or can be composed of two pulleys fixedly coupled to each other.

[0349] Here, the first actuation gear 253 and the second actuation gear 258 are formed to mesh with each other and can be formed to rotate together in opposite directions when either one side rotates.

[0350] The yaw operation unit 202 can include a rotation shaft 243, pulleys 211 and 212 which are the first joystick main pulleys of the operation unit, pulleys 221 and 222 which are the second joystick main pulleys of the operation unit, and a yaw frame 207. Further, the yaw operation unit 202 can further include pulleys 213 and 214 which are the first joystick sub-pulleys formed on one side of the pulleys 211 and 212, and pulleys 223 and 224 which are the second joystick sub-pulleys formed on one side of the pulleys 221 and 222. Here, the pulleys 213 and 214 and the pulleys 223 and 224 can be coupled to a pitch frame 208 described later.

[0351] Here, in the figure, the yaw operation unit 202 includes the pulleys 211 and 212 and the pulleys 221 and 222, and the pulleys 211 and 212 and the pulleys 221 and 222 are each formed to face each other and are shown to include two independently rotatable pulleys, but the idea of the present invention is not limited to this. That is, one or more pulleys having the same or different diameters from each other can be provided by the configuration of the yaw operation unit 202.

[0352] Specifically, on one side of the actuation operation unit 203 on the first handle 204, a rotation shaft 243 which is the operation unit yaw main rotation shaft is formed. At this time, the first handle 204 is formed to be rotatable about the rotation shaft 243.

[0353] Here, the rotation shaft 243 can be formed to form a predetermined angle with the XY plane in which the connection portion 400 is formed. For example, the rotation shaft 243 can be formed in a direction parallel to the Z axis, and when the pitch operation unit 201 rotates in this state, the coordinate system of the rotation shaft 243 can be relatively changed as described above. Of course, the idea of the present invention is not limited to this, and the rotation shaft 243 can be formed in various directions according to the ergonomic design so as to suit the structure of the hand of the user who grips the operation unit 200.

[0354] On one hand, the pulleys 211 and 212 and the pulleys 221 and 222 are coupled to the rotation shaft 243 so as to be rotatable about the rotation shaft 243. And, a wire 301 or a wire 305 which is a first joystick wire can be wound around the pulleys 211 and 212, and a wire 302 or a wire 306 which is a second joystick wire can be wound around the pulleys 221 and 222. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 are respectively formed so as to face each other, and can be composed of two independently rotatable pulleys. Therefore, the wire to be wound and the wire to be unwound can be respectively wound around the separated pulleys, and can operate without interfering with each other.

[0355] The yaw frame 207 rigidly connects the first handle 204, the rotation shafts 241, 242, and 243, and enables the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 to integrally yaw-rotate about the rotation shaft 243.

[0356] The pitch operation unit 201 can include a rotation shaft 246, pulleys 217 and 218 which are the first joystick pitch main pulleys of the operation unit, pulleys 227 and 228 which are the second joystick pitch main pulleys of the operation unit, and a pitch frame. Further, the pitch operation unit 201 can further include a rotation shaft 245, pulleys 215 and 216 which are the first joystick pitch sub-pulleys formed on one side of the pulleys 217 and 218, and pulleys 225 and 226 which are the second joystick pitch sub-pulleys formed on one side of the pulleys 227 and 228. The pitch operation unit 201 can be connected to the bent portion 402 of the connection portion 400 via the rotation shaft 246.

[0357] Specifically, the pitch frame 208 serves as the base frame of the pitch operation unit 201, and a rotation shaft 243 is rotatably coupled to one end thereof. That is, the yaw frame 207 is formed to be rotatable about the rotation shaft 243 with respect to the pitch frame 208.

[0358] As described above, the yaw frame 207 connects the first handle 204, the rotation shafts 243, 241, and 242. Also, since the yaw frame 207 is axially coupled to the pitch frame 208, when the pitch frame 208 rotates in pitch about the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shafts 241, 242, and 243 connected to the pitch frame 208 will rotate in pitch together. That is, when the pitch operation unit 201 rotates about the rotation shaft 246, the actuation operation unit 203 and the yaw operation unit 202 will rotate together with the pitch operation unit 201. In other words, when the user rotates the first handle 204 in pitch about the rotation shaft 246, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 will move together.

[0359] The pulleys 217 and 218, and the pulleys 227 and 228 are rotatably coupled to the rotation shaft 246 so as to be rotatable about the rotation shaft 246 of the pitch frame 208.

[0360] Here, the pulleys 217 and 218 are formed to face each other and can be formed to be independently rotatable. Therefore, the wire being wound and the wire being unwound can be respectively wound around separate pulleys, and they can operate without interfering with each other. Similarly, the pulleys 227 and 228 are also formed to face each other and can be formed to be independently rotatable. Therefore, the wire being wound and the wire being unwound can be respectively wound around separate pulleys, and they can operate without interfering with each other.

[0361] Next, the operations of the wires 303 and 304, which are pitch wires, are as follows.

[0362] The end tool 100 is formed by fixedly connecting a pulley 131, which is an end tool pitch pulley, to an end tool hub 180. In the operation unit 200, a pulley 231 and a pulley 232, which are operation unit pitch pulleys, are fixedly connected to a pitch frame 208. And these pulleys are connected to each other by wires 303 and 304 which are pitch wires, and the pitch operation of the end tool 100 can be more easily performed according to the pitch operation of the operation unit 200. Here, the wire 303 is fixedly connected to the pitch frame 208 via the pulley 231 and the pulley 233, and the wire 304 is fixedly connected to the pitch frame 208 via the pulley 232 and the pulley 234. That is, due to the pitch rotation of the operation unit 200, the pitch frame 208, the pulley 231, and the pulley 232 rotate together around the rotation axis 246, and as a result, the wires 303 and 304 also move, and in addition to the pitch operation of the end tool by the wires 301, 302, 305, and 306 which are jo wires, the power of additional pitch rotation can be transmitted.

[0363] Summarizing the connection relationships between the first handle 204 and the pitch operation unit 201, the yaw operation unit 202, and the actuation operation unit 203 respectively, it is as follows. On the first handle 204, a rotation axis 241, a rotation axis 242, a rotation axis 243, a rotation axis 244, a rotation axis 245, and a rotation axis 246 can be formed. At this time, since the rotation axes 241 and 242 are directly formed on the first handle 204, the first handle 204 and the actuation operation unit 203 can be directly connected. On the other hand, since the rotation axis 243 is directly formed on the first handle 204, the first handle 204 and the yaw operation unit 202 can be directly connected. On the other hand, since the pitch operation unit 201 is formed to be connected to the yaw operation unit 202 on one side of the yaw operation unit 202, the pitch operation unit 201 is not directly connected to the first handle 204, and the pitch operation unit 201 and the first handle 204 can be formed to be indirectly connected via the yaw operation unit 202.

[0364] Continuing to refer to the drawings, in the electrosurgical instrument 10 according to the first embodiment of the present invention, the pitch operation unit 201 and the end tool 100 can be formed on the same or parallel axes (X-axis). That is, a rotation axis 246 of the pitch operation unit 201 is formed at one end of the bending portion 402 of the connection portion 400, and the end tool 100 is formed at the other end of the connection portion 400.

[0365] And, at various locations of the connection portion 400, particularly in the bending portion 402, one or more intermediate pulleys 235 for changing or guiding the path of the wire can be arranged. By forming at least a part of the wire wound around such an intermediate pulley 235 to guide the path of the wire, the wire can be arranged along the bent shape of the bending portion 402.

[0366] Here, in the figure, the connection portion 400 is shown to be curved with a predetermined curvature including the bending portion 402, but the idea of the present invention is not limited to this, and the connection portion 400 can be formed linearly as needed, or can be formed by being bent one or more times. Even in such a case, it can be said that the pitch operation unit 201 and the end tool 100 are formed on substantially the same or parallel axes. In addition, in FIG. 3, it is shown that the pitch operation unit 201 and the end tool 100 are respectively formed on axes parallel to the X-axis, but the idea of the present invention is not limited to this, and the pitch operation unit 201 and the end tool 100 can also be formed on different axes from each other.

[0367] (Actuation Operation, Yaw Operation, Pitch Operation) The actuation operation, yaw operation, and pitch operation in this embodiment will be described as follows.

[0368] First, the actuation operation is as follows.

[0369] When the user pinches the index finger in the ring formed on the first actuation extension 252 and pinches the thumb in the ring formed on the second actuation extension 257, and rotates the actuation extensions 252 and 257 using either one finger or both fingers, the pulley 210 fixedly coupled to the first actuation extension 252 and the first actuation gear 253 rotate about the rotation axis 241, and the pulley 220 fixedly coupled to the second actuation extension 257 and the second actuation gear 258 rotate about the rotation axis 242. At this time, the pulley 210 and the pulley 220 rotate in opposite directions to each other, and thereby the wire 301 and the wire 305 wound with one end fixedly coupled to the pulley 210 and the wire 302 and the wire 306 wound with one end fixedly coupled to the pulley 220 also move in opposite directions to each other. Then, such a rotational force is transmitted to the end tool 100 through the power transmission unit 300, and the two jaws 103 of the end tool 100 perform an actuation operation.

[0370] Here, the actuation operation means an operation of opening and closing the jaws 101 and 102 while the two jaws 101 and 102 rotate in opposite directions to each other as described above. That is, when the actuation extensions 252 and 257 of the actuation operation unit 203 are rotated in a direction approaching each other, the first jaw 101 rotates counterclockwise and the second jaw 102 rotates clockwise to close the end tool 100. Conversely, when the actuation extensions 252 and 257 of the actuation operation unit 203 are rotated in a direction away from each other, the first jaw 121 rotates clockwise and the second jaw 122 rotates counterclockwise to open the end tool 100.

[0371] In this embodiment, for the above-described actuation operation, a second handle is configured with a first actuation extension portion 252 and a second actuation extension portion 257 so that two fingers can grip and operate it. However, the configuration of the actuation operation unit 203 for the actuation operation of opening and closing the two jaws of the end tool 100 with respect to each other is different from that described above, and other modifications such as a configuration in which two actuation pulleys (pulley 210, pulley 220) are operated in opposite directions by one actuation rotation portion are also possible.

[0372] Next, the yaw operation is as follows.

[0373] When the user rotates the first handle 204 about the rotation axis 243 while holding the first handle 204, the actuation operation unit 203 and the yaw operation unit 202 rotate about the rotation axis 243. That is, when the pulley 210 of the first actuation operation unit 251 to which the wire 301 and the wire 305 are fixedly coupled rotates about the rotation axis 243, the wire 301 and the wire 305 wound around the pulley 211 and the pulley 212 move. Similarly, when the pulley 220 of the second actuation operation unit 256 to which the wire 302 and the wire 306 are fixedly coupled rotates about the rotation axis 243, the wire 302 and the wire 306 wound around the pulley 221 and the pulley 222 move. At this time, the wire 301 and the wire 305 connected to the first jaw 101 and the wire 302 and the wire 306 connected to the second jaw 102 are wound around the pulley 211 and the pulley 212 and the pulley 221 and the pulley 222 so that the first jaw 101 and the second jaw 102 rotate in the same direction during yaw rotation. Then, such a rotational force is transmitted to the end tool 100 via the power transmission unit 300, and the two jaws 103 of the end tool 100 perform a yaw operation of rotating in the same direction.

[0374] At this time, since the yaw frame 207 connects the first handle 204, the rotation shafts 241, 242, and 243, the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 will rotate together about the rotation shaft 243.

[0375] Next, the pitch operation is as follows.

[0376] When the user rotates the first handle 204 about the rotation shaft 246 while holding the first handle 204, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 will perform a pitch rotation about the rotation shaft 246. That is, when the pulley 210 of the first actuation operation unit 251 to which the wires 301 and 305 are fixedly coupled rotates about the rotation shaft 246, the wires 301 and 305 wound around the pulley 217 and the pulley 218 will move. Similarly, when the pulley 220 of the second actuation operation unit 256 to which the wires 302 and 306 are fixedly coupled rotates about the rotation shaft 246, the wires 302 and 306 wound around the pulley 227 and the pulley 228 will move. At this time, as described with reference to FIG. 5, the wires 301 and 305, which are the first joystick wires, move in the same direction as each other, and the wires 302 and 306, which are the second joystick wires, move in the same direction as each other so that the first joystick 101 and the second joystick 102 can perform a pitch rotation. The wires 301, 305, 302, and 306, which are joystick wires, are wound around the pulleys 217, 218, 227, and 228, which are operation unit pitch main pulleys, respectively. Then, such a rotational force is transmitted to the end tool 100 via the power transmission unit 300, and the two jaws 103 of the end tool 100 perform a pitch operation.

[0377] At this time, the pitch frame 208 is connected to the yaw frame 207. The yaw frame 207 connects the first handle 204, the rotation shafts 241, 242, and 243. Therefore, when the pitch frame 208 rotates about the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shafts 241, 242, and 243 connected to the pitch frame 208 will rotate together. That is, when the pitch operation unit 201 rotates about the rotation shaft 246, the actuation operation unit 203 and the yaw operation unit 202 will rotate together with the pitch operation unit 201.

[0378] In summary, the electrocautery surgical instrument 10 according to an embodiment of the present invention has pulleys formed at each joint position (actuation joint, yaw joint, pitch joint), and wires (first jaw wire or second jaw wire) are wound around these pulleys. The rotational operation of the operation unit (actuation rotation, yaw rotation, pitch rotation) causes the movement of each wire, and as a result, the end tool 100 is induced to perform the desired operation. Further, an auxiliary pulley can be formed on one side of each pulley, and these auxiliary pulleys can prevent the wire from being wound around one pulley multiple times.

[0379] FIG. 25 is a diagram schematically showing only the configuration of the pulleys and wires constituting the joints of the electrocautery surgical instrument 10 according to an embodiment of the present invention shown in FIG. 2. In FIG. 25, the intermediate pulleys for changing the wire path regardless of the joint movement are omitted.

[0380] Referring to FIG. 25, the operation unit 200 can include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 related to the rotational movement of the first jaw 101.

[0381] In addition, the operation unit 200 can include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 related to the rotational movement of the second jaw 122. (Since the arrangement and configuration of each pulley in the operation unit 200 are the same in principle as those of each pulley in the end tool 100, the specific notations of the reference numerals in the drawings are partially omitted.)

[0382] Pulleys 211 and 212 and pulleys 221 and 222 can be formed to be rotatable independently of each other about a rotating shaft 243 which is the same axis. At this time, pulleys 211 and 212 and pulleys 221 and 222 respectively can be formed by two pulleys which are formed to face each other and are rotatable independently.

[0383] Pulleys 213 and 214 and pulleys 223 and 224 can be formed to be rotatable independently of each other about a rotating shaft 244 which is the same axis. At this time, pulleys 213 and 214 can be formed by two pulleys which are formed to face each other and are rotatable independently, and the two pulleys can be formed to have different diameters from each other. Similarly, pulleys 223 and 224 can be formed by two pulleys which are formed to face each other and are rotatable independently, and the two pulleys can be formed to have different diameters from each other.

[0384] Pulleys 215 and 216 and pulleys 225 and 226 can be formed to be rotatable independently of each other about a rotating shaft 245 which is the same axis. At this time, pulleys 215 and 216 can be formed to have different diameters from each other. Also, pulleys 225 and 226 can be formed to have different diameters from each other.

[0385] The pulleys 217 and 218 and the pulleys 227 and 228 can be formed to be rotatable independently of each other about a rotation axis 246 which is the same axis.

[0386] The wire 301 sequentially passes through the pulleys 217, 215, 213, and 211 of the operation unit 200, is wound around the pulley 210, and is then coupled to the pulley 210 by the fastening member 324. On the other hand, the wire 305 sequentially passes through the pulleys 218, 216, 214, and 212 of the operation unit 200 and is coupled to the pulley 210 by the fastening member 324. Therefore, when the pulley 210 rotates, the wires 301 and 305 are wound around or unwound from the pulley 210 accordingly, and the first jaw 101 rotates.

[0387] The wire 306 sequentially passes through the pulleys 227, 225, 223, and 221 of the operation unit 200, is wound around the pulley 220, and is then coupled to the pulley 220 by the fastening member 327. On the other hand, the wire 302 sequentially passes through the pulleys 228, 226, 224, and 222 of the operation unit 200 and is coupled to the pulley 220 by the fastening member 327. Therefore, when the pulley 220 rotates, the wires 302 and 306 are wound around or unwound from the pulley 220 accordingly, and the second jaw 102 rotates.

[0388] (Conceptual Diagram of Pulley and Wire) FIGS. 27 and 28 are diagrams showing the configurations of the pulleys and wires related to the actuation operation and the yaw operation of the electrosurgical instrument 10 according to an embodiment of the present invention shown in FIG. 2, solved for each of the first jaw and the second jaw. FIG. 27 is a diagram showing only the pulleys and wires related to the second jaw, and FIG. 28 is a diagram showing only the pulleys and wires related to the first jaw. And FIG. 26 is a perspective view showing the yaw operation of the surgical instrument of FIG. 2. Here, in FIG. 26, the components related to the cutting operation are omitted.

[0389] First, the wire operation of the actuation movement will be described.

[0390] Referring to FIG. 28, when the first actuation extension 252 rotates about the rotation axis 241 in the direction of arrow OPA1, the pulley 210 connected to the first actuation extension 252 rotates, and the wires 301 and 305 wound around the pulley 210 move in the directions of W1a and W1b, respectively. As a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPA1.

[0391] Referring to FIG. 27, when the second actuation extension 257 rotates about the rotation axis 242 in the direction of arrow OPA2, the pulley 220 connected to the second actuation extension 257 rotates, and both strands of the wires 302 and 306 wound around the pulley 220 move in the directions of W2a and W2b, respectively. As a result, the second jaw 102 of the end tool 100 rotates in the direction of arrow EPA2. Therefore, when the user operates the first actuation extension 252 and the second actuation extension 257 in a direction approaching each other, the first jaw 101 and the second jaw 102 of the end tool perform an operation of approaching each other.

[0392] Next, the wire operation of the yaw movement will be described.

[0393] First, since the rotation axis 243, the rotation axis 241, and the rotation axis 242 are connected by a yaw frame (see 207 in FIG. 26), the rotation axis 243, the rotation axis 241, and the rotation axis 242 rotate together integrally.

[0394] Referring to FIG. 28, when the first handle 204 is rotated in the direction of arrow OPY1 about the rotation axis 243, the pulleys 210, 211, and 212 and the wires 301 and 305 wound thereon rotate as a whole about the rotation axis 243. As a result, the wires 301 and 305 wound around the pulleys 211 and 212 move in the directions of W1a and W1b, respectively. As a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPY1.

[0395] Referring to FIG. 27, when the first handle 204 is rotated in the direction of arrow OPY2 about the rotation axis 243, the pulleys 220, 221, and 222 and the wires 302 and 306 wound thereon rotate as a whole about the rotation axis 243. As a result, the wires 302 and 306 wound around the pulleys 221 and 222 move to the opposite sides of W1a and W1b, respectively. As a result, the second jaw 102 of the end tool 100 rotates in the direction of arrow EPY2.

[0396] FIGS. 29, 30, and 31 are diagrams showing the configuration of the pulleys and wires related to the cutting operation of the electrosurgical instrument 10 according to an embodiment of the present invention shown in FIG. 2, disassembled for each of the first jaw and the second jaw. Here, FIGS. 29 to 31 are diagrams mainly showing the pulleys and wires related to the second jaw.

[0397] Here, FIGS. 29 to 30 show the activation operation process of closing the two jaws, and FIGS. 30 to 31 show the cutting operation process of cutting the tissue interposed between the two jaws.

[0398] First, the wire operation of the activation operation will be described.

[0399] Referring to FIGS. 29 and 30, when the first actuation extension portion 252 of the first actuation operation portion 251 rotates in the direction of arrow OPA1 about the rotation axis 241, the pulley 210 connected to the first actuation extension portion 252 rotates, and the wires (refer to 301 in FIG. 25) and the wire (refer to 305 in FIG. 25) wound around the pulley 210 move respectively. As a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPA1.

[0400] At this time, the operation portion blade pulley 269 of the blade operation portion 260 is formed to be rotatable about the rotation axis 241 together with the first actuation operation portion 251. Therefore, when the first actuation extension portion 252 rotates about the rotation axis 241, the blade operation portion 260 also rotates about the rotation axis 241 together with the first actuation operation portion 251.

[0401] As a result, during the actuation operation, when the pulley 111 rotates with the end tool 100, the blade pulley 161 also rotates together with the pulley 111. When the first jaw 101 rotates, the blade 171 also rotates together with the first jaw 101.

[0402] Next, the wire operation during the cutting operation will be described.

[0403] Referring to FIGS. 30 and 31, when the blade operation portion 260 is rotated in the direction of arrow OPC1 about the rotation axis 247 which is the operation portion cutting rotation axis, the operation portion blade pulley 269 and the wires 307 and 308 which are the blade wires wound here rotate about the rotation axis 247. As a result, the wires 307 and 308 wound around the operation portion blade pulley 269 move respectively. As a result, the blade pulley 161 of the end tool 100 rotates in the direction of arrow EPC1.

[0404] On the one hand, when the blade operation unit 260 rotates, the operation unit blade pulley 269 rotates about the rotation axis 247, and at this time, the rotation of the blade operation unit 260 does not affect the first actuation operation unit 251.

[0405] As a result, when the operation unit blade pulley 269 rotates, the blade pulley 161 of the end tool 110 rotates independently regardless of the first jaw 101. When the blade pulley 161 rotates independently in this way, the blade 171 is pulled out from the first jaw 101 (or while being pulled into the first jaw 101), and the tissue is cut.

[0406] FIGS. 33, 34, and 35 are diagrams showing the configurations of the pulleys and wires related to the pitch operation of the electrosurgical instrument 10 according to an embodiment of the present invention shown in FIG. 2, resolved for each of the first jaw and the second jaw. FIG. 33 is a diagram showing only the pulleys and wires related to the second jaw, FIG. 34 is a diagram showing only the pulleys and wires related to the first jaw, and FIG. 35 is a diagram showing only the pulleys and wires related to the blade pulley. As shown in FIG. 9 and the like, there are two pulleys related to the pitch operation, and both sides of each wire are wound along the same path, which is represented by a single line in FIGS. 33 and 35. And FIG. 32 is a perspective view showing the pitch operation of the surgical instrument of FIG. 2. Here, in FIG. 32, the components related to the cutting operation are omitted.

[0407] Referring to FIG. 33, when the first handle 204 is rotated in the direction of arrow OPP1 about the rotation axis 246, the pulleys 210, 215, 217, etc. and the wires 301, etc. wound here rotate as a whole about the rotation axis 246. At this time, as shown in FIG. 24, since the wires 301 and 305, which are the first jaw wires, are wound on the upper sides of the pulleys 217 and 218, they will move to the arrow W1 side. As a result, as described with reference to FIG. 5, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPP1.

[0408] Referring to FIG. 34, when the first handle 204 is rotated in the direction of arrow OPP2 about the rotation axis 246, the pulleys 220, 225, 227, etc. and the wire 302, etc. wound here will rotate about the rotation axis 246 as a whole. At this time, as shown in FIG. 24, since the wires 302 and 306, which are the second jaw wires, are wound under the pulleys 227 and 228, they will move to the arrow W2 side. As a result, as described with reference to FIG. 5, the second jaw 102 of the end tool 100 will rotate in the direction of arrow EPP2.

[0409] Referring to FIG. 35, when the first handle 204 is rotated in the direction of arrow OPC1 about the rotation axis 246, the operation part blade pulley 269, pulleys 265, 267, etc. and the wire 307, wire 308, etc. wound here will rotate about the rotation axis 246 as a whole. At this time, since the wires 307 and 308, which are the blade wires, are wound under the pulleys 267 and 268, they will move to the arrow W3 side. As a result, as described with reference to FIG. 5, the blade pulley 161 of the end tool 100 will rotate in the direction of arrow EPC1.

[0410] As a result, during the pitch operation, when the pulley 111 of the end tool 100 rotates about the rotation axis 143, the blade pulley 161 will also rotate about the rotation axis 143 together with the pulley 111. When the first jaw 101 rotates, the blade 171 will also perform a pitch rotation together with the first jaw 101.

[0411] Therefore, the actuation operation, yaw operation, and pitch operation can be performed independently of each other.

[0412] As described with reference to FIG. 1, the actuation operation part 203, yaw operation part 202, and pitch operation part 201 are configured to be the same as the joint configuration of the end tool by having their rotation axes located behind each operation part, enabling the user to perform intuitively consistent operations.

[0413] In particular, for the electrocautery surgical instrument 10 according to an embodiment of the present invention, pulleys are formed at each joint position (actuation joint, yaw joint, pitch joint), and the wire (first joystick wire or second joystick wire) is wound around the pulley. A rotational operation of the operation unit (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, and as a result, induces the end tool 100 to perform a desired operation. Further, an auxiliary pulley can be formed on one side of each pulley, and the auxiliary pulley can prevent the wire from being wound around one pulley multiple times, so that the wires wound around the pulley do not contact each other, and the paths of the wire wound into the pulley and the wire unwound from the pulley are also formed safely, improving the safety and efficiency of the power transmission of the wire and the like.

[0414] On the other hand, as described above, the yaw operation unit 202 and the actuation operation unit 203 are directly formed on the first handle 204. Therefore, when the first handle 204 rotates about the rotation axis 246, the yaw operation unit 202 and the actuation operation unit 203 also rotate together with the first handle 204. As a result, the coordinate systems of the yaw operation unit 202 and the actuation operation unit 203 are not fixed, but continue to change relatively according to the rotation of the first handle 204. That is, in FIG. 2 and the like, the yaw operation unit 202 and the actuation operation unit 203 are shown as being parallel to the Z axis. However, when the first handle 204 rotates, the yaw operation unit 202 and the actuation operation unit 203 are no longer parallel to the Z axis. That is, the coordinate systems of the yaw operation unit 202 and the actuation operation unit 203 change according to the rotation of the first handle 204. However, for the convenience of explanation in this specification, unless otherwise explained, the coordinate systems of the yaw operation unit 202 and the actuation operation unit 203 are described based on the state where the first handle 204 is perpendicular to the connection part 400 as shown in FIG. 2.

[0415] (Correlation between Cutting Operation and Other Operations) The following describes the correlation between the cutting operation and other operations (pitch, yaw, and actuation operations).

[0416] First, during the pitch operation of the end tool 100, the blade pulley 161 also performs a pitch operation. That is, when the pulleys 111 and 121 perform a pitch movement of rotating in the same direction around the rotation axis 143, the blade pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. Otherwise, the blade 171 will move relative to the first joe 101.

[0417] Next, during the yaw operation of the end tool 100, the blade pulley 161 also performs a yaw operation. That is, when the pulleys 111 and 121 perform a yaw movement of rotating in the same direction around the rotation axis 141, the blade pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. Otherwise, the blade 171 will move relative to the first joe 101.

[0418] Next, during the actuation operation of the end tool 100, the blade pulley 161 rotates together with the pulley 111. That is, when the pulleys 111 and 121 perform an actuation movement of rotating in opposite directions around the rotation axis 141, the blade pulley 161 must rotate in the same direction together with the pulley 111. Otherwise, the blade 171 will move relative to the first joe 101.

[0419] On the other hand, during the cutting operation of the end tool 100, the pulleys 111 and 121 do not rotate. That is, when the blade 171 is pulled out from the first joe 101 or pulled into the first joe 101 while the blade pulley 161 rotates around the rotation axis 141, the pulleys 111 and 121 must not rotate. Otherwise, the first joe 101 and the blade 171 will move together, and the blade 171 cannot be pulled out from the first joe 101, and cutting cannot be performed.

[0420] As a result, when the pulley 111, which is the first jump pulley, rotates, the blade pulley 161 connected to the blade 171 housed inside the first jaw 101 must also rotate together with the pulley 111. On the other hand, when the blade pulley 161 rotates for cutting, the pulleys 111 and 121 must be formed so as to maintain their positions without rotating. The correlation between such a cutting operation and other operations (yaw operation and actuation operation) is as described above.

[0421] In other words, the pulleys 111 and 121 can be expressed as being independent of the rotation of the blade pulley 161. That is, even if the blade pulley 161 rotates by the blade wire, the pulleys 111 and 121 do not have to rotate. Conversely, the blade pulley 161 can be expressed as being dependent on the rotation of the pulleys 111 and 121. That is, when the pulley 111 or the pulley 121 rotates by the jaw wire, the blade pulley 161 can be formed to rotate together with the pulley 111 or the pulley 121.

[0422] FIG. 36 is a diagram showing a state in which the jaw has yawed by +90°, and FIG. 37 is a diagram showing a process of performing an actuation operation in a state in which the jaw has yawed by +90°.

[0423] And FIGS. 38, 39, and 40 are plan views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and are diagrams showing a process of performing a cutting operation in a state in which the jaw has yawed by +90°. As shown in FIGS. 38 to 40, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even in a state in which the jaw has yawed by +90°.

[0424] Figures 41, 42, and 43 are plan views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and are diagrams showing the process of performing the cutting operation with the jaw rotated -90° in the yaw direction. As shown in FIGS. 41 to 43, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated -90° in the yaw direction.

[0425] On the other hand, FIG. 44 is a diagram showing a state in which the jaw is rotated -90° in the pitch direction. FIGS. 45, 46, and 47 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and are diagrams showing the state of performing the cutting operation with the jaw rotated -90° in the pitch direction. As shown in FIGS. 45 to 47, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated -90° in the pitch direction.

[0426] Further, FIGS. 48, 49, and 50 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and are diagrams showing the state of performing the cutting operation with the jaw rotated +90° in the pitch direction. As shown in FIGS. 48 to 50, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated +90° in the pitch direction.

[0427] On the one hand, FIG. 51 shows a state where the jaw has pitched -90° and simultaneously yawed +90°. FIGS. 52, 53, and 54 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and show how the cutting operation is performed in a state where the jaw has pitched -90° and simultaneously yawed +90°. As shown in FIGS. 52 to 54, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even in a state where the jaw has pitched -90° and simultaneously yawed +90°.

[0428] FIGS. 55, 56, and 57 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 2, and show how the cutting operation is performed in a state where the jaw has pitched -90° and simultaneously yawed -90°. As shown in FIGS. 55 to 57, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform a normal cutting operation even in a state where the jaw has pitched -90° and simultaneously yawed -90°.

Mode for Carrying Out the Invention

[0429] (First Variant of the First Embodiment - Ingrave) Hereinafter, the end tool 500 of the surgical instrument according to the first modified form of the first embodiment of the present invention will be described. Here, the end tool 500 of the surgical instrument according to the first modified form of the first embodiment of the present invention is characteristically different in the configuration of the end tool hub 580 that serves as an auxiliary pulley as compared with the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. Such a changed configuration compared with the first embodiment will be described in detail later.

[0430] Figs. 58 to 60 are perspective views showing an end tool of an electrocautery surgical instrument according to a first modified form of the first embodiment of the present invention, Fig. 61 is a view showing a state where the jaw is yawed 90° in the clockwise direction, and Fig. 62 is a view showing a state where the jaw is yawed 90° in the counterclockwise direction. Fig. 63 is an enlarged perspective view showing an end tool hub of the electrocautery surgical instrument of Fig. 58.

[0431] Here, Figs. 59 and 60 show a state where the wire is removed, and Figs. 61 and 62 show a state where the jaw pulley coupling part of the end tool hub is removed.

[0432] Referring to Figs. 58 to 63, an end tool 500 according to a first modified form of the first embodiment of the present invention includes a pair of jaws for performing a grip operation, that is, a first jaw 501 and a second jaw 502. Here, each of the first jaw 501 and the second jaw 502, or a component including the first jaw 501 and the second jaw 502 can be referred to as a jaw 503.

[0433] On the other hand, the end tool 500 includes a plurality of pulleys including pulleys 511, 513, and 514 related to the rotational movement of the first jaw 501. Since the pulleys related to the rotational movement of the first jaw 501 in the present embodiment are substantially the same as the pulleys 113, 114, 115, and 116 described in Fig. 11 and the like of the first embodiment, a detailed description thereof is omitted here.

[0434] On the other hand, the end tool 500 includes a plurality of pulleys including a pulley 521 related to the rotational movement of the second jaw 502. Since the pulleys related to the rotational movement of the second jaw 502 in the present embodiment are substantially the same as the pulleys 123, 124, 125, and 126 described in Fig. 11 and the like of the first embodiment, a detailed description thereof is omitted here.

[0435] In addition, the end tool 500 of the first modified form of the first embodiment of the present invention can include a rotation axis 541, a rotation axis 543, and a rotation axis 544. Here, the rotation axis 541 can be inserted through the end tool hub 580, and the rotation axis 543 and the rotation axis 544 can be inserted through the pitch hub 507. The rotation axis 541, the rotation axis 543, and the rotation axis 544 can be sequentially arranged in the direction from the distal end 504 to the proximal end 505 of the end tool 500.

[0436] In addition, the end tool 500 of the first modified form of the first embodiment of the present invention can include an end tool hub 580 and a pitch hub 507.

[0437] The rotation axis 541, which will be described later, is inserted through the end tool hub 580, and at least a part of the pulleys 511 and 521 axially coupled to the rotation axis 541 and the first joint 501 and the second joint 502 coupled thereto can be accommodated inside the end tool hub 580. Here, one embodiment of the present invention is characterized in that a guide portion 583 that serves as an auxiliary pulley is formed on the end tool hub 580. That is, a guide portion 583 that guides the paths of the wires 305 and 302 can be formed on the end tool hub 580. The guide portion 583 of such an end tool hub 580 can change the path of the wire by serving as the auxiliary pulley (see 112, 122, 162 in FIG. 9) in the first embodiment, and the guide portion 583 of the end tool hub 580 that serves as the auxiliary pulley will be described in more detail later.

[0438] On one hand, at one end of the end tool hub 580, a pulley 531 that serves as an end tool pitch pulley can be formed. As shown in FIG. 58, the pulley 531 can be formed as a member separate from the end tool hub 580 and can be coupled to the end tool hub 580. Alternatively, the pulley 531 can be formed integrally with the end tool hub 580. Then, a wire (see 303 in FIG. 13) and a wire 304 are coupled to the pulley 531 that serves as an end tool pitch pulley, and this pulley 531 performs a pitch operation while rotating about the rotation axis 543.

[0439] The rotation axes 543 and 544 penetrate and are inserted into the pitch hub 507, and the pitch hub 507 can be axially coupled to the end tool hub 580 and the pulley 531 by the rotation axis 543. Therefore, the end tool hub 580 and the pulley 531 can be formed to be pitch-rotatable with respect to the pitch hub 507 about the rotation axis 543.

[0440] On one hand, the end tool 500 of the first modified form of the first embodiment of the present invention can further include components such as a first electrode 551, a second electrode 552, a blade pulley 561, a blade link 573, and a blade 571 in order to perform cautery and cutting operations. Here, components such as the blade pulley 561, the blade 571, and the blade link 573 related to the drive of the blade can be collectively referred to as a blade assembly (see 170 in FIG. 7). One modified form of the present invention is characterized in that by arranging a blade assembly (see 170 in FIG. 7) including the blade 571 between the first jog pulley input pulley 511 and the second jog pulley input pulley 521, it becomes possible to execute not only the pitch operation and the yaw operation of the end tool 500 but also a cutting operation using the blade 571. Since the components for performing cautery and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, the detailed description thereof is omitted here.

[0441] The electrosurgical instrument according to the first modified form of the first embodiment of the present invention can include wires 301, 302, 303, 304, 305, 306, 307, and 308, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0442] Further, the electrosurgical instrument according to the first modified form of the first embodiment can include fastening members 321, 323, 324, 326, 327, and 329 that are coupled to each end of each wire in order to couple the wire and the pulley, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0443] Hereinafter, the end tool hub 580 of the first modified form of the first embodiment of the present invention will be described in more detail, and in particular, the guide portion 583 of the end tool hub 580 that serves as an auxiliary pulley will be described in detail.

[0444] The end tool hub 580 includes a first jo pulley coupling portion 581, a second jo pulley coupling portion 582, a guide portion 583, a guide groove 584, and a pitch pulley coupling portion 585.

[0445] Specifically, the first jo pulley coupling portion 581 and the second jo pulley coupling portion 582 are formed to face each other, and the pulleys 511, 521, and the blade pulley 561 are accommodated therein. Further, through holes are formed in each of the jo pulley coupling portions 581 and 582, and the rotating shaft 541 passes through the jo pulley coupling portions 581 and 582 and the pulleys 511, 521, and the blade pulley 581 to axially couple them.

[0446] The first pulley coupling part 581 and the second pulley coupling part 582 are connected by a guide part 583. That is, the first pulley coupling part 581 and the second pulley coupling part 582, which are parallel to each other, are coupled by a guide part 583 formed in a direction substantially perpendicular thereto. The first pulley coupling part 581, the second pulley coupling part 582, and the guide part 583 generally form a "C" shape, and the pulley 511, the pulley 521, and the blade pulley 561 are accommodated inside thereof.

[0447] In other words, it can also be considered that the first pulley coupling part 581 and the second pulley coupling part 582 extend in the X-axis direction from both ends of the guide part 583 formed long in the Z-axis direction.

[0448] Here, the guide part 583 can be generally formed in a columnar shape with a semi-circular cross-section. And this semi-circular part can be arranged to protrude toward the pulley 511, the pulley 521, and the blade pulley 561 side. In other words, it can also be expressed that the guide part 583 is formed to protrude toward the space formed by the first pulley coupling part 581, the second pulley coupling part 582, and the guide part 583. In other words, it can also be expressed that the region of the guide part 583 adjacent to the pulley coupling parts 581 and 582 is curved so that its cross-section has a predetermined curvature.

[0449] Or, in other words, it can also be said that the guide part 583 functions as a kind of pulley member around which the wires 305, 302, 307, and 308 are wound to guide the paths of the wires 305, 302, 307, and 308. However, here the guide part 583 is not a member that rotates around a predetermined axis like a pulley in the original sense, but is formed to be fixed as a part of the end tool hub 580. However, it can be said that it partially performs a function similar to that of a pulley by having wires wound around it.

[0450] Here, the figure shows that the guide portion 583 is formed in a generally semi-circular cylindrical shape in cross-section. That is, it is shown that at least a part of the cross-section of the guide portion 583 on the XY plane forms a predetermined arc shape. However, the idea of the present invention is not limited to this, and it can be said that it can be formed in various shapes and sizes suitable for guiding the paths of the wires 305, 302, 307, and 308, such as being formed with an elliptical cross-section, a parabolic cross-section having a predetermined curvature, or the corners of a polygonal prism being rounded to a certain extent.

[0451] Here, in the portion of the guide portion 583 that comes into contact with the wires 305, 302, 307, and 308, a guide groove 584 can be further formed to better guide the paths of the wires 305, 302, 307, and 308. The guide groove 584 can be formed in a groove-like shape that is recessed to a certain extent from the protruding surface of the guide portion 583.

[0452] Here, the figure shows that the guide groove 584 is formed on the entire arc surface of the guide portion 583, but the idea of the present invention is not limited to this, and it can be said that it is also possible for the guide groove 584 to be formed only on a part of the arc surface of the guide portion 583 as needed.

[0453] By further forming the guide groove 584 in the guide portion 583 in this way, unnecessary friction with the wire can be reduced and the durability of the wire can be improved.

[0454] In the guide portion 583, a pitch pulley coupling portion 585 can be further formed in a direction opposite to the formation direction of the joe pulley coupling portions 581 and 582. The pitch pulley coupling portion 585 can be formed in a direction parallel to the pulley 531 which is a pitch pulley, that is, on the XZ plane. A through hole through which the rotary shaft 543 can be inserted can be formed in the pitch pulley coupling portion 585, and this rotary shaft 543 can penetrate the pitch pulley coupling portion 585 and the pulley 531 to couple these two members. Here, the pitch pulley coupling portion 585 can be formed to be deflected to one side from the center when viewed in the XY plane, and can be formed so as to balance as a whole when the pulley 531 is coupled.

[0455] Hereinafter, the role and function of the guide portion 583 will be described in more detail.

[0456] The guide portion 583 can play a role of expanding the respective rotation radii of the first joe 501 and the second joe 502 by contacting the wire 305 and the wire 302 and changing the arrangement path of the wire 305 and the wire 302 to a certain extent.

[0457] Furthermore, the guide portion 583 can play a role of expanding the rotation radius of the blade pulley 561 by contacting the wire 307 and the wire 308 which are blade wires and changing the arrangement path of the wire 307 and the wire 308 to a certain extent.

[0458] That is, when the auxiliary pulley is not arranged, each of the pulley 511 which is the first joe pulley, the pulley 521 which is the second joe pulley, and the blade pulley 561 can only rotate up to a right angle. However, in the first modified form of the first embodiment of the present invention, by additionally providing the guide portion 583 in the end tool hub 580, an effect that the maximum rotation angle of each pulley is increased can be obtained.

[0459] This enables the two jaws of the end tool 500 to open for the actuation operation in a state where the two jaws are yaw-rotated by 90°. In other words, the configuration of the guide portion 583 of the end tool hub 580 has a feature that the range of yaw rotation in which the actuation operation is possible can be expanded.

[0460] Also, the guide portion 583 of the end tool hub 580 that serves as an auxiliary pulley enables the blade pulley 561 to additionally rotate for the cutting operation in a state where the two jaws are yaw-rotated by 90°. In other words, the configuration of the guide portion 583 of the end tool hub 580 has a feature that the range of yaw rotation in which the cutting operation is possible can be expanded.

[0461] Furthermore, by forming the guide portion 583 on the existing end tool hub 580 without adding a separate structure such as an auxiliary pulley, it has a feature that the expansion of the rotation range can be realized without adding parts and manufacturing processes.

[0462] In this way, there is no need to additionally arrange a separate structure for expanding the rotation angle, the number of parts is reduced, the manufacturing process is simplified, the length of the end tool is shortened only by the size of the auxiliary pulley, and the length of the end tool during the pitch operation is shortened, thereby obtaining the effect that it becomes easier to perform the surgical operation in a narrow space.

[0463] Explaining this in more detail is as follows.

[0464] In the end tool 500 of the surgical instrument according to the first modified form of the first embodiment of the present invention, a guide portion 583 capable of changing the path of the wire is formed on the inner wall of the end tool hub 580, and the arrangement path of the wire is changed without a separate structure. By forming the guide portion 583 on the end tool hub 580 in this way and changing the arrangement paths of the wires 305, 302, 307, and 308 to a certain extent, the tangential directions of the wires 305, 302, 307, and 308 are changed. Therefore, the rotation angles of the fastening members 323, 326, and 329 that connect each wire to the pulley are enlarged.

[0465] That is, the fastening member 326 that connects the wire 302 to the pulley 521 can rotate until it is located on the common internal tangent of the pulley 521 and the guide portion 583. Similarly, the fastening member (see 323 in FIG. 6) that connects the wire 305 to the pulley 511 can rotate until it is located on the common internal tangent of the pulley 511 and the guide portion 583, and the rotation angle of the fastening member (see 323 in FIG. 6) can be enlarged. Similarly, the fastening member 329 that connects the wires 307 and 308 to the pulley 561 can rotate until it is located on the two common internal tangents of the pulley 561 and the guide portion 583, and the rotation angle of the fastening member 329 can be enlarged.

[0466] In other words, the wire 301 and the wire 305 wound around the pulley 511 by the guide portion 583 are arranged on one side with reference to the plane perpendicular to the Y axis and passing through the X axis. At the same time, the wire 302 and the wire 306 wound around the pulley 521 by the guide portion 583 are arranged on the other side with reference to the plane perpendicular to the Y axis and passing through the X axis.

[0467] In other words, the pulleys 513 and 514 are perpendicular to the Y axis and are arranged on one side with reference to the plane passing through the X axis, and the pulleys 523 and 524 are perpendicular to the Y axis and are arranged on the other side with reference to the plane passing through the X axis.

[0468] In other words, the wire 305 is located on the inscribed tangent line between the pulley 511 and the guide portion 583, and the rotation angle of the pulley 511 is enlarged by the guide portion 583. Further, the wire 302 is located on the inscribed tangent line between the pulley 521 and the guide portion 583, and the rotation angle of the pulley 521 is enlarged by the guide portion 583.

[0469] Compared with the surgical instrument of the first embodiment in which a separate auxiliary pulley is formed, the length of the end tool of the surgical instrument of this modified form, in which a guide portion 583 capable of changing the wire path is formed on the inner wall of the end tool hub 580 without forming an auxiliary pulley, can be shortened. By shortening the length of the end tool in this way, when performing surgery in a narrow surgical space in the body, the operation of the operator becomes easier, and the effect of reducing the side effects of the surgery can be obtained.

[0470] According to the present invention as described above, by increasing the radii of rotation of the pulley 511 which is the first joe pulley, the pulley 521 which is the second joe pulley, and the blade pulley 561, it is possible to obtain the effect of expanding the yaw operation range in which normal opening and closing actuation operations and cutting operations can be performed.

[0471] (Second Variant of the First Embodiment - Serrated Blade) Hereinafter, the end tool 600 of the surgical instrument according to the second modified form of the first embodiment of the present invention will be described. Here, the end tool 600 of the surgical instrument according to the second modified form of the first embodiment of the present invention is characteristically different in the configuration of the blade 671 as compared with the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. Hereinafter, the configuration that is different from the first embodiment in this way will be described in detail.

[0472] FIG. 64 is a perspective view showing an end tool of an electrocautery surgical instrument according to a second modified form of the first embodiment of the present invention.

[0473] Referring to FIG. 64, an end tool 600 according to a second modified form of the first embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 601 and a second jaw 602. Further, the end tool 600 can include a blade 671 for a cutting operation, a blade link 673, and a blade pulley 661 related to the linear / rotational movement of the blade 671, and a plurality of pulleys related thereto.

[0474] The blade 671 includes a main body portion (see 171a in FIG. 7), an edge portion 671b, and one or more second guide portions (see 171c in FIG. 7).

[0475] In a region of the main body portion (see 171a in FIG. 7), an edge portion 671b that is sharply formed to cut tissue is formed. At least a part of this edge portion 671b is drawn out outside the first jaw 601, and the tissue disposed between the first jaw 601 and the second jaw 602 can be cut.

[0476] On the other hand, one or more second guide portions (see 171c in FIG. 7) can be formed in another region of the main body portion (see 171a in FIG. 7). For example, the second guide portion (see 171c in FIG. 7) is formed in a protruding shape, and in a state where the second guide portion (see 171c in FIG. 7) is fitted into the groove-shaped first guide portion (see 101e in FIG. 11), when the second guide portion (see 171c in FIG. 7) moves along the first guide portion (see 101e in FIG. 11), the blade 671 moves relative to the first jaw 601. Also, the blade link 673 can be pivotally coupled to the second guide portion (see 171c in FIG. 7).

[0477] The blade link 673 connects the blade pulley 661 and the blade 671, and transmits the rotation of the blade pulley 661 to the blade 671 to cause the blade 671 to linearly move along the direction from the proximal part to the distal part of the first jaw 601. The blade link 673 can be formed in the shape of a long bar, and one end of the blade link 673 can be connected to the blade pulley 661, and the other end can be connected to the blade 671.

[0478] Here, the end tool 600 of the second variant of the first embodiment of the present invention is characterized in that a plurality of serrated portions 671d are formed on the edge portion 671b of the blade 671. By forming a plurality of serrated portions 671d on the edge portion 671b of the blade 671 in this way, the cutting force of the blade 671 can be enhanced, and the effect that the tissue can be cut more quickly and accurately can be obtained.

[0479] (Third Variant of the First Embodiment - Addition of a Second Auxiliary Pulley for Blade Wire) Hereinafter, the end tool 900 of the surgical instrument according to the third variant of the first embodiment of the present invention will be described. Here, the end tool 900 of the surgical instrument according to the third variant of the first embodiment of the present invention is characteristically different from the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above in that an additional blade second auxiliary pulley 967, which is an auxiliary pulley for the blade wire, is provided. Hereinafter, the configuration that is different from the first embodiment in this way will be described in detail.

[0480] FIGS. 65 to 68 are views showing the end tool of the electrocautery surgical instrument according to the third variant of the first embodiment of the present invention. In FIGS. 65 to 68, the pulley related to the blade pulley 961 is shown as the center.

[0481] Referring to FIGS. 65 to 68, the end tool 900 of the third modified form of the first embodiment of the present invention can include a blade pulley 961, a blade auxiliary pulley 962, a pulley 963, a pulley 964, a pulley 965, and a pulley 966 related to the linear / rotary motion of the blade. Further, the end tool 900 of the third modified form of the first embodiment of the present invention can further include a blade second auxiliary pulley 967.

[0482] The blade pulley 961 is formed to face a pulley (refer to 111 in FIG. 6) and a pulley (refer to 121 in FIG. 6) which are end tool joint pulleys, and is formed to be rotatable independently of each other about a rotation axis 941 which is an end tool joint pulley rotation axis.

[0483] Here, one feature of the present invention is that the blade pulley 961, the pulley (refer to 111 in FIG. 6), and the pulley (refer to 121 in FIG. 6) are formed to rotate about the same axis. By forming the blade pulley 961, the pulley (refer to 111 in FIG. 6), and the pulley (refer to 121 in FIG. 6) to rotate about the same axis in this way, it becomes possible to perform a pitch motion / yaw motion / actuation operation and at the same time perform a cutting operation using the blade.

[0484] The blade auxiliary pulley 962 can be additionally provided on one side of the blade pulley 961. In other words, the blade auxiliary pulley 962 can be disposed between the pulley 961 and the pulley 963 / pulley 964. The blade auxiliary pulley 962 can be formed to be rotatable independently of each other about a rotation axis 942 with a pulley (refer to 112 in FIG. 6) and a pulley (refer to 122 in FIG. 6).

[0485] The pulley 963 and the pulley 964 function as blade pitch main pulleys, and the pulley 965 and the pulley 966 function as blade pitch sub-pulleys.

[0486] The blade second auxiliary pulley 967 can be arranged between the blade auxiliary pulley 962 and the pulleys 963 / pulleys 964. The blade auxiliary pulley 962 can be formed to be rotatable about a predetermined axis parallel to the rotation axis 943 which is the central axis of the pulleys 963 and 964.

[0487] Hereinafter, the components related to the rotation of the blade pulley 961 will be described.

[0488] The pulleys 963 and 964 function as blade pitch main pulleys. Here, the wire 307 which is a blade wire is wound around the pulley 963, and the wire 308 which is a blade wire is wound around the pulley 964.

[0489] The pulleys 965 and 966 function as blade pitch sub-pulleys. Here, the wire 307 which is a blade wire is wound around the pulley 965, and the wire 308 which is a blade wire is wound around the pulley 966.

[0490] Here, on one side of the blade pulley 961 and the blade auxiliary pulley 962, the pulleys 963 and 964 are arranged to face each other. Here, the pulleys 963 and 964 are formed to be rotatable independently of each other about the rotation axis 943 which is the end tool pitch rotation axis. Also, on one side of each of the pulleys 963 and 964, the pulleys 965 and 966 are arranged to face each other. Here, the pulleys 965 and 966 are formed to be rotatable independently of each other about the rotation axis 944 which is the end tool pitch auxiliary rotation axis. Here, the figure shows that all of the pulleys 963, 965, 964 and 966 are formed to be rotatable about the Y-axis direction, but the idea of the present invention is not limited to this, and the rotation axes of the respective pulleys can be formed in various directions so as to suit the configuration.

[0491] The wire 307, which is a blade wire, is sequentially wound so as to be in contact with at least a part of the pulley 965, the pulley 963, the blade auxiliary pulley 962, and the blade pulley 961. Then, the wire 308 connected to the wire 307 by the fastening member 329 is sequentially wound so as to be in contact with at least a part of the blade pulley 961, the blade auxiliary pulley 962, the pulley 964, and the pulley 966.

[0492] In other words, the wire 307 and the wire 308, which are blade wires, are sequentially wound so as to be in contact with at least a part of the pulley 965, the pulley 963, the blade auxiliary pulley 962, the blade pulley 961, the blade auxiliary pulley 962, the pulley 964, and the pulley 966, and the wire 307 and the wire 308 are formed to move along the pulley while rotating the pulley.

[0493] Therefore, when the wire 307 is pulled, the fastening member 329 to which the wire 307 is coupled and the blade pulley 961 coupled thereto will rotate in one direction. Conversely, when the wire 308 is pulled, the fastening member 329 to which the wire 308 is coupled and the blade pulley 961 coupled thereto will rotate in the opposite direction.

[0494] Here, the end tool 900 of the surgical instrument according to the third modified form of the first embodiment of the present invention additionally includes a blade second auxiliary pulley 967, which can play a role in preventing friction between the wire 307 and the wire 308, which are blade wires.

[0495] That is, a second blade auxiliary pulley 967 is disposed between the blade auxiliary pulley 962 and the pulley 963 to change the path of the wire 307 entering the end tool hub 980 to a certain extent. That is, the height of the wire 307 in the Z-axis direction and the height of the wire 308 in the Z-axis direction within the end tool hub 980 are made different from each other. In this way, the two wires 307 and 308 wound around the blade auxiliary pulley 962 have a reliable height difference in the Z-axis direction, and it is possible to prevent the wires 307 and 308 that cross each other within the end tool hub 980 from contacting each other.

[0496] According to such a present invention, by preventing friction between the wire 307 and the wire 308 which are blade wires, an effect that the cutting operation operates more smoothly can be obtained.

[0497] <Second Embodiment - Guide Member and Blade Link Deformation> Hereinafter, the end tool 700 of the surgical instrument according to the second embodiment of the present invention will be described. Here, the end tool 700 of the surgical instrument according to the second embodiment of the present invention is characterized in that the configurations of the blade 771 and the blade link 773 are different from those of the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. Hereinafter, the changed configuration compared with the first embodiment will be described in detail.

[0498] FIG. 69 is a perspective view showing an end tool of an electrocautery surgical instrument according to the second embodiment of the present invention, and FIGS. 70, 71, and 72 are plan views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 69.

[0499] Referring to FIGS. 69 to 72, an end tool 700 can include a first jaw 701, a second jaw 702, a first electrode 751, a second electrode 752, a blade pulley 761, a blade link 773, a blade 771, and a number of related pulleys for performing cautery and cutting operations. Here, components such as the blade pulley 761, the blade 771, and the blade link 773 related to the driving of the blade can be collectively referred to as a blade assembly 770. In the second embodiment of the present invention, a blade assembly 770 including a blade 771 is disposed between a pulley 711 which is a first jaw pulley and a pulley 721 which is a second jaw pulley, so that it is possible to perform a cutting operation using the blade 771 together with the pitch operation and the yaw operation of the end tool 700. In this embodiment, the components for performing cautery and cutting operations are substantially the same as the components described in the first embodiment, and thus the detailed description thereof is omitted here.

[0500] A pulley 711 coupled to the first jaw 701, a pulley 721 coupled to the second jaw 702, and a blade pulley 761 connected to the blade 771 are axially coupled to a rotation shaft 741 and are formed to be rotatable about the rotation shaft 741.

[0501] The first jaw 701 can include a guide member 701a and a case (not shown).

[0502] The guide member 701a can be formed with a blade housing portion 701d and a first guide portion 701e. The guide member 701a is coupled to the pulley 711 and can be formed to guide the movement path of the blade 771 housed therein. As an example, the guide member 701a can be formed in two long rod-like shapes facing each other, and inside the guide member 701a, a blade housing portion 701d capable of housing at least a part of the blade 771 and the blade link 773 can be formed. The blade housing portion 701d can be formed long along the direction from the proximal portion to the distal portion of the first jaw 701. The entire blade 771 can be housed in the blade housing portion 701d, or at least a part of the blade 771 can protrude outside the blade housing portion 701d. In other words, it can be considered that the blade 771 moves along the blade housing portion 701d while cutting the tissue. This will be described in more detail later.

[0503] Also, the guide member 701a of the first jaw 701 can be formed with a first guide portion 701e for guiding the movement of the blade 771, which will be described later. For example, the first guide portion 701e can be formed in a groove shape formed along the movement path of the blade 771. Then, with the second guide portion 771c of the blade 771 formed in a protrusion shape fitted into the groove-shaped first guide portion 701e, the second guide portion 771c moves along the first guide portion 701e, so that the blade 771 moves relative to the first jaw 701.

[0504] The blade 771 can include a first link 771a, an edge portion 771b, a second guide portion 771c, a second link 771d, and a third link 771e.

[0505] The edge portion 771b is formed in a bar shape that extends long along the extending direction of the connection portion (refer to 400 in FIG. 3), the region facing the second jaw 702 is formed sharply, and it is formed so as to be able to cut tissue. At least a part of this edge portion 771b is drawn out to the outside of the first jaw 701, and the tissue disposed between the first jaw 701 and the second jaw 702 can be cut.

[0506] One end portion of the edge portion 771b can be axially coupled to the second link 771d, and the other end portion of the edge portion 771b can be axially coupled to the third link 771e. Further, the first link 771a is disposed substantially parallel to the edge portion 771b, and the second link 771d and the third link 771e can also be coupled to the first link 771a.

[0507] As a result, the first link 771a, the edge portion 771b, the second link 771d, and the third link 771e can form a four-bar link or a parallelogram. In other words, the four links are connected to each other to form a closed-loop, the portions where the links are connected form an axial coupling, and a four-bar link or a parallelogram can be formed as a whole. Therefore, when any one link moves, the other three links move together while maintaining the shape of a parallelogram as a whole.

[0508] On the other hand, a second guide portion 771c can be formed in a protruding shape in the vicinity of the position where the first link 771a and the second link 771d meet, and in the vicinity of the position where the first link 771a and the third link 771e meet. Then, with the second guide portion 771c fitted to the first guide portion 701e of the first jaw 701, when the second guide portion 771c moves along the first guide portion 701e, the blade 771 moves with respect to the first jaw 701. Also, a blade link 773 described later can be axially coupled to the second guide portion 771c.

[0509] The blade link 773 connects the blade pulley 761 and the blade 771, transmits the rotation of the blade pulley 761 to the blade 771, and serves to linearly move the blade 771 along the extending direction of the connection part (see 400 in FIG. 3), that is, the X-axis direction. The blade link 773 can be formed in the shape of a long bar. One end of the blade link 773 can be connected to the blade pulley 761, and the other end can be connected to the blade 771 (especially the first link 771a).

[0510] As an example, through holes are formed at both ends of the blade link 773, and these through holes can be respectively fitted to the protruding part (see 161a in FIG. 14) formed on one surface of the blade pulley 761 and the first link 771a of the blade 771. In other words, while one end of the blade link 773 is axially coupled to the blade pulley 761, the other end of the blade link 773 is axially coupled to the blade 771.

[0511] In this state, when the blade pulley 761 rotates around the rotation axis 741, the rotational movement of the blade pulley 761 is transmitted to the blade 771 by the blade link 773 coupled to the blade pulley 761. Then, the transmitted rotational movement of the blade pulley 761 is converted into a linear movement of the blade 771, and the blade 771 can be pulled out from the first joe 701 or drawn into the first joe 701 while linearly moving along the direction from the proximal part to the distal part of the first joe 701.

[0512] That is, the blade link 773 and the blade 771 are combined to form a kind of drive mechanism, and the rotational movement of the blade pulley 761 is converted into a linear movement of the blade 771.

[0513] Thus, the end tool 700 according to the second embodiment of the present invention is characterized in that it includes a blade pulley 761 disposed between a pulley 711 and a pulley 721, and a blade 771 connected to the blade pulley 761 and moving between a first position and a second position in response to the rotation of the blade pulley 761. And, four links include a parallelogram structure so that the blade 771 can move between the first position and the second position by the rotational movement of the blade pulley 761 in this way. By providing the blade pulley 761 and the blade 771 in this way, in a bipolar surgical instrument for cauterizing and cutting tissue, it is characterized in that pitch / yaw / actuation movement is enabled by a pulley / wire method.

[0514] FIG. 70 is a diagram showing a state in which the blade pulley 761 and the blade 771 are located at the first position (i.e., the proximal part of the first jaw), FIG. 72 is a diagram showing a state in which the blade pulley 761 and the blade 771 are located at the second position (i.e., the distal part of the first jaw), and FIG. 71 is a diagram showing a state in which the blade pulley 761 and the blade 771 are located at an arbitrary position between the first position and the second position.

[0515] First, FIG. 70 shows a state in which the blade 771 is located at the first position, that is, the proximal part of the first jaw 701. When the blade pulley 761 rotates in the direction of arrow A in FIG. 71 in the same state as FIG. 70, the blade link 773 coupled to the blade pulley 761 moves generally in the direction of arrow B and reaches the position in FIG. 71. Then, the blade 771 coupled to the blade link 773 moves a certain extent from the proximal part to the distal part of the first jaw 701.

[0516] That is, when the blade pulley 761 rotates in the direction of arrow A in FIG. 71 with the protruding second guide part 771c fitted into the groove-shaped first guide part 701e, the blade link 773 coupled to the blade pulley 761 moves the first link 771a of the blade 771 in the direction of arrow B.

[0517] At this time, since the blade 771 forms a parallelogram structure composed of four links, the second link 771d and the third link 771e connected to the first link 771a will rotate clockwise when viewed in the figure. Then, the edge portion 771b connected to the second link 771d and the third link 771e will be pulled out from the inside of the first jaw 701 to the outside and at the same time move in the direction of arrow C in FIG. 71.

[0518] In other words, the edge portion 771b of the blade 771 will perform a linear motion in the direction of the distal portion of the end tool 700 (i.e., movement in the X-axis direction), and at the same time, it will perform a linear motion in the direction of protruding a certain degree from the inside of the first jaw 701 to the outside (i.e., movement in the Y-axis direction). In this way, while the blade 771 performs movement in the X-axis direction and the Y-axis direction simultaneously, it will cut the tissue (not shown) between the first jaw 701 and the second jaw 702.

[0519] However, here the linear motion of the blade 771 does not mean only a complete straight line. Even if the middle part of the straight line is bent by a predetermined angle or there is a section with a gentle curvature in a certain section, and it is not a complete straight line, it should be understood that it means a motion that can cut the tissue while being a linear motion as a whole.

[0520] When the blade pulley 761 continues to rotate in the direction of arrow A in FIG. 72, the blade link 773 coupled to the blade pulley 761 moves the first link 771a of the blade 771 in the direction of arrow B in FIG. 72.

[0521] At this time, the second link 771d and the third link 771e connected to the first link 771a will rotate clockwise when viewed in the figure. Then, the edge portion 771b connected to the second link 771d and the third link 771e will be pulled back into the inside of the first jaw 701 and at the same time move in the direction of arrow C in FIG. 71, and reach the second position on the distal side of the first jaw 701.

[0522] In other words, the edge portion 771b of the blade 771 performs a linear motion (i.e., movement in the X-axis direction) in the distal direction of the end tool 700, and at the same time, performs a linear motion (i.e., movement in the Y-axis direction) in a direction of being received to a certain extent from the outside to the inside of the first jaw 701.

[0523] By providing the blade pulley 761 and the blade 771 in this way, one feature is that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation movement can perform cauterization and cutting.

[0524] In particular, in the present embodiment, since the blade 771 forms a parallelogram structure composed of four links, the blade 771 draws out from the first jaw 701 while drawing a predetermined arc, so that a smoother cutting operation can be obtained.

[0525] <Third Embodiment - Simple Rotating Blade> Hereinafter, the end tool 800 of the surgical instrument according to the third embodiment of the present invention will be described. Here, the end tool 800 of the surgical instrument according to the third embodiment of the present invention is different in the connection relationship between the blade pulley 861 and the blade 871 as compared with the end tool (see 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. Hereinafter, the configuration different from the first embodiment will be described in detail.

[0526] FIGS. 73 and 74 are perspective views showing an end tool of an electrocautery surgical instrument according to the third embodiment of the present invention.

[0527] Referring to FIGS. 73 and 74, the end tool 800 of the third embodiment of the present invention includes a pair of jaws for performing a grip operation, that is, a first jaw 801 and a second jaw 802.

[0528] On the one hand, the end tool 800 includes a plurality of pulleys related to the rotational movements of the first jo 801 and the second jo 802, such as a first jockey pulley (not shown) and a second jockey pulley 821. Further, the end tool 800 of the third embodiment of the present invention includes a plurality of rotating shafts related to the rotational movements of the first jo 801 and the second jo 802, such as a rotating shaft 541.

[0529] Furthermore, the end tool 800 can include a blade 871 for the cutting operation and a blade pulley 861 related to the linear / rotational movement of the blade 871, and a plurality of pulleys related thereto. Here, components such as the blade pulley 861 and the blade 871 related to the driving of the blade can be collectively referred to as a blade assembly 870. In the third embodiment of the present invention, a blade assembly 870 including a blade 871 is disposed between a pulley 811 that is a first jockey pulley and a pulley 821 that is a second jockey pulley, so that it is possible to execute a cutting operation using the blade 871 together with the pitch operation and the yaw operation of the end tool 800. Since the components for performing the cautery and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, detailed description thereof is omitted here.

[0530] Here, the end tool 800 of the surgical instrument according to the third embodiment of the present invention is characterized in that it does not include a separate blade link for connecting the blade pulley 861 and the blade 871, and the blade 871 is directly connected to the blade pulley 861. Therefore, when the blade pulley 861 rotates about the rotation axis 841, the blade 871 also rotates while cutting is performed.

[0531] Here, the blade pulley 861 and the blade 871 can be formed integrally (one-body), or can be formed of separate members and then joined to each other.

[0532] FIG. 73 is a diagram showing a state where the blade pulley 861 and the blade 871 are in the first position, and FIG. 74 is a diagram showing a state where the blade pulley 861 and the blade 871 are in the second position.

[0533] First, when the blade pulley 861 rotates in the direction of arrow A in FIG. 74 with the blade 871 in the first position as shown in FIG. 73, the blade 871 coupled to the blade pulley 861 also rotates. As shown in FIG. 74, the blade 871 is pulled out to the outside of the first jaw 801 and moves to the second position while cutting the tissue (not shown) between the first jaw 801 and the second jaw 802.

[0534] By providing the blade pulley 861 and the blade 871 in this way, it is a feature that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation movement can perform cauterization and cutting.

[0535] In particular, in the present embodiment, the blade pulley 861 and the blade 871 are directly connected without a separate connection structure, so that the number of parts can be reduced and the effect of facilitating manufacturing can be obtained.

[0536] <Fourth Embodiment - Triple Blade> Hereinafter, the end tool 1100 of the surgical instrument according to the fourth embodiment of the present invention will be described. Here, the end tool 1100 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that the configuration of the blade assembly 1170 is different from that of the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. The configuration that is different from the first embodiment will be described in detail later.

[0537] Figures 75 and 76 are perspective views showing the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention. Figure 75 shows a state where the jaw is closed, and Figure 76 shows a state where the jaw is open. Figure 77 is a perspective view showing the end tool of the electrocautery surgical instrument of Figure 75, showing a state where the blade is pulled out. Figures 78 and 79 are perspective views showing the end tool of the electrocautery surgical instrument of Figure 75. Figure 78 is a view mainly showing the electrode and the electric wire, and Figure 79 is a view mainly showing the blade assembly. Figures 80 and 81 are exploded perspective views showing the end tool of the electrocautery surgical instrument of Figure 75. Figure 82 is a side view showing the end tool of the electrocautery surgical instrument of Figure 75, and Figure 83 is a perspective view showing the end tool of the electrocautery surgical instrument of Figure 75, with a part of the second jaw cut open.

[0538] Referring to FIGS. 75 to 83, the end tool 1100 of the fourth embodiment of the present invention includes a pair of jaws for performing a grip operation, namely a first jaw 1101 and a second jaw 1102. Here, each of the first jaw 1101 and the second jaw 1102, or a component including the first jaw 1101 and the second jaw 1102 can be referred to as a jaw 1103.

[0539] On the other hand, the end tool 1100 includes a plurality of pulleys including a pulley 1111 which is a first jaw pulley coupled to the first jaw 1101. In this embodiment, since the pulleys related to the rotational movement of the first jaw 1101 are substantially the same as the pulleys 112, 113, 114, 115, and 116 described in FIG. 11 etc. of the first embodiment, the detailed description thereof is omitted here.

[0540] On one hand, the end tool 1100 includes a plurality of pulleys including a pulley 1121 which is a second jaw pulley coupled to a second jaw 1102. In this embodiment, the pulleys related to the rotational movement of the second jaw 1102 are substantially the same as the pulleys 122, 123, 124, 125 and 126 described in FIG. 11 etc. of the first embodiment, and thus the detailed description thereof is omitted here.

[0541] Also, the end tool 1100 of the fourth embodiment of the present invention can include a rotation shaft 1141, a rotation shaft 1142, a rotation shaft 1143 and a rotation shaft 1144. Here, the rotation shaft 1141 and the rotation shaft 1142 can be inserted through the end tool hub 1180, and the rotation shaft 1143 and the rotation shaft 1144 can be inserted through the pitch hub 1107. The rotation shaft 1141, the rotation shaft 1142, the rotation shaft 1143 and the rotation shaft 1144 can be sequentially arranged in the direction from the distal end 1104 to the proximal end 1105 of the end tool 1100.

[0542] Also, the end tool 1100 of the fourth embodiment of the present invention can include an end tool hub 1180 and a pitch hub 1107.

[0543] The rotation shaft 1141 and the rotation shaft 1142 described later are inserted through the end tool hub 1180, and at least a part of the pulley 1111 and the pulley 1121 axially coupled to the rotation shaft 1141 and the first jaw 1101 and the second jaw 1102 coupled thereto can be accommodated inside the end tool hub 1180.

[0544] On one hand, at one end of the end tool hub 1180, a pulley 1131 that serves as an end tool pitch pulley can be formed. As shown in FIG. 75, the pulley 1131 can be formed as a member separate from the end tool hub 1180 and can be coupled to the end tool hub 1180. Alternatively, the pulley 1131 can be formed integrally (one-body) with the end tool hub 1180. Then, a wire (see 303 in FIG. 13) and a wire (see 304 in FIG. 13) are coupled to the pulley 1131 that serves as an end tool pitch pulley, and this pulley 1131 performs a pitch operation while rotating about the rotation axis 1143.

[0545] The rotation axis 1143 and the rotation axis 1144 penetrate and are inserted into the pitch hub 1107, and the pitch hub 1107 can be axially coupled to the end tool hub 1180 and the pulley 1131 by the rotation axis 1143. Therefore, the end tool hub 1180 and the pulley 1131 can be formed to be pitch-rotatable with respect to the pitch hub 1107 about the rotation axis 1143.

[0546] On the one hand, the end tool 1100 of the fourth embodiment of the present invention can further include components such as a first electrode 1151, a second electrode 1152, a blade pulley 1161, a blade link 1175, a first blade 1171, a second blade 1172, and a third blade 1173 for performing cautery and cutting operations. Here, components related to the driving of the blade, such as the blade pulley 1161, the first blade 1171, the second blade 1172, the third blade 1173, and the blade link 1175, can be collectively referred to as the blade assembly 1170. The fourth embodiment of the present invention is characterized in that a blade assembly 1170 including a plurality of blades is disposed between a pulley 1111 which is a first joe pulley and a pulley 1121 which is a second joe pulley, enabling the execution of not only the pitch operation and yaw operation of the end tool 1100 but also the cutting operation using the blade. Since the components for performing cautery and cutting operations in this embodiment are substantially the same as those described in the first embodiment, detailed description thereof is omitted here.

[0547] The electrosurgical instrument according to the fourth embodiment of the present invention can include wires 301, 302, 303, 304, 305, 306, 307, and 308, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0548] In addition, the electrosurgical instrument according to the fourth embodiment of the present invention can include fastening members 321, 323, 324, 326, 327, and 329 coupled to each end of each wire for coupling the wire and the pulley, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0549] Hereinafter, the blade assembly 1170 of the electrosurgical instrument 1100 according to the fourth embodiment of the present invention will be described in more detail.

[0550] The first jaw 1101 can include a guide member 1101a and a case (not shown).

[0551] A blade accommodating portion 1101d and a first guide portion 1101e can be formed in the guide member 1101a. The guide member 1101a is connected to a pulley 1111 and can be formed to guide the movement paths of the first blade 1171, the second blade 1172, and the third blade 1173. As an example, the guide member 1101a can be formed in two long rod shapes facing each other, and inside the guide member 1101a, a blade accommodating portion 1101d capable of accommodating at least a part of the first blade 1171, the second blade 1172, the third blade 1173, and the blade link 1175 described later can be formed. The blade accommodating portion 1101d can be formed long along the direction from the proximal portion 1101f to the distal portion 1101g of the first jaw 1101. The entire first blade 1171, the second blade 1172, and the third blade 1173 can be accommodated in the blade accommodating portion 1101d, and at least a part of the first blade 1171, the second blade 1172, and the third blade 1173 can also protrude outside the blade accommodating portion 1101d. In other words, it can also be considered that the first blade 1171, the second blade 1172, and the third blade 1173 move along the blade accommodating portion 1101d while cutting the tissue. This will be described in more detail later.

[0552] Further, a first guide portion 1101e for guiding the movement of the third blade 1173 can be formed on the guide member 1101a of the first jaw 1101. Here, the first guide portion 1101e can be formed on both inner sidewalls of the guide member 1101a that form the blade accommodation portion 1101d. Here, the first guide portion 1101e can be formed in a groove shape along the movement path of the third blade 1173. Then, with the link coupling portion 1173c of the third blade 1173 formed in a protrusion shape fitted into the groove-shaped first guide portion 1101e, the link coupling portion 1173c moves along the first guide portion 1101e, so that the third blade 1173 moves relative to the first jaw 1101.

[0553] Note that in the figure, the first guide portion 1101e is shown as being integrally formed with the guide member 1101a as a component of the first jaw 1101. However, the idea of the present invention is not limited to this, and it can be said that the first guide portion 1101e can also be formed as a separate member from the guide member 1101a and coupled to the guide member 1101a.

[0554] On the other hand, a first electrode 1151 can be formed on the surface of the first jaw 1101 that faces the second jaw 1102. And a second electrode 1152 can be formed on the surface of the second jaw 1102 that faces the first jaw 1101.

[0555] At this time, a slit 1151a can be formed in the first electrode 1151, and at least a part of the first blade 1171, the second blade 1172, and the third blade 1173 can protrude outside the first jaw 1101 and the first electrode 1151 through this slit 1151a.

[0556] Further, a slit 1152a can be formed in the second electrode 1152. At least a part of the first blade 1171, the second blade 1172, and the third blade 1173 that protrude outside the first jaw 1101 can pass through this slit 1152a and be accommodated in the second jaw 1102.

[0557] The first blade 1171 can include a main body portion 1171a, an edge portion 1171b, and one or more link coupling portions 1171c.

[0558] An edge portion 1171b that is sharply formed to cut tissue is formed in a region of the main body portion 1171a. At least a part of this edge portion 1171b is drawn out outside the first jaw 1101, and the tissue disposed between the first jaw 1101 and the second jaw 1102 can be cut.

[0559] On the other hand, one or more link coupling portions 1171c can be formed in another region of the main body portion 1171a. For example, the link coupling portion 1171c is formed in a through-hole shape, and the protruding first blade coupling portion 1175b can be fitted therein.

[0560] The second blade 1172 can include a main body portion 1172a, an edge portion 1172b, one or more link coupling portions 1172c, and a jaw coupling portion 1172d.

[0561] An edge portion 1172b that is sharply formed to cut tissue is formed in a region of the main body portion 1172a. At least a part of this edge portion 1172b is drawn out outside the first jaw 1101, and the tissue disposed between the first jaw 1101 and the second jaw 1102 can be cut.

[0562] On the other hand, one or more link coupling portions 1172c can be formed in other regions of the main body portion 1172a. For example, the link coupling portion 1172c is formed in a long slit shape, and the second blade coupling portion 1175c having a protruding portion shape can be fitted therein.

[0563] On the other hand, a joe coupling portion 1172d can be formed in other regions of the main body portion 1172a. For example, the joe coupling portion 1172d is formed in a shaft shape and can be inserted through the second blade coupling portion 1101c formed in a through-hole shape in the guide member 1101a of the first joe 1101.

[0564] The third blade 1173 can include a main body portion 1173a, an edge portion 1173b, and one or more link coupling portions 1173c.

[0565] An edge portion 1173b that is sharply formed to cut tissue is formed in one region of the main body portion 1173a. At least a part of this edge portion 1173b is drawn out to the outside of the first joe 1101, and the tissue disposed between the first joe 1101 and the second joe 1102 can be cut.

[0566] On the other hand, one or more link coupling portions 1173c can be formed in other regions of the main body portion 1173a. For example, the link coupling portion 1173c is formed in a shaft shape and can be fitted into the first guide portion 1101e of the first joe 1101. Here, the link coupling portion 1173c of the third blade 1173 of the present embodiment is a component corresponding to the second guide portion (see 171c in FIG. 7) of the first embodiment of the present invention, and can perform substantially the same role as the second guide portion (see 171c in FIGS. 1 and 7).

[0567] The blade link 1175 connects the blade pulley 1161 to the first blade 1171, the second blade 1172, and the third blade 1173, and transmits the rotation of the blade pulley 1161 to the first blade 1171, the second blade 1172, and the third blade 1173 so that the first blade 1171, the second blade 1172, and the third blade 1173 move along the direction from the proximal part 1101f to the distal part 1101g of the first joe 1101. The blade link 1175 can be formed in the shape of a long bar, and one end of the blade link 1175 can be connected to the blade pulley 1161, and the other area can be connected to the first blade 1171, the second blade 1172, and the third blade 1173 respectively. To explain this in more detail, it is as follows.

[0568] While moving from the proximal part 1101f side to the distal part 1101g side by the blade link 1175, the pulley coupling part 1175a, the first blade coupling part 1175b, the second blade coupling part 1175c, and the third blade coupling part 1175d can be sequentially formed.

[0569] Specifically, a through-hole-shaped blade pulley coupling part 1175a can be formed at the proximal part 1101f side end of the blade link 1175. And the protrusion 1161a formed on one surface of the blade pulley 1161 can be fitted into the blade pulley coupling part 1175a. In other words, one end of the blade link 1175 and the blade pulley 1161 will be axially coupled.

[0570] The first blade coupling part 1175b of the blade link 1175 can include a plurality of protrusions. On the other hand, the link coupling part 1171c of the first blade 171 can include a plurality of through-holes. Here, each protrusion and each through-hole that are coupled to each other are formed so that their diameters are substantially the same. And the plurality of protrusions of the first blade coupling part 1175b and the plurality of through-holes of the link coupling part 1171c will be coupled to each other.

[0571] With such a configuration, the relative position of the first blade 1171 with respect to the blade link 1175 is fixed. Therefore, the blade link 1175 and the first blade 1171 will move integrally with each other. In other words, when the blade link 1175 moves linearly, the first blade 1171 will also move linearly accordingly.

[0572] The figure shows that the first blade coupling portion 1175b includes a plurality of protrusions, and the link coupling portion 1171c includes a plurality of through holes. However, the idea of the present invention is not limited to this, and the formation positions of the protrusions and the through holes may be reversed with respect to each other.

[0573] The second blade coupling portion 1175c of the blade link 1175 includes a protrusion. And the link coupling portion 1172c of the second blade 1172 is formed in a long slit shape. And the protrusion of the second blade coupling portion 1175c will be fitted into the slit of the link coupling portion 1172c.

[0574] On the other hand, the joe coupling portion 1172d of the second blade 1172 includes a protrusion. And a hole-shaped second blade coupling portion 1101c is formed in the guide member 1101a of the first joe 1101. And the joe coupling portion 1172d of the second blade 1172 is inserted through the second blade coupling portion 1101c of the guide member 1101a, and the second blade 1172 is formed to be rotatable with respect to the guide member 1101a about the joe coupling portion 1172d.

[0575] Therefore, when the blade link 1175 moves linearly, the second blade coupling portion 1175c of the blade link 1175 pushes or pulls the link coupling portion 1172c of the second blade 1172. And at this time, since the joe coupling portion 1172d of the second blade 1172 is axially coupled to the guide member 1101a, the second blade 1172 will rotate with respect to the guide member 1101a.

[0576] The figure shows that the second blade coupling part 1175c includes a protrusion and the link coupling part 1171c includes a slit, but the idea of the present invention is not limited thereto, and the positions of the protrusion and the slit may be reversed.

[0577] Also, the figure shows that the joe coupling part 1172d of the second blade 1172 is formed axially and the guide member 1101a is formed with a through-hole-shaped second blade coupling part 1101c, but the idea of the present invention is not limited thereto, and the formation positions of the shaft and the through-hole may be reversed.

[0578] The third blade coupling part 1175d of the blade link 1175 can include one or more through-holes and one or more slits. And the link coupling part 1173c of the third blade 1173 can include a plurality of protrusions. And the plurality of protrusions of the link coupling part 1173c are respectively fitted into the through-holes and slits of the third blade coupling part 1175d.

[0579] At this time, the link coupling part 1173c of the third blade 1173 penetrates the third blade coupling part 1175d of the blade link 1175 and then is fitted into the first guide part 1101e of the first joe 1101.

[0580] Therefore, when the blade link 1175 moves linearly, the third blade coupling part 1175d of the blade link 1175 pushes or pulls the link coupling part 1173c of the third blade 1173, and thus the third blade 1173 moves along the first guide part 1101e of the first joe 1101. At this time, the movement locus of the third blade 1173 can be determined according to the shape of the first guide part 1101e.

[0581] The figure shows that the link coupling portion 1173c of the third blade 1173 is formed in an axial shape and the first guide portion 1101e of the guide member 1101a is formed in a long groove shape. However, the idea of the present invention is not limited to this, and the formation positions of the shaft and the groove may be reversed.

[0582] When the blade pulley 1161 rotates about the rotation axis 1141 in this state, the rotational movement of the blade pulley 1161 is transmitted to the first blade 1171, the second blade 1172, and the third blade 1173 by the blade link 1175 coupled to the blade pulley 1161. Then, due to the transmitted rotational movement of the blade pulley 1161, the positions of the first blade 1171, the second blade 1172, and the third blade 1173 change, and the first blade 1171, the second blade 1172, and the third blade 1173 are pulled out from the first jaw 1101 or drawn into the first jaw 1101 while moving along the direction from the proximal portion 1101f to the distal portion 1101g of the first jaw 1101.

[0583] That is, the blade link 1175, the first guide portion 1101e of the first jaw 1101, and each blade are combined to form a kind of power transmission mechanism. When the blade pulley 1161 rotates, the first blade 1171, the second blade 1172, and the third blade 1173 connected thereto move between the distal portion 1101g and the proximal portion 1101f of the jaw 1101.

[0584] Hereinafter, the operations of each blade will be described in more detail.

[0585] Figures 84, 85, and 86 are side views showing the cutting operation of the end tool of the electrosurgical instrument in Figure 75, which is a view of the state where the jaw is closed. Figure 87 is a side view showing the cutting operation of the end tool of the electrosurgical instrument in Figure 75, which is a view showing the movement trajectories of the respective blades.

[0586] First, when the blade pulley 1161 rotates sequentially in the directions of arrow R1 in FIG. 85 and arrow R2 in FIG. 86 in the state of FIG. 84, the blade link 1175 coupled to the blade pulley 1161 moves in the directions of arrow D1 in FIG. 85 and arrow D2 in FIG. 86, and will sequentially reach the positions in FIGS. 85 and 86.

[0587] Then, the first blade 1171 coupled to the blade link 1175 moves in the directions of arrow A1 in FIG. 85 and arrow A2 in FIG. 86, and will sequentially reach the positions in FIGS. 85 and 86. At this time, since the blade link 1175 and the first blade 1171 form a kind of two-point connection, the blade link 1175 and the first blade 1171 will move integrally with each other. In other words, when the blade link 1175 moves linearly (or moves nearly linearly), the first blade 1171 will also move linearly (or move nearly linearly) accordingly.

[0588] On the other hand, the second blade 1172 coupled to the blade link 1175 moves in the directions of arrow B1 in FIG. 85 and arrow B2 in FIG. 86, and will sequentially reach the positions in FIGS. 85 and 86. At this time, since the joiner coupling portion 1172d of the second blade 1172 is axially coupled to the guide member 1101a of the first joiner 1101, the second blade 1172 will rotate relative to the guide member 1101a.

[0589] On the other hand, the third blade 1173 coupled to the blade link 1175 moves in the directions of arrow C1 in FIG. 85 and arrow C2 in FIG. 86, and will sequentially reach the positions in FIGS. 85 and 86.

[0590] At this time, with the protruding link coupling portion 1173c fitted into the groove-shaped first guide portion 1101e, the blade link 1175 will push the third blade 1173, and thereby the third blade 1173 will move as a whole along the first guide portion 1101e.

[0591] At this time, since the groove-shaped first guide portion 1101e is formed to be inclined to a certain extent in a certain section, the blade 1171 performs a linear motion (i.e., movement in the X-axis direction) in the direction of the distal portion 1104 of the end tool 1100, and at the same time, performs a linear motion (i.e., movement in the Y-axis direction) in a direction protruding from the inside to the outside of the first jaw 1101 to a certain extent. In this way, while the blade 1171 simultaneously moves in the X-axis direction and the Y-axis direction, it cuts the tissue (not shown) between the first jaw 1101 and the second jaw 1102.

[0592] However, here, the linear motion of the third blade 1173 does not mean only a complete straight line. Even if the middle part of the straight line is bent by a predetermined angle or there is a section with a gentle curvature in a certain section, and it is not a complete straight line, it should be understood that it means a motion that can cut the tissue while being a linear motion as a whole.

[0593] In other words, the first blade 1171 is two-point connected to the blade link 1175, and when the blade link 1175 moves linearly, the first blade 1171 moves linearly with the blade link 1175. One end of the second blade 1172 is pivotally connected to the first jaw 1101, and when the blade link 1175 moves linearly, the second blade 1172 rotates accordingly. The third blade 1173 is fitted to the blade link 1175 and the guide member 1101a of the first jaw 1101, and when the blade link 1175 moves linearly, it moves along the first guide portion 1101e of the guide member 1101a of the first jaw 1101.

[0594] In other words, the first blade 1171 performs a motion close to a linear motion (although it is not a complete linear motion). The second blade 1172 forms an arc while rotating around the rotation axis. The third blade 1173 moves along the slit-shaped first guide portion 1101e formed in the first jaw 1101, and the path is determined according to the shape of the first guide portion 1101e. That is, by adjusting the shape of the first guide portion 1101e, the path of the third blade 1173 can be controlled.

[0595] In other words, three blades 1171, 1172, and 1173 are connected to the blade link 1175. When the blade pulley 1161 rotates, the three blades 1171, 1172, and 1173 connected thereto move together. Specifically, when the blade pulley 1161 rotates, the three blades 1171, 1172, and 1173 move while cutting tissue between the proximal portion 1101f and the distal portion 1101g of the end tool.

[0596] At this time, the first blade 1171 formed on the innermost side, that is, on the proximal portion 1101f side of the end tool 1100, moves while performing a motion close to linear motion. At this time, at least a part of the first blade 1171 is exposed outside the first jaw 1101 in all operating states.

[0597] The second blade 1172 formed in the center moves while drawing a locus close to a semi-circle. At this time, at the starting point (first position) and the ending point (second position) of the operation, at least a part of the second blade 1172 is accommodated in the first jaw 1101, and the second blade 1172 is exposed outside the first jaw 1101 only during the movement from the first position to the second position.

[0598] The third blade 1173 formed on the outermost side, that is, on the distal portion 1101g side of the end tool 1100, moves while drawing a locus close to an arc from the starting point (first position) to a predetermined intermediate position (third position), and moves while performing a motion close to a straight line after the predetermined position (third position). At this time, at the starting point (first position) of the operation, the third blade 1173 is accommodated in the first jaw 1101, and at least a part of the third blade 1173 is exposed outside the first jaw 1101 when moving to the ending point thereafter.

[0599] One feature of this embodiment is to provide a plurality of blades having different trajectories from each other, and to perform cutting two or more times so that a part of the movement range of each blade overlaps, thereby more surely cutting the tissue.

[0600] Referring to FIG. 87, there is an overlapping region R12 between the movement range R1 of the first blade 1171 and the movement range R2 of the second blade 1172. Cutting is performed while the blade passes through this region at least twice, and a more reliable cutting effect can be obtained.

[0601] Similarly, there is an overlapping region R23 between the movement range R2 of the second blade 1172 and the movement range R3 of the third blade 1173. Cutting is performed while the blade passes through this region at least twice, and a more reliable cutting effect can be obtained.

[0602] Thus, one feature of the present invention is that by providing a blade pulley 1161 and a plurality of blades 1171, 1172, 1173, it enables cauterization and cutting with a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation movement.

[0603] In particular, in this embodiment, by providing a plurality of blades having different trajectories from each other, and performing cutting two or more times so that a part of the movement range of each blade overlaps, the effect of more surely cutting the tissue can be obtained.

[0604] On the other hand, FIG. 88 is a diagram showing a state where the jaw is yaw-rotated by +90°, and FIGS. 89, 90, and 91 are plan views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 75, and show the process of performing the cutting operation in a state where the jaw is yaw-rotated by +90°. As shown in FIGS. 89 to 91, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that it can normally perform a cutting operation even when the jaw is yaw-rotated by +90°.

[0605] Figures 92, 93, and 94 are plan views showing the cutting operation of the end tool of the electrocautery surgery instrument of FIG. 75, and are diagrams showing the process of performing the cutting operation with the jaw rotated -90° in yaw. As shown in FIGS. 92 to 94, the end tool of the electrocautery surgery instrument according to the fourth embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated -90° in yaw.

[0606] On the other hand, FIG. 95 is a diagram showing a state in which the jaw is rotated -90° in pitch. Also, FIGS. 96, 97, and 98 are perspective views showing the cutting operation of the end tool of the electrocautery surgery instrument of FIG. 75, and are diagrams showing how the cutting operation is performed with the jaw rotated -90° in pitch. As shown in FIGS. 96 to 98, the end tool of the electrocautery surgery instrument according to the fourth embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated -90° in pitch.

[0607] Also, FIGS. 99, 100, and 101 are perspective views showing the cutting operation of the end tool of the electrocautery surgery instrument of FIG. 75, and are diagrams showing how the cutting operation is performed with the jaw rotated +90° in pitch. As shown in FIGS. 99 to 100, the end tool of the electrocautery surgery instrument according to the fourth embodiment of the present invention is formed so as to be able to perform a normal cutting operation even when the jaw is rotated +90° in pitch.

[0608] On the one hand, FIG. 102 shows a state in which the jaw has pitched -90° and simultaneously yawed +90°. FIGS. 103, 104, and 105 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 75, and show the state in which the jaw pitches -90° and simultaneously yaws +90° and performs the cutting operation. As shown in FIGS. 103 to 105, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that it can normally perform the cutting operation even when the jaw pitches -90° and simultaneously yaws +90°.

[0609] FIGS. 106, 107, and 108 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 75, and show the state in which the jaw pitches -90° and simultaneously yaws -90° and performs the cutting operation. As shown in FIGS. 106 to 108, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that it can normally perform the cutting operation even when the jaw pitches -90° and simultaneously yaws -90°.

[0610] <Fifth Embodiment - Blade Link Assembly> Hereinafter, the end tool 1200 of the surgical instrument according to the fifth embodiment of the present invention will be described. Here, the end tool 1200 of the surgical instrument according to the fifth embodiment of the present invention is characterized in that the configuration of the blade assembly 1270 is different from that of the end tool (refer to 100 in FIGS. 2 and the like) of the surgical instrument according to the first embodiment of the present invention described above. The configuration that is different from the first embodiment in this way will be described in detail later.

[0611] Figures 109 to 112 are perspective views showing the end tool of the electrocautery surgical instrument according to the fifth embodiment of the present invention. Figure 109 shows a state where the jaw is closed, and Figure 110 shows a state where the jaw is open. Figure 111 is an enlarged perspective view showing the end tool of the electrocautery surgical instrument of Figure 110, and Figure 112 is a cutaway perspective view of Figure 111. Figure 113 is an exploded perspective view showing the end tool of the electrocautery surgical instrument of Figure 110. Figures 114, 115, and 116 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of Figure 109. Figure 117 is a perspective view showing the yaw operation of the electrocautery surgical instrument of Figure 109, Figure 118 is a perspective view showing the pitch operation of the electrocautery surgical instrument of Figure 109, and Figure 119 is a plan view showing a state where the end tool of the electrocautery surgical instrument of Figure 109 has pitch rotation and yaw rotation.

[0612] Referring to FIGS. 109 to 113, the end tool 1200 of the fifth embodiment of the present invention includes a pair of jaws, i.e., a first jaw 1201 and a second jaw 1202, for performing a grip operation. Here, each of the first jaw 1201 and the second jaw 1202, or a component including the first jaw 1201 and the second jaw 1202 can be referred to as a jaw 1203.

[0613] On the other hand, the end tool 1200 includes a plurality of pulleys including a pulley 1211 which is a first jaw pulley coupled to the first jaw 1201. In this embodiment, since the pulleys related to the rotational movement of the first jaw 1201 are substantially the same as the pulleys 112, 113, 114, 115, and 116 described in FIG. 11 and the like of the first embodiment, the detailed description thereof is omitted here.

[0614] On the one hand, the end tool 1200 includes a plurality of pulleys including pulley 1221 which is a second jaw pulley coupled to the second jaw 1202. In this embodiment, the pulleys related to the rotational movement of the second jaw 1202 are substantially the same as the pulleys 122, 123, 124, 125, and 126 described in FIG. 11 etc. of the first embodiment, and thus the detailed description thereof is omitted here.

[0615] Also, the end tool 1200 of the fifth embodiment of the present invention can include a rotation shaft 1241, a rotation shaft 1242, a rotation shaft 1243, and a rotation shaft 1244. Here, the rotation shaft 1241 and the rotation shaft 1242 can be inserted through the end tool hub 1280, and the rotation shaft 1243 and the rotation shaft 1244 can be inserted through the pitch hub 1207. The rotation shaft 1241, the rotation shaft 1242, the rotation shaft 1243, and the rotation shaft 1244 can be sequentially arranged in the direction from the distal end 1204 to the proximal end 1205 of the end tool 1200.

[0616] Also, the end tool 1200 of the fifth embodiment of the present invention can include an end tool hub 1280 and a pitch hub 1207.

[0617] The rotation shaft 1241 and the rotation shaft 1242, which will be described later, are inserted through the end tool hub 1280, and at least a part of the pulley 1211 and the pulley 1221 axially coupled to the rotation shaft 1241 and the first jaw 1201 and the second jaw 1202 coupled thereto can be accommodated inside the end tool hub 1280.

[0618] On one side, at one end of the end tool hub 1280, a pulley 1231 that serves as an end tool pitch pulley can be formed. As shown in FIG. 109, the pulley 1231 can be formed as a member separate from the end tool hub 1280 and can be coupled to the end tool hub 1280. Alternatively, the pulley 1231 can be formed integrally (one-body) with the end tool hub 1280. Then, a wire (see 303 in FIG. 13) and a wire (see 304 in FIG. 13) are coupled to the pulley 1231 that serves as an end tool pitch pulley, and this pulley 1231 performs a pitch operation while rotating about the rotation axis 1243.

[0619] The rotation axes 1243 and 1244 penetrate and are inserted into the pitch hub 1207, and the pitch hub 1207 can be axially coupled to the end tool hub 1280 and the pulley 1231 by the rotation axis 1243. Therefore, the end tool hub 1280 and the pulley 1231 can be formed to be pitch-rotatable with respect to the pitch hub 1207 about the rotation axis 1243.

[0620] On one side, the end tool 1200 of the fifth embodiment of the present invention can further include components such as a first electrode 1251, a second electrode 1252, a blade pulley 1261, a blade 1271, a first blade link 1273, a second blade link 1274, and a third blade link 1275 in order to perform cautery and cutting operations.

[0621] Here, components such as the blade pulley 1261, the blade 1271, the first blade link 1273, the second blade link 1174, and the third blade link 1275 related to the drive of the blade can be included and referred to as a blade assembly 1270. Also, components such as the first blade link 1273, the second blade link 1274, and the third blade link 1275 can be included and referred to as a blade link assembly 1272.

[0622] In the fifth embodiment of the present invention, a blade assembly 1270 including a plurality of blade links is disposed between a pulley 1211 which is a first jog pulley and a pulley 1221 which is a second jog pulley, so that it is possible to execute a cutting operation using a blade together with a pitch operation and a yaw operation of the end tool 1200. Components for performing cautery and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, and thus detailed description thereof is omitted here.

[0623] The electrocautery surgical instrument according to the fifth embodiment of the present invention can include wires 301, 302, 303, 304, 305, 306, 307, and 308, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0624] Also, the electrocautery surgical instrument according to the fifth embodiment of the present invention can include fastening members 321, 323, 324, 326, 327, and 329 coupled to each end of each wire for coupling the wire and the pulley, similar to the first embodiment of the present invention shown in FIG. 13 and the like.

[0625] Hereinafter, the blade assembly 1270 of the electrocautery surgical instrument 1200 according to the fifth embodiment of the present invention will be described in more detail.

[0626] The first jog 1201 can include a guide member 1201a and a case (not shown).

[0627] The guide member 1201a can be formed with a blade accommodation portion 1201d and a first guide portion 1201e. The guide member 1201a is coupled to the pulley 1211 and can be formed to guide the movement path of the blade 1271. As an example, the guide member 1201a can be formed in two long rod shapes facing each other, and inside the guide member 1201a, a blade accommodation portion 1201d capable of accommodating at least a part of the blade 1271 and the blade link 1275 described later can be formed. The blade accommodation portion 1201d can be formed long along the direction from the proximal portion 1201f to the distal portion 1201g of the first joe 1201. The entire blade 1271 can be accommodated within this blade accommodation portion 1201d, or at least a part of the blade 1271 can also protrude outside the blade accommodation portion 1201d. In other words, it can also be considered that the blade 1271 moves along the blade accommodation portion 1201d while cutting the tissue. This will be described in more detail later.

[0628] Also, on the guide member 1201a of the first joe 1201, a first guide portion 1201e for guiding the movement of the blade 1271 can be formed. Here, the first guide portion 1201e can be formed on both inner sidewalls of the guide member 1201a that forms the blade accommodation portion 1201d. Here, the first guide portion 1201e can be formed in a groove shape along the movement path of the blade 1271. Then, with the second guide portion 1271c of the blade 1271 formed in a protrusion shape fitted into the groove-shaped first guide portion 1201e, as the second guide portion 1271c moves along the first guide portion 1201e, the blade 1271 will move relative to the first joe 1201.

[0629] Here, the first guide portion 1201e can be formed along a direction substantially the same as the direction from the proximal portion 1201f to the distal portion 1201g of the first jaw 1201, that is, along the X-axis direction. Therefore, the blade 1271 moving along the first guide portion 1201e can perform a linear motion along the X-axis direction. That is, the rotational motion of the blade pulley 1261 is converted into a linear motion of the blade 1271 in the X-axis direction by the blade link assembly 1272. This will be described in more detail later.

[0630] Note that in the figure, the first guide portion 1201e is shown as being integrally formed with the guide member 1201a as a component of the first jaw 1201. However, the idea of the present invention is not limited to this, and it can be said that the first guide portion 1201e can also be formed of a member different from the guide member 1201a and coupled to the guide member 1201a.

[0631] On the other hand, the first electrode 1251 can be formed on the surface of the first jaw 1201 facing the second jaw 1202. And the second electrode 1252 can be formed on the surface of the second jaw 1202 facing the first jaw 1201.

[0632] Here, a part of the blade 1271 can be accommodated in the first jaw 1201, and the remaining part of the blade 1271 can be accommodated in the second jaw 1202. Specifically, the electrosurgical instrument 1200 according to the fifth embodiment of the present invention is different from the previous embodiments in that, in the entire process of the cutting operation, a part of the blade 1271 can be accommodated in the first jaw 1201, and the remaining part of the blade 1271 can be accommodated in the second jaw 1202. That is, in this embodiment, rather than saying that the blade 1271 moves from the first jaw 1201 in the direction of the second jaw, it can be expressed that the blade 1271 linearly moves between the proximal portion 1201f and the distal portion 1201g of the first jaw 1201. This will be described in more detail later.

[0633] The blade 1271 can include a main body portion 1271a, an edge portion 1271b, and one or more second guide portions 1271c.

[0634] In one region of the main body portion 1271a, an edge portion 1271b that is sharply formed to cut tissue is formed. At least a part of this edge portion 1271b can cut the tissue disposed between the first jaw 1201 and the second jaw 1202 while moving between the proximal portion 1201f and the distal portion 1201g of the first jaw 1201.

[0635] On the other hand, one or more second guide portions 1271c can be formed in another region of the main body portion 1271a. For example, the second guide portion 1271c can include a plurality of protrusions. A through hole formed in the third blade link 1275 can be fitted into one of these protrusions. Also, the plurality of protrusions of the second guide portion 1271c can be fitted into the first guide portion 1201e of the first jaw 1201.

[0636] Also, a guide cap 1271d can be further coupled to the plurality of protrusions of the second guide portion 1271c so that the second guide portion 1271c can perform a more stable linear motion within the first guide portion 1201e.

[0637] The blade link assembly 1272 includes a plurality of blade links, connects the blade pulley 1261 and the blade 1271, and serves to transmit the rotation of the blade pulley 1261 to the blade 1271 so that the blade 1271 moves along the direction from the proximal portion 1201f to the distal portion 1201g of the first jaw 1201.

[0638] Here, the blade link assembly 1272 can include a first blade link 1273, a second blade link 1274, and a third blade link 1275.

[0639] One end of the first blade link 1273 is axially coupled to the protruding portion 1261a of the blade pulley 1261, and the other end is axially coupled to the link coupling portion 1274a of the second blade link 1274 by a rotating shaft 1281.

[0640] One end of the second blade link 1274 is axially coupled to the first jaw 1201 by a rotating shaft 1282, and the other end is axially coupled to the third blade link 1275 by a rotating shaft 1283. And a link coupling portion 1274a is formed in a region between both ends of the second blade link 1274, and the link coupling portion 1274a is axially coupled to the first blade link 1273 by a rotating shaft 1281.

[0641] Here, assuming that the relative position of the first jaw 1201 is fixed, the second blade link 1274 can be regarded as rotating about the rotating shaft 1282 which is the coupling portion with the first jaw 1201.

[0642] One end of the third blade link 1275 is axially coupled to the second blade link 1274, and the other end is axially coupled to the blade 1271, more specifically, any one of a plurality of protruding portions of the second guide portion 1271c of the blade 1271.

[0643] Here, through holes are respectively formed in both ends of the first blade link 1273, the second blade link 1274, the third blade link 1275 and the link coupling portion 1274a of the second blade link 1274, and it is shown that a separate shaft is inserted through these through holes, but the idea of the present invention is not limited to this. That is, it can be said that various coupling structures are possible, such as a protruding portion being formed on one component, a through hole being formed on the other component corresponding to this, and the two components being fastened to each other.

[0644] FIGS. 114, 115 and 116 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of FIG. 109.

[0645] In the same state as FIG. 114, when the blade pulley 1261 rotates in the direction of arrow R1 in FIG. 115, the first blade link 1273 axially coupled to the blade pulley 1261 also rotates in the direction of arrow F1 about the protrusion 1261a while rotating together with the blade pulley 1261. Then, the first blade link 1273 will push the second blade link 1274, and by this force, the second blade link 1274 will rotate about the rotation axis 1282 in the direction of arrow G1. In this way, while the second blade link 1274 rotates, it will push the third blade link 1275 in the direction of arrow H1. The third blade link 1275 is moved as a whole by the second blade link 1274 and at the same time rotates about the rotation axis 1283 while moving the blade 1271 in the direction of arrow D1.

[0646] Similarly, in the same state as FIG. 115, when the blade pulley 1261 further rotates in the direction of arrow R2 in FIG. 116, the first blade link 1273 axially coupled to the blade pulley 1261 also rotates in the direction of arrow F2 about the protrusion 1261a while rotating together with the blade pulley 1261. Then, the first blade link 1273 will push the second blade link 1274, and by this force, the second blade link 1274 will rotate about the rotation axis 1282 in the direction of arrow G2. In this way, while the second blade link 1274 rotates, it will push the third blade link 1275 in the direction of arrow H2. The third blade link 1275 is moved as a whole by the second blade link 1274 and at the same time rotates about the rotation axis 1283 while moving the blade 1271 in the direction of arrow D2.

[0647] The end tool of the electrocautery surgical instrument according to the fifth embodiment of the present invention as described above includes a blade link assembly 1272 including a plurality of blade links, so that the blade 1271 performs a linear motion substantially in the same direction as the direction from the proximal portion 1201f to the distal portion 1201g of the first jaw 1201, that is, along the X-axis direction. That is, the rotational motion of the blade pulley 1261 is converted into a linear motion of the blade 1271 in the X-axis direction by the blade link assembly 1272.

[0648] Correspondingly, a part of the blade 1271 is housed inside the first jaw 1201 in all operating states, and the other part of the blade 1271 is housed inside the second jaw 1202 in all operating states. That is, instead of the blade 1271 moving from the first jaw 1201 to the second jaw 1202 side, cutting is performed while the blade 1271 linearly moves between the proximal portion 1201f and the distal portion 1201g of the first jaw 1201.

[0649] With such a configuration, by performing cutting while the blade 1271 linearly moves, the moving path of the blade 1271 is shortened, and the effect of performing cutting simply can be obtained.

[0650] FIG. 117 is a diagram showing a state where the jaw has rotated 90° in yaw, FIG. 118 is a diagram showing a state where the jaw has rotated 90° in pitch, and FIG. 119 is a diagram showing a state where the jaw has rotated 90° in pitch and simultaneously rotated 90° in yaw.

[0651] As shown in FIGS. 117 to 119, the end tool of the electrocautery surgical instrument according to the fifth embodiment of the present invention can normally perform a cutting operation even when the jaw has rotated 90° in pitch or 90° in yaw.

[0652] <Sixth Embodiment - Double Blade> Hereinafter, the end tool 1300 of the surgical instrument according to the sixth embodiment of the present invention will be described. Here, the end tool 1300 of the surgical instrument according to the sixth embodiment of the present invention is characteristically different in the configuration of the blade assembly 1370 compared to the end tool (refer to 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. The configuration that is different compared to the first embodiment will be described in detail later.

[0653] FIGS. 120, 121, and 122 are perspective views showing the end tool of the electrocautery surgical instrument according to the sixth embodiment of the present invention. FIG. 120 shows a state where the jaw is open, and FIG. 121 shows a state where the jaw is closed.

[0654] Referring to FIGS. 120 to 122, the end tool 1300 of the sixth embodiment of the present invention includes a pair of jaws for performing a grip operation, that is, a first jaw 1301 and a second jaw 1302. Here, each of the first jaw 1301 and the second jaw 1302, or a component including the first jaw 1301 and the second jaw 1302 can be referred to as a jaw 1303.

[0655] On the other hand, the end tool 1300 includes a plurality of pulleys including a pulley 1311 which is a first jaw pulley coupled to the first jaw 1301. In this embodiment, since the pulleys related to the rotational movement of the first jaw 1301 are substantially the same as the pulleys 112, 113, 114, 115, and 116 described in FIG. 11 etc. of the first embodiment, the detailed description thereof is omitted here.

[0656] On one hand, the end tool 1300 includes a plurality of pulleys including a pulley 1321 which is a second jaw pulley coupled to a second jaw 1302. In this embodiment, since the pulleys related to the rotational movement of the second jaw 1302 are substantially the same as the pulleys 122, 123, 124, 125 and 126 described in FIG. 11 etc. of the first embodiment, the detailed description thereof is omitted here.

[0657] Hereinafter, the blade assembly 1370 of the electrocautery surgical instrument 1300 according to the sixth embodiment of the present invention will be described in more detail.

[0658] The first jaw 1301 can include a guide member 1301a and a case (not shown).

[0659] A blade accommodating portion 1301d can be formed in the guide member 1301a. The guide member 1301a is connected to the pulley 1311 and can be formed to guide the moving paths of the first blade 1371 and the second blade 1372. And inside the guide member 1301a, a blade accommodating portion 1301d can be formed which can accommodate at least a part of the first blade 1371, the second blade 1372 and the blade link 1375 described later. The blade accommodating portion 1301d can be formed long along the direction from the proximal portion 1301f to the distal portion 1301g of the first jaw 1301. The entire first blade 1371 and the second blade 1372 can be accommodated in this blade accommodating portion 1301d, or at least a part of the first blade 1371 and the second blade 1372 can also protrude outside the blade accommodating portion 1301d. In other words, it can also be considered that the first blade 1371 and the second blade 1372 move along the blade accommodating portion 1301d while cutting the tissue. This will be described in more detail later.

[0660] In addition, the guide member 1301a can be formed with a first blade coupling portion 1301b and a second blade coupling portion 1301c formed in a through-hole shape. The joint coupling portion 1371d of the first blade 1371 can be inserted through the first blade coupling portion 1301b, and the joint coupling portion 1372d of the second blade 1372 can be inserted through the second blade coupling portion 1301c.

[0661] On the other hand, a first electrode 1351 can be formed on the surface of the first jaw 1301 facing the second jaw 1302. And a second electrode 1352 can be formed on the surface of the second jaw 1302 facing the first jaw 1301.

[0662] The first blade 1371 can include a main body portion 1371a, an edge portion 1371b, one or more link coupling portions 1371c, and a joint coupling portion 1371d.

[0663] An edge portion 1371b that is sharply formed to cut tissue is formed in a region of the main body portion 1371a. At least a part of this edge portion 1371b is drawn out of the first jaw 1301, and the tissue disposed between the first jaw 1301 and the second jaw 1302 can be cut.

[0664] On the other hand, one or more link coupling portions 1371c can be formed in another region of the main body portion 1371a. For example, the link coupling portion 1371c is formed in a long slit shape, and a protruding first blade coupling portion 1375b can be fitted thereto.

[0665] On the other hand, a joint coupling portion 1371d can be formed in another region of the main body portion 1371a. For example, the joint coupling portion 1371d is formed in a shaft shape and can be inserted through the first blade coupling portion 1301b formed in a through-hole shape in the guide member 1301a of the first jaw 1301.

[0666] The second blade 1372 can include a main body portion 1372a, an edge portion 1372b, one or more link coupling portions 1372c, and a jaw coupling portion 1372d.

[0667] In one region of the main body portion 1372a, an edge portion 1372b that is sharply formed to cut tissue is formed. At least a part of this edge portion 1372b is drawn out to the outside of the first jaw 1301, and the tissue disposed between the first jaw 1301 and the second jaw 1302 can be cut.

[0668] On the other hand, one or more link coupling portions 1372c can be formed in another region of the main body portion 1372a. For example, the link coupling portion 1372c is formed in a long slit shape, and a protruding second blade coupling portion 1375c can be fitted thereto.

[0669] On the other hand, a jaw coupling portion 1372d can be formed in another region of the main body portion 1372a. For example, the jaw coupling portion 1372d is formed in a shaft shape and can be inserted through a second blade coupling portion 1301c formed in a through-hole shape in a guide member 1301a of the first jaw 1301.

[0670] The blade link 1375 connects the blade pulley 1361 to the first blade 1371 and the second blade 1372, and transmits the rotation of the blade pulley 1361 to the first blade 1371 and the second blade 1372 so that the first blade 1371 and the second blade 1372 move between the proximal portion 1301f and the distal portion 1301g of the first jaw 1301. The blade link 1375 can be formed in a long bar shape, and one end of the blade link 1375 can be connected to the blade pulley 1361, and the other region can be connected to the first blade 1371 and the second blade 1372 respectively. More specifically, it is as follows.

[0671] While moving from the proximal portion 1301f side toward the distal portion 1301g side in the blade link 1375, the pulley coupling portion 1375a, the first blade coupling portion 1375b, and the second blade coupling portion 1375c can be sequentially formed.

[0672] Specifically, a slit-shaped blade pulley coupling portion 1375a can be formed at the proximal portion 1301f side end of the blade link 1375. Then, the protruding portion 1361a formed on one surface of the blade pulley 1361 can be fitted into the blade pulley coupling portion 1375a.

[0673] The first blade coupling portion 1375b of the blade link 1375 includes a protruding portion. And the link coupling portion 1371c of the first blade 1371 is formed in a long slit shape. Then, the protruding portion of the first blade coupling portion 1375b is fitted into the slit of the link coupling portion 1371c.

[0674] On the other hand, the joe coupling portion 1371d of the first blade 1371 includes a protruding portion. And a hole-shaped first blade coupling portion 1301b is formed in the guide member 1301a of the first joe 1301. Then, the joe coupling portion 1371d of the first blade 1371 is inserted through the first blade coupling portion 1301b of the guide member 1301a, and the first blade 1371 is formed to be rotatable with respect to the guide member 1301a about the joe coupling portion 1371d.

[0675] Therefore, when the blade link 1375 moves linearly, the first blade coupling portion 1375b of the blade link 1375 pushes or pulls the link coupling portion 1371c of the first blade 1371. And at this time, since the joe coupling portion 1371d of the first blade 1371 is axially coupled to the guide member 1301a, the first blade 1371 rotates with respect to the guide member 1301a.

[0676] The figure shows that the first blade coupling portion 1375b includes a protrusion and the link coupling ...

Claims

1. In the end tools of surgical instruments, a first jaw and a second jaw that are rotatable independently of each other; a first jaw pulley coupled to the first jaw and configured to be rotatable around a first axis; a second jaw pulley coupled to the second jaw and configured to be rotatable about an axis substantially the same as or parallel to the first axis; a blade pulley formed to be rotatable about an axis substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley or the second jaw pulley; and one or more blades connected to the blade pulley and moving between a proximal end and a distal end of the first jaw in response to rotation of the blade pulley.

2. The surgical instrument end tool of claim 1 , further comprising a blade link connected to the blade pulley and the blade for transmitting rotation of the blade pulley to the blade.

3. 3. The end tool of a surgical instrument according to claim 2, wherein the blade link converts the rotational movement of the blade pulley into a positional movement of the blade.

4. One end of the blade link is connected to the blade pulley, and the other end of the blade link is connected to the blade; 3. The end tool of a surgical instrument according to claim 2, wherein when the blade pulley rotates in one direction, the blade link connected to the blade pulley moves toward the proximal end or the distal end of the first jaw, thereby moving the blade.

5. The end tool of the surgical instrument according to claim 2 , wherein the first jaw is formed with a blade receiving portion in which the blade and at least a part of the blade link are received.

6. The end tool of a surgical instrument according to claim 5 , characterized in that the blade moves along the blade receiving portion of the first jaw.

7. The end tool of the surgical instrument according to claim 5, wherein the second jaw is formed with a slit capable of accommodating at least a portion of the blade pulled out from the first jaw.

8. As the blade pulley rotates in either direction, the blade moves proximally toward the first jaw; 2. The end tool of a surgical instrument according to claim 1, wherein when the blade pulley rotates in the other direction, the blade moves distally of the first jaw.

9. a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis that forms a predetermined angle with the first axis; 2. The end tool of the surgical instrument according to claim 1, further comprising: a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable around an axis substantially the same as or parallel to the second axis.

10. 10. The end tool of a surgical instrument according to claim 9, wherein the blade pulley rotates together with the first and second jaw pulleys when the first and second jaw pulleys rotate in the same direction about the second axis.

11. The end tool of the surgical instrument according to claim 1 , further comprising a blade second auxiliary pulley disposed on one side of the blade pulley.

12. 2. The end tool of a surgical instrument according to claim 1, wherein the blade pulley rotates together with the first jaw pulley and the second jaw pulley when the first jaw pulley and the second jaw pulley rotate in the same direction about the first axis.

13. 2. The end tool of a surgical instrument according to claim 1, wherein when the first jaw pulley and the second jaw pulley rotate in different directions around the first axis, the blade pulley rotates together with either the first jaw pulley or the second jaw pulley.

14. 2. The end tool of a surgical instrument according to claim 1, wherein the first jaw pulley and the second jaw pulley are not allowed to rotate while the blade pulley is rotated about the first axis by a braid wire.

15. a first electrode is formed on a surface of the first jaw facing the second jaw; The end tool of the surgical instrument according to claim 1 , wherein a second electrode is formed on a surface of the second jaw facing the first jaw.

16. The end tool of the surgical instrument according to claim 15, wherein cauterization is performed on tissue while a current is flowing through the first electrode and the second electrode.

17. 17. The surgical instrument end tool of claim 16, wherein once the cauterization is completed, the blade pulley rotates and, in response, the blade cuts the tissue as it moves from the first position to the second position.

18. 2. The end tool of a surgical instrument according to claim 1, wherein the first jaw pulley, the blade pulley and the second jaw pulley are formed by sequential lamination.

19. 2. The end tool of a surgical instrument according to claim 1, wherein the blade pulley is formed between the first jaw pulley and the second jaw pulley.

20. The end tool of the surgical instrument according to claim 1 , wherein the first jaw pulley, the blade pulley and the second jaw pulley are formed to be rotatable independently of each other.

21. The end tool of a surgical instrument according to claim 1 , wherein the edge of the blade is formed with a plurality of serrations.

22. a first jaw wire at least a portion of which is wound around the first jaw pulley; 2. The surgical instrument end tool of claim 1, further comprising a second jaw wire wound at least partially around the second jaw pulley.

Images