End tool of surgical instrument, and surgical instrument comprising the same
The surgical instrument addresses the issue of non-intuitive operation in laparoscopic surgery by allowing the end tool to rotate in multiple directions and aligning its operation with the surgeon's intuitive movements, enhancing precision and efficiency.
Patent Information
- Application Number
- JP2025061464
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2021-04-28
- Filing Date
- 2025-04-02
- Publication Date
- 2025-07-08
- Estimated Expiration
- 2042-04-22
AI Technical Summary
Conventional surgical instruments used in laparoscopic surgery lack intuitive operation, with the direction of the operation part and the end tool often being reversed or confusing, leading to errors and difficulty in performing precise surgical tasks.
A surgical instrument with an end tool that can rotate in two or more directions and operates intuitively with the operation unit, featuring a staple drive assembly with a first and second jaw, pulleys, and a reciprocating movement assembly to convert rotational movement into linear movement for stapling and cutting operations.
The instrument ensures that the operation direction of the surgeon and the end tool are intuitively aligned, improving accuracy, reliability, and speed of surgical procedures.
Smart Images
Figure 2025102928000001_ABST
Abstract
Description
Technical Field
[0001] The present invention relates to an end tool for a surgical instrument and a surgical instrument including the same. Specifically, the present invention relates to an end tool for a surgical instrument that can be rotated in two or more directions and operates intuitively in accordance with the operation of an operation unit, the end tool being attached to a robotic arm for use in laparoscopic surgery or various surgeries or being manually operable, and a surgical instrument including the same.
Background Art
[0002] In recent years, laparoscopic surgery, which can reduce the postoperative recovery time and complications with a small incision, has been actively used. Laparoscopic surgery is widely used in general surgery and the like as a method of making a number of small holes in a patient's abdomen and performing surgery while observing the inside of the abdominal cavity through these holes.
[0003] When performing such laparoscopic surgery, a suturing instrument inserted into the body to suture a surgical site in the abdominal cavity is used, and a surgical stapler that sutures a surgical site using medical staples with the above-described suturing instrument is utilized.
[0004] Generally, a surgical stapler is a medical device that is often used for cutting and anastomosis of organs in abdominal and thoracic organ surgeries. Such surgical staplers include an open stapler used in an open state of thoracotomy or laparotomy and an end stapler used in thoracoscopy and laparoscopy.
[0005] Surgical staplers can perform organ anastomosis simultaneously with the cutting of the surgical site, thus having the advantages of not only shortening the surgical time but also enabling accurate suturing of the surgical site. Moreover, surgical staplers are widely used in modern surgical procedures because they offer faster recovery and less scarring compared to using surgical sutures for tissue cutting and suturing. In particular, surgical staplers are widely used for cutting cancerous tissue and suturing the cut site in cancer surgery.
[0006] The above-described background art is technical information that the inventor has retained for the derivation of the present invention or has acquired during the derivation process of the present invention, and is not necessarily prior art that has been publicly disclosed to the general public before the filing of the present invention.
Summary of the Invention
Problems to be Solved by the Invention
[0007] An object of the present invention is to provide a surgical instrument that can be attached to a robotic arm or manually operable for use in laparoscopic surgery or various surgeries, and is equipped with an end tool that can rotate in two or more directions and operates in an intuitive manner consistent with the operation of the operation part.
Means for Solving the Problems
[0008] One embodiment of the present invention includes an end tool comprising a staple drive assembly including a first jaw, a second jaw formed to face the first jaw, a first jaw pulley coupled to the first jaw and rotatable about a first axis, a second jaw pulley coupled to the second jaw and rotatable about an axis substantially the same as or parallel to the first axis and formed at a certain distance from the first jaw pulley, and one or more staple pulleys at least partially formed between the first jaw pulley and the second jaw pulley; a reciprocating movement assembly coupled to the staple drive assembly and linearly moving when the staple pulley rotates; and a cartridge including a working member that moves in one direction by the reciprocating movement assembly when contacting the reciprocating movement assembly and moving in one direction.
[0009] Other aspects, features, and advantages other than those described above will become apparent from the following drawings, claims, and detailed description of the invention.
Effects of the Invention
[0010] With such a present invention, since the operation direction of the operation part by the surgeon and the operation direction of the end tool are intuitively the same direction, the convenience of the operator is improved, and effects such as the accuracy, reliability, and speed of the surgery can be obtained.
Brief Description of the Drawings
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Best Mode for Carrying Out the Invention
[0012] According to an embodiment of the present invention, in a surgical instrument, a first jaw, a second jaw formed to face the first jaw, 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 and formed to be spaced apart from the first jaw pulley to a certain extent, and one or more staple pulleys at least partially formed between the first jaw pulley and the second jaw pulley, an end tool including a staple drive assembly; a reciprocating movement assembly coupled to the staple drive assembly and linearly moving when the staple pulley rotates rotationally; and a cartridge including a working member that contacts the reciprocating movement assembly and moves in one direction by the reciprocating movement assembly when the reciprocating movement assembly moves in one direction.
[0013] In the present invention, when the staple pulley rotates, the reciprocating movement assembly coupled to the staple drive assembly moves to the distal side or the proximal side of the cartridge.
[0014] In the present invention, when the staple pulley rotates alternately in the clockwise and counterclockwise directions, the reciprocating movement assembly coupled to the staple drive assembly moves alternately to the distal side and the proximal side of the cartridge.
[0015] In the present invention, when the reciprocating movement assembly moves to the distal side of the cartridge, the working member is moved to the distal side of the cartridge by the reciprocating movement assembly.
[0016] In the present invention, the staple drive assembly converts the bidirectional rotational movement of the staple pulley into the reciprocating linear movement of the reciprocating movement assembly coupled to the staple drive assembly.
[0017] In the present invention, while the working member moves in the one direction, the wedge portion of the working member sequentially pushes up a plurality of staples in the cartridge to perform a stapling operation, and at the same time, a blade formed on one side of the wedge portion of the working member performs a cutting operation while moving in the one direction.
[0018] In the present invention, the staple driving assembly includes a link member that connects the staple pulley and the reciprocating movement assembly.
[0019] In the present invention, the working member includes a ratchet member having a ratchet formed on at least one surface, and the ratchet of the ratchet member is formed to be capable of contacting the reciprocating movement assembly.
[0020] In the present invention, the working member moves to the distal side of the cartridge together with the reciprocating movement assembly only when the reciprocating movement assembly moves to the distal side of the cartridge.
[0021] In the present invention, when the staple pulley rotates in a first direction out of the clockwise direction and the counterclockwise direction, the link member connected to the staple pulley, the reciprocating movement assembly connected to the link member, and the working member in contact with the reciprocating movement assembly move in the distal direction of the cartridge.
[0022] In the present invention, when the staple pulley rotates in a direction opposite to the first direction out of the clockwise direction and the counterclockwise direction, the link member connected to the staple pulley and the reciprocating movement assembly connected to the link member move in the proximal direction of the end tool, and the working member stops in the one direction.
[0023] In the present invention, the staple driving assembly includes a first link member connected to one region of the staple pulley and a second link member connected to another region of the staple pulley, and the reciprocating movement assembly includes a first reciprocating member coupled to the first link member and a second reciprocating member coupled to the second link member.
[0024] In the present invention, the working member includes a ratchet member formed with a first ratchet and a second ratchet, and the first ratchet is formed to be contactable with the first reciprocating member, and the second ratchet is formed to be contactable with the second reciprocating member.
[0025] In the present invention, when the staple pulley rotates in one direction, the first ratchet and the first reciprocating member come into contact, and when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member come into contact.
[0026] In the present invention, when the staple pulley rotates in a first direction out of the clockwise direction and the counterclockwise direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the working member in contact with the first reciprocating member move in the distal direction of the cartridge.
[0027] In the present invention, when the staple pulley rotates in a direction opposite to the first direction out of the clockwise direction and the counterclockwise direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the working member in contact with the second reciprocating member move in the distal direction of the cartridge.
[0028] In the present invention, it further includes a staple wire coupled to the staple pulley to rotate the staple pulley.
[0029] In the present invention, there exist a non-activation state in which the staple driving assembly and the reciprocating movement assembly are separated, and an activation state in which the staple driving assembly and the reciprocating movement assembly are fastened, respectively.
[0030] In the present invention, only in the activation state, when the staple pulley rotates, the reciprocating movement assembly linearly moves accordingly.
[0031] In the present invention, it further includes 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.
[0032] In the present invention, the end tool is characterized in that it can yaw-rotate about the first axis and can pitch-rotate about the second axis.
[0033] In the present invention, the first jog pulley, the staple pulley, and the second jog pulley are sequentially laminated and formed.
[0034] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw capable of accommodating a cartridge, a second jaw formed to face the first jaw, coupled to the first jaw, and rotatable about a first axis A first jaw pulley, coupled to the second jaw, rotatably formed about an axis substantially the same as or parallel to the first axis, and formed to be spaced apart from the first jaw pulley by a certain degree A staple drive assembly including one or more staple pulleys at least partially formed between the first jaw pulley and the second jaw pulley, and at least partially in contact with the staple pulley and rotating the staple pulley A staple wire for transmitting the required driving force to the staple pulley, wherein the staple drive assembly is connected to a reciprocating movement assembly of the cartridge, and a rotational movement of the staple pulley is converted into a linear movement of the reciprocating movement assembly.
[0035] In the present invention, an end tool hub including a first jaw pulley coupling portion and a second jaw pulley coupling portion formed to face each other, and a guide portion connecting the first jaw pulley coupling portion and the second jaw pulley coupling portion is further included. The first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub, the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub, and at least a part of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.
[0036] In the present invention, the first axis is sequentially inserted through the first jaw pulley coupling portion, the first jaw pulley, the staple pulley, the second jaw pulley, and the second jaw pulley coupling portion.
[0037] In the present invention, the first jaw pulley, the staple pulley, and the second jaw pulley are sequentially stacked and formed in the end tool hub.
[0038] In the present invention, the first jockey pulley, the staple pulley, and the second jockey pulley are each formed to be rotatable independently of one another.
[0039] The present invention further includes a staple auxiliary pulley disposed between the staple pulley and the guide portion.
[0040] In the present invention, the staple wire is located on a common internal tangent line of the staple pulley and the staple auxiliary pulley, and the rotation angle of the staple pulley is extended by the staple auxiliary pulley.
[0041] In the present invention, in the guide portion, regions adjacent to the first jockey pulley, the staple pulley, and the second jockey pulley are formed to be curved such that their cross-sections have a predetermined curvature.
[0042] In the present invention, the staple wire is located on a common internal tangent line of the staple pulley and the guide portion, and the rotation angle of the staple pulley is extended by the guide portion.
[0043] In the present invention, the staple drive assembly includes a staple link assembly that connects the staple pulley and the reciprocating assembly.
[0044] In the present invention, the staple link assembly includes a first link coupled to the staple pulley and a second link coupled to the first link and the reciprocating assembly, respectively.
[0045] In the present invention, when the staple pulley rotates alternately in the clockwise and counterclockwise directions, the staple link assembly coupled to the staple pulley moves alternately to the distal side and the proximal side of the end tool.
[0046] In the present invention, it is characterized in that the bidirectional rotational movement of the staple pulley is converted into a reciprocating linear movement of the reciprocating movement assembly connected to the staple link assembly by the staple link assembly.
[0047] In the present invention, a guide groove is formed along the longitudinal direction of the first jaw, and the staple link assembly is characterized in that it moves along the guide groove.
[0048] In the present invention, it further includes a jaw rotation shaft that is inserted through the first jaw and the second jaw and serves as the rotation center of the first jaw and the second jaw. The first shaft is a jaw pulley rotation shaft that is inserted through the first jaw pulley and the second jaw pulley and serves as the rotation center of the first jaw pulley and the second jaw pulley. When the first jaw pulley and the second jaw pulley rotate about the jaw pulley rotation shaft, the jaw rotation shaft moves relative to the jaw pulley rotation shaft.
[0049] In the present invention, when the first jaw and the second jaw are closed, the jaw rotation shaft moves in the direction of the distal portion of the end tool, and when the first jaw and the second jaw are opened, the jaw rotation shaft moves in the direction of the proximal portion of the end tool.
[0050] In the present invention, it further includes a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second shaft that forms a predetermined angle with the first shaft, and a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about a shaft that is substantially the same as or parallel to the second shaft.
[0051] In the present invention, the end tool is characterized in that it can rotate in yaw about the first shaft and can rotate in pitch about the second shaft.
[0052] In the present invention, the first jaw wire at least part of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and the second jaw wire at least part of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys are further included.
[0053] 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 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 staple 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 a staple link assembly coupled to the staple pulley and reciprocating in response to bidirectional rotation of the staple pulley are included.
[0054] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw and reciprocates the reciprocating assembly.
[0055] In the present invention, the staple link assembly moves to the distal side or the proximal side of the end tool according to the rotation direction of the staple pulley.
[0056] In the present invention, a protrusion is formed on one side of either the staple pulley or the staple link assembly, and a hole is formed on the other side, and the protrusion is axially coupled to the hole.
[0057] In the present invention, a protruding member is formed on the staple pulley, a slot is formed in the staple link assembly, and when the staple pulley rotates, the protruding member moves while contacting the slot within the slot.
[0058] In the present invention, the staple link assembly is characterized by including a single link.
[0059] In the present invention, the staple link assembly is characterized by including a link member.
[0060] In the present invention, the link member includes a first link coupled to the staple pulley and a second link coupled to the first link.
[0061] In the present invention, the staple link assembly is characterized by including a first link member and a second link member.
[0062] In the present invention, the cartridge housed within the first jaw includes a first reciprocating member and a second reciprocating member, the first link member is connected to the first reciprocating member, and the second link member is connected to the second reciprocating member.
[0063] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly is characterized by moving along the guide groove.
[0064] 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.
[0065] In the present invention, when the first jockey pulley and the second jockey pulley rotate in the same direction about the second axis, the staple pulley is characterized by rotating together with the first jockey pulley and the second jockey pulley.
[0066] In the present invention, when the first jockey pulley and the second jockey pulley rotate in the same direction about the first axis, the staple pulley is characterized by rotating together with the first jockey pulley and the second jockey pulley.
[0067] In the present invention, when the first jockey pulley and the second jockey pulley rotate in different directions from each other about the first axis, the staple pulley is characterized by rotating together with either the first jockey pulley or the second jockey pulley.
[0068] In the present invention, it is characterized in that while the staple pulley is rotating about the first axis by a staple wire, the first jockey pulley and the second jockey pulley do not necessarily have to rotate.
[0069] In the present invention, a cartridge accommodating portion capable of accommodating a cartridge is formed in the first jaw, and an anvil with which staples of the cartridge can come into contact is formed in the second jaw.
[0070] In the present invention, it further includes a first jaw wire at least partially wound around the first jockey pulley, a second jaw wire at least partially wound around the second jockey pulley, and a staple wire at least partially wound around the staple pulley.
[0071] 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 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 staple pulley formed to be rotatable about the first axis and disposed between the first jaw pulley and the second jaw pulley, a staple link assembly coupled to the staple pulley and reciprocating in response to bidirectional rotation of the staple pulley, and a staple wire at least partially in contact with the staple pulley and transmitting a driving force required for rotation of the staple pulley to the staple pulley.
[0072] In the present invention, it is characterized in that the bidirectional rotational movement of the staple pulley is converted into a reciprocating linear movement of the staple link assembly.
[0073] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and the rotational movement of the staple pulley is transmitted to a working member of the cartridge via the staple link assembly and the reciprocating assembly.
[0074] In the present invention, it is characterized in that the bidirectional rotational movement of the staple pulley is converted into a reciprocating linear movement of the reciprocating assembly coupled to the staple link assembly by the staple link assembly.
[0075] In the present invention, it further includes a jaw rotation axis that is inserted through the first jaw and the second jaw and serves as the rotation center of the first jaw and the second jaw. The first axis is a jaw pulley rotation axis that is inserted through the first jaw pulley and the second jaw pulley and serves as the rotation center of the first jaw pulley and the second jaw pulley. When the first jaw pulley and the second jaw pulley rotate around the jaw pulley rotation axis, the jaw rotation axis moves relative to the jaw pulley rotation axis.
[0076] In the present invention, when the first jaw and the second jaw are closed, the jaw rotation axis moves in the direction of the distal portion of the end tool. When the first jaw and the second jaw are opened, the jaw rotation axis moves in the direction of the proximal portion of the end tool.
[0077] In the present invention, a movable coupling hole is formed in the first jaw or the second jaw, and a shaft coupling portion is formed in the first jaw pulley or the second jaw pulley. The shaft coupling portion is formed to be able to move to a certain extent within the movable coupling hole in a state where the shaft coupling portion is fitted into the movable coupling hole.
[0078] In the present invention, when the staple pulley rotates alternately in the clockwise and counterclockwise directions, the staple link assembly connected to the staple pulley moves alternately to the distal portion side and the proximal portion side of the end tool.
[0079] In the present invention, a guide groove is formed along the longitudinal direction of the first jaw, and the staple link assembly moves along the guide groove.
[0080] In the present invention, the end tool further includes an end tool hub including a first pulley coupling portion and a second pulley coupling portion formed to face each other, and a guide portion connecting the first pulley coupling portion and the second pulley coupling portion. In the guide portion, a region adjacent to the first pulley, the staple pulley, and the second pulley is formed to be curved so that a cross section thereof has a predetermined curvature.
[0081] In the present invention, the staple wire is located on a common internal tangent of the staple pulley and the guide portion, and a rotation angle of the staple pulley is extended by the guide portion.
[0082] In the present invention, the first jaw, the first pulley, the second jaw, and the second pulley are formed to rotate about the same rotation axis.
[0083] In the present invention, the first pulley, the staple pulley, and the second pulley are sequentially laminated and formed.
[0084] In the present invention, a guide groove is formed along a longitudinal direction in an anvil of the second jaw, and a clamp of a cartridge accommodated in the first jaw is formed to be movable along the guide groove.
[0085] In the present invention, coupling grooves are formed at both ends of the guide groove of the anvil so that the clamp can be retracted or pulled out with respect to the anvil.
[0086] 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.
[0087] 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 pitch rotation about the second axis.
[0088] In the present invention, a first jog wire at least partially wound around the first jog pulley and the pair of end tool first jog pitch main pulleys, and a second jog wire at least partially wound around the second jog pulley and the pair of end tool second jog pitch main pulleys are further included.
[0089] In the present invention, a staple second auxiliary pulley is disposed between the first jog pulley and the end tool first jog pitch main pulley or between the second jog pulley and the end tool second jog pitch main pulley, is rotatable about an axis that is substantially the same as or parallel to the second axis, and guides the path of the first jog wire or the second jog wire.
[0090] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw capable of accommodating a cartridge, a second jaw formed to face the first jaw, 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 and formed to be spaced apart from the first jaw pulley to a certain extent, one or more staple pulleys at least partially formed between the first jaw pulley and the second jaw pulley, a staple link assembly including a first link member coupled to one region of the staple pulley and a second link member coupled to another region of the staple pulley, and a staple wire at least partially wound around the staple pulley.
[0091] In the present invention, the first link member is coupled to a first reciprocating member of a cartridge accommodated in the first jaw, and the second link member is coupled to a second reciprocating member of a cartridge accommodated in the first jaw.
[0092] In the present invention, a first link coupling portion and a second link coupling portion are formed on the staple pulley, the first link member is coupled to the first link coupling portion, and the second link member is coupled to the second link coupling portion.
[0093] In the present invention, the first link coupling portion and the second link coupling portion are arranged on opposite sides with respect to the central axis of the staple pulley.
[0094] In the present invention, when the staple pulley rotates in one direction, the first link member and the second link member move in opposite directions to each other.
[0095] In the present invention, when the staple pulley rotates in one direction, the first link member moves toward the distal end side of the end tool, and the second link member moves toward the proximal end side of the end tool.
[0096] In the present invention, the cartridge accommodated in the first jaw includes a reciprocating movement assembly including a first reciprocating movement member and a second reciprocating movement member formed to face each other, and a ratchet member formed movably along the reciprocating movement assembly and having a first ratchet and a second ratchet.
[0097] In the present invention, the first ratchet is formed to be in contact with the first reciprocating movement member, and the second ratchet is formed to be in contact with the second reciprocating movement member.
[0098] In the present invention, when the staple pulley rotates in one direction, the first ratchet contacts the first reciprocating movement member, and when the staple pulley rotates in the other direction, the second ratchet contacts the second reciprocating movement member.
[0099] In the present invention, when the staple pulley rotates in one direction, the first reciprocating movement member comes into close contact with the first ratchet and pushes out the first ratchet, so that the ratchet member moves toward the distal end of the cartridge. When the staple pulley rotates in the other direction, the second reciprocating movement member comes into close contact with the second ratchet and pushes out the second ratchet, so that the ratchet member moves toward the distal end of the cartridge.
[0100] In the present invention, when the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the ratchet member in contact with the first reciprocating member move in the direction of the distal portion of the cartridge. When the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the ratchet member in contact with the second reciprocating member move in the direction of the distal portion of the cartridge.
[0101] In the present invention, the first link member includes a first link and a second link, and the second link member includes a third link and a fourth link.
[0102] In the present invention, the height of the fastening portion formed on the first link member and coupled to the first reciprocating member and the height of the fastening portion formed on the second link member and coupled to the second reciprocating member at the first axis are substantially the same.
[0103] In the present invention, the fourth link is formed in a bar shape bent one or more times.
[0104] In the present invention, the first ratchet is formed on one side surface of the ratchet member, and the second ratchet is formed on the other side surface of the ratchet member.
[0105] In the present invention, when the first reciprocating member moves in the proximal direction of the end tool, the first reciprocating member pushes the first ratchet toward the second reciprocating member. When the second reciprocating member moves in the proximal direction of the end tool, the second reciprocating member pushes the second ratchet toward the first reciprocating member.
[0106] In the present invention, the ratchet member includes a first ratchet member having the first ratchet formed on one surface thereof, and a second ratchet member having the second ratchet formed on one surface thereof.
[0107] In the present invention, when the first reciprocating member moves in the proximal direction of the end tool, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves in the proximal direction of the end tool, the second reciprocating member pushes the second ratchet toward the first reciprocating member.
[0108] In the present invention, a first elastic member is interposed between the first ratchet member and the first reciprocating member and applies an elastic force in a direction in which the first ratchet member is in close contact with the first reciprocating member, and a second elastic member is interposed between the first ratchet member and the second reciprocating member and applies an elastic force in a direction in which the second ratchet member is in close contact with the second reciprocating member.
[0109] 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 further included.
[0110] In the present invention, the end tool is characterized in that it can be yaw-rotated about the first axis and can be pitch-rotated about the second axis.
[0111] In the present invention, a first jog wire at least partially wound around the first jog pulley and the pair of end tool first jog pitch main pulleys, and a second jog wire at least partially wound around the second jog pulley and the pair of end tool second jog pitch main pulleys are further included.
[0112] According to an embodiment of the present invention, in an end tool of a surgical instrument, a first jaw capable of accommodating a cartridge, a second jaw formed to face the first jaw, a first jaw pulley coupled to the first jaw and rotatable about a first axis, a second jaw pulley coupled to the second jaw and rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first jaw pulley to a certain extent, a staple pulley disposed between the first jaw pulley and the second jaw pulley and having a protruding member formed in one region, a link having a slot formed in one region into which the protruding member of the staple pulley is inserted, and a staple wire at least partially wound around the staple pulley.
[0113] In the present invention, when the staple pulley rotates, the protruding member moves while contacting the slot within the slot to move the link.
[0114] In the present invention, the link is characterized in that it is formed of a single member.
[0115] In the present invention, when the staple pulley rotates, the link moves along one direction, and here, the link moves according to the width of the slot in the one direction.
[0116] In the present invention, the protruding member is formed in a pin shape, and the link moves by pressing the slot of the link while the protruding member rotates.
[0117] In the present invention, the slot is formed obliquely and is not concentric with the staple pulley, and the pin moves along the slot.
[0118] In the present invention, the protruding member is formed in a cam shape, and the link moves as the protruding member presses the slot of the link while rotating.
[0119] In the present invention, the center of the protruding member does not coincide with the center of the staple pulley, and the protruding member is formed so as to be eccentric to a certain extent with respect to the staple pulley.
[0120] In the present invention, the cartridge accommodated in the first jaw includes a reciprocating assembly and a working member, and there are respectively a non-activated state in which the link and the reciprocating assembly are separated, and an activated state in which the link and the reciprocating assembly are fastened.
[0121] In the present invention, only in the activated state, when the staple pulley rotates, the reciprocating assembly linearly moves accordingly.
[0122] In the present invention, when the first jaw and the second jaw are opened, the reciprocating assembly moves in the direction of the proximal portion of the end tool.
[0123] In the present invention, when the first jaw and the second jaw are closed, the reciprocating assembly and the link come into contact with each other.
[0124] In the present invention, when the staple pulley rotates in a state where the first jaw and the second jaw are closed, the link and the reciprocating assembly are in an activated state where they are fastened.
[0125] In the present invention, by the link, the bidirectional rotational movement of the staple pulley is converted into the reciprocating linear movement of the reciprocating assembly connected to the link.
[0126] In the present invention, it is characterized in that the bidirectional rotational movement of the staple pulley is converted into a reciprocating linear movement of the link.
[0127] In the present invention, it is characterized in that the first jog pulley, the staple pulley, and the second jog pulley are sequentially stacked and formed.
[0128] 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 further included.
[0129] In the present invention, the end tool is formed so as to be capable of yaw rotation about the first axis and pitch rotation about the second axis.
[0130] In the present invention, a first jog wire at least partially wound around the first jog pulley and the pair of end tool first jog pitch main pulleys, and a second jog wire at least partially wound around the second jog pulley and the pair of end tool second jog pitch main pulleys are further included.
[0131] According to an embodiment of the present invention, in a cartridge of a surgical instrument, in a cartridge of a surgical instrument including an end tool rotatable in at least one direction, a housing, a cover covering one surface of the housing and having a slit formed along a first direction which is the longitudinal direction of the housing, a plurality of staples disposed inside the housing, a reciprocating assembly disposed inside the housing and formed to be movable along the first direction with respect to the housing, and having a plurality of uneven portions formed on at least one surface, and a working member formed on one side of the reciprocating assembly, formed to be in contact with the reciprocating assembly, and formed to be movable along the first direction by the reciprocating assembly.
[0132] In the present invention, the reciprocating assembly is connected to a staple driving assembly formed on the end tool, and when a staple pulley of the staple driving assembly rotates, the reciprocating assembly moves along the first direction.
[0133] In the present invention, when the staple pulley rotates alternately in the clockwise direction and the counterclockwise direction, the reciprocating assembly connected to the staple driving assembly moves alternately to the distal side and the proximal side of the cartridge.
[0134] In the present invention, while the reciprocating assembly moves to the distal side of the cartridge, the working member in contact with the reciprocating assembly is moved in the first direction.
[0135] In the present invention, the working member includes a main body, one or more wedges formed on one side of the main body and having an inclined surface formed such that the height on the proximal side is higher than that on the distal side of the cartridge, a blade formed on one side of the wedge and having a sharp edge, and a ratchet member formed on one side of the main body and having one or more ratchets formed to be in contact with the uneven portions of the reciprocating assembly.
[0136] In the present invention, an elastic member is further included, which is formed between the main body or the wedge and the ratchet member and provides an elastic force for pressing the ratchet toward the reciprocating movement assembly.
[0137] In the present invention, when the reciprocating movement assembly moves to the distal side of the cartridge, the reciprocating movement assembly comes into close contact with the ratchet and pushes out the ratchet, so that the working member moves to the distal side of the cartridge.
[0138] In the present invention, when the reciprocating movement assembly moves to the proximal side of the cartridge, the working member is stopped in the one direction.
[0139] In the present invention, when the reciprocating movement assembly moves to the proximal side of the cartridge,
[0140] the inclined surface of the reciprocating movement assembly presses the inclined surface of the ratchet in a direction in which the ratchet member moves away from the reciprocating movement assembly.
[0141] In the present invention, the reciprocating movement assembly includes a first reciprocating movement member and a second reciprocating movement member formed to face each other, and the ratchet member includes a first ratchet formed to be contactable with the first reciprocating movement member and a second ratchet formed to be contactable with the second reciprocating movement member.
[0142] In the present invention, when the first reciprocating member moves toward the distal side of the cartridge, the first reciprocating member comes into close contact with the first ratchet and pushes out the first ratchet, so that the working member moves toward the distal side of the cartridge. When the second reciprocating member moves toward the distal side of the cartridge, the second reciprocating member comes into close contact with the second ratchet and pushes out the second ratchet, so that the working member moves toward the distal side of the cartridge.
[0143] In the present invention, the first reciprocating member and the second reciprocating member alternately move toward the distal side of the cartridge.
[0144] In the present invention, the first reciprocating member is connected to a first link member connected to an area of the staple pulley of the end tool, and the second reciprocating member is connected to a second link member connected to another area of the staple pulley. When the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the ratchet member in contact with the first reciprocating member move toward the distal portion of the cartridge. When the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the ratchet member in contact with the second reciprocating member move toward the distal portion of the cartridge.
[0145] In the present invention, the first ratchet is formed on one side surface of the ratchet member, and the second ratchet is formed on the other side surface of the ratchet member.
[0146] In the present invention, when the first reciprocating member moves in the proximal direction of the cartridge, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves in the proximal direction of the cartridge, the second reciprocating member pushes the second ratchet toward the first reciprocating member.
[0147] In the present invention, the ratchet member includes a first ratchet member having the first ratchet formed on one surface and a second ratchet member having the second ratchet formed on one surface.
[0148] In the present invention, when the first reciprocating member moves in the proximal direction of the cartridge, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves in the proximal direction of the cartridge, the second reciprocating member pushes the second ratchet toward the first reciprocating member.
[0149] In the present invention, a first elastic member that is interposed between the first ratchet member and the first reciprocating member and applies an elastic force in a direction in which the first ratchet member is in close contact with the first reciprocating member, and a second elastic member that is interposed between the first ratchet member and the second reciprocating member and applies an elastic force in a direction in which the second ratchet member is in close contact with the second reciprocating member are further included.
[0150] In the present invention, one or more protrusions are formed in a region of the inner surface of the housing that can contact the working member, and a snap that can contact the protrusion is formed on the working member.
[0151] In the present invention, when the reciprocating assembly moves to the proximal side of the cartridge, the snap and the protrusion come into contact with each other, and it is characterized in that the working member is prevented from moving to the proximal side of the cartridge.
[0152] In the present invention, one end of the snap is coupled to the working member and is formed to be elastically deformable to a certain extent.
[0153] In the present invention, the one or more protrusions include an inclined surface formed such that the height on the distal side is higher than that on the proximal side of the cartridge.
[0154] In the present invention, a clamp extending along the first direction is formed on one side of the blade of the working member.
[0155] In the present invention, a guide groove is formed in the anvil of the second jaw of the end tool along the first direction, and the clamp moves along the guide groove.
[0156] In the present invention, coupling grooves are formed at both ends of the anvil such that the clamp can be retracted or extended with respect to the anvil.
[0157] According to an embodiment of the present invention, in a driving method of a surgical instrument, (a) when a staple pulley of a staple driving assembly rotates in a first direction about a first axis, a staple link assembly connected to the staple pulley and a reciprocating movement assembly of a cartridge connected to the staple link assembly move along a second axis in a distal direction of the cartridge; (b) when the reciprocating movement assembly moves in the distal direction of the cartridge, a working member in contact with the reciprocating movement assembly moves in the distal direction of the cartridge together with the reciprocating movement assembly; (c) while the working member moves in the distal direction of the cartridge, the working member discharges staples in the cartridge to the outside of the cartridge, and at the same time, a blade of the working member moves in the distal direction of the cartridge; and (d) when the staple pulley rotates in a second direction opposite to the first direction about the first axis, the staple link assembly connected to the staple pulley and the reciprocating movement assembly of the cartridge connected to the staple link assembly move in a proximal direction of the cartridge.
[0158] In the present invention, when the staple pulley rotates in the first direction or the second direction, the reciprocating movement assembly moves in the distal direction or the proximal direction of the cartridge.
[0159] In the present invention, the bidirectional rotational movement about the first axis of the staple pulley is converted into a reciprocating linear movement along the second axis of the reciprocating movement assembly connected to the staple pulley.
[0160] In the present invention, due to the reciprocating linear movement of the reciprocating movement assembly, the working member moves in the distal direction of the cartridge.
[0161] In the present invention, a rack is formed on one surface of the reciprocating assembly, the working member includes a ratchet member formed with a ratchet, and the rack pushes out the ratchet member in a state of being in close contact with the ratchet member, so that the ratchet member moves in the distal direction of the cartridge.
[0162] In the present invention, in the step (d), the working member is characterized in that it stops in the second axial direction.
[0163] In the present invention, the working member is characterized in that it moves to the distal side of the cartridge together with the reciprocating assembly only when the reciprocating assembly moves to the distal side of the cartridge.
[0164] In the present invention, the staple driving assembly includes a first link member connected to one region of the staple pulley and a second link member connected to the other region of the staple pulley. The reciprocating assembly includes a first reciprocating member coupled to the first link member and a second reciprocating member coupled to the second link member. The working member includes a ratchet member formed with a first ratchet and a second ratchet.
[0165] In the present invention, in the step (a), the first ratchet contacts the first reciprocating member, and in the step (b), the second ratchet contacts the second reciprocating member.
[0166] In the present invention, in the step (a), the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the working member in contact with the first reciprocating member move in the distal direction of the cartridge, and the second link member connected to the staple pulley and the second reciprocating member connected to the second link member move in the proximal direction of the cartridge.
[0167] In the present invention, in the step (d), the first link member connected to the staple pulley and the first reciprocating member connected to the first link member move in the distal direction of the cartridge, and the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the working member in contact with the second reciprocating member move in the distal direction of the cartridge.
[0168] In the present invention, in the step (d), the working member is characterized by moving in the distal direction of the cartridge.
[0169] The present invention further includes a staple wire that is coupled to the staple pulley to rotate the staple pulley, and is characterized in that the bidirectional rotation of the staple pulley by the staple wire is converted into the reciprocating linear motion of the reciprocating assembly.
[0170] In the present invention, while the working member moves in the distal direction of the cartridge, the wedge portion of the working member sequentially pushes up a plurality of staples in the cartridge to perform a stapling operation, and at the same time, a blade formed on one side of the wedge portion of the working member performs a cutting operation while moving in the distal direction of the cartridge.
[0171] In the present invention, the steps (a) to (d) are repeatedly performed.
Embodiments for Carrying Out the Invention
[0172] Since the present invention can be subjected to various transformations and can have various embodiments, specific embodiments are shown in the drawings and will be described in detail below. However, this is not intended to limit the present invention to the specific embodiments, and it should be understood to include all transformations, equivalents or alternatives included in the spirit and technical scope of the present invention. In the description of the present invention, when it is determined that the specific description of the related known technology obscures the gist of the present invention, the detailed description thereof will be omitted.
[0173] 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.
[0174] The terms used in the present application are merely used to describe specific embodiments and are not intended to limit the present invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In the present application, terms such as "comprising" or "having" are intended to specify the presence of the features, numbers, steps, operations, components, parts, or combinations thereof described herein, and should be understood not to preclude the possibility of the presence or addition of one or more other features, numbers, steps, operations, components, parts, or combinations thereof.
[0175] 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.
[0176] In addition, in describing various embodiments of the present invention, each embodiment should not be interpreted or implemented independently, and it should be understood that the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments described separately.
[0177] The surgical instrument according to the present invention is characterized in that when the operation part is rotated in a certain direction with respect to at least one or more of the operations of pitch, yaw, and actuation operation, the end tool rotates in the same direction as the operation direction of the operation part intuitively.
[0178] 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.
[0179] 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 user's left-right perspective, 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, the operation direction of the user and the movement direction of the end tool are reversed, which may cause an error for the user, and there is a problem that the user's operation is not easy.
[0180] 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.
[0181] Referring to FIG. 1C, some of the conventional surgical instruments are formed in a mirror-symmetric form. When performing a pitch operation, the end tool 120b is formed in front of the rotation center 121b of the end tool, and the operation part 110b is 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 rotation direction of the end tool 120b corresponding thereto 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 it may cause an error. Also, referring to FIG. 1D, when performing a yaw operation, the end tool 120b is formed in front of the rotation center 121b of the end tool, and the operation part 110b is 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 rotation direction of the end tool 120b corresponding thereto 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 it may cause an error. 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 the perspective of the rotation direction or the left-right direction. 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, a 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, so that the operations of the operation part 110c and the end tool 120c intuitively coincide. Stated separately for such characteristics, unlike 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 (more than its own joint) based on its own joint during at least a moment of the operation process.
[0182] Stated separately, in the case of conventional surgical instruments such as those shown in FIGS. 1A, 1B, 1C, and 1D, the end tool is located in front of its own rotation center, while the operation part is formed behind its own rotation center. Due to the operation of the operation part moving 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, it is a structure that does not intuitively match in terms of structure. As a result, there is a problem that a discrepancy occurs in the left - right direction or the rotation direction between the operation of the operation part and the movement of the end tool, which may cause confusion to the user, making it difficult to intuitively and quickly perform the operation of the operation part and increasing the possibility of causing 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 a rotation center formed at the rear, it can be said that the operations intuitively match each other in terms of structure. Stated separately, since the moving part of the operation part also moves based on the rotation center formed at the rear so that the moving part of the end tool moves based on the rotation center formed at the rear, it can be said that the operations intuitively match in terms of structure. As a result, the user can intuitively and quickly perform the operation in the direction of the end tool, and there is an advantage that the possibility of causing mistakes is significantly reduced. Hereinafter, a specific mechanism enabling such a function will be described.
[0183] <First embodiment of surgical instrument>
[0184] FIG. 2 is a perspective view showing a surgical instrument according to a first embodiment of the present invention, and FIG. 3 is a side view of the surgical instrument of FIG. 2. FIGS. 4 and 5 are perspective views showing an end tool of the surgical instrument of FIG. 2. FIG. 6 is a perspective view showing an end tool hub of the end tool of the surgical instrument of FIG. 2. FIGS. 7 and 8 are plan views showing the end tool of the surgical instrument of FIG. 2. FIG. 9 is a side view showing the end tool of the surgical instrument of FIG. 2. FIGS. 10 and 11 are exploded perspective views of the end tool of the surgical instrument of FIG. 2. FIG. 12 is a perspective view showing a first jaw pulley of the surgical instrument of FIG. 2. FIG. 13 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. 14 is a plan view showing a first jaw of the surgical instrument of FIG. 2, and FIG. 15 is a plan view showing a second jaw of the surgical instrument of FIG. 2. FIG. 16 is a plan view showing an opening / closing operation of the first jaw of the surgical instrument of FIG. 2, FIG. 17 is a plan view showing an opening / closing operation of the second jaw of the surgical instrument of FIG. 2, and FIG. 18 is a plan view showing an opening / closing operation of the first jaw and the second jaw of the surgical instrument of FIG. 2. FIG. 19 is a perspective view showing an opening / closing operation of the end tool of the surgical instrument of FIG. 2, and FIG. 20 is a plan view showing an opening / closing operation of the end tool of the surgical instrument of FIG. 2.
[0185] First, referring to FIGS. 2 and 3, a 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.
[0186] Here, the connecting portion 400 is formed in a hollow shaft shape, and one or more wires and electric wires may be accommodated therein. 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 surgical 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 that is coupled to the end tool 100, and the bent portion 402 is formed on the side to which the operation portion 200 is coupled. 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. Expressing this from another aspect, it may be described that at least a part of the pitch operation portion 201 and the yaw operation portion 202 is 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.
[0187] On the other hand, the plane on which the bent portion 402 is formed may be the 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, not only the XZ plane but also other forms of configurations are possible.
[0188] On the other hand, a connector 410 may be formed in the bent portion 402. The connector 410 can be connected to an external power source (not shown), or the connector 410 is connected to the end tool 100 via an electric wire, and can transmit the electrical energy supplied from the external power source (not shown) to the end tool 100. Then, the electrical energy thus transmitted to the end tool 100 can provide a driving force for rotating the staple pulley (see 161 in FIG. 5) clockwise or counterclockwise, which will be described later.
[0189] 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, such as a forceps shape, a stick shape, a lever shape, etc. If the doctor manipulates this, the end tool 100 connected to the interface and inserted into the body of the surgical patient will perform a predetermined operation, and thus the surgery will be performed. Here, in FIG. 2, the operation unit 200 is shown to be formed in a handle shape that can be rotated with a finger inserted, 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.
[0190] The end tool 100 is formed at the other end of the continuous unit 400, is inserted into the surgical site, and performs operations necessary for the surgery. As an example of such an end tool 100, as shown in FIG. 2, a pair of jaws 103 for performing a grip operation can be used. However, the idea of the present invention is not limited to this, and various devices for surgery may be used as the end tool 100. For example, a configuration such as a single-arm cautery may also be used as the end tool. Such an end tool 100 is connected to the operation unit 200 by the power transmission unit 300 and performs operations necessary for the surgery, such as grip, cutting, and suturing operations, by transmitting the driving force of the operation unit 200 through the power transmission unit 300.
[0191] Here, the end tool 100 of the surgical 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 may be formed to perform a pitch movement around the Y-axis in FIG. 2 and perform a yaw movement and an actuation movement around the Z-axis in FIG. 2.
[0192] Here, if we define each of the pitch, yaw, and actuation operations used in the present invention, it is as follows.
[0193] First, the pitch operation means a movement in which the end tool 100 rotates vertically with respect to the direction in which the connecting portion 400 extends (the X-axis direction in FIG. 2), that is, a movement that rotates about the Y-axis in FIG. 2. In other words, it means a movement in which the end tool 100 formed to extend from the connecting portion 400 in the direction in which the connecting portion 400 extends (the X-axis direction in FIG. 2) rotates vertically about the Y-axis with respect to the connecting portion 400.
[0194] Next, the yaw operation means a movement in which the end tool 100 rotates horizontally with respect to the direction in which the connecting portion 400 extends (the X-axis direction in FIG. 2), that is, a movement that rotates about the Z-axis in FIG. 2. In other words, it means a movement in which the end tool 100 formed to extend from the connecting portion 400 in the direction in which the connecting portion 400 extends (the X-axis direction in FIG. 2) rotates horizontally about the Z-axis with respect to the connecting portion 400. That is, it means a movement in which the two jaws 103 formed on the end tool 100 rotate in the same direction about the Z-axis.
[0195] 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 while the jaws open and close. That is, it means a movement in which the two jaws 103 formed on the end tool 100 rotate in opposite directions about the Z-axis.
[0196] 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, etc.
[0197] The end tool 100, operation unit 200, power transmission unit 300, etc. of the surgical instrument 10 in FIG. 2 will be described in detail below.
[0198] (Intuitive drive)
[0199] The intuitive drive of the surgical instrument 10 of the present invention will be described below.
[0200] First, while the user is holding the first handle 204 with the palm, 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 can perform a yaw operation by rotating the first handle 204 about the Z axis (i.e., the rotation axis 243 in FIG. 43). Further, the user can perform an actuation operation by operating the actuation operation unit 203 with the thumb and index finger inserted into the finger hole ring-shaped first actuation extension 252 and / or the second actuation extension 257 formed at one end of the actuation operation unit 203.
[0201] Here, in the surgical instrument 10 according to the first embodiment of the present invention, when the operation unit 200 is rotated in a certain direction with respect to the connecting unit 400, the end tool 100 rotates in a direction that is intuitively the same as the operation direction of the operation unit 200. 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 a direction that is intuitively the same as the said direction to perform a pitch motion or a yaw motion. Here, it may be additionally noted 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 tip of the end tool 100 form a substantially same direction. Of course, the same direction here may not be a direction that completely coincides on the three-dimensional coordinate. For example, it may be understood that it is an identity such that when the user's finger moves to the left, the tip of the end tool 100 also moves to the left, and when the user's finger moves downward, the tip of the end tool 100 also moves downward.
[0202] For this purpose, the surgical 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 connecting 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 forming direction of the end tool 100 at one end of the connecting part 400 and the forming direction of the operation unit 200 at the other end of the connecting 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. Thereby, the operation unit 200 can be configured in the same manner as the moving part of the end tool 100 extending 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 match both in terms of the rotation direction and the left-right direction, and as a result, the same operation can be performed intuitively.
[0203] Specifically, in the case of a conventional surgical instrument, since 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 intuitively match, it is not easy to perform an intuitive operation from the perspective of the surgeon. It takes a long time to become proficient in moving the end tool in the desired direction, and in some cases, there is a problem that a malfunction may occur and damage may be caused to the patient.
[0204] To solve such problems, the surgical instrument 10 according to the first embodiment of the present invention is configured such that the operation direction of the operation unit 200 and the operation direction of the end tool 100 are intuitively in the same direction. For this purpose, the operation unit 200, like the end tool 100, is characterized in that the actually moving parts for the actuation operation, yaw operation, and pitch operation extend in the +X-axis direction from the rotation center of the corresponding joint of each operation.
[0205] Hereinafter, the end tool 100, operation unit 200, power transmission unit 300, etc. of the surgical instrument 10 in FIG. 2 will be described in more detail.
[0206] (Power Transmission Unit)
[0207] Hereinafter, the power transmission unit 300 of the surgical instrument 10 in FIG. 2 will be described in further detail.
[0208] Referring to FIGS. 2 to 20, FIGS. 43, etc., the power transmission unit 300 of the surgical instrument 10 according to an embodiment of the present invention may include wires 301, 302, 303, 304, 305, 306, 307, and 308.
[0209] Here, wire 301 and wire 305 form a pair and can serve as the first jaw wire. Wire 302 and wire 306 form a pair and can serve as the second jaw wire. Here, the components including wire 301 and wire 305 as the first jaw wire and wire 302 and wire 306 as the second jaw wire can be called jaw wires. And wire 303 and wire 304 form a pair and can serve as pitch wires. And wire 307 and wire 308 form a pair and can serve as staple wires.
[0210] Also, the power transmission unit 300 of the surgical instrument 10 according to an embodiment of the present invention may include fastening members (see 321 in FIG. 7), fastening member 323, fastening member 324, fastening member 326, fastening member 327, and a fastening member (see 329 in FIG. 62) that are coupled to each end of each wire to couple the wire and the pulley. Here, each fastening member may be in various forms as needed, such as ball-shaped, tube-shaped, etc.
[0211] Here, on the end tool 100 side, the fastening member (see 321 in FIG. 7) 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 (see 329 in FIG. 62) can serve as a staple wire-end tool fastening member.
[0212] Also, 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 drawings, a pitch wire-operation unit fastening member and a staple wire-operation unit fastening member may be further formed on the operation unit 200 side.
[0213] If the coupling relationship between the wire, the fastening member, and each pulley is described in detail, it is as follows.
[0214] First, the wire 301 and the wire 305, which are the first jaw wires, may be a single wire. A fastening member 323, which is a first jaw wire-end tool fastening member, is fitted into the middle point of the first jaw wire that is a single wire, and after crimping and fixing this fastening member 323, both sides of the first jaw wire centered on the fastening member 323 can be called the wire 301 and the wire 305, respectively.
[0215] Further, the wire 301 and the wire 305, which are the first joystick wires, may be formed of separate wires, and the wire 301 and the wire 305 may be connected by a fastening member 323.
[0216] Then, by coupling this fastening member 323 to the pulley 111, the wire 301 and the wire 305 can be fixedly coupled to the pulley 111. As a result, when the wire 301 and the wire 305 are pulled and wound back, the pulley 111 can rotate.
[0217] On the other hand, a first joystick - operation part fastening member (see 324 in FIG. 43) may be coupled to the end opposite to the location where the fastening member 323 is fastened to the wire 301 and the wire 305.
[0218] Then, by coupling the first joystick - operation part fastening member (see 324 in FIG. 43) to the pulley 210 in this way, the wire 301 and the wire 305 can be fixedly coupled to the pulley 210. As a result, when the pulley 210 rotates by a motor or manual force, the wire 301 and the wire 305 are pulled and wound back, so that the pulley 111 of the end - tool 100 can rotate.
[0219] Similarly, the wire 302 and the wire 306, which are the second joystick wires, are coupled to a fastening member (see 326 in FIG. 43), which is a second joystick - end - tool fastening member, and a second joystick - operation part fastening member (see 327 in FIG. 43), respectively. Then, the fastening member (see 326 in FIG. 43) is coupled to the pulley 121, and the second joystick - operation part fastening member (see 327 in FIG. 43) is coupled to the pulley 220. As a result, when the pulley 220 rotates by a motor or manual force, the wire 302 and the wire 306 are pulled and wound back, so that the pulley 121 of the end - tool 100 can rotate.
[0220] Similarly, wire 303 and wire 304, which are pitch wires, are respectively coupled to a fastening member (see 321 in FIG. 7), which is a pitch wire - end tool fastening member, and a pitch wire - operation part fastening member (not shown). Then, the fastening member (see 321 in FIG. 7) is coupled to pulley 131, and the pitch wire - operation part fastening member (not shown) is coupled to pulley 231. As a result, when pulley 231 is rotated by a motor or manual force, wires 303 and 304 are pulled and wound back, enabling pulley 131 of end tool 100 to rotate.
[0221] Similarly, wire 307 and wire 308, which are staple wires, are respectively coupled to a fastening member (see 329 in FIG. 62), which is a staple wire - end tool fastening member, and a staple wire - operation part fastening member (not shown). Then, the fastening member (see 329 in FIG. 62) is coupled to staple pulley 161, and the staple wire - operation part fastening member (not shown) is coupled to a pulley (see 269 in FIG. 47). As a result, when pulley 269 is rotated by a motor or manual force, wires 307 and 308 are pulled and wound back, enabling staple pulley 161 of end tool 100 to rotate.
[0222] (End tool)
[0223] Hereinafter, end tool 100 of the surgical instrument 10 in FIG. 2 will be described in more detail.
[0224] FIGS. 4 and 5 are perspective views showing the end tool of the surgical instrument in FIG. 2, FIG. 6 is a perspective view showing the end tool hub of the end tool of the surgical instrument in FIG. 2, and FIGS. 7 and 8 are plan views showing the end tool of the surgical instrument in FIG. 2.
[0225] 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. On the other hand, FIG. 7 is a view centered on the wire, and FIG. 8 is a view centered on the pulley.
[0226] Referring to FIGS. 4 to 8 and the like, the end tool 100 of the 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 called a jaw 103.
[0227] Further, the end tool 100 may 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 may be included.
[0228] Here, although the figures show that the opposing pulleys are formed parallel to each other, the idea of the present invention is not limited to this, and it can be said that each pulley may be formed in various positions and sizes suitable for the configuration of the end tool.
[0229] Further, the end tool 100 of the first embodiment of the present invention may include an end tool hub 180 and a pitch hub 107.
[0230] The end tool hub 180 can accommodate at least a part of the pulleys 111 and 121 axially coupled to the rotary shafts 141 and 142, which will be described later, and further penetrate and insert the rotary shafts 141 and 142. Further, the end tool hub 180 can accommodate at least a part of the pulleys 112 and 122 axially coupled to the rotary shaft 142 inside.
[0231] Specifically, referring to FIG. 6, the end tool hub 180 includes a first pulley coupling portion 181, a second pulley coupling portion 182, a guide portion 183, and a pitch pulley coupling portion 185.
[0232] Specifically, the first pulley coupling portion 181 and the second pulley coupling portion 182 are formed to face each other, and the pulleys 111, 121, and the staple pulley 161 are accommodated therein. Further, through holes are formed in the first pulley coupling portion 181 and the second pulley coupling portion 182, respectively, and the rotating shaft 141 passes through the first pulley coupling portion 181, the pulley 111, the staple pulley 161, the pulley 121, and the second pulley coupling portion 182 to axially couple them.
[0233] The first pulley coupling portion 181 and the second pulley coupling portion 182 are connected by the guide portion 183. That is, the first pulley coupling portion 181 and the second 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 pulley coupling portion 181, the second pulley coupling portion 182, and the guide portion 183 are substantially in a "C" shape, and the pulleys 111, 121, and the staple pulley 161 are accommodated therein.
[0234] Here, the pulley 111, which is the first jump pulley, is arranged 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 arranged adjacent to the second jump pulley coupling portion 182 of the end tool hub 180. A staple assembly accommodation portion may 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 staple pulley assembly (see 160 in FIG. 13) and a staple link assembly (see 170 in FIG. 13), which will be described later, may be formed in the staple assembly accommodation portion. Expressing this from another perspective, it may be expressed that at least a part of the staple pulley 161 and the link member 171 are arranged between the first jump pulley coupling portion 181 and the second jump pulley coupling portion 182. In this way, by arranging at least a part of the staple pulley assembly (see 160 in FIG. 13) and the staple link assembly (see 170 in FIG. 13) between the pulley 111, which is the first jump pulley, and the pulley 121, which is the second jump pulley, it is possible to perform staple fastening and cutting operations using the staple pulley 161 together with the pitch operation and yaw operation of the end tool 100. This is a feature of the present invention. This will be described in more detail later.
[0235] On the other hand, a pulley 131 that serves as an end tool pitch pulley may be formed at one end of the end tool hub 180. As shown in FIG. 6, the pulley 131 may be formed integrally (one - body) with the end tool hub 180. That is, a disc - shaped pulley may be formed at one end of the end tool hub 180, and a groove into which a wire can be wound may be formed on its outer peripheral surface. Also, the pulley 131 may be formed as a member separate from the end tool hub 180 and coupled to the end tool hub 180. The above - mentioned 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.
[0236] The pitch hub 107 has a rotation axis 143 and a rotation axis 144, which will be described later, penetrating and inserted therethrough, and the pitch hub 107 and the end tool hub 180 (and the pulley 131) can be axially coupled by the rotation axis 143. Therefore, the end tool hub 180 and the pulley 131 may be formed rotatable with respect to the pitch hub 107 about the rotation axis 143.
[0237] Further, the pitch hub 107 can accommodate at least a part of the pulleys 113, 114, 123, and 124 axially coupled to the rotation axis 143 therein. Also, the pitch hub 107 can accommodate at least a part of the pulleys 115, 116, 125, and 126 axially coupled to the rotation axis 144 therein.
[0238] Also, the end tool 100 of the first embodiment of the present invention may include a rotation axis 141, a rotation axis 142, a rotation axis 143, and a rotation axis 144. As described above, the rotation axis 141 and the rotation axis 142 may be penetratingly inserted into the end tool hub 180, and the rotation axis 143 and the rotation axis 144 may be penetratingly inserted into the pitch hub 107.
[0239] The rotation axis 141, the rotation axis 142, the rotation axis 143, and the rotation axis 144 may be sequentially arranged in the direction from the distal end 104 to the proximal end 105 of the end tool 100. Accordingly, sequentially from the distal end 104, the rotation axis 141 may be called the first pin, the rotation axis 142 may be called the second pin, the rotation axis 143 may be called the third pin, and the rotation axis 144 may be called the fourth pin.
[0240] Here, the rotation axis 141 may function as an end tool joint pulley rotation axis, the rotation axis 142 may function as an end tool joint auxiliary pulley rotation axis, the rotation axis 143 may function as an end tool pitch rotation axis, and the rotation axis 144 may function as an end tool pitch auxiliary rotation axis of the end tool 100.
[0241] One or more pulleys may be fitted onto each of the rotation axes 141, 142, 143, and 144, which will be described in detail below.
[0242] On the other hand, a rotation axis 145 may be further formed on one side of the rotation axis 141, specifically, on the distal portion 104 side of the rotation axis 141. The rotation axis 145 may be inserted through the first jaw 101 and the second jaw 102 and function as a jaw rotation axis. This will be described in detail below.
[0243] The pulley 111 functions as an end tool first jaw pulley, and the pulley 121 functions as an end tool second jaw pulley. The pulley 111 may be referred to as the first jaw pulley, and the pulley 121 may be referred to as the second jaw pulley. These two components may be collectively referred to as the end tool jaw pulley or simply the jaw pulley.
[0244] The pulleys 111 and 121, which are end tool jaw pulleys, are formed to face each other and are rotatably formed independently of each other about the rotation axis 141, which is the end tool jaw pulley rotation axis. At this time, the pulley 111 and the pulley 121 are formed to be separated from each other to a certain extent, and a staple assembly accommodating portion may be formed therebetween. And at least a part of the staple pulley assembly 160 and the staple link assembly 170, which will be described later, may be disposed in this staple assembly accommodating portion.
[0245] Here, in the figure, the pulleys 111 and 121 are formed to rotate about a single rotation axis 141. However, it goes without saying that each end tool jaw pulley may be formed to be rotatable about a separate axis. Here, a first jaw 101 is fixedly coupled to the pulley 111 and rotates with the pulley 111, and a second jaw 102 can be fixedly coupled to the pulley 121 and rotate 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 performed, and when the pulleys 111 and 121 rotate in opposite directions about the rotation axis 141, the actuation operation is performed.
[0246] Here, the first jaw 101 and the pulley 111 may be formed of separate members and coupled to each other, or the first jaw 101 and the pulley 111 may be formed as one body. Similarly, the second jaw 102 and the pulley 121 may be formed of separate members and coupled to each other, or the second jaw 102 and the pulley 121 may be formed as one body.
[0247] 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 may be collectively referred to as an end tool jaw auxiliary pulley or simply an auxiliary pulley.
[0248] Specifically, the pulleys 112 and 122, which are end tool joist auxiliary pulleys, may be further provided on one side of the pulleys 111 and 121. In other words, the pulley 112, which is an auxiliary pulley, may be disposed between the pulley 111 and the pulley 113 / pulley 114. Also, the pulley 122, which is an auxiliary pulley, may be disposed between the pulley 121 and the pulley 123 / pulley 124. The pulleys 112 and 122 may be formed to be rotatable independently of each other about the rotation axis 142. Here, in the figure, the pulleys 112 and 122 are formed to rotate about one rotation axis 142, but it goes without saying that each of the pulleys 112 and 122 may be formed to be rotatable about a separate axis. Such auxiliary pulleys will be described in more detail later.
[0249] The pulleys 113 and 114 function as end tool first joist pitch main pulleys, and the pulleys 123 and 124 function as end tool second joist pitch main pulleys. These two components may be collectively referred to as end tool joist pitch main pulleys.
[0250] The pulleys 115 and 116 function as end tool first joist pitch sub-pulleys, and the pulleys 125 and 126 function as end tool second joist pitch sub-pulleys. These two components may be collectively referred to as end tool joist pitch sub-pulleys.
[0251] Hereinafter, the components related to the rotation of the pulley 111 will be described.
[0252] The pulleys 113 and 114 function as end tool first joist pitch main pulleys. That is, they function as the main rotation pulleys for the pitch operation of the first joist 101. Here, the first joist wire, wire 301, is wound around the pulley 113, and the first joist wire, wire 305, is wound around the pulley 114.
[0253] The pulleys 115 and 116 function as end tool first joystick pitch sub-pulleys. That is, they function as sub-rotating pulleys for the pitch operation of the first joystick 101. Here, the wire 301, which is the first joystick wire, is wound around the pulley 115, and the wire 305, which is the first joystick wire, is wound around the pulley 116.
[0254] Here, on one side of the pulleys 111 and 112, the pulleys 113 and 114 are arranged so as to face each other. Here, the pulleys 113 and 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 the pulleys 113 and 114, the pulleys 115 and 116 are arranged so as to face each other. Here, the pulleys 115 and 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, in the figure, it is shown that all of the pulleys 113, 115, 114, and 116 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 may be formed in various directions so as to be suitable for their configurations.
[0255] The wire 301, which is the first joystick wire, is sequentially wound so as to be in contact with at least a part of the pulleys 115, 113, and 111. Then, the wire 305, which is 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.
[0256] Explaining this from another perspective, the wire 301 and the wire 305, which are the first joystick 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 movable along the pulleys while rotating the pulleys.
[0257] 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.
[0258] Hereinafter, the pulleys 112 and 122 that serve as auxiliary pulleys will be described in more detail.
[0259] The pulley 112 and the pulley 122 are in contact with the wire 305 which is the first jo-wire and the wire 302 which is the second jo-wire, and by changing the arrangement paths of the wire 305 and the wire 302 to a certain extent, they can play a role in expanding the respective rotation angles of the first jo 101 and the second jo 102.
[0260] That is, when the auxiliary pulleys are not arranged, each of the first jo and the second jo could only rotate up to a right angle. However, in one embodiment of the present invention, by further providing the pulleys 112 and 122 which are auxiliary pulleys, as shown in FIG. 8, an effect that the maximum rotation angle increases by θ can be obtained. This enables an operation in which both jaws of the end tool 100 need to be opened for an actuation operation in a state where both jaws are yaw-rotated together by 90° in the L direction. This is because the second jo 102 can rotate by an additional angle θ as shown in FIG. 8. Similarly, the actuation operation is possible even when both jaws are yaw-rotated in the L 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 the pulleys 112 and 122.
[0261] A more detailed explanation of this is as follows.
[0262] 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, each of the end tool first jaw pulley and the end tool second jaw pulley can only rotate up to 90°. In this case, when the first jaw and the second jaw perform an 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 beyond 90°. Therefore, there is a problem that the actuation operation cannot be smoothly performed when the first jaw and the second jaw perform a yaw operation by a certain angle or more.
[0263] In order to solve such a problem, in the case of the surgical instrument 10 of the present invention, pulleys 112 and 122, which are auxiliary pulleys, are further 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 jaw wire, and the wire 302, which is the second jaw wire, to a certain extent, the tangential directions of the wire 305 and the wire 302 are changed. Thus, the fastening member 323 that couples the wire 301 and the pulley 111 can rotate up to the N line in FIG. 8. That is, the fastening member 323, which is the coupling part between the wire 301 and the pulley 111, can rotate until it is located on the common internal tangent of the pulley 111 and the pulley 112. Similarly, the fastening member 326, which is the coupling part between the wire 302 and the pulley 121, can rotate until it is located on the common internal tangent of the pulley 121 and the pulley 122, and the rotation range in the L direction can be expanded.
[0264] In other words, by the pulley 112, the wire 301 and the wire 305, which are the two strands of the first jaw wire wound around the pulley 111, are arranged on either side with reference to the plane perpendicular to the Y axis and passing through the X axis. At the same time, by the pulley 122, the wire 302 and the wire 306, which are the two strands of the second jaw wire wound around the pulley 121, are arranged on the other side with reference to the plane perpendicular to the Y axis and passing through the X axis.
[0265] In other words, the pulleys 113 and 114 are arranged on either side with reference to the plane perpendicular to the Y-axis and passing through the X-axis, and the pulleys 123 and 124 are arranged on the other side with reference to the plane perpendicular to the Y-axis and passing through the X-axis.
[0266] In other words, the wire 305 is located on the internal tangent line between the pulleys 111 and 112, and the rotation angle of the pulley 111 is extended by the pulley 112. Also, the wire 302 is located on the internal tangent line between the pulleys 121 and 122, and the rotation angle of the pulley 121 is extended by the pulley 122.
[0267] With the present invention as described above, by increasing the rotation radii of the jaws 101 and 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.
[0268] Next, the components related to the rotation of the pulley 121 will be described.
[0269] The pulleys 123 and 124 function as the end tool second jaw pitch main pulleys. That is, they function as the main rotation pulleys for the pitch operation of the second jaw 102. Here, the wire 306, which is the second jaw wire, is wound around the pulley 123, and the wire 302, which is the second jaw wire, is wound around the pulley 124.
[0270] The pulleys 125 and 126 function as the end tool second jaw pitch sub-pulleys. That is, they function as the sub-rotation pulleys for the pitch operation of the second jaw 102. Here, the wire 306, which is the second jaw wire, is wound around the pulley 125, and the wire 302, which is the second jaw wire, is wound around the pulley 126.
[0271] On one side of the pulley 121, the pulleys 123 and 124 are arranged to face each other. Here, the 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 the pulleys 123 and 124, the pulleys 125 and 126 are arranged to face each other. Here, the 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, in the figure, it is shown that all of the pulleys 123, 125, 124, and 126 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 may be formed in various directions so as to be suitable for their configurations.
[0272] The wire 306 which is the second joystick wire is sequentially wound so as to be in contact with at least a part of the pulleys 125, 123, and 121. Then, 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.
[0273] Explaining this from another perspective, the wire 306 which is the second joystick wire and the wire 302 are sequentially wound so as to be in contact with at least a part of the pulleys 125, 123, 121, 122, 124, and 126, and the wire 306 and the wire 302 are formed so as to be movable along the pulleys while rotating the pulleys.
[0274] 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.
[0275] Hereinafter, the pitch motion of the present invention will be described in more detail.
[0276] On the other hand, when the wire 301 is pulled in the direction of arrow 301 in FIG. 7 and at the same time the wire 305 is pulled in the direction of arrow 305 in FIG. 7 (that is, when both sides of the first jaw wire are pulled), as shown in FIG. 43, the wires 301 and 305 are wound below the pulleys 113 and 114 that can rotate about the rotation axis 143 which is the end tool pitch rotation axis. Therefore, the end tool hub 180 to which the pulleys 111 and 111 to which the wires 301 and 305 are fixedly coupled are coupled will rotate counterclockwise together about the rotation axis 143 as a whole. As a result, the end tool 100 will perform a pitch motion while rotating downward. At this time, the second jaw 102 and the wires 302 and 306 fixedly coupled thereto are wound above the pulleys 123 and 124 that can rotate about the rotation axis 143. Therefore, the wires 302 and 306 will be rewound in directions opposite to 302 and 306 respectively.
[0277] Conversely, when the wire 302 is pulled in the direction of arrow 302 in FIG. 7 and at the same time the wire 306 is pulled in the direction of arrow 306 in FIG. 7, as shown in FIG. 43, the wires 302 and 306 are wound above the pulleys 123 and 124 that can rotate about the rotation axis 143 which is the end tool pitch rotation axis. Therefore, the end tool hub 180 to which the pulleys 121 and 121 to which the wires 302 and 306 are fixedly coupled are coupled will rotate clockwise together about the rotation axis 143 as a whole. As a result, the end tool 100 will perform a pitch motion while rotating upward. At this time, the first jaw 101 and the wires 301 and 305 fixedly coupled thereto are wound below the pulleys 113 and 114 that can rotate about the rotation axis 143. Therefore, the wires 302 and 306 will move in directions opposite to 301 and 305 respectively.
[0278] On one hand, the end tool 100 of the 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 may be formed integrally with the end tool hub 180 (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.
[0279] 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, and the pulley 131 also rotates together, and as a result, the end tool 100 performs a pitch movement while rotating.
[0280] That is, the 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 movement. By more completely transmitting the driving force of the pitch operation of the operation unit 200 to the end tool 100, the operation reliability can be improved.
[0281] Here, the diameters of pulley 113, pulley 114, pulley 123, and pulley 124, which are end tool jog pitch main pulleys, and the diameter of pulley 131, which is an end tool pitch pulley, may be equal to each other, or may be different from each other. At this time, the ratio of the diameter of the end tool jog pitch main pulley to the diameter of the end tool pitch pulley may be the same as the ratio of the diameter of the operation unit pitch pulley of the operation unit 200 described later to the diameter of the operation unit pitch main pulley. This will be described in detail later.
[0282] (Components related to the staple pulley)
[0283] Hereinafter, the staple pulley 161 of the end tool 100 of the surgical instrument 10 in FIG. 2 will be described in more detail.
[0284] FIG. 9 is a side view showing the end tool of the surgical instrument in FIG. 2, and FIGS. 10 and 11 are perspective views showing the first jaw of the surgical instrument in FIG. 2. FIG. 12 is a perspective view showing the first jaw pulley of the surgical instrument in FIG. 2, and FIG. 13 is an exploded perspective view showing the staple pulley and the staple link of the surgical instrument in FIG. 2.
[0285] Referring to FIGS. 4 to 13 and the like, the end tool 100 of the first embodiment of the present invention may include a staple pulley 161, a staple auxiliary pulley 162, a pulley 163, a pulley 164, a pulley 165, and a pulley 166 related to the linear / rotary motion of each pulley and link for stapling and cutting.
[0286] The staple pulley 161 is formed to face the pulley 111 and the pulley 121 which are end tool joint pulleys, and is formed to be rotatable independently of each other about the rotation axis 141 which is the end tool joint pulley rotation axis. Here, in the figure, the staple pulley 161 is shown as being arranged between the pulley 111 and the pulley 121, but the idea of the present invention is not limited to this, and the staple pulley 161 may be arranged at various positions adjacent to the pulley 111 or the pulley 121.
[0287] Here, the present invention is characterized in that the staple pulley 161, the pulley 111, and the pulley 121 are formed to rotate about substantially the same axis. By forming the staple pulley 161, the pulley 111, and the pulley 121 to rotate about the same axis in this way, it is possible to perform pitch motion / yaw motion / actuation operation, and also possible to perform staple fastening and cutting operations. This will be described in more detail later. However, here in the figure, the staple pulley 161, the pulley 111, and the pulley 121 are formed to rotate about one rotation axis 141, but it goes without saying that each joint pulley may be formed to be rotatable about separate axes that are concentric with each other.
[0288] Explaining this from another perspective, it may be expressed as a structure in which the pulley 111 which is the first joint pulley, the staple pulley 161, and the pulley 121 which is the second joint pulley are sequentially stacked along the rotation axis 141. Alternatively, it may be expressed as a structure in which the staple pulley 161 is arranged between the pulley 111 and the pulley 121 which face each other. Here, the pulley 111 which is the first joint pulley, the staple pulley 161, and the pulley 121 which is the second joint pulley may be formed to be rotatable independently of each other.
[0289] The staple auxiliary pulley 162 may be further provided on one side of the staple pulley 161. In other words, the staple auxiliary pulley 162 may be disposed between the staple pulley 161 and the pulley 163 / pulley 164. The staple auxiliary pulley 162 may be formed to be rotatable independently of the pulley 112 and the pulley 122 about the rotation axis 142. Here, in the figure, the staple auxiliary pulley 162, the pulley 112, and the pulley 122 are formed to rotate about one rotation axis 142, but it goes without saying that each of the staple auxiliary pulley 162, the pulley 112, and the pulley 122 may be formed to be rotatable about a separate axis. Such a staple auxiliary pulley will be described in more detail later.
[0290] The pulley 163 and the pulley 164 may function as staple pitch main pulleys, and the pulley 165 and the pulley 166 may function as staple pitch sub-pulleys.
[0291] Hereinafter, the components related to the rotation of the staple pulley 161 will be described.
[0292] The pulley 163 and the pulley 164 function as staple pitch main pulleys. Here, the wire 307, which is a staple wire, is wound around the pulley 163, and the wire 308, which is a staple wire, is wound around the pulley 164.
[0293] The pulley 165 and the pulley 166 function as staple pitch sub-pulleys. Here, the wire 307, which is a staple wire, is wound around the pulley 165, and the wire 308, which is a staple wire, is wound around the pulley 166.
[0294] Here, on one side of the staple pulley 161 and the staple auxiliary pulley 162, the pulleys 163 and 164 are arranged to face each other. Here, the pulleys 163 and 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 one side of each of the pulleys 163 and 164, the pulleys 165 and 166 are arranged to face each other. Here, the pulleys 165 and 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, in the figure, it is shown that the pulleys 163, 165, 164, and 166 are all formed to be rotatable about the Y-axis direction, but the idea of the present invention is not limited thereto, and the rotation axes of the respective pulleys may be formed in various directions so as to suit their configurations.
[0295] As described above, the rotation axis 141, the rotation axis 142, the rotation axis 143, and the rotation axis 144 may be sequentially arranged in the direction from the distal end 104 to the proximal end 105 of the end tool 100. Thereby, the staple pulley 161, the staple auxiliary pulley 162, the pulleys 163 / pulleys 164, and the pulleys 165 / pulleys 166 may be sequentially arranged from the distal end 104 to the proximal end 105 of the end tool 100.
[0296] The wire 307 which is a staple wire is sequentially wound so as to be in contact with at least a part of the pulleys 165, 163, the staple auxiliary pulley 162, and the staple pulley 161. And the wire 308 connected to the wire 307 by a fastening member (see 329 in FIG. 62) is sequentially wound so as to be in contact with at least a part of the staple pulley 161, the staple auxiliary pulley 162, the pulley 164, and the pulley 166.
[0297] Explaining this from another perspective, the wire 307 and the wire 308, which are staple wires, are sequentially wound so as to be in contact with at least a part of the pulley 165, pulley 163, staple auxiliary pulley 162, staple pulley 161, staple auxiliary pulley 162, pulley 164, and pulley 166, and the wire 307 and the wire 308 are formed so as to be able to move along the pulley while rotating the pulley.
[0298] Therefore, when the wire 307 is pulled, the fastening member (see 329 in FIG. 62) to which the wire 307 is coupled and the staple pulley 161 coupled thereto will rotate in one direction. Conversely, when the wire 308 is pulled, the fastening member (see 329 in FIG. 62) to which the wire 308 is coupled and the staple pulley 161 coupled thereto will rotate in the opposite direction.
[0299] Hereinafter, the staple auxiliary pulley 162 will be described in more detail.
[0300] The staple auxiliary pulley 162 can play a role of expanding the rotation angle of the staple pulley 161 by contacting the wire 307 and the wire 308, which are staple wires, and changing the arrangement path of the wire 307 and the wire 308 to a certain extent.
[0301] That is, when the staple auxiliary pulley is not arranged, the staple pulley can only rotate up to a right angle, but in an embodiment of the present invention, by further providing the staple auxiliary pulley 162, which is an auxiliary pulley, an effect that the maximum rotation angle increases by θ in both directions can be obtained. This enables the staple pulley 161 to rotate for staple fastening and cutting operations and enables the operation of linearly moving the working member 540 described later in a state where both jaws of the end tool 100 are yaw-rotated together by 90°. In other words, it has a feature that the range of yaw rotation in which staple fastening and cutting operations are possible can be expanded through the staple auxiliary pulley 162.
[0302] To explain this in more detail, it is as follows.
[0303] In the case of the surgical instrument 10 of the present invention, a staple auxiliary pulley 162 is further disposed on one side of the staple pulley 161. By disposing the staple auxiliary pulley 162 in this way and changing the arrangement path of the wires 307 and 308 which are staple 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 (see 329 in FIG. 62) that couples the wires 307 and 308 with the staple pulley 161 is enlarged. That is, the fastening member (see 329 in FIG. 62), which is the coupling part of the wires 307 and 308 and the staple pulley 161, can rotate until it is located on the common internal tangent of the staple pulley 161 and the staple auxiliary pulley 162.
[0304] In other words, the wires 307 and 308 are located on the internal tangent of the staple pulley 161 and the staple auxiliary pulley 162, and the rotation angle of the staple pulley 161 is extended by the staple auxiliary pulley 162.
[0305] According to the present invention as described above, by expanding the rotation radius of the staple pulley 161, it is possible to obtain the effect of expanding the yaw operation range in which normal stapling and cutting operations can be performed.
[0306] (Staple drive assembly)
[0307] Hereinafter, the staple drive assembly 150 will be described in more detail.
[0308] Referring to FIG. 13 etc., the staple driving assembly 150 may include a staple pulley assembly 160 and a staple link assembly 170. Here, the staple driving assembly 150 is connected to the reciprocating movement assembly 550 of the cartridge 500 described later, and is characterized by converting the rotational movement of the staple pulley 161 into the linear movement of the reciprocating movement assembly 550. In other embodiments of the present invention described later, the staple driving assembly can also be understood as a concept including a staple pulley assembly and a staple link assembly.
[0309] The staple pulley assembly 160 may include one or more staple pulleys 161. The staple pulley assembly 160 may be formed between the pulley 111 and the pulley 121, adjacent to the pulley 111 and the pulley 121. In this embodiment, it is assumed that the staple pulley assembly 160 includes one staple pulley 161.
[0310] An axially penetrating portion 161a may be formed in the staple pulley 161. The axially penetrating portion 161a is formed in a hole shape, and the rotating shaft 141, which is the end tool joint pulley rotating shaft, may be inserted through the axially penetrating portion 161a. Further, a link connecting portion 161b may be formed in the staple pulley 161. The staple link assembly 170 described later may be connected to the link connecting portion 161b. This will be described in more detail later.
[0311] On the other hand, the end tool 100 of the first embodiment of the present invention may further include a staple link assembly 170 connected to the staple pulley assembly 160. The staple link assembly 170 may include one or more link members 171. The staple link assembly 170 can play a role of connecting the staple pulley assembly 160 and the reciprocating movement assembly 550 of the cartridge 500 described later. In this embodiment, it is assumed that the staple link assembly 170 includes one link member 171, and the link member 171 includes a first link 172 and a second link 173.
[0312] The first link 172 is formed in an elongated bar shape, and through holes may be formed at both ends. The link coupling portion 161b of the staple pulley 161 may be inserted through the through hole at one end of the first link 172. The second link 173 may be inserted through the through hole at the other end of the first link 172.
[0313] The second link 173 is formed in an elongated bar shape and may be coupled to the first link 172. The second link 173 may include a first protrusion 173a, a second protrusion 173b, and a fastening portion 173c.
[0314] Specifically, a first protrusion 173a may be formed at one end of the second link 173. By fitting and axially coupling the first protrusion 173a into the through hole of the first link 172, the second link 173 can be coupled to the first link 172. Further, the first protrusion 173a may be fitted into the guide groove 101b of the first joe 101 described later.
[0315] On the other hand, a second protrusion 173b may be formed in a region at the center of the second link 173. The second protrusion 173b may be fitted into the guide groove 101b of the first joe 101 described later.
[0316] In this way, with the first protrusion 173a and the second protrusion 173b of the second link 173 formed in a protruding shape fitted into the groove-shaped guide groove 101b, the staple link assembly 170 moves with respect to the first joe 101 (and the cartridge 500 inside thereof) as the first protrusion 173a and the second protrusion 173b move along the guide groove 101b. This will be described in more detail later.
[0317] On the other hand, a fastening portion 173c may be formed at the other end of the second link 173. This fastening portion 173c may be coupled to the fastening portion 551a of the reciprocating movement assembly 550 of the cartridge 500 described later.
[0318] In a state similar to that of FIG. 13, when the staple pulley 161 rotates in the clockwise direction, the link member 171 connected to the staple pulley 161 can move as a whole in the direction of the distal portion of the first jaw 101 (see 101f in FIG. 14). Conversely, when the staple pulley 161 rotates in the counterclockwise direction, the link member 171 connected to the staple pulley 161 can move as a whole in the direction of the proximal portion of the first jaw 101 (see 101g in FIG. 14).
[0319] Therefore, the bidirectional rotational movement of the staple pulley assembly 160 can cause the reciprocating linear movement of the reciprocating movement assembly 550 of the cartridge 500 via the staple link assembly 170. This will be described in more detail later.
[0320] (First jaw, second jaw and actuation movement)
[0321] Hereinafter, the coupling structure between the first jaw 101 and the second jaw 102 of the end tool 100 of the surgical instrument 10 in FIG. 2 will be described in more detail.
[0322] FIG. 14 is a plan view showing the first jaw of the surgical instrument in FIG. 2, and FIG. 15 is a plan view showing the second jaw of the surgical instrument in FIG. 2. FIG. 16 is a plan view showing the opening and closing operation of the first jaw of the surgical instrument in FIG. 2, FIG. 17 is a plan view showing the opening and closing operation of the second jaw of the surgical instrument in FIG. 2, and FIG. 18 is a plan view showing the opening and closing operation of the first jaw and the second jaw of the surgical instrument in FIG. 2. FIG. 19 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument in FIG. 2, and FIG. 20 is a plan view showing the opening and closing operation of the end tool of the surgical instrument in FIG. 2.
[0323] Referring to FIGS. 9 to 20 and the like, the first jaw 101 includes a cartridge housing portion 101a, a guide groove 101b, a movable coupling hole 101c, a jaw pulley coupling hole 101d, and a shaft through portion 101e.
[0324] The first jaw 101 is formed in an overall elongated rod shape. A cartridge 500 is accommodated on the distal portion 101f side, and a pulley 111 is coupled to the proximal portion 101g, and it is formed to be rotatable about the rotation axis 141. In other words, the first jaw 101 is formed in a form in which one surface (upper surface) of an overall hollow box is removed, and a cartridge accommodation portion 101a capable of accommodating the cartridge 500 may be formed inside the first jaw 101. That is, the cross-section of the first jaw 101 may be formed in a substantially "U" shape.
[0325] On one side of the cartridge accommodation portion 101a in the first jaw 101, for example, on the proximal portion 101g side, a guide groove 101b for guiding the movement of a staple link assembly 170 described later may be formed. The guide groove 101b may be formed in a groove shape formed along the movement path of the staple link assembly 170. Then, with the first protrusion 173a and the second protrusion 173b of the second link 173 formed in a protrusion shape fitted into the groove-shaped guide groove 101b, the first protrusion 173a and the second protrusion 173b move along the guide groove 101b, so that the staple link assembly 170 moves with respect to the first jaw 101 (and the cartridge 500 inside it). That is, the staple link assembly 170 can move along the guide groove 101b of the first jaw 101.
[0326] On the other hand, a movable coupling hole 101c, a jaw pulley coupling hole 101d, and a shaft through portion 101e may be formed on the proximal end side of the first jaw 101.
[0327] Here, the movable coupling hole 101c is formed to have a predetermined curvature and may be formed in a substantially elliptical shape. The shaft coupling portion 111a of the pulley 111 described later may be fitted into the movable coupling hole 101c. Here, the minor radius of the movable coupling hole 101c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 111a. On the other hand, the major radius of the movable coupling hole 101c may be formed to be larger than the radius of the shaft coupling portion 111a. Therefore, in a state where the shaft coupling portion 111a of the pulley 111 is fitted into the movable coupling hole 101c of the first jaw 101, the shaft coupling portion 111a is formed to be movable to a certain extent within the movable coupling hole 101c. This will be described in more detail later.
[0328] On the other hand, the jaw-pulley coupling hole 101d is formed in a cylindrical hole shape, and the jaw coupling portion 111b of the pulley 111 described later may be fitted into the jaw-pulley coupling hole 101d. Here, the radius of the jaw-pulley coupling hole 101d may be formed to be substantially the same as or slightly larger than the radius of the jaw coupling portion 111b. Therefore, the jaw coupling portion 111b of the pulley 111 may be formed to be rotatably coupled to the jaw-pulley coupling hole 101d of the first jaw 101. This will be described in more detail later.
[0329] The shaft through-hole 101e may be formed relatively on the distal portion 101f side of the first jaw 101 compared to the movable coupling hole 101c and the jaw-pulley coupling hole 101d. The shaft through-hole 101e is formed in a hole shape, and the rotation shaft 145, which is the jaw rotation shaft, may be inserted through the shaft through-hole 101e.
[0330] The second jaw 102 includes an anvil 102a, a movable coupling hole 102c, a jaw-pulley coupling hole 102d, and a shaft through-hole 102e.
[0331] The second jaw 102 is formed in an overall elongated bar shape, with an anvil 102a formed on the distal portion 102f side, a pulley 112 coupled to the proximal portion 102g, and is formed to be rotatable about the rotation shaft 141.
[0332] Specifically, the anvil 102a may be formed in a flat planar shape, and a shape corresponding to the shape of the staple 530 described later may be formed on one of its surfaces. Such an anvil 102a can play the role of a base that supports the opposite side of the working member 540 when the working member 540 pushes up the staple 530 during the stapling operation, allowing the staple 530 to be bent.
[0333] On the other hand, a movable coupling hole 102c, a jaw pulley coupling hole 102d, and a shaft through portion 102e may be formed on the proximal end side of the second jaw 102.
[0334] Here, the movable coupling hole 102c is formed to have a predetermined curvature and may be formed in a substantially elliptical shape. The shaft coupling portion 121a of the pulley 121 described later may be fitted into the movable coupling hole 102c. Here, the minor radius of the movable coupling hole 102c may be substantially the same as or slightly larger than the radius of the shaft coupling portion 121a. On the other hand, the major radius of the movable coupling hole 102c may be formed larger than the radius of the shaft coupling portion 121a. Therefore, in a state where the shaft coupling portion 121a of the pulley 121 is fitted into the movable coupling hole 102c of the second jaw 102, the shaft coupling portion 121a is formed to be movable to a certain extent within the movable coupling hole 102c. This will be described in more detail later.
[0335] On the other hand, the jaw pulley coupling hole 102d is formed in a cylindrical hole shape, and the jaw coupling portion 121b of the pulley 121 described later may be fitted into the jaw pulley coupling hole 102d. Here, the radius of the jaw pulley coupling hole 102d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 121b. Therefore, the jaw coupling portion 121b of the pulley 121 may be formed to be rotatably coupled to the jaw pulley coupling hole 102d of the second jaw 102. This will be described in more detail later.
[0336] On the other hand, the shaft through-hole 102e may be formed relatively closer to the distal portion 102g side of the second jaw 102 than the movable coupling hole 102c and the jaw pulley coupling hole 102d. The shaft through-hole 102e is formed in a hole shape, and the rotation shaft 145, which is the jaw rotation shaft, may be inserted through the shaft through-hole 102e.
[0337] The pulley 111, which is the first jaw pulley, may include a shaft coupling portion 111a and a jaw coupling portion 111b. The pulley 111 is formed in a disk shape that can rotate as a whole, and on one surface thereof, the shaft coupling portion 111a and the jaw coupling portion 111b may be formed to protrude to a certain extent. As described above, the shaft coupling portion 111a of the pulley 111 may be fitted into the movable coupling hole 101c of the first jaw 101, and the jaw coupling portion 111b of the pulley 111 may be fitted into the jaw pulley coupling hole 101d of the first jaw 101. The pulley 111 may be formed to be rotatable about the rotation shaft 141, which is the end tool jaw pulley rotation shaft.
[0338] On the other hand, the pulley 121, which is the second jaw pulley, may also include a shaft coupling portion 121a and a jaw coupling portion 121b. The pulley 121 is formed in a disk shape that can rotate as a whole, and on one surface thereof, the shaft coupling portion 121a and the jaw coupling portion 121b may be formed to protrude to a certain extent. As described above, the shaft coupling portion 112a of the pulley 112 may be fitted into the movable coupling hole 102c of the second jaw 102, and the jaw coupling portion 112b of the pulley 112 may be fitted into the jaw pulley coupling hole 102d of the second jaw 102. The pulley 121 may be formed to be rotatable about the rotation shaft 141, which is the end tool jaw pulley rotation shaft.
[0339] The coupling relationship between the above-described components is as follows.
[0340] The rotation shaft 141, which is the end tool jaw pulley rotation shaft, is sequentially inserted through the shaft coupling portion 111a of the pulley 111, the movable coupling hole 101c of the first jaw 101, the shaft through-hole 161a of the staple pulley 161, the movable coupling hole 102c of the second jaw 102, and the shaft coupling portion 121a of the pulley 121.
[0341] The rotating shaft 145, which is the Joe rotating shaft, is sequentially inserted through the shaft through-hole 101e of the first Joe 101 and the shaft through-hole 102e of the second Joe 102.
[0342] The shaft coupling portion 111a of the pulley 111 fits into the movable coupling hole 101c of the first Joe 101, and the Joe coupling portion 111b of the pulley 111 fits into the Joe-pulley coupling hole 101d of the first Joe 101.
[0343] At this time, the Joe-pulley coupling hole 101d of the first Joe 101 and the Joe coupling portion 111b of the pulley 111 are rotatably shaft-coupled, and the movable coupling hole 101c of the first Joe 101 and the shaft coupling portion 111a of the pulley 111 are movably coupled.
[0344] The shaft coupling portion 121a of the pulley 121 fits into the movable coupling hole 102c of the second Joe 102, and the Joe coupling portion 121b of the pulley 121 fits into the Joe-pulley coupling hole 102d of the second Joe 102.
[0345] At this time, the Joe-pulley coupling hole 102d of the second Joe 101 and the Joe coupling portion 121b of the pulley 121 are rotatably shaft-coupled, and the movable coupling hole 102c of the second Joe 102 and the shaft coupling portion 121a of the pulley 121 are movably coupled.
[0346] Here, the pulley 111 and the pulley 121 rotate about the rotating shaft 141, which is the end tool Joe pulley rotating shaft. The first Joe 101 and the second Joe 102 rotate about the rotating shaft 145, which is the Joe rotating shaft. That is, the rotating shafts of the pulley 111 and the first Joe 101 are different from each other. Similarly, the rotating shafts of the pulley 121 and the second Joe 102 are different from each other.
[0347] That is, the rotation angle of the first Joe 101 is limited to a certain extent by the movable coupling hole 101c, but basically rotates about the rotating shaft 145, which is the Joe rotating shaft. Similarly, the rotation angle of the second Joe 102 is limited to a certain extent by the movable coupling hole 102c, but basically rotates about the rotating shaft 145, which is the Joe rotating shaft.
[0348] The amplification of the grip force due to the coupling relationship between the above-described components will be described.
[0349] The surgical instrument 10 according to an embodiment of the present invention is characterized in that the coupling structure between the first jaw 101 and the second jaw 102 forms an X-shaped structure, and when the first jaw 101 and the second jaw 102 rotate in a direction approaching each other (that is, when the first jaw 101 and the second jaw 102 are closed), the grip force in the direction in which the first jaw 101 and the second jaw 102 are closed becomes even greater. More specifically, it is as follows.
[0350] As described above, in the operation of opening and closing the first jaw 101 and the second jaw 102, there are two axes that serve as the rotation centers. That is, the first jaw 101 and the second jaw 102 perform an opening and closing operation around two axes, namely the rotation axis 141 and the rotation axis 145. At this time, the rotation center of the first jaw 101 and the second jaw 102 is the rotation axis 145, and the rotation center of the pulley 111 and the pulley 121 is the rotation axis 141. At this time, the rotation axis 141 is an axis whose position is relatively fixed, and the rotation axis 145 is an axis whose position moves linearly relatively. In other words, with the position of the rotation axis 141 fixed, when the pulley 111 and the pulley 121 rotate, the rotation axis 145, which is the rotation axis of the first jaw 101 and the second jaw 102, moves back and forth while the first jaw 101 and the second jaw 102 are opened / closed. More specifically, it is as follows.
[0351] In FIG. 17, r1 is the distance from the jaw coupling portion 121b to the shaft coupling portion 121a of the pulley 121, and its length is constant. Therefore, the distance from the rotation axis 141 inserted into the shaft coupling portion 121a to the jaw coupling portion 121b is also constant at r1.
[0352] On the one hand, r2 in Fig. 17 is the distance from the pulley coupling hole 102d of the second jaw 102 to the shaft through-hole 102e, and its length is constant. Therefore, the distance from the jaw coupling part 121b of the pulley 121 inserted into the pulley coupling hole 102d to the rotating shaft 145 inserted into the shaft through-hole 102e is also constant at r2.
[0353] That is, the lengths of r1 and r2 are maintained constant. Therefore, when the pulleys 111 and 121 rotate in the directions of arrow A1 in Fig. 16 and arrow A2 in Fig. 17 around the rotating shaft 141 respectively to perform a close operation, while the lengths of r1 and r2 are maintained constant, the angle between r1 and r2 changes, and the first jaw 101 and the second jaw 102 rotate around the rotating shaft 145. At this time, the rotating shaft 145 itself also moves linearly (i.e., advances / retreats) only in the directions of arrow B1 in Fig. 16 and arrow B2 in Fig. 17.
[0354] That is, assuming that the position of the rotating shaft 141, which is the end tool jaw pulley rotating shaft, is fixed, when the first jaw 101 and the second jaw 102 are closed, the rotating shaft 145, which is the jaw rotating shaft, receives a force in the advancing direction (i.e., the distal part direction). Therefore, the grip force in the direction in which the first jaw 101 and the second jaw 102 are closed becomes even greater.
[0355] Expressing this from another perspective, when the second jaw 102 rotates around the jaw rotating shaft 145, since the lengths of r1 and r2 are maintained constant, when the pulley 121 rotates around the rotating shaft 141, the angle between r1 and r2 will change while the lengths of r1 and r2 are maintained constant. That is, compared with θ1, which is the angle between r1 and r2 in the state where the second jaw 102 is open as shown in Fig. 17(a), θ2, which is the angle between r1 and r2 in the state where the second jaw 102 is closed as shown in Fig. 17(b), becomes even greater.
[0356] Therefore, when the second jaw 102 rotates from the open state to the close state, the rotation axis 145 receives a force in the advancing direction while the angle between r1 and r2 changes.
[0357] At this time, since the rotation axis 141 is a shaft whose position is relatively fixed, the jaw rotation axis 145 will advance in the directions of arrow B1 in FIG. 16 and arrow B2 in FIG. 17, and the grip force will further increase in the direction in which the second jaw 102 is closed.
[0358] From another perspective, when the pulley 111 and the pulley 121 rotate around the rotation axis 141 which is a shaft with a fixed relative position, the distance between r1 and r2 remains constant while the angle θ between r1 and r2 changes. And when the angle θ changes in this way, the first jaw 101 and the second jaw 102 will push or pull the rotation axis 145, so the rotation axis 145 will advance or retreat. At this time, when the first jaw 101 and the second jaw 102 rotate in the closing direction, the rotation axis 145 advances in the directions of arrow B1 in FIG. 16 and arrow B2 in FIG. 17 while the grip force further increases. Conversely, when the first jaw 101 and the second jaw 102 rotate in the opening direction, the rotation axis 145 will retreat in the direction opposite to arrow B1 in FIG. 16 and arrow B2 in FIG. 17.
[0359] With such a configuration, when the first jaw 101 and the second jaw 102 are closed, the grip force becomes stronger, and the effect of strongly performing the actuation operation with less force by the surgeon can be obtained.
[0360] (Cartridge)
[0361] Hereinafter, the cartridge 500 of the surgical instrument 10 in FIG. 2 will be described in more detail.
[0362] FIG. 21 is a perspective view showing the first jaw and the cartridge of the surgical instrument of FIG. 2. FIG. 22 is an exploded perspective view showing the cartridge of FIG. 21, FIG. 23 is an assembled perspective view showing the cartridge of FIG. 21, FIG. 24 is a side view showing the cartridge of FIG. 21, FIG. 25 is a perspective sectional view showing the cartridge of FIG. 21, FIG. 26 is a side sectional view showing the cartridge of FIG. 21. FIGS. 27 and 28 are perspective views showing the working member of the cartridge of FIG. 21. FIG. 29 is a side sectional view showing the structure related to stapling of the end tool of the surgical instrument of FIG. 2, and FIGS. 30 and 31 are perspective sectional views showing the stapling structure of the end tool of the surgical instrument of FIG. 2. FIGS. 32 to 35 are perspective views showing the ratchet driving operation of the end tool of FIG. 30, and FIGS. 36 and 37 are plan views showing the ratchet driving operation of the end tool of FIG. 30. FIG. 38 is a perspective view showing the ratchet driving operation of the end tool of FIG. 30 as a whole. FIGS. 39 and 40 are perspective views showing the stapling operation of the end tool of FIG. 30 as a whole.
[0363] Referring to FIGS. 21 to 40 and the like, the cartridge 500 is formed to be attachable and detachable to the first jaw 101, and includes a plurality of staples 530 and a blade 542 therein for suturing and cutting tissue. Here, the cartridge 500 may include a cover 510, a housing 520, a staple 530, a drawing member 535, a working member 540, and a reciprocating assembly 550.
[0364] The housing 520 forms the outer shape of the cartridge 500, and is formed in a form in which one surface (upper surface) of an overall hollow box is removed, and may be formed to accommodate the reciprocating assembly 550, the working member 540, and the staple 530 therein. Here, the housing 520 may be formed in a substantially "U" - shaped cross - section.
[0365] The cover 510 is formed to cover the upper part of the housing 520. The cover 510 may be formed with staple holes 511 through which a plurality of staples 530 can be discharged to the outside. Before staple driving, the staples 530 accommodated inside the housing 520 are pushed up by the working member 540 during the stapling operation, pulled out through the staple holes 511 of the cover 510 to the outside of the cartridge 500, and stapling is performed.
[0366] On the other hand, a slit 512 may be formed in the cover 510 along its longitudinal direction. The blade 542 of the working member 540 may protrude to the outside of the cartridge 500 through the slit 512. While the blade 542 of the working member 540 passes along this slit 512, the tissue that has completed stapling can be cut.
[0367] A plurality of staples 530 may be arranged inside the housing 520. As the working member 540 described later moves linearly in one direction, the plurality of staples 530 can be sequentially pushed up from inside the housing 520 to the outside for suturing, that is, stapling. Here, the material of the staples 530 may include titanium, stainless steel, etc.
[0368] On the other hand, a drawing member 535 may be further arranged between the housing 520 and the staples 530. In other words, it may be expressed that the staples 530 are arranged on the upper part of the drawing member 535. In this case, while the working member 540 moves linearly in one direction, it pushes up the drawing member 535, and this drawing member 535 can push up the staples 530.
[0369] In this way, both the case where the working member 540 directly pushes up the staples 530 and the case where the working member 540 pushes up the drawing member 535 and the drawing member 535 pushes up the staples 530 (that is, the case where the working member 540 indirectly pushes up the staples 530) are included, and it can be explained that the working member 540 pushes up the staples 530.
[0370] A reciprocating assembly 550 may be disposed below the interior of the housing 520. The reciprocating assembly 550 may include one or more reciprocating members 551. In the present embodiment, one reciprocating member 551 is shown, but in the embodiments described below, a plurality of reciprocating members 551 may be provided.
[0371] In the present embodiment, the reciprocating member 551 may be a rack. The reciprocating member 551 may include uneven portions 551b and fastening portions 551a. Specifically, the reciprocating member 551 may be formed in the shape of a long bar, and a plurality of serrated uneven portions 551b may be formed on one surface. The uneven portions 551b may be formed to be capable of contacting a working member 540 described later, particularly a ratchet member 543 of the working member 540. In other words, the reciprocating member 551 may include a plurality of uneven portions 551b having a shape that meshes with a ratchet 543a of the ratchet member 543.
[0372] On the other hand, although not shown in the figure, the reciprocating member 551 may be provided with various shaped members that are directly or indirectly connected to the staple pulley 161 and are capable of linear reciprocating motion in accordance with the rotational motion of the staple pulley 161, other than the rack shape. For example, the reciprocating member 551 may be in the form of a clutch without uneven portions.
[0373] Here, the reciprocating member 551 may not be fixedly coupled to other components of the cartridge 500 and may be formed to be movable relative to other components of the cartridge 500. That is, the reciprocating member 551 can perform a reciprocating linear motion with respect to the housing 520 and the cover 510 coupled to the housing 520.
[0374] On one hand, a fastening portion 551a may be formed on the proximal end 501 side of the reciprocating member 551 adjacent to the pulley 111. This fastening portion 551a may be fastened and coupled to the staple link assembly 170 of the end tool 100. Therefore, when the staple link assembly 170 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the reciprocating member 551 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction). This will be described in more detail later.
[0375] The working member 540 may be disposed inside the housing 520. The working member 540 may be formed to be in contact with the reciprocating member 551 and may be formed to linearly move in one direction in response to the reciprocating linear motion of the reciprocating member 551. In other words, the working member 540 interacts with the reciprocating member 551 and performs stapling and cutting while moving along the extending direction of the connecting portion 400.
[0376] The working member 540 may include a wedge 541, a blade 542, a ratchet member 543, an elastic member 544, and a main body 545.
[0377] The main body 545 may be formed in a rectangular column shape and forms the base of the working member 540.
[0378] The wedge 541 may be formed on at least one side of the main body 545 and may be formed to have a predetermined inclined surface. That is, the wedge 541 may be formed to be inclined to a certain extent in the extending direction of the connecting portion 400. In other words, it may be formed such that the height of the proximal end 501 side is higher than that of the distal end 502 side of the cartridge 500. In the figure, it is shown that two wedges 541 are formed on the left and right of the main body 545, but the idea of the present invention is not limited thereto, and it may be formed in various numbers and shapes according to the shape of the staple 530 or the drawing member 535 in contact with the wedge 541.
[0379] Such a wedge 541 is formed to be sequentially contactable with the extraction member 535 or the plurality of staples 530, and can serve to sequentially push up the staples 530. As shown in FIG. 40 and the like described later, while the working member 540 moves toward the distal portion 502 side, the staples 530 can be sequentially pushed up to serve to extract them outside the cartridge 500.
[0380] A blade 542 may be formed on one side of the wedge 541, more specifically, on the proximal portion 501 side of the wedge 541. In one region of the blade 542, an edge 542a that is sharply formed to cut tissue is formed. At least a part of this edge 542a is drawn out to the outside of the first jaw 101 and the cartridge 500, and the tissue disposed between the first jaw 101 and the second jaw 102 can be cut. The edge 542a of the blade 542 may always be drawn out to the outside of the first jaw 101. Alternatively, the edge 542a of the blade 542 may normally be housed inside the first jaw 101 or the cartridge 500 and be drawn out to the outside of the first jaw 101 only when the working member 540 moves along the longitudinal direction.
[0381] The ratchet member 543 may be formed on one side of the wedge 541, more specifically, at the lower part of the wedge 541, and may be formed to face the reciprocating member 551 described later. The ratchet member 543 may be formed in a bar shape and may include a plurality of ratchets 543a on one surface. The ratchet member 543 causes the working member 540 to move only in one direction (i.e., the distal portion direction) with respect to the reciprocating member 551. The ratchet 543a of the ratchet member 543 may be formed to be contactable with the uneven portion 551b of the above-described reciprocating member 551.
[0382] The elastic member 544 is formed on either side of the main body 545 or the wedge 541 and serves to apply a predetermined elastic force to the ratchet member 543. As an example, one region of the elastic member 544 is connected to the wedge 541 or the main body 545, and the other region of the elastic member 544 is connected to the ratchet member 543, and the elastic member 544 may connect the wedge 541 or the main body 545 and the ratchet member 543. Here, the elastic member 544 can apply an elastic force in the direction in which the ratchet member 543 is in close contact with the reciprocating member 551. For this reason, the elastic member 544 may be formed in the form of a leaf spring, and may also be provided in various forms such as a coil spring and a disc spring that can provide a predetermined elastic force to the ratchet member 543.
[0383] Here, the ratchet 543a of the ratchet member 543 is formed such that the first surface 543a1 (specifically, the side surface of the distal portion 502) has a predetermined angle and a gentle inclination, and the second surface 543a2 (specifically, the side surface of the proximal portion 501) may be formed perpendicular or nearly perpendicular.
[0384] And, so as to mesh with the ratchet 543a of the ratchet member 543, the uneven portion 551b of the reciprocating member 551 is also formed such that the first surface 551b1 (specifically, the side surface of the proximal portion 501) has a predetermined angle and a gentle inclination, and the second surface 551b2 (specifically, the side surface of the distal portion 502) may be formed perpendicular or nearly perpendicular.
[0385] In a state where the reciprocating member 551 and the ratchet member 543 are fastened to each other (or meshed with each other or in close contact with each other), the inclined first surface 543a1 of the ratchet 543a and the inclined first surface 551b1 of the uneven portion 551b may be arranged to face each other (that is, to abut). Also, the perpendicular second surface 543a2 of the ratchet 543a and the perpendicular second surface 551b2 of the uneven portion 551b may be arranged to face each other (that is, to abut).
[0386] With such a configuration, in the state where the ratchet 543a and the uneven portion 551b are fastened (or meshed) with each other, they act as a kind of ratchet, and only movement in a certain one direction is possible.
[0387] As an example, assuming that the reciprocating member 551 is in a fixed state, the working member 540 can move in the direction in which the second surface 543a2 and the second surface 551b2 formed vertically move away from each other, but cannot move in the direction in which they approach each other in the state where the second surface 543a2 and the second surface 551b2 are in contact.
[0388] Expressing this from another perspective, in the state where the reciprocating member 551 and the ratchet member 543 are fastened (or meshed or in close contact) with each other, when the reciprocating member 551 moves in the direction of the distal portion 502, the ratchet member 543 will move together with the reciprocating member 551 in the direction of the distal portion 502. That is, the second surface 551b2 perpendicular to the reciprocating member 551 presses the second surface 543a2 perpendicular to the working member 540, and the ratchet member 543 will move together with the reciprocating member 551 in the direction of the distal portion 502.
[0389] Conversely, in the state where the reciprocating member 551 and the ratchet member 543 are fastened (or meshed or in close contact) with each other, when the reciprocating member 551 moves in the direction of the proximal portion 501, the ratchet member 543 will be in a fixed state and only the reciprocating member 551 alone will move in the direction of the proximal portion 501. That is, in the state where the working member 540 is fixed, the inclined first surface 551b1 of the reciprocating member 551 will move along the inclined first surface 543a1 of the working member 540, and only the reciprocating member 551 alone will move in the direction of the proximal portion 501.
[0390] Referring to FIGS. 34 to 37, in the same state as FIGS. 34 and 36, when the reciprocating member 551 moves in the direction of the proximal portion 501 (in the direction of arrow K1 in FIGS. 35 and 37), while the inclined first surface 551b1 of the reciprocating member 551 moves along the inclined first surface 543a1 of the working member 540, the ratchet member 543 is pressed and pushed in the direction of arrow K2 in FIG. 35 as a whole. And at this time, the elastic member 544 also elastically deforms to some extent.
[0391] In this state, when the reciprocating member 551 further moves in the direction of the proximal portion 501 and the inclined first surface 551b1 of the reciprocating member 551 exceeds the tip of the inclined first surface 543a1 of the working member 540, the uneven portion 551b of the reciprocating member 551 will meet the next ratchet 543a of the ratchet member 543. At this time, since the elastic member 544 applies an elastic force in the direction in which the ratchet member 543 is in close contact with the reciprocating member 551, the front surfaces of the reciprocating member 551 and the ratchet member 543 are in close contact again.
[0392] As a result, the cartridge 500 is housed in the cartridge housing portion 101a of the first jaw 101, and at this time, the reciprocating member 551 of the cartridge 500 is coupled to the staple link assembly 170 of the end tool 100. Therefore, the rotational movement of the staple pulley 161 of the end tool 100 is converted into the linear movement of the reciprocating member 551 through the staple link assembly 170.
[0393] At this time, the fastening portion 551a of the reciprocating member 551 is connected to the staple pulley 161 via the staple link assembly 170. When the staple pulley 161 rotates alternately in the clockwise direction / counterclockwise direction, the reciprocating member 551 can repeat forward and backward movements. When the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551. When the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward and the working member 540 can stop in place. While repeating this process, as the working member 540 moves forward, the staple 530 is stapled by the wedge 541, and at the same time, the blade 542 can cut the tissue to which the staple is applied.
[0394] A more detailed description of this is as follows.
[0395] (stapling and cutting action)
[0396] Referring to FIG. 38, the driving method of the surgical instrument according to an embodiment of the present invention is as follows.
[0397] First, when the staple pulley 161 rotates in one of the clockwise direction and the counterclockwise direction, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating assembly 550 of the cartridge 500 connected to the staple link assembly 170 move in the direction of the distal portion 502 of the cartridge 500.
[0398] Then, when the reciprocating assembly 550 moves in the direction of the distal portion 502 of the cartridge 500, the working member 540 in contact with the reciprocating assembly 550 moves in the direction of the distal portion 502 of the cartridge 500 together with the reciprocating assembly 550.
[0399] Then, while the working member 540 moves in the direction of the distal portion 502 of the cartridge 500, the working member 540 discharges the staple 530 to the outside of the cartridge 500, and at the same time, the blade 542 of the working member 540 moves in the direction of the distal portion 502 of the cartridge 500.
[0400] On the one hand, when the staple pulley 161 rotates in one direction different from the clockwise and counterclockwise directions, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating movement assembly 550 of the cartridge 500 connected to the staple link assembly 170 move in the direction of the proximal portion 501 of the cartridge 500, and at this time the working member 540 is stopped.
[0401] And such steps are repeated, and the stapling operation by the wedge 541 and the cutting operation by the blade 542 are performed simultaneously.
[0402] A more detailed explanation of this is as follows.
[0403] First, in the state as shown in Fig. 38(a), when the staple pulley 161 rotates in the direction of arrow A1 (i.e., clockwise) as shown in Fig. 38(b), the staple link assembly 170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 170 move in the direction of arrow B1 (i.e., the distal portion direction). In this state, since the reciprocating member 551 and the working member 540 are in close contact with each other by an elastic member (see 544 in Fig. 37), when the reciprocating member 551 moves in the direction of arrow B1, the working member 540 also moves in the direction of arrow B1 together with the reciprocating member 551.
[0404] Next, when the staple pulley 161 further rotates in the direction of arrow A2 as shown in Fig. 38(c), the staple link assembly 170, the reciprocating member 551, and the working member 540 connected thereto will further move in the direction of arrow B2.
[0405] In this state, when the staple pulley 161 stops rotating, as shown in Fig. 38(d), the staple link assembly 170, the reciprocating member 551, and the working member 540 will also stop.
[0406] In this state, as shown in FIG. 38(e), when the staple pulley 161 starts to rotate in the direction of arrow A3 (i.e., counterclockwise), the staple link assembly 170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 170 move in the direction of arrow B3 (i.e., proximal direction). In this state, due to the fastening structure between the ratchet member 543 and the reciprocating member 551, even when the reciprocating member 551 moves in the B3 direction, the overall position of the working member 540 is maintained as it is, and while the elastic member 544 repeatedly undergoes elastic deformation and restoration, only the ratchet member 543 repeatedly moves away from and comes into contact with the reciprocating member 551 to a certain extent (see FIGS. 35 and 37). That is, even when the reciprocating member 551 moves in the direction of arrow B3, the working member 540 stops in place when viewed from the X-axis direction.
[0407] As shown in FIG. 38(f), when the staple pulley 161 further rotates in the direction of arrow A4, only the staple link assembly 170 and the reciprocating member 551 connected thereto will further move in the direction of arrow B4.
[0408] In this state, when the rotation of the staple pulley 161 stops, as shown in FIG. 38(a), the staple link assembly 170, the reciprocating member 551, and the working member 540 will also stop.
[0409] Repeating such a process, when the staple pulley 161 rotates alternately in the clockwise / counterclockwise directions, the reciprocating member 551 repeatedly moves forward and backward, and the working member 540 repeatedly moves forward and stops, and as a result, the working member 540 moves toward the distal portion 502 side. And while the working member 540 moves toward the distal portion 502 side, the staple fastening operation by the wedge 541 and the cutting operation by the blade 542 are performed simultaneously.
[0410] Hereinafter, the staple fastening operation of the surgical instrument according to an embodiment of the present invention will be described.
[0411] FIG. 39 is a perspective view showing the staple operation of the end tool of FIG. 30 by section, and FIG. 40 is a perspective view showing the staple operation of the end tool of FIG. 30 as a whole.
[0412] Referring to FIGS. 39 and 40, in a state as shown in FIG. 39(a), while the working member 540 moves in the direction of arrow A1 in FIG. 39(b), the wedge 541 of the working member 540 pushes up the extraction member 535, and the extraction member 535 pushes up one side below the staple 530. As a result, the staple 530 is discharged outside the first jaw 101 and the cartridge 500.
[0413] In this state, when the working member 540 further moves in the direction of arrow A2 in FIG. 39(c), and the discharged staple 530 is continuously pushed up by the working member 540 in a state of contacting the anvil 102a of the second jaw 102, stapling is performed while both ends of the staple 530 are bent.
[0414] While such operations are continuously performed, as shown in FIG. 40, stapling is sequentially performed from the staple 530 on the proximal portion 501 side to the staple 530 on the distal portion 502 side among the plurality of staples 530.
[0415] (Operation unit)
[0416] FIGS. 41 and 42 are perspective views showing the operation portion of the surgical instrument of FIG. 2. FIG. 43 is a diagram simply showing only the configuration of the pulley and the wire constituting the joint of the surgical instrument shown in FIG. 2.
[0417] Referring to FIGS. 2 to 42, the operation unit 200 of the 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. 41 and 42 show only the components related to the pitch / yaw / actuation movement of the surgical instrument 10.
[0418] Further, the operation unit 200 of the surgical instrument 10 may further include a staple operation unit 260 that controls the movement of the staple pulley assembly 160 of the end tool 100 to perform stapling and cutting.
[0419] The operation unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 related to the rotational movement of the first jaw 101. Further, it may 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 may include pulleys 231, 232, 233, and 234 related to the pitch movement. Further, it may include a pulley 235 that is an intermediate pulley disposed in the middle of the bent portion 402 of the connecting portion 400.
[0420] Here, although the figures show that the opposing pulleys are formed parallel to each other, the idea of the present invention is not limited to this, and it can be said that each pulley may be formed in various positions and sizes adapted to the configuration of the operation unit.
[0421] In addition, the operation unit 200 of the first embodiment of the present invention may 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 may function as an operation unit first jo actuator rotation shaft, and the rotation shaft 242 may function as an operation unit second jo actuator rotation shaft. Then, the rotation shaft 243 may function as an operation unit yaw main rotation shaft, and the rotation shaft 244 may function as an operation unit yaw sub rotation shaft. Then, the rotation shaft 245 may function as an operation unit pitch sub rotation shaft, and the rotation shaft 246 may function as an operation unit pitch main rotation shaft.
[0422] The rotation shafts 241 / rotation shafts 242, rotation shaft 243, rotation shaft 244, rotation shaft 245, and rotation shaft 246 may be sequentially arranged in the direction from the distal end 205 to the proximal end 206 of the operation unit 200.
[0423] One or more pulleys may be fitted onto each of the rotation shafts 241, 242, 243, 244, 245, and 246, which will be described in detail later.
[0424] 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, and these components may be collectively referred to as operation unit actuator pulleys.
[0425] The pulley 211 and the pulley 212 function as operation unit first jo yaw main pulleys, and the pulley 221 and the pulley 222 function as operation unit second jo yaw main pulleys, and these components may be collectively referred to as operation unit yaw main pulleys.
[0426] The pulley 213 and the pulley 214 function as operation unit first jo yaw sub pulleys, and the pulley 223 and the pulley 224 function as operation unit second jo yaw sub pulleys, and these components may be collectively referred to as operation unit yaw sub pulleys.
[0427] 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, and these components may be collectively referred to as the operation unit pitch sub-pulleys.
[0428] 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, and these components may be collectively referred to as the operation unit pitch main pulleys.
[0429] 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.
[0430] When classifying the above components from the perspective of the operation unit for each movement (pitch / yaw / actuation), it is as follows.
[0431] The pitch operation unit 201 that controls the pitch movement of the end tool 100 may include the pulleys 215, 216, 217, 218, 225, 226, 227, 228, 231, 232, and 234. Further, the pitch operation unit 201 may include the rotary shafts 245 and 246. Further, the pitch operation unit 201 may further include the pitch frame 208.
[0432] The yaw operation unit 202 that controls the yaw movement of the end tool 100 may include the pulleys 211, 212, 213, 214, 221, 222, 223, and 224. Further, the yaw operation unit 202 may include the rotary shafts 243 and 244. Further, the yaw operation unit 202 may further include the yaw frame 207.
[0433] The actuation operation unit 203 that controls the actuation movement of the end tool 100 may include a pulley 210, a pulley 220, a rotating shaft 241, and a rotating shaft 242. Further, the actuation operation unit 203 may further include a first actuation operation unit 251 and a second actuation operation unit 256.
[0434] Hereinafter, each component of the operation unit 200 will be described in more detail.
[0435] The first handle 204 is formed so that it can be held by hand by the user, and in particular, it may be formed so that the user can grasp it so as to wrap the first handle 204 with the palm of his or her hand. 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 connecting portion 400.
[0436] 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 finger hole ring shape and can operate as a second handle.
[0437] Here, the rotation shafts 241 and 242, which are the actuation rotation shafts, may be formed at a predetermined angle with the XY plane in which the connecting portion 400 is formed. For example, the rotation shafts 241 and 242 may be formed in a direction parallel to the Z axis. In this state, when the pitch operation unit 201 or the yaw operation unit 202 rotates, the coordinate system of the actuation operation unit 203 may change relatively. Of course, the idea of the present invention is not limited to this. Depending on ergonomic design, the rotation shafts 241 and 242 may be formed in various directions so as to conform to the hand structure of the user who grips the actuation operation unit 203.
[0438] On the other hand, the pulley 210, the first actuation extension part 252, and the first actuation gear 253 may be fixedly coupled to each other and formed to be rotatable together about the rotation shaft 241. Here, the pulley 210 may be composed of one pulley or may be composed of two pulleys fixedly coupled to each other.
[0439] Similarly, the pulley 220, the second actuation extension part 257, and the second actuation gear 258 may be fixedly coupled to each other and formed to be rotatable together about the rotation shaft 242. Here, the pulley 220 may be composed of one pulley or may be composed of two pulleys fixedly coupled to each other.
[0440] Here, the first actuation gear 253 and the second actuation gear 258 may be formed to mesh with each other and may be formed to rotate together in opposite directions when either side rotates.
[0441] The yaw operation unit 202 may 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 may 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 may be coupled to a pitch frame 208 described later.
[0442] 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 respectively 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 may be provided according to the configuration of the yaw operation unit 202.
[0443] Specifically, on the first handle 204, on one side of the actuation operation unit 203, 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.
[0444] Here, the rotation shaft 243 may be formed to form a predetermined angle with the XY plane in which the connecting portion 400 is formed. For example, the rotation shaft 243 may 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 may change relatively as described above. Of course, the idea of the present invention is not limited to this, and the rotation shaft 243 may be formed in various directions according to the ergonomic design so as to conform to the hand structure of the user holding the operation unit 200.
[0445] On one hand, the pulleys 211 and 212 and the pulleys 221 and 222 are coupled to the rotary shaft 243 so as to be rotatable about the rotary shaft 243. And, a wire 301 or a wire 305 which is a first joystick wire may be wound around the pulleys 211 and 212, and a wire 302 or a wire 306 which is a second joystick wire may be wound around the pulleys 221 and 222. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be formed so as to face each other, respectively, and may be composed of two independently rotatable pulleys. Therefore, the wire to be wound and the wire to be unwound can be wound around the separated pulleys, respectively, and can operate without interfering with each other.
[0446] The yaw frame 207 rigidly connects the first handle 204, the rotary shafts 241, 242, and 243, and enables the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 to be integrally yaw-rotatable about the rotary shaft 243.
[0447] The pitch operation unit 201 may include a rotary 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 208. Further, the pitch operation unit 201 may further include a rotary 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 may be connected to the bent portion 402 of the connecting portion 400 via the rotary shaft 246.
[0448] Specifically, the pitch frame 208 serves as the base frame of the pitch operation unit 201, and the rotary shaft 243 is rotatably coupled to one end portion. That is, the yaw frame 207 is formed so as to be rotatable about the rotary shaft 243 with respect to the pitch frame 208.
[0449] As described above, the yaw frame 207 connects the first handle 204, the rotation shafts 243, 241, and 242, and the yaw frame 207 is axially coupled to the pitch frame 208. Therefore, when the pitch frame 208 pitch-rotates about the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shafts 241, 242, and 243, which are connected to the pitch frame 208, all pitch-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 rotate together with the pitch operation unit 201. In other words, when the user pitch-rotates the first handle 204 about the rotation shaft 246, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 all move together.
[0450] The pulleys 217 and 218 and the pulleys 227 and 228 are coupled to the rotation shaft 246 so as to be rotatable about the rotation shaft 246 of the pitch frame 208.
[0451] Here, the pulleys 217 and 218 may be formed to face each other and may be formed to be independently rotatable. Therefore, the wire to be wound and the wire to be unwound can be respectively wound around the separated pulleys, and they can operate without interfering with each other. Similarly, the pulleys 227 and 228 may also be formed to face each other and may be formed to be independently rotatable. Therefore, the wire to be wound and the wire to be unwound can be respectively wound around the separated pulleys, and they can operate without interfering with each other.
[0452] Next, the operations of the wires 303 and 304, which are the pitch wires, are as follows.
[0453] 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. The operation unit 200 is formed by fixedly connecting a pulley 231 and a pulley 232, which are operation unit pitch pulleys, to a pitch frame 208. 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, when the pitch frame 208, the pulley 231, and the pulley 232 rotate together about the rotation axis 246 due to the pitch rotation of the operation unit 200, as a result, the wires 303 and 304 also move, and additional power of pitch rotation can be transmitted separately from the pitch operation of the end tool by the wires 301, 302, 305, and 306, which are jo-wires.
[0454] Summarizing the connection relationships between the first handle 204 and each of the pitch operation unit 201, the yaw operation unit 202, and the actuation operation unit 203 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 may 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 may 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 may 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 may be formed to be indirectly connected via the yaw operation unit 202.
[0455] Continuing with reference to the drawings, in the surgical instrument 10 according to the first embodiment of the present invention, the pitch operation unit 201 and the end tool 100 may be formed on the same or parallel axes (X-axis). That is, the rotation axis 246 of the pitch operation unit 201 is formed at one end of the bent portion 402 of the connecting portion 400, and the end tool 100 is formed at the other end of the connecting portion 400.
[0456] And, one or more intermediate pulleys 235 for changing or guiding the path of the wire may be arranged in the middle of the connecting portion 400, particularly in the bent portion 402. By forming the wire such that at least a part of the wire is wound around such an intermediate pulley 235 to guide the path of the wire, the wire may be arranged along the bent shape of the bent portion 402.
[0457] Here, in the drawings, the connecting portion 400 is shown as being curved with a bent portion 402 to have a predetermined curvature, but the idea of the present invention is not limited to this. The connecting portion 400 may be formed linearly as needed, may be formed by bending one or more times. Even in such cases, it can be said that the pitch operation unit 201 and the end tool 100 are formed on substantially the same or parallel axes. Also, in FIG. 3, the pitch operation unit 201 and the end tool 100 are shown as being formed on axes parallel to the X-axis, but the idea of the present invention is not limited to this. The pitch operation unit 201 and the end tool 100 may be formed on different axes from each other.
[0458] The staple operation unit 260 is connected to the staple pulley 161 of the end tool 100 by wires 307 and 308 which are staple wires, and can serve to alternately rotate the staple pulley 161 clockwise or counterclockwise.
[0459] Therefore, although not shown in the figure, the staple operation unit 260 may include a motor (not shown). That is, while the user is pressing the staple operation unit 260 formed in a button shape, the motor (not shown) is driven to alternately rotate the operation unit staple pulley (see 269 in FIG. 47) clockwise or counterclockwise. And thereby, the staple pulley 161 of the end tool 100 can be alternately rotated clockwise or counterclockwise.
[0460] (Actuation operation, yaw operation, pitch operation)
[0461] The actuation operation, yaw operation, and pitch operation in this embodiment will be described as follows.
[0462] First, the actuation operation is as follows.
[0463] When the user inserts the index finger into the finger hole ring formed in the first actuation extension 252 and inserts the thumb into the finger hole ring formed in 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. Therefore, the wires 301 and 305 with one end fixedly coupled to the pulley 210 and wound around it, and the wires 302 and 306 with one end fixedly coupled to the pulley 220 and wound around it also move in opposite directions to each other. And such 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 the actuation operation.
[0464] Here, the actuation operation means that, as described above, the two jaws 101 and 102 rotate in opposite directions to each other, opening and closing the jaws 101 and 102. That is, when the actuation extension parts 252 and 257 of the actuation operation part 203 are rotated in a direction approaching each other, the first jaw 101 rotates counterclockwise, and the second jaw 102 rotates clockwise while the end tool 100 is closed. Conversely, when the actuation extension parts 252 and 257 of the actuation operation part 203 are rotated in a direction away from each other, the first jaw 121 rotates clockwise, and the second jaw 122 rotates counterclockwise while the end tool 100 opens.
[0465] In this embodiment, for the above-described actuation operation, the first actuation extension part 252 and the second actuation extension part 257 are provided to form a second handle so that it can be grasped and operated with two fingers. However, the configuration of the actuation operation part 203 for the actuation operation of opening and closing the two jaws of the end tool 100 with respect to each other can be, unlike the above-described configuration, other variations such as a configuration in which two actuation pulleys (pulley 210, pulley 220) operate in opposite directions to each other with one actuation rotation part are also fully possible.
[0466] Next, the yaw operation is as follows.
[0467] 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 will yaw-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 will 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 will 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. And 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.
[0468] At this time, since the yaw frame 207 connects the first handle 204, the rotation axis 241, the rotation axis 242, and the rotation axis 243, the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 will all rotate about the rotation axis 243 together.
[0469] Next, the pitch operation is as follows.
[0470] When the user rotates the first handle 204 about the rotation axis 246 while holding the first handle 204, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 will pitch-rotate about the rotation axis 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 axis 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 axis 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 pitch-rotate. 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.
[0471] At this time, the pitch frame 208 is connected to the yaw frame 207, and the yaw frame 207 connects the first handle 204, the rotation axes 241, 242, and 243. Therefore, when the pitch frame 208 rotates about the rotation axis 246, the yaw frame 207, the first handle 204, the rotation axes 241, 242, and 243 connected to the pitch frame 208 will all rotate. That is, when the pitch operation unit 201 rotates about the rotation axis 246, the actuation operation unit 203 and the yaw operation unit 202 will rotate together with the pitch operation unit 201.
[0472] In summary, the surgical instrument 10 according to an embodiment of the present invention has pulleys formed at each joint point (actuation joint, yaw joint, pitch joint), and a wire (first jaw wire or second jaw 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 a desired operation of the end tool 100. Further, an auxiliary pulley may be formed on one side of each pulley, and these auxiliary pulleys prevent the wire from being wound around one pulley multiple times.
[0473] FIG. 43 is a diagram schematically showing only the configuration of the pulleys and wires constituting the joints of the surgical instrument 10 according to an embodiment of the present invention shown in FIG. 2. In FIG. 43, the intermediate pulleys for changing the wire path regardless of the joint movement are omitted.
[0474] Referring to FIG. 43, the operation unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 related to the rotational movement of the first jaw 101.
[0475] Further, the operation unit 200 may 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 the arrangement and configuration of each pulley in the end tool 100, the specific notations of the reference numerals on the drawing are partially omitted.)
[0476] The pulleys 211 and 212 and the pulleys 221 and 222 may be formed to be rotatable independently of each other about a rotation axis 243 that is the same axis. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be formed to face each other and may be formed of two pulleys that are rotatable independently.
[0477] Pulley 213 and pulley 214, and pulley 223 and pulley 224 may be formed to be rotatable independently of each other about a rotating shaft 244 that is the same axis. At this time, pulley 213 and pulley 214 may be formed to face each other and may be formed of two pulleys that are rotatable independently, and at this time, the two pulleys may be formed to have different diameters from each other. Similarly, pulley 223 and pulley 224 may be formed to face each other and may be formed of two pulleys that are rotatable independently, and at this time, the two pulleys may be formed to have different diameters from each other.
[0478] Pulley 215 and pulley 216, and pulley 225 and pulley 226 may be formed to be rotatable independently of each other about a rotating shaft 245 that is the same axis. At this time, pulley 215 and pulley 216 may be formed to have different diameters from each other. Also, pulley 225 and pulley 226 may be formed to have different diameters from each other.
[0479] Pulley 217 and pulley 218, and pulley 227 and pulley 228 may be formed to be rotatable independently of each other about a rotating shaft 246 that is the same axis.
[0480] Wire 301 passes sequentially through pulley 217, pulley 215, pulley 213, and pulley 211 of operation unit 200, is wound around pulley 210, and is then coupled to pulley 210 by fastening member 324. On the other hand, wire 305 passes sequentially through pulley 218, pulley 216, pulley 214, and pulley 212 of operation unit 200 and is coupled to pulley 210 by fastening member 324. Therefore, when pulley 210 rotates, wire 301 and wire 305 are wound around or unwound from pulley 210 accordingly, and first jaw 101 rotates.
[0481] The wire 306 passes successively through the pulleys 227, 225, 223, and 221 of the operation unit 200, is wound around the pulley 220, and then is coupled to the pulley 220 by the fastening member 327. On the other hand, the wire 302 passes successively 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.
[0482] (Conceptual diagram of pulley and wire)
[0483] Figs. 45 and 46 are diagrams showing the configurations of the pulleys and wires related to the actuation operation and the yaw operation of the surgical 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. 45 is a diagram showing only the pulleys and wires related to the second jaw, and Fig. 46 is a diagram showing only the pulleys and wires related to the first jaw. And Fig. 44 is a perspective view showing the yaw operation of the surgical instrument of Fig. 2. Here, in Fig. 44, the components related to the stapling and cutting operations are omitted.
[0484] First, the wire operation of the actuation operation will be described.
[0485] Referring to Fig. 46, when the first actuation extension 252 rotates in the direction of arrow OPA1 about the rotation axis 241, the pulley 210 coupled 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, and as a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPA1.
[0486] Referring to FIG. 45, 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 wire 302 and the wire 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 move closer to each other.
[0487] Next, the wire operation for the yaw movement will be described.
[0488] 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. 30), the rotation axis 243, the rotation axis 241, and the rotation axis 242 will rotate together as a unit.
[0489] Referring to FIG. 46, when the first handle 204 rotates about the rotation axis 243 in the direction of arrow OPY1, the pulley 210, the pulley 211, and the pulley 212 rotate about the rotation axis 243 as a whole with the wire 301 and the wire 305 wound around them. As a result, the wire 301 and the wire 305 wound around the pulley 211 and the pulley 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.
[0490] Referring to FIG. 45, when the first handle 204 is rotated in the direction of arrow OPY2 about the rotation axis 243, the pulleys 220, 221, and 222 rotate about the rotation axis 243 as a whole with the wires 302 and 306 wound thereon. As a result, the wires 302 and 306 wound around the pulleys 221 and 222 move to the opposite side of W1a and the opposite side of W1b, respectively. As a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPY2.
[0491] FIGS. 47, 48, and 49 are diagrams showing the configuration of pulleys and wires related to the stapling and cutting operations of the surgical 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. Here, FIGS. 47 to 49 are diagrams mainly showing the pulleys and wires related to the second jaw.
[0492] Here, FIGS. 47 to 48 show the activation operation process of closing the two jaws, and FIGS. 48 to 49 show the operation process of stapling and cutting the tissue intervening between the two jaws.
[0493] First, the wire operation of the activation operation will be described.
[0494] Referring to FIGS. 47 and 48, when the first activation extension 252 of the first activation operation unit 251 rotates in the direction of arrow OPA1 about the rotation axis 241, the pulley 210 connected to the first activation extension 252 rotates, and the wires (see 301 in FIG. 43) and the wire (see 305 in FIG. 43) 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.
[0495] At this time, the operation unit staple pulley 269 of the staple operation unit 260 is formed to be rotatable about the rotation axis 241 together with the first actuation operation unit 251. Therefore, when the first actuation extension part 252 rotates about the rotation axis 241, the staple operation unit 260 also rotates about the rotation axis 241 together with the first actuation operation unit 251.
[0496] As a result, during the actuation operation, when the pulley 111 rotates with the end tool 100, the staple pulley 161 also rotates together with the pulley 111.
[0497] Next, the wire operation for the stapling and cutting operations will be described.
[0498] Referring to FIGS. 48 and 49, when the staple operation unit 260 is rotated in the direction of arrow OPC1 about the rotation axis 247 which is the operation unit cutting rotation axis, the operation unit staple pulley 269 and the wires 307 and 308 which are the staple wires wound here rotate about the rotation axis 247, and as a result, the wires 307 and 308 wound around the operation unit staple pulley 269 move respectively, and as a result, the staple pulley 161 of the end tool 100 rotates in the direction of arrow EPC1.
[0499] On the other hand, when the staple operation unit 260 rotates, the operation unit staple pulley 269 rotates about the rotation axis 247, and at this time, the rotation of the staple operation unit 260 does not affect the first actuation operation unit 251.
[0500] As a result, when the operation unit staple pulley 269 rotates, the staple pulley 161 of the end tool 100 rotates independently regardless of the first jaw 101. Then, when the staple pulley 161 rotates alternately in the clockwise / counterclockwise directions, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating movement assembly 550 of the cartridge 500 connected thereto perform a reciprocating linear motion. As a result, while the working member 540 of the cartridge 500 moves in the direction of the distal portion 502, stapling and cutting operations are performed.
[0501] Here, in the figure, the staple operation unit 260 is shown as being formed in a bar shape and the user manually rotates the staple operation unit 260, but the idea of the present invention is not limited thereto. That is, as described above, the staple operation unit 260 may include a motor (not shown), and while the user presses the staple operation unit 260 formed in a button shape, the motor (not shown) is driven to alternately rotate the operation unit staple pulley 269 in the clockwise or counterclockwise directions. Then, thereby, the staple pulley 161 of the end tool 100 can rotate alternately in the clockwise or counterclockwise directions.
[0502] FIGS. 51, 52, and 53 are diagrams showing the configuration of the pulleys and wires related to the pitch operation of the surgical 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. 51 is a diagram showing only the pulleys and wires related to the second jaw, FIG. 52 is a diagram showing only the pulleys and wires related to the first jaw, and FIG. 53 is a diagram showing only the pulleys and wires related to the staple 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 shown by a single line in FIGS. 51 and 53. FIG. 50 is a perspective view showing the pitch operation of the surgical instrument of FIG. 2. Here, in FIG. 50, the components related to the stapling and cutting operations are omitted.
[0503] Referring to FIG. 51, 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 wire 301 wound around here, etc., will rotate about the rotation axis 246 as a whole. At this time, as shown in FIG. 51, since the wire 301 and the wire 305, which are the first jaw wires, are wound above 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 will rotate in the direction of arrow EPP1.
[0504] Referring to FIG. 52, 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 wound around here, etc., will rotate about the rotation axis 246 as a whole. At this time, as shown in FIG. 52, since the wire 302 and the wire 306, which are the second jaw wires, are wound below 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.
[0505] Referring to FIG. 53, when the first handle 204 is rotated in the direction of arrow OPC1 about the rotation axis 246, the operation part staple pulley 269, the pulleys 265, 267, etc., and the wire 307 and the wire 308 wound around here, etc., will rotate about the rotation axis 246 as a whole. At this time, since the wire 307 and the wire 308, which are staple wires, are wound below the pulleys 267 and 268, they will move to the arrow W3 side. As a result, as described with reference to FIG. 5, the staple pulley 161 of the end tool 100 will rotate in the direction of arrow EPC1.
[0506] As a result, during the pitch operation, when the pulley 111 of the end tool 100 rotates about the rotation axis 143, the staple pulley 161 will also rotate about the rotation axis 143 together with the pulley 111.
[0507] Therefore, the actuation operation, the yaw operation, and the pitch operation can be independently operated.
[0508] As described with reference to FIG. 1, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 are configured in the same manner as the joint configuration of the end tool by having their respective rotation axes located behind each operation unit, enabling the user to perform operations that intuitively match.
[0509] In particular, the surgical instrument 10 according to an embodiment of the present invention has pulleys formed at each joint point (actuation joint, yaw joint, pitch joint), and is formed such that a wire (first joystick wire or second joystick wire) is wound around the pulley. The rotational operation of the operation unit (actuation rotation, yaw rotation, pitch rotation) causes the movement of each wire, and as a result, induces the desired operation of the end tool 100. Further, an auxiliary pulley may be formed on one side of each pulley, so that the wire cannot be wound around one pulley multiple times by these auxiliary pulleys. The wires wound around the pulley do not contact each other, and the path of the wire wound into the pulley and the wire unwound from the pulley is also formed safely, improving the safety and efficiency of the power transmission of the wire.
[0510] On the one 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 as the first handle 204 rotates. That is, in FIG. 2 and the like, the yaw operation unit 202 and the actuation operation unit 203 are shown to be parallel to the Z axis. However, when the first handle 204 rotates, the yaw operation unit 202 and the actuation operation unit 203 no longer become parallel to the Z axis. That is, the coordinate systems of the yaw operation unit 202 and the actuation operation unit 203 have changed according to the rotation of the first handle 204. However, in this specification, for the convenience of explanation, 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 connecting portion 400 as shown in FIG. 2.
[0511] (Correlation of stapling and cutting operations with other operations)
[0512] Hereinafter, the correlation between the stapling and cutting operations and other operations (pitch, yaw, and actuation operations) will be described.
[0513] First, during the pitch operation of the end tool 100, the staple 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 staple pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. If the staple pulley 161 does not rotate together with the pulleys 111 and 121 when they rotate around the rotation axis 143, there is a risk that the cartridge 500 connected to the staple pulley 161 will move relative to the first jaw 101 and be separated from the first jaw 101. Furthermore, the rotation of the staple pulley 161 that is not synchronized with the pulley 111 may cause the reciprocating member 551 to move forward unintentionally, and as a result, may cause an unintentional stapling operation.
[0514] Next, during the yaw operation of the end tool 100, the staple 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 staple pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. If the staple pulley 161 does not rotate together with the pulleys 111 and 121 when they rotate around the rotation axis 141, there is a risk that the cartridge 500 connected to the staple pulley 161 will move relative to the first jaw 101 and be separated from the first jaw 101. Furthermore, the rotation of the staple pulley 161 that is not synchronized with the pulley 111 may cause the reciprocating member 551 to move forward unintentionally, and as a result, may cause an unintentional stapling operation.
[0515] Next, during the actuation operation of the end tool 100, the staple 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 about the rotation axis 141, the staple pulley 161 must rotate in the same direction as the pulley 111. If the staple pulley 161 does not rotate together with the pulley 111 when the pulley 111 rotates about the rotation axis 143, there is a risk that the cartridge 500 connected to the staple pulley 161 will move relative to the first jaw 101 and be separated from the first jaw 101. Further, the rotation of the staple pulley 161 not synchronized with the pulley 111 may cause the reciprocating member 551 to move forward unintentionally, and as a result, may cause an unintentional stapling operation.
[0516] On the other hand, during the stapling and cutting operations of the end tool 100, the pulleys 111 and 121 do not rotate. That is, when the staple pulley 161 rotates about the rotation axis 141 and the reciprocating member 551 of the link member 171 and the cartridge 500 connected thereto performs a linear reciprocating motion, the pulleys 111 and 121 must not rotate. Otherwise, the first jaw 101 or the second jaw 102 will rotate during the stapling and cutting operations, and the stapling and cutting operations cannot be performed normally.
[0517] As a result, when the pulley 111, which is the first jaw pulley, rotates, the staple pulley 161 housed inside the first jaw 101 must also rotate together with the pulley 111. On the other hand, when the staple pulley 161 rotates for stapling and cutting, the pulleys 111 and 121 must be formed to maintain their positions without rotating. The correlation between such stapling and cutting operations and other operations (yaw operation and actuation operation) is as described above.
[0518] Viewed from another perspective, it can be said that the pulley 111 and the pulley 121 are independent of the rotation of the staple pulley 161. That is, even if the staple pulley 161 rotates due to the staple wire, the pulleys 111 and 121 do not have to rotate. Conversely, the staple pulley 161 can be said to be dependent on the rotation of the pulley 111. That is, when the pulley 111 rotates by the jaw wire, the staple pulley 161 may be formed to rotate together with the pulley 111.
[0519] Figures 54 and 56 are diagrams showing the state where the jaw has been yawed by -90°, and Figures 55 and 57 are diagrams showing the process of performing the actuation operation in the state where the jaw has been yawed by -90°. Here, Figures 54 and 55 are diagrams showing the pulley 111, and Figures 56 and 57 are diagrams with the pulley 111 omitted.
[0520] Figures 58 and 60 are diagrams showing the state where the jaw has been yawed by +90°, and Figures 59 and 61 are diagrams showing the process of performing the actuation operation in the state where the jaw has been yawed by +90°. Here, Figures 58 and 59 are diagrams showing the pulley 111, and Figures 60 and 61 are diagrams with the pulley 111 omitted.
[0521] As shown in Figures 54 to 61, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that it can normally perform the actuation operation even when the jaw is yawed by +90° or -90°.
[0522] FIG. 62 is a plan view showing the stapling and cutting operations of the end tool of the surgical instrument in FIG. 2, and shows the process of performing the stapling and cutting operations with the jaw rotated +90° in the yaw direction. As shown in FIG. 62, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that it can normally perform stapling and cutting operations even when the jaw is rotated +90° in the yaw direction.
[0523] Specifically, when the pulley 111, the pulley 121, and the staple pulley 161 rotate +90 degrees about the rotation axis 141 and the staple pulley 161 rotates alternately in the clockwise / counterclockwise directions, the link member 171 and the reciprocating member 551 connected thereto repeat forward and backward movements. When the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551, and when the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward and the working member 540 stops in place. While repeating such a process, the working member 540 moves toward the distal portion 502 side and stapling and cutting operations are performed.
[0524] FIG. 63 is a plan view showing the stapling and cutting operations of the end tool of the surgical instrument in FIG. 2, and shows the process of performing the stapling and cutting operations with the jaw rotated -90° in the yaw direction. As shown in FIG. 63, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that it can normally perform stapling and cutting operations even when the jaw is rotated -90° in the yaw direction.
[0525] Specifically, when the pulley 111, the pulley 121, and the staple pulley 161 rotate -90 degrees around the rotation axis 141 and the staple pulley 161 rotates alternately in the clockwise / counterclockwise directions, the link member 171 and the reciprocating member 551 connected thereto repeat forward and backward movements. Then, when the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551, and when the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward and the working member 540 stops in place. While repeating such a process, the working member 540 moves toward the distal portion 502 side, and stapling and cutting operations are performed.
[0526] FIG. 64 is a diagram showing a state where the jaw rotates -90° in pitch, and FIG. 65 is a diagram showing a process of performing an actuation operation in a state where the jaw rotates -90° in pitch. FIG. 66 is a diagram showing a state where the jaw rotates +90° in pitch, and FIG. 67 is a diagram showing a process of performing an actuation operation in a state where the jaw rotates +90° in pitch.
[0527] Referring to FIGS. 64 to 67, it can be seen that in performing the pitch operation, the operations of the operation unit 200 and the end tool 100 intuitively coincide. That is, when the operation unit 200 rotates in the + direction with respect to the pitch rotation axis (Y axis), the end tool 100 also rotates in the + direction with respect to the pitch rotation axis (Y axis). Also, when the operation unit 200 rotates in the - direction with respect to the pitch rotation axis (Y axis), the end tool 100 also rotates in the - direction with respect to the pitch rotation axis (Y axis). Here, the rotation angle of the operation unit 200 and the rotation angle of the end tool 100 may be variously set according to the ratio of the pulleys.
[0528] FIG. 68 is a diagram showing a state where the jaw is yawed by +90°, and FIG. 69 is a diagram showing a process of performing an actuation operation in a state where the jaw is yawed by +90°. FIG. 70 is a diagram showing a state where the jaw is yawed by -90°, and FIG. 71 is a diagram showing a process of performing an actuation operation in a state where the jaw is yawed by -90°.
[0529] Referring to FIGS. 68 to 71, it can be seen that in performing the yaw operation, the operations of the operation unit 200 and the end tool 100 intuitively coincide. That is, when the operation unit 200 rotates in the + direction with respect to the yaw rotation axis (Z-axis), the end tool 100 also rotates in the + direction with respect to the yaw rotation axis (Z-axis). Also, when the operation unit 200 rotates in the - direction with respect to the yaw rotation axis (Z-axis), the end tool 100 also rotates in the - direction with respect to the yaw rotation axis (Z-axis). Here, the rotation angle of the operation unit 200 and the rotation angle of the end tool 100 may be variously set according to the ratio of the pulleys.
[0530] FIG. 72 is a diagram showing a state where the jaw is pitch-rotated by -90° and simultaneously yawed by +90°, and FIG. 73 is a diagram showing a process of performing an actuation operation in a state where the jaw is pitch-rotated by -90° and simultaneously yawed by +90°. FIG. 74 is a diagram showing a state where the jaw is pitch-rotated by +90° and simultaneously yawed by -90°, and FIG. 75 is a diagram showing a process of performing an actuation operation in a state where the jaw is pitch-rotated by +90° and simultaneously yawed by -90°.
[0531] Referring to FIGS. 72 to 75, it can be seen that even when performing the pitch operation and the yaw operation simultaneously, the operations of the operation unit 200 and the end tool 100 intuitively coincide.
[0532] <Second embodiment - Engraving>
[0533] 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 configuration of the end tool hub 780 that serves as an auxiliary pulley is different compared to the end tool (see 100 in FIG. 2 etc.) of the surgical instrument according to the first embodiment of the present invention described above. The different configurations compared to the first embodiment will be described in detail later.
[0534] FIG. 87 is a perspective view showing the end tool of the surgical instrument according to the second embodiment of the present invention, and FIGS. 88 and 89 are enlarged views of the end tool of the surgical instrument in FIG. 87. FIGS. 90 and 91 are enlarged views showing the end tool of the surgical instrument in FIG. 87 from another angle. FIGS. 92 and 93 are views showing a state where the jaw of the end tool of the surgical instrument in FIG. 87 is yawed counterclockwise by 90°. FIG. 94 is an enlarged perspective view showing the end tool hub of the surgical instrument in FIG. 87.
[0535] Here, FIGS. 89 and 91 show a state where the wire is removed, and FIG. 93 shows a state where the jaw pulley coupling part and the jaw pulley of the end tool hub are removed.
[0536] Referring to FIGS. 87 to 94, the end tool 700 of the second embodiment of the present invention includes a pair of jaws for performing a grip operation, that is, a first jaw 701 and a second jaw 702. Here, each of the first jaw 701 and the second jaw 702, or a component including the first jaw 701 and the second jaw 702 can be called a jaw 703.
[0537] On the one hand, the end tool 700 includes a plurality of pulleys including pulleys 711, 713, and 714 related to the rotational movement of the first jaw 701. In this embodiment, the pulleys related to the rotational movement of the first jaw 701 are substantially the same as the pulleys 113, 114, 115, and 116 described in FIG. 8 and the like of the first embodiment, so the detailed description thereof is omitted here.
[0538] On the other hand, the end tool 700 includes a plurality of pulleys including a pulley 721 related to the rotational movement of the second jaw 702. In this embodiment, the pulley related to the rotational movement of the second jaw 702 is substantially the same as the pulleys 123, 124, 125, and 126 described in FIG. 8 and the like of the first embodiment, so the detailed description thereof is omitted here.
[0539] In addition, the end tool 700 of the second embodiment of the present invention may include a rotating shaft 741, a rotating shaft 743, and a rotating shaft 744. Here, the rotating shaft 741 may be inserted through the end tool hub 780, and the rotating shaft 743 and the rotating shaft 744 may be inserted through the pitch hub 707. The rotating shaft 741, the rotating shaft 743, and the rotating shaft 744 may be sequentially arranged in the direction from the distal end 704 to the proximal end 705 of the end tool 700.
[0540] In addition, the end tool 700 of the second embodiment of the present invention may include an end tool hub 780 and a pitch hub 707.
[0541] A rotating shaft 741, which will be described later, penetrates and is inserted into the end tool hub 780. Further, at least a part of a pulley 711 and a pulley 721 axially coupled to the rotating shaft 741 and first and second jaws 701 and 702 coupled thereto may be accommodated inside the end tool hub 780. Here, an embodiment of the present invention is characterized in that a guide portion 783 serving as an auxiliary pulley is formed on the end tool hub 780. That is, a guide portion 783 for guiding the paths of the wires 305 and 302 may be formed on the end tool hub 780. Such a guide portion 783 of the end tool hub 780 can change the path of the wire by serving as the auxiliary pulley (see 112, 122, and 162 in FIG. 9) in the first embodiment, and the guide portion 783 of the end tool hub 780 serving as the auxiliary pulley will be described in more detail later.
[0542] On the other hand, a pulley 731 serving as an end tool pitch pulley may be formed at one end of the end tool hub 780. The pulley 731 may be formed of a member different from the end tool hub 780 and may be coupled to the end tool hub 780. Alternatively, the pulley 731 may be formed integrally with the end tool hub 780. Then, wires (see 303 in FIG. 5) and wires (see 304 in FIG. 5) are coupled to the pulley 731 serving as an end tool pitch pulley, and this pulley 731 performs a pitch operation while rotating about the rotating shaft 743.
[0543] A rotating shaft 743 and a rotating shaft 744 penetrate and are inserted into the pitch hub 707, and the pitch hub 707 can be axially coupled to the end tool hub 780 and the pulley 731 by the rotating shaft 743. Therefore, the end tool hub 780 and the pulley 731 may be formed to be pitch-rotatable with respect to the pitch hub 707 about the rotating shaft 743.
[0544] On the other hand, the end tool 700 of the second embodiment of the present invention may further include components such as a staple drive assembly (see 150 in FIG. 13) including a staple pulley assembly (see 160 in FIG. 13) and a staple link assembly (see 170 in FIG. 13) for performing stapling and cutting operations.
[0545] The staple pulley assembly (see 160 in FIG. 13) may be formed adjacent to the pulley 711 and the pulley 721 between the pulley 711 and the pulley 721. In this embodiment, it is assumed that the staple pulley assembly (see 160 in FIG. 13) includes one staple pulley 761.
[0546] The staple link assembly (see 170 in FIG. 13) may include one or more link members 771. The staple link assembly (see 170 in FIG. 13) can play a role of connecting the staple pulley assembly 760 and the reciprocating movement assembly (see 550 in FIG. 22) of the cartridge (see 500 in FIG. 22). In this embodiment, it is assumed that the staple link assembly (see 170 in FIG. 13) includes one link member 771, and the link member 771 includes a first link 772 and a second link 773.
[0547] On the other hand, the second embodiment of the present invention is characterized in that by arranging a staple pulley assembly (see 160 in FIG. 13) and a staple link assembly (see 170 in FIG. 13) between the pulley 711 which is the first jog pulley and the pulley 721 which is the second jog pulley, it is possible to perform stapling and cutting operations using the cartridge (see 500 in FIG. 22) together with the pitch operation and the yaw operation of the end tool 700. Since the components for performing the stapling 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.
[0548] The surgical instrument according to the second embodiment of the present invention may include wires 301, 302, 303, 304, 305, 306, 307, and 308, similar to the first embodiment of the present invention shown in FIG. 7 and the like.
[0549] Further, the surgical instrument according to the second embodiment may include fastening members 321, 323, 324, 326, 327, and 329 coupled to each end of each wire to couple the wire and the pulley, similar to the first embodiment of the present invention shown in FIG. 7 and the like.
[0550] Hereinafter, the end tool hub 780 of the second embodiment of the present invention will be described in more detail, and in particular, the guide portion 783 of the end tool hub 780 that serves as an auxiliary pulley will be described in detail.
[0551] The end tool hub 780 includes a first jog pulley coupling portion 781, a second jog pulley coupling portion 782, a guide portion 783, a guide groove 784, and a pitch pulley coupling portion 785.
[0552] Specifically, the first jog pulley coupling portion 781 and the second jog pulley coupling portion 782 are formed to face each other, and the pulleys 711, 721, and staple pulley 761 are accommodated therein. Further, through holes are formed in the respective jog pulley coupling portions 781, 782, and the rotating shaft 741 passes through the jog pulley coupling portions 781, 782 and the pulleys 711, 721, and staple pulley 761 to axially couple them.
[0553] The first pulley coupling portion 781 and the second pulley coupling portion 782 are connected by a guide portion 783. That is, the first pulley coupling portion 781 and the second pulley coupling portion 782, which are parallel to each other, are coupled by a guide portion 783 formed in a direction substantially perpendicular thereto. The first pulley coupling portion 781, the second pulley coupling portion 782, and the guide portion 783 are substantially in a "C" shape, and the pulley 711, the pulley 721, and the staple pulley 761 are accommodated therein.
[0554] Explaining this from another perspective, it may also be expressed that the first pulley coupling portion 781 and the second pulley coupling portion 782 extend in the X-axis direction from both ends of the guide portion 783 that is long in the Z-axis direction.
[0555] Here, the guide portion 783 may be formed in a columnar shape with a substantially semi-circular cross-section. And this semi-circular portion may be arranged to protrude toward the pulley 711, the pulley 721, and the staple pulley 761. Expressing this from another perspective, it may also be expressed that the guide portion 783 protrudes into the space formed by the first pulley coupling portion 781, the second pulley coupling portion 782, and the guide portion 783. Expressing this from another perspective, it may also be expressed that the region of the guide portion 783 adjacent to the pulley coupling portions 781 and 782 is formed to be curved so that its cross-section has a predetermined curvature.
[0556] Alternatively, expressing this from another perspective, it can be said that the guide portion 783 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 portion 783 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 780. However, it can be said that it performs a function somewhat similar to that of a pulley by having wires wound around it.
[0557] Here, in the figure, the guide portion 783 is shown to be formed in a columnar shape with a substantially semi-circular cross-section. That is, at least a part of the cross-section of the guide portion 783 on the XY plane is shown to be in a predetermined arc shape. However, the idea of the present invention is not limited to this, and it can be said that the cross-section may be formed to have a predetermined curvature such as an elliptical shape or a parabolic shape, or the corners of a polygonal prism may be formed to be rounded to a certain extent, and it may be formed in various shapes and sizes suitable for guiding the paths of the wire 305, the wire 302, the wire 307, and the wire 308.
[0558] Here, in the portion of the guide portion 783 that contacts the wire 305, the wire 302, the wire 307, and the wire 308, a guide groove 784 may be further formed to better guide the paths of the wire 305, the wire 302, the wire 307, and the wire 308. The guide groove 784 may be formed in a groove shape that is recessed to a certain extent from the protruding surface of the guide portion 783.
[0559] Here, in the figure, the guide groove 784 is shown to be formed on the entire arc surface of the guide portion 783, 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 784 to be formed only on a part of the arc surface of the guide portion 783 as needed.
[0560] By further forming the guide groove 784 in the guide portion 783 in this way, the durability of the wire can be improved.
[0561] In the guide portion 783, a pitch pulley coupling portion 785 may be further formed in a direction opposite to the formation direction of the joe pulley coupling portions 781 and 782. The pitch pulley coupling portion 785 may be formed in a direction parallel to the pulley 731 which is a pitch pulley, that is, on the XZ plane. A through hole through which the rotary shaft 743 can be inserted may be formed in the pitch pulley coupling portion 785, and the rotary shaft 743 can penetrate through the pitch pulley coupling portion 785 and the pulley 731 so that these two members can be coupled. Here, the pitch pulley coupling portion 785 may be formed with a certain degree of deflection to one side from the center when viewed from the XY plane, and may be formed so as to be overall balanced when the pulley 731 is coupled.
[0562] Hereinafter, the role and function of the guide portion 783 will be described in more detail.
[0563] The guide portion 783 can play a role of expanding the respective rotation radii of the first joe 701 and the second joe 702 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.
[0564] Furthermore, the guide portion 783 can play a role of expanding the rotation radius of the staple pulley 761 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.
[0565] That is, when the auxiliary pulley is not arranged, each of the pulley 711 which is the first joe pulley, the pulley 721 which is the second joe pulley, and the staple pulley 761 could only rotate up to a right angle. However, in the second embodiment of the present invention, by further providing the guide portion 783 in the end tool hub 780, the effect of increasing the maximum rotation angle of each pulley can be obtained.
[0566] This enables the two jaws of the end tool 700 to open for the actuation operation when both jaws are yaw-rotated by 90°. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the feature of being able to expand the range of yaw rotation in which the actuation operation is possible. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the feature of being able to expand the range of yaw rotation in which the actuation operation is possible.
[0567] Also, the guide portion 783 of the end tool hub 780 that serves as an auxiliary pulley enables the staple pulley 761 to rotate further for the cutting operation when both jaws are yaw-rotated by 90°. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the feature of being able to expand the range of yaw rotation in which the cutting operation is possible.
[0568] Furthermore, by forming the guide portion 783 on the existing end tool hub 780 without adding a separate structure such as an auxiliary pulley, it has the feature of being able to expand the rotation range without adding parts or manufacturing processes.
[0569] In this way, there is no need to further 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, the length of the end tool during the pitch operation is shortened, and thus the effect of making it easier to perform the surgical operation in a narrow space can be obtained.
[0570] A more detailed explanation of this is as follows.
[0571] In the end tool 700 of the surgical instrument according to the second embodiment of the present invention, by forming a guide portion 783 capable of changing the path of the wire on the inner wall of the end tool hub 780, the arrangement path of the wire can be changed without a separate structure. By forming the guide portion 783 in the end tool hub 780 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. Accordingly, the rotation angles of the fastening members 323, 326, and 329 that connect each wire to the pulley are expanded.
[0572] That is, the fastening member 326 that connects the wire 302 to the pulley 721 can rotate until it is positioned on the common internal tangent line of the pulley 721 and the guide portion 783. Similarly, the fastening member (see 323 in FIG. 8) that connects the wire 305 to the pulley 711 can rotate until it is positioned on the common internal tangent line of the pulley 711 and the guide portion 783, and the rotation angle of the fastening member (see 323 in FIG. 8) can be expanded. Similarly, the fastening member 329 that connects the wires 307 and 308 to the pulley 761 can rotate until it is positioned on the common internal tangent line of the pulley 761 and the guide portion 783, and the rotation angle of the fastening member 329 can be expanded.
[0573] Explaining this from another perspective, the wire 301 and the wire 305 wound around the pulley 711 by the guide portion 783 are arranged on one side with reference to a 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 721 by the guide portion 783 are arranged on the other side with reference to a plane perpendicular to the Y-axis and passing through the X-axis.
[0574] In other words, the pulleys 713 and 714 are arranged on one side with reference to a plane perpendicular to the Y-axis and passing through the X-axis, and the pulleys 723 and 724 are arranged on the other side with reference to a plane perpendicular to the Y-axis and passing through the X-axis.
[0575] In other words, the wire 305 is located on the inscribed tangent line between the pulley 711 and the guide portion 783, and the rotation angle of the pulley 711 is extended by the guide portion 783. Also, the wire 302 is located on the inscribed tangent line between the pulley 721 and the guide portion 783, and the rotation angle of the pulley 721 is extended by the guide portion 783.
[0576] Compared with the surgical instrument of the first embodiment in which another auxiliary pulley is formed, the length of the end tool of the surgical instrument of this modification, in which no auxiliary pulley is formed and a guide portion 783 capable of changing the wire path is formed on the inner wall of the end tool hub 780, can be shortened. By shortening the length of the end tool in this way, when performing surgery in a narrow surgical space within the human body, the operation of the operator becomes easier, and the effect of reducing the side effects of the surgery can be obtained.
[0577] According to the present invention as described above, by increasing the radii of rotation of the pulley 711 which is the first jaw pulley, the pulley 721 which is the second jaw pulley, and the staple pulley 761, an effect of expanding the yaw operation range in which normal opening / closing actuation operations and cutting operations can be performed can be obtained.
[0578] <Third embodiment - direct connection type>
[0579] 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 characterized in that the configuration and the coupling relationship between the first jaw 801 and the second jaw 802 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 different configuration compared with the first embodiment will be described in detail.
[0580] Figs. 95 and 96 are perspective views showing the end tool of the surgical instrument according to the third embodiment of the present invention. Here, Fig. 96 shows the state where the end tool hub is removed. Fig. 97 is a perspective view showing the state where the end tool of the surgical instrument in Fig. 96 is opened, and Fig. 98 is a perspective view showing the state where the end tool of the surgical instrument in Fig. 96 is closed. Fig. 99 is a side view showing the end tool of the surgical instrument in Fig. 96. Figs. 100 and 101 are exploded perspective views of the end tool of the surgical instrument in Fig. 96. Fig. 102 is a plan view showing the state where the first jaw of the end tool of the surgical instrument in Fig. 96 is opened to the maximum extent. Figs. 103 and 104 are plan views showing the opening and closing operations of the end tool of the surgical instrument in Fig. 96.
[0581] Referring to Figs. 95 to 104, the end tool 800 of the third embodiment of the present invention includes a pair of jaws 803 for performing a grip operation, that is, a first jaw 801 and a second jaw 802. Here, each of the first jaw 801 and the second jaw 802, or a component including the first jaw 801 and the second jaw 802 can be called a jaw 803.
[0582] On the other hand, the end tool 800 includes a plurality of pulleys including pulleys 811 and 812 related to the rotational movement of the first jaw 801. In this embodiment, the pulleys related to the rotational movement of the first jaw 801 are substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in Fig. 8 and the like of the first embodiment, so the detailed description thereof is omitted here.
[0583] On the one hand, the end tool 800 includes a plurality of pulleys including pulleys 821 and 822 related to the rotational movement of the second jaw 802. In this embodiment, the pulleys related to the rotational movement of the second jaw 802 are substantially the same as the pulleys 121, 122, 123, 124, 125, and 126 described in FIG. 8 of the first embodiment, etc., so the detailed description thereof is omitted here.
[0584] Also, the end tool 800 of the third embodiment of the present invention may include a rotary shaft 841, a rotary shaft 842, a rotary shaft 843, and a rotary shaft 844. Here, the rotary shaft 841 and the rotary shaft 842 may be inserted through the end tool hub 880, and the rotary shaft 843 and the rotary shaft 844 may be inserted through the pitch hub 807. The rotary shaft 841, the rotary shaft 842, the rotary shaft 843, and the rotary shaft 844 may be sequentially arranged in the direction from the distal end 804 to the proximal end 805 of the end tool 800.
[0585] Also, the end tool 800 of the third embodiment of the present invention may include an end tool hub 880 and a pitch hub 807.
[0586] The rotary shafts 841 and 842, which will be described later, are inserted through the end tool hub 880. Further, at least a part of the pulleys 811 and 821 axially coupled to the rotary shaft 841 and the first jaw 801 and the second jaw 802 coupled thereto may be accommodated inside the end tool hub 880.
[0587] The rotary shafts 843 and 844 are inserted through the pitch hub 807, and the pitch hub 807 can be axially coupled to the end tool hub 880 by the rotary shaft 843. Therefore, the end tool hub 880 may be formed to be pitch-rotatable with respect to the pitch hub 807 around the rotary shaft 843.
[0588] On the one hand, the end tool 800 of the third embodiment of the present invention may further include components such as a staple pulley assembly (see 160 in FIG. 13) for performing stapling and cutting operations.
[0589] The staple pulley assembly (see 160 in FIG. 13) may be formed adjacent to the pulley 811 and the pulley 821 between the pulley 811 and the pulley 821. In this embodiment, it is assumed that the staple pulley assembly (see 160 in FIG. 13) includes one staple pulley 861.
[0590] On the other hand, the third embodiment of the present invention is characterized in that by disposing a staple pulley assembly (see 160 in FIG. 13) between the pulley 811 which is the first jog pulley and the pulley 821 which is the second jog pulley, it is possible to perform staple stapling and cutting operations using a cartridge (see 500 in FIG. 22) together with the pitch operation and yaw operation of the end tool 800. Since the components for performing the stapling 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.
[0591] Hereinafter, the first jog 801 and the second jog 802 of the end tool 800 of the surgical instrument according to the third embodiment of the present invention will be described in more detail.
[0592] The end tool 800 of the surgical instrument according to the third embodiment of the present invention is characterized in that it does not separately include a jog pulley rotation axis and a jog rotation axis, and one rotation axis 841 simultaneously serves as the jog pulley rotation axis and the jog rotation axis. In other words, in this embodiment, when connecting the first jog 801 and the second jog 802, a direct connection structure is adopted instead of the X-shaped structure in the first embodiment.
[0593] That is, in the first embodiment of the present invention, a rotating shaft that is a joe pulley rotating shaft (see 141 in FIG. 17) and a rotating shaft that is a joe rotating shaft (see 145 in FIG. 17) are provided separately, and the gripping force when the joe is closed is made stronger. On the other hand, in the third embodiment of the present invention, the rotating shaft 841 serves both as the joe rotating shaft and the joe pulley rotating shaft, and each joe and the joe pulley rotate together integrally.
[0594] Specifically, the first joe 801 includes a cartridge accommodating portion (see 101a in FIG. 14) and a guide groove 801b. The first joe 801 is formed in an overall elongated rod shape. A cartridge 500 is accommodated on the distal portion 801f side, a pulley 811 is coupled to the proximal portion 801g, and it is formed to be rotatable about the rotating shaft 841.
[0595] Here, although the figure shows that the first joe 801 and the pulley 811 are integrally formed, it can be said that a configuration in which the first joe 801 and the pulley 811 are formed of separate members and coupled is also possible.
[0596] The second joe 802 includes an anvil 802a. The second joe 802 is formed in an overall elongated rod shape. An anvil 802a is formed on the distal portion 802f side, a pulley 812 is coupled to the proximal portion 802g, and it is formed to be rotatable about the rotating shaft 841.
[0597] Here, although the figure shows that the second joe 802 and the pulley 821 are integrally formed, it can be said that a configuration in which the second joe 802 and the pulley 821 are formed of separate members and coupled is also possible.
[0598] The rotating shaft 841, which is an end tool joe pulley rotating shaft, is sequentially inserted through the pulley 811 coupled to (or integrally formed with) the first joe 801, the staple pulley 861, and the pulley 821 coupled to (or integrally formed with) the second joe 802.
[0599] Therefore, the pulley 811 coupled to (or integrally formed with) the first jaw 801, the staple pulley 861, and the pulley 821 coupled to (or integrally formed with) the second jaw 802 will all rotate about the rotation axis 841.
[0600] In addition, the third embodiment of the present invention includes an auxiliary pulley 812. The auxiliary pulley 812 can play a role in expanding the respective rotation radii of the first jaw 801 and the second jaw 802 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.
[0601] As a result, different from the first embodiment, in this embodiment, since there is no separate jaw rotation axis that restrains the first jaw 801 and the second jaw 802, the rotation angle between the first jaw 801 and the second jaw 802 is extended up to about 120 degrees. Further, without a separate connection structure for the X-shaped structure connection between the first jaw 801 and the second jaw 802, the first jaw 801 and the second jaw 802 are coupled by one axis, so that the number of parts can be reduced and the manufacturing can be facilitated.
[0602] <Fourth Embodiment - Dual Rack>
[0603] Hereinafter, the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention will be described. Here, the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention is characteristically different in the staple link assembly 970 and the reciprocating movement assembly 950 of the cartridge 910 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. Hereinafter, the different configurations compared to the first embodiment will be described in detail.
[0604] Figures 105 and 106 are perspective views showing the end tool of the surgical instrument according to the fourth embodiment of the present invention. Here, FIG. 106 shows a state where the end tool hub is removed. FIGS. 107 and 108 are perspective views of the end tool of the surgical instrument of FIG. 105 viewed from another angle. Here, FIG. 108 shows a state where the end tool hub is removed. FIG. 109 is a side view showing the end tool of the surgical instrument of FIG. 105. FIGS. 110 and 111 are exploded perspective views of the end tool of the surgical instrument of FIG. 105. FIG. 112 is an exploded perspective view of the staple link assembly of the surgical instrument of FIG. 105. FIGS. 113 and 114 are side views and plan views showing each operating state of the staple link assembly of FIG. 105. FIG. 115 is a perspective view showing the internal structure of the end tool of the surgical instrument of FIG. 105. FIGS. 116 and 117 are perspective views showing each operating state of the end tool of FIG. 115. FIGS. 118 and 119 are perspective views showing each operating state of the end tool of FIG. 115. Here, FIGS. 118 and 119 mainly show the operations of the reciprocating movement assembly and the staple link assembly. FIGS. 120 and 121 are perspective views showing each operating state of the end tool of FIG. 115. Here, FIGS. 120 and 121 mainly show the operations of the reciprocating movement assembly and the working member.
[0605] Referring to FIGS. 105 to 121, the end tool 900 of the fourth embodiment of the present invention includes a pair of jaws 903 for performing a grip operation, that is, a first jaw 901 and a second jaw 902. Here, each of the first jaw 901 and the second jaw 902, or a component including the first jaw 901 and the second jaw 902 can be called a jaw 903.
[0606] On the one hand, the end tool 900 includes a plurality of pulleys including pulleys 911 and 912 related to the rotational movement of the first jaw 901. In this embodiment, the pulleys related to the rotational movement of the first jaw 901 are substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in FIG. 8 of the first embodiment and the like, so the detailed description thereof is omitted here.
[0607] On the other hand, the end tool 900 includes a plurality of pulleys including pulleys 921 and 922 related to the rotational movement of the second jaw 902. In this embodiment, the pulleys related to the rotational movement of the second jaw 902 are substantially the same as the pulleys 121, 122, 123, 124, 125, and 126 described in FIG. 8 of the first embodiment and the like, so the detailed description thereof is omitted here.
[0608] Further, the end tool 900 of the fourth embodiment of the present invention may include a rotating shaft 941, a rotating shaft 942, a rotating shaft 933, and a rotating shaft 944. Here, the rotating shaft 941 and the rotating shaft 942 may be inserted through the end tool hub 980, and the rotating shaft 933 and the rotating shaft 944 may be inserted through the pitch hub 907. The rotating shaft 941, the rotating shaft 942, the rotating shaft 933, and the rotating shaft 944 may be sequentially arranged in the direction from the distal end 904 to the proximal end 905 of the end tool 900.
[0609] Further, the end tool 900 of the fourth embodiment of the present invention may include an end tool hub 980 and a pitch hub 907.
[0610] The rotating shaft 941 and the rotating shaft 942 are inserted through the end tool hub 980, and further, at least a part of the pulleys 911 and 921 axially coupled to the rotating shaft 941 and the first jaw 901 and the second jaw 902 coupled thereto may be accommodated inside the end tool hub 980.
[0611] A rotation shaft 933 and a rotation shaft 944 are inserted through a pitch hub 907, and the pitch hub 907 can be axially coupled to an end tool hub 980 by the rotation shaft 933. Accordingly, the end tool hub 980 may be formed to be pitch-rotatable with respect to the pitch hub 907 about the rotation shaft 933.
[0612] On the other hand, the end tool 900 according to the fourth embodiment of the present invention may further include components such as a staple drive assembly (see 150 in FIG. 13), which includes a staple pulley assembly 960 and a staple link assembly 970, in order to perform stapling and cutting operations.
[0613] The staple pulley assembly 960 may be formed adjacent to the pulley 911 and the pulley 921 between the pulley 911 and the pulley 921. In the present embodiment, it is assumed that the staple pulley assembly 960 includes one staple pulley 961.
[0614] The fourth embodiment of the present invention is characterized in that by disposing the staple pulley assembly 960 between the pulley 911, which is the first joe pulley, and the pulley 921, which is the second joe pulley, it is possible to perform not only the pitch operation and the yaw operation of the end tool 900 but also the stapling and cutting operations using the cartridge 910.
[0615] Hereinafter, the staple pulley assembly 960, the staple link assembly 970, and the reciprocating movement assembly 950 of the cartridge 910 of the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention will be described in more detail.
[0616] The end tool 900 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that the staple link assembly 970 includes a first link member 971 and a second link member 976, and the reciprocating movement assembly 950 of the cartridge 910 includes a first reciprocating movement member 951 and a second reciprocating movement member 952 to form a kind of dual rack structure.
[0617] Referring to FIGS. 105 to 121 etc., the staple pulley assembly 960 may include one or more staple pulleys 961.
[0618] A shaft penetration portion 961a may be formed in the staple pulley 961. The shaft penetration portion 961a is formed in a hole shape, and the rotation shaft 941, which is the end tool jaw pulley rotation shaft, may be inserted through the shaft penetration portion 961a.
[0619] In addition, a first link coupling portion 961b and a second link coupling portion 961c may be formed in the staple pulley 961. The first link member 971 of the staple link assembly 970 may be coupled to the first link coupling portion 961b, and the second link member 976 of the staple link assembly 970 may be coupled to the second link coupling portion 961c. Here, the first link coupling portion 961b and the second link coupling portion 961c may be arranged on opposite sides with respect to the central axis of the staple pulley 961.
[0620] On the other hand, the end tool 900 of the fourth embodiment of the present invention may further include a staple link assembly 970 connected to the staple pulley assembly 960. Here, the staple link assembly 970 can play a role of connecting the staple pulley assembly 960 and the reciprocating movement assembly 950 of the cartridge 910 described later. The end tool 900 of the fourth embodiment of the present invention is characterized in that the staple link assembly 970 includes two pairs of link members, namely a first link member 971 and a second link member 976.
[0621] The first link member 971 may include a first link 972 and a second link 973.
[0622] The first link 972 may be formed in an elongated bar shape, and through holes may be formed at both ends. The first link coupling portion 961b of the staple pulley 961 may be inserted through the through hole at one end of the first link 972. The second link 973 may be inserted through the through hole at the other end of the first link 972.
[0623] The second link 973 may be formed in an elongated bar shape and may be coupled to the first link 972. The second link 973 may include a first protrusion 973a, a second protrusion 973b, and a fastening portion 973c.
[0624] Specifically, the first protrusion 973a may be formed at one end of the second link 973. By fitting and axially coupling the first protrusion 973a into the through hole of the first link 972, the second link 973 can be coupled to the first link 972. Further, the first protrusion 973a may be fitted into the first guide groove 901b of the first joe 901 described later.
[0625] On the other hand, the second protrusion 973b may be formed in a region at the center of the second link 973. The second protrusion 973b may be fitted into the first guide groove 901b of the first joe 901 described later.
[0626] In this way, in a state where the first protrusion 973a and the second protrusion 973b of the second link 973 formed in a protrusion shape are fitted into the groove-shaped first guide groove 901b, the first protrusion 973a and the second protrusion 973b move along the first guide groove 901b, so that the first link member 971 moves with respect to the first joe 901 (and the cartridge 910 inside it). This will be described in more detail later.
[0627] On the other hand, a fastening portion 973c may be formed at the other end of the second link 973. This fastening portion 973c may be coupled to a fastening portion 951a of a first reciprocating member 951 of the cartridge 910 described later.
[0628] In the state as shown in FIG. 113, when the staple pulley 961 rotates in the direction of arrow A1 in FIG. 114 (i.e., clockwise), the first link member 971 coupled to the staple pulley 961 can move in the direction of arrow B1 in FIG. 114, in other words, in the direction of the distal portion 901f of the first jaw 901. Conversely, when the staple pulley 961 rotates counterclockwise, the first link member 971 coupled to the staple pulley 961 can move in the direction of arrow C1 in FIG. 114, in other words, in the direction of the proximal portion 901g of the first jaw 901.
[0629] Therefore, the bidirectional rotational movement of the staple pulley assembly 960 can cause the reciprocating linear movement of the first reciprocating member 951 of the cartridge 910 via the first link member 971 of the staple link assembly 970. This will be described in more detail later.
[0630] The second link member 976 may include a third link 977 and a fourth link 978.
[0631] The third link 977 is formed in an elongated bar shape, and through holes may be formed at both ends. The second link coupling portion 961c of the staple pulley 961 may be inserted through the through hole at one end of the third link 977. The fourth link 978 may be inserted through the through hole at the other end of the third link 977.
[0632] The fourth link 978 is formed in a bar shape bent one or more times and may be coupled to the third link 977. The fourth link 978 may include a first protrusion 978a, a second protrusion 978b, and a fastening portion 978c.
[0633] Specifically, a first protrusion 978a may be formed at one end of the fourth link 978. By fitting the first protrusion 978a into the through hole of the third link 977 and axially coupling them, the fourth link 978 can be coupled to the third link 977. Further, the first protrusion 978a may be fitted into a second guide groove 901c of a first joe 901 described later.
[0634] On the other hand, a second protrusion 978b may be formed in a region at the center of the fourth link 978. The second protrusion 978b may be fitted into the second guide groove 901c of the first joe 901 described later.
[0635] In this way, with the first protrusion 978a and the second protrusion 978b of the fourth link 978 formed in a protruding shape fitted into the groove-shaped second guide groove 901c, when the first protrusion 978a and the second protrusion 978b move along the second guide groove 901c, the second link member 976 moves with respect to the first joe 901 (and the cartridge 910 inside it). This will be described in more detail later.
[0636] On the other hand, a fastening portion 978c may be formed at the other end of the fourth link 978. This fastening portion 978c may be coupled to a fastening portion 952a of a second reciprocating member 952 of the cartridge 910 described later.
[0637] Here, the fourth link 978 may include two horizontal regions and one vertical region connecting them.
[0638] Specifically, since the first link coupling portion 961b and the second link coupling portion 961c are arranged on opposite sides with respect to the central axis of the staple pulley 961, there will be a height difference (with respect to the Z-axis direction) between the first link 972 coupled to the first link coupling portion 961b and the third link 977 coupled to the second link coupling portion 961c.
[0639] In contrast, it is structurally easy for the first reciprocating member 951 and the second reciprocating member 952 of the reciprocating movement assembly 950 described later to be located at the same height as each other (with reference to the Z-axis direction).
[0640] Therefore, in order to connect the third link 977 and the second reciprocating member 952, the fourth link 978 may be formed in a bar shape bent one or more times.
[0641] Here, a first protrusion 978a and a second protrusion 978b may be formed in the first horizontal region, and a fastening portion 978c may be formed in the second horizontal region.
[0642] In the state as shown in Fig. 113, when the staple pulley 961 rotates in the direction of arrow A1 in Fig. 114 (i.e., clockwise), the second link member 976 connected to the staple pulley 961 can move in the direction of arrow C1 in Fig. 114, in other words, in the direction of the proximal portion 901g of the first jaw 901. Conversely, when the staple pulley 961 rotates counterclockwise, the second link member 976 connected to the staple pulley 961 can move in the direction of arrow B1 in Fig. 114, in other words, in the direction of the distal portion 901f of the first jaw 901.
[0643] Therefore, the bidirectional rotational movement of the staple pulley assembly 960 can cause the reciprocating linear movement of the second reciprocating member 952 of the cartridge 910 via the second link member 976 of the staple link assembly 970. This will be described in more detail later.
[0644] As described above, the first link coupling portion 961b and the second link coupling portion 961c may be arranged on opposite sides of each other with reference to the central axis of the staple pulley 961. The first link member 971 is coupled to the first link coupling portion 961b, and the second link member 976 is coupled to the second link coupling portion 961c.
[0645] Therefore, when the staple pulley 961 rotates in one direction (e.g., clockwise), the first link member 971 advances and the second link member 976 retracts. On the other hand, when the staple pulley 961 rotates in the other direction (e.g., counterclockwise), the first link member 971 retracts and the second link member 976 advances.
[0646] With such a configuration, when the staple pulley 961 rotates alternately in the clockwise and counterclockwise directions, the first link member 971 and the second link member 976 perform linear reciprocating motion, and at this time, the first link member 971 and the second link member 976 move in opposite directions to each other. That is, when the first link member 971 advances (i.e., moves toward the distal end side), the second link member 976 retracts (i.e., moves toward the proximal end side). Conversely, when the first link member 971 retracts (i.e., moves toward the proximal end side), the second link member 976 advances (i.e., moves toward the distal end side).
[0647] (cartridge)
[0648] Hereinafter, the cartridge 910 of the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention will be described in more detail.
[0649] The cartridge 910 of the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that the reciprocating movement assembly 950 includes a first reciprocating movement member 951 and a second reciprocating movement member 952.
[0650] Specifically, referring to FIGS. 115 to 117 and the like, the cartridge 910 is formed to be attachable and detachable to the first jaw 101, and includes a plurality of staples (see 530 in FIG. 22) and a working member 940 therein, and performs tissue suturing and cutting.
[0651] Here, the cartridge 910 may include a cover (refer to 510 in FIG. 22), a housing 920, staples (refer to 530 in FIG. 22), a working member 940, and a reciprocating assembly 950.
[0652] The housing 920 forms the outer shape of the cartridge 910, and may be formed in a shape in which one surface (upper surface) is removed from an overall hollow box, and may be formed to accommodate the reciprocating assembly 950, the working member 940, and staples (refer to 530 in FIG. 22) therein. Here, the cross section of the housing 920 may be formed in a substantially "U" shape.
[0653] A plurality of staples (refer to 530 in FIG. 22) may be arranged inside the housing 920. As the working member 940 described later moves linearly in one direction, the plurality of staples (refer to 530 in FIG. 22) can be sequentially pushed up from the inside of the housing 920 to the outside for stitching, that is, stapling.
[0654] The reciprocating assembly 950 may be arranged below the inside of the housing 920. In the present embodiment, the reciprocating assembly 950 includes a first reciprocating member 951 and a second reciprocating member 952.
[0655] In the present embodiment, the first reciprocating member 951 and the second reciprocating member 952 may be racks. The first reciprocating member 951 may include a concavo-convex portion 951b and a fastening portion 951a.
[0656] Specifically, the first reciprocating member 951 may be formed in an elongated bar shape, and a plurality of serrated concavo-convex portions 951b may be formed on one surface. The concavo-convex portion 951b may be formed to be in contact with the working member 940 described later, particularly the ratchet member 943 of the working member 940. In other words, the first reciprocating member 951 may include a plurality of concavo-convex portions 951b having a shape that meshes with the first ratchet 943a of the ratchet member 943.
[0657] Similarly, the second reciprocating member 952 may include a concavo-convex portion 952b and a fastening portion 952a. That is, the second reciprocating member 952 may include a plurality of concavo-convex portions 952b having a shape that meshes with the second ratchet 943b of the ratchet member 943.
[0658] Here, the first reciprocating member 951 and the second reciprocating member 952 may not be fixedly coupled to other components of the cartridge 910 and may be formed to be movable relative to other components of the cartridge 910. That is, the first reciprocating member 951 and the second reciprocating member 952 may perform a reciprocating linear motion with respect to the housing 920 and the cover 510 coupled to the housing 920.
[0659] On the other hand, a fastening portion 951a may be formed on the proximal end side adjacent to the pulley 911 in the first reciprocating member 951, and this fastening portion 951a may be fastened and coupled to the first link member 971 of the staple link assembly 970 of the end tool 900. Therefore, when the first link member 971 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (that is, the Y-axis direction), the first reciprocating member 951 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (that is, the Y-axis direction).
[0660] Similarly, a fastening portion 952a may be formed on the proximal end side adjacent to the pulley 911 in the second reciprocating member 952, and this fastening portion 952a may be fastened and coupled to the second link member 976 of the staple link assembly 970 of the end tool 900. Therefore, when the second link member 976 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (that is, the Y-axis direction), the second reciprocating member 952 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (that is, the Y-axis direction).
[0661] A working member 940 may be disposed inside the housing 920. The working member 940 is formed to be capable of contacting the first reciprocating member 951 and the second reciprocating member 952, and may be formed to linearly move in one direction in response to the reciprocating linear motion of the first reciprocating member 951 and the second reciprocating member 952. In other words, the working member 940 interacts with the first reciprocating member 951 and the second reciprocating member 952, and performs stapling and cutting while moving along the extending direction of the connecting portion 400.
[0662] The working member 940 may include a wedge (see 541 in FIG. 22), a blade (see 542 in FIG. 22), a ratchet member 943, and an elastic member (see 544 in FIG. 22). Here, in the figure, the remaining components of the working member 940 excluding the ratchet member 943, that is, the wedge, the blade, etc. are shown omitted, but it goes without saying that such components may be included in the working member 940.
[0663] The ratchet member 943 may include a first ratchet 943a and a second ratchet 943b. Here, the first ratchet 943a may be formed to be meshed with the first reciprocating member 951, and the second ratchet 943b may be formed to be meshed with the second reciprocating member 952. That is, the first ratchet 943a is meshed (or in close contact) with the first reciprocating member 951, and the working member 940 is advanced by the first reciprocating member 951, and the second ratchet 943b is meshed (or in close contact) with the second reciprocating member 952, and the working member 940 is advanced by the second reciprocating member 952, and these operations are alternately performed.
[0664] Here, due to the structural shape of the ratchet member 943 itself, the ratchet member 943 can be alternately in close contact with the first reciprocating member 951 and the second reciprocating member 952 even without a separate elastic member. This will be described in more detail below.
[0665] (Operation of reciprocating assembly and working member)
[0666] Hereinafter, the operations of the reciprocating assembly 950 and the working member 940 will be described in more detail.
[0667] FIGs. 120 and 121 are diagrams showing the respective operating states of the reciprocating assembly 950 and the working member 940. Here, FIG. 120(a) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact, FIG. 120(e) is a diagram showing a state in which the second ratchet 943b of the ratchet member 943 and the second reciprocating member 952 are in close contact, and FIG. 120(i) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact again.
[0668] And from FIG. 120(a) to FIG. 120(e), it shows the operating state while the staple pulley 961 rotates counterclockwise (opposite to the arrow A1 in FIG. 114) and the second reciprocating member 952 moves forward. Here, from FIG. 120(e) to FIG. 120(i), it shows the operating state while the staple pulley 961 rotates clockwise (in the direction of the arrow A1 in FIG. 114) and the first reciprocating member 951 moves forward.
[0669] First, the operations from FIG. 120(a) to FIG. 120(e) will be described.
[0670] FIG. 120(a) shows a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact.
[0671] In this state, when the staple pulley 961 rotates counterclockwise (in the direction opposite to the arrow A1 in Fig. 114), as shown in Fig. 120(b), the first reciprocating member 951 moves in the direction of arrow b1 (i.e., retreats), and the second reciprocating member 952 moves in the direction of arrow b2 (i.e., advances). Then, the uneven portion 951b of the first reciprocating member 951 pushes the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, whereby the ratchet member 943 rotates and moves in the direction of arrow b3 as a whole. When the ratchet member 943 rotates and moves in the direction of arrow b3, the first ratchet 943a of the ratchet member 943 starts to separate from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 starts to contact the uneven portion 952b of the second reciprocating member 952.
[0672] In this state, when the staple pulley 961 further rotates counterclockwise (in the direction opposite to the arrow A1 in Fig. 114), as shown in Fig. 120(c), the first reciprocating member 951 further moves in the direction of arrow c1 (i.e., retreats), and the second reciprocating member 952 further moves in the direction of arrow c2 (i.e., advances). Then, the uneven portion 951b of the first reciprocating member 951 further pushes the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, whereby the ratchet member 943 rotates and moves further in the direction of arrow c3 as a whole. When the ratchet member 943 rotates and moves in the direction of arrow c3, the first ratchet 943a of the ratchet member 943 further separates from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 further contacts the uneven portion 952b of the second reciprocating member 952.
[0673] In this state, when the staple pulley 961 further rotates counterclockwise (opposite to the arrow A1 in Fig. 114), as shown in Fig. 120(d), the first reciprocating member 951 further moves in the direction of arrow d1 (i.e., retracts), and the second reciprocating member 952 further moves in the direction of arrow d2 (i.e., advances). Then, the uneven portion 951b of the first reciprocating member 951 further presses the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, whereby the ratchet member 943 rotates and moves further in the direction of arrow d3 as a whole. When the ratchet member 943 rotates and moves in the direction of arrow d3, the first ratchet 943a of the ratchet member 943 is completely separated from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 comes into close contact with the uneven portion 952b of the second reciprocating member 952.
[0674] In this state, when the staple pulley 961 further rotates counterclockwise (opposite to the arrow A1 in Fig. 114), as shown in Fig. 120(e), the first reciprocating member 951 further moves in the direction of arrow e1 (i.e., retracts), and the second reciprocating member 952 further moves in the direction of arrow e2 (i.e., advances). Then, since the second ratchet 943b of the ratchet member 943 is in close contact with the uneven portion 952b of the second reciprocating member 952, the ratchet member 943 linearly moves in the direction of arrow e4 by the second reciprocating member 952.
[0675] Next, the operations from Fig. 120(e) to Fig. 120(i) will be described.
[0676] Fig. 120(e) shows a state where the second ratchet 943b of the ratchet member 943 is in close contact with the second reciprocating member 952.
[0677] In this state, when the staple pulley 961 rotates in the clockwise direction (the direction of arrow A1 in Fig. 114), as shown in Fig. 120(f), the first reciprocating member 951 moves in the direction of arrow f1 (i.e., advances), and the second reciprocating member 952 moves in the direction of arrow f2 (i.e., retreats). Then, the uneven portion 952b of the second reciprocating member 952 pushes the second ratchet 943b of the ratchet member 943 toward the first reciprocating member 951, whereby the ratchet member 943 rotates and moves in the direction of arrow f3 as a whole. When the ratchet member 943 rotates and moves in the direction of arrow f3, the second ratchet 943b of the ratchet member 943 starts to separate from the uneven portion 952b of the second reciprocating member 952, and the first ratchet 943a of the ratchet member 943 starts to contact the uneven portion 951b of the first reciprocating member 951.
[0678] In this state, when the staple pulley 961 further rotates in the clockwise direction (the direction of arrow A1 in Fig. 114), as shown in Fig. 120(g), the first reciprocating member 951 further moves in the direction of arrow g1 (i.e., advances), and the second reciprocating member 952 further moves in the direction of arrow g2 (i.e., retreats). Then, the uneven portion 952b of the second reciprocating member 952 further pushes the second ratchet 943b of the rat...
Claims
1. A first jaw capable of accommodating a cartridge, A second jaw formed to face the first jaw, 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, formed to be rotatable about an axis that is the same as or parallel to the first axis, and formed to be spaced apart from the first jaw pulley by a certain degree, A staple drive assembly including one or more staple pulleys at least partially formed between the first jaw pulley and the second jaw pulley, and A staple wire that at least partially contacts the staple pulley and transmits the driving force required for the rotation of the staple pulley to the staple pulley, The staple drive assembly is connected to the reciprocating movement assembly of the cartridge, and the rotational movement of the staple pulley is converted into a linear movement of the reciprocating movement assembly. An end tool of a surgical instrument, characterized in that.
2. Further including an end tool hub including a first jaw pulley coupling portion and a second jaw pulley coupling portion formed to face each other, and a guide portion connecting the first jaw pulley coupling portion and the second jaw pulley coupling portion, The first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub, The second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub, The end tool of the surgical instrument according to claim 1, characterized in that at least a part of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.
3. The end tool of the surgical instrument according to claim 2, characterized in that the first axis is sequentially inserted through the first jaw pulley coupling portion, the first jaw pulley, the staple pulley, the second jaw pulley, and the second jaw pulley coupling portion.
4. The end tool of the surgical instrument according to claim 2, characterized in that the first jaw pulley, the staple pulley, and the second jaw pulley are sequentially arranged along the rotation axis within the end tool hub.
5. The first jump pulley, the staple pulley, and the second jump pulley are each formed to be rotatable independently of one another, and the end tool of the surgical instrument according to claim 2 is characterized in that.
6. The end tool of the surgical instrument according to claim 2, further comprising a staple auxiliary pulley disposed between the staple pulley and the guide portion.
7. The staple wire is located on a common inscribed line of the staple pulley and the staple auxiliary pulley, and the rotation angle of the staple pulley is expanded by the staple auxiliary pulley, and the end tool of the surgical instrument according to claim 6 is characterized in that.
8. In the guide portion, a region adjacent to the first jump pulley, the staple pulley, and the second jump pulley is formed to be curved so that its cross section has a predetermined curvature, and the end tool of the surgical instrument according to claim 2 is characterized in that.
9. The staple wire is located on a common inscribed line of the staple pulley and the guide portion, and the rotation angle of the staple pulley is expanded by the guide portion, and the end tool of the surgical instrument according to claim 8 is characterized in that.
10. The staple drive assembly includes a staple link assembly that connects the staple pulley and the reciprocating movement assembly, and the end tool of the surgical instrument according to claim 1 is characterized in that.
11. The staple link assembly a first link coupled to the staple pulley and a second link coupled to the first link and the reciprocating movement assembly respectively, and the end tool of the surgical instrument according to claim 10 is characterized in that.
12. When the staple pulley rotates alternately in the clockwise and counterclockwise directions, the staple link assembly coupled to the staple pulley moves alternately to the distal side and the proximal side of the end tool, and the end tool of the surgical instrument according to claim 10 is characterized in that.
13. The end tool of the surgical instrument according to claim 10, wherein the bidirectional rotational movement of the staple pulley is converted into a reciprocating linear movement of the reciprocating movement assembly connected to the staple link assembly by the staple link assembly.
14. A guide groove is formed along the longitudinal direction of the first jaw, The staple link assembly is characterized in that it moves along the guide groove, and the end tool of the surgical instrument according to claim 10.
15. Further including a jaw rotation axis that is inserted through the first jaw and the second jaw and serves as the rotation center of the first jaw and the second jaw, The first shaft is a jaw pulley rotation axis that is inserted through the first jaw pulley and the second jaw pulley and serves as the rotation center of the first jaw pulley and the second jaw pulley, When the first jaw pulley and the second jaw pulley rotate about the jaw pulley rotation axis, the jaw rotation axis moves relative to the jaw pulley rotation axis, and the end tool of the surgical instrument according to claim 1.
16. When the first jaw and the second jaw are closed, the jaw rotation axis moves in the distal direction of the end tool, When the first jaw and the second jaw are opened, the jaw rotation axis moves in the proximal direction of the end tool, and the end tool of the surgical instrument according to claim 15.
17. 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 The end tool of the surgical instrument according to claim 1, further including a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis identical or parallel to the second axis.
18. The end tool is characterized in that it can rotate in yaw about the first axis and can rotate in pitch about the second axis, and the end tool of the surgical instrument according to claim 17.
19. The first jump pulley, a first jump wire at least partially wound around the first jump pitch main pulley of the pair of end tools, and The end tool of the surgical instrument according to claim 17, further comprising a second jump wire at least partially wound around the second jump pulley and the second jump pitch main pulley of the pair of end tools.
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