End tool of surgical instrument, and surgical instrument having end tool

Abstract

To provide an end tool of surgical instruments, and the surgical instruments having the end tool.SOLUTION: Surgical instruments can be operated manually or by being attached to a robot arm so as to being used in a laparoscopic surgery or various surgeries. The surgical instruments comprise an end tool which can be rotated in two or more directions and which operates so as to intuitively correspond to an operation of an operation part. The end tool of the surgical instruments, and the surgical instruments having the end tool are provided.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to an end tool of a surgical instrument and a surgical instrument equipped with the same, and more particularly to a surgical instrument that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various other surgeries, and that has an end tool that can rotate in two or more directions and operates in a manner that intuitively matches the operation of the operating part, and a surgical instrument equipped with the same. [Background technology]

[0002] In recent years, laparoscopic surgery, which uses small incisions to reduce post-operative recovery time and complications, has been widely used. Laparoscopic surgery involves making multiple small holes in the patient's abdomen, through which the inside of the abdominal cavity can be observed, and is widely used in general surgery and other procedures.

[0003] When performing such laparoscopic surgery, a suturing mechanism is inserted into the body to suture the surgical site within the abdominal cavity, and a surgical stapler is used to suture the surgical site using medical staples in the suturing mechanism.

[0004] In general, surgical staplers are medical instruments widely used for cutting and anastomosis of organs in abdominal and thoracic organ surgeries. There are two types of surgical staplers: open staplers, which are used in open chest or abdominal surgery, and endo staplers, which are used with thoracoscopes and laparoscopes.

[0005] Surgical staplers have the advantage of shortening the surgical time and achieving accurate suturing of the surgical site by simultaneously cutting the surgical site and anastomosis of the organ. Furthermore, surgical staplers are widely used in modern surgical procedures due to the advantage of faster recovery and less scarring than when using surgical sutures for tissue cutting and suturing. In particular, surgical staplers are widely used in cancer surgery to cut cancerous tissue and suture the cut site.

[0006] The above-mentioned background art is technical information that the inventor possessed for the purpose of deriving the present invention or that he acquired in the process of deriving the present invention, and is not necessarily publicly known art that was made public to the general public prior to the filing of the present invention. Summary of the Invention [Problem to be solved by the invention]

[0007] The present invention aims to provide a surgical instrument that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various other surgeries, and that has an end tool that can rotate in two or more directions and that operates in a manner that intuitively matches the operation of the operating part. [Means for solving the problem]

[0008] The present invention provides a surgical instrument comprising: an end tool including 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 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 a certain distance from the first jaw pulley, and a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a reciprocating assembly connected to the staple drive assembly and moving linearly as the first staple pulley and the second staple pulley rotate; and a cartridge including a working member that comes into contact with the reciprocating assembly and is moved in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction. [Effects of the Invention]

[0009] With this invention, the direction in which the surgeon operates the operating unit and the direction in which the end tool operates are intuitively the same, thereby improving convenience for the surgeon and achieving the effects of improving the accuracy, reliability, speed, etc. of the surgery. [Brief explanation of the drawings]

[0010] [Figure 1] Figure 1(a) is a conceptual diagram showing the pitch movement of a conventional surgical instrument, Figure 1(b) is a conceptual diagram showing the yaw movement; Figure 1(c) is a conceptual diagram showing the pitch movement of another conventional surgical instrument, Figure 1(d) is a conceptual diagram showing the yaw movement; Figure 1(e) is a conceptual diagram showing the pitch movement of a surgical instrument according to the present invention, and Figure 1(f) is a conceptual diagram showing the yaw movement. [Figure 2] FIG. 2 is a perspective view showing a surgical instrument according to a first embodiment of the present invention. [Figure 3] 3 is a side view of the surgical instrument of FIG. 2. FIG. [Figure 4]4 is a perspective view showing an end tool of the surgical instrument of FIG. 2. FIG. [Figure 5] 5 is a perspective view showing an end tool of the surgical instrument of FIG. 2. FIG. [Figure 6] 6 is a perspective view showing an end tool hub of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 7] 7 is a plan view showing an end tool of the surgical instrument of FIG. 2. FIG. [Figure 8] 8 is a plan view showing an end tool of the surgical instrument of FIG. 2. FIG. [Figure 9] 9 is a side view showing the end tool of the surgical instrument of FIG. 2. FIG. [Figure 10] 10 is an exploded perspective view of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 11] 11 is an exploded perspective view of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 12] 12 is a perspective view showing a first jaw pulley of the surgical instrument of FIG. 2. FIG. [Figure 13] 13 is a plan view showing a first jaw of the surgical instrument of FIG. 2. FIG. [Figure 14] 14 is a plan view showing a second jaw of the surgical instrument of FIG. 2. FIG. [Figure 15] 15 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. [Figure 16] 16 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. [Figure 17] 17 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 18] 18 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 19]19 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 20] 20 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 21] 21 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. FIG. [Figure 22] 22 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. FIG. [Figure 23] 23 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. FIG. [Figure 24] 24 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. FIG. [Figure 25] 25 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 2. FIG. [Figure 26] 26 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 2. FIG. [Figure 27] 27 is a perspective view showing a first jaw and a cartridge of the surgical instrument of FIG. 2. FIG. [Figure 28] FIG. 28 is an exploded perspective view showing the cartridge of FIG. [Figure 29] FIG. 29 is an assembled perspective view showing the cartridge of FIG. 27. [Figure 30] FIG. 30 is a side view of the cartridge of FIG. [Figure 31] FIG. 31 is a perspective cross-sectional view showing the cartridge of FIG. [Figure 32] 32 is a side cross-sectional view showing the cartridge of FIG. 27. FIG. [Figure 33] 33 is a perspective view showing the working member of the cartridge of FIG. 27. FIG. [Figure 34]34 is a perspective view showing the working member of the cartridge of FIG. 27. FIG. [Figure 35] 35 is a side cross-sectional view showing a stapling-related structure of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 36] 36 is a perspective cross-sectional view showing a stapling structure of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 37] 37 is a perspective cross-sectional view showing a stapling structure of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 38] 38 is a perspective view illustrating the ratchet actuation of the end tool of FIG. 30. FIG. [Figure 39] 39 is a perspective view illustrating the ratchet drive operation of the end tool of FIG. 30. FIG. [Figure 40] 40 is a perspective view illustrating the ratchet drive operation of the end tool of FIG. [Figure 41] 41 is a perspective view illustrating the ratchet actuation of the end tool of FIG. 30. FIG. [Figure 42] 42 is a plan view illustrating the ratchet drive operation of the end tool of FIG. [Figure 43] 43 is a plan view illustrating the ratchet drive operation of the end tool of FIG. [Figure 44] 44 is a perspective view generally illustrating the ratchet actuation of the end tool of FIG. [Figure 45] 45 is a perspective view generally illustrating the stapling of the endotool of FIG. 36. FIG. [Figure 46] 46 is a perspective view generally illustrating the stapling of the endotool of FIG. 36. FIG. [Figure 47] 47 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. FIG. [Figure 48] 48 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. FIG. [Figure 49]FIG. 49 is a diagram simply showing only the configuration of pulleys and wires that constitute the joints of the surgical instrument shown in FIG. [Figure 50] 50 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. FIG. [Figure 51] FIG. 51 is a diagram illustrating the configuration of pulleys and wires associated with the actuation and yaw movements of the surgical instrument shown in FIG. 2, resolved for each of the first and second jaws. [Figure 52] FIG. 52 is a diagram illustrating the configuration of pulleys and wires associated with the actuation and yaw movements of the surgical instrument shown in FIG. 2, resolved for each of the first and second jaws. [Figure 53] FIG. 53 shows the configuration of pulleys and wires associated with the stapling and cutting action of the surgical instrument shown in FIG. 2, disassembled relative to the first and second jaws, respectively. [Figure 54] FIG. 54 is a diagram illustrating the configuration of pulleys and wires associated with the stapling and cutting action of the surgical instrument shown in FIG. 2, disassembled relative to the first and second jaws, respectively. [Figure 55] FIG. 55 shows the pulley and wire arrangements associated with the stapling and cutting action of the surgical instrument shown in FIG. 2, disassembled relative to the first and second jaws, respectively. [Figure 56] 56 is a perspective view showing the pitch movement of the surgical instrument of FIG. 2. FIG. [Figure 57] FIG. 57 is a diagram showing the configuration of pulleys and wires associated with the pitch movement of the surgical instrument shown in FIG. 2, resolved for each of the first and second jaws. [Figure 58] FIG. 58 is a diagram illustrating the configuration of pulleys and wires associated with the pitch movement of the surgical instrument shown in FIG. 2, resolved for each of the first and second jaws. [Figure 59]FIG. 59 is a diagram showing the configuration of pulleys and wires associated with the pitch movement of the surgical instrument shown in FIG. 2, resolved for each of the first and second jaws. [Figure 60] FIG. 60 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation when the jaw is yaw rotated by −90°. [Figure 61] FIG. 61 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw rotated by −90°. [Figure 62] FIG. 62 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw rotated by −90°. [Figure 63] FIG. 63 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation when the jaw is yaw rotated by −90°. [Figure 64] FIG. 64 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation when the jaw is yaw rotated by +90°. [Figure 65] FIG. 65 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation when the jaw is yaw rotated by +90°. [Figure 66] Figure 66 is a plan view showing the actuation operation of the end tool of the surgical instrument of Figure 2, and shows the process of performing the actuation operation with the jaw rotated by +90° in yaw. [Figure 67]FIG. 67 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation when the jaw is yaw rotated by +90°. [Figure 68] FIG. 68 is a plan view showing stapling by the end tool of the surgical instrument of FIG. 2, showing the process of stapling with the jaws rotated by +90° in yaw. [Figure 69] FIG. 69 is a plan view showing stapling by the end tool of the surgical instrument of FIG. 2, showing the process of stapling with the jaws rotated by +90° in the yaw direction. [Figure 70] FIG. 70 is a plan view showing stapling by the end tool of the surgical instrument of FIG. 2, showing the process of stapling with the jaws rotated by −90° in yaw. [Figure 71] FIG. 71 is a plan view showing stapling by the end tool of the surgical instrument of FIG. 2, showing the process of stapling with the jaws rotated by −90° in yaw. [Figure 72] 72 is a perspective view showing the pitch movement of the surgical instrument of FIG. 2. FIG. [Figure 73] 73 is a perspective view showing the pitch movement of the surgical instrument of FIG. 2. FIG. [Figure 74] 74 is a perspective view showing the pitch movement of the surgical instrument of FIG. 2. FIG. [Figure 75] 75 is a perspective view showing the pitch movement of the surgical instrument of FIG. 2. FIG. [Figure 76] 76 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. FIG. [Figure 77] 77 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. FIG. [Figure 78] 78 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. FIG. [Figure 79]79 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. FIG. [Figure 80] FIG. 80 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. [Figure 81] FIG. 81 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. [Figure 82] FIG. 82 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. [Figure 83] FIG. 83 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. [Figure 84] FIG. 84 is a perspective view showing an end tool of a surgical instrument according to a modified example of the present invention. [Figure 85] FIG. 85 is a perspective view showing an end tool of a surgical instrument according to a modified example of the present invention. [Figure 86] 86 is an exploded perspective view of the end tool of the surgical instrument of FIG. 84. FIG. [Figure 87] 87 is an exploded perspective view of the end tool of the surgical instrument of FIG. 84. FIG. [Figure 88] 88 is an exploded perspective view showing a staple pulley assembly and a staple link assembly of the surgical instrument of FIG. 84; FIG. [Figure 89] 89 is an exploded perspective view showing a staple pulley assembly and a staple link assembly of the surgical instrument of FIG. 84; FIG. [Figure 90] 90 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 84. FIG. [Figure 91] 91 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 84. FIG. [Figure 92]92 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 84. FIG. [Figure 93] 93 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 84. FIG. BEST MODE FOR CARRYING OUT THE INVENTION

[0011] According to an embodiment of the present invention, an end tool of a surgical instrument includes: a first jaw; a second jaw formed opposite to the first jaw; a first jaw pulley coupled to the first jaw and formed rotatable about a first axis; a second jaw pulley coupled to the second jaw and formed rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced a certain distance from the first jaw pulley; and a staple drive assembly including a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a reciprocating assembly connected to the first staple drive assembly and moving linearly when the first staple pulley and the second staple pulley rotate; and a working member that comes into contact with the reciprocating assembly and is moved in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction.

[0012] In the present invention, when the first staple pulley or the second staple pulley rotates, the reciprocating assembly connected to the staple drive assembly moves toward the distal or proximal side of the cartridge.

[0013] In the present invention, when the first staple pulley or the second staple pulley rotates alternately in a clockwise and counterclockwise direction, the reciprocating assembly connected to the staple drive assembly moves alternately to the distal side and the proximal side of the cartridge.

[0014] In the present invention, when the reciprocating assembly moves toward the distal portion of the cartridge, the working member is moved toward the distal portion of the cartridge by the reciprocating assembly.

[0015] The present invention is characterized in that the staple drive assembly converts the bidirectional rotational motion of the first staple pulley or the second staple pulley into the reciprocating linear motion of the reciprocating assembly connected to the staple drive assembly.

[0016] In the present invention, while the working member moves in the one direction, the wedge portion of the working member pushes up the plurality of staples in the cartridge in order to staple them, and at the same time, a blade formed on one side of the wedge portion of the working member moves in the one direction to perform a cutting operation.

[0017] In the present invention, the staple drive assembly includes a link member that connects the first staple pulley and the second staple pulley with the reciprocating assembly.

[0018] 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 so as to be able to come into contact with the reciprocating assembly.

[0019] In the present invention, the working member moves toward the distal end of the cartridge together with the reciprocating assembly only when the reciprocating assembly moves toward the distal end of the cartridge.

[0020] In the present invention, when the first staple pulley rotates in a first direction of either clockwise or counterclockwise, and the second staple pulley rotates in a direction opposite to the first direction of either clockwise or counterclockwise, the link member connected to the first staple pulley and the second staple pulley, the reciprocating assembly connected to the link member, and the working member in contact with the reciprocating assembly move toward the distal portion of the cartridge.

[0021] In the present invention, when the first staple pulley rotates in the direction opposite to the first direction among clockwise and counterclockwise directions, and the second staple pulley rotates in the first direction among clockwise and counterclockwise directions, the link member connected to the staple pulley and the reciprocating assembly connected to the link member move toward the proximal portion of the end tool, and the working member is stopped in the one direction.

[0022] The present invention is characterized in that a first protruding member is formed on the first staple pulley, a second protruding member is formed on the second staple pulley, a first slot is formed on a surface of the link member facing the first staple pulley, and a second slot is formed on a surface of the link member facing the second staple pulley.

[0023] In the present invention, the first protruding member and the second protruding member are formed in a cam shape, and the first protruding member presses the first slot of the link member as it rotates, and the second protruding member presses the second slot of the link member as it rotates, causing the link member to move.

[0024] In the present invention, the center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree relative to the first staple pulley, and the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed to be eccentric to a certain degree relative to the second staple pulley.

[0025] In the present invention, when the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, and when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

[0026] In the present invention, the stapler further includes a first staple wire coupled to the first staple pulley to rotate the first staple pulley, and a second staple wire coupled to the second staple pulley to rotate the second staple pulley.

[0027] In the present invention, the end tool further includes a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable around a second axis that forms 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 around an axis that is substantially the same as or parallel to the second axis.

[0028] In the present invention, the end tool is formed to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

[0029] In the present invention, the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are laminated in order.

[0030] In the present invention, the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

[0031] According to an embodiment of the present invention, an end tool of a surgical instrument includes 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 at a certain distance from the first jaw pulley, and a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley. a staple drive assembly including a staple wire, a first staple wire that contacts at least a portion of the first staple pulley to transmit a driving force required for rotating the first staple pulley to the first staple pulley, and a second staple wire that contacts at least a portion of the second staple pulley to transmit a driving force required for rotating the second staple pulley to the second staple pulley, wherein the staple drive assembly is connected to a reciprocating assembly of the cartridge, and rotational motion of the staple pulley is converted into linear motion of the reciprocating assembly.

[0032] The present invention is characterized in that the staple drive assembly further includes 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, wherein the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub, and the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub, and at least a portion of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

[0033] In the present invention, the first shaft is inserted through the first jaw pulley connecting portion, the first jaw pulley, the first staple pulley, the second staple pulley, the second jaw pulley, and the second jaw pulley connecting portion in that order.

[0034] In the present invention, the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are stacked in order inside the end tool hub.

[0035] In the present invention, the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are formed to be rotatable independently of each other.

[0036] In the present invention, the stapler further includes a first staple assist pulley disposed between the first staple pulley and the guide portion.

[0037] In the present invention, the first staple wire is located on a common inscribed line of the first staple pulley and the first staple assist pulley, and the rotation angle of the first staple pulley is expanded by the first staple assist pulley.

[0038] In the present invention, the staple drive assembly includes a staple link assembly connecting the first staple pulley and the second staple pulley to the reciprocating assembly.

[0039] In the present invention, the staple link assembly includes link members respectively coupled to the first staple pulley, the second staple pulley, and the reciprocating assembly.

[0040] In the present invention, a first protruding member is formed on the first staple pulley, a second protruding member is formed on the second staple pulley, a first slot to which the first protruding member is coupled and a second slot to which the second protruding member is coupled are formed on the link member, and when the first staple pulley rotates, the first protruding member moves within the first slot while contacting the first slot, and when the second staple pulley rotates, the second protruding member moves within the second slot while contacting the second slot.

[0041] In the present invention, the first slot and the second slot are formed symmetrically to each other on the link member, and when the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, and when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

[0042] In the present invention, when the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, the staple link assembly connected to the first staple pulley or the second staple pulley moves alternately to the distal side and the proximal side of the end tool.

[0043] In the present invention, the staple link assembly converts the bidirectional rotational motion of the first staple pulley or the second staple pulley into the reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

[0044] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly moves along the guide groove.

[0045] In the present invention, the jaw rotation shaft may further include a jaw rotation shaft that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and 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 a rotation center between the first jaw pulley and the second jaw pulley, and when the first jaw pulley and the second jaw pulley rotate around the jaw pulley rotation shaft, the jaw rotation shaft moves relative to the jaw pulley rotation shaft.

[0046] The present invention is characterized in that when the first jaw and the second jaw are closed, the jaw rotation axis moves toward the distal portion of the end tool, and when the first jaw and the second jaw are opened, the jaw rotation axis moves toward the proximal portion of the end tool.

[0047] In the present invention, the end tool further includes a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable around a second axis that forms 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 around an axis that is substantially the same as or parallel to the second axis.

[0048] In the present invention, the end tool is formed to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

[0049] In the present invention, the end tool further includes a first jaw wire, at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire, at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0050] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis that is substantially the same as or parallel to the first axis, a first staple pulley formed to be rotatable about an axis that is substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley, a second staple pulley formed to be rotatable about an axis that is substantially the same as or parallel to the first axis and disposed adjacent to the second jaw pulley, and staple link assemblies that are connected to the first staple pulley and the second staple pulley, respectively, and that reciprocate in response to bidirectional rotation of the first staple pulley or the second staple pulley.

[0051] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw and causes the reciprocating assembly to reciprocate.

[0052] The present invention is characterized in that the staple link assembly moves toward the distal end or the proximal end of the end tool depending on the rotation direction of the first staple pulley or the second staple pulley.

[0053] The present invention is characterized in that a first protruding member is formed on the first staple pulley, a second protruding member is formed on the second staple pulley, a first slot is formed on a surface of the staple link assembly facing the first staple pulley, and a second slot is formed on a surface of the staple link assembly facing the second staple pulley.

[0054] In the present invention, when the first staple pulley rotates, the first protruding member moves within the first slot while contacting the first slot, and when the second staple pulley rotates, the second protruding member moves within the second slot while contacting the second slot.

[0055] In the present invention, the staple link assembly is characterized by including a single link.

[0056] In the present invention, the first protruding member and the second protruding member are formed in a cam shape, and the first protruding member presses the first slot of the staple link assembly as it rotates, and the second protruding member presses the second slot of the staple link assembly as it rotates, thereby moving the staple link assembly.

[0057] In the present invention, the center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree relative to the first staple pulley, and the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed to be eccentric to a certain degree relative to the second staple pulley.

[0058] In the present invention, the first slot and the second slot are formed symmetrically to each other on the staple link assembly.

[0059] In the present invention, when the first staple pulley and the second staple pulley rotate in opposite directions, the staple link assembly moves in one direction, and when the first staple pulley and the second staple pulley rotate in the same direction, the staple link assembly is stopped in the one direction.

[0060] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly moves along the guide groove.

[0061] In the present invention, a pair of end tool first jaw pitch main pulleys are formed on one side of the first jaw pulley and are rotatable around a second axis that forms a predetermined angle with the first axis;

[0062] 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.

[0063] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction around the second axis, the first staple pulley and the second staple pulley rotate together with the first jaw pulley and the second jaw pulley.

[0064] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction around the first axis, the first staple pulley and the second staple pulley rotate together with the first jaw pulley and the second jaw pulley.

[0065] In the present invention, when the first jaw pulley and the second jaw pulley rotate in different directions around the first axis, the first staple pulley and the second staple pulley rotate together with either the first jaw pulley or the second jaw pulley.

[0066] The present invention is characterized in that while the first staple pulley and the second staple pulley are rotated around the first shaft by the staple wire, the first jaw pulley and the second jaw pulley do not need to rotate.

[0067] In the present invention, the first jaw is formed with a cartridge accommodating portion capable of accommodating a cartridge, and the second jaw is formed with an anvil with which the staples of the cartridge can come into contact.

[0068] The stapler further includes a first jaw wire at least partially wound around the first jaw pulley, a second jaw wire at least partially wound around the second jaw pulley, a first staple wire at least partially wound around the first staple pulley, and a second staple wire at least partially wound around the second staple pulley.

[0069] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and 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 rotatable about the first axis, a second jaw wire at least partially wound around the second jaw pulley, a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis that forms a predetermined angle with the first axis, and a second jaw pitch main pulley formed on one side of the second jaw pulley and rotatable about an axis that is substantially the same as or parallel to the second axis. the first staple pulley and the second staple pulley are formed rotatably around the first axis and are disposed between the first jaw pulley and the second jaw pulley; a staple link assembly connected to the first staple pulley and the second staple pulley and reciprocating in accordance with the rotation of the first staple pulley or the second staple pulley in both directions; a first staple wire at least partially contacting the first staple pulley to transmit a driving force required for the rotation of the first staple pulley to the first staple pulley; and a second staple wire at least partially contacting the second staple pulley to transmit a driving force required for the rotation of the second staple pulley to the second staple pulley.

[0070] The present invention is characterized in that the bidirectional rotational motion of the first staple pulley or the second staple pulley is converted into a reciprocating linear motion of the staple link assembly.

[0071] 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 motion of the first staple pulley or the second staple pulley is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

[0072] The present invention is characterized in that the staple link assembly converts the bidirectional rotational motion of the first staple pulley or the second staple pulley into the reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

[0073] In the present invention, the jaw rotation shaft may further include a jaw rotation shaft that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and 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 a rotation center between the first jaw pulley and the second jaw pulley, and when the first jaw pulley and the second jaw pulley rotate around the jaw pulley rotation shaft, the jaw rotation shaft moves relative to the jaw pulley rotation shaft.

[0074] The present invention is characterized in that when the first jaw and the second jaw are closed, the jaw rotation axis moves toward the distal portion of the end tool, and when the first jaw and the second jaw are opened, the jaw rotation axis moves toward the proximal portion of the end tool.

[0075] 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, and the shaft coupling portion is configured to be able to move within the movable coupling hole to a certain extent when the shaft coupling portion is fitted into the movable coupling hole.

[0076] In the present invention, when the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, the staple link assembly connected to the first staple pulley or the second staple pulley moves alternately toward the distal end side and the proximal end side of the end tool.

[0077] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly moves along the guide groove.

[0078] In the present invention, the staple link assembly includes link members coupled to the first staple pulley and the second staple pulley, respectively.

[0079] The present invention is characterized in that a first protruding member is formed on the first staple pulley, a second protruding member is formed on the second staple pulley, a first slot is formed on a surface of the link member facing the first staple pulley, and a second slot is formed on a surface of the link member facing the second staple pulley.

[0080] In the present invention, the first protruding member and the second protruding member are formed in a cam shape, and the first protruding member presses the first slot of the link member as it rotates, and the second protruding member presses the second slot of the link member as it rotates, causing the link member to move.

[0081] In the present invention, the center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree relative to the first staple pulley, and the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed to be eccentric to a certain degree relative to the second staple pulley.

[0082] In the present invention, the thickness of the first slot and the thickness of the second slot are each formed thinner than the thickness of the link member.

[0083] In the present invention, the sum of the thickness of the first slot and the thickness of the second slot is substantially the same as the thickness of the link member.

[0084] In the present invention, when the first staple pulley rotates, the first protruding member moves within the first slot while contacting the first slot, and when the second staple pulley rotates, the second protruding member moves within the second slot while contacting the second slot.

[0085] In the present invention, the first slot and the second slot are formed symmetrically on the link member, and when the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, and when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

[0086] In the present invention, the protruding member is formed in a pin shape, and as the protruding member rotates, it presses the slot of the link, causing the link to move.

[0087] In the present invention, the slot is formed obliquely rather than concentrically with the staple pulley, and the pin moves along the slot.

[0088] In the present invention, the link member is formed of a single member.

[0089] In the present invention, the end tool further includes a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable around a second axis that forms 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 around an axis that is substantially the same as or parallel to the second axis.

[0090] In the present invention, the end tool is formed to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

[0091] In the present invention, the end tool further includes a first jaw wire, at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire, at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0092] In the present invention, the stapler further includes a pair of first staple pitch main pulleys formed on one side of the first staple pulley and rotatable around a second axis that forms a predetermined angle with the first axis, and a pair of second staple pitch main pulleys formed on one side of the second staple pulley and rotatable around an axis that is substantially the same as or parallel to the second axis.

[0093] In the present invention, the staple wire removal prevention pulley is further included, which is arranged between the first staple pulley and the first staple pitch main pulley or between the second staple pulley and the second staple pitch main pulley, and is formed to be rotatable around an axis that is substantially the same as or parallel to the second axis, and which guides the path of the first staple wire or the second staple wire.

[0094] According to an embodiment of the present invention, a method of driving a surgical instrument includes the steps of: (a) when a first staple pulley of a staple drive assembly rotates about a first axis in a first direction and a second staple pulley rotates about the first axis in a second direction opposite to the first direction, a staple link assembly connected to the first staple pulley and the second staple pulley, and a reciprocating assembly of a cartridge connected to the staple link assembly, moving along the second axis toward a distal portion of the cartridge; and (b) when the reciprocating assembly moves toward the distal portion of the cartridge, a working member in contact with the reciprocating assembly moves along the second axis toward a distal portion of the cartridge. (c) a step of moving the working member toward the distal portion of the cartridge while the working member is moving toward the distal portion of the cartridge, the working member ejecting the staples in the cartridge out of the cartridge at the same time that the blade of the working member moves toward the distal portion of the cartridge; and (d) a step of moving the staple link assembly connected to the first staple pulley and the second staple pulley and the reciprocating assembly of the cartridge connected to the staple link assembly toward the proximal portion of the cartridge when the first staple pulley rotates in the second direction about the first axis and the second staple pulley rotates in the first direction about the first axis.

[0095] In the present invention, when the first staple pulley or the second staple pulley rotates in the first direction or the second direction, the reciprocating assembly moves toward the distal end of the cartridge or toward the proximal end of the cartridge.

[0096] The present invention is characterized in that bidirectional rotational movement of the first staple pulley or the second staple pulley about the first axis is converted into reciprocating linear movement along the second axis of the reciprocating assembly connected to the first staple pulley and the second staple pulley.

[0097] In the present invention, the reciprocating linear motion of the reciprocating assembly causes the working member to move toward the distal portion of the cartridge.

[0098] In the present invention, a rack is formed on one surface of the reciprocating assembly, and the working member includes a ratchet member having a ratchet formed thereon, and the rack is in close contact with the ratchet member and pushes the ratchet member, causing the ratchet member to move toward the distal portion of the cartridge.

[0099] In the present invention, in the step (d), the working member is stopped in the second axial direction.

[0100] In the present invention, the working member moves toward the distal end of the cartridge together with the reciprocating assembly only when the reciprocating assembly moves toward the distal end of the cartridge.

[0101] In the present invention, the stapler further includes a first staple wire coupled to the first staple pulley to rotate the first staple pulley, and a second staple wire coupled to the second staple pulley to rotate the second staple pulley, and the bidirectional rotation of the first staple pulley or the first staple pulley by the first staple wire or the second staple wire is converted into a reciprocating linear motion of the reciprocating assembly.

[0102] In the present invention, the wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge to staple them while the working member moves toward the distal portion of the cartridge, and at the same time, a blade formed on one side of the wedge portion of the working member moves toward the distal portion of the cartridge to perform a cutting operation.

[0103] The present invention is characterized in that the steps (a) to (d) are repeatedly performed.

[0104] Other aspects, features, and advantages beyond those described above will become apparent from the following drawings, claims, and detailed description of the invention. DETAILED DESCRIPTION OF THE INVENTION

[0105] Since the present invention can be modified in various ways and can have various embodiments, specific embodiments are shown in the drawings and will be described in detail. However, this is not intended to limit the present invention to the specific embodiments, and it should be understood that the present invention includes all modifications, equivalents, and alternatives that fall within the spirit and technical scope of the present invention. In describing the present invention, if a detailed description of related publicly known technology is considered to obscure the gist of the present invention, the detailed description will be omitted.

[0106] Terms such as first and second may be used to describe various components, but the components should not be limited by the terms. The terms are used only to distinguish one component from another.

[0107] The terms used in this application are merely used to describe specific embodiments and are not intended to limit the present invention. The singular expressions include the plural expressions unless the context clearly dictates otherwise. In this application, terms such as "comprise" or "have" are intended to specify the presence of 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.

[0108] Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the description with reference to the accompanying drawings, the same or corresponding components will be given the same drawing numbers, and duplicate descriptions thereof will be omitted.

[0109] Furthermore, in describing various embodiments of the present invention, it should be understood that each embodiment should not be interpreted or implemented independently, but that the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments that are described separately.

[0110] The surgical instrument according to the present invention is characterized in that when the operating part is rotated in a certain direction for at least one of pitch, yaw, and actuation movements, the end tool intuitively rotates in the same direction as the operating direction of the operating part.

[0111] FIG. 1A is a conceptual diagram of pitch motion of a conventional surgical instrument, and FIG. 1B is a conceptual diagram of yaw motion.

[0112] 1A, when a conventional surgical instrument performs a pitch movement, the end tool 120a is formed forward of the center of rotation 121a of the end tool, and the operating unit 110a is formed rearward of the center of rotation 111a of the operating unit, so that when the operating unit 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operating unit 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. On the other hand, referring to FIG. 1B, when a conventional surgical instrument performs a yaw movement, the end tool 120a is formed forward of the center of rotation 121a of the end tool, and the operating unit 110a is formed rearward of the center of rotation 111a of the operating unit, so that when the operating unit 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operating unit 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. In this case, from the perspective of the user's left-right direction, when the user moves the operation unit 110a to the left, the end tool 120a moves to the right, and when the user moves the operation unit 110a to the right, the end tool 120a moves to the left. As a result, the user's operation direction and the movement direction of the end tool are reversed, which may cause the user to make an error and makes the user's operation difficult.

[0113] FIG. 1C is a conceptual diagram of pitch motion of another conventional surgical instrument, and FIG. 1D is a conceptual diagram of yaw motion.

[0114] Referring to FIG. 1C , some conventional surgical instruments are formed in a mirror-symmetrical shape. When performing a pitch movement, the end tool 120b is formed forward of the rotation center 121b of the end tool, and the operating unit 110b is formed rearward of the rotation center 111b of the operating unit. When the operating unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operating unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the perspective of the rotation direction of the operating unit and the end tool, the rotation direction in which the user rotates the operating unit 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there are problems such as confusion about the operation direction for the user, and the joint movement being unintuitive, which can lead to mistakes. 1D , when performing a yaw operation, the end tool 120b is formed forward of the rotation center 121b of the end tool, and the operating unit 110b is formed rearward of the rotation center 111b of the operating unit. When the operating unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operating unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the perspective of the rotation direction of the operating unit and the end tool, the rotation direction in which the user rotates the operating unit 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there is a problem that the user may be confused about the operation direction, and the joint operation is not intuitive, which may lead to mistakes. As such, when a user performs a pitch or yaw operation on a conventional surgical instrument, the user's operation direction and the movement direction of the end tool do not match each other in terms of either the rotation direction or the left-right direction. This is because the joint configuration of the endo-tool and the operating part differ from each other in the joint configuration of conventional surgical instruments: the endo-tool is formed forward of its center of rotation, while the operating part is formed rearward of its center of rotation.To solve this problem, the surgical instrument according to one embodiment of the present invention shown in Figures 1E and 1F is characterized in that the endotool 120c is formed forward of the rotation center 121c of the endotool, and the operating unit 110c is also formed forward of the rotation center 111c of the operating unit, so that the movements of the operating unit 110c and the endotool 120c intuitively match. To express this characteristic in another way, unlike existing examples in which the operating unit is configured to move closer to the user's joint (i.e., away from the endotool) as shown in Figures 1A, 1B, 1C, and 1D, the surgical instrument according to one embodiment of the present invention shown in Figures 1E and 1F is configured so that at least a portion of the operating unit is closer to the endotool (than the user's joint) relative to the user's joint at least for a certain moment during the operation process.

[0115] Explaining this separately, in the case of conventional surgical instruments such as those shown in Figures 1A, 1B, 1C, and 1D, the endotool is located forward of its center of rotation, while the operating unit is formed rearward of its center of rotation. Therefore, operating the operating unit, which moves rearward while the front is fixed, moves the endotool, which moves forward while the rear is fixed, resulting in a structure that is not intuitively consistent. This can lead to inconsistencies between the operation of the operating unit and the operation of the endotool in terms of left-right or rotational direction, which can confuse the user and make it difficult to operate the operating unit intuitively and quickly, potentially leading to errors. In contrast, in the surgical instrument according to one embodiment of the present invention, both the endotool and the operating unit move based on a center of rotation formed at the rear, so that their operations can be said to be intuitively consistent. Explaining this separately, just as the moving part of the endotool moves based on a center of rotation formed at the rear, the moving part of the operating unit also moves based on the same center of rotation formed at the rear, so that their operations can be said to be intuitively consistent. This allows the user to intuitively and quickly steer the direction of the end tool, which has the advantage of significantly reducing the possibility of mistakes. A specific mechanism that enables this function will be described below.

[0116] <First embodiment of surgical instrument>

[0117] FIG. 2 is a perspective view of a surgical instrument according to a first embodiment of the present invention. FIG. 3 is a side view of the surgical instrument of FIG. 2. FIGS. 4 and 5 are perspective views of an endotool of the surgical instrument of FIG. 2. FIG. 6 is a perspective view of an endotool hub of the endotool of the surgical instrument of FIG. 2. FIGS. 7 and 8 are plan views of the endotool of the surgical instrument of FIG. 2. FIG. 9 is a side view of the endotool of the surgical instrument of FIG. 2. FIGS. 10 and 11 are exploded perspective views of the endotool of the surgical instrument of FIG. 2. FIG. 12 is a perspective view of a first jaw pulley of the surgical instrument of FIG. 2. FIG. 13 is a plan view of a first jaw of the surgical instrument of FIG. 2. FIG. 14 is a plan view of a second jaw of the surgical instrument of FIG. 2. FIGS. 15 and 16 are exploded perspective views of a staple pulley and staple link of the surgical instrument of FIG. 2. Figures 17 and 18 are side views showing the operating state of a staple pulley in the end tool of the surgical instrument of Figure 2. Figures 19 and 20 are perspective views showing the operating state of a staple pulley in the end tool of the surgical instrument of Figure 2. Figures 21, 22, 23, and 24 are plan views showing the opening and closing operations of the first and second jaws of the surgical instrument of Figure 2. Figures 25 and 26 are perspective views showing the opening and closing operations of the end tool of the surgical instrument of Figure 2.

[0118] First, referring to FIGS. 2 and 3, a surgical instrument 2000 according to a first embodiment of the present invention includes an end tool 2100, an operating section 200, a power transmission section 300, and a connecting section 400.

[0119] Here, the connecting portion 400 may be formed in the shape of a hollow shaft, and one or more wires and electrical cables may be housed therein. The operating portion 200 is coupled to one end of the connecting portion 400, and the end tool 2100 is coupled to the other end, and the connecting portion 400 may serve to connect the operating portion 200 and the end tool 2100. Here, the connecting portion 400 of the surgical instrument 2000 according to the first embodiment of the present invention is characterized by including a straight portion 401 and a bent portion 402, with the straight portion 401 formed on the side coupled to the end tool 2100 and the bent portion 402 formed on the side coupled to the operating portion 200. As such, the end of the connecting portion 400 on the operating portion 200 side is bent, so that the pitch operating portion 201, the yaw operating portion 202, and the actuation operating portion 203 are formed on an extension line of the end tool 2100 or adjacent to the extension line. Expressed from another perspective, this can be explained as at least a portion of the pitch operation unit 201 and the yaw operation unit 202 being housed in a recess formed by the bent portion 402. Such a shape of the bent portion 402 allows the shapes and operations of the operation unit 200 and the end tool 2100 to match more intuitively.

[0120] Meanwhile, the plane on which the bent portion 402 is formed may be the pitch plane, i.e., substantially the same plane as the XZ plane in Fig. 2. In this way, by forming the bent portion 402 on substantially the same plane as the XZ plane, interference between the operating units can be reduced. Of course, for intuitive operation of the end tool and the operating unit, configurations other than the XZ plane are also possible.

[0121] Meanwhile, a connector 410 may be formed on the bending portion 402. The connector 410 may be connected to an external power source (not shown), or the connector 410 may be connected to the end tool 2100 via an electric wire, and may transmit electrical energy supplied from the external power source (not shown) to the end tool 2100. The electrical energy transmitted to the end tool 2100 in this manner may provide a driving force for rotating a staple pulley (see 161 in FIG. 5 ), which will be described later, in a clockwise or counterclockwise direction.

[0122] The operating unit 200 is formed at one end of the connecting unit 400 and is provided as an interface that can be directly operated by a surgeon, for example, in the form of forceps, a stick, a lever, etc. When the surgeon operates the operating unit 200, the endotool 2100 connected to the interface and inserted into the body of the surgical patient performs a predetermined operation, thereby performing surgery. Here, in Fig. 2, the operating unit 200 is shown as being formed in the shape of a handle that can be rotated with a finger inserted, but the concept of the present invention is not limited thereto, and various types of operating units that can be connected to the endotool 2100 and operate the endotool 2100 are possible.

[0123] The endotool 2100 is formed at the other end of the continuous portion 400 and is inserted into a surgical site to perform operations required for surgery. As an example of such an endotool 2100, a pair of jaws 2103 for gripping, as shown in FIG. 2, may be used. However, the concept of the present invention is not limited thereto, and various surgical devices may be used as the endotool 2100. For example, a single-arm cautery may also be used as the endotool. The endotool 2100 is connected to the operating unit 200 by the power transmission unit 300, and receives the driving force of the operating unit 200 via the power transmission unit 300 to perform operations required for surgery, such as gripping, cutting, and suturing.

[0124] Here, the end tool 2100 of the surgical instrument 2000 according to the first embodiment of the present invention is formed to be rotatable in at least one direction, and for example, the end tool 2100 may be formed to perform a pitch movement around the Y axis of FIG. 2, as well as a yaw movement and an actuation movement around the Z axis of FIG. 2.

[0125] Here, the pitch, yaw, and actuation movements used in the present invention are defined as follows.

[0126] First, the pitch movement refers to the movement of the end tool 2100 rotating up and down relative to the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), i.e., the movement of rotating around the Y-axis in FIG. 2. In other words, it refers to the movement of the end tool 2100, which is formed extending from the connecting part 400 in the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), rotating up and down relative to the connecting part 400 around the Y-axis.

[0127] Next, the yaw movement refers to the movement of the end tool 2100 rotating left and right with respect to the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), i.e., the movement of rotating around the Z-axis in FIG. 2. In other words, it refers to the movement of the end tool 2100 formed by extending from the connecting part 400 in the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2) rotating left and right with respect to the connecting part 400 around the Z-axis. In other words, it refers to the movement of two jaws 2103 formed on the end tool 2100 rotating in the same direction with each other around the Z-axis.

[0128] Meanwhile, the actuation operation refers to the movement of the end tool 2100 rotating around the same rotation axis as the yaw operation, but the two jaws 2103 rotating in opposite directions to each other, thereby closing and opening the jaws. That is, it refers to the movement of the two jaws 2103 formed on the end tool 2100 rotating in opposite directions to each other around the Z axis.

[0129] The power transmission unit 300 connects the operating unit 200 and the end tool 2100, and serves to transmit the driving force of the operating unit 200 to the end tool 2100, and may include a plurality of wires, pulleys, links, joints, gears, etc.

[0130] The end tool 2100, the operating unit 200, the power transmission unit 300, and the like of the surgical instrument 2000 shown in FIG. 2 will be described in detail below.

[0131] (Intuitive Drive)

[0132] The following describes the intuitive operation of the surgical instrument 2000 of the present invention.

[0133] First, while holding first handle 204 in the palm of the hand, the user can rotate first handle 204 about the Y-axis (i.e., rotation axis 246 in FIG. 25) to perform a pitch movement, and can rotate first handle 204 about the Z-axis (i.e., rotation axis 243 in FIG. 43) to perform a yaw movement. In addition, the user can operate actuation operation unit 203 with their thumb and index finger inserted into first actuation extension portion 252 and / or second actuation extension portion 257, which are finger hole rings formed at one end of actuation operation unit 203, to perform an actuation movement.

[0134] The surgical instrument 2000 according to the first embodiment of the present invention is characterized in that when the operating unit 200 is rotated in one direction relative to the connecting unit 400, the end tool 2100 intuitively rotates in the same direction as the operating direction of the operating unit 200. In other words, when the first handle 204 of the operating unit 200 is rotated in one direction, the end tool 2100 also intuitively rotates in the same direction as the one direction, performing a pitch or yaw movement. Here, the intuitively same direction may be added to mean that the direction of movement of the user's finger holding the operating unit 200 and the direction of movement of the tip of the end tool 2100 are substantially the same. Of course, the same direction here does not have to be a completely identical direction in three-dimensional coordinates. For example, it may be understood to mean that when the user's finger moves left, the tip of the end tool 2100 also moves left, and when the user's finger moves down, the tip of the end tool 2100 also moves down.

[0135] For this reason, the surgical instrument 2000 according to the first embodiment of the present invention is characterized in that the operating unit 200 and the endotool 2100 are formed in the same direction based on a plane perpendicular to the extension axis (X-axis) of the connecting unit 400. That is, when viewed based on the YZ plane in FIG. 2, the operating unit 200 is formed extending in the +X-axis direction, and the endotool 2100 is also formed extending in the +X-axis direction. In other words, the forming direction of the endotool 2100 at one end of the connecting unit 400 and the forming direction of the operating unit 200 at the other end of the connecting unit 400 can be said to be the same direction based on the YZ plane. In other words, the operating unit 200 can be said to be formed in a direction away from the torso of the user holding it, i.e., in the direction in which the endotool 2100 is formed. That is, the first handle 204, the first actuation operation unit 251, the second actuation operation unit 256, etc., which are gripped and moved by the user for actuation, yaw, and pitch movements, have portions that move to perform each movement formed to extend in the +X-axis direction from the rotation center of each joint for that movement. This allows the operation unit 200 to be configured in the same way as the moving portions of the end tool 2100 formed to extend in the +X-axis direction from the rotation center of each joint for that movement, and as described with reference to Fig. 1, the operation direction of the user and the movement direction of the end tool coincide in both the rotational direction and the left-right direction, resulting in the same intuitive operation being possible.

[0136] Specifically, in the case of conventional surgical instruments, the direction in which the user operates the operating part and the actual operating direction of the end tool are different and do not intuitively match, which makes it difficult for the surgeon to operate intuitively, takes a long time to become skilled at moving the end tool in the desired direction, and in some cases, malfunctions can occur, potentially causing injury to the patient.

[0137] To solve this problem, the surgical instrument 2000 according to the first embodiment of the present invention intuitively aligns the operation direction of the operating unit 200 with the operating direction of the end tool 2100. To this end, the operating unit 200, like the end tool 2100, is characterized in that the parts that actually move for actuation, yaw, and pitch movements extend in the +X-axis direction from the rotation center of the joint corresponding to each movement.

[0138] The end tool 2100, the operating unit 200, the power transmission unit 300, and the like of the surgical instrument 2000 in FIG. 2 will be described in more detail below.

[0139] (Power transmission section)

[0140] The power transmission section 300 of the surgical instrument 2000 of FIG. 2 will now be described in more detail.

[0141] Referring to Figures 2 to 20, 49, etc., the power transmission section 300 of the surgical instrument 2000 according to one embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, wire 307, wire 308, wire 309, and wire 310.

[0142] Here, wire 301 and wire 305 form a pair and can serve as a first jaw wire. Wire 302 and wire 306 form a pair and can serve as a second jaw wire. Here, a component including wire 301 and wire 305, which are the first jaw wires, and wire 302 and wire 306, which are the second jaw wires, can be called a jaw wire. Then, wire 303 and wire 304 form a pair and can serve as pitch wires. Then, wire 307 and wire 308 form a pair and can serve as staple wires.

[0143] Furthermore, the power transmission unit 300 of the surgical instrument 2000 according to an embodiment of the present invention may include fastening members 321, 323, 324, 326, 327, 329, and 330, which are coupled to the ends of the wires to couple the wires to the pulleys. Here, each fastening member may have various shapes, such as a ball shape or a tube shape, as needed.

[0144] Here, on the end tool 2100 side, the fastening member 321 can play the role of a pitch wire-end tool fastening member, the fastening member 323 can play the role of a first jaw wire-end tool fastening member, the fastening member 326 can play the role of a second jaw wire-end tool fastening member, and the fastening member 329 / fastening member 330 can play the role of a staple wire-end tool fastening member.

[0145] Furthermore, on the operating unit 200 side, the fastening member 324 can serve as a first jaw wire-operating unit fastening member, and the fastening member 327 can serve as a second jaw wire-operating unit fastening member. Although not shown in the drawings, the operating unit 200 side may further be provided with a pitch wire-operating unit fastening member and a staple wire-operating unit fastening member.

[0146] The connection relationship between the wire, the fastening member, and the pulleys will be described in detail below.

[0147] First, wire 301 and wire 305, which are first jaw wires, may be one single wire. Fastening member 323, which is a first jaw wire-end tool fastening member, is sandwiched at the midpoint of the first jaw wire, which is a single wire, and fastening member 323 is crimped and fixed, and then both strands of the first jaw wire with fastening member 323 at the center can be called wire 301 and wire 305, respectively.

[0148] Alternatively, the first jaw wires 301 and 305 may be formed of separate wires, and the wires 301 and 305 may be connected by the fastening member 323 .

[0149] Then, by connecting this fastening member 323 to the pulley 2111, the wire 301 and the wire 305 can be fixedly connected to the pulley 2111. This allows the wire 301 and the wire 305 to be pulled and unwound, causing the pulley 2111 to rotate.

[0150] On the other hand, the ends of wire 301 and wire 305 opposite to where fastening member 323 is fastened may be joined to a first jaw wire-operating portion fastening member (see 324 in FIG. 49).

[0151] By connecting the first jaw wire-operating portion fastening member (see 324 in FIG. 49) to the pulley 210 in this manner, the wires 301 and 305 can be fixedly connected to the pulley 210. As a result, when the pulley 210 is rotated by a motor or by human power, the wires 301 and 305 are pulled or unwound, and the pulley 2111 of the end tool 2100 can be rotated.

[0152] Similarly, wire 302 and wire 306, which are second jaw wires, are coupled to a fastening member (see 326 in FIG. 49) which is a second jaw wire-end tool fastening member and a second jaw wire-operating portion fastening member (see 327 in FIG. 49), respectively. The fastening member (see 326 in FIG. 49) is coupled to pulley 2121, and the second jaw wire-operating portion fastening member (see 327 in FIG. 49) is coupled to pulley 220. As a result, when pulley 220 is rotated by a motor or by human power, wires 302 and 306 are pulled or unwound, and pulley 2121 of end tool 2100 can be rotated.

[0153] Similarly, wires 303 and 304, which are pitch wires, are coupled to fastening member 321, which is a pitch wire-end tool fastening member, and a pitch wire operating unit fastening member (not shown), respectively. Fastening member 321 is coupled to pulley 2131, and pitch wire operating unit fastening member (not shown) is coupled to pulley 231. As a result, when pulley 231 is rotated by a motor or by human power, wires 303 and 304 are pulled or unwound, allowing pulley 2131 of end tool 2100 to rotate.

[0154] Similarly, wire 307 and wire 308, which are first staple wires, are coupled to a fastening member (see 329 in FIG. 68) which is a staple wire-endotool fastening member and a staple wire-operating portion fastening member (not shown), respectively. The fastening member (see 329 in FIG. 68) is coupled to a first staple pulley 2181, and the staple wire-operating portion fastening member (not shown) is coupled to a pulley (see 269 in FIG. 53). As a result, when pulley 269 is rotated by a motor or by human power, wire 307 and wire 308 are pulled or unwound, and the first staple pulley 2181 of end tool 2100 can be rotated.

[0155] Similarly, the wires 309 and 310 which are second staple wires are respectively coupled to a fastening member (see 330 in FIG. 69) which is a staple wire-endotool fastening member and a staple wire-operating portion fastening member (not shown). The fastening member (see 330 in FIG. 69) is coupled to a second staple pulley 2191, and the staple wire-operating portion fastening member (not shown) is coupled to a pulley (see 270 in FIG. 53). As a result, when the pulley 270 is rotated by a motor or by human power, the wires 309 and 310 are pulled or unwound, and the second staple pulley 2191 of the end tool 2100 can be rotated.

[0156] (end tool)

[0157] The endotool 2100 of the surgical instrument 2000 of FIG. 2 is described in further detail below.

[0158] 4 and 5 are perspective views showing the end tool of the surgical instrument of FIG. 2, FIG. 6 is a perspective view showing the end tool hub of the end tool of the surgical instrument of FIG. 2, and FIGS. 7 and 8 are plan views showing the end tool of the surgical instrument of FIG. 2.

[0159] Here, Fig. 4 shows a state in which the end tool hub 2106 and the pitch hub 2107 are coupled, and Fig. 5 shows a state in which the end tool hub 2106 is detached. Meanwhile, Fig. 7 is a view mainly showing the wire, and Fig. 8 is a view mainly showing the pulley.

[0160] 4 to 8, an end tool 2100 according to a first embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 2101 and a second jaw 2102. Here, each of the first jaw 2101 and the second jaw 2102, or a component including the first jaw 2101 and the second jaw 2102, can be referred to as a jaw 2103.

[0161] The end tool 2100 may also include pulleys 2111, 2112, 2113, 2114, 2115, and 2116 for rotational movement of the first jaw 2101. The end tool 2100 may also include pulleys 2121, 2122, 2123, 2124, 2125, and 2126 for rotational movement of the second jaw 2102.

[0162] Here, although the drawings show opposing pulleys formed parallel to each other, the spirit of the present invention is not limited thereto, and it can be said that each pulley can be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0163] Additionally, the end tool 2100 of the first embodiment of the present invention may include an end tool hub 2106 and a pitch hub 2107 .

[0164] The end tool hub 2106 has a rotating shaft 2141 and a rotating shaft 2142, which will be described later, inserted therethrough, and can further accommodate at least a portion of a pulley 2111 and a pulley 2121 axially coupled to the rotating shaft 2141. The end tool hub 2106 can also accommodate at least a portion of a pulley 2112 and a pulley 2122 axially coupled to the rotating shaft 2142.

[0165] In particular, referring to FIG. 6, the end tool hub 2106 includes a first jaw pulley coupling portion 2106a, a second jaw pulley coupling portion 2106b, a guide portion 2106c, a pitch pulley coupling portion 2106e, and a separation prevention pulley coupling portion 2106f.

[0166] In detail, the first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b are formed to face each other, and house therein the pulley 2111, the pulley 2121, the first staple pulley 2181, and the second staple pulley 2191. Furthermore, a through hole is formed in each of the first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b, and the rotation shaft 2141 passes through the first jaw pulley coupling portion 2106a, the pulley 2111, the first staple pulley 2181, the second staple pulley 2191, the pulley 2121, and the second jaw pulley coupling portion 2106b to axially couple them together.

[0167] The first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b are connected by a guide portion 2106c. In other words, the first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b, which are parallel to each other, are coupled by a guide portion 2106c formed in a direction approximately perpendicular thereto, and the first jaw pulley coupling portion 2106a, the second jaw pulley coupling portion 2106b, and the guide portion 2106c form an approximately U-shape, inside which the pulley 2111, the pulley 2121, the first staple pulley 2181, and the second staple pulley 2191 are housed.

[0168] Here, the pulley 2111 serving as the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion 2106a of the end tool hub 2106, and the pulley 2121 serving as the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion 2106b of the end tool hub 2106, and a staple assembly receiving portion can be formed between the first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b. At least a portion of a staple pulley assembly (see 2160 in FIG. 10) and a staple link assembly (see 2170 in FIG. 10), which will be described later, may be formed in the staple assembly receiving portion. From another perspective, this can also be expressed as at least a portion of the first staple pulley 2181, the second staple pulley 2191, and the link member 2171 being disposed between the first jaw pulley coupling portion 2106a and the second jaw pulley coupling portion 2106b. Therefore, at least a portion of the staple pulley assembly (see 2160 in FIG. 10) and the staple link assembly (see 2170 in FIG. 10) are disposed between the pulley 2111 which is the first jaw pulley and the pulley 2121 which is the second jaw pulley, and this is one feature of the present invention that it is possible to perform stapling and cutting operations using the first staple pulley 2181 and the second staple pulley 2191 in addition to pitch and yaw movements of the end tool 2100. This will be described in more detail later.

[0169] Meanwhile, a pulley 2131 that serves as an end tool pitch pulley may be formed at one end of the end tool hub 2106. As shown in FIG. 6, the pulley 2131 may be formed integrally with the end tool hub 2106. That is, a disk-shaped pulley may be formed at one end of the end tool hub 2106, and a groove around which a wire can be wound may be formed on the outer circumferential surface of the pulley. Alternatively, the pulley 2131 may be formed as a separate member from the end tool hub 2106 and coupled to the end tool hub 2106. The wires 303 and 304 described above are coupled to the pulley 2131 that serves as the end tool pitch pulley, and the pulley 2131 performs pitch motion while rotating about the rotation axis 2143.

[0170] Meanwhile, a separation prevention pulley coupling portion 2106f may be further formed on one side of the pulley 2131. The separation prevention pulley coupling portion 2106f may be formed parallel to a rotation axis 2143 which is the end tool pitch rotation axis, and may be formed to couple pulleys 2187, 2188, 2197, and 2198, which will be described later. Here, the pulleys 2187 and 2188 can function as first staple wire separation prevention pulleys, and the pulleys 2197 and 2198 can function as second staple wire separation prevention pulleys. This will be described in more detail later.

[0171] Rotation shafts 2143 and 2144, which will be described later, are inserted through the pitch hub 2107, and the pitch hub 2107, the end tool hub 2106, and the pulley 2131 can be axially coupled by the rotation shaft 2143. Therefore, the end tool hub 2106 and the pulley 2131 can be formed to be able to pitch rotate relative to the pitch hub 2107 around the rotation shaft 2143.

[0172] Furthermore, pitch hub 2107 can accommodate at least a portion of pulleys 2113, 2114, 2123, and 2124 axially coupled to rotation shaft 2143. Pitch hub 2107 can accommodate at least a portion of pulleys 2115, 2116, 2125, and 2126 axially coupled to rotation shaft 2144.

[0173] Meanwhile, the end tool 2100 according to the first embodiment of the present invention may include the rotation shaft 2141, the rotation shaft 2142, the rotation shaft 2143, and the rotation shaft 2144. As described above, the rotation shaft 2141 and the rotation shaft 2142 may be inserted through the end tool hub 2106, and the rotation shaft 2143 and the rotation shaft 2144 may be inserted through the pitch hub 2107.

[0174] The rotation shafts 2141, 2142, 2143, and 2144 can be arranged sequentially from the distal end 2104 to the proximal end 2105 of the end tool 2100. Therefore, starting from the distal end 2104, the rotation shaft 2141 can be called pin 1, the rotation shaft 2142 can be called pin 2, the rotation shaft 2143 can be called pin 3, and the rotation shaft 2144 can be called pin 4.

[0175] Here, rotation axis 2141 can function as the end tool jaw pulley rotation axis, rotation axis 2142 can function as the end tool jaw auxiliary pulley rotation axis, rotation axis 2143 can function as the end tool pitch rotation axis, and rotation axis 2144 can function as the end tool pitch auxiliary rotation axis of end tool 2100.

[0176] Each of these rotating shafts 2141, 2142, 2143, 2144 may be fitted with one or more pulleys, which will be described in detail below.

[0177] Meanwhile, a rotation shaft 2145 may be further formed on one side of the rotation shaft 2141, more specifically on the distal portion 2104 side of the rotation shaft 2141. The rotation shaft 2145 may be inserted through the first jaw 2101 and the second jaw 2102 and function as a jaw rotation shaft, which will be described in detail below.

[0178] Pulley 2111 functions as an end tool first jaw pulley, and pulley 2121 functions as an end tool second jaw pulley. Pulley 2111 is also called the first jaw pulley, and pulley 2121 is also called the second jaw pulley, and these two components are sometimes referred to collectively as end tool jaw pulleys or simply jaw pulleys.

[0179] Pulleys 2111 and 2121, which are end tool jaw pulleys, are formed to face each other and are formed to be rotatable independently of each other around a first rotation shaft 2141, which is an end tool jaw pulley rotation shaft. At this time, pulley 2111 and pulley 2121 are formed to be spaced apart to a certain extent, and a staple assembly accommodating portion can be formed therebetween. At least a portion of a staple pulley assembly 2160 and a staple link assembly 2170, which will be described later, can be disposed in this staple assembly accommodating portion.

[0180] Here, in the figure, the pulley 2111 and the pulley 2121 are formed to rotate around one rotation axis 2141, but it goes without saying that each end tool jaw pulley may be formed to be rotatable around a separate axis. Here, a first jaw 2101 is fixedly connected to the pulley 2111 and rotates together with the pulley 2111, and a second jaw 2102 is fixedly connected to the pulley 2121 and rotates together with the pulley 2121. Yaw movement and actuation movement of the end tool 2100 occur in response to the rotation of the pulleys 2111 and 2121. That is, when the pulleys 2111 and 2121 rotate in the same direction around the rotation axis 2141, a yaw movement occurs, and when the pulleys 2111 and 2121 rotate in opposite directions around the rotation axis, an actuation movement occurs.

[0181] Here, the first jaw 2101 and the pulley 2111 may be formed as separate members and coupled to each other, or the first jaw 2101 and the pulley 2111 may be formed as a single body. Similarly, the second jaw 2102 and the pulley 2121 may be formed as separate members and coupled to each other, or the second jaw 2102 and the pulley 2121 may be formed as a single body.

[0182] Pulley 2112 functions as an end tool first jaw auxiliary pulley, and pulley 2122 functions as an end tool second jaw auxiliary pulley, and these two components may be collectively referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0183] In detail, the end tool jaw auxiliary pulleys, pulley 2112 and pulley 2122, may be further provided on one side of pulley 2111 and pulley 2121. That is, pulley 2112, which is an auxiliary pulley, may be disposed between pulley 2111 and pulley 2113 / pulley 2114. Furthermore, pulley 2122, which is an auxiliary pulley, may be disposed between pulley 2121 and pulley 2123 / pulley 2124. Pulley 2112 and pulley 2122 may be formed to be rotatable independently of each other about rotation axis 2142. Here, although pulley 2112 and pulley 2122 are formed to rotate about a single rotation axis 2142 in the figure, it goes without saying that pulley 2112 and pulley 2122 may be formed to be rotatable about separate axes. Such auxiliary pulleys will be described in more detail later.

[0184] Pulleys 2113 and 2114 function as end tool first jaw pitch main pulleys, and pulleys 2123 and 2124 function as end tool second jaw pitch main pulleys, and these two components can also be collectively referred to as end tool jaw pitch main pulleys.

[0185] Pulleys 2115 and 2116 function as end tool first jaw pitch sub-pulleys, and pulleys 2125 and 2126 function as end tool second jaw pitch sub-pulleys, and these two components can be collectively referred to as end tool jaw pitch sub-pulleys.

[0186] The components involved in the rotation of the pulley 2111 will be described below.

[0187] Pulley 2113 and pulley 2114 function as end tool first jaw pitch main pulleys. That is, pulley 2113 and pulley 2114 function as main rotating pulleys for the pitch operation of first jaw 2101. Here, wire 301, which is the first jaw wire, is wound around pulley 2113, and wire 305, which is the first jaw wire, is wound around pulley 2114.

[0188] Pulley 2115 and pulley 2116 function as end tool first jaw pitch sub-pulleys. That is, pulley 2115 and pulley 2116 function as sub-rotating pulleys for the pitch operation of first jaw 2101. Here, wire 301, which is the first jaw wire, is wound around pulley 2115, and wire 305, which is the first jaw wire, is wound around pulley 2116.

[0189] Pulleys 2113 and 2114 are disposed on one side of pulleys 2111 and 2112 so as to face each other. Pulleys 2113 and 2114 are formed so as to be able to rotate independently of each other about rotation axis 2143, which is the end tool pitch rotation axis. Pulleys 2115 and 2116 are disposed on one side of pulleys 2113 and 2114 so as to face each other. Pulleys 2115 and 2116 are formed so as to be able to rotate independently of each other about rotation axis 2144, which is the end tool pitch auxiliary rotation axis. Although the drawings show pulleys 2113, 2115, 2114, and 2116 as all being rotatable about the Y-axis, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0190] Wire 301, which is the first jaw wire, is wound around pulley 2115, pulley 2113, and pulley 2111 in sequence so that at least a portion of the wire comes into contact with pulley 2115, pulley 2113, and pulley 2111. Wire 305, which is connected to wire 301 by fastening member 323, is wound around pulley 2111, pulley 2112, pulley 2114, and pulley 2116 in sequence so that at least a portion of the wire comes into contact with pulley 2115, pulley 2113, and pulley 2111.

[0191] Explaining this from another perspective, the first jaw wires, wire 301 and wire 305, are wound sequentially around pulley 2115, pulley 2113, pulley 2111, pulley 2112, pulley 2114, and pulley 2116 so that at least a portion of them come into contact with each other, and wire 301 and wire 305 are formed to move along the pulleys while rotating the pulleys.

[0192] Therefore, when wire 301 is pulled in the direction of arrow 301 in Fig. 7, fastening member 323 to which wire 301 is coupled and pulley 2111 coupled thereto rotate in the direction of arrow L in Fig. 7. Conversely, when wire 305 is pulled in the direction of arrow 305 in Fig. 7, fastening member 323 to which wire 305 is coupled and pulley 2111 coupled thereto rotate in the direction of arrow R in Fig. 7.

[0193] Next, the components related to the rotation of the pulley 2121 will be described.

[0194] Pulley 2123 and pulley 2124 function as end tool second jaw pitch main pulleys. That is, pulley 2123 and pulley 2124 function as main rotating pulleys for the pitch operation of second jaw 2102. Here, wire 306, which is the second jaw wire, is wound around pulley 2123, and wire 302, which is the second jaw wire, is wound around pulley 2124.

[0195] Pulley 2125 and pulley 2126 function as end tool second jaw pitch sub-pulleys. That is, pulley 2125 and pulley 2126 function as sub-rotating pulleys for the pitch operation of second jaw 102. Here, wire 306, which is the second jaw wire, is wound around pulley 2125, and wire 302, which is the second jaw wire, is wound around pulley 2126.

[0196] Pulleys 2123 and 2124 are disposed on one side of pulley 2121 so as to face each other. Pulleys 2123 and 2124 are formed so as to be rotatable independently of each other around rotation axis 2143, which is the end tool pitch rotation axis. Pulleys 2125 and 2126 are disposed on one side of pulleys 2123 and 2124 so as to face each other. Pulleys 2125 and J15 pulleys 2123 and J25 are formed so as to be rotatable independently of each other around rotation axis 2144, which is the end tool pitch auxiliary rotation axis. Although the drawings show pulleys 2123, 2125, 2124, and 2126 as all being rotatable around the Y-axis, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0197] The wire 306, which is the second jaw wire, is wound around the pulley 2125, the pulley 2123, and the pulley 2121 in order so that at least a portion of the wire is in contact with the pulley 2125, the pulley 2123, and the pulley 2121. The wire 302, which is connected to the wire 306 by the fastening member 326, is wound around the pulley 2121, the pulley 2122, the pulley 2124, and the pulley 2126 in order so that at least a portion of the wire is in contact with the pulley 2125, the pulley 2123, and the pulley 2121.

[0198] Explaining this from another perspective, the second jaw wires, wire 306 and wire 302, are wound sequentially around pulley 2125, pulley 2123, pulley 2121, pulley 2122, pulley 2124, and pulley 2126 so that at least a portion of them come into contact with each other, and wire 306 and wire 302 are formed to move along the pulleys while rotating them.

[0199] Therefore, when wire 306 is pulled in the direction of arrow 306 in Fig. 7, fastening member 322 to which wire 306 is coupled and pulley 2121 coupled thereto rotate in the direction of arrow R in Fig. 7. Conversely, when wire 302 is pulled in the direction of arrow 302 in Fig. 7, fastening member 326 to which wire 302 is coupled and pulley 2121 coupled thereto rotate in the direction of arrow L in Fig. 7.

[0200] Pulley 2112 and pulley 2122, which act as auxiliary pulleys, are described in more detail below.

[0201] Pulley 2112 and pulley 2122 can play a role in increasing the rotation angle of first jaw 2101 and second jaw 2102, respectively, by contacting wire 305, which is the first jaw wire, and wire 302, which is the second jaw wire, and changing the placement paths of wire 305 and wire 302 to a certain extent.

[0202] That is, without the auxiliary pulleys, the first and second jaws could only rotate up to a right angle. However, in one embodiment of the present invention, by further providing auxiliary pulleys 2112 and 2122, the maximum rotation angle can be increased by θ as viewed in FIG. 8 . This enables the two jaws of the end tool 2100 to perform an actuation operation in which the two jaws must spread apart when the two jaws are yaw-rotated 90° in the L direction. This is because the second jaw 2102 can rotate by an additional angle (θ), as in FIG. 8 . Similarly, actuation is possible even when the two jaws are yaw-rotated in the L direction. In other words, the pulleys 2112 and 2122 have the advantage of expanding the range of yaw rotation within which actuation is possible.

[0203] This will be explained in more detail as follows.

[0204] When the auxiliary pulley is not provided, the first jaw wire is fixedly connected to the end tool first jaw pulley, and the second jaw wire is fixedly connected to the end tool second jaw pulley, so the end tool first jaw pulley and the end tool second jaw pulley can only rotate up to 90°. In this case, if an actuation operation is performed with the first jaw and the second jaw positioned on the 90° line, the first jaw can spread, but the second jaw cannot rotate more than 90°. Therefore, there was a problem in that the actuation operation could not be performed smoothly when the first jaw and the second jaw were performing a yaw operation more than a certain angle.

[0205] To solve this problem, in the surgical instrument 2000 of the present invention, auxiliary pulleys 2112 and 2122 are further disposed on one side of pulley 2111 and pulley 2121. By disposing pulley 2112 and pulley 2122 in this manner, the arrangement paths of wire 305 (first jaw wire) and wire 302 (second jaw wire) are changed to a certain extent, thereby changing the tangential directions of wire 305 and wire 302, and thereby allowing fastening member 323 connecting wire 301 and pulley 2111 to rotate up to line N in Figure 8. In other words, fastening member 323, which connects wire 301 and pulley 2111, can rotate until it is positioned on the common inscribed line of pulley 2112 and pulley 122. Similarly, fastening member 326, which is the connecting portion between wire 302 and pulley 2121, can rotate until it is positioned on the common inscribed line of pulleys 2121 and 2122, and the rotation range in the L direction can be expanded.

[0206] That is, wire 301 and wire 305, which are two strands of the first jaw wire wound around pulley 2111 by pulley 2112, are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis. At the same time, wire 302 and wire 306, which are two strands of the second jaw wire wound around pulley 2121 by pulley 2122, are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0207] In other words, pulleys 2113 and 2114 are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 2123 and 2124 are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0208] In other words, wire 305 is located on the inscribed line between pulley 2111 and pulley 2112, and the rotation angle of pulley 2111 is increased by pulley 2112. Wire 302 is located on the inscribed line between pulley 2121 and pulley 2122, and the rotation angle of pulley 2121 is increased by pulley 2122.

[0209] According to the present invention, the rotation radius of the jaw 2101 and the jaw 2102 is increased, which has the effect of widening the yaw operation range in which normal opening and closing actuation operations can be performed.

[0210] The pitch movement of the present invention will be described in more detail below.

[0211] On the other hand, when the wire 301 is pulled toward the arrow 301 in FIG. 7 and at the same time the wire 305 is pulled toward the arrow 305 in FIG. 7 (i.e., when both strands of the first jaw wire are pulled), as shown in FIG. 49, the wire 301 and the wire 305 are wound around the lower part of the pulley 2113 and the pulley 2114 which can rotate around the rotation axis 2143 which is the end tool pitch rotation axis, and therefore the pulley 2111 to which the wire 301 and the wire 305 are fixedly connected and the end tool hub 2106 to which the pulley 2111 is connected rotate together in the counterclockwise direction around the rotation axis 2143, and as a result the end tool 2100 rotates downward while performing a pitch motion. At this time, the second jaw 102 and the wire 302 and wire 306 fixedly connected thereto are wound around the upper part of the pulley 2123 and pulley 2124 which can rotate around the rotation axis 2143, so that the wire 302 and wire 306 are unwound in the opposite direction to the wires 302 and 306, respectively.

[0212] Conversely, when the wire 302 is pulled in the direction of the arrow 302 in Fig. 7 and the wire 306 is simultaneously pulled in the direction of the arrow 306 in Fig. 7, the wires 302 and 306 are wound around the upper parts of the pulleys 2123 and 2124 that can rotate around the rotation axis 2143, which is the end tool pitch rotation axis, as shown in Fig. 49, so the pulley 2121 to which the wires 302 and 306 are fixedly connected and the end tool hub 2106 to which the pulley 2121 is connected rotate together in the clockwise direction around the rotation axis 2143, resulting in the end tool 2100 performing a pitch motion while rotating upward. At this time, the first jaw 2101 and the wires 301 and 305 fixedly connected thereto are wound around the lower parts of the pulleys 2113 and 2114 that can rotate around the rotation axis 2143, so the wires 302 and 306 move in the opposite direction to the wires 301 and 305, respectively.

[0213] Meanwhile, the endotool 2100 of the surgical instrument 2000 of the present invention may further include a pulley 2131 that is an endotool pitch pulley, the operating unit 200 may further include pulleys 231 and 232 that are operating unit pitch pulleys, and the power transmission unit 300 may further include wires 303 and 304 that are pitch wires. In particular, the pulley 2131 of the endotool 2100 may be rotatable around a rotation axis 2143 that is an endotool pitch rotation axis, and may be formed integrally with the endtool hub 2106 (or fixedly coupled to the endtool hub 2106). In addition, the wires 303 and 304 may serve to connect the pulley 2131 of the endotool 2100 to the pulleys 231 and 232 of the operating unit 200.

[0214] Therefore, when pulleys 231 and 232 of operating unit 200 rotate, the rotation of pulleys 231 and 232 is transmitted to pulley 2131 of end tool 2100 via wires 303 and 304, causing pulley 2131 to rotate as well, resulting in end tool 2100 performing a pitch motion while rotating.

[0215] That is, the surgical instrument 2000 according to the first embodiment of the present invention includes a pulley 2131 of the end tool 2100, pulleys 231 and 232 of the operating unit 200, and wires 303 and 304 of the power transmission unit 300 for transmitting power for pitch movement, thereby enabling the driving force of the pitch movement of the operating unit 200 to be more completely transmitted to the end tool 2100, thereby improving operational reliability.

[0216] Here, the diameters of pulleys 2113, 2114, 2123, and 2124, which are end tool jaw pitch main pulleys, may be the same as or different from the diameter of pulley 2131, which is the end tool pitch pulley. In this case, the ratio of the diameter of the end tool jaw 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 to the diameter of the operation unit pitch main pulley of operation unit 200, which will be described later. This will be explained in detail later.

[0217] (Staple pulley related components)

[0218] The first staple pulley 2181 and the second staple pulley 2191 of the staple pulley assembly 2160 of the endotool 2100 of the surgical instrument 2000 of Figure 2 will be described in further detail below.

[0219] Fig. 9 is a side view showing an end tool of the surgical instrument of Fig. 2, Figs. 10 and 11 are perspective views showing a first jaw 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 a plan view showing the first jaw of the surgical instrument of Fig. 2, Fig. 14 is a plan view showing the second jaw of the surgical instrument of Fig. 2, and Figs. 15 and 16 are exploded perspective views showing a staple pulley and staple link of the surgical instrument of Fig. 2.

[0220] 4 to 16, the end tool 2100 according to the first embodiment of the present invention may include a first staple pulley 2181, a first staple assist pulley 2182, a pulley 2183, a pulley 2184, a pulley 2185, and a pulley 2186, which are associated with the linear / rotational movement of each pulley and link for stapling and cutting. The end tool 2100 according to the first embodiment of the present invention may further include a pulley 2187 and a pulley 2188.

[0221] Furthermore, the end tool 2100 of the first embodiment of the present invention may include a second staple pulley 2191, a second staple assist pulley 2192, a pulley 2193, a pulley 2194, a pulley 2195, and a pulley 2196 associated with the linear / rotational movement of each pulley and link for stapling and cutting. Also, the end tool 2100 of the first embodiment of the present invention may further include a pulley 2197 and a pulley 2198.

[0222] The first staple pulley 2181 and the second staple pulley 2191 are formed to face pulley 2111 and pulley 2121, which are end tool jaw pulleys, and are formed to be rotatable independently of each other around a rotation axis 2141, which is an end tool jaw pulley rotation axis. Here, in the figure, the first staple pulley 2181 and the second staple pulley 2191 are disposed between pulley 2111 and pulley 2121, but the spirit of the present invention is not limited thereto, and the first staple pulley 2181 and the second staple pulley 2191 can be disposed at various positions adjacent to pulley 2111 or pulley 2121.

[0223] Here, one feature of the present invention is that the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 are formed to rotate about substantially the same axis. In this way, by forming the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 to rotate about the same axis, pitch movement / yaw movement / actuation operation can be performed, and stapling and cutting operations can also be performed. This will be explained in more detail later. However, in the figure here, the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 are formed to rotate about a single rotation axis 2141, but it goes without saying that the respective pulleys may be formed to be rotatable about separate axes that are concentric with each other.

[0224] Explaining this from another perspective, it can also be expressed as a structure in which the pulley 2111 serving as the first jaw pulley, the first staple pulley 2181, the second staple pulley 2191, and the pulley 2121 serving as the second jaw pulley are stacked in order along the rotation shaft 2141. Alternatively, it can also be expressed as a structure in which the first staple pulley 2181 and the second staple pulley 2191 are disposed between the pulley 2111 and the pulley 2121 that face each other. Here, the pulley 2111 serving as the first jaw pulley, the first staple pulley 2181, the second staple pulley 2191, and the pulley 2121 serving as the second jaw pulley may be formed to be rotatable independently of each other.

[0225] The first staple assist pulley 2182 may be further provided on one side of the first staple pulley 2181. That is, the first staple assist pulley 2182 can be disposed between the first staple pulley 2181 and the pulley 2183 / pulley 2184. The first staple assist pulley 2182 may be formed to be rotatable about the rotation axis 2142 independently of the pulley 2112 and the pulley 2122.

[0226] Meanwhile, pulleys 2187 and 2188 can be further disposed between the first staple assist pulley 2182 and the pulley 2183 / pulley 2184. The pulleys 2187 and 2188 may be formed to be rotatable around a separation prevention pulley coupling portion 2106f of the end tool hub 2106. Here, the separation prevention pulley coupling portion 2106f may be formed parallel to the rotation axis 2143 which is the central axis of the pulleys 2183 and 2184. Here, the pulleys 2187 and 2188 can function as first staple wire separation prevention pulleys.

[0227] On the other hand, pulleys 2183 and 2184 can function as staple pitch main pulleys, and pulleys 2185 and 2186 can function as staple pitch sub pulleys.

[0228] The second staple assist pulley 2192 may be further provided on one side of the second staple pulley 2191. That is, the second staple assist pulley 2192 may be disposed between the second staple pulley 2191 and the pulley 2193 / pulley 2194. The second staple assist pulley 2192 may be formed to be rotatable about the rotation axis 2142 independently of the pulley 2112 and the pulley 2122.

[0229] Here, in the figures, the first staple assist pulley 2182, the second staple assist pulley 2192, the pulley 2112, and the pulley 2122 are formed to rotate around one rotation shaft 2142, but it goes without saying that the first staple assist pulley 2182, the second staple assist pulley 2192, the pulley 2112, and the pulley 2122 may each be formed to be rotatable around a separate shaft. Such staple assist pulleys will be described in more detail later.

[0230] Meanwhile, pulleys 2197 and 2198 can be further disposed between the second staple assist pulley 2192 and the pulleys 2193 / 2194. The pulleys 2197 and 2198 may be formed to be rotatable around a separation prevention pulley coupling portion 2106f of the end tool hub 2106. Here, the separation prevention pulley coupling portion 2106f may be formed parallel to the rotation axis 2143 which is the central axis of the pulleys 2183 and 2184. Here, the pulleys 2197 and 2198 can function as second staple wire separation prevention pulleys.

[0231] On the other hand, pulleys 2193 and 2194 can function as staple pitch main pulleys, and pulleys 2195 and 2196 can function as staple pitch sub pulleys.

[0232] The first staple assist pulley 2182 will be described in more detail below.

[0233] The first staple auxiliary pulley 2182 can play a role in enlarging the rotation angle of the first staple pulley 2181 by coming into contact with the wire 308, which is the first staple wire, and changing the arrangement path of the wire 308 to a certain extent.

[0234] That is, if no staple auxiliary pulley is provided, the staple pulley can only rotate up to a right angle, but in one embodiment of the present invention, by further providing the first staple auxiliary pulley 2182 which is an auxiliary pulley, it is possible to obtain the effect of increasing the maximum rotation angle by θ. This means that when the two jaws of the end tool 2100 are rotated 90° together in yaw, the first staple pulley 2181 rotates for stapling and cutting operations, enabling the operation of linearly moving the working member 540, which will be described later. In other words, it has the characteristic of being able to expand the range of yaw rotation in which stapling and cutting operations are possible via the first staple auxiliary pulley 2182.

[0235] This will be explained in more detail as follows.

[0236] In the case of the surgical instrument 2000 of the present invention, a first staple assist pulley 2182 is further disposed on one side of the first staple pulley 2181. By disposing the first staple assist pulley 2182 in this manner and changing the arrangement path of the wire 308, which is the first staple wire, to a certain extent, the tangential direction of the wire 308 is changed, and therefore the rotation angle of the fastening member (see 329 in FIG. 62) that connects the wire 308 and the first staple pulley 2181 is increased. In other words, the fastening member (see 329 in FIG. 62), which is the connecting portion between the wire 308 and the first staple pulley 2181, becomes rotatable until it is positioned on the common inscribed line of the first staple pulley 2181 and the staple assist pulley 2182.

[0237] In other words, the wire 308 is located on the inscribed line between the first staple pulley 2181 and the first staple assist pulley 2182, and the rotation angle of the first staple pulley 2181 is increased by the first staple assist pulley 2182.

[0238] According to the present invention, the rotation radius of the first staple pulley 2181 is increased, which has the effect of widening the yaw operation range in which normal stapling and cutting operations can be performed.

[0239] The pulleys 2187 and 2188, which are the first staple wire slippage prevention pulleys, will be described in more detail below.

[0240] The end tool 2100 of the surgical instrument according to the first embodiment of the present invention further includes pulleys 2187 and 2188 which are first staple wire separation prevention pulleys, and can serve to prevent separation of the first staple wires, wires 307 and 308.

[0241] That is, pulleys 2187 and 2188 are disposed between the first staple assist pulley 2182 and pulleys 2183 and 2184, and the path of wire 307 heading towards first staple assist pulley 2181 via pulley 2183 and the path of wire 308 heading towards first staple assist pulley 2182 via pulley 2184 are changed to a certain extent. More specifically, the paths of wire 307 and wire 308 are changed to a certain extent so that wire 307 heading towards first staple pulley 2181 via pulley 2183 and wire 308 heading towards first staple assist pulley 2182 via pulley 2184 become parallel to the X-axis.

[0242] Specifically, the height in the Z-axis direction of the wire 307 wound around the pulley 2183 is different from the height in the Z-axis direction of the wire 307 heading towards the first staple pulley 2181. Similarly, the height in the Z-axis direction of the wire 308 wound around the pulley 2184 and coming out is different from the height in the Z-axis direction of the wire 308 heading towards the first staple auxiliary pulley 2182. Therefore, if the pulley 2187 / pulley 2188, which is the first staple wire separation prevention pulley, were not present, the path of the wire 307 / wire 308 would be oblique (i.e., the fleet angle of the wire relative to the pulley would increase), and therefore there is a risk that the wire 307 / wire 308 will come off the pulley, and there is also a risk that the wire 307 / wire 308 will be damaged.

[0243] Therefore, in this embodiment, pulley 2187 / pulley 2188, which is a first staple wire slippage prevention pulley, is arranged between the first staple auxiliary pulley 2182 and pulley 2183 / pulley 2184, and serves to change the path of wire 307 / wire 308 to a certain extent so that after being wound around pulley 2183 / pulley 2184, wire 307 / wire 308 heading toward the distal portion 2104 of the end tool 2100 becomes parallel to the X-axis.

[0244] According to the present invention, the wires 307 and 308, which are the first staple wires, are prevented from coming off the pulleys, thereby making it possible to obtain the effect of making the cutting operation smoother.

[0245] The components related to the rotation of the first staple pulley 2181 will be described below.

[0246] Pulley 2183 and pulley 2184 function as staple pitch main pulleys. Here, a wire 307 which is a first staple wire is wound around pulley 2183, and a wire 308 which is a first staple wire is wound around pulley 2184.

[0247] Pulley 2185 and pulley 2186 function as staple pitch sub-pulleys. Here, a wire 307 which is a first staple wire is wound around pulley 2185, and a wire 308 which is a first staple wire is wound around pulley 2186.

[0248] Here, pulleys 2183 and 2184 are arranged on one side of the first staple pulley 2181, the first staple auxiliary pulley 2182, and the pulleys 2187 and 2188 to face each other. Here, the pulleys 2183 and 2184 are formed to be rotatable independently of each other around a rotation axis 2143 that is the end tool pitch rotation axis. In addition, pulleys 2185 and 2186 are arranged on one side of the pulleys 2183 and 2184 to face each other. Here, the pulleys 2185 and 2186 are formed to be rotatable independently of each other around the rotation axis 2144 that is the end tool pitch auxiliary rotation axis. Here, although the drawings show pulley 2183, pulley 2185, pulley 2184, and pulley 2186 as all being configured to be rotatable around the Y-axis direction, the spirit of the present invention is not limited to this, and the rotation axis of each pulley can be configured in various directions as appropriate for the configuration.

[0249] As described above, the rotation shaft 2141, the rotation shaft 2142, the rotation shaft 2143, and the rotation shaft 2144 can be arranged in sequence from the distal end 2104 toward the proximal end 2105 of the end tool 2100. This allows the first staple pulley 2181, the first staple assist pulley 2182, the pulleys 2187 / 2188, the pulleys 2183 / 2184, and the pulleys 2185 / 2186 to be arranged in sequence from the distal end 2104 toward the proximal end 2105 of the end tool 2100.

[0250] Wire 307, which is the first staple wire, is wound in this order so that at least a portion of it comes into contact with pulley 2185, pulley 2183, pulley 2187, and first staple pulley 2181. Then, wire 308, which is connected to wire 307 by a fastening member (see 329 in FIG. 62), is wound in this order so that at least a portion of it comes into contact with first staple pulley 2181, first staple assistant pulley 2182, pulley 2188, pulley 2184, and pulley 2186.

[0251] To explain this from another perspective, wires 307 and 308, which are the first staple wires, are wound around pulley 2185, pulley 2183, pulley 2187, first staple pulley 2181, first staple auxiliary pulley 2182, pulley 2188, pulley 2184, and pulley 2186 so that they are in at least partial contact with each other, and are formed so that wires 307 and 308 can move along the pulleys while rotating them.

[0252] Therefore, when wire 307 is pulled, the fastening member (see 329 in FIG. 62) to which wire 307 is coupled and the first staple pulley 2181 coupled thereto rotate in one direction. Conversely, when wire 308 is pulled, the fastening member (see 329 in FIG. 62) to which wire 308 is coupled and the first staple pulley 2181 coupled thereto rotate in the opposite direction.

[0253] On the other hand, the second staple pulley 2191, the second staple auxiliary pulley 2192, and related components such as pulley 2193, pulley 2194, pulley 2195, pulley 2196, pulley 2197, pulley 2198, wire 309, wire 310, etc. can have the same or similar configuration as the components associated with the first staple pulley 2181 described above.

[0254] Specifically, pulley 2193 and pulley 2194 function as staple pitch main pulleys. Here, a wire 310 which is the second staple wire is wound around pulley 2193, and a wire 309 which is the second staple wire is wound around pulley 2194.

[0255] Pulley 2195 and pulley 2196 function as staple pitch sub-pulleys. Here, a wire 310 which is a second staple wire is wound around pulley 2195, and a wire 309 which is a second staple wire is wound around pulley 2196.

[0256] Here, pulleys 2193 and 2194 are arranged on one side of the second staple pulley 2191, the second staple auxiliary pulley 2192, and the pulleys 2197 and 2198 so as to face each other. Here, the pulleys 2193 and 2194 are formed to be rotatable independently of each other around a rotation axis 2143 which is an end tool pitch rotation axis. In addition, pulleys 2195 and 2196 are arranged on one side of the pulleys 2193 and 2194 so as to face each other. Here, the pulleys 2195 and 2196 are formed to be rotatable independently of each other around the rotation axis 2144 which is an end tool pitch auxiliary rotation axis. Here, although the drawings show pulley 2193, pulley 2195, pulley 2194, and pulley 2196 as all being configured to be rotatable around the Y-axis direction, the spirit of the present invention is not limited to this, and the rotation axis of each pulley can be configured in various directions as appropriate for the configuration.

[0257] As described above, the rotation shaft 2141, the rotation shaft 2142, the rotation shaft 2143, and the rotation shaft 2144 can be arranged in sequence from the distal end 2104 toward the proximal end 2105 of the end tool 2100. This allows the second staple pulley 2191, the second staple assist pulley 2192, the pulleys 2197 / 2198, the pulleys 2193 / 2194, and the pulleys 2195 / 2196 to be arranged in sequence from the distal end 2104 toward the proximal end 2105 of the end tool 2100.

[0258] Wire 310, which is the second staple wire, is wound in this order so that at least a portion of it comes into contact with pulley 2195, pulley 2193, pulley 2197, and first staple pulley 2191. Then, wire 309, which is connected to wire 310 by a fastening member (see 330 in FIG. 62), is wound in this order so that at least a portion of it comes into contact with first staple pulley 2191, first staple assistant pulley 2192, pulley 2198, pulley 2194, and pulley 2196.

[0259] To explain this from another perspective, the second staple wires, wire 310 and wire 309, are wound so that they are in at least partial contact with pulley 2195, pulley 2193, pulley 2197, first staple pulley 2191, first staple auxiliary pulley 2192, pulley 2198, pulley 2194, and pulley 2196, and are formed so that wire 310 and wire 309 can move along the pulleys while rotating them.

[0260] Therefore, when wire 310 is pulled, the fastening member (see 330 in FIG. 62) to which wire 310 is coupled and the first staple pulley 2191 coupled thereto rotate in one direction. Conversely, when wire 309 is pulled, the fastening member (see 330 in FIG. 62) to which wire 309 is coupled and the first staple pulley 2191 coupled thereto rotate in the opposite direction.

[0261] (staple drive assembly)

[0262] The staple drive assembly 2150 is described in more detail below.

[0263] 15 to 20, staple drive assembly 2150 can include a staple pulley assembly 2160 and a staple link assembly 2170. Here, staple drive assembly 2150 is characterized in that it is coupled to a reciprocating assembly 550 of cartridge 500, which will be described later, and converts rotational movement of staple pulley assembly 2160 into linear movement of reciprocating assembly 550. In other embodiments of the present invention, which will be described later, the staple drive assembly can also be understood as a concept including a staple pulley assembly and a staple link assembly.

[0264] Staple pulley assembly 2160 can include one or more staple pulleys. Staple pulley assembly 2160 may be formed between pulley 2111 and pulley 2121, adjacent to pulley 2111 and pulley 2121. In this embodiment, it is assumed that staple pulley assembly 2160 includes two staple pulleys, a first staple pulley 2181 and a second staple pulley 2191.

[0265] The staple link assembly 2170 can include one or more link members 2171. And, the link member 2171 can include one or more links. In the first embodiment of the present invention, it is assumed that the staple link assembly 2170 includes one link member 2171, and the link member 2171 includes one link.

[0266] The end tool 2100 of the surgical instrument according to the present invention is characterized in that the staple pulley assembly 2160 and the staple link assembly 2170 form a cam / slot structure, which has the effect of amplifying the force that advances the reciprocating assembly 550.

[0267] In particular, the staple pulley assembly 2160 can include a first staple pulley 2181 and a second staple pulley 2191 .

[0268] The first staple pulley 2181 can include a main body 2181a, a protruding member 2181b, and a shaft penetrating portion 2181c.

[0269] The main body 2181a is formed in a disk shape.

[0270] A shaft through-hole 2181c can be formed in the center of the main body 2181a. The shaft through-hole 2181c is formed in a hole shape, and the rotation shaft 2141, which is the end tool jaw pulley rotation shaft, can be inserted through the shaft through-hole 2181c.

[0271] Furthermore, a protruding member 2181b may be formed on the main body 2181a of the first staple pulley 2181. The protruding member 2181b can be coupled to the link member 2171 of the staple link assembly 2170. Here, the center of the protruding member 2181b does not coincide with the center of the first staple pulley 2181, and the protruding member 2181b can be formed to be eccentric to a certain degree with respect to the first staple pulley 2181. The protruding member 2181b can be fitted into a first slot 2171d of the link member 2171, which will be described later.

[0272] The second staple pulley 2191 can include a main body 2191a, a protruding member 2191b, and a shaft penetrating portion 2191c.

[0273] The main body 2191a is formed in a disk shape.

[0274] A shaft through-hole 2191c can be formed in the center of the main body 2191a. The shaft through-hole 2191c is formed in a hole shape, and a rotation shaft 2141, which is the end tool jaw pulley rotation shaft, can be inserted through the shaft through-hole 2191c.

[0275] Furthermore, a protruding member 2191b may be formed on the main body 2191a of the second staple pulley 2191. The protruding member 2191b can be coupled to the link member 2171 of the staple link assembly 2170. Here, the center of the protruding member 2191b does not coincide with the center of the second staple pulley 2191, and the protruding member 2191b can be formed so as to be eccentric to a certain degree with respect to the first staple pulley 2191. The protruding member 2191b can be fitted into a second slot 2171e of the link member 2171, which will be described later.

[0276] Meanwhile, the end tool 2100 of the present invention further includes a staple link assembly 2170 connected to the staple pulley assembly 2160, and the staple link assembly 2170 may include a link member 2171. Here, the staple link assembly 2170 may serve to connect the staple pulley assembly 2160 and a reciprocating assembly 2150 of the cartridge 2110, which will be described later.

[0277] This embodiment is characterized in that the staple link assembly 2170 includes one link member 2171, and the link member 2171 includes only one link. In other words, the staple pulley assembly 2160 and the staple link assembly 2170 are coupled by a cam / slot structure, so that even when the staple link assembly 2170 includes only one link, the rotational movement of the staple pulley assembly 2160 can be converted into the linear movement of the staple link assembly 2170.

[0278] In particular, the link member 2171 may be formed of a single link.

[0279] The link member 2171 may be formed in a form of combining a thin and long bar with an oval flat plate, and may be formed in a substantially "L" shape. Here, the link member 2171 may include a first protrusion 2171a, a second protrusion 2171b, a fastening portion 2171c, a first slot 2171d, and a second slot 2171e.

[0280] A first protrusion 2171a and a second protrusion 2171b may be formed in one region of the center of the link member 2171. The first protrusion 2171a and the second protrusion 2171b can be fitted into the guide groove 2101b of the first jaw 2101.

[0281] In this manner, with the first protrusion 2171a and the second protrusion 2171b of the link member 2171 formed in a protrusion shape fitted into the groove-shaped guide groove 2101b, the first protrusion 2171a and the second protrusion 2171b move along the guide groove 2101b, causing the link member 2171 to move relative to the first jaw 2101 (and the cartridge 500 therein). This will be described in more detail later.

[0282] Meanwhile, a fastening portion 2171c may be formed at one end of the link member 2171. This fastening portion 2171c can be coupled with the fastening portion 551a of the reciprocating member 551 of the cartridge 500.

[0283] Meanwhile, a first slot 2171d and a second slot 2171e may be formed at the end of the link member 2171 opposite to the end where the fastening portion 2171c is formed.

[0284] Specifically, a first slot 2171d may be formed on a surface of the link member 2171 facing the first staple pulley 2181. Here, the first slot 2171d is formed in the shape of an elongated hole, into which the protruding member 2181b of the first staple pulley 2181 can be fitted. The first slot 2171d may be formed to have a predetermined curvature and may be formed in a substantially elliptical shape. In this case, the first slot 2171d may be formed to be larger than the protruding member 2181b to a certain extent. Therefore, when the protruding member 2181b of the first staple pulley 2181 is fitted in the first slot 2171d of the link member 2171, the protruding member 2181b is formed to be able to move within the first slot 2171d to a certain extent.

[0285] As described above, the protruding member 2181b can be formed to be eccentric to a certain degree with respect to the center of the first staple pulley 2181. Therefore, when the first staple pulley 2181 rotates, the protruding member 2181b can push the first slot 2171d while in contact with the first slot 2171d, thereby moving the link member 2171. In other words, when the first staple pulley 2181 rotates, the protruding member 2181b moves within the first slot 2171d while in contact with the first slot 2171d, thereby allowing the link member 2171 to move linearly along the guide groove 2101b of the first jaw 2101.

[0286] Here, the first slot 2171d may be formed so as to penetrate approximately half of the total thickness of the link member 2171, rather than penetrating the entire thickness of the link member 2171. From another perspective, the first slot 2171d can be formed to have substantially the same thickness as the thickness of the protruding member 2181b of the first staple pulley 2181.

[0287] Meanwhile, a second slot 2171e may be formed in the link member 2171. Specifically, the second slot 2171e may be formed in a surface of the link member 2171 facing the second staple pulley 2191. Here, the second slot 2171e is formed in the shape of an elongated hole, into which the protruding member 2191b of the second staple pulley 2191 can be fitted. The second slot 2171e may be formed to have a predetermined curvature and be formed in a substantially elliptical shape. In this case, the second slot 2171e may be formed to be larger than the protruding member 2191b to a certain extent. Therefore, when the protruding member 2191b of the second staple pulley 2191 is fitted in the second slot 2171e of the link member 2171, the protruding member 2191b is formed to be able to move within the second slot 2171e to a certain extent.

[0288] As described above, the protruding member 2191b can be formed to be eccentric to a certain degree with respect to the center of the second staple pulley 2191. Therefore, when the second staple pulley 2191 rotates, the protruding member 2191b can push the second slot 2171e while in contact with the second slot 2171e, thereby moving the link member 2171. In other words, when the second staple pulley 2191 rotates, the protruding member 2191b moves within the second slot 2171e while in contact with the second slot 2171e, thereby allowing the link member 2171 to move linearly along the guide groove 2101b of the first jaw 2101.

[0289] Here, the second slot 2171e may be formed so as to penetrate approximately half of the total thickness of the link member 2171, rather than penetrating the entire thickness of the link member 2171. From another perspective, the second slot 2171e can be formed to have substantially the same thickness as the thickness of the protruding member 2191b of the first staple pulley 2191.

[0290] Here, the first slot 2171d and the second slot 2171e may be formed to at least partially overlap each other, and the sum of the thicknesses of the first slot 2171d and the second slot 2171e in the Y-axis direction may be formed to be approximately the same as the thickness of the link member 2171 in the Y-axis direction.

[0291] Here, the first slot 2171d and the second slot 2171e may be formed symmetrically in the up and down direction with respect to the rotation shaft 2141. In this way, since the first slot 2171d and the second slot 2171e are formed symmetrically in the up and down direction with respect to the rotation shaft 2141, the protruding member 2181b of the first staple pulley 2181 and the protruding member 2191b of the second staple pulley 2191 coupled to the link member 2171 can also be arranged symmetrically with respect to each other. This will be described in more detail later.

[0292] (Displacement and movement of staple link assembly due to rotation of staple pulley)

[0293] The displacement of the staple link assembly 2170 due to the rotation of the first staple pulley 2181 and the second staple pulley 2191 will be described below.

[0294] 17, in the first embodiment of the present invention, the first staple pulley 2181 and the staple link assembly 2170 are coupled in a cam / slot configuration. That is, a cam-shaped protruding member 2181b formed on the first staple pulley 2181 is coupled to a first slot 2171d formed on the link member 2171. Therefore, when the first staple pulley 2181 rotates in the direction of arrow A, the displacement of the protruding member 2181b of the first staple pulley 2181 in the X-axis direction is B. Then, the displacement of the staple link assembly 2170 in the X-axis direction is C.

[0295] 18, in the first embodiment of the present invention, the second staple pulley 2191 and the staple link assembly 2170 are coupled in a cam / slot configuration. That is, a cam-shaped protruding member 2191b formed on the second staple pulley 2191 is coupled to a second slot 2171e formed on the link member 2171. Therefore, when the second staple pulley 2191 rotates in the direction of arrow D, the displacement of the protruding member 2191b of the second staple pulley 2191 in the X-axis direction is E. Then, the displacement of the staple link assembly 2170 in the X-axis direction is F.

[0296] In comparison, if the staple pulley and staple link assembly are connected by a link shaft rather than a cam / slot connection, the displacement of the staple link assembly in the X-axis direction will be much longer than in the first embodiment of the present invention.

[0297] In other words, compared to when the staple pulley and staple link assembly are axially connected, when the staple pulley and staple link assembly are cam / slot connected as in this embodiment, the displacement of the staple link assembly in the X-axis direction is reduced even if the staple pulley rotates the same amount.

[0298] On the other hand, since work is the product of force and displacement, if we assume that the work of rotating the staple pulley is the same, displacement and force are inversely proportional to each other. Therefore, if displacement decreases, force increases inversely proportional to it.

[0299] As a result, in the first embodiment of the present invention, the first staple pulley 2181 and the second staple pulley 2191 are each coupled to the staple link assembly 2170 in a cam / slot configuration, and the displacement of the staple link assembly 2170 in the X-axis direction due to the rotation of the first staple pulley 2181 and the second staple pulley 2191 is relatively reduced compared to other embodiments, so the force that the staple link assembly 2170 receives in the X-axis direction is relatively increased compared to a simple link structure.

[0300] This first embodiment of the present invention amplifies the force that advances the staple link assembly 2170 and the reciprocating assembly 550 connected thereto, thereby providing the effect of more robust stapling.

[0301] In particular, since the first embodiment of the present invention includes two staple pulleys (i.e., the first staple pulley 2181 and the second staple pulley 2191) that are symmetrical to each other, the force with which the staple pulley assembly 2160 pushes the staple link assembly 2170 can be amplified by approximately twice as much as when only one staple pulley is provided.

[0302] Furthermore, since the first staple pulley 2181 and the second staple pulley 2191 are disposed symmetrically on the left and right with respect to the XZ plane, the left and right balance is achieved when stapling, and the end tool 2100 does not sway left and right as a whole, and an effect can be obtained in which operation is stable about the rotation axis 2141 which is the yaw rotation axis. Furthermore, by winding the wires 307 and 308 which are the first staple wires and the wires 309 and 310 which are the second staple wires in opposite directions with respect to the rotation axis 2143 which is the pitch rotation axis, an effect can be obtained in which the vibrations about the rotation axis 2143 can be mutually canceled out.

[0303] The rotation directions of the first staple pulley 2181 and the second staple pulley 2191 will be described below.

[0304] Referring to Figures 17, 18, 19, and 20, the first staple pulley 2181 advances the staple link assembly 2170 when rotated in the direction of arrow A in Figure 20 (i.e., clockwise), and the second staple pulley 2191 advances the staple link assembly 2170 when rotated in the direction of arrow D in Figure 20 (i.e., counterclockwise).

[0305] Conversely, the first staple pulley 2181 retracts the staple link assembly 2170 when rotated counterclockwise, and the second staple pulley 2191 retracts the staple link assembly 2170 when rotated clockwise.

[0306] As a result, when the first staple pulley 2181 and the second staple pulley 2191 rotate in opposite directions, the staple link assembly 2170 moves (forward or backward). Conversely, when the first staple pulley 2181 and the second staple pulley 2191 rotate in the same direction, the rotations of the two pulleys cancel each other out, and the staple link assembly 2170 does not move.

[0307] As a result, in a state similar to that shown in Figure 19, when the first staple pulley 2181 rotates clockwise and the second staple pulley 2191 rotates counterclockwise, the link member 2171 connected to the first staple pulley 2181 and the second staple pulley 2191 can move as a whole toward the distal portion of the first jaw 2101 (see 2101f in Figure 13).

[0308] Conversely, when the first staple pulley 2181 rotates counterclockwise and the second staple pulley 2191 rotates clockwise, the link member 2171 connected to the first staple pulley 2181 and the second staple pulley 2191 can move as a whole toward the proximal portion of the first jaw 2101 (see 101g in Figure 13).

[0309] Thus, bidirectional rotational motion of the staple pulley assembly 2160 can cause reciprocating linear motion of the reciprocating assembly 550 of the cartridge 500 through the staple link assembly 2170, as will be described in more detail below.

[0310] (First jaw, second jaw and actuation movement)

[0311] The coupling structure between the first jaw 2101 and the second jaw 2102 of the end tool 2100 of the surgical instrument 2000 of FIG. 2 will be described in more detail below.

[0312] Fig. 13 is a plan view showing a first jaw of the surgical instrument of Fig. 2, and Fig. 14 is a plan view showing a second jaw of the surgical instrument of Fig. 2. Figs. 21 and 22 are plan views showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of Fig. 2. Figs. 23 and 24 are plan views showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of Fig. 2. Figs. 25 and 26 are perspective views showing the opening and closing operations of the end tool of the surgical instrument of Fig. 2.

[0313] 9 to 26, the first jaw 2101 includes a cartridge accommodating portion 2101a, a guide groove 2101b, a movable coupling hole 2101c, a jaw pulley coupling hole 2101d, and a shaft through portion 2101e.

[0314] The first jaw 2101 is formed in an elongated rod shape overall, with the cartridge 500 accommodated on the distal portion 2101f side, and a pulley 2111 coupled to the proximal portion 2101g so as to be rotatable around a rotation axis 2141. In other words, the first jaw 2101 is formed in a form in which one surface (top surface) of an empty box has been removed overall, and a cartridge accommodating portion 2101a capable of accommodating the cartridge 500 can be formed inside the first jaw 2101. That is, the cross section of the first jaw 2101 may be formed in a substantially "U" shape.

[0315] In the first jaw 2101, a guide groove 2101b that guides movement of the staple link assembly 2170, which will be described later, may be formed on one side of the cartridge accommodating portion 2101a, for example, on the side of the proximal portion 2101g. The guide groove 2101b may be formed in a groove shape that is formed along a movement path of the staple link assembly 2170. Then, in a state in which the first protrusion 2171a and the second protrusion 2171b of the link member 2171 formed in a protrusion shape are fitted into the groove-shaped guide groove 2101b, the first protrusion 2171a and the second protrusion 2171b move along the guide groove 2101b, whereby the staple link assembly 2170 moves relative to the first jaw 2101 (and the cartridge 500 therein). In other words, the staple link assembly 2170 can move along the guide groove 2101b of the first jaw 2101.

[0316] On the other hand, a movable coupling hole 2101c, a jaw pulley coupling hole 2101d, and a shaft through-hole 2101e may be formed on the proximal end side of the first jaw 2101.

[0317] Here, the movable coupling hole 2101c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 2111a of a pulley 2111, which will be described later, can be fitted into this movable coupling hole 2101c. Here, the minor radius of the movable coupling hole 2101c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 2111a. Meanwhile, the major radius of the movable coupling hole 2101c may be formed to be larger than the radius of the shaft coupling portion 2111a. Therefore, when the shaft coupling portion 2111a of the pulley 2111 is fitted into the movable coupling hole 2101c of the first jaw 2101, the shaft coupling portion 2111a is formed to be able to move within the movable coupling hole 2101c to a certain extent. This will be described in more detail later.

[0318] Meanwhile, the jaw pulley coupling hole 2101d is formed in a cylindrical hole, and a jaw coupling portion 2111b of a pulley 2111, which will be described later, can be fitted into this jaw pulley coupling hole 2101d. Here, the radius of the jaw pulley coupling hole 2101d may be formed to be substantially the same as or slightly larger than the radius of the jaw coupling portion 2111b. Therefore, the jaw coupling portion 2111b of the pulley 2111 can be formed to be rotatably coupled to the jaw pulley coupling hole 2101d of the first jaw 2101. This will be described in more detail later.

[0319] The shaft through-portion 2101e may be formed relatively closer to the distal portion 2101f of the first jaw 2101 as compared with the movable coupling hole 2101c and the jaw pulley coupling hole 2101d. The shaft through-portion 2101e is formed in a hole shape, and a rotation shaft 2145, which is a jaw rotation shaft, can be inserted through the shaft through-portion 2101e.

[0320] The second jaw 2102 includes an anvil 2102a, a movable coupling hole 2102c, a jaw pulley coupling hole 2102d, and a shaft through-portion 2102e.

[0321] The second jaw 2103 is formed in an elongated rod shape overall, with an anvil 2102a formed on the distal portion 2102f side, and a pulley 2112 coupled to the proximal portion 2102g, so that it can rotate around a rotation axis 2141.

[0322] In detail, the anvil 2102a is formed in a flat plane shape, and one surface thereof may be formed with a shape corresponding to the shape of the staple 530, which will be described later. When the working member 540 pushes up the staple 530 during stapling, such an anvil 2102a can function as a base for supporting the opposite side of the working member 540 and bending the staple 530.

[0323] On the other hand, a movable coupling hole 2102c, a jaw pulley coupling hole 2102d, and a shaft through-hole 2102e may be formed on the proximal end side of the second jaw 2102.

[0324] Here, the movable coupling hole 2102c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 2121a of a pulley 2121, which will be described later, can be fitted into this movable coupling hole 2102c. Here, the minor radius of the movable coupling hole 2102c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 2121a. Meanwhile, the major radius of the movable coupling hole 2102c may be formed to be larger than the radius of the shaft coupling portion 2121a. Therefore, when the shaft coupling portion 2121a of the pulley 2121 is fitted into the movable coupling hole 2102c of the first jaw 2102, the shaft coupling portion 2121a is formed to be able to move within the movable coupling hole 2102c to a certain extent. This will be described in more detail later.

[0325] Meanwhile, the jaw pulley coupling hole 2102d is formed in a cylindrical hole, and a jaw coupling portion 2121b of a pulley 2121, which will be described later, can be fitted into this jaw pulley coupling hole 2102d. Here, the radius of the jaw pulley coupling hole 2102d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 2121b. Therefore, the jaw coupling portion 2121b of the pulley 2121 can be formed to be rotatably coupled to the jaw pulley coupling hole 2102d of the first jaw 2102. This will be described in more detail later.

[0326] On the other hand, the shaft through-portion 2102e may be formed relatively closer to the distal portion 2102f side of the second jaw 2102 as compared with the movable coupling hole 2102c and the jaw pulley coupling hole 2102d. The shaft through-portion 2102e is formed in a hole shape, and a rotation shaft 2145, which is the jaw rotation shaft, can be inserted through the shaft through-portion 2102e.

[0327] The pulley 2111, which is the first jaw pulley, may include a shaft coupling portion 2111a and a jaw coupling portion 2111b. The pulley 2111 may be formed in a rotatable disk shape overall, with the shaft coupling portion 2111a and the jaw coupling portion 2111b formed to protrude to a certain extent from one surface of the pulley. As described above, the shaft coupling portion 2111a of the pulley 2111 may be fitted into the movable coupling hole 2101c of the first jaw 2101, and the jaw coupling portion 2111b of the pulley 2111 may be fitted into the jaw pulley coupling hole 2101d of the first jaw 2101. The pulley 2111 may be formed to be rotatable around the rotation axis 2141, which is the end tool jaw pulley rotation axis.

[0328] Meanwhile, the pulley 2121, which is the second jaw pulley, may also include a shaft coupling portion 2121a and a jaw coupling portion 2121b. The pulley 2121 may be formed in a generally rotatable disk shape, with the shaft coupling portion 2121a and the jaw coupling portion 2121b formed to protrude to a certain extent from one surface thereof. As described above, the shaft coupling portion 2112a of the pulley 2112 may be fitted into the movable coupling hole 2102c of the first jaw 2102, and the jaw coupling portion 2112b of the pulley 2112 may be fitted into the jaw pulley coupling hole 2102d of the first jaw 2102. The pulley 2121 may be formed to be rotatable around the rotation axis 2141, which is the end tool jaw pulley rotation axis.

[0329] The coupling relationships between the above-mentioned components are as follows:

[0330] The rotation shaft 2141, which is the end tool jaw pulley rotation shaft, is inserted through the shaft coupling portion 2111a of the pulley 2111, the movable coupling hole 2101c of the first jaw 2101, the shaft through portion 2181c of the first staple pulley 2181, the movable coupling hole 2102c of the second jaw 2102, and the shaft coupling portion 2121a of the pulley 2121 in that order.

[0331] A rotation shaft 2145 that is a jaw rotation shaft is inserted through the shaft through-hole 2101e of the first jaw 2101 and the shaft through-hole 2102e of the second jaw 2102 in this order.

[0332] The shaft coupling portion 2111 a of the pulley 2111 is fitted into the movable coupling hole 2101 c of the first jaw 2101 , and the jaw coupling portion 2111 b of the pulley 2111 is fitted into the jaw pulley coupling hole 2101 d of the first jaw 2101 .

[0333] At this time, the jaw pulley coupling hole 2101d of the first jaw 2101 and the jaw coupling portion 2111b of the pulley 2111 are rotatably coupled to each other, and the movable coupling hole 2101c of the first jaw 2101 and the shaft coupling portion 2111a of the pulley 2111 are movably coupled to each other.

[0334] The shaft coupling portion 2121 a of the pulley 2121 is fitted into the movable coupling hole 2102 c of the first jaw 2102 , and the jaw coupling portion 2121 b of the pulley 2121 is fitted into the jaw pulley coupling hole 2102 d of the second jaw 2102 .

[0335] At this time, the jaw pulley coupling hole 2102d of the second jaw 2101 and the jaw coupling portion 2121b of the pulley 2121 are rotatably coupled to each other, and the movable coupling hole 2102c of the second jaw 2102 and the shaft coupling portion 2121a of the pulley 2121 are movably coupled to each other.

[0336] Here, the pulley 2111 and the pulley 2121 rotate around a rotation axis 2141 which is the end tool jaw pulley rotation axis. The first jaw 2101 and the second jaw 2102 rotate around a rotation axis 2145 which is the jaw rotation axis. In other words, the pulley 2111 and the first jaw 2101 have different rotation axes. Similarly, the pulley 2121 and the second jaw 2102 have different rotation axes.

[0337] That is, the first jaw 2101 has its rotation angle limited to a certain extent by the movable coupling hole 2101c, but basically rotates around the rotation axis 2145, which is the jaw rotation axis. Similarly, the second jaw 2102 has its rotation angle limited to a certain extent by the movable coupling hole 2102c, but basically rotates around the rotation axis 2145, which is the jaw rotation axis.

[0338] The amplification of the grip force due to the coupling relationship between the above-mentioned components will now be described.

[0339] A surgical instrument 2000 according to one embodiment of the present invention is characterized in that the coupling structure between the first jaw 2101 and the second jaw 2102 forms an X-shape, and when the first jaw 2101 and the second jaw 2102 rotate in a direction toward each other (i.e., when the first jaw 2101 and the second jaw 2102 are closed), the grip force in the closing direction of the first jaw 2101 and the second jaw 2102 becomes even greater. This will be explained in more detail as follows.

[0340] As described above, there are two axes that serve as centers of rotation when the first jaw 2101 and the second jaw 2102 open and close. That is, the first jaw 2101 and the second jaw 2102 open and close around two axes, rotation axis 2141 and rotation axis 2145. At this time, the center of rotation of the first jaw 2101 and the second jaw 2102 is rotation axis 2145, and the center of rotation of the pulleys 2111 and 2121 is rotation axis 2141. At this time, rotation axis 2141 is an axis whose position is fixed relatively, and rotation axis 2145 is an axis whose position moves linearly relatively. In other words, when the position of the rotation axis 2141 is fixed and the pulleys 2111 and 2121 rotate, the rotation axis 2145, which is the rotation axis of the first jaw 2101 and the second jaw 2102, moves back and forth, causing the first jaw 2101 and the second jaw 2102 to open and close.

[0341] With this configuration, when the first jaw 2101 and the second jaw 2102 are closed, the grip force becomes stronger, and the effect of enabling the surgeon to perform a strong actuation operation with less force can be obtained.

[0342] (cartridge)

[0343] The cartridge 500 of the surgical instrument 2000 of FIG. 2 will now be described in more detail.

[0344] FIG. 27 is a perspective view showing the first jaw and cartridge of the surgical instrument of FIG. 2. FIG. 28 is an exploded perspective view showing the cartridge of FIG. 27. FIG. 29 is an assembled perspective view showing the cartridge of FIG. 27. FIG. 30 is a side view showing the cartridge of FIG. 27. FIG. 31 is a perspective cross-sectional view showing the cartridge of FIG. 27. FIG. 32 is a side cross-sectional view showing the cartridge of FIG. 27. FIGS. 33 and 34 are perspective views showing a working member of the cartridge of FIG. 27. FIG. 35 is a side cross-sectional view showing a stapling-related structure of the endotool of the surgical instrument of FIG. 2. FIGS. 36 and 37 are perspective cross-sectional views showing the stapling structure of the endotool of the surgical instrument of FIG. 2. FIGS. 38 to 41 are perspective views showing the ratchet drive operation of the endotool of FIG. 30. FIGS. 42 and 43 are plan views showing the ratchet drive operation of the endotool of FIG. 36. FIG. 44 is a perspective view showing an overall ratchet drive operation of the endotool of FIG. 36. 45 and 46 are perspective views generally illustrating the stapling of the endotool of FIG.

[0345] 27 to 46, the cartridge 500 is formed to be attachable to and detachable from the first jaw 2101, includes a plurality of staples 530 and a blade 542 therein, and performs suturing and cutting of tissue. Here, the cartridge 500 can include a cover 510, a housing 520, the staples 530, a puller member 535, a working member 540, and a reciprocating assembly 550.

[0346] The housing 520 forms the outer shape of the cartridge 500, and may be formed in a form in which one surface (top surface) of a generally hollow box is removed, and may be formed to accommodate the reciprocating assembly 550, the working member 540, and the staples 530 therein. Here, the cross section of the housing 520 may be formed in a substantially "U" shape.

[0347] 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 ejected to the outside. Before the stapling drive, the staples 530 housed inside the housing 520 are pushed up by the working member 540 during the stapling operation, pass through the staple holes 511 in the cover 510, and are pulled out to the outside of the cartridge 500, where the stapling is performed.

[0348] Meanwhile, 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. As the blade 542 of the working member 540 passes along this slit 512, it can cut the tissue after the staple fastening is completed.

[0349] A plurality of staples 530 may be disposed inside the housing 520. As a working member 540 (described later) moves linearly in one direction, the plurality of staples 530 are sequentially pushed up from the inside to the outside of the housing 520 to perform suturing, i.e., stapling. Here, the material of the staples 530 may include titanium, stainless steel, etc.

[0350] Meanwhile, a pull-out member 535 may be further disposed between the housing 520 and the staples 530. In other words, it may be expressed that the staples 530 are disposed on the upper part of the pull-out member 535. In this case, the working member 540 moves linearly in one direction to push up the pull-out member 535, and the pull-out member 535 can push up the staples 530.

[0351] In this way, it can be said that the working member 540 pushes up the staples 530, including both a case where the working member 540 directly pushes up the staples 530 and a case where the working member 540 pushes up the pull-out member 535 and the pull-out member 535 pushes up the staples 530 (i.e., a case where the working member 540 indirectly pushes up the staples 530).

[0352] A reciprocating assembly 550 may be disposed below and within the housing 520. The reciprocating assembly 550 may include one or more reciprocating members 551. While the present embodiment is shown as including one reciprocating member 551, in embodiments described below, multiple reciprocating members 551 may be included.

[0353] In this embodiment, the reciprocating member 551 may be a rack. The reciprocating member 551 may include a concave-convex portion 551b and a fastening portion 551a. Specifically, the reciprocating member 551 may be formed in a long bar shape, and may have a plurality of sawtooth-like concave-convex portions 551b formed on one surface. The concave-convex portion 551b may be formed to be able to come into contact with a working member 540, which will be described later, in particular, a ratchet member 543 of the working member 540. In other words, the reciprocating member 551 may include a plurality of concave-convex portions 551b shaped to mesh with a ratchet 543a of the ratchet member 543.

[0354] Meanwhile, although not shown in the drawings, the reciprocating member 551 may be provided as a member of various shapes other than a rack shape, which is directly or indirectly connected to the staple pulley assembly 2160 and is capable of linear reciprocating motion according to the rotational motion of the staple pulley assembly 2160. For example, the reciprocating member 551 may be in the form of a clutch without any uneven portion.

[0355] Here, the reciprocating member 551 may not be fixedly connected to other components of the cartridge 500, but may be formed to be movable relative to other components of the cartridge 500. That is, the reciprocating member 551 may perform a reciprocating linear motion with respect to the housing 520 and the cover 510 connected to the housing 520.

[0356] Meanwhile, a fastening portion 551a may be formed on the reciprocating member 551 at the proximal end 501 side adjacent to the pulley 2111, and this fastening portion 551a may be fastened and coupled to the staple link assembly 2170 of the end tool 2100. Therefore, when the staple link assembly 2170 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.

[0357] A working member 540 may be disposed inside the housing 520. The working member 540 may be formed to be able to come into contact with the reciprocating member 551 and to move linearly in one direction in response to the reciprocating linear movement 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 extension direction of the connecting portion 400.

[0358] The working member 540 may include a wedge 541 , a blade 542 , a ratchet member 543 , a resilient member 544 , and a body 545 .

[0359] The body 545 may be formed in the shape of a rectangular pillar and forms the base of the working member 540 .

[0360] 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 degree in the extending direction of the connecting portion 400. In other words, the wedge 541 may be formed so that the height of the proximal portion 501 side of the cartridge 500 is higher than the height of the distal portion 502 side. Although the figures show two wedges 541 formed on each side of the main body 545, the concept of the present invention is not limited thereto, and various numbers and shapes of wedges may be formed depending on the shape of the staple 530 or the puller member 535 that comes into contact with the wedges 541.

[0361] Such a wedge 541 is formed so as to be able to sequentially come into contact with the puller member 535 or the plurality of staples 530, and can play a role in sequentially pushing up the staples 530. As shown in FIG. 40 etc., which will be described later, as the working member 540 moves toward the distal portion 502, the wedge 541 can play a role in sequentially pushing up the staples 530 and pulling them out of the cartridge 500.

[0362] 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. A sharp edge 542a that cuts tissue is formed in one region of the blade 542. At least a portion of this edge 542a is drawn to the outside of the first jaw 2101 and the cartridge 500, so that tissue disposed between the first jaw 2101 and the second jaw 2102 can be cut. The edge 542a of the blade 542 may always be drawn to the outside of the first jaw 2101. Alternatively, the edge 542a of the blade 542 may be normally housed inside the first jaw 2101 or the cartridge 500, and may be drawn to the outside of the first jaw 2101 only when the working member 540 moves along the longitudinal direction.

[0363] The ratchet member 543 may be formed on one side of the wedge 541, more specifically, on a lower portion of the wedge 541, and may be formed to face the reciprocating member 551 described below. 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., toward the distal end) relative to the reciprocating member 551. The ratchet 543a of the ratchet member 543 may be formed to be able to come into contact with the uneven portion 551b of the reciprocating member 551 described above.

[0364] 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. For example, one region of the elastic member 544 may be connected to the wedge 541 or the main body 545, and another region of the elastic member 544 may be connected to the ratchet member 543, so that the elastic member 544 connects the wedge 541 or the main body 545 to the ratchet member 543. Here, the elastic member 544 can apply an elastic force in a direction in which the ratchet member 543 comes into close contact with the reciprocating member 551. For this reason, the elastic member 544 may be formed in the form of a leaf spring, or may be provided in various other forms that can apply a predetermined elastic force to the ratchet member 543, such as a coil spring or a disc spring.

[0365] Here, the ratchet 543a of the ratchet member 543 may have a first surface 543a1 (specifically, the side surface of the distal portion 502) formed to have a predetermined angle and a gentle slope, and a second surface 543a2 (specifically, the side surface of the proximal portion 501) formed to be vertical or nearly vertical.

[0366] In order to engage with the ratchet 543a of the ratchet member 543, the uneven portion 551b of the reciprocating member 551 may also be formed such that the first surface 551b1 (more specifically, the side surface of the proximal portion 501) has a gentle slope at a predetermined angle, and the second surface 551b2 (more specifically, the side surface of the distal portion 502) is vertical or nearly vertical.

[0367] When reciprocating member 551 and ratchet member 543 are fastened (or engaged, or in close contact) with each other, inclined first surface 543a1 of ratchet 543a and inclined first surface 551b1 of uneven portion 551b may be arranged to face each other (i.e., to abut). Also, vertical second surface 543a2 of ratchet 543a and vertical second surface 551b2 of uneven portion 551b may be arranged to face each other (i.e., to abut).

[0368] With this configuration, when ratchet 543a and concave / convex portion 551b are fastened (or meshed) with each other, they act as a kind of ratchet, and movement in only one direction is possible.

[0369] As an example, assuming that the reciprocating member 551 is fixed, the working member 540 can move in a direction in which the vertically formed second surfaces 543a2 and 551b2 move away from each other, but cannot move in a direction in which the second surfaces 543a2 and 551b2 move toward each other while in contact with each other.

[0370] From another perspective, when the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other and the reciprocating member 551 moves toward the distal portion 502, the ratchet member 543 moves together with the reciprocating member 551 toward the distal portion 502. That is, the vertical second surface 551b2 of the reciprocating member 551 presses the vertical second surface 543a2 of the working member 540, and the ratchet member 543 moves together with the reciprocating member 551 toward the distal portion 502.

[0371] Conversely, when the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other and the reciprocating member 551 moves toward the proximal part 501, the ratchet member 543 remains fixed and only the reciprocating member 551 moves independently toward the proximal part 501. That is, with the working member 540 remaining fixed, the inclined first surface 551b1 of the reciprocating member 551 moves along the inclined first surface 543a1 of the working member 540, and only the reciprocating member 551 moves independently toward the proximal part 501.

[0372] 40 to 43, when the reciprocating member 551 moves toward the proximal portion 501 (in the direction of arrow K1 in FIGS. 41 and 43) in the same state as in FIGS. 40 and 42, the inclined first surface 551b1 of the reciprocating member 551 moves along the inclined first surface 543a1 of the working member 540, and the ratchet member 543 is pressed and pushed as a whole in the direction of arrow K2 in FIG. 35. At this time, the elastic member 544 also elastically deforms to a certain extent.

[0373] In this state, when reciprocating member 551 moves further toward proximal portion 501 and inclined first surface 551b1 of reciprocating member 551 passes the tip of inclined first surface 543a1 of working member 540, uneven portion 551b of reciprocating member 551 comes into contact with the next ratchet 543a of ratchet member 543. At this time, elastic member 544 applies an elastic force in a direction in which ratchet member 543 comes into close contact with reciprocating member 551, and therefore reciprocating member 551 and ratchet member 543 again come into close contact with each other at their front faces.

[0374] As a result, the cartridge 500 is housed in the cartridge housing portion 2101a of the first jaw 2101, and at this time, the reciprocating member 551 of the cartridge 500 and the staple link assembly 2170 of the end tool 2100 are coupled together. Therefore, the rotational movement of the first staple pulley 2181 of the end tool 2100 is converted into the linear movement of the reciprocating member 551 via the staple link assembly 2170.

[0375] 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, and when the staple pulley 161 rotates alternately clockwise and counterclockwise, the reciprocating member 551 can repeatedly move forward and backward. 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 can remain stationary. By repeating this process, the working member 540 moves forward, and the staples 530 are stapled by the wedge 541, and at the same time, the blade 542 can cut the stapled tissue.

[0376] This will be explained in more detail as follows.

[0377] (stapling and cutting action)

[0378] Referring to FIG. 44, a method for operating a surgical instrument according to one embodiment of the present invention is as follows.

[0379] First, when the first staple pulley 2181 rotates clockwise and the second staple pulley 2191 rotates counterclockwise, the staple link assembly 2170 connected to the staple pulley assembly 2160 and the reciprocating assembly 550 of the cartridge 500 connected to the staple link assembly 2170 move toward the distal portion 502 of the cartridge 500.

[0380] As the reciprocating assembly 550 moves toward the distal portion 502 of the cartridge 500 , the working member 540 in contact with the reciprocating assembly 550 moves toward the distal portion 502 of the cartridge 500 along with the reciprocating assembly 550 .

[0381] Then, as the working member 540 moves toward the distal portion 502 of the cartridge 500 , the working member 540 ejects the staples 530 out of the cartridge 500 , and the blade 542 of the working member 540 moves toward the distal portion 502 of the cartridge 500 .

[0382] On the other hand, when the first staple pulley 2181 rotates counterclockwise and the second staple pulley 2191 rotates clockwise, the staple link assembly 2170 connected to the staple pulley assembly 2160 and the reciprocating assembly 550 of the cartridge 500 connected to the staple link assembly 2170 move toward the proximal portion 501 of the cartridge 500, and at this time the working member 540 is stopped.

[0383] These steps are then repeated, with the stapling action by the wedge 541 and the cutting action by the blade 542 being performed simultaneously.

[0384] This will be explained in more detail as follows.

[0385] 44(a), when the first staple pulley 2181 rotates in the direction of arrow A1 (i.e., clockwise) and the second staple pulley 2191 rotates in the direction of arrow B1 (i.e., counterclockwise) as shown in Fig. 44(b), the staple link assembly 2170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 2170 move in the direction of arrow C1 (i.e., toward the distal portion). In this state, the reciprocating member 551 and the working member 540 are in close contact with each other due to the elastic member (see 544 in Fig. 43), and therefore, when the reciprocating member 551 moves in the direction of arrow C1, the working member 540 also moves in the direction of arrow C1 together with the reciprocating member 551.

[0386] On the other hand, as shown in Figure 44(c), when the first staple pulley 2181 rotates in the direction of arrow A2 (i.e., counterclockwise) and the second staple pulley 2191 rotates in the direction of arrow B2 (i.e., clockwise), the staple link assembly 2170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 2170 move in the direction of arrow C2 (i.e., toward the proximal portion). In this state, due to the fastening structure between the ratchet member 543 and the reciprocating member 551, even if the reciprocating member 551 moves in the C2 direction, the overall position of the working member 540 is maintained as is, and only the ratchet member 543 repeatedly moves away from and into contact with the reciprocating member 551 to a certain extent as the elastic member 544 repeatedly elastically deforms and restores (see Figures 41 and 43). In other words, even if the reciprocating member 551 moves in the direction of arrow C2, the working member 540 remains at that position when viewed from the X-axis direction.

[0387] As shown in Figure 44(d), when the first staple pulley 2181 rotates further in the direction of arrow A3 and the second staple pulley 2191 rotates further in the direction of arrow B3, only the staple link assembly 2170 and the reciprocating member 551 connected thereto move further in the direction of arrow C3.

[0388] In this state, when the first staple pulley 2181 stops rotating, the staple link assembly 2170, the reciprocating member 551, and the working member 540 also stop rotating, as shown in FIG. 44(a).

[0389] While repeating this process, when the first staple pulley 2181 and the second staple pulley 2191 rotate alternately in the clockwise and counterclockwise directions, the reciprocating member 551 repeatedly moves forward and backward, and the working member 540 repeatedly moves forward and stops, resulting in the working member 540 moving toward the distal portion 502. Then, while the working member 540 moves toward the distal portion 502, the stapling action by the wedge 541 and the cutting action by the blade 542 are simultaneously performed.

[0390] Hereinafter, stapling using a surgical instrument according to one embodiment of the present invention will be described.

[0391] 45 is a perspective view showing the stapling of the end tool of FIG. 36 in sections, and FIG. 46 is a perspective view showing the stapling of the end tool of FIG. 36 as a whole.

[0392] 45 and 46, in the same state as in FIG. 45(a), while the working member 540 moves in the direction of arrow A1 in FIG. 45(b), the wedge 541 of the working member 540 pushes up the pull-out member 535, and the pull-out member 535 pushes up one side below the staple 530. As a result, the staple 530 is ejected to the outside of the first jaw 2101 and the cartridge 500.

[0393] In this state, when the working member 540 moves further in the direction of arrow A2 in FIG. 45(c), the ejected staple 530 continues to be pushed up by the working member 540 while in contact with the anvil 2102a of the second jaw 2102, and both ends of the staple 530 are bent and stapled.

[0394] While such an operation is continuously performed, as shown in FIG. 46, among the plurality of staples 530, stapling is performed in order from the staples 530 on the proximal portion 501 side to the staples 530 on the distal portion 502 side.

[0395] (Operation unit)

[0396] Figures 47 and 48 are perspective views showing the operation portion of the surgical instrument of Figure 2. Figure 49 is a diagram simply showing only the configuration of pulleys and wires that form the joints of the surgical instrument shown in Figure 2.

[0397] 2 to 49, the operating unit 200 of the surgical instrument 2000 according to the first embodiment of the present invention includes a first handle 204 that can be held by a user, an actuation operating unit 203 that controls the actuation movement of the end tool 2100, a yaw operating unit 202 that controls the yaw movement of the end tool 2100, and a pitch operating unit 201 that controls the pitch movement of the end tool 2100. Here, it can be understood that only the components related to the pitch / yaw / actuation movements of the surgical instrument 2000 are shown in FIGS.

[0398] Additionally, the operating portion 200 of the surgical instrument 2000 may further include a staple operating portion 260 that controls the movement of the staple pulley assembly 160 of the end tool 2100 to perform stapling and cutting.

[0399] The operating unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 involved in the rotational motion of the first jaw 2101. The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 involved in the rotational motion of the second jaw 2102. The operating unit 200 may also include pulleys 231, 232, 233, and 234 involved in the pitch motion. The operating unit 200 may also include pulley 235, which is an intermediate pulley, arranged in the middle of the bent portion 402 of the connecting portion 400.

[0400] Here, although the figures show the opposing pulleys formed parallel to each other, the concept of the present invention is not limited to this, and each pulley may be formed in various positions and sizes suited to the configuration of the operating unit.

[0401] Furthermore, the operation unit 200 according to the first embodiment of the present invention may include rotational shafts 241, 242, 243, 244, 245, and 246. Here, the rotational shaft 241 may function as an operation unit first jaw actuation rotational shaft, and the rotational shaft 242 may function as an operation unit second jaw actuation rotational shaft. The rotational shaft 243 may function as an operation unit yaw main rotational shaft, and the rotational shaft 244 may function as an operation unit yaw sub-rotational shaft. The rotational shaft 245 may function as an operation unit pitch sub-rotational shaft, and the rotational shaft 246 may function as an operation unit pitch main rotational shaft.

[0402] The rotation shafts 241 / 242, 243, 244, 245, and 246 may be arranged sequentially from the distal end 205 to the proximal end 206 of the operating portion 200.

[0403] Each of these rotating shafts 241, 242, 243, 244, 245, and 246 may be fitted with one or more pulleys, as will be described in more detail below.

[0404] Pulley 210 functions as an operating portion first jaw actuation pulley, and pulley 220 functions as an operating portion second jaw actuation pulley, and these components may be generally referred to as operating portion actuation pulleys.

[0405] Pulley 211 and pulley 212 function as an operating unit first jaw-yaw main pulley, and pulley 221 and pulley 222 function as an operating unit second jaw-yaw main pulley, and these components may be commonly referred to as operating unit yaw main pulleys.

[0406] Pulleys 213 and 214 function as an operating unit first jaw-yaw sub-pulley, and pulleys 223 and 224 function as an operating unit second jaw-yaw sub-pulley, and these components may be commonly referred to as operating unit yaw sub-pulleys.

[0407] Pulleys 215 and 216 function as operating unit first jaw pitch sub-pulleys, and pulleys 225 and 226 function as operating unit second jaw pitch sub-pulleys, and these components may be commonly referred to as operating unit pitch sub-pulleys.

[0408] Pulleys 217 and 218 function as the first jaw pitch main pulley of the operating unit, and pulleys 227 and 228 function as the second jaw pitch main pulley of the operating unit, and these components may be commonly referred to as the operating unit pitch main pulley.

[0409] Pulleys 231 and 232 function as operation unit pitch wire main pulleys, and pulleys 233 and 234 function as operation unit pitch wire sub-pulleys.

[0410] The above components can be classified as follows from the viewpoint of the operating parts for each movement (pitch / yaw / actuation).

[0411] The pitch operation unit 201 that controls the pitch movement of the end tool 2100 may include a pulley 215, a pulley 216, a pulley 217, a pulley 218, a pulley 225, a pulley 226, a pulley 227, a pulley 228, a pulley 231, a pulley 232, and a pulley 234. The pitch operation unit 201 may also include a rotation shaft 245 and a rotation shaft 246. The pitch operation unit 201 may further include a pitch frame 208.

[0412] The yaw operation unit 202 that controls the yaw movement of the end tool 2100 may include a pulley 211, a pulley 212, a pulley 213, a pulley 214, a pulley 221, a pulley 222, a pulley 223, and a pulley 224. The yaw operation unit 202 may also include a rotation shaft 243 and a rotation shaft 244. The yaw operation unit 202 may further include a yaw frame 207.

[0413] The actuation operation unit 203 that controls the actuation movement of the end tool 2100 may include a pulley 210, a pulley 220, a rotation shaft 241, and a rotation shaft 242. The actuation operation unit 203 may further include a first actuation operation unit 251 and a second actuation operation unit 256.

[0414] Each component of the operation unit 200 will be described in more detail below.

[0415] The first handle 204 is formed so that it can be held by a user's hand, and in particular, may be formed so that the user can wrap the palm of their hand around the first handle 204. 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 a bent portion 402 of the connecting unit 400.

[0416] 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 unit 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 unit 257, and a second actuation gear 258. Here, the ends of the first actuation extension unit 252 and the second actuation extension unit 257 are formed in the shape of a finger hole ring and can function as a second handle.

[0417] Here, the rotation axes 241 and 242, which are actuation rotation axes, may be formed to form a predetermined angle with the XY plane on which the coupling unit 400 is formed. For example, the rotation axes 241 and 242 may be formed in a direction parallel to the Z axis, and 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 concept of the present invention is not limited thereto, and the rotation axes 241 and 242 may be formed in various directions to suit the hand structure of a user holding the actuation operation unit 203 according to ergonomic design.

[0418] Meanwhile, the pulley 210, the first actuation extension 252, and the first actuation gear 253 may be fixedly coupled to each other and may be formed to be rotatable together around the rotation axis 241. Here, the pulley 210 may be formed of one pulley or two pulleys fixedly coupled to each other.

[0419] Similarly, pulley 220, second actuation extension 257, and second actuation gear 258 may be fixedly coupled to each other and formed to be rotatable together around rotation axis 242. Here, pulley 220 may be composed of one pulley, or may be composed of two pulleys fixedly coupled to each other.

[0420] 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 the opposite direction when either side rotates.

[0421] The yaw operation unit 202 may include a rotation shaft 243, pulleys 211 and 212 which are operation unit first jaw-yaw main pulleys, pulleys 221 and 222 which are operation unit second jaw-yaw main pulleys, and a yaw frame 207. The yaw operation unit 202 may further include pulleys 213 and 214 which are operation unit first jaw-yaw sub-pulleys formed on one side of the pulleys 211 and 212, and pulleys 223 and 224 which are operation unit second jaw-yaw 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, which will be described later.

[0422] Here, the drawings show yaw operation unit 202 including pulleys 211 and 212 and pulleys 221 and 222, where pulleys 211 and 212 and pulleys 221 and 222 are respectively formed to face each other and are provided with two independently rotatable pulleys, but the concept of the present invention is not limited to this. In other words, one or more pulleys having the same or different diameters may be provided according to the configuration of yaw operation unit 202.

[0423] Specifically, a rotation axis 243, which is the operation unit yaw main rotation axis, is formed on one side of the actuation operation unit 203 on the first handle 204. In this case, the first handle 204 is formed to be rotatable around the rotation axis 243.

[0424] Here, the rotation axis 243 may be formed to form a predetermined angle with the XY plane on which the connecting unit 400 is formed. For example, the rotation axis 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 axis 243 may change relatively as described above. Of course, the concept of the present invention is not limited thereto, and the rotation axis 243 may be formed in various directions to suit the hand structure of a user holding the operation unit 200 according to ergonomic design.

[0425] Meanwhile, pulleys 211 and 212 and pulleys 221 and 222 are coupled to a rotation shaft 243 so as to be rotatable about the rotation shaft 243. A wire 301 or 305 serving as a first jaw wire may be wound around pulleys 211 and 212, and a wire 302 or 306 serving as a second jaw wire may be wound around pulleys 221 and 222. In this case, pulleys 211 and 212 and pulleys 221 and 222 may be formed to face each other and may be configured as two pulleys that can rotate independently. Therefore, the wire to be wound and the wire to be unwound can be wound around separate pulleys, respectively, and can operate without interfering with each other.

[0426] The yaw frame 207 rigidly connects the first handle 204, the rotation axis 241, the rotation axis 242, and the rotation axis 243, allowing the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 to yaw rotate as a unit around the rotation axis 243.

[0427] The pitch operation unit 201 may include a rotating shaft 246, pulleys 217 and 218 which are operation unit first jaw pitch main pulleys, pulleys 227 and 228 which are operation unit second jaw pitch main pulleys, and a pitch frame 208. The pitch operation unit 201 may further include a rotating shaft 245, pulleys 215 and 216 which are operation unit first jaw pitch sub-pulleys formed on one side of the pulleys 217 and 218, and pulleys 225 and 226 which are operation unit second jaw pitch sub-pulleys formed on one side of the pulleys 227 and 228. The pitch operation unit 201 may be connected to a bending portion 402 of the connection unit 400 via the rotating shaft 246.

[0428] Specifically, pitch frame 208 serves as a base frame of pitch operation unit 201, and one end of pitch frame 208 is rotatably coupled to rotation shaft 243. That is, yaw frame 207 is formed to be rotatable around rotation shaft 243 relative to pitch frame 208.

[0429] As described above, the yaw frame 207 connects the first handle 204, the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242, and the yaw frame 207 is also axially coupled to the pitch frame 208. Therefore, when the pitch frame 208 pitches around the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, which are connected to the pitch frame 208, all rotate in pitch. In other words, when the pitch operation unit 201 rotates around 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 pitches the first handle 204 around the rotation shaft 246, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 move together.

[0430] Pulleys 217 and 218 and pulleys 227 and 228 are coupled to a rotation axis 246 of pitch frame 208 so as to be rotatable about the rotation axis 246 .

[0431] Here, pulleys 217 and 218 may be formed to face each other and to be rotatable independently. Therefore, the winding wire and the unwinding wire can be wound around the separate pulleys, respectively, and can operate without interfering with each other. Similarly, pulleys 227 and 228 may be formed to face each other and to be rotatable independently. Therefore, the winding wire and the unwinding wire can be wound around the separate pulleys, respectively, and can operate without interfering with each other.

[0432] Next, the operation of the pitch wires, wire 303 and wire 304, is as follows.

[0433] The end tool 2100 is formed with a pulley 2131, which is an end tool pitch pulley, fixedly coupled to the end tool hub 180, and the operating unit 200 is formed with pulleys 231 and 232, which are operating unit pitch pulleys, fixedly coupled to the pitch frame 208. These pulleys are connected to each other by wires 303 and 304, which are pitch wires, so that the pitch movement of the end tool 2100 can be more easily performed in response to the pitch operation of the operating unit 200. Here, the wire 303 is fixedly coupled to the pitch frame 208 via the pulleys 231 and 233, and the wire 304 is fixedly coupled to the pitch frame 208 via the pulleys 232 and 234. In other words, the pitch rotation of the operating unit 200 causes the pitch frame 208 and the pulleys 231 and 232 to rotate together around the rotation axis 246, and as a result, the wires 303 and 304 also move, and additional pitch rotation power can be transmitted in addition to the pitch movement of the end tool caused by the jaw wires, wires 301, 302, 305, and 306.

[0434] The connection relationships between the first handle 204 and the pitch operation unit 201, the yaw operation unit 202, and the actuation operation unit 203 can be summarized as follows: Rotational shafts 241 and 242, and rotational shafts 243, 244, 245, and 246 may be formed on the first handle 204. In this case, since rotational shafts 241 and 242 are formed directly on the first handle 204, the first handle 204 and the actuation operation unit 203 may be directly connected. On the other hand, since rotational shaft 243 is formed directly on the first handle 204, the first handle 204 and the yaw operation unit 202 may be directly connected. Meanwhile, since the pitch operation unit 201 is formed on one side of the yaw operation unit 202 so as to be connected to the yaw operation unit 202, the pitch operation unit 201 may not be directly connected to the first handle 204, and the pitch operation unit 201 and the first handle 204 may be formed so as to be indirectly connected via the yaw operation unit 202.

[0435] Continuing to refer to the figures, in the surgical instrument 2000 according to the first embodiment of the present invention, the pitch control unit 201 and the end tool 2100 may be formed on the same or parallel axis (X axis). That is, the rotation axis 246 of the pitch control unit 201 is formed at one end of the bending portion 402 of the connecting portion 400, and the end tool 2100 is formed at the other end of the connecting portion 400.

[0436] 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 portion of the bent portion 402. By guiding the path of the wire by winding at least a portion of the wire around such intermediate pulleys 235, the wire may be arranged along the bent shape of the bent portion 402.

[0437] Here, in the figure, the connecting portion 400 is shown as having a bent portion 402 and being curved to have a predetermined curvature, but the concept of the present invention is not limited thereto, and the connecting portion 400 may be formed straight or bent one or more times as necessary, and even in such cases, the pitch control portion 201 and the end tool 2100 can be said to be formed on substantially the same axis or on parallel axes. Also, in Figure 3, the pitch control portion 201 and the end tool 2100 are shown as being formed on axes parallel to the X axis, but the concept of the present invention is not limited thereto, and the pitch control portion 201 and the end tool 2100 may be formed on different axes.

[0438] The staple operating portion 260 is connected to a first staple pulley 2181 of the end tool 2100 by wires 307 and 308 which are first staple wires, and can serve to rotate the first staple pulley 2181 alternately in a clockwise or counterclockwise direction. The staple operating portion 260 is connected to a second staple pulley 2191 of the end tool 2100 by wires 309 and 310 which are second staple wires, and can serve to rotate the second staple pulley 2191 alternately in a clockwise or counterclockwise direction.

[0439] For this reason, although not shown in the figures, the staple operating portion 260 may include a motor (not shown). That is, while a user is pressing the staple operating portion 260 formed in a button shape, the motor (not shown) is driven to rotate the operating portion staple pulley (see 269 in FIG. 47) alternately in a clockwise or counterclockwise direction. This allows the first staple pulley 2181 and the second staple pulley 2191 of the end tool 2100 to rotate alternately in a clockwise or counterclockwise direction.

[0440] (actuation, yaw, pitch)

[0441] The actuation operation, yaw operation, and pitch operation in this embodiment will be described below.

[0442] First, the actuation operation is as follows.

[0443] When a user places his / her index finger in the finger hole ring formed in first actuation extension 252 and his / her thumb in the finger hole ring formed in second actuation extension 257 and rotates actuation extensions 252, 257 with one or both fingers, pulley 210 and first actuation gear 253, which are fixedly connected to first actuation extension 252, rotate about rotation axis 241, and pulley 220 and second actuation gear 258, which are fixedly connected to second actuation extension 257, rotate about rotation axis 242. At this time, pulley 210 and pulley 220 rotate in opposite directions, and therefore wires 301 and 305, one end of which is fixedly connected and wound around pulley 210, and wires 302 and 306, one end of which is fixedly connected and wound around pulley 220, also move in opposite directions. Such a rotational force is transmitted to the end tool 2100 via the power transmission unit 300, and the two jaws 2103 of the end tool 2100 perform an actuation operation.

[0444] Here, as described above, the actuation operation refers to the operation of opening and closing the two jaws 2101, 2102 as the jaws 2101, 2102 rotate in opposite directions. That is, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated toward each other, the first jaw 2101 rotates counterclockwise and the second jaw 2102 rotates clockwise, closing the end tool 2100. Conversely, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated away from each other, the first jaw 2101 rotates clockwise and the second jaw 2102 rotates counterclockwise, opening the end tool 2100.

[0445] In this embodiment, for the above-described actuation operation, the second handle is provided with the first actuation extension 252 and the second actuation extension 257, and can be gripped and operated with two fingers. However, the configuration of the actuation operation unit 203 for the actuation operation of opening and closing the two jaws of the end tool 2100 from each other is different from that described above, and other modified examples are also possible, such as a configuration in which two actuation pulleys (pulley 210, pulley 220) operate in opposite directions from each other using one actuation rotating unit.

[0446] Next, the yaw motion is as follows:

[0447] When a user rotates first handle 204 about rotation axis 243 while gripping first handle 204, actuation operation unit 203 and yaw operation unit 202 will yaw rotate about rotation axis 243. That is, when pulley 210 of first actuation operation unit 251, to which wires 301 and 305 are fixedly coupled, rotates about rotation axis 243, wires 301 and 305 wound around pulleys 211 and 212 will move. Similarly, when pulley 220 of second actuation operation unit 256, to which wires 302 and 306 are fixedly coupled, rotates about rotation axis 243, wires 302 and 306 wound around pulleys 221 and 222 will move. At this time, the wires 301 and 305 connected to the first jaw 2101 and the wires 302 and 306 connected to the second jaw 2102 are wound around the pulleys 211 and 212 and the pulleys 221 and 222 so that the first jaw 2101 and the second jaw 2102 rotate in the same direction during yaw rotation. Then, this rotational force is transmitted to the end tool 2100 via the power transmission unit 300, and the two jaws 2103 of the end tool 2100 perform a yaw operation in which they rotate in the same direction.

[0448] At this time, the yaw frame 207 connects the first handle 204, the rotation axis 241, the rotation axis 242, and the rotation axis 243, so that the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 rotate together around the rotation axis 243.

[0449] Next, the pitch operation is as follows:

[0450] When the user rotates first handle 204 about rotation axis 246 while gripping first handle 204, actuation operation unit 203, yaw operation unit 202, and pitch operation unit 201 pitch rotate about rotation axis 246. That is, when pulley 210 of first actuation operation unit 251, to which wires 301 and 305 are fixedly coupled, rotates about rotation axis 246, wires 301 and 305 wound around pulleys 217 and 218 move. Similarly, when pulley 220 of second actuation operation unit 256, to which wires 302 and 306 are fixedly coupled, rotates about rotation axis 246, wires 302 and 306 wound around pulleys 227 and 228 move. 5, the wires 301 and 305 serving as the first jaw wires move in the same direction, and the wires 302 and 306 serving as the second jaw wires move in the same direction, so that the first jaw 2101 and the second jaw 2102 can pitch rotate. The jaw wires, wires 301, 305, wire 302, and wire 306, are wound around pulleys 217, 218, 227, and 228, which are the operation unit pitch main pulleys. Such a rotational force is then transmitted to the end tool 2100 via the power transmission unit 300, and the two jaws 2103 of the end tool 2100 perform pitch movement.

[0451] 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 shaft 241, the rotation shaft 242, and the rotation shaft 243, so when the pitch frame 208 rotates around the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243 connected to the pitch frame 208 rotate together. In other words, when the pitch operation unit 201 rotates around the rotation shaft 246, the actuation operation unit 203 and the yaw operation unit 202 rotate together with the pitch operation unit 201.

[0452] In summary, the surgical instrument 2000 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), a wire (first jaw wire or second jaw wire) is wound around this pulley, and rotational operation (actuation rotation, yaw rotation, pitch rotation) of the operating unit causes movement of each wire, thereby inducing a desired movement of the end tool 2100. Furthermore, an auxiliary pulley may be formed on one side of each pulley, and these auxiliary pulleys prevent the wire from being wound multiple times around one pulley.

[0453] Figure 49 is a simplified diagram showing only the configuration of pulleys and wires that constitute the joints of the surgical instrument 2000 according to one embodiment of the present invention shown in Figure 2. In Figure 43, the intermediate pulleys for changing the path of the wires regardless of joint movement are omitted.

[0454] Referring to FIG. 49, the operating unit 200 may include a pulley 210, a pulley 211, a pulley 212, a pulley 213, a pulley 214, a pulley 215, a pulley 216, a pulley 217, and a pulley 218 that are involved in the rotational movement of the first jaw 2101.

[0455] The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 involved in the rotational movement of the second jaw 2102. (The arrangement and configuration of each pulley in the operating unit 200 is fundamentally the same as the arrangement and configuration of each pulley in the end tool 2100, so specific notation of the reference numerals in the drawings will be omitted.)

[0456] Pulleys 211 and 212, and pulleys 221 and 222 may be formed to be rotatable independently of each other around the same axis, rotation axis 243. In this case, pulleys 211 and 212, and pulleys 221 and 222, respectively, may be formed to face each other and may be formed as two pulleys formed to be rotatable independently of each other.

[0457] Pulleys 213 and 214, and pulleys 223 and 224 may be formed to be independently rotatable about the same axis, rotation axis 244. In this case, pulleys 213 and 214 may be formed to face each other and be formed as two pulleys formed to be independently rotatable, and in this case, the two pulleys may be formed to have different diameters. Similarly, pulleys 223 and 224 may be formed to face each other and be formed as two pulleys formed to be independently rotatable, and in this case, the two pulleys may be formed to have different diameters.

[0458] Pulleys 215 and 216 and pulleys 225 and 226 may be formed to be rotatable independently of each other around the same axis, rotation axis 245. In this case, pulleys 215 and 216 may be formed to have different diameters. Also, pulleys 225 and 226 may be formed to have different diameters.

[0459] Pulleys 217 and 218 and pulleys 227 and 228 may be formed to be rotatable independently of each other about the same rotation axis 246 .

[0460] The wire 301 passes through pulleys 217, 215, 213, and 211 of the operating unit 200 in this order, and is wound around pulley 210, and then is coupled to pulley 210 by a fastening member 324. On the other hand, the wire 305 passes through pulleys 218, 216, 214, and 212 of the operating unit 200 in this order, and is coupled to pulley 210 by a fastening member 324. Therefore, when the pulley 210 rotates, the wires 301 and 305 are wound around or unwound from the pulley 210 accordingly, and the first jaw 2101 rotates.

[0461] The wire 306 passes through pulleys 227, 225, 223, and 221 of the operating unit 200 in this order, and is wound around pulley 220, and then coupled to pulley 220 by a fastening member 327. On the other hand, the wire 302 passes through pulleys 228, 226, 224, and 222 of the operating unit 200 in this order, and is coupled to pulley 220 by a fastening member 327. Therefore, when pulley 220 rotates, the wires 302 and 306 are wound or unwound around pulley 220 accordingly, and the second jaw 2102 rotates.

[0462] (Conceptual diagram of pulley and wire)

[0463] Figures 51 and 52 are views showing the configurations of pulleys and wires associated with the actuation and yaw operations of the surgical instrument 2000 according to one embodiment of the present invention shown in Figure 2, resolved for the first and second jaws, respectively. Figure 51 is a view showing only the pulleys and wires associated with the second jaw, and Figure 52 is a view showing only the pulleys and wires associated with the first jaw. Figure 50 is a perspective view showing the yaw operation of the surgical instrument of Figure 2. Note that components associated with the stapling and cutting operations have been omitted from Figure 50.

[0464] First, the wire operation of the actuation operation will be described.

[0465] Referring to Figure 52, when the first actuation extension 252 rotates in the direction of arrow OPA1 around the rotation axis 241, the pulley 210 connected to the first actuation extension 252 rotates, and the wires 301 and 305 wound around the pulley 210 move in the directions W1a and W1b, respectively, resulting in the first jaw 2101 of the end tool 2100 rotating in the direction of arrow EPA1.

[0466] 51, when second actuation extension 257 rotates in the direction of arrow OPA2 around rotation axis 242, pulley 220 connected to second actuation extension 257 rotates, and wires 302 and 306 wound around pulley 220 move in the directions of W2a and W2b, respectively, resulting in second jaw 2102 of end tool 2100 rotating in the direction of arrow EPA2. Therefore, when a user operates first actuation extension 252 and second actuation extension 257 in directions that bring them closer together, first jaw 2101 and second jaw 2102 of the end tool move closer to each other.

[0467] Next, the wire operation for yaw movement will be described.

[0468] First, the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 are connected by a yaw frame (see 207 in FIG. 30), so the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 rotate together as a unit.

[0469] Referring to Figure 52, when the first handle 204 is rotated in the direction of the arrow OPY1 around the rotation axis 243, the pulleys 210, 211, and 212, along with the wires 301 and 305 wound around them, rotate as a whole around the rotation axis 243, and as a result, the wires 301 and 305 wound around the pulleys 211 and 212 move in the directions W1a and W1b, respectively, and as a result, the first jaw 2101 of the end tool 2100 rotates in the direction of the arrow EPY1.

[0470] Referring to Figure 51, when the first handle 204 is rotated in the direction of the arrow OPY2 around the rotation axis 243, pulleys 220, 221, and 222, along with the wires 302 and 306 wound thereon, rotate as a whole around the rotation axis 243, and as a result, the wires 302 and 306 wound around pulleys 221 and 222 move to the opposite side of W1a and the opposite side of W1b, respectively, and as a result, the first jaw 2101 of the end tool 2100 rotates in the direction of the arrow EPY2.

[0471] Figures 53, 54, and 55 are views showing the configurations of pulleys and wires associated with the stapling and cutting operations of the surgical instrument 2000 according to one embodiment of the present invention shown in Figure 2, with the first jaw and the second jaw disassembled. Here, Figures 53 to 55 are views mainly showing the pulleys and wires associated with the second jaw.

[0472] Here, FIGS. 53 and 54 show the actuation process for closing the two jaws, and FIGS. 54 and 55 show the process for stapling and cutting the tissue interposed between the two jaws.

[0473] First, the wire operation of the actuation operation will be described.

[0474] Referring to Figures 53 and 54, when the first actuation extension 252 of the first actuation operating unit 251 rotates in the direction of arrow OPA1 around the rotation axis 241, the pulley 210 connected to the first actuation extension 252 rotates, causing the wire (see 301 in Figure 49) and wire (see 305 in Figure 49) wound around the pulley 210 to move, resulting in the first jaw 2101 of the end tool 2100 rotating in the direction of arrow EPA1.

[0475] At this time, the operation portion staple pulley 269 of the staple operation portion 260 is formed to be rotatable around the rotation shaft 241 together with the first actuation operation portion 251. Therefore, when the first actuation extension portion 252 rotates around the rotation shaft 241, the staple operation portion 260 also rotates around the rotation shaft 241 together with the first actuation operation portion 251.

[0476] As a result, when the pulley 111 rotates on the end tool 2100 during actuation, the staple pulley 161 also rotates together with the pulley 111 .

[0477] The wire action of the stapling and cutting operation will now be described.

[0478] Referring to Figure 55(a), when the staple operating unit 260 is rotated in the direction of arrow OPC1 around the rotation axis 247, which is the operating unit cutting rotation axis, the operating unit staple pulley 269 and the wires 307 and 308, which are the first staple wires wound thereon, rotate around the rotation axis 247, and as a result, the wires 307 and 308 wound around the operating unit staple pulley 269 move, respectively, and as a result, the first staple pulley 2181 of the end tool 2100 rotates in the direction of arrow EPC1.

[0479] Referring to Figure 55(b), when the staple operating unit 260 is rotated in the direction of arrow OPC1 around the rotation axis 247, which is the operating unit cutting rotation axis, the operating unit staple pulley 269 and the second staple wires 309 and 310 wound thereon rotate around the rotation axis 247, and as a result, the wires 309 and 310 wound around the operating unit staple pulley 269 move, and as a result, the second staple pulley 2191 of the end tool 2100 rotates in the direction of arrow EPC1.

[0480] On the other hand, when the staple operating portion 260 rotates, the operating portion staple pulley 269 rotates about the rotation axis 247 , and at this time, the rotation of the staple operating portion 260 does not affect the first actuation operating portion 251 .

[0481] As a result, when the operating portion staple pulley 269 rotates, the first staple pulley 2181 and the second staple pulley 2191 of the end tool 2100 rotate independently of the first jaw 2101. When the first staple pulley 2181 and the second staple pulley 2191 rotate alternately in the clockwise / counterclockwise direction, the staple link assembly 2170 connected to the first staple pulley 2181 and the second staple pulley 2191 and the reciprocating assembly 550 of the cartridge 500 connected thereto perform reciprocating linear motion, whereby the working member 540 of the cartridge 500 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0482] At this time, as described above, the first staple pulley 2181 and the second staple pulley 2191 can rotate in opposite directions to each other. For example, when the staple operating portion 260 rotates in one direction, the first staple pulley 2181 rotates clockwise and the second staple pulley 2191 rotates counterclockwise, allowing the staple link assembly 2170 to move toward the distal portion 2104 of the end tool 2100. On the other hand, when the staple operating portion 260 rotates in the opposite direction, the first staple pulley 2181 rotates counterclockwise and the second staple pulley 2191 rotates clockwise, allowing the staple link assembly 2170 to move toward the proximal portion 2105 of the end tool 2100.

[0483] Here, in the figures, the staple operating portion 260 is shown as being formed in a bar shape and rotated manually by a user, but the spirit of the present invention is not limited thereto. That is, as described above, the staple operating portion 260 may include a motor (not shown), and while a user presses the staple operating portion 260 formed in a button shape, the motor (not shown) is driven to rotate the operating portion staple pulley 269 alternately in a clockwise or counterclockwise direction. This allows the first staple pulley 2181 and the second staple pulley 2191 of the end tool 2100 to rotate alternately in a clockwise or counterclockwise direction.

[0484] 57, 58, and 59 are views showing the configuration of pulleys and wires associated with the pitch operation of the surgical instrument 2000 according to one embodiment of the present invention shown in FIG. 2, with the first and second jaws disassembled. FIG. 57 shows only the pulleys and wires associated with the second jaw, and FIG. 58 shows only the pulleys and wires associated with the first jaw. FIG. 59 shows only the pulleys and wires associated with the staple pulleys. As shown in FIG. 9 and other figures, there are two pulleys associated with the pitch operation, and both strands of each wire are wound along the same path, which is shown by a single line in FIGS. 57 and 59. FIG. 56 is a perspective view showing the pitch operation of the surgical instrument of FIG. 2. Note that components associated with the stapling and cutting operations have been omitted from FIG. 56.

[0485] 57, when first handle 204 is rotated in the direction of arrow OPP1 around rotation axis 246, pulleys 210, 215, 217, etc., and wire 301 wound thereon, etc., rotate as a whole around rotation axis 246. At this time, wires 301 and 305, which are first jaw wires, are wound above pulleys 217 and 218, as shown in FIG. 57, and therefore move toward the arrow W1 side. As a result, as described with reference to FIG. 5, first jaw 2101 of end tool 2100 rotates in the direction of arrow EPP1.

[0486] 58, when first handle 204 is rotated in the direction of arrow OPP2 around rotation axis 246, pulleys 220, 225, 227, etc., and wire 302 wound thereon, etc., rotate as a whole around rotation axis 246. At this time, wires 302 and 306, which are second jaw wires, are wound below pulleys 227 and 228, as shown in FIG. 58, and therefore move toward the arrow W2 side. As a result, as described with reference to FIG. 5, second jaw 2102 of end tool 2100 rotates in the direction of arrow EPP2.

[0487] 59, when the first handle 204 is rotated in the direction of the arrow OPC1 around the rotation shaft 246, the operation section staple pulley 269, pulley 265, pulley 267, etc., and the wires 307 and 308 wound thereon, etc., rotate as a whole around the rotation shaft 246. At this time, the wires 307 and 308, which are the first staple wires, are wound below the pulleys 267 and 268, and therefore move to the side of the arrow W3. As a result, as described with reference to FIG. 5, the first staple pulley 2181 of the end tool 2100 rotates in the direction of the arrow EPC1.

[0488] As a result, during pitching, when the pulley 2111 of the end tool 2100 rotates around the rotation axis 2143 , the first staple pulley 2181 also rotates around the rotation axis 2143 together with the pulley 2111 .

[0489] Therefore, actuation, yaw, and pitch operations can be performed independently of each other.

[0490] As explained with reference to Figure 1, the actuation operation unit 203, yaw operation unit 202, and pitch operation unit 201 have their rotation axes located behind each operation unit, and are configured in the same manner as the joint configuration of the end tool, allowing the user to intuitively perform the same operations.

[0491] In particular, the surgical instrument 2000 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), and a wire (first jaw wire or second jaw wire) is wound around this pulley, and rotational operation of the operating unit (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, thereby inducing a desired operation of the end tool 2100. Furthermore, 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, prevent the wires wound around the pulleys from contacting each other, and safely form a path for the wire being wound around the pulley and the wire being unwound, thereby improving the safety and efficiency of power transmission of the wire.

[0492] On the other hand, as described above, the yaw operation unit 202 and the actuation operation unit 203 are formed directly on the first handle 204. Therefore, when the first handle 204 rotates around 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 system of the yaw operation unit 202 and the actuation operation unit 203 is not fixed, but continues to change relatively as the first handle 204 rotates. That is, in FIG. 2 and other figures, the yaw operation unit 202 and the actuation operation unit 203 are shown as being parallel to the Z axis. However, when the first handle 204 rotates, the yaw operation unit 202 and the actuation operation unit 203 are no longer parallel to the Z axis. That is, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 changes in response to the rotation of the first handle 204. However, for the sake of convenience, unless otherwise specified, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 is described in this specification based on the state in which the first handle 204 is positioned perpendicular to the connecting unit 400, as shown in Figure 2.

[0493] (Correlation of stapling and cutting operations with other operations)

[0494] The correlation between the stapling and cutting motions and the other motions (pitch, yaw and actuation motions) is described below.

[0495] First, during the pitch movement of the end tool 2100, the first staple pulley 2181 and the second staple pulley 2191 also perform a pitch movement. That is, when the pulley 2111 and the pulley 2121 perform a pitch movement in which they rotate in the same direction around the rotation shaft 2143, the first staple pulley 2181 and the second staple pulley 2191 must also rotate in the same direction together with the pulleys 2111 and 2121. If the first staple pulley 2181 and the second staple pulley 2191 do not rotate together when the pulleys 2111 and 2121 rotate around the rotation shaft 2143, there is a risk that the cartridge 500 connected to the first staple pulley 2181 and the second staple pulley 2191 will move relative to the first jaw 2101 and be separated from the first jaw 2101. Furthermore, rotation of the first staple pulley 2181 and the second staple pulley 2191 out of synchronization with the pulley 2111 can cause unintended advancement of the reciprocating member 551, which can result in unintended stapling.

[0496] Next, when the end tool 2100 yaws, the first staple pulley 2181 and the second staple pulley 2191 also yaw. That is, when the pulley 2111 and the pulley 2121 perform a yaw motion in which they rotate in the same direction around the rotation shaft 2141, the first staple pulley 2181 and the second staple pulley 2191 must also rotate in the same direction as the pulleys 2111 and 2121. If the first staple pulley 2181 and the second staple pulley 2191 do not rotate together when the pulleys 2111 and 2121 rotate around the rotation shaft 2141, there is a risk that the cartridge 500 connected to the first staple pulley 2181 and the second staple pulley 2191 will move relatively to the first jaw 2101 and be separated from the first jaw 2101. Furthermore, rotation of the first staple pulley 2181 and the second staple pulley 2191 out of synchronization with the pulley 2111 can cause unintended advancement of the reciprocating member 551, which can result in unintended stapling.

[0497] Next, during an actuation operation of the end tool 2100, the first staple pulley 2181 and the second staple pulley 2191 rotate together with the pulley 2111. That is, when the pulley 2111 and the pulley 2121 perform an actuation movement in which they rotate in opposite directions about the rotation shaft 2141, the first staple pulley 2181 and the second staple pulley 2191 must rotate together with the pulley 2111. If the first staple pulley 2181 and the second staple pulley 2191 do not rotate together when the pulley 2111 rotates about the rotation shaft 2143, there is a risk that the cartridge 500 connected to the first staple pulley 2181 and the second staple pulley 2191 will move relatively to the first jaw 2101 and be separated from the first jaw 2101. Furthermore, rotation of the first staple pulley 2181 and the second staple pulley 2191 out of synchronization with the pulley 2111 can cause unintended advancement of the reciprocating member 551, which can result in unintended stapling.

[0498] On the other hand, the pulley 2111 and the pulley 2121 do not rotate during the stapling and cutting operations of the end tool 2100. In other words, if the link member 2171 and the reciprocating member 551 of the cartridge 500 connected thereto perform linear reciprocating motion while the first staple pulley 2181 and the second staple pulley 2191 rotate about the rotation shaft 2141, the pulley 2111 and the pulley 2121 must not rotate. Otherwise, the first jaw 2101 or the second jaw 2102 would rotate during the stapling and cutting operations, preventing the stapling and cutting operations from being performed normally.

[0499] As a result, when the pulley 2111, which is the first jaw pulley, rotates, the first staple pulley 2181 and the second staple pulley 2191 housed inside the first jaw 2101 must also rotate together with the pulley 2111. On the other hand, when the first staple pulley 2181 and the second staple pulley 2191 rotate for stapling and cutting, the pulleys 2111 and 2121 must be configured to maintain their positions without rotating. The correlation between such stapling and cutting operations and other operations (yaw operation and actuation operation) has been described above.

[0500] From another perspective, this can be expressed as the pulley 2111 and the pulley 2121 being independent of the rotation of the first staple pulley 2181 and the second staple pulley 2191. In other words, even if the first staple pulley 2181 and the second staple pulley 2191 are rotated by the staple wire, the pulleys 2111 and 2121 do not have to rotate. Conversely, the first staple pulley 2181 and the second staple pulley 2191 can be expressed as being dependent on the rotation of the pulley 2111. In other words, when the pulley 2111 is rotated by the jaw wire, the first staple pulley 2181 and the second staple pulley 2191 can also be formed to rotate together with the pulley 2111.

[0501] Figures 60 and 62 are diagrams showing a state in which the jaw has yaw rotated by -90°, and Figures 61 and 63 are diagrams showing the process of performing an actuation operation in a state in which the jaw has yaw rotated by -90°. Here, Figures 60 and 61 are diagrams showing the pulley 2111, and Figures 62 and 63 are diagrams in which the pulley 2111 is omitted.

[0502] Figures 64 and 66 are diagrams showing a state in which the jaw has yaw rotated by +90°, and Figures 65 and 67 are diagrams showing the process of performing an actuation operation in a state in which the jaw has yaw rotated by +90°. Here, Figures 64 and 65 are diagrams showing the pulley 2111, and Figures 66 and 67 are diagrams in which the pulley 2111 is omitted.

[0503] As shown in Figures 60 to 67, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal actuation even when the jaw is yaw rotated by +90° or -90°.

[0504] 68 and 69 are plan views showing the stapling and cutting operations of the endotool of the surgical instrument of Fig. 2, illustrating the process of performing the stapling and cutting operations with the jaw rotated by +90° in a yaw direction. As shown in Fig. 68, the endotool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal stapling and cutting operations even with the jaw rotated by +90° in a yaw direction.

[0505] In detail, when the first staple pulley 2181 rotates alternately clockwise and counterclockwise in a state in which the pulley 2111, the pulley 2121, and the first staple pulley 2181 have rotated +90° around the rotation shaft 2141, the link member 2171 and the reciprocating member 551 connected thereto repeatedly move forward and backward. 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 remains stationary. While repeating this process, the working member 540 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0506] 70 and 71 are plan views showing the stapling and cutting operations of the endotool of the surgical instrument of Fig. 2, illustrating the process of performing the stapling and cutting operations with the jaws rotated by -90° in a yaw direction. As shown in Fig. 70, the endotool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal stapling and cutting operations even with the jaws rotated by -90° in a yaw direction.

[0507] In detail, when the first staple pulley 2181 rotates alternately clockwise and counterclockwise in a state in which the pulley 2111, the pulley 2121, and the first staple pulley 2181 are rotated −90° around the rotation shaft 2141, the link member 2171 and the reciprocating member 551 connected thereto repeatedly move forward and backward. 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 remains stationary. While repeating this process, the working member 540 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0508] Figure 72 shows a state in which the jaw has been pitch-rotated by -90°, Figure 73 shows a process of performing an actuation operation in which the jaw has been pitch-rotated by -90°, Figure 74 shows a state in which the jaw has been pitch-rotated by +90°, and Figure 75 shows a process of performing an actuation operation in which the jaw has been pitch-rotated by +90°.

[0509] 72 to 75, it can be seen that the operations of the operating unit 200 and the end tool 2100 intuitively match when performing pitch operation. That is, when the operating unit 200 rotates in the positive direction based on the pitch rotation axis (Y axis), the end tool 2100 also rotates in the positive direction based on the pitch rotation axis (Y axis). Also, when the operating unit 200 rotates in the negative direction based on the pitch rotation axis (Y axis), the end tool 2100 also rotates in the negative direction based on the pitch rotation axis (Y axis). Here, the rotation angles of the operating unit 200 and the end tool 2100 can be set in various ways depending on the ratio of the pulleys.

[0510] Figure 76 shows a state in which the jaw has yaw rotated by +90°, Figure 77 shows a process of performing an actuation operation in which the jaw has yaw rotated by +90°, Figure 78 shows a state in which the jaw has yaw rotated by -90°, and Figure 79 shows a process of performing an actuation operation in which the jaw has yaw rotated by -90°.

[0511] 76 to 79, it can be seen that the operations of the operating unit 200 and the end tool 2100 intuitively match when performing yaw operation. That is, when the operating unit 200 rotates in the positive direction based on the yaw rotation axis (Z axis), the end tool 2100 also rotates in the positive direction based on the yaw rotation axis (Z axis). Also, when the operating unit 200 rotates in the negative direction based on the yaw rotation axis (Z axis), the end tool 2100 also rotates in the negative direction based on the yaw rotation axis (Z axis). Here, the rotation angles of the operating unit 200 and the end tool 2100 can be set in various ways depending on the ratio of the pulleys.

[0512] Figure 80 is a diagram showing a state in which the jaw has pitch rotated by -90° and simultaneously rotated in yaw by +90°, Figure 81 is a diagram showing a process of performing an actuation operation in which the jaw has pitch rotated by -90° and simultaneously rotated in yaw by +90°, Figure 82 is a diagram showing a state in which the jaw has pitch rotated by +90° and simultaneously rotated in yaw by -90°, and Figure 83 is a diagram showing a process of performing an actuation operation in which the jaw has pitch rotated by +90° and simultaneously rotated in yaw by -90°.

[0513] 80 to 83, it can be seen that the operations of the operating unit 200 and the end tool 2100 intuitively match even when pitch and yaw operations are performed simultaneously.

[0514] <One variation - pin slot type>

[0515] An endotool 2200 of a surgical instrument according to one modified example of the present invention will be described below. Here, the endotool 2200 of a surgical instrument according to one modified example of the present invention is characterized by different configurations of a staple pulley assembly 2260 and a staple link assembly 2270 compared to the endotool 100 of a surgical instrument according to the first embodiment of the present invention described above (see FIG. 2 etc.). Such configurations that differ from the first embodiment will be described in detail below.

[0516] Figures 84 and 85 are perspective views showing an end tool of a surgical instrument according to one variation of the present invention. Figures 86 and 87 are exploded perspective views of the end tool of the surgical instrument of Figure 84. Figures 88 and 89 are exploded perspective views showing a staple pulley assembly and a staple link assembly of the surgical instrument of Figure 84. Figures 90 and 91 are side views showing the operating state of the staple pulley of the end tool of the surgical instrument of Figure 84. Figures 92 and 93 are perspective views showing the operating state of the staple pulley of the end tool of the surgical instrument of Figure 84. Here, Figure 85 shows a state in which the end tool hub has been removed.

[0517] 84 to 93, an end tool 2200 according to a modified example of the present invention includes a pair of jaws 2203 for performing a gripping operation, namely, a first jaw 2201 and a second jaw 2202. Here, each of the first jaw 2201 and the second jaw 2202, or a component including the first jaw 2201 and the second jaw 2202, can be referred to as a jaw.

[0518] On the other hand, the end tool 2200 includes a plurality of pulleys including a pulley 2211 and a pulley 2212 that are related to the rotational movement of the first jaw 2201. In this embodiment, the pulleys that are related to the rotational movement of the first jaw 2201 are substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in FIG. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0519] On the other hand, the end tool 2200 includes a plurality of pulleys including a pulley 2221 and a pulley 2222 that are related to the rotational movement of the second jaw 2202. The pulleys related to the rotational movement of the second jaw 2202 in this embodiment are substantially the same as the pulleys 121, 122, 123, 124, 125, and 126 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0520] Furthermore, the end tool 2200 of one modified example of the present invention may include a rotation shaft 2241, a rotation shaft 2242, a rotation shaft 2243, and a rotation shaft 2244. Here, the rotation shafts 2241 and 2242 may be inserted through the end tool hub 2206, and the rotation shafts 2243 and 2244 may be inserted through the pitch hub 2207. The rotation shafts 2241, 2242, 2243, and 2244 may be arranged sequentially from the distal end 2204 of the end tool 2200 toward the proximal end 2205.

[0521] Additionally, the end tool 2200 of one variation of the present invention may include an end tool hub 22802206 and a pitch hub 2207.

[0522] The end tool hub 2280 has the rotating shaft 2241 and the rotating shaft 2242 inserted therethrough, and the pulley 2211 and the pulley 2221 axially coupled to the rotating shaft 2241, and at least a portion of the first jaw 2201 and the second jaw 2202 coupled thereto, may be housed inside the end tool hub 2280.

[0523] The rotation shaft 2243 and the rotation shaft 2244 are inserted through the pitch hub 2207, and the pitch hub 2207 can be axially coupled to the end tool hub 2280 by the rotation shaft 2243. Therefore, the end tool hub 2280 can be formed to be pitch rotatable relative to the pitch hub 2207 around the rotation shaft 2243.

[0524] On the other hand, an end tool 2200 according to one variation of the present invention may further include components such as a staple pulley assembly 2260 and a staple drive assembly (see 150 in FIG. 15) including a staple link assembly 2270 to perform stapling and cutting operations.

[0525] Staple pulley assembly 2260 can be formed adjacent to pulley 2211 and pulley 2221 between pulley 2211 and pulley 2221. In the present embodiment, it is assumed that staple pulley assembly 2260 includes a first staple pulley 2281 and a second staple pulley 2291.

[0526] In one variation of the present invention, a staple pulley assembly 2260 is disposed between the first jaw pulley, pulley 2211, and the second jaw pulley, pulley 2221, thereby enabling the stapling and cutting operations to be performed using the cartridge 2210 along with the pitch and yaw movements of the end tool 2200.

[0527] The staple pulley assembly 2260, staple link assembly 2270, and reciprocating assembly 2250 of the end tool 2200 of the surgical instrument according to one variation of the present invention will be described in more detail below.

[0528] The end tool 2200 of the surgical instrument according to one modification of the present invention is characterized in that the staple pulley assembly 2260 and the staple link assembly 2270 form a pin slot structure. This configuration has the effect of amplifying the force that advances the reciprocating assembly 550.

[0529] 84 to 93, etc., staple pulley assembly 2260 can include a first staple pulley 2281 and a second staple pulley 2291.

[0530] The first staple pulley 2281 can include a main body 2281a, a protruding member 2281b, and a shaft penetrating portion 2281c.

[0531] The main body 2281a is formed in a disk shape.

[0532] A shaft through-hole 2281c can be formed in the center of the main body 2281a. The shaft through-hole 2281c is formed in a hole shape, and the rotation shaft 2241, which is the end tool jaw pulley rotation shaft, can be inserted through the shaft through-hole 2281c.

[0533] Furthermore, a protruding member 2281b may be formed on the main body 2281a of the first staple pulley 2281. The protruding member 2281b can be coupled to a link member 2271 of the staple link assembly 2270. Here, the protruding member 2281b is formed in a pin shape and can be fitted into a first slot 2272d of the link member 2271, which will be described later.

[0534] On the other hand, the second staple pulley 2291 can include a main body 2291a, a protruding member 2291b, and a shaft penetrating portion 2291c.

[0535] The main body 2291a is formed in a disk shape.

[0536] A shaft through-hole 2291c can be formed in the center of the main body 2291a. The shaft through-hole 2291c is formed in a hole shape, and the rotation shaft 2241, which is the rotation shaft of the end tool jaw pulley, can be inserted through the shaft through-hole 2291c.

[0537] Furthermore, a protruding member 2291b may be formed on the main body 2291a of the second staple pulley 2291. The protruding member 2291b can be coupled to a link member 2271 of the staple link assembly 2270. Here, the protruding member 2291b is formed in a pin shape and can be fitted into a second slot 2272e of the link member 2271, which will be described later.

[0538] Meanwhile, the end tool 2200 of one variation of the present invention may further include a staple link assembly 2270 connected to the staple pulley assembly 2260, and the staple link assembly 2270 may include a link member 2271. Here, the staple link assembly 2270 may serve to connect the staple pulley assembly 2260 and a reciprocating assembly (see 550 in FIG. 28 ) of the cartridge (see 500 in FIG. 28 ).

[0539] This embodiment is characterized in that staple link assembly 2270 includes one link member 2271, and link member 2271 includes only one link. In other words, staple pulley assembly 2260 and staple link assembly 2270 are coupled by a pin and slot structure, so that even when staple link assembly 2270 includes only one link, the rotational movement of staple pulley assembly 2260 can be converted into linear movement of staple link assembly 2270.

[0540] In particular, the link member 2271 may be formed of a single link.

[0541] The link member 2271 may be formed in a substantially L-shape by combining a thin and long bar with an oval flat plate, and may include a first protrusion 2272a, a second protrusion 2272b, a fastening portion 2272c, a first slot 2272d, and a second slot 2272e.

[0542] A first protrusion 2272a and a second protrusion 2272b may be formed in one region of the center of the link member 2271. The first protrusion 2272a and the second protrusion 2272b can be fitted into the guide groove 2201b of the first jaw 2201.

[0543] In this manner, with the first protrusion 2272a and the second protrusion 2272b of the link member 2271 formed in a protrusion shape fitted into the groove-shaped guide groove 2201b, the first protrusion 2272a and the second protrusion 2272b move along the guide groove 2201b, causing the link member 2271 to move relative to the first jaw 2201 (and the cartridge 500 therein). This will be described in more detail later.

[0544] Meanwhile, a fastening portion 2271c may be formed at one end of the link member 2271. This fastening portion 2272c can be coupled with a fastening portion (see 551a in FIG. 28) of a reciprocating member (see 551 in FIG. 28) of a cartridge (see 500 in FIG. 28).

[0545] Meanwhile, a first slot 2171d and a second slot 2171e may be formed at the end of the link member 2171 opposite to the end where the fastening portion 2171c is formed.

[0546] Specifically, a first slot 2171d may be formed on a surface of the link member 2171 facing the first staple pulley 2181. Here, the first slot 2171d is formed in the shape of an elongated hole, into which the protruding member 2181b of the first staple pulley 2181 can be fitted. The first slot 2171d may be formed to have a predetermined curvature and may be formed in a substantially elliptical shape. Here, the minor radius of the first slot 2272d may be formed to be substantially the same as or slightly larger than the radius of the protruding member 2281b. Meanwhile, the major radius of the first slot 2272d may be formed to be larger than the radius of the protruding member 2281b. Therefore, when the protruding member 2281b of the first staple pulley 2281 is fitted in the first slot 2272d of the link member 2271, the protruding member 2281b is formed to be able to move within the first slot 2272d to a certain extent.

[0547] Here, the first slot 2272d may be formed obliquely rather than concentrically. Therefore, when the first staple pulley 2281 rotates, the protruding member 2281b can push the first slot 2272d while in contact with the first slot 2272d, thereby moving the link member 2271. In other words, when the first staple pulley 2281 rotates, the protruding member 2281b moves within the first slot 2272d while in contact with the first slot 2272d, thereby allowing the link member 2271 to move linearly along the guide groove 2201b of the first jaw 2201.

[0548] Here, the first slot 2271d may be formed so as to penetrate approximately half of the total thickness of the link member 2271, rather than penetrating the entire thickness of the link member 2271. From another perspective, the first slot 2271d can be formed to have substantially the same thickness as the thickness of the protruding member 2281b of the first staple pulley 2281.

[0549] Meanwhile, a second slot 2271e may be formed in the link member 2271. Specifically, the second slot 2271e may be formed in a surface of the link member 2271 facing the second staple pulley 2191. Here, the second slot 2271e is formed in the shape of an elongated hole, into which the protruding member 2291b of the second staple pulley 2291 can be fitted. The second slot 2271e is formed to have a predetermined curvature, and may be formed in a substantially elliptical shape.

[0550] Here, the minor radius of the second slot 2272e may be formed to be substantially the same as or slightly larger than the radius of the protruding member 2291b. Meanwhile, the major radius of the second slot 2272e may be formed to be larger than the radius of the protruding member 2291b. Therefore, when the protruding member 2291b of the second staple pulley 2291 is fitted into the second slot 2272e of the link member 2271, the protruding member 2291b is configured to be able to move within the second slot 2272e to a certain extent.

[0551] As described above, the second slot 2272e can be formed obliquely rather than concentrically. Therefore, when the second staple pulley 2291 rotates, the protruding member 2291b can push the second slot 2272e while in contact with the second slot 2272e, thereby moving the link member 2271. In other words, when the second staple pulley 2291 rotates, the protruding member 2291b moves within the second slot 2272e while in contact with the second slot 2272e, thereby allowing the link member 2271 to move linearly along the guide groove 2201b of the first jaw 2201.

[0552] Here, the second slot 2271e may be formed so as to penetrate approximately half of the total thickness of the link member 2271, rather than penetrating the entire thickness of the link member 2271. From another perspective, the second slot 2271e can be formed to have substantially the same thickness as the thickness of the protruding member 2291b of the second staple pulley 2291.

[0553] Here, the first slot 2271d and the second slot 2271e may be formed to at least partially overlap each other, and the sum of the thicknesses of the first slot 2271d and the second slot 2271e in the Y-axis direction may be formed to be approximately equal to the thickness of the link member 2271 in the Y-axis direction.

[0554] Here, the first slot 2271d and the second slot 2271e may be formed symmetrically in the up and down direction with respect to the rotation shaft 2241. In this way, since the first slot 2271d and the second slot 2271e are formed symmetrically in the up and down direction with respect to the rotation shaft 2241, the protruding member 2281b of the first staple pulley 2281 coupled to the link member 2271 and the protruding member 2291b of the second staple pulley 2291 can also be arranged symmetrically with respect to each other. This will be described in more detail later.

[0555] (Displacement and movement of staple link assembly due to rotation of staple pulley)

[0556] The displacement of the staple link assembly 2270 due to the rotation of the first staple pulley 2281 and the second staple pulley 2291 will be described below.

[0557] 88, in one modified example of the present invention, the first staple pulley 2281 and the staple link assembly 2270 are coupled in a pin and slot form. That is, a pin-shaped protruding member 2281b formed on the first staple pulley 2281 is coupled to a first slot 2271d formed on the link member 2271. Therefore, when the first staple pulley 2281 rotates in the direction of arrow A, the displacement of the protruding member 2281b of the first staple pulley 2281 in the X-axis direction is B. Then, the displacement of the staple link assembly 2270 in the X-axis direction is C.

[0558] 89, in the first embodiment of the present invention, the second staple pulley 2291 and the staple link assembly 2270 are coupled in a pin and slot form. That is, a fin-shaped protruding member 2291b formed on the second staple pulley 2291 is coupled to a second slot 2271e formed on the link member 2271. Therefore, when the second staple pulley 2291 rotates in the direction of arrow D, the displacement of the protruding member 2291b of the second staple pulley 2291 in the X-axis direction is E. Then, the displacement of the staple link assembly 2270 in the X-axis direction is F.

[0559] In comparison, when the staple pulley and the staple link assembly are connected by a link shaft rather than by a pin and slot connection, the displacement of the staple link assembly in the X-axis direction becomes much longer compared to one variant of the present invention.

[0560] In other words, compared to when the staple pulley and staple link assembly are axially connected, when the staple pulley and staple link assembly are pin-slot connected as in this embodiment, the displacement of the staple link assembly in the X-axis direction is reduced even if the staple pulley rotates the same amount.

[0561] On the other hand, since work is the product of force and displacement, if we assume that the work of rotating the staple pulley is the same, displacement and force are inversely proportional to each other. Therefore, if displacement decreases, force increases inversely proportional to it.

[0562] As a result, in one modified example of the present invention, the first staple pulley 2281 and the second staple pulley 2291 are each connected to the staple link assembly 2270 in a pin and slot form, and the displacement of the staple link assembly 2270 in the X-axis direction due to the rotation of the first staple pulley 2281 and the second staple pulley 2291 is relatively reduced compared to other embodiments, so the force that the staple link assembly 2270 receives in the X-axis direction is relatively increased compared to a simple link structure.

[0563] This variation of the present invention provides the effect of amplifying the force that advances staple link assembly 2270 and associated shuttle assembly 550, thereby providing a stronger stapling effect.

[0564] In particular, in one modified example of the present invention, two staple pulleys (i.e., the first staple pulley 2281 and the second staple pulley 2291) that are symmetrical to each other are provided, and therefore the force with which the staple pulley assembly 2260 presses the staple link assembly 2270 can be amplified by approximately twice as much as when only one staple pulley is provided. Furthermore, since the first staple pulley 2281 and the second staple pulley 2291 are disposed symmetrically to each other on the left and right with respect to the XZ plane, left and right balance is achieved when stapling, and an effect can be obtained in which the end tool 2200 operates stably without shaking from side to side as a whole.

[0565] The rotation directions of the first staple pulley 2281 and the second staple pulley 2291 will be described below.

[0566] Referring to Figures 90, 91, 92, and 93, the first staple pulley 2281 advances the staple link assembly 2270 when rotated in the direction of arrow A in Figure 93 (i.e., clockwise), and the second staple pulley 2291 advances the staple link assembly 2270 when rotated in the direction of arrow D in Figure 93 (i.e., counterclockwise).

[0567] Conversely, the first staple pulley 2281 retracts the staple link assembly 2270 when rotated counterclockwise, and the second staple pulley 2291 retracts the staple link assembly 2270 when rotated clockwise.

[0568] As a result, when the first staple pulley 2281 and the second staple pulley 2291 rotate in opposite directions, the staple link assembly 2270 moves (forward or backward). Conversely, when the first staple pulley 2281 and the second staple pulley 2291 rotate in the same direction, the rotations of the two pulleys cancel each other out, and the staple link assembly 2270 does not move.

[0569] As a result, in the state shown in Figure 92, when the first staple pulley 2281 rotates clockwise and the second staple pulley 2291 rotates counterclockwise, the link member 2271 connected to the first staple pulley 2281 and the second staple pulley 2291 can move as a whole toward the distal portion of the first jaw 2201 (see 2101f in Figure 13).

[0570] Conversely, when the first staple pulley 2281 rotates counterclockwise and the second staple pulley 2291 rotates clockwise, the link member 2271 connected to the first staple pulley 2281 and the second staple pulley 2291 can move as a whole toward the proximal portion of the first jaw 2201 (see 2101g in Figure 13).

[0571] Thus, bidirectional rotational motion of staple pulley assembly 2260 can cause reciprocating linear motion of a reciprocating assembly (see 550 in FIG. 28) of the cartridge (see 500 in FIG. 28) via staple link assembly 2270.

[0572] Although the present invention has been described with reference to one embodiment shown in the drawings, it is understood that this is merely an example, and that various modifications and variations of the embodiment are possible by those skilled in the art. Therefore, the true technical scope of protection of the present invention should be determined by the technical spirit of the appended claims. [Industrial Applicability]

[0573] The present invention relates to an end tool of a surgical instrument and a surgical instrument equipped with the same, and in particular to a surgical instrument that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various other surgeries, and can be used in a surgical instrument equipped with an end tool that can rotate in two or more directions and operates in a manner that intuitively matches the operation of the operating part, and a surgical instrument equipped with the same.

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 configured to be rotatable around 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, the second jaw pulley being spaced apart from the first jaw pulley by a certain distance; a staple drive assembly including a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a first staple wire that contacts at least a portion of the first staple pulley to transmit a driving force required for rotating the first staple pulley to the first staple pulley; a second staple wire that contacts at least a portion of the second staple pulley to transmit a driving force required for rotating the second staple pulley to the second staple pulley, The end tool of a surgical instrument, characterized in that the staple drive assembly is connected to a reciprocating assembly of the cartridge, and rotational motion of the first staple pulley and the second staple pulley is converted into linear motion of the reciprocating assembly.

2. 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; 2. The end tool of a surgical instrument according to claim 1, wherein at least a portion of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

3. 3. The end tool of the surgical instrument according to claim 2, wherein the first shaft is inserted through the first jaw pulley connection portion, the first jaw pulley, the first staple pulley, the second staple pulley, the second jaw pulley, and the second jaw pulley connection portion in that order.

4. 3. The end tool of a surgical instrument according to claim 2, wherein the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are stacked in order within the end tool hub.

5. 3. The end tool of the surgical instrument according to claim 2, wherein the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are formed to be rotatable independently of each other.

6. The end tool of the surgical instrument according to claim 2 , further comprising a first staple assist pulley disposed between the first staple pulley and the guide portion.

7. 7. The end tool of a surgical instrument according to claim 6, wherein the first staple wire is located on a common inscribed line of the first staple pulley and the first staple assist pulley, and the rotation angle of the first staple pulley is expanded by the first staple assist pulley.

8. The surgical instrument end tool of claim 1 , wherein the staple drive assembly includes a staple link assembly connecting the first and second staple pulleys to the reciprocating assembly.

9. The staple link assembly includes: The end tool of a surgical instrument according to claim 8 , further comprising link members respectively connecting the first staple pulley, the second staple pulley, and the reciprocating assembly.

10. The first staple pulley is formed with a first protruding member, The second staple pulley is formed with a second protruding member, The link member has a first slot to which the first protruding member is coupled and a second slot to which the second protruding member is coupled, When the first staple pulley rotates, the first protruding member moves within the first slot while contacting the first slot; 10. The end tool of a surgical instrument according to claim 9, wherein when the second staple pulley rotates, the second protruding member moves within the second slot while contacting the second slot.

11. the first slot and the second slot are formed symmetrically to each other on the link member, When the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, 11. The end tool of a surgical instrument according to claim 10, wherein when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

12. When the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, The end tool of a surgical instrument according to claim 8, wherein the staple link assembly connected to the first staple pulley or the second staple pulley alternately moves toward the distal side and the proximal side of the end tool.

13. The end tool of a surgical instrument according to claim 8, characterized in that the staple link assembly converts bidirectional rotational motion of the first staple pulley or the second staple pulley into reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

14. The first jaw has a guide groove formed along its longitudinal direction, The end tool of a surgical instrument according to claim 8, wherein the staple link assembly moves along the guide groove.

15. a jaw rotation axis that is inserted through the first jaw and the second jaw and serves as a rotation center between 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 a rotation center of the first jaw pulley and the second jaw pulley, 2. The end tool of the surgical instrument according to claim 1, wherein 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.

16. When the first jaw and the second jaw are closed, the jaw axis of rotation moves toward a distal portion of the end tool; The surgical instrument endotool of claim 15, wherein when the first jaw and the second jaw open, the jaw axis of rotation moves toward a proximal portion of the endotool.

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

18. The end tool of the surgical instrument according to claim 17, wherein the end tool is configured to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

19. a first jaw wire at least partially wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys; The surgical instrument end tool according to claim 17, further comprising a second jaw wire at least partially wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

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