End tool of surgical instrument and electric ablation surgical instrument including the same

Abstract

To provide an electric ablation surgical instrument including an end tool that is rotatable in two or more directions and operates so as to intuitively match with operation of an operation part.SOLUTION: An end tool of a surgical instrument includes: a first jaw and a second jaw each independently rotatable; a first jaw pulley connected to the first jaw; a second jaw pulley connected to the second jaw; an end tool hub having one end to which a first rotation shaft is inserted and penetrates therethrough and the other end to which a third rotation shaft different from the first rotation shaft is inserted and penetrates therethrough, and storing at least a part of the first jaw pulley and the second jaw pulley therein; a blade formed so as to be at least partially stored inside the first jaw or the second jaw; a guide tube formed so as to penetrate the end tool hub and extending to the blade side; and a blade wire that has one end connected to the blade and transmits a drive force necessary for movement of the blade to the blade.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present invention relates to an end tool of a surgical instrument and an electrocautery surgical instrument, 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. [Background technology]

[0002] Surgery often requires the cutting and joining of bodily tissues, including organs, muscle tissue, connective tissue, and blood vessels. For centuries, sharp blades and sutures have been used for cutting and joining. However, cutting bodily tissues during surgery, especially relatively highly vascularized tissues, can result in bleeding. Therefore, physicians have needed surgical instruments and methods to slow or reduce bleeding during surgery.

[0003] In recent years, electrosurgical instruments have become available that use electrical energy to perform certain surgical procedures. For example, electrosurgical instruments have been developed that include one or more electrodes configured to receive electrical energy in surgical instruments such as graspers, scissors, tweezers, blades, needles, and hooks. The electrical energy delivered via the electrodes can be used to coagulate, join, or cut tissue in a patient's body. In particular, when using electrical energy, cutting and hemostasis can also be achieved simultaneously.

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

[0005] 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]

[0006] The present invention aims to provide an electrocautery surgical instrument that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various other surgical procedures, 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. [Means for solving the problem]

[0007] (Second embodiment of electrocautery surgical instrument - X-shaped structure formed between first jaw and second jaw)

[0008] Fig. 41 is a perspective view showing an electrocautery surgical instrument according to a second embodiment of the present invention, Figs. 42 to 47 are views showing an end tool of the electrocautery surgical instrument of Fig. 41.

[0009] Referring to FIG. 41, an electrocautery surgical instrument 10 according to a second embodiment of the present invention includes an end tool 700, an operating section 200, a power transmission section 300, and a connecting section 400.

[0010] The electrocautery surgical instrument 10 according to the second embodiment of the present invention differs from the electrocautery surgical instrument 10 according to the first embodiment in the configuration of the end tool 700, and therefore the configuration of the end tool 700 will be described in detail below.

[0011] An end tool 700 is formed on the other end of the connecting portion 400, and is inserted into the surgical site to perform the operations required for the surgery. As an example of such an end tool 700, a pair of jaws 703 for performing a gripping operation can be used, as shown in FIG.

[0012] However, the concept of the present invention is not limited thereto, and various surgical devices may be used as the endotool 700. For example, a single-arm cautery or other configuration may also be used as the endotool 700. Such an endotool 700 is connected to the operating unit 200 by the power transmission unit 300, and the driving force of the operating unit 200 is transmitted via the power transmission unit 300 to perform operations required for surgery, such as gripping, cutting, and suturing.

[0013] Here, the end tool 700 of the electrocautery surgical instrument 10 according to the second embodiment of the present invention is configured to be rotatable in at least one direction. For example, the end tool 700 can be configured to perform pitch movement around the Y axis in FIG. 41 and yaw movement and actuation movement around the Z axis in FIG. 41.

[0014] 42 to 47, 55, and 56, an end tool 700 of an electrocautery surgical instrument 10 according to the second embodiment of the present invention has a first jaw 701 formed with a jaw rotation shaft 701e, a tube through-hole 701f, a jaw pulley coupling hole 701d, and a movable coupling hole 701c, and a second jaw 702 that faces the first jaw 701 and can be connected to the first jaw 701 has a shaft through-hole 702e, a movable coupling hole 702c, and a hole 702d that is a jaw pulley coupling hole, through which the rotation shaft 701e formed in the first jaw 701 can pass. Except for this, the end tool 700 has the same configurations and effects as the first electrode 751, the second electrode 752, the pitch hub 750, the end tool hub 760, and the plurality of rotation shafts 741, 743, and 744.

[0015] Figure 48 is a perspective view of the end tool hub of the electrocautery surgical instrument of Figure 41. Figures 49 and 50 are cutaway perspective views of the end tool hub of Figure 48. Figures 51 and 52 are perspective views of the end tool hub of Figure 48. Figure 53 is a side view of the end tool hub and guide tube of Figure 48. Figure 54 is a top view of the end tool hub and guide tube of Figure 48.

[0016] 48 to 54, the end tool hub 760 provided on the end tool 700 of the electrocautery surgical instrument 10 of FIG. 41 has a predetermined radius of curvature on the inner circumferential surface of the end tool hub 760 to allow the guide tube 670 to move in a gentle curved line, and a yaw round portion 767 and a pitch round portion 766 can be formed in a curved surface shape.

[0017] In addition, a yaw slit 765 may be formed on a plane perpendicular to the first rotation axis 741 so that the guide tube 770, which passes through the end tool hub 760 and guides the movement path of the blade 775 and the blade wire 307 connected to the blade 775, can move stably through the end tool hub 760.

[0018] In addition, a pitch slit 764, which is a separation space, can be formed between the opposing first pitch pulley portion 763a and second pitch pulley portion 763b so that the guide tube 670 can pass through, which has the effect of allowing the guide tube 770 to move stably in the pitch slit 764.

[0019] Referring to FIG. 51, together with the yaw slit 765 formed in the end tool hub 760, the yaw rotation shaft 741 can be divided into two to provide a pair, and the guide tube 670 can be moved through the space formed between the pair of halves of the yaw rotation shaft 741.

[0020] Referring to Figures 51 to 54, the end tool hub 760 of the electrocautery surgical instrument according to the second embodiment has the same configuration as the end tool hub 660 of the electrocautery surgical instrument according to the first embodiment, and therefore detailed description thereof will be omitted to the extent that it overlaps.

[0021] Figure 55 is a perspective view showing a first jaw of an endotool of the electrocautery surgical instrument of Figure 41. Figure 56 is a perspective view showing a second jaw of an endotool of the electrocautery surgical instrument of Figure 41.

[0022] Referring to Figure 55, the first jaw 701 of the end tool 700 of the electrocautery surgical instrument of Figure 41 may include a jaw rotation axis 701e formed with a tube through hole 701f and protruding therefrom, a movable coupling hole 701c, and a jaw pulley coupling hole 701d.

[0023] The first jaw 701 is formed in an elongated rod shape overall, and a path through which the blade 775 can move is formed on the distal side (see Figure 55, left side), and a pulley 711, which is the first jaw pulley, is connected to the proximal side (see Figure 55, right side) so that it can rotate around a rotation axis 741.

[0024] 55, a movable coupling hole 701c and a jaw pulley coupling hole 701d may be formed on the proximal side of the first jaw 701. Here, the movable coupling hole 701c may be formed to have a predetermined curvature and may be formed in a substantially elliptical shape.

[0025] A shaft coupling portion 711a formed on the first jaw pulley 711 can be fitted into the movable coupling hole 701c formed in the first jaw 701. Here, the minor radius of the movable coupling hole 701c may be substantially the same as or slightly larger than the radius of the shaft coupling portion 711a.

[0026] 55, the major axis of the movable coupling hole 701c can be larger than the radius of the shaft coupling portion 711a. Therefore, a path can be formed so that the shaft coupling portion 711a can move to a certain extent within the movable coupling hole 701c when the shaft coupling portion 711a of the pulley 711 is fitted into the movable coupling hole 701c of the first jaw 701. This will be described in detail later.

[0027] Referring to FIG. 55, a jaw pulley coupling hole 701d formed in the first jaw 701 is formed in a cylindrical hole shape, and a jaw coupling portion 711b of a pulley 711 can be fitted into the jaw pulley coupling hole 701d.

[0028] Here, the radius of the jaw pulley coupling hole 101d may be substantially the same as or relatively larger than the radius of the jaw coupling portion 711b. Therefore, the jaw coupling portion 711b of the pulley 711 may be formed to be rotatably coupled to the jaw pulley coupling hole 701d of the first jaw 701. This will be described in more detail later.

[0029] 56, the second jaw 702 disposed opposite the first jaw 701 can include a shaft through-portion 702e, a movable coupling hole 702c, and a jaw pulley coupling hole 702d. The second jaw 702 can be formed in an elongated rod shape overall, with the shaft through-portion 702e formed in a distal portion and the jaw pulley coupling hole 702d formed in a proximal portion.

[0030] 59, the movable coupling hole 702c formed in the second jaw 702 may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. The shaft coupling portion 721a of the pulley 721 can be fitted into this movable coupling hole 702c. Here, the minor radius of the movable coupling hole 702c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 721a.

[0031] Meanwhile, the major radius of the movable coupling hole 702c may be formed relatively larger than the radius of the shaft coupling portion 721a. Therefore, the shaft coupling portion 721a is formed to be able to move to a certain extent from the inside of the movable coupling hole 702c when the shaft coupling portion 721a of the pulley 721 is fitted into the movable coupling hole 702c of the second jaw 702. This will be described in more detail later.

[0032] Meanwhile, the jaw pulley coupling hole 702d is formed in a cylindrical hole shape, and the jaw coupling portion 721b of the pulley 721 can be fitted into the jaw pulley coupling hole 702d. Here, the radius of the jaw pulley coupling hole 702d may be substantially the same as or larger than the radius of the jaw coupling portion 721b. Therefore, the jaw coupling portion 721b of the pulley 721 can be rotatably coupled to the jaw pulley coupling hole 702d of the second jaw 702.

[0033] On the other hand, the shaft through-hole 702e may be formed closer to the distal portion of the second jaw 702 than the movable coupling hole 702c and the jaw pulley coupling hole 702d.

[0034] 55 and 56, a shaft through-hole 702e formed in the second jaw 702 is formed in a hole shape, and a jaw rotation shaft 701e formed in the first jaw 701 can be inserted through the shaft through-hole 702e.

[0035] 57, pulley 711, which is a first jaw pulley, may include a shaft coupling portion 711a and a jaw coupling portion 711b. Pulley 711 is generally formed in a rotatable disk shape, and shaft coupling portion 711a and jaw coupling portion 711b may be formed to protrude to a certain extent from one surface (the lower surface, see FIG. 57).

[0036] As described above, the shaft coupling portion 711a of the pulley 711 can be fitted into the movable coupling hole 701c of the first jaw 701, and the jaw coupling portion 711b of the pulley 711 can be fitted into the jaw pulley coupling hole 701d of the first jaw 701. The pulley 711 can be formed to be rotatable around the rotation axis 741, which is the end tool jaw pulley rotation axis.

[0037] Meanwhile, the second jaw pulley, pulley 721, may also include a shaft coupling portion 721a and a jaw coupling portion 721b.

[0038] The second jaw pulley, pulley 721, is generally formed in a rotatable disk shape, and a shaft coupling portion 721a and a jaw coupling portion 721b may be formed on one surface thereof so as to protrude to a certain extent. As described above, the shaft coupling portion 712a of pulley 712 may be fitted into the movable coupling hole 702c of the second jaw 702, and the jaw coupling portion 712b of pulley 712 may be fitted into the jaw pulley coupling hole 702d of the second jaw 702. Pulley 721 may be formed to be rotatable around a rotation axis 741, which is the end tool jaw pulley rotation axis.

[0039] The coupling relationships between the above-mentioned components are as follows:

[0040] A rotation shaft 741, which is the end tool jaw pulley rotation shaft, is inserted through the shaft coupling portion 711a of the pulley 711, the movable coupling hole 701c of the first jaw 701, the movable coupling hole 702c of the second jaw 702, and the shaft coupling portion 721a of the pulley 721 in this order.

[0041] A rotary shaft 701e, which is a jaw rotary shaft, is inserted through a shaft through-hole 702e of the second jaw 702.

[0042] The shaft coupling portion 711 a of the pulley 711 is fitted into the movable coupling hole 701 c of the first jaw 701 , and the jaw coupling portion 711 b of the pulley 711 is fitted into the jaw pulley coupling hole 701 d of the first jaw 701 .

[0043] At this time, the jaw pulley coupling hole 701d of the first jaw 701 and the jaw coupling portion 711b of the pulley 711 are rotatably coupled to each other, and the movable coupling hole 701c of the first jaw 701 and the shaft coupling portion 711a of the pulley 711 are movably coupled to each other.

[0044] The shaft coupling portion 721 a of the pulley 721 is fitted into the movable coupling hole 702 c of the second jaw 702 , and the jaw coupling portion 721 b of the pulley 721 is fitted into the jaw pulley coupling hole 702 d of the second jaw 702 .

[0045] At this time, the jaw pulley coupling hole 702d of the second jaw 702 and the jaw coupling portion 721b of the pulley 721 are rotatably coupled to each other, and the movable coupling hole 702c of the second jaw 702 and the shaft coupling portion 721a of the pulley 721 are movably coupled to each other.

[0046] Here, the pulley 711 and the pulley 721 rotate around a rotation axis 741, which is the end tool jaw pulley rotation axis. The first jaw 701 and the second jaw 702 rotate around a rotation axis 701e, which is the jaw rotation axis. That is, the pulley 711 and the first jaw 701 have different rotation axes. Similarly, the pulley 721 and the second jaw 702 have different rotation axes.

[0047] That is, the first jaw 701 rotates around the rotation axis 701e, which is the jaw rotation axis, although its rotation angle is limited to a certain extent by the movable coupling hole 701c. Similarly, the second jaw 702 rotates around the rotation axis 701e, which is the jaw rotation axis, although its rotation angle is limited to a certain extent by the movable coupling hole 702c.

[0048] The amplification of the grip force due to the coupling relationship between the above-mentioned components will now be described.

[0049] Figure 58 is a plan view showing the opening and closing operation of a first jaw of an endotool of the electrocautery surgical instrument of Figure 41. Figure 59 is a plan view showing the opening and closing operation of a second jaw of an endotool of the electrocautery surgical instrument of Figure 41. Figure 60 is a plan view showing the opening and closing operation of the first and second jaws of the endotool of the electrocautery surgical instrument of Figure 41.

[0050] 58 to 60, the electrocautery surgical instrument 10 according to the second embodiment is characterized in that the coupling structure between the first jaw 701 and the second jaw 702 forms an X-shape, and when the first jaw 701 and the second jaw 702 rotate in a direction toward each other (i.e., when the first jaw 701 and the second jaw 702 are closed), the grip force in the direction in which the first jaw 701 and the second jaw 702 are closed increases. This will be explained in more detail as follows.

[0051] As described above, there are two axes that serve as centers of rotation when first jaw 701 and second jaw 702 are opened and closed.

[0052] That is, the first jaw 701 and the second jaw 702 open and close around two axes, the rotation axis 741 and the rotation axis 701e. At this time, the rotation center of the first jaw 701 and the second jaw 702 is the rotation axis 701e, and the rotation center of the pulley 711 and the pulley 721 is the rotation axis 741.

[0053] At this time, the rotation shaft 741 is an axis whose position is fixed relative to the pulleys, and the rotation shaft 701e is an axis whose position moves linearly relative to the pulleys. That is, when the pulleys 711 and 721 rotate with the rotation shaft 741 in a fixed position, the rotation shaft 701e, which is the rotation shaft of the first jaw 701 and the second jaw 702, moves back and forth, thereby opening and closing the first jaw 701 and the second jaw 702. This will be explained in more detail as follows.

[0054] 58, r1 is the distance from jaw coupling portion 711b to shaft coupling portion 711a of pulley 711, and this length is constant. Therefore, the distance from rotating shaft 741 inserted into shaft coupling portion 711a to jaw coupling portion 711b is also constant at r1.

[0055] 58 is the distance from the jaw pulley coupling hole 701d of the first jaw 701 to the rotation axis 701e, which is the jaw rotation axis, and this length is constant. Therefore, the distance from the jaw coupling portion 711b of the pulley 711 inserted into the jaw pulley coupling hole 701d to the jaw rotation axis 701e is also constant at r2.

[0056] Referring to Fig. 58, the lengths of r1 and r2 are kept constant. Therefore, when pulleys 711 and 721 rotate around rotation axis 741 in the directions of arrows A1 in Fig. 58 and A2 in Fig. 59 to perform a closing operation, first jaw 701 and second jaw 702 rotate around rotation axis 701e while the angle between r1 and r2 changes with the lengths of r1 and r2 kept constant. At this time, rotation axis 701e itself moves linearly (i.e., moves forward / backward) by the distance indicated by arrow C1 in Fig. 58 and arrow C2 in Fig. 59.

[0057] That is, assuming that the position of the rotation axis 741, which is the end tool jaw pulley rotation axis, is fixed, when the first jaw 701 and the second jaw 702 are closed, the rotation axis 701e, which is the jaw rotation axis, receives a force in the forward direction (i.e., toward the distal end), which has the effect of further increasing the grip force in the direction in which the first jaw 701 and the second jaw 702 are closed.

[0058] From another perspective, as the second jaw 702 rotates around the jaw rotation axis 701e, the lengths of r1 and r2 are kept constant, and therefore, when the pulley 721 rotates around the rotation axis 741, the angle between r1 and r2 changes while the lengths of r1 and r2 are kept constant. That is, compared to the angle between r1 and r2 when the second jaw 702 is open as shown in Figure 59(a), the angle between r1 and r2 when the second jaw 702 is closed as shown in Figure 59(b) is relatively large.

[0059] Therefore, when the second jaw 702 rotates from an open state to a closed state, the angle between r1 and r2 changes and the jaw rotation axis 701e passing through the axis passing portion 702e formed in the second jaw 702 receives a force in the forward direction.

[0060] At this time, since the rotation axis 741 is an axis whose position is relatively fixed, the jaw rotation axis 701e moves forward in the direction of arrow C1 in FIG. 58 and arrow C2 in FIG. 59, which has the effect of further increasing the grip force in the direction in which the second jaw 702 is closed.

[0061] From another perspective, when pulleys 711 and 721 rotate around rotation axis 741, an axis whose relative position is fixed, the angle between r1 and r2 changes while the distance between r1 and r2 remains constant. When the angle changes in this way, first jaw 701 and second jaw 702 push or pull on jaw rotation axis 701e, causing the rotation axis 701e to move forward or backward.

[0062] At this time, when the first jaw 701 and the second jaw 702 rotate in the direction to close, the rotation shaft 701e advances in the direction of arrow C1 in FIG. 58 and arrow C2 in FIG. 59, and the grip force becomes even greater.

[0063] Conversely, when the first jaw 701 and the second jaw 702 rotate in the direction to open, the rotary shaft 701e moves backward in the direction opposite to the arrow C1 in FIG. 58 and the arrow C2 in FIG.

[0064] With this configuration, when the first jaw 701 and the second jaw 702 are closed, the grip force becomes stronger, and the effect is obtained that the surgeon can perform a strong actuation operation with less force.

[0065] That is, as shown in FIG. 60, as the first jaw 701 and the second jaw 702, which have an X-shaped structure, rotate relatively around the first rotation axis 741, which is a fixed axis, the rotation axis 701e, which is the jaw rotation axis, advances toward the distal end of the end tool 700, thereby having the effect of amplifying the gripping force.

[0066] 61 and 62 are plan views showing the opening and closing operations of the first jaw 701 and the second jaw 702 due to the actuation operation of the end tool 700 of the electrocautery surgical instrument of FIG.

[0067] Referring to Figures 61 and 62, the first jaw 701 and the second jaw 702 are connected in an X-shaped structure, and when pulley 711, which is the first jaw pulley, and pulley 721, which is the second jaw pulley, rotate around a fixed rotation axis 741 as the center of rotation, the first jaw 701 and the second jaw 702 rotate relative to each other, thereby enabling actuation operation.

[0068] The end tool 700 of the electrocautery surgical instrument 10 according to the second embodiment of the present invention has the advantage that as the first jaw 701 and the second jaw 702 rotate relative to each other, the jaw rotation axis 701e moves forward / backward, thereby amplifying the gripping force, especially when moving forward.

[0069] Referring to FIG. 62, as the pulleys 711 and 721 rotate in opposite directions with the first rotation shaft 741 as the rotation center axis, the first jaw 701 and the second jaw 702 connected to the pulleys 711 and 721, respectively, rotate in opposite directions and move away from each other, so that the end tool 700 can be in an open state.

[0070] Referring to Figures 61 to 65, when the first jaw 701 and the second jaw 702 are closed as shown in Figure 61, the cutting operation of Figures 63 to 65 is performed, which can also be expressed as cutting the tissue between the first jaw 701 and the second jaw 702.

[0071] 63 can be defined as a state in which the blade 775 is maximally retracted toward the proximal portion 705 of the end tool, or as a state in which the blade 775 is positioned adjacent to the pulley 711 / pulley 712.

[0072] 65 can be defined as a state in which the blade 775 is maximally extended toward the distal portion 704 of the end tool 700. Alternatively, the third position can be defined as a state in which the blade 775 is located as far away from the pulley 711 / pulley 712 as possible.

[0073] First, as shown in Figure 62, with the first jaw 701 and the second jaw 702 open, the tissue to be cut is positioned between the first jaw 701 and the second jaw 702, and then an actuation operation is performed to close the first jaw 701 and the second jaw 702 as shown in Figure 61.

[0074] Next, with the braid wire 307 and the blade 775 positioned at the first position as shown in Fig. 63, currents of different polarities are passed through the first electrode 751 and the second electrode 752, respectively, to cauterize the tissue between the first jaw 701 and the second jaw 702. At this time, a generator (not shown) that supplies power to the electrodes can itself monitor at least some of the current, voltage, resistance, impedance, and temperature, and can stop supplying power when cauterization is complete.

[0075] When the cauterization is completed in this manner, the blade wire 307 is moved sequentially in the direction of arrow A1 in Figure 64 and the direction of arrow A2 in Figure 65, and the blade 775 connected to the blade wire 307 moves from a first position at the proximal portion 705 of the end tool toward a third position at the distal portion 704 of the end tool, sequentially reaching the positions in Figures 64 and 65.

[0076] In this way, the blade 775 moves in the X-axis direction and cuts the tissue located between the first jaw 701 and the second jaw 702.

[0077] However, the linear movement of the blade 775 here does not mean only a perfectly straight line, but rather a movement that is sufficient to cut tissue when viewed as a whole, even if it is not a perfectly straight line, such as when the middle part of the straight line is bent at a predetermined angle, or there is a section with a gentle curvature in a certain section.

[0078] On the other hand, if the braid wire 307 is pulled in the opposite direction in this state, the braid 775 coupled to the braid wire 307 will also return to the first position.

[0079] According to the present invention, it is possible to obtain an effect that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation motion can be used to perform cauterization and cutting.

[0080] 66 and 67 are diagrams showing the process of opening and closing the end tool 700 of the electrocautery surgical instrument 10 of FIG. 41 after a +90° yaw rotation.

[0081] 66, in operation unit 200, pulley 711 and pulley 721 opposing pulley 711 can rotate about first rotation shaft 741 via wire power transmission unit 300. In FIG. 66, when pulley 711 and pulley 721 rotate in opposite directions, first jaw 701 and second jaw 702 coupled to pulley 711 and pulley 721, respectively, rotate relatively in directions approaching each other to perform actuation, and first jaw 701 and second jaw 702 can be in a closed state as shown in FIG. 67.

[0082] 66 and 67 are diagrams showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after yaw rotation of −90°.

[0083] Referring to Figures 66 and 67, yaw rotation of -90° is possible with the first rotation axis 741 as the rotation center axis, and as the pulleys 711 and 721 rotate in different directions, the first jaw 701 and the second jaw 702 connected to the pulleys 711 and 721, respectively, can perform actuation in directions in which they move closer to or farther away from each other.

[0084] 66 to 69, the blade assembly, specifically the guide tube 770, has one end connected to the connecting portion 400 and the other end opposite to the end tool 700, and the length is kept constant.

[0085] When the end tool 700, specifically the first jaw 701 and the second jaw 702, rotates around the first rotation axis 741 as the central axis of rotation, the guide tube 770 is also gently bent with a predetermined radius of curvature, thereby providing a stable movement path for the blade wire 307 that can move between the distal portion 704 and the proximal portion 705 of the end tool 700.

[0086] 70 and 71 are diagrams showing the path of the guide tube 770 and the movement path of the blade 775 when the end tool 700 of the electrocautery surgical instrument of FIG. 41 performs a cutting operation with a yaw rotation of +90°.

[0087] Referring to Figures 70 and 71, the end tool 700 of the electrocautery surgical instrument 10 according to the second embodiment of the present invention is configured to be able to perform a normal cutting operation even when the jaws 701 and 702 are yaw rotated by +90°.

[0088] Specifically, the blade wire 307 comes out from inside the guide tube 770, and the blade 775 connected to the blade wire 307 moves along direction A, which is the direction from the proximal portion 705 to the distal portion 704 of the end tool 700, to perform the cutting operation.

[0089] Figures 72 and 73 are views showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 41 is pitch rotated by -90°. Figures 74 and 75 are views showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 41 is pitch rotated by +90°. Figure 76 is a view showing the path of the guide tube when the end tool of the electrocautery surgical instrument of Figure 41 is pitch rotated by -90°. Figures 77 and 78 are views showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of Figure 41 is pitch rotated by -90° and performs a cutting operation. Figure 79 is a perspective view showing the pitch rotation and yaw rotation states of the electrocautery surgical instrument of Figure 41. 80 to 82 are diagrams showing how the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time.

[0090] Figures 74 and 75 are views showing the process of opening and closing operations when the end tool 700 of the electrocautery surgical instrument of Figure 41 is pitch-rotated by +90°. Figure 76 is a view showing the path of the guide tube 770 when the end tool 700 of the electrocautery surgical instrument of Figure 41 is pitch-rotated by -90°. Figures 77 and 78 are views showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of Figure 41 is pitch-rotated by -90° and performs a cutting operation.

[0091] 72 to 78, the end tool 700 of the electrocautery surgical instrument according to the second embodiment of the present invention is configured to be able to perform a normal cutting operation even when the jaws 701 and 702 are pitch rotated by -90° and +90°.

[0092] On the other hand, Figure 79 shows a state in which the jaws have pitch rotated by -90° and simultaneously rotated by +90° in yaw, and Figures 80 to 82 show how the end tool 700 of the electrocautery surgical instrument of Figure 41 performs a cutting operation in a state in which it has pitch rotated by -90° and simultaneously rotated by +90° in yaw.

[0093] 79 to 82, the end tool 700 of the electrocautery surgical instrument 10 according to the second embodiment of the present invention may be configured to be able to perform a normal cutting operation even when the jaws 701 and 702 are pitch rotated by -90° and yaw rotated by +90° at the same time.

[0094] (Modification of the second embodiment - auxiliary pulley arranged on the end tool hub)

[0095] The following describes an endotool 700 of a surgical instrument according to a modification of the second embodiment of the present invention. The endotool 700 of a surgical instrument according to the modification of the second embodiment of the present invention is characterized by differences in the configuration of the endotool hub 760' and the configuration of the auxiliary pulleys 712 and 722 compared to the endotool of a surgical instrument according to the second embodiment of the present invention described above. These differences from the second embodiment will be described in detail later.

[0096] 83 to 85 are views showing an end tool of an electrocautery surgical instrument according to a modified example of the second embodiment of the present invention.

[0097] Referring to Figures 83 to 85, an end tool 700 according to a modified example of the second embodiment of the present invention includes a pair of jaws for performing a gripping operation, specifically a first jaw 701 and a second jaw 702, where each of the first jaw 701 and the second jaw 702, or a component that collectively includes the first jaw 701 and the second jaw 702, can be referred to as jaw 703.

[0098] The end tool 700 according to the modification of the second embodiment may include pulleys 711, 712, 713, 714, 715, and 716 associated with the rotational movement of the first jaw 701. Also, the end tool 700 may include pulleys 721, 722, 723, 724, 725, and 726 associated with the rotational movement of the second jaw 702.

[0099] Here, although the drawings show opposing pulleys formed parallel to each other, the concept of the present invention is not limited thereto, and each pulley may be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0100] The end tool 700 according to the modified example of the second embodiment of the present invention may further include a pulley 712 and a pulley 722 compared to the end tool 700 according to the second embodiment of the present invention shown in FIG.

[0101] Referring to Figures 84 and 85, pulley 712 functions as an end tool first jaw auxiliary pulley and pulley 722 functions as an end tool second jaw auxiliary pulley, and these two components may be referred to collectively as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0102] In particular, pulleys 712 and 722, which are end tool jaw auxiliary pulleys, may be further provided on one side of pulleys 711 and 721. That is, pulley 712, which is an auxiliary pulley, may be disposed between pulley 711 and pulleys 713 / 714. Also, pulley 722, which is an auxiliary pulley, may be disposed between pulley 721 and pulleys 723 / 724.

[0103] Pulley 712 and pulley 722 may be formed to be rotatable independently of each other about second rotation shaft 742 .

[0104] Pulley 712 and pulley 722 can play a role in increasing the rotation angle of first jaw 701 and second jaw 702, respectively, by coming into contact with 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.

[0105] In other words, if no auxiliary pulleys were provided, the first jaw 701 and the second jaw 702 could only rotate up to a right angle, but in the modified example of the second embodiment, by further providing auxiliary pulleys, pulley 712 and pulley 722, it is possible to obtain the effect of increasing the maximum rotation angle by a certain angle.

[0106] This allows the two jaws of the end tool 700 to be yaw rotated together by 90° clockwise or counterclockwise, with the two jaws having to open for actuation.

[0107] In other words, it has the feature of being able to widen the range of yaw rotation that can be actuated via pulley 712 and pulley 722. This will be explained in more detail as follows.

[0108] When the auxiliary pulley is not in place, the first jaw wire 305 is fixedly coupled to the end tool first jaw pulley 711 and the second jaw wire 302 is fixedly coupled to the end tool second jaw pulley 721, so that each of the end tool first jaw pulley 711 and the end tool second jaw pulley 721 can only rotate up to 90°.

[0109] In this case, if actuation is performed with the first jaw 701 and the second jaw 702 positioned on the 90° line, the first jaw 701 can spread, but the second jaw 702 cannot rotate more than 90°. Therefore, when the first jaw 701 and the second jaw 702 are performing yaw movements beyond a certain angle, there is a problem in that actuation cannot be performed smoothly.

[0110] To solve this problem, in the case of electrocautery surgical instrument 10 of the present invention, auxiliary pulleys 712 and 722 are further disposed on one side of pulley 711 and pulley 721. By disposing pulleys 712 and 722 in this manner and changing the arrangement paths of wire 305 (first jaw wire) and wire 302 (second jaw wire) to a certain extent, the tangential directions of wire 305 and wire 302 are changed, and therefore fastening member 324 connecting wire 302 and pulley 721 can be further rotated by a certain angle.

[0111] That is, fastening member 326, which is the joint between wire 302 and pulley 721, can rotate until it is positioned on the common inscribed line between pulleys 721 and 722. Similarly, fastening member 323, which is the joint between wire 305 and pulley 711, can rotate until it is positioned on the common inscribed line between pulleys 711 and 712, thereby expanding the rotation range.

[0112] In other words, wire 301 and wire 305, which are both strands of the first jaw wire wound around pulley 712, are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis by pulley 712, which is an auxiliary pulley. At the same time, wire 302 and wire 306, which are both strands of the second jaw wire wound around pulley 721, are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis by pulley 722.

[0113] In other words, pulleys 713 and 714 are disposed on either side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 723 and 724 are disposed on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0114] In other words, the wire 305 is located on the inscribed line between the pulleys 711 and 712, and the rotation angle of the pulley 711 is increased by the pulley 712. The wire 302 is located on the inscribed line between the pulleys 721 and 722, and the rotation angle of the pulley 721 is increased by the pulley 722.

[0115] According to the present invention, the rotation radius of the first jaw 701 and the second jaw 702 is increased, thereby providing the effect of expanding the yaw operation range in which normal opening and closing actuation operations can be performed.

[0116] 38, a first rotating shaft 741 and a second rotating shaft 742 are inserted through an end tool hub 760′ according to a modified example of the second embodiment of the present invention. Unlike the end tool hub 760 according to the second embodiment of the present invention, a first wire guide portion and a second wire guide portion are not formed on each surface of the opposing first jaw pulley coupling portion 762a and second jaw pulley coupling portion 762b, and the end tool hub 760′ further includes pulleys 712 and 722 that are configured separately from the end tool hub 760′ and can be coupled with the second rotating shaft 742 that is inserted through the end tool hub 760′, allowing them to function as auxiliary pulleys.

[0117] The second rotating shaft 742 inserted into the end tool hub 760′ may include two shafts, a first sub-shaft and a second sub-shaft, which are arranged facing each other and spaced apart by a predetermined distance. The second rotating shaft 742 is divided into two parts and spaced apart by a predetermined distance, so that a guide tube 770 can pass through the end tool hub 760′ and the pitch hub 750 therebetween.

[0118] 83, the first rotation shaft 741, the second rotation shaft 742, the third rotation shaft 743, and the fourth rotation shaft 744 can be arranged in order from the distal end 704 to the proximal end 705 of the end tool 700. Therefore, starting from the distal end 704, the first rotation shaft 741 can be called pin 1, the second rotation shaft 742 can be called pin 2, the third rotation shaft 743 can be called pin 3, and the fourth rotation shaft 744 can be called pin 4.

[0119] The modified example of the second embodiment of the present invention differs from the second embodiment in that the end tool hub 760′ is not integrally formed with the main body 761 but is provided as a separate part, and the pulleys 721 and 722 axially connected to the end tool hub 760′ by the second rotation shaft 742 function as auxiliary pulleys. Except for this, the remaining configuration is the same as that of the end tool 700 according to the second embodiment, and therefore detailed explanations will be omitted where overlapping.

[0120] (Third embodiment of electrocautery surgical instrument)

[0121] Fig. 86 is a perspective view showing an electrocautery surgical instrument according to a third embodiment of the present invention, Figs. 87 to 92 are views showing an end tool of the electrocautery surgical instrument of Fig. 86.

[0122] Referring to FIG. 86, an electrocautery surgical instrument 10 according to a third embodiment of the present invention includes an end tool 800, an operating section 200, a power transmission section 300, and a coupling section 400.

[0123] The electrocautery surgical instrument 10 according to the third embodiment of the present invention differs from the electrocautery surgical instrument 10 according to the second embodiment in the configuration of the end tool 800, specifically the configuration of the yaw hub 880, the actuation link 892, etc., which will be described in detail below.

[0124] 86 and 87, an end tool 800 according to a third embodiment of the present invention is formed on the other end of the connecting portion 400 and inserted into the surgical site to perform the operations required for the surgery. As an example of such an end tool 800, a pair of jaws 803 can be used to perform a gripping operation, as shown in FIG.

[0125] However, the concept of the present invention is not limited thereto, and various surgical devices may be used as endotool 800. For example, a single-arm cautery instrument or other configuration may also be used as endotool 800.

[0126] Such an end tool 800 is connected to an operating unit 200 and a power transmission unit 300, and the driving force of the operating unit 200 is transmitted via the power transmission unit 300, thereby performing operations necessary for surgery such as gripping, cutting, and suturing.

[0127] Here, the end tool 800 of the electrocautery surgical instrument 10 according to the third embodiment of the present invention is configured to be rotatable in at least one or more directions. For example, the end tool 800 can be configured to perform pitch movement around the Y axis in FIG. 86, as well as yaw movement and actuation movement around the Z axis in FIG. 86.

[0128] (End tool according to the third embodiment)

[0129] The endotool 800 of the electrocautery surgical instrument 10 of FIG. 86 will now be described in further detail.

[0130] Fig. 86 is a perspective view showing an electrocautery surgical instrument according to a third embodiment of the present invention, Figs. 87 to 92 are views showing an end tool of the electrocautery surgical instrument of Fig. 86.

[0131] Fig. 87 shows a state in which the end tool hub 860 and the pitch hub 850 are coupled together, and Fig. 88 shows a state in which the end tool hub 860, the yaw hub 880, and the pitch hub 850 are detached. Fig. 89 shows a state in which the yaw hub 880 and the end tool hub 860 are coupled together, and Fig. 90 shows a state in which the first jaw 801 and the second jaw 802 are detached. Meanwhile, Fig. 91 is a view focusing on the wire, and Fig. 92 is a view focusing on the pulley.

[0132] 87, 88, 91, and 92, an end tool 800 according to a third embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 801 and a second jaw 802. Here, each of the first jaw 801 and the second jaw 802, or a component including the first jaw 801 and the second jaw 802, can be referred to as a jaw 803.

[0133] The end tool 800 may also include a pulley 891, a pulley 813, a pulley 814, a pulley 815, and a pulley 816 associated with the rotational movement of the first jaw 801. The end tool 800 may also include a pulley 881, a pulley 823, a pulley 824, a pulley 825, and a pulley 826 associated with the rotational movement of the second jaw 802.

[0134] Here, although the drawings show opposing pulleys formed parallel to each other, the concept of the present invention is not limited thereto, and each pulley may be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0135] Referring to FIG. 87, a third embodiment end tool 800 of the present invention can include an end tool hub 860 , a pitch hub 850 , and a yaw hub 880 .

[0136] The end tool hub 860 has a first rotating shaft 841 (described later) inserted therethrough, and can accommodate at least a portion of a pulley 891 and a pulley 881 axially coupled to the first rotating shaft 841 inside.

[0137] The end tool hub 860 according to the third embodiment of the present invention is the same as the end tool hubs 660 and 760 according to the first and second embodiments, and therefore detailed description thereof will be omitted to the extent that it overlaps.

[0138] 87 , a third rotation shaft 843 and a fourth rotation shaft 844 (described later) are inserted through the pitch hub 850, and the pitch hub 850 can be axially coupled to a first pitch pulley portion 863 a and a second pitch pulley portion 863 b of the end tool hub 860 by the third rotation shaft 843. Therefore, the end tool hub 860 can be formed to be rotatable relative to the pitch hub 850 around the third rotation shaft 843.

[0139] Furthermore, pitch hub 850 can accommodate at least a portion of pulleys 813, 814, 823, and 824 axially coupled to third rotating shaft 843. Furthermore, pitch hub 850 can accommodate at least a portion of pulleys 815, 816, 825, and 826 axially coupled to fourth rotating shaft 844.

[0140] One end of the pitch hub 850 is connected to the end tool hub 860 , and the other end of the pitch hub 850 is connected to the coupling portion 400 .

[0141] Referring to FIG. 87, the first rotation axis 841 can function as the end tool jaw pulley rotation axis, the third rotation axis 843 can function as the end tool pitch rotation axis, and the fourth rotation axis 844 can function as the end tool pitch auxiliary rotation axis of the end tool 100.

[0142] Here, each rotation shaft may be divided into two parts, and the divided rotation shafts may be spaced apart from each other because the guide tube 870 passes through the end tool hub 860 and the pitch hub 850.

[0143] That is, a guide tube 870 can be passed between the first and second sub-shafts of each rotation shaft. This will be described in more detail later. Here, the first and second sub-shafts can be arranged on the same axis, or can be arranged with a certain offset.

[0144] Although the drawings show each rotating shaft as being divided into two, the concept of the present invention is not limited to this. That is, each rotating shaft may be bent midway to form an escape route for the guide tube 870.

[0145] 87 and 88, the end tool 800 according to the third embodiment of the present invention may further include an actuation rotation shaft 845. In detail, the actuation rotation shaft 845 may be provided at a joint between the first jaw 801 and the second jaw 802, and the second jaw 802 may perform an actuation operation by rotating around the actuation rotation shaft 845 while the first jaw 801 is fixed. Here, the actuation rotation shaft 845 may be disposed closer to the distal portion 804 than the first rotation shaft 841.

[0146] Here, one feature of the end tool 800 of the third embodiment of the present invention is that the first rotation axis 841, which is a yaw rotation axis, and the actuation rotation axis 845 are not the same axis but are provided separately.

[0147] That is, the first rotation axis 841, which is the rotation axis of the jaw pulleys 881 / 891 and also the rotation axis of the yaw operation, and the actuation rotation axis 845, which is the rotation axis of the second jaw 802 relative to the first jaw 801 and also the rotation axis of the actuation operation, are formed at a certain distance from each other, thereby providing an effect of ensuring a space in which the guide tube 870 and the braid wire 307 housed therein can be gently bent. Such actuation rotation axis 845 will be described in more detail later.

[0148] Pulley 891 functions as an end tool first jaw pulley, and pulley 881 functions as an end tool second jaw pulley. Pulley 891 is also called the first jaw pulley, and pulley 881 is also called the second jaw pulley, and these two components can be collectively referred to as end tool jaw pulleys or simply jaw pulleys.

[0149] Pulley 891 and pulley 881, which are end tool jaw pulleys, can be arranged side by side and formed to face each other, and can be independently rotated about first rotation shaft 841, which is the end tool jaw pulley rotation shaft.

[0150] At this time, the pulley 891 and the pulley 881 are formed to be spaced apart to a certain extent so that the blade assembly can be accommodated therebetween.

[0151] In other words, the blade assembly including the guide tube 870 can be positioned between the pulley 891 and the pulley 881 .

[0152] Meanwhile, the end tool 800 of the third embodiment of the present invention may further include components such as a first electrode 851, a second electrode 852, a guide tube 870, and a blade 875 to perform cautery and cutting operations.

[0153] Here, components related to driving the blade, such as guide tube 870 and blade 875, can be collectively referred to as a blade assembly. One modification of the present invention is characterized in that a blade assembly including blade 875 is disposed between pulley 891, which is a first jaw pulley, and pulley 881, which is a second jaw pulley, thereby enabling pitch and yaw movements of end tool 800 as well as cutting operations using the blade. In this embodiment, the components for performing cautery and cutting operations are substantially the same as the components described in the first and second embodiments, and therefore detailed description thereof will be omitted.

[0154] The electrocautery surgical instrument 10 according to the third embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and braid wire 307, similar to the first embodiment of the present invention.

[0155] (Jaw-link-pulley connection structure)

[0156] The jaw-link-pulley connection structure of the end tool 800 according to the third embodiment of the present invention will be described in more detail below.

[0157] 87 to 101, an end tool 800 according to the third embodiment of the present invention includes a first jaw 801, a second jaw 802, a yaw hub 880, an actuation link 592, a pulley 891 that is a first jaw pulley, and a pulley 881 that is a second jaw pulley. Hereinafter, the pulley 891 will be referred to as the first jaw pulley 891, and the pulley 881 will be referred to as the second jaw pulley 881.

[0158] 97 to 100, the first jaw pulley 891 may be formed as a type of multi-layer pulley. In other words, the first jaw pulley 891 may be formed in the form of two pulleys joined together, and may have two grooves formed on its outer circumferential surface.

[0159] Specifically, a first coupling portion 891a may be formed on one surface of the first jaw pulley 891, and a second coupling portion 891b may be formed in the shape of a groove on the other surface opposite to the surface on which the first coupling portion 891a is formed.

[0160] At this time, the positions of the first coupling portion 891a and the second coupling portion 891b are such that the wires 301 and 305 overlap each other. In other words, the wires 302 and 306 wound around the first jaw pulley 891 can be formed so that at least a portion of each of them overlaps with each other.

[0161] Expressed from another perspective, the first connecting portion 891a and the second connecting portion 891b can be arranged asymmetrically when viewed from the XY plane, and can be arranged so as to be biased toward one of the regions of the first jaw pulley 891.

[0162] From another perspective, the first coupling portion 891a may be formed at a position where the wire 301 can be wound around the outer circumferential surface of the first jaw pulley 891 by a central angle between 90° and 360°. Similarly, the second coupling portion 891b may be formed at a position where the wire 305 can be wound around the outer circumferential surface of the first jaw pulley 891 by a central angle between 90° and 360°.

[0163] A fastening member 334a is coupled to one end of the wire 301, and the fastening member 334a may be coupled to a first coupling portion 891a of the first jaw pulley 891. A fastening member 334b ​​is coupled to one end of the wire 305, and the fastening member 334b ​​may be coupled to a second coupling portion 891b of the first jaw pulley 891.

[0164] When the wire 301 is referred to as the first jaw wire R and the wire 305 is referred to as the first jaw wire L, the first coupling portion 891a to which the first jaw wire R301 is coupled is formed on the opposite side to the side to which the first jaw wire R301 is input, and the rotation angle of the first jaw pulley 891 can be increased by extending the length by which the first jaw wire R305 is wound around the first jaw pulley 891.

[0165] In addition, the second coupling portion 891b to which the first jaw wire L302 is coupled is formed on one side opposite to the other side to which the first jaw wire L302 is input, and by extending the length by which the first jaw wire L302 is wound around the first jaw pulley 891, the rotation angle of the first jaw pulley 891 can be increased.

[0166] The first coupling portion 891a and the second coupling portion 891b can increase the radius of rotation of the first jaw pulley 891. Increasing the length of the wire 301 / wire 305 wound around the first jaw pulley 891 in this way can ensure a long stroke of the actuation link 892. This will be described in more detail later.

[0167] Referring to FIG. 90, the yaw hub 880 is located between the first jaw 801 and the second jaw 802 and the first jaw pulley 891 and the second jaw pulley 881 , and can include a yaw hub body 882 .

[0168] A first jaw pulley 891 may be formed at one end of the yaw hub 880. A guide slit 883 may be formed along the longitudinal direction at the other end of the yaw hub 880. A guide pin 893 protruding from an actuation link 892 (described later) may be fitted into the guide slit 883.

[0169] 90 and 93, a through-hole through which the actuation rotation shaft 845 is inserted may be formed on one side of the guide slit 883 on the yaw hub 880. Referring to Fig. 93, the second jaw pulley 881 is integrally formed on one side of the yaw hub 880, but this is not limited thereto and various modifications are possible.

[0170] Although not shown in the figure, the second jaw pulley 881 and the yaw hub 880 may be formed as separate members, and the second jaw pulley 881 and the yaw hub 880, specifically the yaw hub body 882, may be fixedly coupled together.

[0171] The two divided first rotary shafts 841 can be inserted through the first jaw pulley 891 and the second jaw pulley 881, respectively.

[0172] In this way, the second jaw pulley 881 and the yaw hub 880 are integrally formed or fixedly connected, so that the yaw hub 880 does not rotate relative to the second jaw pulley 881. When the second jaw pulley 881 rotates around the first rotation shaft 841, the yaw hub 880 can also rotate around the first rotation shaft 841 together with the second jaw pulley 881.

[0173] 90 and 91, an actuation rotation shaft 845 can be disposed on a yaw hub 880. The actuation rotation shaft 845 can be divided into two parts, and the divided multiple actuation rotation shafts 845 can be disposed at a certain distance from each other, and the guide tube 870 and the braid wire 30 and braid 875 housed therein can pass through the space formed between the multiple actuation rotation shafts 845.

[0174] Referring to FIG. 90, a guide slit 883 formed on the yaw hub 880, specifically the yaw hub body 882, can be formed to extend along the longitudinal direction between the actuation rotation axis 845 and the yaw rotation axis 841.

[0175] Referring to Figure 90, the guide slit 883 may be formed with an equal width along the longitudinal direction, and the guide pin 893 protruding from the actuation link 892 can move within the guide slit 883, specifically, can move linearly.

[0176] Referring to FIG. 93, an actuation pulley coupling part 885 may be protruded from one side of the yaw hub 880 opposite to the other side where the second jaw pulley 881 is formed, so that the actuation pulley coupling part 885 can be coupled with the first jaw pulley 891.

[0177] The actuation pulley coupling portion 885 may share a central axis with the yaw rotation axis 841. However, this is not limited thereto, and various modifications are possible, such as arranging them side by side at a distance from each other.

[0178] 101, the actuation link 892 may be formed to extend along the longitudinal direction. The actuation link 892 may include a link body 892a and a bent portion 892b. The link body 892a is a portion formed to extend along the longitudinal direction, and the bent portion 892b may be bent at least once and connected to the link body 892a.

[0179] This allows one side of actuation link 892 where bent portion 892b is located to be formed in a "U" shape.

[0180] Referring to FIG. 101, a pin coupling hole (reference numeral not set) may be formed on one surface of a bent portion 892b arranged parallel to and spaced apart from a link body 892a.

[0181] A pin coupling hole may also be formed on one surface of the link body 892a facing the bent portion 892b so as to correspond to the pin coupling hole. A guide pin 893 may be coupled to the pin coupling hole. A plurality of guide pins 893 may be provided, and may be coupled to the pin coupling hole formed on each surface of the bent portion 892b and the link body 892a facing each other.

[0182] The multiple guide pins 893 can be spaced apart to a certain extent, and one side region of the "U" shaped actuation link 892 formed by the bent portion 892b and the link body 892a can provide a movement path for the guide tube 870 to pass through. The "U" shaped region formed by the bent portion 892b and the link body 892a has the effect of not interfering with the movement path of the guide tube 870 moving inside the yaw hub 880 and the end tool hub 860 when the actuation link 892 moves linearly.

[0183] 101, a link through-hole 892c may be formed on one side of the link body 892a opposite to the side to which the bent portion 892b is connected. A protrusion 891c formed on the first jaw pulley 891 may be fitted into the link through-hole 892c while being axially coupled.

[0184] Therefore, when the first jaw pulley 891 rotates, the actuation link 892 moves while rotating around the protrusion 891c.

[0185] A guide pin 893 provided on the actuation link 892 fits into a guide slit 883 formed in the yaw hub 880 and is movable along the shape of the guide slit 883 .

[0186] The guide pin 893 that passes through the guide slit 883 can fit into the slots 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively. The first jaw 801 and the second jaw 802 have an X-shaped structure, and the guide pin 893 can fit into the slot 801a formed in the first jaw 801 and the slot 801b formed in the second jaw 802 at the same time.

[0187] The first jaw 801 and the second jaw 802 can perform actuation by moving away from or approaching each other with the actuation rotation axis 845 as the center of rotation.

[0188] 102 to 104, when the first jaw pulley 891 rotates in the A1 direction, the actuation link 892, which is axially coupled to the protrusion 891c formed on the first jaw pulley 891, moves in the B1 direction. Specifically, the guide pin 893 provided on the actuation link 892 moves linearly along the guide slit 883 formed in the yaw hub 880, and the guide pin 893 fits into the slots 801a and 802a formed in the first jaw 801 and the second jaw 802, so that the guide pin 893 presses the first jaw 801 and the second jaw 802. Therefore, as the actuation link 892 moves, the first jaw 801 and the second jaw 802 rotate around the actuation rotation axis 845, thereby performing an actuation operation.

[0189] Referring to FIG. 103, when the actuation link 892 moves distally, the first jaw 801 and the second jaw 802 can perform actuation in the C1 direction based on the actuation rotation axis 845 along the C1 direction.

[0190] Referring to Figure 104, when the guide pin 893 moves to the distal end to its maximum extent on the slots 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively, the first jaw 801 and the second jaw 802 are further spread apart in the C2 direction.

[0191] In addition, since the first jaw pulley 891 is formed in a multi-layer structure and the first jaw wires 301, 305 are wound so as to overlap in different layers, the length wound around the first jaw pulley 891 can be extended, which has the effect of increasing the rotation angle of the first jaw pulley 891.

[0192] Figures 105 to 108 are perspective views showing the actuation operation of the end tool of the electrocautery surgical instrument of Figure 86. A guide pin 893 provided on an actuation link 892 is movable along slots 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively, which allows the first jaw 801 and the second jaw 802 to perform actuation operations with an actuation rotation axis 845 as the central axis of rotation.

[0193] Figures 109 to 111 are partial cross-sectional views showing the operation of the blade of the end tool of the electrocautery surgical instrument of Figure 86. The operation of blade 875 is the same as in the first and second embodiments, so detailed explanation will be omitted to the extent that it overlaps with those embodiments.

[0194] 112 and 113 are bottom views showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after yaw rotation of +90°.

[0195] The guide slit 883 formed in the yaw hub 880 is formed along a linear direction, and the actuation rotation shaft 845 can be arranged along the longitudinal center axis of the guide slit 883.

[0196] The slots 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively, may be formed to be inclined at a certain angle with respect to the longitudinal central axis of the guide slit 883 formed in the yaw hub 880.

[0197] As a result, the actuation rotation axis 845 is fixed, and when the actuation link 892, which moves by transmitting power from the first jaw pulley 891, specifically the guide pin 893, moves forward toward the actuation rotation axis 845, the first jaw 801 and the second jaw 803 move away from each other as shown in Figure 113.

[0198] In Figures 114 and 115, when the end tool of the electrocautery surgical instrument in Figure 86 is rotated in yaw by +90°, the first jaw pulley 891 rotates, and the guide pin 893 provided on the actuation link 892 connected to the first jaw pulley 891 moves through the guide slit 883 formed in the yaw hub 880 and the slots 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively, thereby enabling actuation operation to be performed even in the yaw rotated state.

[0199] Referring to Figures 116 to 125, when the end tool 800 is rotated in yaw, there is a possibility that problems may occur if the guide tube 870 comes into contact with the actuation link 892. However, the actuation link 892 of the present invention has a bent portion 892b connected to the link body 892a that forms a "U" shape, preventing contact with the guide tube 870 and allowing the blade wire 307 and guide tube 870 to move stably in response to the yaw, pitch, and actuation movements of the end tool 800.

[0200] Referring to Figures 126 to 136, the end tool 800 of the electrocautery surgical instrument 10 according to the third embodiment of the present invention can be configured to be able to perform a normal cutting operation even when the jaws 801, 802 are rotated in both pitch and yaw directions.

[0201] An end tool 800 according to the third embodiment of the present invention is characterized in that it employs a pin-slot structure to ensure a grip force during actuation.

[0202] In particular, in the pin-slot structure, the actuation link 892 must move a longer distance to rotate the first jaw 801 in the same direction (i.e., a long stroke of the actuation link 892 is required). In addition, in order for the actuation link 590 to move a longer distance, the first jaw pulley 891 must rotate more. From another perspective, when the first jaw pulley 891 is rotated further to rotate the first jaw 801 in the same direction, more force is applied to the first jaw 801 as the first jaw pulley 891 rotates more, and therefore the grip force during actuation can be amplified.

[0203] In order to further rotate the first jaw pulley 891 in this manner, the first jaw pulley 891 is formed into a multi-layer structure as described above, and the length of the wires 301 and 305 wound around the first jaw pulley 891 is increased, thereby ensuring a long stroke of the actuation link 892.

[0204] (Modification of the third embodiment - auxiliary pulley arranged on the end tool hub)

[0205] The following describes an endotool 800 of a surgical instrument according to a modification of the third embodiment of the present invention. The endotool 300 of a surgical instrument according to the modification of the third embodiment of the present invention is characterized by differences in the configuration of the endotool hub 860' and the configuration of the auxiliary pulleys 812 and 822 compared to the endotool of a surgical instrument according to the third embodiment of the present invention described above. These differences from the third embodiment will be described in detail later.

[0206] 137 to 139 are views showing an end tool of an electrocautery surgical instrument according to a modification of the third embodiment of the present invention.

[0207] Referring to Figures 137 to 138, an end tool 800 according to a modified example of the third embodiment of the present invention includes a pair of jaws for performing a gripping operation, specifically a first jaw 801 and a second jaw 802, where each of the first jaw 801 and the second jaw 802, or the component encompassing the first jaw 801 and the second jaw 802, can be referred to as jaw 803.

[0208] The end tool 800 according to the modification of the third embodiment may include pulleys 811, 812, 813, 814, 815, and 816 associated with the rotational movement of the first jaw 801. Also, the end tool 800 may include pulleys 821, 822, 823, 824, 825, and 826 associated with the rotational movement of the second jaw 802.

[0209] Here, although the drawings show opposing pulleys formed parallel to each other, the concept of the present invention is not limited thereto, and each pulley may be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0210] The end tool 800 according to the modified example of the third embodiment of the present invention may further include a pulley 812 and a pulley 822 compared to the end tool 800 according to the third embodiment of the present invention shown in FIG.

[0211] Referring to Figures 137 to 139, pulley 812 functions as an end tool first jaw auxiliary pulley, and pulley 822 functions as an end tool second jaw auxiliary pulley, and these two components can be collectively referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0212] In particular, pulleys 812 and 822, which are end tool jaw auxiliary pulleys, may be further provided on one side of pulleys 811 and 821. That is, pulley 812, which is an auxiliary pulley, may be disposed between pulley 811 and pulleys 813 and 814. Furthermore, pulley 822, which is an auxiliary pulley, may be disposed between pulley 821 and pulleys 823 and 824.

[0213] Pulley 812 and pulley 822 may be formed to be rotatable independently of each other about second rotation shaft 842 .

[0214] Pulley 812 and pulley 822 can play a role in increasing the rotation angle of first jaw 801 and second jaw 802, respectively, by coming into contact with 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.

[0215] In other words, if no auxiliary pulleys were provided, the first jaw 801 and the second jaw 802 could only rotate up to a right angle, but in the modified example of the third embodiment, by further providing auxiliary pulleys, pulley 812 and pulley 822, it is possible to obtain the effect of increasing the maximum rotation angle by a certain angle.

[0216] This allows for operation in which the two jaws of the end tool 800 must open for actuation to occur with both jaws yaw rotated 90° clockwise or counterclockwise.

[0217] In other words, it has the feature of being able to widen the range of yaw rotation that can be actuated via pulley 812 and pulley 822. This will be explained in more detail as follows.

[0218] When the auxiliary pulley is not in place, the first jaw wire 305 is fixedly coupled to the end tool first jaw pulley 811 and the second jaw wire 302 is fixedly coupled to the end tool second jaw pulley 821, so that each of the end tool first jaw pulley 811 and the end tool second jaw pulley 821 can only rotate up to 90°.

[0219] In this case, if actuation is performed with the first jaw 801 and the second jaw 802 positioned on the 90° line, the first jaw 801 can spread, but the second jaw 802 cannot rotate more than 90°. Therefore, there is a problem in that actuation cannot be performed smoothly when the first jaw 801 and the second jaw 802 are performing a yaw movement of more than a certain angle.

[0220] To solve this problem, in the case of electrocautery surgical instrument 10 of the present invention, auxiliary pulleys 812 and 822 are further disposed on one side of pulley 811 and pulley 821. By disposing pulleys 812 and 822 in this manner, the 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 thus fastening member 324 connecting wire 302 and pulley 821 can be further rotated by a certain angle.

[0221] That is, fastening member 326, which is the joint between wire 302 and pulley 821, can rotate until it is positioned on the common inscribed line between pulleys 821 and 822. Similarly, fastening member 323, which is the joint between wire 305 and pulley 811, can rotate until it is positioned on the common inscribed line between pulleys 811 and 812, thereby expanding the rotation range.

[0222] In other words, by pulley 812, which is an auxiliary pulley, wire 301 and wire 305, which are both strands of the first jaw wire wound around pulley 812, are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis. At the same time, by pulley 822, wire 302 and wire 306, which are both strands of the second jaw wire wound around pulley 821, are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0223] In other words, pulleys 813 and 814 are disposed on either side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 823 and 824 are disposed on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0224] In other words, wire 305 is located on the inscribed line between pulley 811 and pulley 812, and pulley 812 widens the rotation angle of pulley 811. Wire 302 is located on the inscribed line between pulley 821 and pulley 822, and pulley 822 widens the rotation angle of pulley 821.

[0225] According to the present invention, the rotation radius of the first jaw 801 and the second jaw 802 is increased, thereby providing the effect of widening the yaw operation range in which normal opening and closing actuation operations can be performed.

[0226] The modified example of the third embodiment of the present invention differs from the third embodiment in that the end tool hub 860′ is not integrally formed with the main body 861 but is provided as a separate part, and the pulleys 821 and 822 axially connected to the end tool hub 860′ by the second rotation shaft 842 function as auxiliary pulleys. Except for this, the remaining configuration is the same as that of the end tool 800 according to the third embodiment, and therefore detailed explanations will be omitted where overlapping.

[0227] <Fourth embodiment of electrocautery surgical instrument>

[0228] FIG. 140 is a perspective view showing an electrocautery surgical instrument according to a fourth embodiment of the present invention. FIGS. 141 to 146 are views showing an end tool of the electrocautery surgical instrument of FIG. 140. FIG. 147 is a perspective view showing an end tool hub of the electrocautery surgical instrument of FIG. 140. FIGS. 148 and 149 are cutaway perspective views of the end tool hub of FIG. 147. FIGS. 150 and 151 are perspective views of the end tool hub of FIG. 147. FIG. 152 is a side view showing the end tool hub and guide tube of FIG. 147. FIG. 153 is a plan view showing the end tool hub and guide tube of FIG. 147. FIG. 154 is a perspective view showing an actuation hub of the electrocautery surgical instrument of FIG. 140 of FIG. 147. FIG. 155 is a cutaway perspective view of the actuation hub of FIG. 154. Figure 156 is an exploded perspective view showing the endotool of the electrocautery surgical instrument of Figure 140. Figure 157 is a perspective view showing the first jaw of the endotool of the electrocautery surgical instrument of Figure 140. Figure 158 is a perspective view showing the second jaw of the endotool of the electrocautery surgical instrument of Figure 140. Figure 159 is a perspective view showing the first jaw pulley of the electrocautery surgical instrument of Figure 140. Figure 160 is a plan view showing the opening and closing operation of the first jaw of the endotool of the electrocautery surgical instrument of Figure 140. Figure 161 is a plan view showing the opening and closing operation of the second jaw of the endotool of the electrocautery surgical instrument of Figure 140. Figure 162 is a plan view showing the opening and closing operation of the first and second jaws of the endotool of the electrocautery surgical instrument of Figure 140.

[0229] 140 to 162, an electrocautery surgical instrument 10 according to a fourth embodiment of the present invention includes an end tool 1100, an operating section 200, a power transmission section 300, and a connecting section 400. As shown in FIG.

[0230] Here, the connecting portion 400 is formed in the shape of a hollow shaft and can accommodate one or more wires and electrical cables therein. The operating portion 200 is coupled to one end of the connecting portion 400, and the end tool 1100 is coupled to the other end of the connecting portion 400, and the connecting portion 400 can function to connect the operating portion 200 to the end tool 1100. Here, the connecting portion 400 of the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention is characterized in that it includes a straight portion 401 and a bent portion 402, and the straight portion 401 is formed on the side that couples with the end tool 1100, and the bent portion 402 is formed on the side that couples with the operating portion 200. As a result of the end of the connecting portion 400 on the operating portion 200 side being bent in this manner, 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 1100 or adjacent to the extension line. Expressed another way, this can also be described 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 1100 to match more intuitively.

[0231] On the other hand, 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. 140. In this way, by forming the bent portion 402 on substantially the same plane as the XZ plane, interference between the operating portions can be reduced. Of course, for intuitive operation of the end tool and the operating portion, configurations other than the XZ plane may be possible.

[0232] Meanwhile, a connector 410 may be formed at the bent portion 402. The connector 410 may be connected to an external power source (not shown), and may be connected to the jaws 1103 via electric wires 411 and 412, thereby transmitting electrical energy supplied from the external power source (not shown) to the jaws 1103. Here, the connector 410 may be a bipolar type having two electrodes, or a monopolar type having one electrode.

[0233] The operating unit 200 is formed at one end of the connecting unit 400 and is provided with an interface that can be directly operated by a surgeon, for example, in the shape of forceps, a stick, a lever, etc. When the surgeon operates this, the endotool 1100, which is connected to the interface and inserted into the body of the surgical patient, performs a predetermined operation to perform surgery. Here, in Figure 140, 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 to this, and it can be said that various types of operating units that can be connected to the endotool 1100 and operate the endotool 1100 are possible.

[0234] The endotool 1100 is formed at the other end of the connecting portion 400 and is inserted into the surgical site to perform the operations required for the surgery. As an example of such an endotool 1100, a pair of jaws 1103 for performing a gripping operation, as shown in FIG. 140 , may be used. However, the concept of the present invention is not limited thereto, and various surgical devices may be used as the endotool 1100. For example, a single-arm cautery may also be used as the endotool. Such an endotool 1100 is connected to the operating unit 200 by the power transmission unit 300, and the driving force of the operating unit 200 is transmitted via the power transmission unit 300 to perform the operations required for the surgery, such as gripping, cutting, and suturing.

[0235] Here, the end tool 1100 of the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention is formed to be rotatable in at least one or more directions, and for example, the end tool 1100 may be formed to perform a pitch movement around the Y axis of FIG. 140, as well as a yaw movement and actuation movement around the Z axis of FIG. 140.

[0236] The power transmission unit 300 connects the operating unit 200 and the end tool 1100 and serves to transmit the driving force of the operating unit 200 to the end tool 1100, and may include a plurality of wires, pulleys, links, joints, gears, etc.

[0237] The end tool 1100, the operating section 200, the power transmission section 300, etc. of the electrocautery surgical instrument 10 shown in FIG. 140 will be described in detail later.

[0238] (Power transmission section)

[0239] The power transmission section 300 of the electrocautery surgical instrument 10 of FIG. 140 will be described in further detail below.

[0240] 140 to 146, etc., the power transmission section 300 of the electrocautery surgical instrument 10 according to one embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and braid wire 307.

[0241] 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. And wire 303 and wire 304 form a pair and can serve as a pitch wire.

[0242] Furthermore, the power transmission unit 300 of the electrocautery surgical instrument 10 according to one embodiment of the present invention may include fastening members 321, 322, 323, 324, 326, and 327 coupled to the ends of each wire to couple the wire to the pulley. Here, each fastening member may have various shapes, such as a ball shape or a tube shape, as needed.

[0243] Here, on the end tool 1100 side, fastening member 321 / fastening member 322 can play the role of a pitch wire-end tool fastening member, fastening member 323 can play the role of a first jaw wire-end tool fastening member, and fastening member 326 can play the role of a second jaw wire-end tool fastening member.

[0244] Furthermore, on the operating unit 200 side, fastening member 324 can serve as a first jaw wire-operating unit fastening member, and 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 blade wire-operating unit fastening member.

[0245] The connection relationship between the wire, the fastening member, and the pulleys will be described in detail below.

[0246] First, wire 301 and wire 305, which are first jaw wires, may be one single wire. After clamping fastening member 323, which is a first jaw wire-end tool fastening member, at the midpoint of first jaw wire, which is a single wire, and crimping and fixing fastening member 323, both strands of first jaw wire can be called wire 301 and wire 305, respectively, with fastening member 323 at the center.

[0247] 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 .

[0248] Then, by connecting this fastening member 323 to the pulley 1111, the wire 301 and the wire 305 can be fixedly connected to the pulley 1111. This allows the wire 301 and the wire 305 to be pulled and unwound, causing the pulley 1111 to rotate.

[0249] Meanwhile, a first jaw wire-operating portion fastening member 324 may be coupled to the ends of the wires 301 and 305 opposite to where the fastening member 323 is fastened.

[0250] By connecting first jaw wire-operating portion fastening member 324 to pulley 211 in this manner, wire 301 and wire 305 can be fixedly connected to pulley 211. As a result, when pulley 211 is rotated by a motor or by human power, wire 301 and wire 305 are pulled or unwound, allowing pulley 1111 of end tool 1100 to rotate.

[0251] Similarly, wire 302 and wire 306, which are second jaw wires, are coupled to fastening member 326, which is a second jaw wire-end tool fastening member, and second jaw wire-operating portion fastening member 327, respectively. Fastening member 326 is coupled to pulley 1121, and second jaw wire-operating portion fastening member 327 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 1121 of end tool 1100 can be rotated.

[0252] Similarly, pitch wire 304 is coupled to pitch wire-end tool fastener 321 and a pitch wire operating section fastener (not shown), and pitch wire 303 is coupled to pitch wire-end tool fastener 322 and a pitch wire operating section fastener (not shown).

[0253] Fastener 321 is coupled to first pitch pulley portion 1163a of end tool hub 1160, fastener 322 is coupled to second pitch pulley portion 1163b of end tool hub 1160, and pitch wire-operating portion fastener (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 end tool hub 1160 of end tool 1100 to rotate.

[0254] Meanwhile, one end of the braid wire 307 is coupled to a blade 1175, which will be described later, and the other end is coupled to a blade operating unit 260 of the operating unit 200. By operating the blade operating unit 260, the braid wire 307 can perform a cutting action while moving from the proximal portion 1105 of the end tool 1100 toward the distal portion 1104, or the braid wire 307 can return from the distal portion 1104 of the end tool 1100 toward the proximal portion 1105.

[0255] In this case, at least a portion of the braid wire 307 may be housed within a guide tube 1170, which will be described later. Therefore, when the guide tube 1170 is bent in response to pitch or yaw movement of the end tool 1100, the braid wire 307 housed therein may also be bent along with the guide tube 1170. Such a guide tube 1170 will be described in more detail later.

[0256] Furthermore, the braid wire 307 is formed so as to be able to move linearly within the connecting portion 400 along the longitudinal direction of the connecting portion 400. One end of the braid wire 307 is coupled to the blade 1175, so when the braid wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 1175 connected thereto also moves linearly. In other words, when the braid wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 1175 connected thereto moves toward the distal portion 1104 or the proximal portion 1105 of the end tool 1100, thereby performing a cutting operation. This will be described in more detail later.

[0257] (end tool)

[0258] The endotool 1100 of the electrocautery surgical instrument 10 of FIG. 140 will be described in further detail below.

[0259] Fig. 140 is a perspective view showing an electrocautery surgical instrument according to a fourth embodiment of the present invention. Figs. 141 to 146 are views showing an end tool of the electrocautery surgical instrument of Fig. 140.

[0260] Here, Fig. 141 shows a state in which the end tool hub 1160 and the pitch hub 1150 are coupled together, and Fig. 142 shows a state in which the end tool hub 1160 and the pitch hub 1150 are removed. Fig. 143 shows a state in which the first jaw 1101 and the second jaw 1102 are removed, and Fig. 144 shows a state in which the first jaw 1101, the second jaw 1102, the pulley 1111, the pulley 1121, etc. are removed. Meanwhile, Fig. 145 is a view mainly showing the wires, and Fig. 146 is a view mainly showing the pulleys.

[0261] 140 to 162, an end tool 1100 according to a fourth embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 1101 and a second jaw 1102. Here, each of the first jaw 1101 and the second jaw 1102, or a component that collectively includes the first jaw 1101 and the second jaw 1102, can be referred to as a jaw 1103.

[0262] The end tool 1100 may also include pulleys 1111, 1113, 1114, 1115, and 1116 associated with the rotational movement of the first jaw 1101. The end tool 1100 may also include pulleys 1121, 1123, 1124, 1125, and 1126 associated with the rotational movement of the second jaw 1102.

[0263] Here, although the drawings show opposing pulleys formed parallel to each other, the concept of the present invention is not limited thereto, and each pulley may be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0264] Additionally, the fourth embodiment end tool 1100 of the present invention may include an end tool hub 1160 and a pitch hub 1150 .

[0265] A first rotating shaft 1141, which will be described later, is inserted through the end tool hub 1160, and the pulley 1111 and pulley 1121 axially coupled to the first rotating shaft 1141 and at least a portion of the first jaw 1101 and second jaw 1102 coupled thereto may be housed inside the end tool hub 1160. Here, one feature of one embodiment of the present invention is that a wire guide portion 1168 that functions as an auxiliary pulley is formed in the end tool hub 1160. That is, the end tool hub 1160 may be formed with a first wire guide portion 1168a and a second wire guide portion 1168b that guide the paths of the wires 305 and 302. Such a wire guide portion 1168 of the end tool hub 1160 can function as an auxiliary pulley (see 612, 622 in Figure 39) in a modified example of the first embodiment, thereby changing the path of the wire; the first wire guide portion 1168a and second wire guide portion 1168b of the end tool hub 1160, which function as an auxiliary pulley in this manner, will be described in more detail later.

[0266] Meanwhile, a first pitch pulley portion 1163a and a second pitch pulley portion 1163b that serve as end tool pitch pulleys may be formed at one end of the end tool hub 1160. The wires 303 and 304, which are pitch wires, are coupled to the first pitch pulley portion 1163a and the second pitch pulley portion 1163b that serve as end tool pitch pulleys, and the end tool hub 1160 performs a pitch movement while rotating about the third rotation axis 1143.

[0267] A third rotation shaft 1143 and a fourth rotation shaft 1144 are inserted through the pitch hub 1150, and the third rotation shaft 1143 allows the pitch hub 1150 to be axially compressed with the end tool hub 1160. Therefore, the end tool hub 1160 can be formed to be pitch rotatable relative to the pitch hub 1150 around the third rotation shaft 1143.

[0268] Furthermore, the pitch hub 1150 can accommodate at least a portion of the pulleys 1113, 1114, 1123, and 1124 axially coupled to the third rotating shaft 1143. The pitch hub 1150 can accommodate at least a portion of the pulleys 1115, 1116, 1125, and 1126 axially coupled to the fourth rotating shaft 1144.

[0269] One end of the pitch hub 1150 is connected to the end tool hub 1160 , and the other end of the pitch hub 1150 is connected to the coupling portion 400 .

[0270] Here, the end tool 1100 according to the fourth embodiment of the present invention may include a first rotating shaft 1141, a third rotating shaft 1143, and a fourth rotating shaft 1144. As described above, the first rotating shaft 1141 may be inserted through the end tool hub 1160, and the third rotating shaft 1143 and the fourth rotating shaft 1144 may be inserted through the pitch hub 1150.

[0271] The first rotation shaft 1141, the third rotation shaft 1143, and the fourth rotation shaft 1144 can be arranged in order from the distal end 1104 toward the proximal end 1105 of the end tool 1100. Therefore, in order from the distal end 1104, the first rotation shaft 1141 can also be called the first pin, the third rotation shaft 1143 the third pin, and the fourth rotation shaft 1144 the fourth pin.

[0272] Here, the first rotation axis 1141 can function as an end tool jaw pulley rotation axis, the third rotation axis 1143 can function as an end tool pitch rotation axis, and the fourth rotation axis 1144 can function as an end tool pitch auxiliary rotation axis of the end tool 1100.

[0273] Here, each rotation axis may include two axes, a first sub-axis and a second sub-axis, or may be expressed as being formed by dividing each rotation axis into two.

[0274] For example, the first rotation shaft 1141 may include two shafts, a first sub-shaft 1141a and a second sub-shaft 1141b, the third rotation shaft 1143 may include two shafts, a first sub-shaft 1143a and a second sub-shaft 1143b, and the fourth rotation shaft 1144 may include two shafts, a first sub-shaft and a second sub-shaft.

[0275] The reason each rotation shaft is divided into two parts is so that a guide tube 1170, which will be described later, passes through the end tool hub 1160 and the pitch hub 1150. That is, the guide tube 1170 can pass between the first sub-shaft and the second sub-shaft of each rotation shaft. This will be described in more detail later. Here, the first sub-shaft and the second sub-shaft may be arranged on the same axis, or may be arranged with a certain amount of offset.

[0276] Although the drawings show each rotating shaft as being divided into two, the concept of the present invention is not limited to this. That is, each rotating shaft may be bent midway to form an escape route for the guide tube 1170.

[0277] Each of these rotating shafts 1141, 1143, 1144 may be fitted with one or more pulleys, which will be described in more detail below.

[0278] Meanwhile, the end tool 1100 may further include an actuation rotation axis 1145. Specifically, the first jaw 1101 and the second jaw 1102 may be axially coupled by the actuation rotation axis 1145, and in this state, the first jaw 1101 and the second jaw 1102 may perform an actuation operation while rotating around the actuation rotation axis 1145. Here, the actuation rotation axis 1145 may be disposed closer to the distal portion 1104 than the first rotation axis 1141.

[0279] Here, one feature of the end tool 1100 of the fourth embodiment of the present invention is that the first rotation axis 1141, which is the yaw rotation axis, and the actuation rotation axis 1145 are provided separately rather than on the same axis. That is, the first rotation axis 1141, which is the rotation axis of the pulleys 1111 and 1121 that are jaw pulleys and is the rotation axis of the yaw operation, and the actuation rotation axis 1145, which is the rotation axis of the second jaw 1102 relative to the first jaw 1101 and is the rotation axis of the actuation operation, are formed at a certain distance from each other, thereby ensuring a space in which the guide tube 1170 and the braid wire 307 housed therein can be gently bent. The actuation rotation axis 1145 will be described in more detail later.

[0280] Pulley 1111 functions as an end tool first jaw pulley, and pulley 1121 functions as an end tool second jaw pulley. Pulley 1111 can also be referred to as a first jaw pulley, and pulley 1121 can also be referred to as a second jaw pulley, and these two components can be collectively referred to as end tool jaw pulleys or simply jaw pulleys.

[0281] Pulleys 1111 and 1121, which are end tool jaw pulleys, are formed to face each other and are independently rotatable about a first rotation axis 1141, which is the end tool jaw pulley rotation axis. Pulleys 1111 and 1121 are formed to be spaced apart to a certain extent, and a blade assembly housing can be formed therebetween. At least a portion of a blade assembly, which will be described later, can be disposed in this blade assembly housing. In other words, a blade assembly including a guide tube 1170 is disposed between pulleys 1111 and 1121.

[0282] Here, the pulley 1111 is coupled with the first jaw 1101, and when the pulley 1111 rotates around the first rotation shaft 1141, the first jaw 1101 can also rotate around the first rotation shaft 1141 together.

[0283] Meanwhile, the pulley 1121 is connected to the second jaw 1102, and when the pulley 1121 rotates around the first rotation shaft 1141, the second jaw 1102 connected thereto can rotate around the first rotation shaft 1141.

[0284] The yaw motion and actuation motion of the end tool 1100 are performed in response to the rotation of the pulley 1111 and the pulley 1121. That is, when the pulley 1111 and the pulley 1121 rotate in the same direction around the first rotation axis 1141, the first jaw 1101 and the second jaw 1102 rotate around the first rotation axis 1141, thereby performing a yaw motion. On the other hand, when the pulley 1111 and the pulley 1121 rotate in the opposite direction around the first rotation axis 1141, the first jaw 1101 and the second jaw 1102 rotate around the actuation rotation axis 1145, thereby performing an actuation motion.

[0285] Pulleys 1113 and 1114 function as end tool first jaw pitch main pulleys, and pulleys 1123 and 1124 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.

[0286] Pulleys 1115 and 1116 function as end tool first jaw pitch sub-pulleys, and pulleys 1125 and 1126 function as end tool second jaw pitch sub-pulleys, and these two components can also be collectively referred to as end tool jaw pitch sub-pulleys.

[0287] The components involved in the rotation of the pulley 1111 will be described below.

[0288] Pulley 1113 and pulley 1114 function as end tool first jaw pitch main pulleys. That is, they function as main rotating pulleys for the pitch operation of first jaw 1101. Here, a wire 301 which is the first jaw wire is wound around pulley 1113, and a wire 305 which is the first jaw wire is wound around pulley 1114.

[0289] Pulley 1115 and pulley 1116 function as end tool first jaw pitch sub-pulleys. That is, they function as sub-rotating pulleys for the pitch operation of first jaw 1101. Here, a wire 301 which is the first jaw wire is wound around pulley 1115, and a wire 305 which is the first jaw wire is wound around pulley 1116.

[0290] Here, pulleys 1113 and 1114 are disposed on one side of pulley 1111 so as to face each other. Here, pulleys 1113 and 1114 are formed to be independently rotatable about a third rotation axis 1143, which is an end tool pitch rotation axis. In addition, pulleys 1115 and 1116 are disposed on one side of pulleys 1113 and 1114 so as to face each other. Here, pulleys 1115 and 1116 are formed to be independently rotatable about a fourth rotation axis 1144, which is an end tool pitch auxiliary rotation axis. Here, in the drawing, pulleys 1113, 1115, 1114, and 1116 are all shown as being rotatable about the Y-axis direction, but the concept 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.

[0291] Wire 301, which is the first jaw wire, is wound around pulley 1115, pulley 1113, and pulley 1111 in sequence so that at least a portion of the wire comes into contact with pulley 1115, pulley 1113, and pulley 1111. Wire 305, which is connected to wire 301 by fastening member 323, is wound around pulley 1111, first wire guide portion 1168a of end tool hub 1160, pulley 1114, and pulley 1116 in sequence so that at least a portion of the wire comes into contact with pulley 1115, pulley 1113, and pulley 1111.

[0292] Explaining this from another perspective, the first jaw wires, wire 301 and wire 305, are wound sequentially so that at least a portion of them contact pulley 1115, pulley 1113, pulley 1111, first wire guide portion 1168a of end tool hub 1160, pulley 1114, and pulley 1116, and wire 301 and wire 305 are formed so that they can move along the pulleys while rotating the pulleys.

[0293] Therefore, when wire 301 is pulled in the direction of arrow 301 in Fig. 145, fastening member 323 to which wire 301 is coupled and pulley 1111 coupled thereto rotate counterclockwise. Conversely, when wire 305 is pulled in the direction of arrow 305 in Fig. 145, fastening member 323 to which wire 305 is coupled and pulley 1111 coupled thereto rotate clockwise in Fig. 145.

[0294] Next, components related to the rotation of the pulley 1121 will be described.

[0295] Pulley 1123 and pulley 1124 function as end tool second jaw pitch main pulleys. That is, they function as main rotating pulleys for the pitch operation of second jaw 1102. Here, wire 306, which is the second jaw wire, is wound around pulley 1123, and wire 302, which is the second jaw wire, is wound around pulley 1124.

[0296] Pulley 1125 and pulley 1126 function as end tool second jaw pitch sub-pulleys. That is, they function as sub-rotating pulleys for the pitch operation of second jaw 1102. Here, wire 306, which is the second jaw wire, is wound around pulley 1125, and wire 302, which is the second jaw wire, is wound around pulley 1126.

[0297] Here, pulleys 1123 and 1124 are disposed on one side of pulley 1121 so as to face each other. Pulleys 1123 and 1124 are formed to be independently rotatable about a third rotation axis 1143, which is an end tool pitch rotation axis. Pulleys 1125 and 1126 are disposed on one side of pulleys 1123 and 1124 so as to face each other. Pulleys 1125 and 1126 are formed to be independently rotatable about a fourth rotation axis 1144, which is an end tool pitch auxiliary rotation axis. Here, in the drawings, pulleys 1123, 1125, 1124, and 1126 are all shown as being rotatable about the Y-axis direction, but the concept 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.

[0298] The wire 306, which is the second jaw wire, is wound around the pulley 1125, the pulley 1123, and the pulley 1121 in order so that at least a portion of the wire contacts the pulley 1125, the pulley 1123, and the pulley 1121. The wire 302, which is connected to the wire 306 by the fastening member 326, is wound around the pulley 1121, the second wire guide portion 1168b of the end tool hub 1160, the pulley 1124, and the pulley 1126 in order so that at least a portion of the wire contacts the pulley 1125, the pulley 1123, and the pulley 1121.

[0299] Explaining this from another perspective, wire 306, which is the second jaw wire, and wire 302 are wound sequentially so as to be in at least partial contact with pulley 1125, pulley 1123, pulley 1121, second wire guide portion 1168b of end tool hub 1160, pulley 1124, and pulley 1126, and wire 306 and wire 302 are formed so as to be able to move along the pulleys while rotating the pulleys.

[0300] Therefore, when wire 306 is pulled in the direction of arrow 306 in Fig. 145, fastening member 326 to which wire 306 is coupled and pulley 1121 coupled thereto rotate in the clockwise direction in Fig. 145. Conversely, when wire 302 is pulled in the direction of arrow 302 in Fig. 145, fastening member 326 to which wire 302 is coupled and pulley 1121 coupled thereto rotate in the counterclockwise direction in Fig. 145.

[0301] The pitch movement of the present invention will be described in more detail below.

[0302] On the other hand, when the wire 301 is pulled toward the arrow 301 in FIG. 145 and at the same time the wire 305 is pulled toward the arrow 305 in FIG. 145 (i.e., when both strands of the first jaw wire are pulled), as shown in FIG. 144, the wire 301 and the wire 305 are wound around the lower part of the pulley 1113 and the pulley 1114 which are rotatable around the third rotation axis 1143 which is the end tool pitch rotation axis, and therefore the pulley 1111 to which the wire 301 and the wire 305 are fixedly connected and the end tool hub 1160 to which the pulley 1111 is connected rotate together in the counterclockwise direction around the third rotation axis 1143, and as a result the end tool 1100 performs a pitch motion while rotating downward. At this time, the second jaw 1102 and the wires 302 and 306 fixedly connected thereto are wound around the upper parts of the pulleys 1123 and 1124 which are rotatable around the third rotation axis 1143, so that the wires 302 and 306 are rewound in the opposite direction to the pulleys 302 and 306, respectively.

[0303] Conversely, when the wire 302 is pulled in the direction of the arrow 302 in Fig. 145 and the wire 306 is simultaneously pulled in the direction of the arrow 306 in Fig. 145, the wires 302 and 306 are wound around the upper parts of the pulleys 1123 and 1124 that are rotatable around the third rotation axis 1143, which is the end tool pitch rotation axis, as shown in Fig. 144, so that the pulley 1121 to which the wires 302 and 306 are fixedly coupled and the end tool hub 1160 to which the pulley 1121 is coupled rotate together in the clockwise direction around the third rotation axis 1143 as a whole, resulting in the end tool 1100 performing a pitch motion while rotating upward. At this time, the first jaw 1101 and the wires 301 and 305 fixedly coupled thereto are wound around the lower parts of the pulleys 1113 and 1114 that are rotatable around the third rotation axis 1143, so that the wires 302 and 306 move in the opposite direction to the pulleys 301 and 305, respectively.

[0304] Meanwhile, the end tool hub 1160 of the end tool 1100 of the electrocautery surgical instrument 10 of the present invention may further include a first pitch pulley portion 1163a and a second pitch pulley portion 1163b that serve as end tool pitch pulleys, 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.

[0305] In detail, the end tool hub 1160 including the first pitch pulley portion 1163a and the second pitch pulley portion 1163b may be formed to be rotatable around the third rotation axis 1143, which is the end tool pitch rotation axis. In addition, the wires 303 and 304 can serve to connect the first pitch pulley portion 1163a and the second pitch pulley portion 1163b of the end tool 1100 to the pulleys 231 and 232 of the operating unit 200.

[0306] Therefore, when pulleys 231 and 232 of operating unit 200 rotate, the rotation of pulleys 231 and 232 is transmitted to end tool hub 1160 of end tool 1100 via wires 303 and 304, causing end tool hub 1160 to rotate together, resulting in end tool 1100 performing a pitch motion while rotating.

[0307] That is, the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention includes a first pitch pulley portion 1163a and a second pitch pulley portion 1163b of the end tool 1100, pulleys 231 and 232 of the operating unit 200, and wires 303 and 304 of the power transmission unit 300 for transmitting power for the pitch movement, and the driving force of the pitch movement of the operating unit 200 is more completely transmitted to the end tool 1100, thereby improving operational reliability.

[0308] (braid wire and guide tube)

[0309] The braid wire 307 and guide tube 1170 of the present invention are described in more detail below.

[0310] The guide tube 1170 according to the present invention is formed to enclose the braid wire 307 at a predetermined section, and at this time, the braid wire 307 can move inside the guide tube 1170. In other words, with the braid wire 307 inserted inside the guide tube 1170, the braid wire 307 can move relative to the guide tube 1170.

[0311] Here, the guide tube 1170 prevents the braid wire 307 from bending in an unintended direction when the braid wire 307 is pushed or pulled, and serves to guide the path of the braid wire 307. The guide tube 1170 allows for a smooth cutting operation.

[0312] Meanwhile, one end of the guide tube 1170 may be fixedly coupled to an actuation hub 1190, which will be described later. Here, the actuation hub 1190 may function as a first coupling part. The other end of the guide tube 1170 may be fixedly coupled to a second coupling part (not shown) within the connecting part 400. As both ends of the guide tube 1170 are fixedly coupled to predetermined points (the first coupling part and the second coupling part), the overall length of the guide tube 1170 can be kept constant. Therefore, the length of the braid wire 307 inserted into the guide tube 1170 can also be kept constant.

[0313] Meanwhile, the guide tube 1170 according to the present invention may be made of a flexible material and bendable. Therefore, when the end tool 1100 yaws about the first rotation axis 1141 or pitches about the third rotation axis 1143, the guide tube 1170 may bend while its shape is deformed accordingly. Furthermore, when the guide tube 1170 is bent, the braid wire 307 inside it is also bent.

[0314] Here, the length of the guide tube 1170 is constant, but as the end tool 1100 rotates in pitch or yaw, the relative position and distance between the first coupling portion (i.e., actuation hub 1190) and the second coupling portion (not shown) may change. Therefore, a space is required for the guide tube 1170 to move by the amount of this change in distance. For this reason, a pitch slit 1164 and a yaw slit 1165 may be provided in the end tool hub 1160 to form a space for the guide tube 1170 to move. The configuration of such an end tool hub 1160 will be described in detail later.

[0315] Meanwhile, as described above, the braid wire 307 is inserted through the guide tube 1170, and the braid wire 307 is movable relative to the guide tube 1170 inside the guide tube 1170. That is, when the braid wire 307 is pulled while the guide tube 1170 is fixed, the braid 1175 connected to the braid wire 307 moves toward the proximal portion 1105, and when the braid wire 307 is pushed in, the braid 1175 connected to the braid wire 307 moves toward the distal portion 1104.

[0316] This will be explained in more detail as follows.

[0317] To reliably perform a cutting operation using the blade 1175, it is most reliable to push or pull the blade 1175 with the blade wire 307. Furthermore, in order for the blade wire 307 to push or pull the blade 1175, a guide tube 1170 capable of guiding the path of the blade wire 307 must be provided. If the guide tube 1170 does not guide the path of the blade wire 307 (i.e., if it does not grip the blade wire 307), cutting will not occur even when the blade wire 307 is pushed, and the middle portion of the blade wire 307 may be bent. Therefore, to reliably perform a cutting operation using the blade 1175, the blade wire 307 and the guide tube 1170 must be included.

[0318] Incidentally, to drive the cutting operation using the blade wire 307, it is necessary to cut while pushing the blade wire 307, and so a wire that is relatively hard (i.e., hard to bend) must be used as the blade wire 307 so that the blade wire 307 can receive the force at this time. However, a hard (i.e., hard to bend) wire has a small range of bending, and may be permanently deformed if a force exceeding a certain level is applied.

[0319] Another way to think about this is that for a stiff (i.e., hard to bend) wire, there is a minimum radius of curvature that it can bend or stretch without permanent deformation. In other words, if the wire or guide tube is bent below a certain radius of curvature, both the wire and the guide tube will be permanently deformed while remaining bent, making it impossible to cut while moving back and forth. Therefore, it is necessary to maintain the blade wire 307 so that it can be bent with a gentle curvature.

[0320] Therefore, to prevent the braid wire 307 from bending sharply as it passes through the pulley, space is required between the jaw 1103 (i.e., the actuation rotation axis 1145) and the end tool hub 1160 (i.e., the first rotation axis 1141, which is the yaw axis) to allow the braid wire 307 to bend gently.

[0321] For this reason, the present invention is characterized by having a first rotation axis 1141, which is a yaw rotation axis, and an actuation rotation axis 1145 separately, and by separating the first rotation axis 1141 and the actuation rotation axis 1145 to a certain extent, a space is formed in which the blade wire 307 and the guide tube 1170 can bend gently.

[0322] In addition, the braid wire 307 and the guide tube 1170 must pass through the end tool hub 1160 and be connected to the blade 1175, and space is required within the end tool hub 1160 for the braid wire 307 and the guide tube 1170 to bend. Therefore, 1) spaces for the braid wire 307 / guide tube 1170 to pass through and bend at the same time, i.e., pitch slits 1164 and yaw slits 1165, are formed within the end tool hub 1160, 2) each rotation axis must be formed in two, and 3) a pitch round portion 1166 and a yaw round portion 1167 are further formed to guide the bending of the braid wire 307 and the guide tube 1170.

[0323] From another perspective, when one end of the guide tube 1170 is fixed within the connecting portion 400 and the other end moves while making pitch and yaw movements, the guide tube 1170 bends in the direction that allows it to achieve the gentlest curvature (hereinafter referred to as the "maximum gentle curvature") according to the change in the distance between the two ends. Only by achieving the maximum gentle curvature in the natural state can the braid wire 307 move smoothly and permanent deformation not occur.

[0324] Therefore, to ensure the maximum gradual curvature, pitch slits 1164 and yaw slits 1165 can be formed on the path of the guide tube 1170, and further pitch rounds 1166 and yaw rounds 1167 can be formed on the end tool hub 1160. This allows the guide tube 1170 to have a shape that is as similar as possible to the maximum gradual curvature (even if it is not the maximum gradual curvature).

[0325] Such an end tool hub 1160 is described in more detail below.

[0326] (End Tool Hub)

[0327] Fig. 147 is a perspective view of the end tool hub of the electrocautery surgical instrument of Fig. 140. Figs. 148 and 149 are cutaway perspective views of the end tool hub of Fig. 147. Figs. 150 and 151 are perspective views of the end tool hub of Fig. 147. Fig. 152 is a side view of the end tool hub and guide tube of Fig. 147. Fig. 153 is a top view of the end tool hub and guide tube of Fig. 147.

[0328] 147 to 153, an end tool hub 1160 includes a main body portion 1161, a first jaw pulley coupling portion 1162a, a second jaw pulley coupling portion 1162b, a first pitch pulley portion 1163a, a second pitch pulley portion 1163b, a pitch slit 1164, a yaw slit 1165, a pitch round portion 1166, a yaw round portion 1167, and a wire guide portion 1168. The wire guide portion 1168 includes a first wire guide portion 1168a and a second wire guide portion 1168b.

[0329] A first jaw pulley coupling portion 1162a and a second jaw pulley coupling portion 1162b may be formed on the distal side of the end tool hub 1160. Here, the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b are formed to face each other, and the pulleys 1111 and 1121 are housed therein. Here, the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b may be formed approximately parallel to a plane perpendicular to the first rotation axis 1141, which is the yaw rotation axis.

[0330] The first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b are connected by the main body portion 1161. That is, the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b, which are parallel to each other, are coupled by the main body portion 1161 formed in a direction approximately perpendicular thereto, and the first jaw pulley coupling portion 1162a, the second jaw pulley coupling portion 1162b, and the main body portion 1161 form an approximately "U" shape, with the pulleys 1111 and 1121 housed inside.

[0331] From another perspective, this can also be expressed as first jaw pulley connecting portion 1162a and second jaw pulley connecting portion 1162b being formed extending from main body portion 1161 in the X-axis direction.

[0332] Here, the pulley 1111 serving as the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion 1162a of the end tool hub 1160, and the pulley 1121 serving as the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion 1162b of the end tool hub 1160, and a yaw slit 1165 can be formed between the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b. At least a portion of a blade assembly, which will be described later, can be disposed within the yaw slit 1165. From another perspective, this can also be expressed as at least a portion of a guide tube 1170 of the blade assembly being disposed between the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b. In this way, one feature of the present invention is that by disposing the blade assembly including the guide tube 1170 between the pulley 1111, which is the first jaw pulley, and the pulley 1121, which is the second jaw pulley, it is possible to perform not only pitch and yaw movements of the end tool 1100, but also cutting operations using the blade 1175. This will be described in more detail later.

[0333] Meanwhile, a through hole is formed in the first jaw pulley coupling portion 1162a, and the first rotating shaft 1141 passes through the first jaw pulley coupling portion 1162a and the pulley 1111 to axially couple them. Also, a through hole is formed in the second jaw pulley coupling portion 1162b, and the first rotating shaft 1141 passes through the second jaw pulley coupling portion 1162b and the pulley 1121 to axially couple them.

[0334] In this case, as described above, the first rotating shaft 1141, which is the yaw rotating shaft, can be divided into two parts, the first sub-shaft 1141a and the second sub-shaft 1141b, and the guide tube 1170 can pass between the first sub-shaft 1141a and the second sub-shaft 1141b of the first rotating shaft 1141.

[0335] A yaw slit 1165 can be formed between the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b. By forming the yaw slit 1165 in the end tool hub 1160 in this manner, the guide tube 1170 can pass through the inside of the end tool hub 1160.

[0336] From another perspective, the first rotation shaft 1141 is separated into upper and lower parts without passing through the end tool hub 1160, and the yaw slit 1165 can be formed in the vicinity of the first rotation shaft 1141 on a plane perpendicular to the first rotation shaft 1141. Therefore, the guide tube 1170 can move within the yaw slit 1165 (i.e., move left and right) while passing through the vicinity of the first rotation shaft 1141.

[0337] Meanwhile, a yaw round portion 1167 may be further formed on the main body portion 1161. The yaw round portion 1167 may be rounded to have a predetermined curvature. Specifically, when viewed from a plane perpendicular to the first rotation axis 1141, which is the yaw rotation axis, the yaw round portion 1167 may be rounded to have a predetermined curvature. For example, the yaw round portion 1167 may be formed in a fan shape and may be formed along a path that the guide tube 1170 curves on the XY plane. In this way, the yaw round portion 1167 can play a role in guiding the path of the guide tube 1170 when the end tool 1100 performs yaw rotation.

[0338] A wire guide portion 1168 that guides the path of a wire passing through the end tool hub 1160 is formed on one side of the main body portion 1161. Here, the wire guide portion 1168 includes a first wire guide portion 1168a and a second wire guide portion 1168b. Here, the first wire guide portion 1168a may be formed on the inner surface of the first jaw pulley coupling portion 1162a. And the second wire guide portion 1168b may be formed on the inner surface of the second jaw pulley coupling portion 1162b.

[0339] Here, wire guide portion 1168 may be formed in the shape of a cylinder with a substantially semicircular cross section. This semicircular portion can be disposed so as to protrude toward pulley 1111 and pulley 1121. From another perspective, this can also be expressed as wire guide portion 1168 being formed to protrude toward the space formed by first jaw pulley coupling portion 1162a, second jaw pulley coupling portion 1162b, and main body portion 1161. From another perspective, this can also be expressed as the region of wire guide portion 1168 adjacent to first jaw pulley coupling portion 1162a and second jaw pulley coupling portion 1162b being curved so that its cross section has a predetermined curvature.

[0340] Or, from another perspective, the wire guide portion 1168 has the wires 305 and 302 wound around its outer circumferential surface, and can be said to function as a kind of pulley member that guides the paths of the wires 305 and 302. However, the wire guide portion 1168 here is not a member that rotates around a predetermined axis like a pulley in the original sense, but is formed to be fixed as part of the end tool hub 1160, and can be said to perform some of the functions of a pulley by having the wires wound around it.

[0341] Here, in the figure, wire guide portion 1168 is shown as having a cylindrical shape with a semicircular cross section. That is, at least a portion of the cross section of wire guide portion 1168 on the XY plane is shown as having a predetermined arc shape. However, the concept of the present invention is not limited to this, and it can be said that the wire guide portion 1168 can be formed into various shapes and sizes suitable for guiding the paths of wires 305 and 302, such as a cross section formed to have a predetermined curvature such as an ellipse or parabola, or a polygonal prism with corners that are rounded to a certain extent.

[0342] Here, a guide groove may be further formed in the portion of the wire guide portion 1168 that contacts the wire 305 and the wire 302 to better guide the paths of the wire 305 and the wire 302. The guide groove may be formed in the shape of a groove that is recessed to a certain extent from the protruding surface of the wire guide portion 1168.

[0343] Here, although the figure shows the guide groove as being formed over the entire arcuate surface of the wire guide portion 1168, the concept of the present invention is not limited to this, and it can be said that the guide groove can be formed over only a portion of the arcuate surface of the wire guide portion 1168 if necessary.

[0344] By forming a guide groove in the wire guide portion 1168 in this way, unnecessary friction with the wire can be reduced, and the durability of the wire can be improved.

[0345] A first pitch pulley portion 1163a and a second pitch pulley portion 1163b that function as end tool pitch pulleys may be formed on the proximal side of the end tool hub 1160. Here, the first pitch pulley portion 1163a and the second pitch pulley portion 1163b may be formed to face each other. Here, the first pitch pulley portion 1163a and the second pitch pulley portion 1163b may be formed approximately parallel to a plane perpendicular to the third rotation axis 1143, which is the pitch rotation axis.

[0346] Specifically, one end of the end tool hub 1160 is formed in a disk shape like a pulley, and grooves around which wires are wound are formed on the outer circumferential surface to form a first pitch pulley portion 1163a and a second pitch pulley portion 1163b. The above-mentioned wires 303 and 304 are coupled to the first pitch pulley portion 1163a and the second pitch pulley portion 1163b, which function as end tool pitch pulleys, and the end tool hub 1160 performs a pitch movement while rotating about the third rotation axis 1143.

[0347] On the other hand, although not shown in the figure, the pitch pulley can also be formed as a member separate from the end tool hub 1160 and coupled to the end tool hub 1160.

[0348] The first pitch pulley portion 1163a and the second pitch pulley portion 1163b are connected by the main body portion 1161. That is, the first pitch pulley portion 1163a and the second pitch pulley portion 1163b, which are parallel to each other, are joined by the main body portion 1161 formed in a direction approximately perpendicular thereto, and the first pitch pulley portion 1163a, the second pitch pulley portion 1163b, and the main body portion 1161 form an approximately "U" shape.

[0349] From another perspective, this can also be expressed as first pitch pulley portion 1163a and second pitch pulley portion 1163b extending from main body portion 1161 in the −X-axis direction.

[0350] Meanwhile, a through hole is formed in the first pitch pulley portion 1163a, so that the third rotating shaft 1143 can pass through the first pitch pulley portion 1163a. ​​Also, a through hole is formed in the second pitch pulley portion 1163b, so that the third rotating shaft 1143 can pass through the second pitch pulley portion 1163b.

[0351] In this case, as described above, the third rotation shaft 1143, which is the pitch rotation shaft, can be divided into two parts, the first sub-shaft 1143a and the second sub-shaft 1143b, and the guide tube 1170 can pass between the first sub-shaft 1143a and the second sub-shaft 1143b of the third rotation shaft 1143.

[0352] A pitch slit 1164 can be formed between the first pitch pulley portion 1163a and the second pitch pulley portion 1163b. By forming the pitch slit 1164 in the end tool hub 1160 in this manner, a guide tube 1170 can pass through the interior of the end tool hub 1160.

[0353] From another perspective, the third rotation shaft 1143 is separated into left and right halves without passing through the end tool hub 1160, and the pitch slit 1164 can be formed near the third rotation shaft 1143 on a plane perpendicular to the third rotation shaft 1143. Therefore, the guide tube 1170 can move (i.e., move up and down) within the pitch slit 1164 while passing through the vicinity of the third rotation shaft 1143.

[0354] Meanwhile, a pitch round portion 1166 may be further formed on the main body portion 1161. The pitch round portion 1166 may be rounded to have a predetermined curvature. Specifically, when viewed from a plane perpendicular to the third rotation axis 1143, which is the pitch rotation axis, the pitch round portion 1166 may be rounded to have a predetermined curvature. For example, the pitch round portion 1166 may be formed in a fan shape and may be formed along the path of the guide tube 1170 bending on the XZ plane. In this way, the pitch round portion 1166 can play a role in guiding the path of the guide tube 1170 when the end tool 1100 performs pitch rotation.

[0355] Here, the pitch slit 1164 and the yaw slit 1165 can be formed to be connected to each other. Therefore, the guide tube 1170 and the braid wire 307 therein can be disposed to completely penetrate the inside of the end tool hub 1160. This allows the blade 1175 coupled to one end of the braid wire 307 to perform reciprocating linear motion inside the first jaw 1101 and the second jaw 1102.

[0356] As such, the present invention is characterized in that the braid wire 307 and the guide tube 1170 must pass through the end tool hub 1160 and be connected to the blade 1175, and space is required within the end tool hub 1160 for the braid wire 307 and the guide tube 1170 to bend. Therefore, 1) spaces for the braid wire 307 / guide tube 1170 to pass through and bend at the same time, i.e., pitch slit 1164 and yaw slit 1165, are formed within the end tool hub 1160, 2) the rotation axis is formed in two parts, and 3) a pitch round portion 1166 and a yaw round portion 1167 are further formed to guide the bending of the braid wire 307 / guide tube 1170.

[0357] The role and function of the wire guide portion 1168 will be explained in more detail below.

[0358] The wire guide portion 1168 can play a role in increasing the rotation radius of each of the first jaw 1101 and the second jaw 1102 by coming into contact with the wires 305 and 302 and changing the placement paths of the wires 305 and 302 to a certain extent.

[0359] In other words, if an auxiliary pulley is not provided, the first jaw pulley, pulley 1111, and the second jaw pulley, pulley 1121, can only rotate up to a right angle, but in the fourth embodiment of the present invention, by further providing a wire guide portion 1168 on the end tool hub 1160, the maximum rotation angle of each pulley can be increased.

[0360] This enables an operation in which the two jaws of the end tool 1100 must open for an actuation operation when the two jaws are yaw rotated by 90°. In other words, the configuration of the wire guide portion 1168 of the end tool hub 1160 has the characteristic of being able to widen the range of yaw rotation in which actuation operation is possible. In other words, the configuration of the wire guide portion 1168 of the end tool hub 1160 has the characteristic of being able to widen the range of yaw rotation in which actuation operation is possible.

[0361] Furthermore, by forming the wire guide portion 1168 on the end tool hub 1160 that already existed, without adding a separate structure such as an auxiliary pulley, the rotation range can be expanded without adding any additional parts or manufacturing processes.

[0362] In this way, there is no need to install a separate structure to expand the rotation angle, the number of parts is reduced, the manufacturing process is simplified, the length of the end tool is shortened by the size of the auxiliary pulley, and the length of the end tool when performing pitch movements is shortened, making it easier to perform surgical operations in a small space.

[0363] This will be explained in more detail as follows.

[0364] The end tool 1100 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that a wire guide portion 1168 that can change the path of the wire is formed on the inner wall of the end tool hub 1160, thereby changing the layout path of the wire without using a separate structure. By forming the wire guide portion 1168 in the end tool hub 1160 in this way and changing the layout paths of the wires 305 and 302 to a certain extent, the tangential directions of the wires 305 and 302 are changed, and therefore the rotation angle of the fastening members 323 and 326 that connect the wires to the pulleys is increased.

[0365] That is, the fastening member 326 that connects the wire 302 and the pulley 1121 can rotate until it is positioned on the common inscribed line between the pulley 1121 and the wire guide portion 1168. Similarly, the fastening member (see 323 in FIG. 6) that connects the wire 305 and the pulley 1111 can rotate until it is positioned on the common inscribed line between the pulley 1111 and the wire guide portion 1168, and the rotation angle of the fastening member (see 323 in FIG. 6) can be increased.

[0366] From another perspective, wire 301 and wire 305 wound around pulley 1111 by wire guide unit 1168 are positioned on one side of a plane perpendicular to the Y axis and passing through the X axis. At the same time, wire 302 and wire 306 wound around pulley 1121 by wire guide unit 1168 are positioned on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0367] In other words, pulleys 1113 and 1114 are arranged on one side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 1123 and 1124 are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0368] In other words, the wire 305 is located on the inscribed line between the pulley 1111 and the wire guide portion 1168, and the wire guide portion 1168 widens the rotation angle of the pulley 1111. In addition, the wire 302 is located on the inscribed line between the pulley 1121 and the wire guide portion 1168, and the wire guide portion 1168 widens the rotation angle of the pulley 1121.

[0369] Compared to the surgical instrument of the first embodiment, which has a separate auxiliary pulley, the surgical instrument of this embodiment does not have an auxiliary pulley but has a wire guide portion 1168 that can change the path of the wire on the inner wall of the endotool hub 1160, making it possible to shorten the length of the endotool. As the length of the endotool is shortened in this way, it becomes easier for the surgeon to operate the instrument when performing surgery in a narrow surgical space inside the human body, and it is possible to obtain the effect of reducing side effects of surgery.

[0370] According to the present invention, the rotation radius of the first jaw pulley, pulley 1111, and the second jaw pulley, pulley 1121, is increased, which has the effect of widening the yaw operation range in which normal opening / closing actuation and cutting operations can be performed.

[0371] (Actuation Hub)

[0372] Fig. 154 is a perspective and cutaway perspective view of the actuation hub of the electrocautery surgical instrument of Fig. 140 of Fig. 147. Fig. 155 is a cutaway perspective view of the actuation hub of Fig. 154 with a guide tube, braid wire, and braid attached. Fig. 156 is an exploded perspective view of the end tool of the electrocautery surgical instrument of Fig. 140.

[0373] 154 to 156, the actuation hub 1190 may be formed in a box shape with a hollow space formed therein. The actuation hub 1190 is coupled to the first jaw 1101 and the second jaw 1102, respectively. Specifically, the actuation hub 1190 is axially coupled to the first jaw 1101 by a first actuation rotation shaft 1145a. The actuation hub 1190 is axially coupled to the second jaw 1102 by a second actuation rotation shaft 1145b. In this case, the first actuation rotation shaft 1145a and the second actuation rotation shaft 1145b may be arranged on the same line in the Z-axis direction.

[0374] A tube fixing portion 1190a may be formed inside the actuation hub 1190, and one end of the guide tube 1170 may be fixedly coupled to the tube fixing portion 1190a.

[0375] Meanwhile, a blade receiving portion 1190b may be formed inside the actuation hub 1190, and the blade 1175 may be received in the blade receiving portion 1190b.

[0376] A wire through hole 1190c can be formed between the tube fixing portion 1190a and the blade accommodating portion 1190b in the actuation hub 1190.

[0377] That is, a tube fixing portion 1190 a , a wire through-hole 1190 c , and a blade accommodating portion 1190 b are sequentially formed inside the actuation hub 1190 , and the blade wire 307 can pass through the inside of the actuation hub 1190 and be connected to the blade 1175 .

[0378] In this way, by providing an actuation hub 1190 to which the guide tube 1170 is connected between the first jaw 1101 and the second jaw 1102, even when the first jaw 1101 or the second jaw 1102 rotates around the first rotation axis 1141 or the actuation rotation axis 1145, the guide tube 1170 does not bend or the bending angle can be reduced.

[0379] In detail, when the guide tube 1170 is directly connected to the first jaw 1101 or the second jaw 1102, when the first jaw 1101 or the second jaw 1102 rotates, one end of the guide tube 1170 also rotates together with the first jaw 1101 or the second jaw 1102, causing the guide tube 1170 to bend.

[0380] In contrast, when the guide tube 1170 is connected to an actuation hub 1190 that is independent of the rotation of the jaw 1103, as in this embodiment, the guide tube 1170 does not bend even when the first jaw 1101 or the second jaw 1102 rotates, or if it bends slightly, the bending angle can be made small.

[0381] In other words, by changing the direct connection between the guide tube 1170 and the jaw 1103 by the actuation hub 1190 to an indirect connection, the degree to which the guide tube 1170 bends when the jaw 1103 rotates is reduced.

[0382] (First jaw, second jaw and actuation movement)

[0383] The coupling structure between the first jaw 1101 and the second jaw 1102 of the end tool 1100 of the surgical instrument 10 in FIG. 140 will be described in more detail below.

[0384] 157 to 162, the first jaw 1101 includes a movable coupling hole 1101c, a jaw pulley coupling hole 1101d, and a shaft through-hole 1101e.

[0385] The first jaw 1101 is formed in the shape of an elongated rod as a whole, and has a pulley 1111 coupled to one end thereof so as to be rotatable together with the pulley 1111 .

[0386] On the other hand, a movable coupling hole 1101c, a jaw pulley coupling hole 1101d, and a shaft through-hole 1101e may be formed on the side of the first jaw 1101 that couples with the pulley 1111, that is, on the proximal end side.

[0387] Here, the movable coupling hole 1101c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 1111a of a pulley 1111, which will be described later, can be fitted into this movable coupling hole 1101c. Here, the minor radius of the movable coupling hole 1101c may be substantially the same as or slightly larger than the radius of the shaft coupling portion 1111a. Meanwhile, the major radius of the movable coupling hole 1101c may be larger than the radius of the shaft coupling portion 1111a. Therefore, when the shaft coupling portion 1111a of the pulley 1111 is fitted into the movable coupling hole 1101c of the first jaw 1101, the shaft coupling portion 1111a can move within the movable coupling hole 1101c to a certain extent. This will be described in more detail later.

[0388] Meanwhile, the jaw pulley coupling hole 1101d is formed in a cylindrical hole, and a jaw coupling portion 1111b of a pulley 1111, which will be described later, can be fitted into this jaw pulley coupling hole 1101d. Here, the radius of the jaw pulley coupling hole 1101d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 1111b. Therefore, the jaw coupling portion 1111b of the pulley 1111 can be formed to be rotatably coupled to the jaw pulley coupling hole 1101d of the first jaw 1101. This will be described in more detail later.

[0389] The shaft through-portion 1101e may be formed relatively closer to the distal portion of the first jaw 1101 as compared with the movable coupling hole 1101c and the jaw pulley coupling hole 1101d. The shaft through-portion 1101e is formed in a hole shape, and the actuation rotation shaft 1145 can be inserted through the shaft through-portion 1101e.

[0390] The second jaw 1102 includes a movable coupling hole 1102c, a jaw pulley coupling hole 1102d, and a shaft through-hole 1102e.

[0391] The second jaw 1102 is formed in the shape of an elongated rod as a whole, and has a pulley 1121 coupled to one end thereof so as to be rotatable together with the pulley 1121 .

[0392] On the other hand, a movable coupling hole 1102c, a jaw pulley coupling hole 1102d, and a shaft through-hole 1102e may be formed on the side of the second jaw 1102 that couples with the pulley 1111, that is, on the proximal end side.

[0393] The movable coupling hole 1102c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 1121a of a pulley 1121 (described later) can be fitted into the movable coupling hole 1102c. The radius of the movable coupling hole 1102c may be substantially the same as or slightly larger than the radius of the shaft coupling portion 1121a. The major axis of the movable coupling hole 1102c may be larger than the radius of the shaft coupling portion 1121a. Therefore, when the shaft coupling portion 1121a of the pulley 1121 is fitted into the movable coupling hole 1102c of the second jaw 1102, the shaft coupling portion 1121a can move within the movable coupling hole 1102c to a certain extent. This will be described in more detail later.

[0394] Meanwhile, the jaw pulley coupling hole 1102d is formed in a cylindrical hole, and a jaw coupling portion 1121b of a pulley 1121, which will be described later, can be fitted into this jaw pulley coupling hole 1102d. Here, the radius of the jaw pulley coupling hole 1102d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 1121b. Therefore, the jaw coupling portion 1121b of the pulley 1121 can be formed to be rotatably coupled to the jaw pulley coupling hole 1102d of the second jaw 1102. This will be described in more detail later.

[0395] On the other hand, the shaft through-portion 1102e may be formed relatively closer to the distal portion of the second jaw 1102 as compared with the movable coupling hole 1102c and the jaw pulley coupling hole 1102d. The shaft through-portion 1102e is formed in a hole shape, and the actuation rotation shaft 1145 can be inserted through the shaft through-portion 1102e.

[0396] The pulley 1111, which is the first jaw pulley, may include a shaft coupling portion 1111a and a jaw coupling portion 1111b. The pulley 1111 may be formed in a rotatable disk shape overall, with the shaft coupling portion 1111a and the jaw coupling portion 1111b protruding to a certain extent from one surface of the pulley. As described above, the shaft coupling portion 1111a of the pulley 1111 may be fitted into the movable coupling hole 1101c of the first jaw 1101, and the jaw coupling portion 1111b of the pulley 1111 may be fitted into the jaw pulley coupling hole 1101d of the first jaw 1101. The pulley 1111 may be formed to be rotatable around the first rotation axis 1141, which is the end tool jaw pulley rotation axis.

[0397] Meanwhile, the pulley 1121, which is the second jaw pulley, may also include a shaft coupling portion 1121a and a jaw coupling portion 1121b. The pulley 1121 may be formed in a generally rotatable disk shape, with the shaft coupling portion 1121a and the jaw coupling portion 1121b formed to protrude to a certain extent from one surface of the pulley. As described above, the shaft coupling portion 1112a of the pulley 1112 may be fitted into the movable coupling hole 1102c of the second jaw 1102, and the jaw coupling portion 1112b of the pulley 1112 may be fitted into the jaw pulley coupling hole 1102d of the second jaw 1102. The pulley 1121 may be formed to be rotatable around the first rotation axis 1141, which is the end tool jaw pulley rotation axis.

[0398] The coupling relationships between the above-mentioned components are as follows:

[0399] The first rotating shaft 1141, which is the end tool jaw pulley rotating shaft, is inserted through the shaft coupling portion 1111a of the pulley 1111, the movable coupling hole 1101c of the first jaw 1101, the movable coupling hole 1102c of the second jaw 1102, and the shaft coupling portion 1121a of the pulley 1121 in that order.

[0400] The first actuation rotating shaft 1145a is inserted through the shaft through-portion 1101e of the first jaw 1101 and the actuation hub 1190 in that order. The second actuation rotating shaft 1145b is inserted through the shaft through-portion 1102e of the second jaw 1102 and the actuation hub 1190 in that order.

[0401] The shaft coupling portion 1111 a of the pulley 1111 is fitted into the movable coupling hole 1101 c of the first jaw 1101 , and the jaw coupling portion 1111 b of the pulley 1111 is fitted into the jaw pulley coupling hole 1101 d of the first jaw 1101 .

[0402] At this time, the jaw pulley coupling hole 1101d of the first jaw 1101 and the jaw coupling portion 1111b of the pulley 1111 are rotatably coupled to each other, and the movable coupling hole 1101c of the first jaw 1101 and the shaft coupling portion 1111a of the pulley 1111 are movably coupled to each other. (Here, "movably coupled" means that the shaft coupling portion 1111a of the pulley 1111 is coupled so as to be able to move to a certain extent within the movable coupling hole 1101c of the first jaw 1101.)

[0403] The shaft coupling portion 1121 a of the pulley 1121 is fitted into the movable coupling hole 1102 c of the second jaw 1102 , and the jaw coupling portion 1121 b of the pulley 1121 is fitted into the jaw pulley coupling hole 1102 d of the second jaw 1102 .

[0404] At this time, the jaw pulley coupling hole 1102d of the second jaw 1101 and the jaw coupling portion 1121b of the pulley 1121 are rotatably coupled to each other, and the movable coupling hole 1102c of the second jaw 1102 and the shaft coupling portion 1121a of the pulley 1121 are movably coupled to each other.

[0405] Here, the pulley 1111 and the pulley 1121 rotate around a first rotation axis 1141, which is the end tool jaw pulley rotation axis. On the other hand, the first jaw 1101 and the second jaw 1102 rotate around an actuation rotation axis 1145. In other words, the pulley 1111 and the first jaw 1101 have different rotation axes. Similarly, the pulley 1121 and the second jaw 1102 have different rotation axes.

[0406] That is, the first jaw 1101 has its rotation angle limited to a certain extent by the movable coupling hole 1101c, but basically rotates around the actuation rotation axis 1145, which is the jaw rotation axis. Similarly, the second jaw 1102 has its rotation angle limited to a certain extent by the movable coupling hole 1102c, but basically rotates around the actuation rotation axis 1145, which is the jaw rotation axis.

[0407] The amplification of the grip force due to the coupling relationship between the above-mentioned components will now be described.

[0408] A surgical instrument 110 according to an embodiment of the present invention has a feature in that the coupling structure between the first jaw 1101 and the second jaw 1102 forms an X-shape, and when the first jaw 1101 and the second jaw 1102 rotate in a direction toward each other (i.e., when the first jaw 1101 and the second jaw 1102 are closed), the grip force in the direction in which the first jaw 1101 and the second jaw 1102 are closed increases. This will be explained in more detail as follows.

[0409] As described above, there are two axes that serve as the center of rotation when the first jaw 1101 and the second jaw 1102 open and close. That is, the first jaw 1101 and the second jaw 1102 open and close around two axes, the first rotation axis 1141 and the actuation rotation axis 1145. At this time, the center of rotation of the first jaw 1101 and the second jaw 1102 is the actuation rotation axis 1145, and the center of rotation of the pulley 1111 and the pulley 1121 is the first rotation axis 1141. At this time, the first rotation axis 1141 is an axis whose position is fixed relative to the pulley, and the actuation rotation axis 1145 is an axis whose position moves linearly relative to the pulley. That is, when the pulley 1111 and the pulley 1121 rotate with the position of the first rotating shaft 1141 fixed, the actuation rotating shaft 1145, which is the rotating shaft of the first jaw 1101 and the second jaw 1102, moves back and forth, and the first jaw 1101 and the second jaw 1102 open / close. This will be explained in more detail as follows.

[0410] 161 is the distance from the jaw coupling portion 1121b to the shaft coupling portion 1121a of the pulley 1121, and this length is constant. Therefore, the distance from the first rotating shaft 1141 inserted into the shaft coupling portion 1121a to the jaw coupling portion 1121b is also constant at r1.

[0411] 161 is the distance from the jaw pulley coupling hole 1102d of the second jaw 1102 to the shaft penetrating portion 1102e, and this length is constant. Therefore, the distance from the jaw coupling portion 1121b of the pulley 1121 inserted in the jaw pulley coupling hole 1102d to the rotating shaft 1145 inserted in the shaft penetrating portion 1102e is also constant at r2.

[0412] That is, the lengths of r1 and r2 are kept constant. Therefore, when the pulley 1111 and the pulley 1121 rotate around the first rotation shaft 1141 in the directions of arrow B1 in FIG. 160 and arrow B2 in FIG. 161 to perform a closing operation, the first jaw 1101 and the second jaw 1102 rotate around the actuation rotation shaft 1145 while the angle between r1 and r2 changes with the lengths of r1 and r2 kept constant, and at this time the actuation rotation shaft 1145 itself also moves linearly (i.e., forward / backward) by the amount of arrow C1 in FIG. 160 and arrow C2 in FIG. 161.

[0413] That is, assuming that the position of the first rotation axis 1141, which is the rotation axis of the end tool jaw pulley, is fixed, when the first jaw 1101 and the second jaw 1102 are closed, the actuation rotation axis 1145, which is the jaw rotation axis, is subjected to a force in the forward direction (i.e., toward the distal end), and therefore the grip force in the direction in which the first jaw 1101 and the second jaw 1102 are closed becomes even greater.

[0414] From another perspective, as the second jaw 1102 rotates around the actuation rotation axis 1145, the lengths of r1 and r2 are maintained constant, and therefore, when the pulley 1121 rotates around the first rotation axis 1141, the angle between r1 and r2 changes while the lengths of r1 and r2 remain constant. That is, compared to θ1, which is the angle between r1 and r2 when the second jaw 1102 is open as shown in FIG. 161(a), θ2, which is the angle between r1 and r2 when the second jaw 1102 is closed as shown in FIG. 161(b), becomes larger.

[0415] Therefore, when the second jaw 1102 rotates from an open position to a closed position, the angle between r1 and r2 changes and the actuation rotation axis 1145 receives a force in the forward direction.

[0416] At this time, since the first rotating shaft 1141 is an axis whose position is relatively fixed, the actuation rotating shaft 1145 moves forward in the direction of arrow C1 in FIG. 160 and arrow C2 in FIG. 161, and the grip force increases further in the direction in which the second jaw 1102 is closed.

[0417] From another perspective, when the pulleys 1111 and 1121 rotate around the first rotation axis 1141, which is an axis whose relative position is fixed, the angle θ between r1 and r2 changes while the distance between r1 and r2 remains constant. When the angle θ changes in this way, the first jaw 1101 and the second jaw 1102 push or pull the actuation rotation axis 1145, causing the actuation rotation axis 1145 to move forward or backward. When the first jaw 1101 and the second jaw 1102 rotate in the closing direction, the actuation rotation axis 1145 moves forward in the direction of arrow C1 in FIG. 160 and arrow C2 in FIG. 161, further increasing the grip force. Conversely, when the first jaw 1101 and the second jaw 1102 rotate in the direction to open, the actuation rotation shaft 1145 moves backward in the direction opposite to the arrow C1 in FIG. 160 and the arrow C2 in FIG.

[0418] With this configuration, when the first jaw 1101 and the second jaw 1102 are closed, the grip force becomes stronger, and the surgeon can perform a strong actuation operation with less force.

[0419] (Cauterization and cutting related components)

[0420] Next, referring to Figures 140 to 162, etc., an end tool 1100 of a fourth embodiment of the present invention can include a first jaw 1101, a second jaw 1102, a first electrode 1151, a second electrode 1152, a guide tube 1170, and a blade 1175 for performing cautery and cutting operations.

[0421] Here, components related to driving the blade, such as the guide tube 1170 and the blade 1175, can be collectively referred to as a blade assembly. One embodiment of the present invention is characterized in that the blade assembly including the guide tube 1170 and the blade 1175 is disposed between the first jaw pulley, pulley 1111, and the second jaw pulley, pulley 1121, thereby enabling the end tool 1100 to perform pitch and yaw movements as well as cutting operations using the blade 1175. This will be described in more detail.

[0422] As described above, the first jaw 1101 is connected to the first jaw pulley 1111, and when the first jaw pulley 1111 rotates around the first rotation shaft 1141, the first jaw 1101 rotates together with the first jaw pulley 1111 and also rotates around the first rotation shaft 1141.

[0423] Meanwhile, a first electrode 1151 may be formed on a surface of the first jaw 1101 facing the second jaw 1102. And a second electrode 1152 may be formed on a surface of the second jaw 1102 facing the first jaw 1101.

[0424] At this time, a slit 1151a can be formed in the first electrode 1151, and the blade 1175 can be moved through this slit 1151a. Also, a slit 1152a can be formed in the second electrode 1152, and the blade 1175 can be moved through this slit 1152a.

[0425] Meanwhile, although not shown in the drawings, a spacer (not shown) may be formed between the first jaw 1101 and the first electrode 1151, and a spacer (not shown) may be formed between the second jaw 1102 and the second electrode 1152. This spacer (not shown) may include an insulating material such as ceramic. Alternatively, the first jaw 1101 and the second jaw 1102 themselves may be made of a non-conductor, so that the first electrode 1151 and the second electrode 1152 are insulated from each other until they come into contact with each other without the need for a separate insulator.

[0426] Meanwhile, although not shown in the drawings, one or more sensors (not shown) may be further formed on at least one of the first jaw 1101 or the second jaw 1102. The sensors (not shown) may be configured to measure at least a portion of the current, voltage, resistance, impedance, and temperature when tissue is positioned between the first jaw 1101 and the second jaw 1102 and current flows through the first electrode 1151 and the second electrode 1152 to perform cauterization.

[0427] Alternatively, without providing a separate sensor, a generator (not shown) that supplies power to the electrodes may directly monitor and control at least some of the current, voltage, resistance, impedance, and temperature.

[0428] A region of the blade 1175 can be sharpened to form an edge for cutting tissue, and tissue positioned between the first jaw 1101 and the second jaw 1102 can be cut while at least a portion of the blade 1175 moves between the distal portion 1104 and the proximal portion 1105 of the end tool 1100.

[0429] Here, one feature of the endotool 1100 of the electrocautery surgical instrument 10 according to one embodiment of the present invention is that it includes a guide tube 1170 and a blade 1175 disposed between a pulley 1111 and a pulley 1121. The provision of the guide tube 1170 and the blade 1175 allows for a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation motion, enabling both cauterization and cutting. This will be described in more detail as follows.

[0430] Various types of electrocautery surgical instruments have been developed. Among these, vessel resection devices known as advanced energy devices or vessel sealers have added sensing functionality compared to conventional bipolar cautery methods. They supply power of opposite polarity to two electrodes, which generates heat to denature blood vessels and stop bleeding, and then use a blade to cut the area where bleeding has stopped. The impedance of the tissue (or blood vessel) is measured while the current is flowing to determine whether cauterization is complete, and once cauterization is complete, the current supply is automatically stopped and the tissue is cut using the blade.

[0431] Such bipolar vascular resection devices must be equipped with a blade for cutting tissue after cauterization, and an instrument for linearly reciprocating the blade must be further provided on the end tool, so articulation movements such as pitch / yaw movements are often not possible.

[0432] On the other hand, there have been attempts to achieve joint movement in bipolar vascular resection devices using a bending joint connecting multiple segments, but in this case, there was a problem that the rotation angle was limited and it was difficult to accurately control the movement of the end tool.

[0433] On the other hand, in the case of a method of stopping bleeding and cutting using ultrasonic vibrations, it is impossible to provide a joint due to the physical characteristics of ultrasonic waves.

[0434] To solve this problem, one feature of the end tool 1100 of the electrocautery surgical instrument 10 according to one embodiment of the present invention is that it includes a guide tube 1170 disposed between a pulley 1111 and a pulley 1121, and a blade 1175 that moves between a first position and a second position in response to movement of a blade wire 307 disposed inside the guide tube 1170. By including the guide tube 1170 and the blade 1175 in this manner, one feature of the end tool 1100 is that it is possible to perform pitch, yaw, and actuation movements using a pulley / wire system in a bipolar surgical instrument for cauterizing and cutting tissue.

[0435] Fig. 163 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of Fig. 140 is closed, Fig. 164 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of Fig. 140 is open, Fig. 165 is a diagram showing a state in which the braid wire 307 and the blade 1175 are located in a first position, Fig. 166 is a diagram showing a state in which the braid wire 307 and the blade 1175 are located in a second position, and Fig. 167 is a diagram showing a state in which the braid wire 307 and the blade 1175 are located in a third position.

[0436] Referring to Figures 163 to 167, when the first jaw 1101 and the second jaw 1102 are closed as shown in Figure 163, the cutting operation of Figures 165 to 167 is performed, which can also be expressed as cutting the tissue between the first jaw 1101 and the second jaw 1102.

[0437] 165 can be defined as a state in which the blade 1175 is maximally retracted toward the proximal portion 1105 of the end tool 1100. Alternatively, the first position can be defined as a state in which the blade 1175 is positioned adjacent to the pulley 1111 / pulley 1121.

[0438] 167 can be defined as a state in which the blade 1175 is maximally extended toward the distal portion 1104 of the end tool 1100. Alternatively, it can be defined as a state in which the blade 1175 is located as far away from the pulley 1111 / pulley 1121 as possible.

[0439] First, as shown in Figure 164, with the first jaw 1101 and the second jaw 1102 open, the tissue to be cut is positioned between the first jaw 1101 and the second jaw 1102, and then an actuation operation is performed to close the first jaw 1101 and the second jaw 1102 as shown in Figure 163.

[0440] Next, with the braid wire 307 and the braid 1175 positioned at the first position as shown in FIG. 165, currents of different polarities are passed through the first electrode 1151 and the second electrode 1152, respectively, to cauterize the tissue between the first jaw 1101 and the second jaw 1102. At this time, a generator (not shown) that supplies power to the electrodes can itself monitor at least some of the current, voltage, resistance, impedance, and temperature, and can stop supplying power when cauterization is complete.

[0441] When the cauterization is completed in this manner, the blade wire 307 moves sequentially in the direction of arrow A1 in FIG. 155 and in the direction of arrow A2 in FIG. 167, and the blade 1175 coupled to the blade wire 307 moves from a first position 1105 at the proximal portion of the end tool 1100 toward a third position 1104 at the distal portion of the end tool 1100, sequentially reaching the positions in FIGS. 166 and 167.

[0442] In this way, the blade 1175 cuts the tissue between the first jaw 1101 and the second jaw 1102 while moving in the X-axis direction.

[0443] However, the linear movement of the blade 1175 here does not mean only a perfectly straight line, but rather a movement that is sufficient to cut tissue when viewed as a whole, even if it is not a perfectly straight line, such as when the middle part of the straight line is bent at a predetermined angle, or there is a section with a gentle curvature in a certain section.

[0444] On the other hand, if the braid wire 307 is pulled in the opposite direction in this state, the braid 1175 coupled to the braid wire 307 will also return to the first position.

[0445] According to the present invention, it is possible to obtain an effect that a multi-joint / multi-degree-of-freedom surgical instrument capable of pitch / yaw / actuation motion can be used to perform cauterization and cutting.

[0446] (Operation unit)

[0447] Figures 216 and 217 are perspective views showing the operating portion of the surgical instrument of Figure 140. Figure 218 is a simplified diagram showing only the configuration of pulleys and wires that form the joints of the electrocautery surgical instrument shown in Figure 140.

[0448] 140 to 162 and 216 to 218, the operating unit 200 of the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention includes a first handle 204 that can be held by the user, an actuation operating unit 203 that controls the actuation movement of the end tool 1100, a yaw operating unit 202 that controls the yaw movement of the end tool 1100, and a pitch operating unit 201 that controls the pitch movement of the end tool 1100. Here, it can be understood that only the components related to the pitch / yaw / actuation movements of the electrocautery surgical instrument 10 are shown in FIGS. 216 and 217.

[0449] In addition, the operating unit 200 of the electrocautery surgical instrument 10 further includes a blade operating unit 260 that controls the movement of the blade of the end tool 1100 to perform cutting, and a cauterization operating unit 270 that controls the supply of electrical energy to the first electrode 1151 and the second electrode 1152 of the end tool 1100 to perform cauterization.

[0450] The operating unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 related to the rotational movement of the first jaw 1101. The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 related to the rotational movement of the second jaw 1102. The operating unit 200 may also include pulleys 231, 232, 233, and 234 related to the pitch movement. The operating unit 200 may also include pulleys 235, which are intermediate pulleys disposed at various locations in the bent portion 402 of the connecting portion 400.

[0451] Here, although the figures show opposing pulleys formed parallel to each other, the spirit of the present invention is not limited to this, and it can be said that each pulley can be formed in various positions and sizes suitable for the configuration of the operating part.

[0452] Furthermore, the operation unit 200 according to the fourth embodiment of the present invention can include rotation shafts 241, 242, 243, 244, 245, and 246. Here, the rotation shaft 241 can function as an operation unit first jaw actuation rotation shaft, and the rotation shaft 242 can function as an operation unit second jaw actuation rotation shaft. The rotation shaft 243 can function as an operation unit yaw main rotation shaft, and the rotation shaft 244 can function as an operation unit yaw sub-rotation shaft. The rotation shaft 245 can function as an operation unit pitch sub-rotation shaft, and the rotation shaft 246 can function as an operation unit pitch main rotation shaft.

[0453] The rotation shafts 241 / 242, 243, 244, 245 and 246 can be arranged sequentially from the distal end 205 to the proximal end 206 of the operating portion 200.

[0454] Each of the rotary shafts 241, 242, 243, 244, 245, and 246 may be fitted with one or more pulleys, which will be described in detail later.

[0455] 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 can also be generally referred to as operating portion actuation pulleys.

[0456] Pulleys 211 and 212 function as an operating unit first jaw-yaw main pulley, and pulleys 221 and 222 function as an operating unit second jaw-yaw main pulley, and these components can also be commonly referred to as an operating unit yaw main pulley.

[0457] 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 can also be commonly referred to as an operating unit yaw sub-pulley.

[0458] 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 can also be commonly referred to as operating unit pitch sub-pulleys.

[0459] Pulleys 217 and 218 function as first jaw pitch main pulleys of the operating unit, and pulleys 227 and 228 function as second jaw pitch main pulleys of the operating unit, and these components can also be commonly referred to as operating unit pitch main pulleys.

[0460] 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.

[0461] The above components can be classified in terms of the operating parts for each movement (pitch / yaw / actuation) as follows:

[0462] The pitch operation unit 201, which controls the pitch movement of the end tool 1100, may include pulleys 215, 216, 217, 218, 225, 226, 227, 228, 231, 232, and 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.

[0463] The yaw operation unit 202 that controls the yaw movement of the end tool 1100 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.

[0464] The actuation operating unit 203 that controls the actuation movement of the end tool 1100 may include a pulley 210, a pulley 220, a rotation shaft 241, and a rotation shaft 242. The actuation operating unit 203 may further include a first actuation operating unit 251 and a second actuation operating unit 256.

[0465] Each component of the operation unit 200 will be described in more detail below.

[0466] The first handle 204 is formed so that it can be held by a user's hand, and in particular, can be formed so that the user can wrap their palm 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.

[0467] 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 a ring shape and can operate as a second handle.

[0468] 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 connecting unit 400 is formed. For example, the rotation axes 241 and 242 may be formed in a direction parallel to the Z axis. In this state, when the pitch operation unit 201 or the yaw operation unit 202 rotates, the coordinate system of the actuation operation unit 203 may change relatively. Of course, the 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 structure of the hand of a user holding the actuation operation unit 203 according to ergonomic design.

[0469] 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.

[0470] Similarly, the pulley 220, the second actuation extension 257, and the second actuation gear 258 may be fixedly coupled to each other and may be formed to be rotatable together around the rotation axis 242. Here, the pulley 220 may be formed of one pulley or may be formed of two pulleys fixedly coupled to each other.

[0471] 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 one side rotates.

[0472] The yaw operating unit 202 may include a rotation shaft 243, pulleys 211 and 212 which are operating unit first jaw-yaw main pulleys, pulleys 221 and 222 which are operating unit second jaw-yaw main pulleys, and a yaw frame 207. The yaw operating unit 202 may further include pulleys 213 and 214 which are operating unit first jaw-yaw sub-pulleys formed on one side of the pulleys 211 and 212, and pulleys 223 and 224 which are operating 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.

[0473] Here, in the figure, the yaw operation unit 202 is shown as including pulleys 211 and 212 and pulleys 221 and 222, where pulleys 211 and 212 and pulleys 221 and 222 are formed to face each other and are shown as two independently rotatable pulleys, but the concept of the present invention is not limited thereto. That is, one or more pulleys having the same or different diameters may be provided depending on the configuration of the yaw operation unit 202.

[0474] 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.

[0475] 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 structure of the hand of a user holding the operation unit 200 according to ergonomic design.

[0476] 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 first jaw wire, ie, wire 301 or wire 305, may be wound around pulleys 211 and 212, and a second jaw wire, ie, wire 302 or wire 306, 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 winding wire and the unwinding wire can be wound around separate pulleys, respectively, and can operate without interfering with each other.

[0477] 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 integrally around the rotation axis 243.

[0478] 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 the bending portion 402 of the connecting portion 400 via the rotating shaft 246.

[0479] 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.

[0480] 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, pitch 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. 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.

[0481] 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 .

[0482] 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 may be wound around separate pulleys, respectively, and may 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 may be wound around separate pulleys, respectively, and may operate without interfering with each other.

[0483] Next, the operation of the pitch wires, wire 303 and wire 304, is as follows.

[0484] The end tool 1100 is formed with a pulley 1131, which is an end tool pitch pulley, fixedly coupled to the end tool hub 1180, 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 wires 303 and 304, which are pitch wires, so that the pitch movement of the end tool 1100 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. That is, 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 by the jaw wires, wires 301, 302, 305 and 306.

[0485] The connection relationships between the first handle 204 and the pitch operation unit 201, yaw operation unit 202, and 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 the 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. Meanwhile, since the 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 is not directly connected to the first handle 204, and the pitch operation unit 201 and the first handle 204 can be formed so as to be indirectly connected via the yaw operation unit 202.

[0486] Continuing to refer to the drawings, in the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention, the pitch control unit 201 and the end tool 1100 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 bent portion 402 of the connecting portion 400, and the end tool 1100 is formed at the other end of the connecting portion 400.

[0487] One or more intermediate pulleys 235 for changing or guiding the path of the wire can be arranged in various places in the connecting portion 400, particularly in the bent portion 402. By guiding the path of the wire so that at least a portion of the wire is wound around such intermediate pulleys 235, the wire can be arranged along the bent shape of the bent portion 402.

[0488] Here, in the figure, the connecting portion 400 is shown to be curved to have a predetermined curvature by including a bending portion 402, 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 needed, and even in such cases, it can be said that the pitch control portion 201 and the end tool 1100 are formed on substantially the same or parallel axes. Furthermore, in Figure 3, the pitch control portion 201 and the end tool 1100 are shown to be 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 1100 can also be formed on different axes.

[0489] (actuation, yaw, pitch)

[0490] The actuation operation, yaw operation, and pitch operation in this embodiment will be described below.

[0491] First, the actuation operation is as follows.

[0492] When a user places his / her index finger in the ring formed on first actuation extension 252 and his / her thumb in the ring formed on second actuation extension 257 and rotates actuation extensions 252, 257 using either or both fingers, pulley 210 and first actuation gear 253, which are fixedly connected to first actuation extension 252, rotate around rotation axis 241, and pulley 220 and second actuation gear 258, which are fixedly connected to second actuation extension 257, rotate around 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 1100 via the power transmission unit 300, and two jaws 1103 of the end tool 1100 perform actuation operations.

[0493] As described above, the actuation operation here refers to the operation of opening and closing the two jaws 1101, 1102 as they 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 1101 rotates counterclockwise and the second jaw 1102 rotates clockwise, closing the end tool 1100. Conversely, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated away from each other, the first jaw 1101 rotates clockwise and the second jaw 1102 rotates counterclockwise, opening the end tool 1100.

[0494] In this embodiment, for the above-described actuation operation, the second handle is configured 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 1100 relative to each other may be modified in other ways, such as a configuration in which one actuation rotating unit operates two actuation pulleys (pulley 210, pulley 220) in opposite directions to each other.

[0495] Next, the yaw motion is as follows:

[0496] When the 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 1101 and the wires 302 and 306 connected to the second jaw 1102 are wound around the pulleys 211 and 212 and the pulleys 221 and 222 so that the first jaw 1101 and the second jaw 1102 rotate in the same direction during yaw rotation. Then, this rotational force is transmitted to the end tool 1100 via the power transmission unit 300, and the two jaws 1103 of the end tool 1100 perform a yaw operation in which they rotate in the same direction.

[0497] 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.

[0498] Next, the pitch action is as follows:

[0499] 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 will 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 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 246, wires 302 and 306 wound around pulleys 227 and 228 will 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 1101 and the second jaw 1102 can pitch rotate. The jaw wires 301, 305, 302, and 306 are wound around the operation unit pitch main pulleys 217, 218, 227, and 228, respectively. This rotational force is then transmitted to the end tool 1100 via the power transmission unit 300, and the two jaws 1103 of the end tool 1100 perform pitch movement.

[0500] 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.

[0501] In summary, the electrocautery surgical instrument 10 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint position (actuation joint, yaw joint, pitch joint), 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 the desired movement of the end tool 1100. Furthermore, an auxiliary pulley can be formed on one side of each pulley, and these auxiliary pulleys can prevent the wire from being wound multiple times around one pulley.

[0502] Figure 218 is a simplified diagram showing only the configuration of pulleys and wires that constitute the joints of the electrocautery surgical instrument 10 according to one embodiment of the present invention shown in Figure 140. In Figure 218, an intermediate pulley for changing the route of the wires independently of the joint movement is omitted.

[0503] Referring to FIG. 218, the operating portion 200 can 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 related to the rotational movement of the first jaw 1101.

[0504] The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 related to the rotational motion of the second jaw 1102. (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 1100, so some of the specific reference numerals in the drawings will be omitted.)

[0505] Pulleys 211 and 212, and pulleys 221 and 222 may be formed to be rotatable independently of each other around the same axis, i.e., rotation axis 243. In this case, pulleys 211 and 212, and pulleys 221 and 222 may be formed to face each other and may be formed as two pulleys formed to be rotatable independently of each other.

[0506] Pulleys 213 and 214 and pulleys 223 and 224 may be formed to be independently rotatable about the same rotation axis 244. In this case, pulleys 213 and 214 may be formed of two pulleys that are formed to face each other and are independently rotatable, and the two pulleys may be formed to have different diameters. Similarly, pulleys 223 and 224 may be formed of two pulleys that are formed to face each other and are independently rotatable, and the two pulleys may be formed to have different diameters.

[0507] Pulleys 215 and 216 and pulleys 225 and 226 may be formed to be rotatable independently of each other around the same axis, i.e., rotation axis 245. In this case, pulleys 215 and 216 may be formed to have different diameters from each other. Also, pulleys 225 and 226 may be formed to have different diameters from each other.

[0508] The pulleys 217 and 218 and the pulleys 227 and 228 may be formed to be rotatable independently of each other about the same rotation axis 246 .

[0509] The wire 301 passes through pulleys 217, 215, 213, and 211 of the operating unit 200 in succession, is wound around pulley 210, and is then 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 succession, and is then coupled to pulley 210 by a fastening member 324. Therefore, when the pulley 210 rotates, the wires 301 and 305 are wound or unwound around the pulley 210, causing the first jaw 1101 to rotate.

[0510] The wire 306 passes through pulleys 227, 225, 223, and 221 of the operating unit 200 in this order, is wound around the pulley 220, and is then coupled to the 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 then coupled to the pulley 220 by a fastening member 327. Therefore, when the pulley 220 rotates, the wires 302 and 306 are wound or unwound around the pulley 220, causing the second jaw 1102 to rotate.

[0511] (Pulley and wire concept diagram)

[0512] Figures 220 and 221 are views illustrating the configurations of pulleys and wires associated with the actuation and yaw operations of the electrocautery surgical instrument 10 according to one embodiment of the present invention shown in Figure 140, with the first and second jaws respectively resolved. Figure 220 is a view illustrating only the pulleys and wires associated with the second jaw, and Figure 221 is a view illustrating only the pulleys and wires associated with the first jaw. Figure 219 is a perspective view illustrating the yaw operation of the surgical instrument of Figure 140. Components associated with the cutting operation have been omitted from Figure 219.

[0513] First, the wire operation of the actuation operation will be described.

[0514] Referring to Figure 221, 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 1101 of the end tool 1100 rotating in the direction of arrow EPA1.

[0515] 220, 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 1102 of end tool 1100 rotating in the direction of arrow EPA2. Therefore, when a user operates first actuation extension 252 and second actuation extension 257 in a direction that brings them closer together, first jaw 1101 and second jaw 1102 of the end tool move closer to each other.

[0516] Next, the wire operation for yaw movement will be described.

[0517] First, the rotary shaft 243, the rotary shaft 241, and the rotary shaft 242 are connected by a yaw frame (see 207 in FIG. 216), so that the rotary shaft 243, the rotary shaft 241, and the rotary shaft 242 rotate together as a unit.

[0518] Referring to Figure 221, 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 and the wires 301 and 305 wound thereon 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 1101 of the end tool 1100 rotates in the direction of the arrow EPY1.

[0519] Referring to Figure 220, when the first handle 204 is rotated in the direction of the arrow OPY2 around the rotation axis 243, the pulleys 220, 221, and 222 and 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 the pulleys 221 and 222 move toward the opposite side of W1a and the opposite side of W1b, respectively, and as a result, the first jaw 1101 of the end tool 1100 rotates in the direction of the arrow EPY2.

[0520] 223 and 224 are views illustrating the configuration of the pulleys and wires for the pitch operation of the electrocautery surgical instrument 10 according to one embodiment of the present invention shown in FIG. 140, with the first and second jaws respectively unfolded. FIG. 223 is a view illustrating only the pulleys and wires for the second jaw, and FIG. 224 is a view illustrating only the pulleys and wires for the first jaw. As shown in FIG. 140 and other figures, there are two pulleys for the pitch operation, and both strands of each wire are wound along the same path, which is represented by a single line in FIG. 223. FIG. 222 is a perspective view illustrating the pitch operation of the surgical instrument of FIG. 140. Note that components related to the cutting operation have been omitted from FIG. 222.

[0521] 223, 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, wire 301 and wire 305, which are the first jaw wires, are wound above pulleys 217 and 218, and therefore move toward the arrow W1 side. As a result, first jaw 1101 of end tool 1100 rotates in the direction of arrow EPP1.

[0522] 224, 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 around them, etc., rotate as a whole around rotation axis 246. At this time, wire 302 and wire 306, which are the second jaw wires, are wound below pulleys 227 and 228, and therefore move toward the arrow W2 side. As a result, second jaw 1102 of end tool 1100 rotates in the direction of arrow EPP2.

[0523] Therefore, actuation, yaw, and pitch operations can be performed independently of each other.

[0524] As explained with reference to Figure 140, the actuation operation unit 203, yaw operation unit 202, and pitch operation unit 201 are configured in the same manner as the joint configuration of an end tool, with each rotation axis located behind the corresponding operation unit, allowing the user to intuitively perform consistent operations.

[0525] In particular, the electrocautery surgical instrument 10 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 the pulley, and rotation of the operating unit (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, thereby inducing a desired operation of the end tool 1100. Furthermore, an auxiliary pulley can be formed on one side of each pulley, and these auxiliary pulleys can prevent the wire from being wound around one pulley multiple times, prevent the wires wound around the pulleys from contacting each other, and safely form paths for the wire being wound around the pulleys and the wire being unwound, thereby improving the safety and efficiency of wire power transmission.

[0526] 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. 140 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 as the first handle 204 rotates. However, for the sake of convenience, unless otherwise specified, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 has been 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.

[0527] (end tool pitch, yaw, cutting motion)

[0528] Figures 168 and 169 are diagrams showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 140 is rotated by +90° in a yaw direction, and Figures 170 and 171 are diagrams showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 140 is rotated by -90° in a yaw direction.

[0529] As shown in Figures 168 to 171, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that it can perform normal opening and closing operations, i.e., actuation operations, even when the jaws are yaw rotated by +90° to -90°.

[0530] 172 and 173 are diagrams showing the process of performing a cutting operation when the end tool of the electrocautery surgical instrument of FIG. 140 is rotated by +90° in a yaw direction.

[0531] As shown in Figures 172 and 173, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is configured so that it can perform a normal cutting operation even when the jaw is yaw rotated by +90°.

[0532] Figures 174 and 175 are views showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 140 is rotated by a pitch of +90°. Figures 176 and 177 are views showing the process of opening and closing operations when the end tool of the electrocautery surgical instrument of Figure 140 is rotated by a pitch of -90°. Figure 178 is a cutaway perspective view of the end tool of the electrocautery surgical instrument of Figure 176. Figures 179 and 180 are views showing the process of cutting operations when the end tool of the electrocautery surgical instrument of Figure 140 is rotated by a pitch of -90°.

[0533] As shown in Figures 174 to 180, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that it can perform a normal cutting operation even when the jaws are pitch-rotated by -90°.

[0534] On the other hand, Figure 181 is a diagram showing a state in which the jaw has pitch rotated by -90° and simultaneously rotated by +90° in a yaw direction, and Figures 182, 183, and 184 are perspective views showing the cutting operation of the end tool of the electrocautery surgical instrument of Figure 140, showing how the cutting operation is performed in a state in which the jaw has pitch rotated by -90° and simultaneously rotated by +90° in a yaw direction.

[0535] As shown in Figures 181 to 184, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is configured so that it can perform a normal cutting operation even when the jaws are pitch rotated by -90° and yaw rotated by +90°.

[0536] (First modified example of the fourth embodiment)

[0537] The following describes an endotool 1200 of a surgical instrument according to a first modified example of the fourth embodiment of the present invention. The endotool 1200 of a surgical instrument according to the first modified example of the fourth embodiment of the present invention is characterized by a different configuration of an actuation hub 1290 compared to the endotool 1100 of a surgical instrument according to the fourth embodiment of the present invention (see FIG. 140 etc.). Such configurations that differ from the fourth embodiment will be described in detail later.

[0538] Figures 185 and 186 are perspective views showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. Figures 187 and 188 are plan views showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. Figures 189 and 190 are views showing an actuation hub of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention.

[0539] Referring to Figures 185 to 190, an end tool 1200 of a first variant of the fourth embodiment of the present invention includes a pair of jaws, i.e., a first jaw 1201 and a second jaw 1202, for performing a gripping operation, where each of the first jaw 1201 and the second jaw 1202, or a component that encompasses the first jaw 1201 and the second jaw 1202, can be referred to as jaw 1203.

[0540] Meanwhile, the end tool 1200 includes a plurality of pulleys, including pulley 1211, pulley 1213, and pulley 1214, which are associated with the rotational movement of the first jaw 1201. Meanwhile, the end tool 1200 includes a plurality of pulleys, including pulley 1221, which is associated with the rotational movement of the second jaw 1202.

[0541] Furthermore, the end tool 1200 of the first modified example of the fourth embodiment of the present invention may include a rotation shaft 1241, a rotation shaft 1243, and a rotation shaft 1244. Here, the rotation shaft 1241 may be inserted through the end tool hub 1260, and the rotation shaft 1243 and the rotation shaft 1244 may be inserted through the pitch hub 1250. The rotation shafts 1241, 1243, and 1244 may be arranged in order from the distal end 1204 of the end tool 1200 toward the proximal end 1205.

[0542] Moreover, the end tool 1200 of the first modified example of the fourth embodiment of the present invention can include an end tool hub 1260 and a pitch hub 1250 .

[0543] A rotating shaft 1241 is inserted through the end tool hub 1260, and the pulleys 1211 and 1221 axially connected to the rotating shaft 1241, and at least a portion of the first jaw 1201 and second jaw 1202 connected thereto, can be accommodated inside the end tool hub 1260.

[0544] Meanwhile, a first pitch pulley portion 1263a and a second pitch pulley portion 1263b that serve as end tool pitch pulleys may be formed at one end of the end tool hub 1260. A wire (see 303 in FIG. 146) and a wire (see 304 in FIG. 146) are coupled to the first pitch pulley portion 1263a and the second pitch pulley portion 1263b that serve as end tool pitch pulleys, and the end tool hub 1260 performs a pitch movement while rotating around the rotation axis 1243.

[0545] The rotation shaft 1243 and the rotation shaft 1244 are inserted through the pitch hub 1250, and the pitch hub 1250 can be axially coupled to the end tool hub 1260 by the rotation shaft 1243. Therefore, the end tool hub 1260 can be formed to be pitch rotatable with respect to the pitch hub 1250 around the rotation shaft 1243.

[0546] Meanwhile, the end tool 1200 of the first modification of the fourth embodiment of the present invention may further include components such as a first electrode 1251, a second electrode 1252, a guide tube 1271, and a blade 1275 to perform cautery and cutting operations. Here, the components related to driving the blade, such as the guide tube 1271 and the blade 1275, may be collectively referred to as a blade assembly. Since the components for performing cautery and cutting operations in this embodiment are substantially the same as the components described in the fourth embodiment, detailed description thereof will be omitted here.

[0547] The electrocautery surgical instrument according to the first variant of the fourth embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and blade wire 307, similar to the fourth embodiment of the present invention shown in Figure 140, etc.

[0548] The actuation hub 1290 according to the first modification of the fourth embodiment of the present invention will be described in more detail below.

[0549] 185 to 190, actuation hub 1290 may be formed in the shape of a hollow box. Here, a first coupling hole 1290a may be formed on one surface of actuation hub 1290, specifically the surface that contacts first jaw 1201, and a second coupling hole 1290b may be formed on the other surface of actuation hub 1290, specifically the surface that contacts second jaw 1202.

[0550] In this case, the first coupling hole 1290a may be formed to be offset to a certain extent in one direction from the center line in the X-axis direction, and the second coupling hole 1290b may be formed to be offset to a certain extent in the other direction from the center line in the X-axis direction.

[0551] In other words, the first coupling hole 1290a and the second coupling hole 1290b are not on the same line in the Z-axis direction, but are offset from each other to a certain extent.

[0552] The actuation hub 1290 is coupled to the first jaw 1201 and the second jaw 1202, respectively. In particular, the first actuation rotating shaft 1291 is inserted through the first jaw 1201 and the first coupling hole 1290a of the actuation hub 1290, thereby axially coupling the actuation hub 1290 to the first jaw 1201. In addition, the second actuation rotating shaft 1292 is inserted through the second coupling hole 1290b of the second jaw 1202 and the actuation hub 1290, thereby axially coupling the actuation hub 1290 to the second jaw 1202.

[0553] Meanwhile, as described in Figure 154, etc., a tube fixing portion, a wire through hole, and a blade accommodating portion are sequentially formed inside the actuation hub 1290, and the blade wire 307 can pass through the inside of the actuation hub 1290 and be connected to the blade 1275.

[0554] In this way, by providing an actuation hub 1290 to which the guide tube 1270 is connected between the first jaw 1201 and the second jaw 1202, even when the first jaw 1201 or the second jaw 1202 rotates around the first rotation axis 1241 or the actuation rotation axis 1245, the guide tube 1270 does not bend or the bending angle can be reduced.

[0555] In detail, when the guide tube 1270 is directly connected to the first jaw 1201 or the second jaw 1202, when the first jaw 1201 or the second jaw 1202 rotates, one end of the guide tube 1270 also rotates together with the first jaw 1201 or the second jaw 1202, causing the guide tube 1270 to bend.

[0556] In contrast, when the guide tube 1270 is connected to an actuation hub 1290 that is unrelated to the rotation of the jaw 1203, as in this embodiment, the guide tube 1270 will not bend even if the first jaw 1201 or the second jaw 1202 rotates, or even if it bends slightly, the bending angle can be made small.

[0557] In other words, by changing the direct connection between the guide tube 1270 and the jaw 1203 by the actuation hub 1290 to an indirect connection, the degree to which the guide tube 1270 bends when the jaw 1203 rotates is reduced.

[0558] In particular, in the end tool 1200 of the first modified example of the fourth embodiment of the present invention, when the actuation hub 1290 is coupled to the first jaw 1201 and the second jaw 1202, the first actuation rotation axis 1291 and the second actuation rotation axis 1292 are not on the same line in the Z-axis direction but are offset from each other to a certain extent. Therefore, when the first jaw 1201 and the second jaw 1202 perform an actuation operation, the first actuation rotation axis 1291 and the second actuation rotation axis 1292 form a kind of two-point support, which makes it possible to obtain the effect of more stable actuation.

[0559] (Second modified example of the fourth embodiment)

[0560] The following describes an endotool 1300 of a surgical instrument according to a second modified example of the fourth embodiment of the present invention. The endotool 1300 of a surgical instrument according to the second modified example of the fourth embodiment of the present invention is characterized by a different configuration of the actuation hub 1390 compared to the endotool 1100 of a surgical instrument according to the fourth embodiment of the present invention (see FIG. 140, etc.). Such configurations that differ from the fourth embodiment will be described in detail later.

[0561] Figures 191 to 196 are views showing an endotool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. Figures 197 and 198 are views showing an actuation hub of the endotool of the electrocautery surgical instrument of Figure 191. Figure 199 is a perspective view showing a second jaw pulley of the endotool of the electrocautery surgical instrument of Figure 191. Figures 200 and 201 are views showing the endotool of the electrocautery surgical instrument of Figure 191.

[0562] Referring to Figures 191 to 201, an end tool 1300 of a second modified example of the fourth embodiment of the present invention includes a pair of jaws, i.e., a first jaw 1301 and a second jaw 1302, for performing a gripping operation, and each of the first jaw 1301 and the second jaw 1302, or the components encompassing the first jaw 1301 and the second jaw 1302, can be referred to as jaw 1303.

[0563] Meanwhile, the end tool 1300 includes a plurality of pulleys, including pulley 1311, pulley 1313, and pulley 1314, that are associated with the rotational movement of the first jaw 1301. Meanwhile, the end tool 1300 includes a plurality of pulleys, including pulley 1321, that are associated with the rotational movement of the second jaw 1302.

[0564] Furthermore, the end tool 1300 according to the second modified example of the fourth embodiment of the present invention may include a rotation shaft 1341, a rotation shaft 1343, and a rotation shaft 1344. Here, the rotation shaft 1341 may be inserted through the end tool hub 1360, and the rotation shafts 1343 and 1344 may be inserted through the pitch hub 1350.

[0565] Additionally, the end tool 1300 of the second modified example of the fourth embodiment of the present invention may include an end tool hub 1360 and a pitch hub 1350 .

[0566] On the other hand, the end tool 1300 of the second variant of the fourth embodiment of the present invention may further include components such as a first electrode 1351, a second electrode 1352, a guide tube 1371, and a blade 1375 to perform cautery and cutting operations.

[0567] The electrocautery surgical instrument according to the second variant of the fourth embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and blade wire 307, similar to the fourth embodiment of the present invention shown in Figure 140, etc.

[0568] The components of this modified example described above are substantially the same as the components described in the fourth embodiment, and therefore detailed description thereof will be omitted here.

[0569] The actuation hub 1390 according to the second modification of the fourth embodiment of the present invention will be described in more detail below.

[0570] 191 to 201, the actuation hub 1390 may be formed in the shape of a box with a hollow space formed therein.

[0571] Here, a first coupling hole 1390a may be formed on one side of the actuation hub 1390, more specifically, the side that contacts the first jaw 1301, and a second coupling hole 1390b ​​may be formed on the other side of the actuation hub 1390, more specifically, the side that contacts the second jaw 1302.

[0572] In this case, the first coupling hole 1390a may be formed to be offset to a certain extent in one direction from the center line in the X-axis direction, and the second coupling hole 1390b ​​may be formed to be offset to a certain extent in the other direction from the center line in the X-axis direction.

[0573] In other words, the first and second coupling holes 1390a and 1390b ​​are not on the same line in the Z-axis direction, but are offset from each other to a certain extent.

[0574] The actuation hub 1390 is coupled to the first jaw 1301 and the second jaw 1302, respectively. Specifically, the first actuation rotating shaft 1391 is inserted through a first coupling hole 1390a of the first jaw 1301 and the actuation hub 1390, thereby axially coupling the actuation hub 1390 to the first jaw 1301. Furthermore, the second actuation rotating shaft 1392 is inserted through a second coupling hole 1390b ​​of the second jaw 1302 and the actuation hub 1390, thereby axially coupling the actuation hub 1390 to the second jaw 1302.

[0575] Meanwhile, as described in Figure 154, etc., a tube fixing portion, a wire through hole, and a blade accommodating portion are sequentially formed inside the actuation hub 1390, and the blade wire 307 can pass through the inside of the actuation hub 1390 and be connected to the blade 1375.

[0576] Furthermore, a guide slit 1390c can be formed along the longitudinal direction (i.e., the X-axis direction) on one or both surfaces of the actuation hub 1390. A slit coupling portion 1321c formed on the pulley 1321 is fitted into the guide slit 1390c, and the linear movement of the pulley 1321 in the X-axis direction can be guided by the guide slit 1390c.

[0577] Specifically, the pulley 1321 may be formed with a shaft coupling portion 1321a, a jaw coupling portion 1321b, and a slit coupling portion 1321c. Here, the shaft coupling portion 1321a and the jaw coupling portion 1321b may be formed in the same manner as those described in the fourth embodiment, etc. The slit coupling portion 1321c may be formed to protrude further than the shaft coupling portion 1321a to a certain extent. Such a slit coupling portion 1321c fits into a guide slit 1390c of the actuation hub 1390.

[0578] On the other hand, although not shown in the drawing, the pulley 1311 can also be formed with a slit coupling portion (not shown).

[0579] In this way, by providing an actuation hub 1390 to which the guide tube 1370 is connected between the first jaw 1301 and the second jaw 1302, even when the first jaw 1301 or the second jaw 1302 rotates around the first rotation axis 1341 or the actuation rotation axis 1345, the guide tube 1370 does not bend or the bending angle can be reduced.

[0580] In detail, when the guide tube 1370 is directly connected to the first jaw 1301 or the second jaw 1302, when the first jaw 1301 or the second jaw 1302 rotates, one end of the guide tube 1370 also rotates together with the first jaw 1301 or the second jaw 1302, causing the guide tube 1370 to bend.

[0581] In contrast, when the guide tube 1370 is connected to an actuation hub 1390 that is independent of the rotation of the jaw 1303, as in this embodiment, the guide tube 1370 does not bend even when the first jaw 1301 or the second jaw 1302 rotates, or even if it bends slightly, the bending angle can be made small.

[0582] In other words, by changing the direct connection between the guide tube 1370 and the jaw 1303 by the actuation hub 1390 to an indirect connection, the degree to which the guide tube 1370 bends when the jaw 1303 rotates is reduced.

[0583] In particular, in the end tool 1300 of the second modified example of the fourth embodiment of the present invention, when the actuation hub 1390 is coupled to the first jaw 1301 and the second jaw 1302, the first actuation rotation axis 1391 and the second actuation rotation axis 1392 are not on the same line in the Z-axis direction but are offset from each other to a certain extent. Therefore, when the first jaw 1301 and the second jaw 1302 perform an actuation operation, the first actuation rotation axis 1391 and the second actuation rotation axis 1392 form a kind of two-point support, which makes it possible to obtain the effect of more stable actuation.

[0584] Furthermore, in the end tool 1300 of the second modified example of the fourth embodiment of the present invention, a slit coupling portion 1321c formed in the pulley 1321 may be fitted into a guide slit 1390c in the actuation hub 1390, and the linear movement of the pulley 1321 in the X-axis direction may be guided by the guide slit 1390c. That is, when the first jaw 1301 and the second jaw 1302 perform an actuation operation, the first jaw 1301 and the second jaw 1302 move along the guide slit 1390c in the actuation hub 1390, thereby obtaining the effect of making the actuation operation more stable.

[0585] (Third modified example of the fourth embodiment)

[0586] The following describes an endotool 1400 of a surgical instrument according to a third modified example of the fourth embodiment of the present invention. The endotool 1400 of a surgical instrument according to the third modified example of the fourth embodiment of the present invention is characterized by a different configuration of an actuation hub 1490 compared to the endotool 1100 of a surgical instrument according to the fourth embodiment of the present invention (see FIG. 140, etc.). Such configurations that differ from the fourth embodiment will be described in detail later.

[0587] Figures 202 to 205 are views showing an endotool of an electrocautery surgical instrument according to a third modified example of the fourth embodiment of the present invention. Figures 206 and 207 are views showing an actuation hub of the endotool of the electrocautery surgical instrument of Figure 202. Figure 208 is a perspective view showing a second jaw pulley of the endotool of the electrocautery surgical instrument of Figure 202.

[0588] Referring to Figures 202 to 208, an end tool 1400 of a third variant of the fourth embodiment of the present invention includes a pair of jaws, i.e., a first jaw 1401 and a second jaw 1402, for performing a gripping operation, wherein each of the first jaw 1401 and the second jaw 1402, or a component encompassing the first jaw 1401 and the second jaw 1402, can be referred to as jaw 1403.

[0589] Meanwhile, the end tool 1400 includes a plurality of pulleys, including pulley 1411, pulley 1413, and pulley 1414, that are associated with the rotational movement of the first jaw 1401. Meanwhile, the end tool 1400 includes a plurality of pulleys, including pulley 1421, that are associated with the rotational movement of the second jaw 1402.

[0590] Furthermore, the end tool 1400 according to the third modified example of the fourth embodiment of the present invention may include a rotation shaft 1441, a rotation shaft 1443, and a rotation shaft 1444. Here, the rotation shaft 1441 may be inserted through the end tool hub 1460, and the rotation shafts 1443 and 1444 may be inserted through the pitch hub 1450.

[0591] Additionally, the end tool 1400 of the third modification of the fourth embodiment of the present invention may include an end tool hub 1460 and a pitch hub 1450 .

[0592] On the other hand, the end tool 1400 of the third variant of the fourth embodiment of the present invention may further include components such as a first electrode 1451, a second electrode 1452, a guide tube 1471, and a blade 1475 to perform cautery and cutting operations.

[0593] The electrocautery surgical instrument according to the third variant of the fourth embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and blade wire 307, similar to the fourth embodiment of the present invention shown in Figure 140, etc.

[0594] The components of this modified example described above are substantially the same as the components described in the fourth embodiment, and therefore detailed description thereof will be omitted here.

[0595] The actuation hub 1490 according to the third modification of the fourth embodiment of the present invention will be described in more detail below.

[0596] 202 to 208, the actuation hub 1490 may be formed in the shape of a box with a hollow space formed therein.

[0597] Here, a first coupling hole 1490a may be formed on one side of the actuation hub 1490, more specifically, the side that contacts the first jaw 1401, and a second coupling hole 1490b may be formed on the other side of the actuation hub 1490, more specifically, the side that contacts the second jaw 1402.

[0598] In this case, the first coupling hole 1490a and the second coupling hole 1490b may be positioned on the same line in the Z-axis direction.

[0599] The actuation hub 1490 is coupled to the first jaw 1401 and the second jaw 1402, respectively. In particular, the first actuation rotating shaft 1491 is inserted through the first jaw 1401 and the first coupling hole 1490a of the actuation hub 1490, thereby axially coupling the actuation hub 1490 to the first jaw 1401. Furthermore, the second actuation rotating shaft 1492 is inserted through the second jaw 1402 and the second coupling hole 1490b of the actuation hub 1490, thereby axially coupling the actuation hub 1490 to the second jaw 1402.

[0600] Meanwhile, as described in Figure 154, etc., a tube fixing portion, a wire through hole, and a blade accommodating portion are sequentially formed inside the actuation hub 1490, and the blade wire 307 can pass through the inside of the actuation hub 1490 and be connected to the blade 1475.

[0601] Furthermore, a guide slit 1490c can be formed along the longitudinal direction (i.e., the X-axis direction) on one or both surfaces of the actuation hub 1490. A slit coupling portion 1421c formed on the pulley 1421 is fitted into the guide slit 1490c, and the linear movement of the pulley 1421 in the X-axis direction can be guided by the guide slit 1490c.

[0602] Specifically, the pulley 1421 may be formed with a shaft coupling portion 1421a, a jaw coupling portion 1421b, and a slit coupling portion 1421c. Here, the shaft coupling portion 1421a and the jaw coupling portion 1421b may be formed in the same manner as those described in the fourth embodiment and the like. The slit coupling portion 1421c may be formed to protrude further from the shaft coupling portion 1421a to a certain extent. Such a slit coupling portion 1421c fits into a guide slit 1490c of the actuation hub 1490.

[0603] On the other hand, although not shown in the drawing, the pulley 1411 can also be formed with a slit coupling portion (not shown).

[0604] In this way, by providing an actuation hub 1490 to which the guide tube 1470 is connected between the first jaw 1401 and the second jaw 1402, even when the first jaw 1401 or the second jaw 1402 rotates around the first rotation axis 1441 or the actuation rotation axis 1445, the guide tube 1470 does not bend or the bending angle can be reduced.

[0605] In particular, when the guide tube 1470 is directly connected to the first jaw 1401 or the second jaw 1402, when the first jaw 1401 or the second jaw 1402 rotates, one end of the guide tube 1470 also rotates together with the first jaw 1401 or the second jaw 1402, causing the guide tube 1470 to bend.

[0606] In contrast, when the guide tube 1470 is connected to an actuation hub 1490 that is independent of the rotation of the jaw 1403, as in this embodiment, the guide tube 1470 does not bend even when the first jaw 1401 or the second jaw 1402 rotates, or even if it bends slightly, the bending angle can be made small.

[0607] In other words, by changing the direct connection between the guide tube 1470 and the jaw 1403 by the actuation hub 1490 to an indirect connection, the degree to which the guide tube 1470 bends when the jaw 1403 rotates is reduced.

[0608] In particular, in the end tool 1400 of the third modified example of the fourth embodiment of the present invention, a slit coupling portion 1421c formed in the pulley 1421 is fitted into a guide slit 1490c of the actuation hub 1490, and the linear movement of the pulley 1421 in the X-axis direction may be guided by the guide slit 1490c. That is, when the first jaw 1401 and the second jaw 1402 perform an actuation operation, the first jaw 1401 and the second jaw 1402 move along the guide slit 1490c of the actuation hub 1490, thereby achieving the effect of more stable actuation.

[0609] (Fourth Modification of the Fourth Embodiment)

[0610] The following describes an endotool 1500 of a surgical instrument according to a fourth modified example of the fourth embodiment of the present invention. The endotool 1500 of a surgical instrument according to the fourth modified example of the fourth embodiment of the present invention is characterized by a different configuration of an actuation hub 1590 compared to the endotool 1100 of a surgical instrument according to the fourth embodiment of the present invention (see FIG. 140 etc.). Such configurations that differ from the fourth embodiment will be described in detail later.

[0611] Figures 209 to 213 are views showing an endotool of an electrocautery surgical instrument according to a fourth modified example of the fourth embodiment of the present invention. Figures 214 and 215 are views showing an actuation hub of the endotool of the electrocautery surgical instrument of Figure 209.

[0612] Referring to Figures 209 to 215, an end tool 1500 of a fourth variant of the fourth embodiment of the present invention includes a pair of jaws, i.e., a first jaw 1501 and a second jaw 1502, for performing a gripping operation, wherein each of the first jaw 1501 and the second jaw 1502, or a component encompassing the first jaw 1501 and the second jaw 1502, can be referred to as jaw 1503.

[0613] Meanwhile, end tool 1500 includes a plurality of pulleys, including pulley 1511, pulley 1513, and pulley 1514, that are associated with the rotational movement of first jaw 1501. Meanwhile, end tool 1500 includes a plurality of pulleys, including pulley 1521, that are associated with the rotational movement of second jaw 1502.

[0614] Furthermore, an end tool 1500 according to a fourth modification of the fourth embodiment of the present invention may include a rotation shaft 1541, a rotation shaft 1543, and a rotation shaft 1544. Here, the rotation shaft 1541 may be inserted through an end tool hub 1560, and the rotation shaft 1543 and the rotation shaft 1544 may be inserted through a pitch hub 1550. The rotation shafts 1541, 1543, and 1544 may be arranged in order from a distal end 1504 of the end tool 1500 toward a proximal end 1505.

[0615] Additionally, the end tool 1500 of the fourth variation of the fourth embodiment of the present invention may include an end tool hub 1560 and a pitch hub 1550 .

[0616] A rotating shaft 1541 is inserted through the end tool hub 1560, and the pulleys 1511 and 1521 axially connected to the rotating shaft 1541, and at least a portion of the first jaw 1501 and second jaw 1502 connected thereto, can be accommodated inside the end tool hub 1560.

[0617] Meanwhile, a first pitch pulley portion 1563a and a second pitch pulley portion 1563b that serve as end tool pitch pulleys may be formed at one end of the end tool hub 1560. A wire (see 303 in FIG. 146) and a wire (see 304 in FIG. 146) are coupled to the first pitch pulley portion 1563a and the second pitch pulley portion 1563b that serve as end tool pitch pulleys, and the end tool hub 1560 performs a pitch movement while rotating around the rotation axis 1543.

[0618] The rotation shaft 1543 and the rotation shaft 1544 are inserted through the pitch hub 1550, and the rotation shaft 1543 enables the pitch hub 1550 to be axially coupled to the end tool hub 1560. Therefore, the end tool hub 1560 can be formed to be pitch rotatable relative to the pitch hub 1550 around the rotation shaft 1543.

[0619] Meanwhile, the end tool 1500 of the fourth modification of the fourth embodiment of the present invention may further include components such as a first electrode 1551, a second electrode 1552, a guide tube 1571, and a blade 1575 to perform cautery and cutting operations. Here, the components related to driving the blade, such as the guide tube 1571 and the blade 1575, may be collectively referred to as a blade assembly. The components for performing cautery and cutting operations in this embodiment are substantially the same as the components described in the fourth embodiment, and therefore detailed description thereof will be omitted here.

[0620] An electrocautery surgical instrument according to the fourth variant of the fourth embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and blade wire 307, similar to the fourth embodiment of the present invention shown in Figure 140, etc.

[0621] The actuation hub 1590 according to the fourth modification of the fourth embodiment of the present invention will be described in more detail below.

[0622] 209 to 215, actuation hub 1590 may be formed in the shape of a hollow box. Here, a first coupling hole 1590a is formed on one surface of actuation hub 1590, more specifically, the surface that contacts first jaw 1501, and a second coupling hole 1590b is formed on the other surface of actuation hub 1590, more specifically, the surface that contacts second jaw 1502. In this case, first coupling hole 1590a and second coupling hole 1590b can be arranged on the same line in the Z-axis direction.

[0623] The actuation hub 1590 is coupled to the first jaw 1501 and the second jaw 1502, respectively. In particular, the first actuation rotation shaft 1591 is inserted through the first jaw 1501 and the first coupling hole 1590a of the actuation hub 1590, thereby axially coupling the actuation hub 1590 to the first jaw 1501. Furthermore, the second actuation rotation shaft 1592 is inserted through the second jaw 1502 and the second coupling hole 1590b of the actuation hub 1590, thereby axially coupling the actuation hub 1590 to the second jaw 1502.

[0624] Meanwhile, as described in Figure 154, etc., a tube fixing portion, a wire through hole, and a blade accommodating portion are sequentially formed inside the actuation hub 1590, and the blade wire 307 can pass through the inside of the actuation hub 1590 and be connected to the blade 1575.

[0625] In this way, by providing an actuation hub 1590 to which the guide tube 1570 is connected between the first jaw 1501 and the second jaw 1502, even when the first jaw 1501 or the second jaw 1502 rotates around the first rotation axis 1541 or the actuation rotation axis 1545, the guide tube 1570 does not bend or the bending angle can be reduced.

[0626] In particular, when the guide tube 1570 is directly connected to the first jaw 1501 or the second jaw 1502, when the first jaw 1501 or the second jaw 1502 rotates, one end of the guide tube 1570 also rotates together with the first jaw 1501 or the second jaw 1502, causing the guide tube 1570 to bend.

[0627] In contrast, when the guide tube 1570 is connected to an actuation hub 1590 that is independent of the rotation of the jaw 1503, as in this embodiment, the guide tube 1570 does not bend even when the first jaw 1501 or the second jaw 1502 rotates, or if it bends slightly, the bending angle can be made small.

[0628] In other words, by changing the direct connection between the guide tube 1570 and the jaw 1503 by the actuation hub 1590 to an indirect connection, the degree to which the guide tube 1570 bends when the jaw 1503 rotates is reduced.

[0629] 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. [Effects of the Invention]

[0630] 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]

[0631] [Figure 1]Figure 1(a) is a conceptual diagram showing the pitch motion of a conventional surgical instrument, and Figure 1(b) is a conceptual diagram showing the yaw motion. Figure 1(c) is a conceptual diagram showing the pitch motion of another conventional surgical instrument, and Figure 1(d) is a conceptual diagram showing the yaw motion. Figure 1(e) is a conceptual diagram showing the pitch motion of a surgical instrument according to the present invention, and Figure 1(f) is a conceptual diagram showing the yaw motion. [Figure 2] FIG. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention. [Figure 3] 3 is a perspective view of an end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 4] 4 is a perspective view of an end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 5] 5 is a perspective view of an end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 6] 6 is a perspective view of an end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 7] 7 is a plan view of the end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 8] 8 is a plan view of the end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 9] 9 is a perspective view of an end tool hub of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 10] 10 is a cutaway perspective view of the end tool hub of FIG. 9. FIG. [Figure 11] 11 is a cutaway perspective view of the end tool hub of FIG. 9. FIG. [Figure 12] 12 is a perspective view of the end tool hub of FIG. 9. FIG. [Figure 13] 13 is a perspective view of the end tool hub of FIG. 9. FIG. [Figure 14] 14 is a side view of the end tool hub and guide tube of FIG. 9. FIG. [Figure 15]15 is a top view of the end tool hub and guide tube of FIG. 9. FIG. [Figure 16] 16 is a plan view showing the opening and closing operation of the end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 17] 17 is a plan view showing the opening and closing operation of the end tool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 18] 18 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 19] 19 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 20] 20 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 2. FIG. [Figure 21] FIG. 21 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after yaw rotation of −90°. [Figure 22] 22 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after yaw rotation of −90°. [Figure 23] FIG. 23 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after yaw rotation of +90°. [Figure 24] FIG. 24 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after yaw rotation of +90°. [Figure 25] FIG. 25 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation in a state where the end tool is yaw-rotated by +90°. [Figure 26] FIG. 26 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation in a state where the end tool is yaw-rotated by +90°. [Figure 27] FIG. 27 is a diagram showing a process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after a pitch rotation of −90°. [Figure 28] FIG. 28 is a diagram showing a process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 2 after a pitch rotation of −90°. [Figure 29] FIG. 29 is a diagram showing a process in which the end tool of the electrocautery surgical instrument of FIG. 2 performs an opening and closing operation after being pitch-rotated by +90°. [Figure 30] FIG. 30 is a diagram showing a process in which the end tool of the electrocautery surgical instrument of FIG. 2 performs an opening and closing operation after being pitch-rotated by +90°. [Figure 31] FIG. 31 is a diagram showing the path of the guide tube when the end tool of the electrocautery surgical instrument of FIG. 2 is pitch-rotated by −90°. [Figure 32] FIG. 32 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 33] FIG. 33 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 34] FIG. 34 is a perspective view showing the electrocautery surgical instrument of FIG. 2 in a pitch-rotated and yaw-rotated state. [Figure 35] FIG. 35 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 36] FIG. 36 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 37]FIG. 37 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 2 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 38] FIG. 38 is a diagram showing an end tool of an electrocautery surgical instrument according to a modification of the first embodiment of the present invention. [Figure 39] FIG. 39 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the first embodiment of the present invention. [Figure 40] FIG. 40 is a diagram showing an end tool of an electrocautery surgical instrument according to a modification of the first embodiment of the present invention. [Figure 41] FIG. 41 is a perspective view showing an electrocautery surgical instrument according to a second embodiment of the present invention. [Figure 42] 42 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 43] 43 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 44] 44 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 45] 45 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 46] 46 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 47] 47 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 48] 48 is a perspective view of an end tool hub of the electrocautery surgical instrument of FIG. 41; [Figure 49] 49 is a cutaway perspective view of the end tool hub of FIG. 48. FIG. [Figure 50] 50 is a cutaway perspective view of the end tool hub of FIG. 48. FIG. [Figure 51] 51 is a perspective view of the end tool hub of FIG. 48. FIG. [Figure 52] 52 is a perspective view of the end tool hub of FIG. 48. FIG. [Figure 53] 53 is a side view of the end tool hub and guide tube of FIG. 48. FIG. [Figure 54] 54 is a top view of the end tool hub and guide tube of FIG. 48. FIG. [Figure 55] 55 is a perspective view of a first jaw of an endotool of the electrocautery surgical instrument of FIG. 41; FIG. [Figure 56] 56 is a perspective view of a second jaw of an end tool of the electrocautery surgical instrument of FIG. 41; FIG. [Figure 57] 57 is a perspective view of a first jaw pulley of an end tool of the electrocautery surgical instrument of FIG. 41; FIG. [Figure 58] 58 is a plan view showing the opening and closing operation of the first jaw of the end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 59] 59 is a plan view showing the opening and closing operation of the second jaw of the end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 60] 60 is a plan view showing the opening and closing operations of the first and second jaws of the end tool of the electrocautery surgical instrument of FIG. [Figure 61] 61 is a plan view showing the opening and closing action of the first jaw and the second jaw due to the actuation action of the end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 62] 62 is a plan view showing the opening and closing action of the first jaw and the second jaw due to the actuation action of the end tool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 63] 63 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 64] 64 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 65] 65 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 41. FIG. [Figure 66] FIG. 66 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after yaw rotation of +90°. [Figure 67] FIG. 67 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after yaw rotation of +90°. [Figure 68] FIG. 68 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after yaw rotation of −90°. [Figure 69] FIG. 69 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after yaw rotation of −90°. [Figure 70] FIG. 70 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation with the end tool rotated by +90° in yaw. [Figure 71] FIG. 71 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation with the end tool rotated by +90° in yaw. [Figure 72] FIG. 72 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after a pitch rotation of −90°. [Figure 73] FIG. 73 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after a pitch rotation of −90°. [Figure 74] FIG. 74 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after a pitch rotation of +90°. [Figure 75]FIG. 75 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 41 after a pitch rotation of +90°. [Figure 76] FIG. 76 is a diagram showing the path of the guide tube when the end tool of the electrocautery surgical instrument of FIG. 41 is pitch-rotated by −90°. [Figure 77] FIG. 77 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 78] FIG. 78 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 79] FIG. 79 is a perspective view showing the electrocautery surgical instrument of FIG. 41 in a pitch-rotated and yaw-rotated state. [Figure 80] FIG. 80 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 81] FIG. 81 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 82] FIG. 82 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 41 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 83] FIG. 83 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the second embodiment of the present invention. [Figure 84] FIG. 84 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the second embodiment of the present invention. [Figure 85]FIG. 85 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the second embodiment of the present invention. [Figure 86] FIG. 86 is a perspective view showing an electrocautery surgical instrument according to a third embodiment of the present invention. [Figure 87] FIG. 87 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. [Figure 88] FIG. 88 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 89] FIG. 89 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. [Figure 90] 90 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 91] 91 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 92] 92 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 93] 93 is a perspective view of the yaw hub of the endotool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 94] 94 is a cutaway perspective view of the yaw hub of the endotool of the electrocautery surgical instrument of FIG. 86; [Figure 95] 95 is a perspective view of the yaw hub of the endotool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 96] 96 is a perspective view of the yaw hub of the endotool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 97] 97 is a perspective view of an actuation pulley and wire of an endotool of the electrocautery surgical instrument of FIG. 86; [Figure 98] 98 is a perspective view of an actuation pulley and wire of an endotool of the electrocautery surgical instrument of FIG. 86; [Figure 99]99 is a perspective view of an actuation pulley of an end tool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 100] 100 is a perspective view of an actuation pulley of an end tool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 101] 101 is a perspective view of an actuation link of an endotool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 102] 102 is a diagram showing the opening and closing action of the first and second jaws of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 103] 103 is a diagram showing the opening and closing operations of the first and second jaws of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 104] 104 is a diagram showing the opening and closing action of the first and second jaws of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 105] 105 is a perspective view illustrating the actuation of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 106] 106 is a perspective view illustrating the actuation of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 107] 107 is a perspective view illustrating the actuation of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 108] 108 is a perspective view illustrating the actuation of the end tool of the electrocautery surgical instrument of FIG. 86. FIG. [Figure 109] 109 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 86; [Figure 110] 110 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 86; [Figure 111]111 is a partial cross-sectional view showing the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 86; FIG. [Figure 112] FIG. 112 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after yaw rotation of +90°. [Figure 113] FIG. 113 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after yaw rotation of +90°. [Figure 114] FIG. 114 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after yaw rotation of +90°. [Figure 115] FIG. 115 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after yaw rotation of +90°. [Figure 116] FIG. 116 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with a yaw rotation of +90°. [Figure 117] FIG. 117 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with a yaw rotation of +90°. [Figure 118] FIG. 118 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with a yaw rotation of +90°. [Figure 119] FIG. 119 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with a yaw rotation of +90°. [Figure 120] FIG. 120 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 121]FIG. 121 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 122] FIG. 122 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 123] FIG. 123 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 124] FIG. 124 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 125] FIG. 125 shows the actuation link and guide tube of the electrocautery surgical instrument of FIG. 86 with the end tool rotated +90° in yaw. [Figure 126] FIG. 126 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after it has been pitch-rotated by −90°. [Figure 127] FIG. 127 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after it has been pitch-rotated by −90°. [Figure 128] FIG. 128 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after a pitch rotation of +90°. [Figure 129] FIG. 129 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 86 after a pitch rotation of +90°. [Figure 130] FIG. 130 is a diagram showing the path of the guide tube when the end tool of the electrocautery surgical instrument of FIG. 86 is pitch rotated by −90°. [Figure 131]FIG. 131 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with the end tool pitch-rotated by +90°. [Figure 132] FIG. 132 is a diagram showing the path of the guide tube and the moving path of the blade when the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation with the end tool pitch-rotated by +90°. [Figure 133] FIG. 133 is a perspective view showing the electrocautery surgical instrument of FIG. 86 in a pitch-rotated and yaw-rotated state. [Figure 134] FIG. 134 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 135] FIG. 135 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 136] FIG. 136 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 86 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 137] FIG. 137 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the third embodiment of the present invention. [Figure 138] FIG. 138 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the third embodiment of the present invention. [Figure 139] FIG. 139 is a diagram showing an end tool of an electrocautery surgical instrument according to a modified example of the third embodiment of the present invention. [Figure 140] FIG. 140 is a perspective view showing an electrocautery surgical instrument according to a fourth embodiment of the present invention. [Figure 141] FIG. 141 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 142]FIG. 142 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 143] FIG. 143 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 144] FIG. 144 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 145] FIG. 145 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 146] FIG. 146 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 147] 147 is a perspective view of an end tool hub of the electrocautery surgical instrument of FIG. 140; FIG. [Figure 148] 148 is a cutaway perspective view of the end tool hub of FIG. 147; [Figure 149] 149 is a cutaway perspective view of the end tool hub of FIG. 147; [Figure 150] 150 is a perspective view of the end tool hub of FIG. 147. FIG. [Figure 151] FIG. 151 is a perspective view of the end tool hub of FIG. 147; [Figure 152] 152 is a side view of the end tool hub and guide tube of FIG. 147. FIG. [Figure 153] 153 is a top view of the end tool hub and guide tube of FIG. 147; [Fig. 154] 154 is a perspective and cutaway perspective view of the actuation hub of the electrocautery surgical instrument of FIG. 140 of FIG. 147. FIG. [Figure 155] FIG. 155 is a cutaway perspective view of the actuation hub of FIG. 154 with the guide tube, braid wire, and braid attached. [Figure 156] 156 is an exploded perspective view of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 157] 157 is a perspective view of a first jaw of an end tool of the electrocautery surgical instrument of FIG. 140; FIG. [Figure 158] 158 is a perspective view of a second jaw of an end tool of the electrocautery surgical instrument of FIG. 140; FIG. [Figure 159] 159 is a perspective view of a first jaw pulley of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 160] 160 is a plan view showing the opening and closing operation of the first jaw of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 161] 161 is a plan view showing the opening and closing operation of the second jaw of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 162] 162 is a plan view showing the opening and closing action of the first and second jaws of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 163] 163 is a plan view showing the opening and closing operation of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Fig. 164] 164 is a plan view showing the opening and closing operation of the end tool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 165] 165 is a partial cross-sectional view illustrating the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 166] 166 is a partial cross-sectional view showing the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 167] 167 is a partial cross-sectional view showing the operation of the blade of the endotool of the electrocautery surgical instrument of FIG. 140; [Figure 168] FIG. 168 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after yaw rotation of −90°. [Figure 169]FIG. 169 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after yaw rotation of −90°. [Figure 170] FIG. 170 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after yaw rotation of +90°. [Figure 171] FIG. 171 is a bottom view showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after yaw rotation of +90°. [Fig. 172] FIG. 172 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation while rotating in yaw. [Figure 173] FIG. 173 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation while rotating in yaw. [Fig. 174] FIG. 174 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after a pitch rotation of +90°. [Figure 175] FIG. 175 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after a pitch rotation of +90°. [Figure 176] FIG. 176 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after it has been pitch-rotated by −90°. [Figure 177] FIG. 177 is a diagram showing the process of opening and closing the end tool of the electrocautery surgical instrument of FIG. 140 after it has been pitch-rotated by −90°. [Figure 178] FIG. 178 is a diagram showing the path of the guide tube when the end tool of the electrocautery surgical instrument of FIG. 140 is pitch rotated by −90°. [Figure 179]FIG. 179 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 180] FIG. 180 is a diagram showing the path of the guide tube and the movement path of the blade when the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation with the end tool pitch-rotated by −90°. [Figure 181] FIG. 181 is a perspective view showing the electrocautery surgical instrument of FIG. 140 in a pitch-rotated and yaw-rotated state. [Figure 182] FIG. 182 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 183] FIG. 183 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 184] FIG. 184 is a diagram showing a state in which the end tool of the electrocautery surgical instrument of FIG. 140 performs a cutting operation after pitch rotation of −90° and yaw rotation of +90° at the same time. [Figure 185] FIG. 185 is a perspective view showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 186] FIG. 186 is a perspective view showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 187] FIG. 187 is a plan view showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 188] FIG. 188 is a plan view showing an end tool of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 189]FIG. 189 is a diagram showing an actuation hub of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 190] FIG. 190 is a diagram showing an actuation hub of an electrocautery surgical instrument according to a first modified example of the fourth embodiment of the present invention. [Figure 191] FIG. 191 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 192] FIG. 192 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 193] FIG. 193 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 194] FIG. 194 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 195] FIG. 195 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 196] FIG. 196 is a view showing an end tool of an electrocautery surgical instrument according to a second modified example of the fourth embodiment of the present invention. [Figure 197] FIG. 197 shows an actuation hub of the end tool of the electrocautery surgical instrument of FIG. [Figure 198] FIG. 198 shows an actuation hub of the end tool of the electrocautery surgical instrument of FIG. 191. [Figure 199] 199 is a perspective view of a second jaw pulley of an end tool of the electrocautery surgical instrument of FIG. 191; FIG. [Figure 200] FIG. 200 shows an end tool of the electrocautery surgical instrument of FIG. [Figure 201]FIG. 201 is a diagram showing an end tool of the electrocautery surgical instrument of FIG. [Figure 202] FIG. 202 is a diagram showing an end tool of an electrocautery surgical instrument according to a third modified example of the fourth embodiment of the present invention. [Figure 203] FIG. 203 is a diagram showing an end tool of an electrocautery surgical instrument according to a third modified example of the fourth embodiment of the present invention. [Figure 204] FIG. 204 is a diagram showing an end tool of an electrocautery surgical instrument according to a third modified example of the fourth embodiment of the present invention. [Figure 205] FIG. 205 is a diagram showing an end tool of an electrocautery surgical instrument according to a third modified example of the fourth embodiment of the present invention. [Figure 206] FIG. 206 is a diagram illustrating the actuation hub of the end tool of the electrocautery surgical instrument of FIG. [Figure 207] FIG. 207 shows an actuation hub of the end tool of the electrocautery surgical instrument of FIG. 202. [Figure 208] 208 is a perspective view of a second jaw pulley of an end tool of the electrocautery surgical instrument of FIG. 202. FIG. [Figure 209] FIG. 209 is a diagram showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. [Figure 210] FIG. 210 is a view showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. [Figure 211] FIG. 211 is a view showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. [Figure 212] FIG. 212 is a view showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. [Figure 213]FIG. 213 is a view showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. [Figure 214] FIG. 214 is a diagram illustrating an actuation hub of an end tool of the electrocautery surgical instrument of FIG. [Figure 215] FIG. 215 is a diagram illustrating an actuation hub of an end tool of the electrocautery surgical instrument of FIG. [Figure 216] 216 is a perspective view showing an operating portion of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 217] 217 is a perspective view showing the operating portion of the electrocautery surgical instrument of FIG. 140. FIG. [Figure 218] FIG. 218 is a simplified diagram showing only the configuration of pulleys and wires that form the joints of the electrocautery surgical instrument shown in FIG. [Figure 219] FIG. 219 is a perspective view showing the yaw movement of the electrocautery surgical instrument of FIG. [Figure 220] FIG. 220 is a diagram illustrating the configurations of pulleys and wires due to actuation and yaw movements of the electrocautery surgical instrument shown in FIG. 140, with the first and second jaws respectively resolved. [Figure 221] FIG. 221 is a diagram illustrating the configurations of pulleys and wires due to actuation and yaw movements of the electrocautery surgical instrument shown in FIG. 140, with the first and second jaws respectively resolved. [Figure 222] FIG. 222 is a perspective view showing the pitch action of the electrocautery surgical instrument of FIG. [Figure 223] FIG. 223 is a diagram illustrating the configuration of pulleys and wires for the pitch operation of the electrocautery surgical instrument shown in FIG. 140, with the first and second jaws respectively resolved. [Figure 224]FIG. 224 is a diagram showing the configuration of pulleys and wires for the pitch operation of the electrocautery surgical instrument shown in FIG. 140, with the first and second jaws respectively resolved. DETAILED DESCRIPTION OF THE INVENTION

[0632] The present invention can be modified in various ways and can have various embodiments, and specific embodiments will be illustrated in the drawings and described in detail. However, it should be understood that this is not intended to limit the present invention to the specific embodiments, and includes all modifications, equivalents, and alternatives within the spirit and technical scope of the present invention. In describing the present invention, if it is determined that a detailed description of related publicly known technology may interfere with the gist of the present invention, the detailed description will be omitted.

[0633] 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.

[0634] 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" specify the presence of features, numbers, steps, operations, components, parts, or combinations thereof described herein, and should be understood not to preclude the presence or additional possibility of one or more other features, numbers, steps, operations, components, parts, or combinations thereof.

[0635] 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.

[0636] Furthermore, in describing various embodiments of the present invention, it should be understood that each embodiment does not need to be interpreted or implemented independently, and that the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments that are described separately.

[0637] One feature of the electrocautery surgical instrument of the present invention is that when the operating unit is rotated in one direction for at least one of pitch, yaw, and actuation operations, the end tool intuitively rotates in the same direction as the operating direction of the operating unit.

[0638] FIG. 1a is a conceptual diagram of pitch motion of a conventional surgical instrument, and FIG. 1b is a conceptual diagram of yaw motion.

[0639] 1a, when performing a pitch movement of a conventional surgical instrument, the end tool 120a is formed in front of the rotation center 121a of the end tool, and the operating unit 110a is formed behind the rotation center 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 120a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. On the other hand, referring to FIG. 1b, when performing a yaw movement of a conventional surgical instrument, the end tool 120a is formed in front of the rotation center 121a of the end tool, and the operating unit 110a is formed behind the rotation center 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 120a 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 can cause user error and makes user operation difficult.

[0640] FIG. 1c is a conceptual diagram of pitch motion of another conventional surgical instrument, and FIG. 1d is a conceptual diagram of yaw motion.

[0641] 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 in front of the end tool's rotation center 121b, and the operating unit 110b is formed behind the operating unit's rotation center 111b. 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 non-intuitive joint movements, which can lead to mistakes. Referring to FIG. 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 are problems such as confusion for the user about the operation direction, unintuitive joint operation, and potential mistakes. Thus, when a user performs 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 in either the rotational 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, a surgical instrument according to an embodiment of the present invention shown in Figures 1e and 1f has a feature in which an endotool 120c is formed forward of a rotation center 121c of the endotool, and an operating unit 110c is also formed forward of a rotation center 111c of the operating unit, so that the operations of the operating unit 110c and the endotool 120c intuitively match. Expressing this characteristic in another way, unlike existing examples in which the operating unit is configured to move closer to the user relative to its own joint (i.e., away from the endotool), as shown in Figures 1a, 1b, 1c, and 1d, the surgical instrument according to an embodiment of the present invention shown in Figures 1e and 1f is configured so that at least a portion of the operating unit moves closer to the endotool (than its own joint) relative to its own joint at a certain moment during the operation process.

[0642] In other words, 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, the operation of the operating unit, which moves rearward while the front is fixed, moves the endotool, which moves forward while the rear is fixed. This results 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 direction 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 relative to a center of rotation formed at the rear, so that their operations are intuitively consistent with each other. In other words, just as the moving part of the endotool moves relative to a center of rotation formed at the rear, the moving part of the operating unit also moves relative to a corresponding center of rotation formed at the rear, so that their operations are intuitively consistent with each other. This allows the user to intuitively and quickly steer the end tool direction, which has the advantage of significantly reducing the possibility of mistakes. The specific mechanism that enables this function will be described below.

[0643] <First embodiment of electrocautery surgical instrument>

[0644] FIG. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention. FIGS. 3, 4, 5, and 6 are perspective views showing an end tool of the electrocautery surgical instrument of FIG. 2. FIGS. 7 and 8 are plan views showing the end tool of the electrocautery surgical instrument of FIG. 2. FIG. 9 is a perspective view showing an end tool hub of the electrocautery surgical instrument of FIG. 2. FIGS. 10 and 11 are cutaway perspective views of the end tool hub of FIG. 9. FIGS. 12 and 13 are perspective views showing the end tool hub of FIG. 9. FIG. 14 is a side view showing the end tool hub and guide tube of FIG. 9. FIG. 15 is a plan view showing the end tool hub and guide tube of FIG. 9. FIGS. 16 and 17 are plan views showing the opening and closing operations of the end tool of the electrocautery surgical instrument of FIG. 2.

[0645] First, referring to FIGS. 2 and 3, the electrocautery surgical instrument 10 according to the first embodiment of the present invention includes an end tool 600, an operating section 200, a power transmission section 300, and a connecting section 400.

[0646] Here, the connecting portion 400 is formed in the shape of a hollow shaft and can accommodate one or more wires and electrical cables therein. The operating portion 200 is coupled to one end of the connecting portion 400, and the end tool 600 is coupled to the other end of the connecting portion 400, and the connecting portion 400 can serve to connect the operating portion 200 and the end tool 600. Here, the connecting portion 400 of the electrocautery surgical instrument 10 according to the first embodiment of the present invention is characterized in that it includes a straight portion 401 and a bent portion 402, and the straight portion 401 is formed on the side that is coupled to the end tool 600, and the bent portion 402 is formed on the side that is 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 600 or adjacent to the extension line. Expressed from another perspective, this can also be described 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 600 to more intuitively match.

[0647] 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 may be possible.

[0648] Meanwhile, a connector 410 may be formed at the bent portion 402. The connector 410 may be connected to an external power source (not shown), and may be connected to the jaw 603 via electric wires 411 and 412, so that electrical energy supplied from the external power source (not shown) may be transmitted to the jaw 603. Here, the connector 410 may be a bipolar type having two electrodes, or may be a monopolar type having one electrode.

[0649] The operating unit 200 is formed at one end of the connecting unit 400 and is provided with an interface that can be directly operated by a surgeon, for example, in the shape of forceps, a stick, a lever, etc. When the surgeon operates this, the endotool 600, which is connected to the interface and inserted into the body of the surgical patient, performs a predetermined operation, thereby performing surgery. Here, Fig. 2 shows that the operating unit 200 is formed in the shape of a handle that can be rotated while being held with the fingers, but the concept of the present invention is not limited to this, and it can be said that various types of operating units that can be connected to the endotool 600 and operate the endotool 600 are possible.

[0650] The endotool 600 is formed at the other end of the connecting portion 400 and is inserted into the surgical site to perform the operations required for surgery. As an example of such an endotool 600, a pair of jaws 603 for performing a gripping operation, as shown in FIG. 2 , can be used. However, the concept of the present invention is not limited thereto, and various surgical devices can be used as the endotool 600. For example, a one-arm cauterization device can also be used as the endotool. Such an endotool 600 is connected to the operating unit 200 by the power transmission unit 300, and performs the operations required for surgery, such as gripping, cutting, and suturing, by transmitting the driving force of the operating unit 200 via the power transmission unit 300.

[0651] Here, the end tool 600 of the electrocautery surgical instrument 10 according to the first embodiment of the present invention is formed to be rotatable in at least one direction. For example, the end tool 600 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.

[0652] Here, the pitch, yaw, and actuation movements used in the present invention are defined as follows.

[0653] First, the pitch movement refers to the movement of the end tool 600 rotating up and down relative to the extension direction of the connecting part 400 (X-axis direction in FIG. 2), that is, the movement of rotating around the Y-axis in FIG. 2. In other words, it refers to the movement of the end tool 600, which is formed extending from the connecting part 400 in the extension direction of the connecting part 400 (X-axis direction in FIG. 2), rotating up and down relative to the connecting part 400 around the Y-axis.

[0654] Next, the yaw movement refers to the movement of the end tool 600 rotating left and right with respect to the extension direction of the connecting part 400 (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 600 formed by extending from the connecting part 400 in the extension direction of the connecting part 400 (X-axis direction in FIG. 2) rotating left and right around the Z-axis with respect to the connecting part 400. In other words, it refers to the movement of two jaws 603 formed on the end tool 600 rotating in the same direction with each other around the Z-axis.

[0655] Meanwhile, the actuation movement refers to the movement in which the end tool 600 rotates around the same rotation axis as the yaw movement, but the two jaws 603 rotate in opposite directions to each other, causing the jaws to contract or open. That is, it refers to the movement in which the two jaws 603 formed on the end tool 600 rotate in opposite directions to each other around the Z axis.

[0656] The power transmission unit 300 connects the operating unit 200 and the end tool 600 and serves to transmit the driving force of the operating unit 200 to the end tool 600, and may include multiple wires, pulleys, links, sections, gears, etc.

[0657] The end tool 600, the operating section 200, the power transmission section 300, and the like of the electrocautery surgical instrument 10 shown in FIG. 2 will be described later.

[0658] (Intuitive Drive)

[0659] The following describes the intuitive operation of the electrocautery surgical instrument 10 of the present invention.

[0660] First, while holding first handle 204 in the palm of the hand, the user can rotate first handle 204 around the Y axis to perform a pitch movement, and rotate first handle 204 around the Z axis to perform a yaw movement. Also, the user can operate actuation operation unit 203 with their thumb and index finger inserted into ring-shaped first actuation extension portion and / or second actuation extension portion formed at one end of actuation operation unit 203 to perform an actuation movement.

[0661] One feature of the electrocautery surgical instrument 10 according to the first embodiment of the present invention is that when the operating unit 200 is rotated in one direction relative to the connecting unit 400, the end tool 600 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 600 also intuitively rotates in the same direction as the one direction, performing a pitch or yaw movement. Here, "intuitively the same direction" can be further explained as the direction of movement of the user's finger holding the operating unit 200 and the direction of movement of the distal end of the end tool 600 being substantially the same. Of course, the "same direction" does not have to be a completely identical direction in three-dimensional coordinates. For example, it can be understood that when the user's finger moves leftward, the distal end of the end tool 600 also moves leftward, and when the user's finger moves down, the distal end of the end tool 600 also moves down.

[0662] For this reason, one feature of the electrocautery surgical instrument 10 according to the first embodiment of the present invention is that the operating unit 200 and the endotool 600 are formed in the same direction relative to a plane perpendicular to the extension axis (X-axis) of the connecting unit 400. That is, when viewed relative to the YZ plane in FIG. 2 , the operating unit 200 is formed extending in the +X-axis direction, and the endotool 600 is also formed extending in the +X-axis direction. In other words, the direction in which the endotool 600 is formed at one end of the connecting unit 400 and the direction in which the operating unit 200 is formed at the other end of the connecting unit 400 are the same relative to the YZ plane. In other words, the operating unit 200 is formed in a direction away from the torso of the user holding it, i.e., in the direction in which the endotool 600 is formed. That is, the first handle 204, the first actuation operation unit 251, the second actuation operation unit 256, etc., which are grasped and moved by the user for actuation, yaw, and pitch movements, have moving portions 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 600 formed to extend in the +X-axis direction from the rotation center of each joint for that movement, and as described in 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.

[0663] In particular, with 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 harm to the patient.

[0664] To solve this problem, the electrocautery surgical instrument 10 according to the first embodiment of the present invention is characterized in that the operation direction of the operating unit 200 and the actuation direction of the end tool 600 are intuitively the same. To achieve this, like the end tool 600, the operating unit 200 has a feature in which the parts that actually move for actuation, yaw, and pitch movements are formed to extend in the +X-axis direction from the rotation center of the joint corresponding to each movement.

[0665] The end tool 600, the operating section 200, the power transmission section 300, etc. of the electrocautery surgical instrument 10 of FIG. 2 will be described in more detail below.

[0666] (Power transmission section)

[0667] The power transmission section 300 of the electrocautery surgical instrument 10 of FIG. 2 will now be described in further detail.

[0668] 2 to 4, 6, 7, 19, 20, 26, 33, 36, and 37, the power transmission section 300 of the electrocautery surgical instrument 10 according to one embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, and braid wire 307.

[0669] 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. And wire 303 and wire 304 form a pair and can serve as a pitch wire.

[0670] Furthermore, the power transmission unit 300 of the electrocautery surgical instrument 10 according to one embodiment of the present invention may include fastening members 321, 322, 323, and 324 coupled to the ends of the wires to connect the wires to the pulleys. Here, each fastening member may have various shapes, such as a ball shape or a tube shape, as needed.

[0671] Here, on the end tool 600 side, fastening member 321 / fastening member 322 can play the role of a pitch wire-end tool fastening member, fastening member 323 can play the role of a first jaw wire-end tool fastening member, and fastening member 324 can play the role of a second jaw wire-end tool fastening member.

[0672] Although not shown in the drawings, the operation section 200 may further include a fastening member for fastening the first jaw wire and the operation section, and a fastening member for fastening the second jaw wire and the operation section.

[0673] Although not shown in the drawings, the operation unit 200 may further be provided with a pitch wire-operation unit fastening member and a braid wire-operation unit fastening member.

[0674] The connection relationship between the wire, the fastening member, and the pulleys will be described in detail below.

[0675] First, wire 301 and wire 305, which are first jaw wires, may be one single wire. After clamping fastening member 323, which is a first jaw wire-end tool fastening member, at the midpoint of first jaw wire, which is a single wire, and crimping and fixing fastening member 323, both strands of first jaw wire can be called wire 301 and wire 305, respectively, with fastening member 323 at the center.

[0676] 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 .

[0677] Then, by connecting this fastening member 323 to the pulley 611, the wire 301 and the wire 305 can be fixedly connected to the pulley 611. This allows the wire 301 and the wire 305 to be pulled and unwound, causing the pulley 611 to rotate.

[0678] Meanwhile, a first jaw wire-operating portion fastening member (not shown) may be coupled to the ends of wire 301 and wire 305 opposite to the portion where fastening member 323 is fastened.

[0679] As a result, when the pulley of the operating unit 200 is rotated by a motor or by human power, the wires 301 and 305 are pulled or unwound, and the pulley 611 of the end tool 600 can be rotated.

[0680] Similarly, second jaw wires 302 and 306 are coupled to second jaw wire-to-end tool fastener 324 and a second jaw wire-to-operating portion fastener (not shown), respectively.

[0681] Then, fastening member 324 is coupled to pulley 621, and second jaw wire operating portion fastening member is coupled to the pulley, so that when the pulley is rotated by a motor or by human power, wire 302 and wire 306 are pulled or unwound, allowing pulley 621 of the end tool to rotate.

[0682] Similarly, pitch wire 304 is coupled to pitch wire-end tool fastener 321 and a pitch wire operating section fastener (not shown), and pitch wire 303 is coupled to pitch wire-end tool fastener 322 and a pitch wire operating section fastener (not shown).

[0683] The fastening member 321 is coupled to the first pitch pulley portion 663a of the end tool hub 660, the fastening member 322 is coupled to the second pitch pulley portion 663b of the end tool hub 660, and the pitch wire-operation unit fastening member (not shown) is coupled to a pulley provided in the operation unit 200. As a result, when the pulley provided in the operation unit 200 is rotated by a motor or by human power, the wires 303 and 304 are pulled or unwound, and the end tool hub 660 of the end tool 600 can be rotated.

[0684] Meanwhile, one end of the braid wire 307 is coupled to a blade 675, which will be described later, and the other end is coupled to a blade operating portion (not shown) of the operating portion 200. By operating the blade operating portion, the braid wire 307 can perform a cutting action while moving from the proximal portion 605 toward the distal portion 604 of the end tool, or the braid wire 307 can return from the distal portion 604 toward the proximal portion 605 of the end tool.

[0685] In this case, at least a portion of the braid wire 307 may be housed within a guide tube 670, which will be described later. Therefore, when the guide tube 670 is bent in response to a pitch or yaw movement of the end tool 600, the braid wire 307 housed therein may also be bent together with the guide tube 670. Such a guide tube 670 will be described in more detail later.

[0686] Furthermore, the braid wire 307 is formed so as to be able to move linearly within the connecting part 400 along the longitudinal direction of the connecting part 400. One end of the braid wire 307 is connected to the blade 675, so when the braid wire 307 moves linearly along the longitudinal direction of the connecting part 400, the blade 675 connected thereto also moves linearly.

[0687] That is, when the blade wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 675 connected thereto performs a cutting action while moving toward the distal portion 604 or the proximal portion 605 of the end tool 600. This will be described in more detail later.

[0688] (end tool)

[0689] The endotool 600 of the electrocautery surgical instrument 10 of FIG. 2 is described in further detail below.

[0690] FIG. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention. FIGS. 3, 4, 5, and 6 are perspective views showing an end tool ...

Claims

1. In the end tools of surgical instruments, a first jaw and a second jaw, each of which is independently rotatable; a first jaw pulley connected to the first jaw and configured to be rotatable around a first rotation axis; a second jaw pulley connected to the second jaw and configured to be rotatable around an axis substantially the same as or parallel to the first rotation axis; an end tool hub, one end of which is penetrated and inserted by the first rotary shaft and the other end of which is penetrated and inserted by a third rotary shaft different from the first rotary shaft, and in which at least a portion of the first jaw pulley and the second jaw pulley are housed; a blade at least partially housed within the first jaw or the second jaw and configured to be movable between a proximal portion and a distal portion of the first jaw or the second jaw; a guide tube formed to penetrate the end tool hub and extend toward the blade; An end tool of a surgical instrument, characterized in that it includes a blade wire, one end of which is connected to the blade, which transmits the driving force necessary to move the blade to the blade, and at least a portion of which is positioned within the guide tube.

2. The end tool hub a main body portion to which the first jaw pulley and the second jaw pulley are connected; a first jaw pulley coupling portion and a second jaw pulley coupling portion extending in one direction from the main body portion and facing each other; 2. The end tool of the surgical instrument according to claim 1, further comprising: a first pitch pulley portion and a second pitch pulley portion formed to extend from the main body portion in a direction opposite to the one direction and formed to face each other.

3. the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub; the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub; The end tool of the surgical instrument according to claim 2, wherein at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

4. 3. The end tool of the surgical instrument according to claim 2, wherein a yaw slit through which the guide tube can pass is formed between the first jaw pulley coupling portion and the second jaw pulley coupling portion.

5. 5. The surgical instrument end tool according to claim 4, wherein a yaw round portion having a predetermined curvature is formed on one side of the yaw slit to guide a bending path of the guide tube in a yaw direction.

6. the first rotation shaft includes a first sub-shaft formed on the first jaw pulley coupling portion side and a second sub-shaft formed on the second jaw pulley coupling portion side, 5. The end tool of the surgical instrument according to claim 4, wherein the first sub-shaft and the second sub-shaft of the first rotation shaft are spaced apart by a predetermined distance, and the yaw slit is formed between the first sub-shaft and the second sub-shaft.

7. 3. The end tool of the surgical instrument according to claim 2, wherein a pitch slit through which the guide tube can pass is formed between the first pitch pulley portion and the second pitch pulley portion.

8. 8. The end tool of claim 7, wherein a pitch round portion having a predetermined curvature is formed on one side of the pitch slit to guide the pitch direction bending path of the guide tube.

9. the third rotation shaft includes a first sub-shaft formed on the first pitch pulley portion side and a second sub-shaft formed on the second pitch pulley portion side, The end tool of the surgical instrument according to claim 7, wherein the pitch slit is formed between the first sub-shaft and the second sub-shaft of the third rotation shaft.

10. a yaw slit through which the guide tube can pass is formed between the first jaw pulley coupling portion and the second jaw pulley coupling portion; A pitch slit through which the guide tube can pass is formed between the first pitch pulley portion and the second pitch pulley portion, The end tool of the surgical instrument according to claim 2, wherein the yaw slit and the pitch slit are formed to be connected to each other.

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

12. The surgical instrument end tool according to claim 11 , further comprising first and second jaw assist pulleys disposed between the first and second jaw pulleys and the body portion of the end tool hub.

13. 13. The end tool of the surgical instrument according to claim 12, wherein the first jaw wire is located on a common inscribed line of the first jaw pulley and the first jaw assist pulley, and the first jaw assist pulley widens the rotation angle of the first jaw pulley.

14. 12. The surgical instrument end tool according to claim 11, wherein a first wire guide portion and a second wire guide portion are formed in the main body portion in an area adjacent to the first jaw pulley and the second jaw pulley, the cross section of which is curved to have a predetermined curvature.

15. 15. The end tool of a surgical instrument according to claim 14, wherein the first jaw wire is located on a common inscribed line of the first jaw pulley and the first wire guide portion, and the rotation angle of the first jaw pulley is widened by the first wire guide portion.

16. a first electrode is formed on a surface of the first jaw facing the second jaw; 2. The end tool of a surgical instrument according to claim 1, wherein a second electrode is formed on a surface of the second jaw facing the first jaw.

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

18. 18. The end tool of a surgical instrument according to claim 17, wherein, once the cauterization is completed, the blade wire moves, and the blade cuts the tissue while moving from the proximal side to the distal side of the first jaw accordingly.

19. The end tool of the surgical instrument according to claim 1, wherein at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

20. The end tool of the surgical instrument according to claim 1, wherein the guide tube accommodates at least a portion of the braid wire therein and is formed to be bent to a certain extent.

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