End tool of surgical instrument and surgical instrument having the same

Abstract

The present invention relates to an end tool of a surgical instrument and a surgical instrument having the same.SOLUTION: BACKGROUND OF THE INVENTION Field of the Invention The present invention relates to a surgical instrument, and more particularly, to a surgical instrument including an end tool that is rotatable in two or more directions and operates to intuitively match an operation of an operator in the surgical instrument that is mounted on a robot arm or manually operated to be used in laparoscopic surgery or various types of surgery, and a surgical instrument including the same.SELECTED DRAWING: Figure 42

Description

[Technical Field]

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

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

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

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

[0005] Surgical staplers have the advantage of shortening surgery time and accurately suturing the surgical site because they can simultaneously cut the surgical site and anastomose the organ. Furthermore, surgical staplers are widely used in modern surgeries because they allow for faster recovery and less scarring than surgical sutures used for tissue cutting and suturing. In particular, surgical staplers are widely used in cancer surgery to cut cancerous tissue and suture the cut site.

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

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

[0008] The present invention provides an end tool including a staple drive assembly including a first jaw, a second jaw formed to face the first jaw, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first jaw pulley by a certain amount, and one or more staple pulleys formed adjacent to the first jaw pulley or the second jaw pulley; and a staple drive assembly connected to the staple drive assembly, which drives the staple pulley when the staple pulley rotates. The cartridge includes a reciprocating member that moves more linearly than the reciprocating member, and a contact member that is formed to be able to come into contact with the reciprocating member, and a working member that moves in one direction together with the reciprocating member when the reciprocating member rotates in one direction, and when the reciprocating member moves to a distal portion of the cartridge, the contact member restricts the relative movement between the working member and the reciprocating member, so that the reciprocating member and the working member move together, and when the reciprocating member moves to a proximal portion of the cartridge, the relative movement between the working member and the reciprocating member is possible, so that only the reciprocating member can move. [Effects of the Invention]

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

[0010] [Figure 1]Figure 1(a) is a conceptual diagram of the pitch motion of a conventional surgical instrument, Figure 1(b) is a conceptual diagram of the yaw motion of a conventional surgical instrument, Figure 1(c) is a conceptual diagram of the pitch motion of another conventional surgical instrument, Figure 1(d) is a conceptual diagram of the yaw motion of another conventional surgical instrument, Figure 1(e) is a conceptual diagram of the pitch motion of a surgical instrument according to the present invention, and Figure 1(f) is a conceptual diagram of the yaw motion of a surgical instrument according to the present invention. [Figure 2] 1 is a perspective view showing a surgical instrument according to a first embodiment of the present invention. [Figure 3] FIG. 3 is a side view of the surgical instrument of FIG. 2. [Figure 4] FIG. 3 is a perspective view showing an end tool of the surgical instrument of FIG. 2. [Figure 5] FIG. 3 is a perspective view showing an end tool of the surgical instrument of FIG. 2. [Figure 6] 3 is a perspective view showing an end tool hub of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 7] FIG. 3 is a plan view showing an end tool of the surgical instrument of FIG. 2. [Figure 8] FIG. 3 is a plan view showing an end tool of the surgical instrument of FIG. 2. [Figure 9] 3 is a side view showing an end tool of the surgical instrument of FIG. 2. [Figure 10] FIG. 3 is an exploded perspective view of an end tool of the surgical instrument of FIG. 2. [Figure 11] FIG. 3 is an exploded perspective view of an end tool of the surgical instrument of FIG. 2. [Figure 12] 3 is a perspective view showing a first jaw pulley of the surgical instrument of FIG. 2. FIG. [Figure 13] 3 is a plan view showing a first jaw of the surgical instrument of FIG. 2. FIG. [Figure 14] 3 is a plan view showing a second jaw of the surgical instrument of FIG. 2. FIG. [Figure 15]3 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. [Figure 16] 3 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. [Figure 17] 3 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 18] 3 is a side view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 2. FIG. [Figure 19] 3 is a perspective view showing an operating state of a staple pulley in an end tool of the surgical instrument of FIG. 2. FIG. [Figure 20] 3 is a perspective view showing an operating state of a staple pulley in an end tool of the surgical instrument of FIG. 2. FIG. [Figure 21] 3 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. [Figure 22] 3 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. [Figure 23] 3 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. [Figure 24] 3 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 2. [Figure 25] 3 is a perspective view showing the opening and closing operation of an end tool of the surgical instrument of FIG. 2. [Figure 26] 3 is a perspective view showing the opening and closing operation of an end tool of the surgical instrument of FIG. 2. [Figure 27] 3 is a perspective view showing a first jaw and a cartridge of the surgical instrument of FIG. 2. FIG. [Figure 28] FIG. 28 is an exploded perspective view showing the cartridge of FIG. 27. [Figure 29] FIG. 28 is an assembled perspective view showing the cartridge of FIG. 27. [Figure 30]FIG. 28 is a side view of the cartridge of FIG. 27. [Figure 31] FIG. 28 is a perspective cross-sectional view showing the cartridge of FIG. 27. [Figure 32] FIG. 28 is a side cross-sectional view showing the cartridge of FIG. 27. [Figure 33] 3 is a perspective cross-sectional view showing a stapling structure of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 34] 3 is a perspective cross-sectional view showing a stapling structure of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 35] FIG. 28 is a perspective view showing a working member of the cartridge of FIG. 27. [Figure 36] FIG. 28 is a perspective view showing a working member of the cartridge of FIG. 27. [Figure 37] FIG. 28 is a perspective view showing a working member of the cartridge of FIG. 27. [Figure 38] FIG. 36 is a perspective view showing the working member of FIG. 35 coupled with a reciprocating member. [Figure 39] FIG. 36 is a perspective view showing the working member of FIG. 35 coupled with a reciprocating member. [Figure 40] 34 is a plan view showing the clutch driving operation of the end tool of FIG. 33. FIG. [Figure 41] 34 is a plan view showing the clutch driving operation of the end tool of FIG. 33. FIG. [Figure 42] FIG. 34 is a perspective view showing an overall clutch driving operation of the end tool of FIG. 33. [Figure 43] FIG. 34 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 33. [Figure 44] FIG. 34 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 33. [Figure 45] FIG. 3 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. [Figure 46] FIG. 3 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. [Figure 47] 3 is a diagram simply illustrating only the configuration of pulleys and wires that constitute the joints of the surgical instrument shown in FIG. 2. FIG. [Figure 48] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 49] 3 is a diagram illustrating the configuration of pulleys and wires involved in the actuation operation and yaw operation of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively resolved; FIG. [Figure 50] 3 is a diagram illustrating the configuration of pulleys and wires involved in the actuation operation and yaw operation of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively resolved; FIG. [Figure 51] 3 is a view showing the configuration of pulleys and wires involved in the stapling and cutting operations of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 52] 3 is a view showing the configuration of pulleys and wires involved in the stapling and cutting operations of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 53] 3 is a view showing the configuration of pulleys and wires involved in the stapling and cutting operations of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 54] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 55] 3 is a diagram illustrating the configuration of pulleys and wires involved in the pitch movement of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 56] 3 is a diagram illustrating the configuration of pulleys and wires involved in the pitch movement of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 57] 3 is a diagram illustrating the configuration of pulleys and wires involved in the pitch movement of the surgical instrument shown in FIG. 2, with the first jaw and the second jaw respectively disassembled. FIG. [Figure 58]3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw-rotated by −90°. FIG. [Figure 59] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw-rotated by −90°. FIG. [Figure 60] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw-rotated by −90°. FIG. [Figure 61] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw is yaw-rotated by −90°. FIG. [Figure 62] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw has been yaw-rotated by +90°. FIG. [Figure 63] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw has been yaw-rotated by +90°. FIG. [Figure 64] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw has been yaw-rotated by +90°. FIG. [Figure 65] 3 is a plan view showing the actuation operation of the end tool of the surgical instrument of FIG. 2, showing the process of the actuation operation in a state where the jaw has been yaw-rotated by +90°. FIG. [Figure 66] 3 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 2, showing the process of performing the stapling operation with the jaw rotated by +90° in yaw. FIG. [Figure 67] 3 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 2, showing the process of performing the stapling operation with the jaw rotated by +90° in yaw. FIG. [Figure 68] 3 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 2, showing the process of performing the stapling operation in a state where the jaws are yaw-rotated by −90°. FIG. [Figure 69] 3 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 2, showing the process of performing the stapling operation in a state where the jaws are yaw-rotated by −90°. FIG. [Figure 70] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 71] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 72] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 73] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 74] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 75] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 76] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 77] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 78] 3 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. FIG. [Figure 79] 3 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. FIG. [Figure 80] 3 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. FIG. [Figure 81]3 is a plan view showing a state in which the end tool of the surgical instrument of FIG. 2 has been rotated in pitch and yaw directions. FIG. [Figure 82] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a first modified example of the first embodiment of the present invention. [Figure 83] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a first modified example of the first embodiment of the present invention. [Figure 84] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a first modified example of the first embodiment of the present invention. [Figure 85] FIG. 83 is a perspective view showing the working member of FIG. 82 coupled with a reciprocating member. [Figure 86] FIG. 83 is a perspective view showing the working member of FIG. 82 coupled with a reciprocating member. [Figure 87] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a second modified example of the first embodiment of the present invention. [Figure 88] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a second modified example of the first embodiment of the present invention. [Figure 89] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a second modified example of the first embodiment of the present invention. [Figure 90] 88 is a plan view showing the resilient member and contact member of the working member of FIG. 87 in more detail. FIG. [Figure 91] 88 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 87. FIG. [Figure 92] 88 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 87. FIG. [Figure 93] 88 is a plan view showing the clutch driving operation of the end tool of FIG. 87. [Figure 94] 88 is a plan view showing the clutch driving operation of the end tool of FIG. 87. [Figure 95] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a third modified example of the first embodiment of the present invention. [Figure 96]FIG. 10 is a perspective view showing a working member of a surgical instrument according to a third modified example of the first embodiment of the present invention. [Figure 97] FIG. 96 is a perspective view showing the working member of FIG. 95 coupled with a reciprocating member. [Figure 98] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. [Figure 99] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. [Figure 100] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. [Figure 101] 99 is a plan view showing the resilient member and contact member of the working member of FIG. 98 in more detail. FIG. [Figure 102] 99 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 98. [Figure 103] 99 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 98. [Figure 104] 99 is a plan view showing the clutch driving operation of the end tool of FIG. 98. [Figure 105] 99 is a plan view showing the clutch driving operation of the end tool of FIG. 98. [Figure 106] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. [Figure 107] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. [Figure 108] FIG. 10 is a perspective view showing a working member of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. [Figure 109] 107 is a plan view showing the resilient member and contact member of the working member of FIG. 106 in more detail. FIG. [Figure 110] 107 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 106. FIG. [Figure 111]107 is a plan view showing the operating state of the elastic member and the contact member of the working member of FIG. 106. FIG. [Figure 112] 107 is a plan view showing the clutch driving operation of the end tool of FIG. 106. FIG. [Figure 113] 107 is a plan view showing the clutch driving operation of the end tool of FIG. 106. FIG. [Figure 114] FIG. 10 is a perspective view showing a surgical instrument according to a second embodiment of the present invention. [Figure 115] FIG. 115 is a side view of the surgical instrument of FIG. 114. [Figure 116] 115 is a perspective view showing an end tool of the surgical instrument of FIG. 114. [Figure 117] 115 is a perspective view showing an end tool of the surgical instrument of FIG. 114. [Figure 118] 115 is a perspective view showing an end tool of the surgical instrument of FIG. 114. [Figure 119] 115 is a perspective view showing an end tool of the surgical instrument of FIG. 114. [Figure 120] 115 is a plan view showing the end tool of the surgical instrument of FIG. 114. [Figure 121] 115 is a plan view showing the end tool of the surgical instrument of FIG. 114. [Figure 122] FIG. 115 is an exploded perspective view of the end tool of the surgical instrument of FIG. 114. [Figure 123] 115 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 114. [Figure 124] 115 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 114. [Figure 125] 115 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 114. [Figure 126] 115 is a plan view showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of FIG. 114. [Figure 127]115 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 114. [Figure 128] 115 is an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 114. [Figure 129] 115 is a front view showing the staple pulley and staple link of the surgical instrument of FIG. 114. [Figure 130] 115 is a side view showing the operating state of the staple pulley in the end tool of the surgical instrument of FIG. 114. [Figure 131] 115 is a side view showing the operating state of the staple pulley in the end tool of the surgical instrument of FIG. 114. [Figure 132] 115 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 114. [Figure 133] 115 is a perspective view showing an operating state of a staple pulley in the end tool of the surgical instrument of FIG. 114. [Figure 134] 115 is a perspective view showing a first jaw and a cartridge of the surgical instrument of FIG. 114. [Figure 135] FIG. 135 is an exploded perspective view showing the cartridge of FIG. 134. [Figure 136] FIG. 135 is an assembled perspective view of the cartridge of FIG. 134. [Figure 137] FIG. 135 is a side view of the cartridge of FIG. 134. [Figure 138] FIG. 135 is a perspective cross-sectional view showing the cartridge of FIG. 134. [Figure 139] FIG. 135 is a side cross-sectional view of the cartridge of FIG. 134. [Figure 140] FIG. 135 is a perspective view showing the working member of the cartridge of FIG. 134. [Figure 141] FIG. 135 is a perspective view showing the working member of the cartridge of FIG. 134. [Figure 142] FIG. 135 is a perspective view showing the working member of the cartridge of FIG. 134. [Figure 143]FIG. 135 is a perspective view showing the working member of the cartridge of FIG. 134. [Figure 144] 115 is a side cross-sectional view showing the stapling-related structure of the end tool of the surgical instrument of FIG. 114. [Figure 145] 115 is a perspective cross-sectional view showing the stapling structure of the end tool of the surgical instrument of FIG. 114. [Figure 146] 115 is a perspective cross-sectional view showing the stapling structure of the end tool of the surgical instrument of FIG. 114. [Figure 147] 138 is a perspective view showing the ratchet drive operation of the end tool of FIG. 137. FIG. [Figure 148] 138 is a perspective view showing the ratchet drive operation of the end tool of FIG. 137. FIG. [Figure 149] 146 is a plan view showing the ratchet drive operation of the end tool of FIG. 145. FIG. [Figure 150] FIG. 146 is a perspective view generally illustrating the ratchet drive operation of the end tool of FIG. 145. [Figure 151] FIG. 146 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 145. [Figure 152] FIG. 146 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 145. [Figure 153] FIG. 115 is a perspective view showing the end tool of FIG. 114 with the jaws pitch-rotated by +90°. [Fig. 154] 154A and 154B are side views of the end tool of FIG. 153, with some components omitted in each view. [Figure 155] 154A and 154B are side views of the end tool of FIG. 153, with some components omitted in each view. [Figure 156] 154A and 154B are side views of the end tool of FIG. 153, with some components omitted in each view. [Figure 157] FIG. 154 is a side cross-sectional view of the end tool of FIG. 153; [Figure 158] FIG. 154 is a perspective cross-sectional view of the end tool of FIG. 153; [Figure 159]FIG. 154 is a perspective view showing the actuation operation of the end tool of FIG. 153, showing the process of the actuation operation with the jaws pitch rotated by +90°. [Figure 160] FIG. 154 is a perspective view showing the actuation operation of the end tool of FIG. 153, showing the process of the actuation operation with the jaws pitch rotated by +90°. [Figure 161] FIG. 115 is a perspective view showing the end tool of FIG. 114 with the jaws pitch-rotated by −90°. [Figure 162] 162A and 162B are side views of the end tool of FIG. 161, with some components omitted in each view. [Figure 163] 162A and 162B are side views of the end tool of FIG. 161, with some components omitted in each view. [Fig. 164] 162A and 162B are side views of the end tool of FIG. 161, with some components omitted in each view. [Figure 165] FIG. 162 is a side cross-sectional view of the end tool of FIG. 161; [Figure 166] FIG. 162 is a perspective cross-sectional view of the end tool of FIG. 161; [Figure 167] FIG. 162 is a perspective view showing the actuation operation of the end tool of FIG. 161, showing the process of the actuation operation when the jaws are pitch rotated by +90°. [Figure 168] FIG. 162 is a perspective view showing the actuation operation of the end tool of FIG. 161, showing the process of the actuation operation when the jaws are pitch rotated by +90°. [Figure 169] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is in a neutral state. FIG. [Figure 170] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is in a neutral state. FIG. [Figure 171] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is pitch rotated by −90°. FIG. [Fig. 172] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is pitch rotated by −90°. FIG. [Figure 173] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is pitch rotated by −90°. FIG. [Fig. 174] 115 is a perspective view showing the actuation operation of the surgical instrument of FIG. 114, showing the process of the actuation operation when the jaw is pitch rotated by −90°. FIG. [Figure 175] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a first modified example of the second embodiment of the present invention. [Figure 176] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a first modified example of the second embodiment of the present invention. [Figure 177] FIG. 176 is a detailed perspective view of the end tool of FIG. 175. [Figure 178] FIG. 176 is a detailed perspective view of the end tool of FIG. 175. [Figure 179] FIG. 176 is a side view of the end tool of FIG. 175. [Figure 180] FIG. 176 is a plan view of the end tool of FIG. 175. [Figure 181] FIG. 176 is an exploded perspective view of the end tool of FIG. 175; [Figure 182] FIG. 182 is an exploded perspective view of a staple pulley and a link member of the end tool of FIG. 181. [Figure 183] 176 is a plan view showing the operation of the jaw pulley of the end tool of FIG. 175. [Figure 184] 176 is a plan view showing the operation of the staple pulley of the end tool of FIG. 175. [Figure 185] FIG. 176 is a perspective view showing the actuation operation of the end tool of FIG. 175, showing the process of the actuation operation in a state where the jaws are pitch rotated by +90°. [Figure 186] FIG. 176 is a perspective view showing the actuation operation of the end tool of FIG. 175, showing the process of the actuation operation in a state where the jaws are pitch rotated by +90°. [Figure 187] FIG. 187 is a side view of the end tool of FIG. 186. [Figure 188] FIG. 187 is a side cross-sectional view of the end tool of FIG. 186. [Figure 189] FIG. 176 is a perspective view showing the actuation operation of the end tool of FIG. 175, showing the process of the actuation operation in a state where the jaws are pitch rotated by −90°. [Figure 190] FIG. 176 is a perspective view showing the actuation operation of the end tool of FIG. 175, showing the process of the actuation operation in a state where the jaws are pitch rotated by −90°. [Figure 191] FIG. 191 is a side view of the end tool of FIG. 190. [Figure 192] FIG. 191 is a side cross-sectional view of the end tool of FIG. 190; [Figure 193] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a second modified example of the second embodiment of the present invention. [Figure 194] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a second modified example of the second embodiment of the present invention. [Figure 195] FIG. 194 is a detailed perspective view of the end tool of FIG. 193. [Figure 196] FIG. 194 is a detailed perspective view of the end tool of FIG. 193. [Figure 197] FIG. 194 is a side view of the end tool of FIG. 193. [Figure 198] FIG. 194 is a plan view of the end tool of FIG. 193. [Figure 199] FIG. 194 is an exploded perspective view of the end tool of FIG. 193; [Figure 200] FIG. 199 is an exploded perspective view of a staple pulley and a link member of the end tool of FIG. [Figure 201] 194 is a plan view showing the operation of the jaw pulley of the end tool of FIG. 193. [Figure 202] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a third modified example of the second embodiment of the present invention. [Figure 203] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a third modified example of the second embodiment of the present invention. [Figure 204] FIG. 203 is a detailed perspective view of the end tool of FIG. 202. [Figure 205] FIG. 203 is a detailed perspective view of the end tool of FIG. 202. [Figure 206] FIG. 203 is a side view of the end tool of FIG. 202. [Figure 207] FIG. 203 is a plan view of the end tool of FIG. 202. [Figure 208] FIG. 203 is an exploded perspective view of the end tool of FIG. 202. [Figure 209] FIG. 199 is an exploded perspective view of a staple pulley and a link member of the end tool of FIG. [Figure 210] FIG. 199 is a perspective view of a second jaw of the end tool of FIG. [Figure 211] 203 is a plan view showing the operation of the jaw pulley of the end tool of FIG. 202. [Figure 212] 203 is a plan view showing the operation of the jaw pulley of the end tool of FIG. 202. BEST MODE FOR CARRYING OUT THE INVENTION

[0011] According to an embodiment of the present invention, a surgical instrument includes a staple drive assembly including a first jaw, a second jaw formed to face the first jaw, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first jaw pulley by a certain amount, and one or more staple pulleys formed adjacent to the first jaw pulley or the second jaw pulley; and a staple drive assembly connected to the staple drive assembly to rotate the staple pulley. The cartridge includes a reciprocating member that moves linearly when the reciprocating member moves, and a contact member that is formed to be able to come into contact with the reciprocating member, and a working member that moves in one direction together with the reciprocating member when the reciprocating member moves in one direction, and when the reciprocating member moves to a distal portion of the cartridge, the contact member restricts the relative movement between the working member and the reciprocating member, so that the reciprocating member and the working member move together, and when the reciprocating member moves to a proximal portion of the cartridge, the relative movement between the working member and the reciprocating member is permitted, so that only the reciprocating member moves.

[0012] In the present invention, when the reciprocating member moves to the distal portion of the cartridge, the contact member and the reciprocating member become engaged, restricting the relative movement between the working member and the reciprocating member, and when the reciprocating member moves to the proximal portion of the cartridge, the engagement between the contact member and the reciprocating member is released, allowing the relative movement between the working member and the reciprocating member.

[0013] In the present invention, when the staple pulley rotates, the reciprocating member connected to the staple drive assembly moves toward the distal end or the proximal end of the cartridge.

[0014] In the present invention, when the staple pulley rotates alternately in a clockwise and counterclockwise direction, the reciprocating member connected to the staple drive assembly moves alternately toward the distal end and the proximal end of the cartridge.

[0015] In the present invention, when the reciprocating member moves toward the distal portion of the cartridge, the working member is moved toward the distal portion of the cartridge by the reciprocating member.

[0016] The present invention is characterized in that the staple drive assembly converts bidirectional rotational motion of the staple pulley into reciprocating linear motion of the reciprocating member connected to the staple drive assembly.

[0017] In the present invention, while the working member moves in the one direction, the wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge to perform a stapling operation, and at the same time, a blade formed on one side of the wedge portion of the working member moves in the one direction to perform a cutting operation.

[0018] In the present invention, when the reciprocating member moves toward the distal portion of the cartridge, the contact member and the reciprocating member become engaged with each other, and the reciprocating member pushes the working member including the contact member, causing the working member to move toward the distal portion of the cartridge.

[0019] In the present invention, when the reciprocating member moves toward the proximal portion of the cartridge, the working member is stopped in the one direction.

[0020] In the present invention, the contact member is formed to be spaced apart from the reciprocating member by a certain amount when the reciprocating member moves toward the proximal portion of the cartridge.

[0021] In the present invention, the staple drive assembly includes a link member connecting the staple pulley and the reciprocating member.

[0022] In the present invention, when the staple pulley rotates in a first direction of clockwise and counterclockwise, the link member connected to the staple pulley, the reciprocating member connected to the link member, and the working member in contact with the reciprocating member move toward the distal portion of the cartridge.

[0023] In the present invention, when the staple pulley rotates in the clockwise or counterclockwise direction opposite to the first direction, the link member connected to the staple pulley and the reciprocating member connected to the link member move toward the proximal portion of the end tool, and the working member is stopped in the one direction.

[0024] In the present invention, the working member further includes a main body, one or more wedges formed on one side of the main body and including an inclined surface formed so that the height of the proximal side of the cartridge is higher than that of the distal side, and a blade formed on one side of the wedge and including a sharply formed edge, and the contact member is characterized in that it is disposed in a receiving portion formed on one surface of the main body.

[0025] In the present invention, the storage section formed in the main body has an inclined portion formed on the surface facing the reciprocating member, and the width of the storage section narrows as it moves toward the distal end of the cartridge.

[0026] In the present invention, the distance between the inclined portion and the reciprocating member is formed so as to decrease toward the distal portion of the cartridge.

[0027] In the present invention, when the contact member is pressurized in a direction that reduces the distance between the inclined portion and the reciprocating member, the contact member and the reciprocating member become engaged, and the relative movement between the reciprocating member and the working member is blocked.

[0028] In the present invention, the contact member is formed so that the center distance, which is the distance from the center of rotation to the end, differs in each region.

[0029] In the present invention, when the region of the contact member where the center distance is relatively long comes into contact with the reciprocating member, the contact member and the reciprocating member become engaged with each other, restricting the relative movement between the working member and the reciprocating member, and when the region of the contact member where the center distance is relatively short comes into contact with the reciprocating member, the engagement between the contact member and the reciprocating member is released, allowing the working member and the reciprocating member to move relative to each other.

[0030] In the present invention, the stapler further includes a staple wire coupled with the staple pulley to rotate the staple pulley.

[0031] In the present invention, the end tool further includes a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable around a second axis that forms a predetermined angle with the first axis, and a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable around an axis that is substantially the same as or parallel to the second axis.

[0032] In the present invention, the end tool is formed to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

[0033] The present invention is characterized in that the first jaw pulley, the one or more staple pulleys, and the second jaw pulley are laminated in this order.

[0034] According to an embodiment of the present invention, a surgical instrument cartridge having an end tool that can rotate in at least one direction includes a housing, a cover that covers one surface of the housing and has a slit formed along a first direction that is the longitudinal direction of the housing, a plurality of staples that are arranged inside the housing along the first direction, a reciprocating member that is arranged inside the housing and is formed to be movable relative to the housing along the first direction, and a working member that is formed on one side of the reciprocating member and is formed to be able to come into contact with the reciprocating member and is formed to be movable along the first direction by the reciprocating member, wherein when the reciprocating member moves to a distal portion of the cartridge, the contact member restricts the relative movement between the working member and the reciprocating member, and the reciprocating member and the working member move together, and when the reciprocating member moves to a proximal portion of the cartridge, the relative movement between the working member and the reciprocating member is permitted, and only the reciprocating member moves.

[0035] In the present invention, the reciprocating member is connected to a staple drive assembly formed on the end tool, and when a staple pulley of the staple drive assembly rotates, the reciprocating member moves along the first direction.

[0036] In the present invention, when the staple pulley rotates alternately in a clockwise and counterclockwise direction, the reciprocating member connected to the staple drive assembly moves alternately toward the distal end and the proximal end of the cartridge.

[0037] In the present invention, when the reciprocating member moves to the distal portion of the cartridge, the contact member and the reciprocating member are engaged with each other, restricting the relative movement between the working member and the reciprocating member, and when the reciprocating member moves to the proximal portion of the cartridge, the engagement between the contact member and the reciprocating member is released, allowing the relative movement between the working member and the reciprocating member.

[0038] In the present invention, the working member is movable only toward the distal portion of the cartridge, and movement toward the proximal portion of the cartridge is restricted.

[0039] In the present invention, the working member and the reciprocating member form a one-way clutch that allows movement in only one direction and restricts movement in the opposite direction.

[0040] In the present invention, the working member further includes a main body, one or more wedges formed on one side of the main body and including an inclined surface formed so that the height of the proximal side of the cartridge is higher than that of the distal side, and a blade formed on one side of the wedge and including a sharply formed edge, and the contact member is characterized in that it is disposed in a receiving portion formed on one surface of the main body.

[0041] In the present invention, when the reciprocating member moves toward the distal portion of the cartridge, the contact member and the reciprocating member become engaged with each other, and the reciprocating member pushes the working member including the contact member, causing the working member to move toward the distal portion of the cartridge.

[0042] In the present invention, when the reciprocating member moves toward the proximal portion of the cartridge, the working member is stopped in the one direction.

[0043] In the present invention, the contact member is formed to be spaced apart from the reciprocating member by a certain amount when the reciprocating member moves toward the proximal portion of the cartridge.

[0044] The present invention further includes an elastic member formed between the body and the contact member to provide an elastic force for pressing the contact member in any direction.

[0045] In the present invention, the storage section formed in the main body has an inclined portion formed on the surface facing the reciprocating member, and the width of the storage section narrows as it moves toward the distal end of the cartridge.

[0046] In the present invention, the distance between the inclined portion and the reciprocating member is formed so as to decrease toward the distal portion of the cartridge.

[0047] In the present invention, when the contact member is pressurized in a direction that reduces the distance between the inclined portion and the reciprocating member, the contact member and the reciprocating member become engaged, and the relative movement between the reciprocating member and the working member is blocked.

[0048] In the present invention, when the contact member simultaneously contacts the working member and the reciprocating member to form an engaged state, a locked state is formed in which relative movement between the working member and the reciprocating member is blocked, and when the contact member separates from at least one of the working member and the reciprocating member to release the engaged state, an unlocked state is formed in which relative movement between the working member and the reciprocating member is possible.

[0049] In the present invention, the elastic member presses the contact member in a direction that reduces the gap between the inclined portion and the reciprocating member.

[0050] In the present invention, the contact member is formed so that the center distance, which is the distance from the center of rotation to the end, differs in each region.

[0051] In the present invention, when the region of the contact member where the center distance is relatively long comes into contact with the reciprocating member, the contact member and the reciprocating member become engaged with each other, restricting the relative movement between the working member and the reciprocating member, and when the region of the contact member where the center distance is relatively short comes into contact with the reciprocating member, the engaged state between the contact member and the reciprocating member is released, allowing the working member and the reciprocating member to move relative to each other.

[0052] In the present invention, the contact member includes a main body portion and a protruding portion formed to protrude from the main body portion and be capable of contacting the reciprocating member, and the protruding portion includes a long axis portion having a relatively long center distance and a short axis portion having a relatively short center distance.

[0053] In the present invention, when torque is applied to the contact member in the direction in which the long shaft portion contacts the reciprocating member, the contact member and the reciprocating member become engaged, and when torque is applied to the contact member in the direction in which the shortened portion contacts the reciprocating member, the engaged state between the contact member and the reciprocating member is released.

[0054] In the present invention, the contact member is formed so that the center distance from the center of the main body portion to the end of the protrusion increases as the contact member advances toward the proximal portion of the cartridge.

[0055] 43. The surgical instrument cartridge according to claim 42, wherein the elastic member presses the contact member in a direction in which the long shaft portion contacts the reciprocating member.

[0056] In the present invention, the contact members are sprags.

[0057] In the present invention, the contact member is a cam that rotates around a predetermined rotation axis.

[0058] According to an embodiment of the present invention, a method for driving a surgical instrument includes the steps of: (a) when a staple pulley of a staple drive assembly rotates about a first axis in a first direction, a staple link assembly connected to the staple pulley and a reciprocating member of a cartridge connected to the staple link assembly move along a second axis toward a distal portion of the cartridge; (b) when the reciprocating member moves toward the distal portion of the cartridge, the reciprocating member and a working member contacting the reciprocating member are engaged with each other, and the working member moves toward the distal portion of the cartridge together with the reciprocating member; (c) a step in which the working member moves toward the distal portion of the cartridge while ejecting the staples in the cartridge out of the cartridge and the blade of the working member moves toward the distal portion of the cartridge, and (d) a step in which the staple pulley rotates about the first axis in a second direction opposite to the first direction, causing the staple link assembly connected to the staple pulley and the reciprocating member of the cartridge connected to the staple link assembly to move toward the proximal portion of the cartridge.

[0059] In the present invention, when the staple pulley rotates in the first direction or the second direction, the reciprocating member moves toward the distal portion of the cartridge or toward the proximal portion of the cartridge.

[0060] The present invention is characterized in that the bidirectional rotational movement of the staple pulley about the first axis is converted into the reciprocating linear movement of the reciprocating member connected to the staple pulley along the second axis.

[0061] In the present invention, the working member is moved toward the distal portion of the cartridge by the reciprocating linear motion of the reciprocating member.

[0062] In the present invention, the working member includes a contact member formed on one side of the reciprocating member and configured to be able to come into contact with the reciprocating member, and step (b) is characterized in that when the reciprocating member moves to the distal portion of the cartridge, the contact member and the reciprocating member become engaged with each other, restricting the relative movement between the working member and the reciprocating member, and the working member moves toward the distal portion of the cartridge together with the reciprocating member.

[0063] In the present invention, step (d) is characterized in that when the reciprocating member moves to the proximal portion of the cartridge, the engagement between the contact member and the reciprocating member is released, allowing relative movement between the working member and the reciprocating member, and with the working member stopped, only the reciprocating member moves toward the proximal portion of the cartridge.

[0064] The present invention is characterized in that in step (d), the working member is stationary in the second axial direction.

[0065] In the present invention, the working member moves toward the distal portion of the cartridge together with the reciprocating member only when the reciprocating member moves toward the distal portion of the cartridge.

[0066] The present invention is characterized in that the stapler further includes a staple wire coupled with the staple pulley to rotate the staple pulley, and the bidirectional rotation of the staple pulley by the staple wire is converted into a reciprocating linear motion of the reciprocating member.

[0067] In the present invention, while the working member moves toward the distal portion of the cartridge, the wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge to perform a stapling operation, and at the same time, a blade formed on one side of the wedge portion of the working member moves toward the distal portion of the cartridge to perform a cutting operation.

[0068] The present invention is characterized in that the steps (a) to (d) are repeatedly performed.

[0069] According to an embodiment of the present invention, a surgical instrument includes an end tool including a first jaw, a second jaw formed opposite the first jaw and rotatable about a first axis relative to the first jaw, and a staple drive assembly including one or more staple pulleys formed at least partially within the first jaw or the second jaw and rotatable about an axis substantially identical to or parallel to the first axis; a reciprocating assembly connected to the staple drive assembly and moving linearly thereby when the one or more staple pulleys rotate; and a cartridge including a working member that comes into contact with the reciprocating assembly and moves in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction.

[0070] In the present invention, the end tool further includes a pair of first pitch main pulleys formed on one side of the staple drive assembly and rotatable around a second axis, and a pair of second pitch main pulleys formed on one side of the staple drive assembly and rotatable around an axis substantially the same as or parallel to the second axis.

[0071] In the present invention, the end tool further includes a pair of first pitch sub-pulleys formed on one side of the first pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis, and a pair of second pitch sub-pulleys formed on one side of the second pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0072] In the present invention, the end tool is formed to be rotatable by a pitch around the second axis.

[0073] In the present invention, the end tool includes a first pulley and a second pulley formed to face each other within the first jaw or the second jaw and rotatable around an axis substantially identical to or parallel to the first axis, wherein at least one of the first pulley or the second pulley is the staple pulley of the staple drive assembly.

[0074] In the present invention, the pitch main pulley further includes a first wire coupled to the first pulley to rotate the first pulley and wound around at least a portion of the pair of first pitch main pulleys, and a second wire coupled to the second pulley to rotate the second pulley and wound around at least a portion of the pair of second pitch main pulleys.

[0075] In the present invention, the first pulley is a first staple pulley of the staple drive assembly, and the second pulley is a second staple pulley of the staple drive assembly.

[0076] In the present invention, the end tool further includes an actuation wire connected to the second jaw for rotating the second jaw relative to the first jaw by pushing or pulling the second jaw.

[0077] In the present invention, the first pulley is a jaw pulley connected to the first jaw or the second jaw to rotate the first jaw or the second jaw, and the second pulley is a staple pulley of the staple drive assembly.

[0078] In the present invention, when the staple pulley rotates, the reciprocating assembly connected to the staple drive assembly moves toward the distal end or the proximal end of the cartridge.

[0079] In the present invention, when the staple pulley rotates alternately in a clockwise and counterclockwise direction, the reciprocating assembly connected to the staple drive assembly moves alternately toward the distal end and the proximal end of the cartridge.

[0080] In the present invention, when the reciprocating assembly moves toward the distal portion of the cartridge, the working member is moved toward the distal portion of the cartridge by the reciprocating assembly.

[0081] The present invention is characterized in that the staple drive assembly converts bidirectional rotational motion of the staple pulley into reciprocating linear motion of a reciprocating assembly connected to the staple drive assembly.

[0082] In the present invention, while the working member moves in the one direction, the wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge to perform a stapling operation, and at the same time, a blade formed on one side of the wedge portion of the working member moves in the one direction to perform a cutting operation.

[0083] In the present invention, the staple drive assembly includes a link member connecting the staple pulley and the reciprocating assembly.

[0084] In the present invention, the working member may include a ratchet member having a ratchet formed on at least one surface, and the ratchet of the ratchet member may be formed to be able to come into contact with the reciprocating assembly.

[0085] In the present invention, the working member moves toward the distal end of the cartridge together with the reciprocating assembly only when the reciprocating assembly moves toward the distal end of the cartridge.

[0086] In the present invention, when the staple pulley rotates in a first direction of clockwise and counterclockwise, the link member connected to the staple pulley, the reciprocating assembly connected to the link member, and the working member in contact with the reciprocating assembly move toward the distal portion of the cartridge.

[0087] In the present invention, when the staple pulley rotates in the direction opposite to the first direction among the clockwise and counterclockwise directions, the link member connected to the staple pulley and the reciprocating assembly connected to the link member move toward the proximal portion of the end tool, and the working member is stopped in the one direction.

[0088] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw capable of accommodating a cartridge; a second jaw formed opposite to the first jaw and rotatable about a first axis relative to the first jaw; a staple drive assembly including one or more staple pulleys formed at least partially within the first jaw and rotatable about an axis substantially identical to or parallel to the first axis; staple wires that contact at least partially with the staple pulleys and transmit to the staple pulleys a driving force required to rotate the staple pulleys; a pair of first pitch main pulleys formed on one side of the staple drive assembly and rotatable about a second axis; and a pair of second pitch main pulleys formed on one side of the staple drive assembly and rotatable about an axis substantially identical to or parallel to the second axis, wherein the staple drive assembly is connected to a reciprocating assembly of the cartridge, and rotational motion of the staple pulleys is converted into linear motion of the reciprocating assembly.

[0089] In the present invention, the staple drive assembly further includes a staple link assembly that connects the staple pulley and the reciprocating assembly and reciprocates in response to bidirectional rotation of the staple pulley.

[0090] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and causes the reciprocating assembly to reciprocate.

[0091] In the present invention, when the staple pulley rotates alternately in a clockwise and counterclockwise direction, the staple link assembly connected to the staple pulley moves alternately toward the distal end and the proximal end of the end tool.

[0092] The present invention is characterized in that the staple link assembly converts bidirectional rotational motion of the staple pulley into reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

[0093] In the present invention, a protruding member is formed on the staple pulley, a slot is formed on the staple link assembly, and when the staple pulley rotates, the protruding member moves within the slot while contacting the slot.

[0094] In the present invention, the protruding member is formed in the form of a cam, and as the protruding member rotates, it presses the slot of the staple link assembly, causing the staple link assembly to move.

[0095] In the present invention, the center of the protruding member does not coincide with the center of the staple pulley, and the protruding member is formed to be eccentric to a certain degree with respect to the staple pulley.

[0096] In the present invention, when the staple pulley rotates in a first direction of clockwise and counterclockwise, the staple link assembly connected to the staple pulley and the reciprocating assembly connected to the staple link assembly move toward the distal portion of the cartridge.

[0097] In the present invention, when the staple pulley rotates in the direction opposite to the first direction, either clockwise or counterclockwise, the staple link assembly connected to the staple pulley moves toward the proximal portion of the end tool.

[0098] In the present invention, the end tool further includes a pair of first pitch sub-pulleys formed on one side of the first pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis, and a pair of second pitch sub-pulleys formed on one side of the second pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0099] In the present invention, the end tool is formed to be rotatable by a pitch around the second axis.

[0100] In the present invention, the end tool includes a first pulley and a second pulley formed to face each other within the first jaw or the second jaw and rotatable around an axis substantially identical to or parallel to the first axis, wherein at least one of the first pulley or the second pulley is the staple pulley of the staple drive assembly.

[0101] In the present invention, the pitch main pulley further includes a first wire coupled to the first pulley to rotate the first pulley and wound around at least a portion of the pair of first pitch main pulleys, and a second wire coupled to the second pulley to rotate the second pulley and wound around at least a portion of the pair of second pitch main pulleys.

[0102] In the present invention, the apparatus further includes a staple auxiliary pulley disposed between the staple pulley and the pair of first pitch main pulleys or the pair of second pitch main pulleys.

[0103] In the present invention, the staple wire is located on a common inscribed line of the staple pulley and the staple assist pulley, and the rotation angle of the staple pulley is expanded by the staple assist pulley.

[0104] In the present invention, when the first jaw and the second jaw rotate in the same direction around the second axis, the staple pulley rotates together with the first jaw and the second jaw.

[0105] In the present invention, the first and second jaws do not rotate while the staple pulley is rotated by the staple wire.

[0106] In the present invention, the first jaw is formed with a cartridge accommodating portion capable of accommodating a cartridge, and the second jaw is formed with an anvil with which the staples of the cartridge can come into contact.

[0107] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw capable of accommodating a cartridge, a second jaw formed to face the first jaw and rotatable about a first axis relative to the first jaw, an actuation wire connected to the second jaw and rotating the second jaw relative to the first jaw by pushing or pulling the second jaw, a staple pulley assembly including a first staple pulley and a second staple pulley formed at least partially within the first jaw and rotatable about an axis substantially the same as or parallel to the first axis, and a staple pulley assembly for supporting the first staple pulley and the second staple pulley. the staple pulley includes a staple link assembly connected to the first staple pulley or the second staple pulley and reciprocating in response to rotation of the first staple pulley or the second staple pulley, a first staple wire at least partially wound around the first staple pulley, a second staple wire at least partially wound around the second staple pulley, a pair of first pitch main pulleys formed on one side of the first staple pulley and rotatable about a second axis, and a pair of second pitch main pulleys formed on one side of the second staple pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0108] The present invention is characterized in that the bidirectional rotational motion of the staple pulley assembly is converted into the reciprocating linear motion of the staple link assembly.

[0109] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and the rotational motion of the staple pulley assembly is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

[0110] The present invention is characterized in that the staple link assembly moves toward the distal end or the proximal end of the end tool depending on the rotation direction of the first staple pulley or the second staple pulley.

[0111] In the present invention, the staple link assembly includes link members respectively coupled to the first staple pulley, the second staple pulley, and the reciprocating assembly.

[0112] In the present invention, a first protruding member is formed on the first staple pulley, a second protruding member is formed on the second staple pulley, and a first slot to which the first protruding member is coupled and a second slot to which the second protruding member is coupled are formed on the link member, and when the first staple pulley rotates, the first protruding member moves within the first slot while contacting the first slot, and when the second staple pulley rotates, the second protruding member moves within the second slot while contacting the second slot.

[0113] In the present invention, the first slot and the second slot are formed symmetrically to each other on the link member, and when the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, and when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

[0114] In the present invention, the first protruding member and the second protruding member are formed in the form of a cam, and the first protruding member presses the first slot while rotating, and the second protruding member presses the second slot while rotating, thereby moving the staple link assembly.

[0115] In the present invention, the center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree relative to the first staple pulley, and the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed to be eccentric to a certain degree relative to the second staple pulley.

[0116] In the present invention, when the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, the staple link assembly connected to the first staple pulley or the second staple pulley moves alternately to the distal side and the proximal side of the end tool.

[0117] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly moves along the guide groove.

[0118] In the present invention, the end tool includes a guide tube that accommodates at least a portion of the actuation wire therein and is formed so as to be bent to a certain degree.

[0119] The actuation wire passes through the inside of the guide tube and is connected to the second jaw.

[0120] In the present invention, when the guide tube is bent to a certain extent, the actuation wire inside the guide tube is also bent together with the guide tube.

[0121] In the present invention, the actuation wire is formed within the guide tube so as to be movable along the guide tube.

[0122] In the present invention, the first jaw includes a cartridge accommodating portion formed at one end, and a first pitch pulley portion and a second pitch pulley portion formed at the other end so as to face each other.

[0123] The present invention is characterized in that at least a portion of the guide tube is disposed between the first pitch pulley portion and the second pitch pulley portion.

[0124] In the present invention, a pitch slit through which the guide tube can pass is formed between the first pitch pulley portion and the second pitch pulley portion.

[0125] In the present invention, the second 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, and the pitch slit is formed between the first sub-shaft and the second sub-shaft of the second shaft.

[0126] In the present invention, a guide pin is formed at one end of the actuation wire, a pin guide groove is formed in the first jaw in which the guide pin can move, and a pin guide groove is formed in the second jaw in which the guide pin can move.

[0127] In the present invention, with the guide pin engaged with the pin guide groove of the first jaw and the pin guide groove of the second jaw, the guide pin moves along the pin guide groove of the first jaw and presses the pin guide groove of the second jaw, thereby rotating the second jaw relative to the first jaw.

[0128] In the present invention, the end tool further includes a pair of first pitch sub-pulleys formed on one side of the first pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis, and a pair of second pitch sub-pulleys formed on one side of the second pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0129] In the present invention, the end tool is formed to be rotatable by a pitch around the second axis.

[0130] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw capable of accommodating a cartridge, a second jaw formed opposite to the first jaw, a jaw pulley coupled to the first jaw or the second jaw and formed rotatably about a first axis, a staple pulley assembly including a staple pulley formed at least partially within the first jaw or the second jaw and formed rotatably about an axis substantially identical to or parallel to the first axis, a staple link assembly connected to the staple pulley and reciprocating in response to rotation of the staple pulley, a jaw wire at least partially wound around the jaw pulley, a staple wire at least partially wound around the staple pulley, a pair of first pitch main pulleys formed on one side of the jaw pulley and formed rotatably about a second axis, and a pair of second pitch main pulleys formed on one side of the staple pulley and formed rotatably about an axis substantially identical to or parallel to the second axis.

[0131] The present invention is characterized in that the bidirectional rotational motion of the staple pulley assembly is converted into the reciprocating linear motion of the staple link assembly.

[0132] In the present invention, when the staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, the staple link assembly connected to the staple pulley moves alternately toward the distal end and the proximal end of the end tool.

[0133] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and the rotational motion of the staple pulley assembly is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

[0134] The present invention is characterized in that the staple link assembly converts bidirectional rotational motion of the staple pulley into reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

[0135] In the present invention, the staple link assembly includes link members coupled to the staple pulley and the reciprocating assembly, respectively.

[0136] In the present invention, a protruding member is formed on the staple pulley, and a slot to which the protruding member is coupled is formed on the link member, and when the staple pulley rotates, the protruding member moves within the slot while contacting the slot.

[0137] In the present invention, the protruding member is formed in the form of a cam, and the protruding member rotates and presses the slot, thereby moving the staple link assembly.

[0138] In the present invention, the center of the protruding member does not coincide with the center of the staple pulley, and the protruding member is formed to be eccentric to a certain degree with respect to the staple pulley.

[0139] In the present invention, a protruding member is formed on the jaw pulley, and a slot to which the protruding member is coupled is formed on the second jaw, and when the jaw pulley rotates, the protruding member moves within the slot while contacting the slot.

[0140] In the present invention, the protruding member is formed in the form of a cam, and the protruding member rotates and presses the slot, thereby moving the second jaw.

[0141] In the present invention, the center of the protruding member does not coincide with the center of the jaw pulley, and the protruding member is formed to be eccentric to a certain degree with respect to the jaw pulley.

[0142] In the present invention, the jaw pulley connecting link is further included, which connects the jaw pulley and the second jaw.

[0143] In the present invention, when the jaw pulley rotates, the rotation of the jaw pulley is transmitted to the second jaw via the jaw pulley connecting link, and the second jaw rotates relative to the first jaw.

[0144] In the present invention, the jaw pulley is formed integrally with the second jaw.

[0145] In the present invention, when the jaw pulley rotates as the jaw wire coupled to the jaw pulley is pushed or pulled, the second jaw formed integrally with the jaw pulley rotates together with the jaw pulley.

[0146] In the present invention, the end tool further includes a pair of first pitch sub-pulleys formed on one side of the first pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis, and a pair of second pitch sub-pulleys formed on one side of the second pitch main pulley and rotatable about an axis substantially the same as or parallel to the second axis.

[0147] In the present invention, the end tool is formed to be rotatable by a pitch around the second axis.

[0148] In the present invention, the jaw pulley and the staple pulley are formed so as to be rotatable independently of each other.

[0149] Other aspects, features, and advantages beyond those described above will become apparent from the following drawings, claims, and detailed description of the invention. DETAILED DESCRIPTION OF THE INVENTION

[0150] Since the present invention can be modified in various ways and can have various embodiments, specific embodiments are shown in the drawings and will be described in detail. However, this is not intended to limit the present invention to the specific embodiments, and it should be understood that the present invention includes all modifications, equivalents, and alternatives that fall within the spirit and technical scope of the present invention. In describing the present invention, if a detailed description of related publicly known technology is considered to obscure the gist of the present invention, the detailed description will be omitted.

[0151] 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.

[0152] The terms used in this application are merely used to describe specific embodiments and are not intended to limit the present invention. The singular expressions include the plural expressions unless the context clearly dictates otherwise. In this application, terms such as "comprise" or "have" are intended to specify the presence of features, numbers, steps, operations, components, parts, or combinations thereof described herein, and should be understood not to preclude the possibility of the presence or addition of one or more other features, numbers, steps, operations, components, parts, or combinations thereof.

[0153] 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.

[0154] Furthermore, in describing various embodiments of the present invention, it should be understood that each embodiment should not be interpreted or implemented independently, but that the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments that are described separately.

[0155] The surgical instrument according to the present invention is characterized in that when the operating part is rotated in a certain direction for at least one of pitch, yaw, and actuation movements, the end tool intuitively rotates in the same direction as the operating direction of the operating part.

[0156] FIG. 1A is a conceptual diagram of pitch motion of a conventional surgical instrument, and FIG. 1B is a conceptual diagram of yaw motion.

[0157] 1A, when a conventional surgical instrument performs a pitch movement, the end tool 120a is formed forward of the center of rotation 121a of the end tool, and the operating unit 110a is formed rearward of the center of rotation 111a of the operating unit, so that when the operating unit 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operating unit 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. On the other hand, referring to FIG. 1B, when a conventional surgical instrument performs a yaw movement, the end tool 120a is formed forward of the center of rotation 121a of the end tool, and the operating unit 110a is formed rearward of the center of rotation 111a of the operating unit, so that when the operating unit 110a is rotated clockwise, the end tool 120a also rotates clockwise, and when the operating unit 110a is rotated counterclockwise, the end tool 120a also rotates counterclockwise. In this case, from the perspective of the user's left-right direction, when the user moves the operation unit 110a to the left, the end tool 120a moves to the right, and when the user moves the operation unit 110a to the right, the end tool 120a moves to the left. As a result, the user's operation direction and the movement direction of the end tool are reversed, which may cause the user to make an error and makes the user's operation difficult.

[0158] FIG. 1C is a conceptual diagram of pitch motion of another conventional surgical instrument, and FIG. 1D is a conceptual diagram of yaw motion.

[0159] Referring to FIG. 1C , some conventional surgical instruments are formed in a mirror-symmetrical shape. When performing a pitch movement, the end tool 120b is formed forward of the rotation center 121b of the end tool, and the operating unit 110b is formed rearward of the rotation center 111b of the operating unit. When the operating unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operating unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the perspective of the rotation direction of the operating unit and the end tool, the rotation direction in which the user rotates the operating unit 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there are problems such as confusion about the operation direction for the user, and the joint movement being unintuitive, which can lead to mistakes. 1D , when performing a yaw operation, the end tool 120b is formed forward of the rotation center 121b of the end tool, and the operating unit 110b is formed rearward of the rotation center 111b of the operating unit. When the operating unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operating unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the perspective of the rotation direction of the operating unit and the end tool, the rotation direction in which the user rotates the operating unit 110b and the corresponding rotation direction of the end tool 120b are opposite to each other. As a result, there is a problem that the user may be confused about the operation direction, and the joint operation is not intuitive, which may lead to mistakes. As such, when a user performs a pitch or yaw operation on a conventional surgical instrument, the user's operation direction and the movement direction of the end tool do not match each other in terms of either the rotation direction or the left-right direction. This is because the joint configuration of the endo-tool and the operating part differ from each other in the joint configuration of conventional surgical instruments: the endo-tool is formed forward of its center of rotation, while the operating part is formed rearward of its center of rotation.To solve this problem, the surgical instrument according to one embodiment of the present invention shown in Figures 1E and 1F is characterized in that the endotool 120c is formed forward of the rotation center 121c of the endotool, and the operating unit 110c is also formed forward of the rotation center 111c of the operating unit, so that the movements of the operating unit 110c and the endotool 120c intuitively match. To express this characteristic in another way, unlike existing examples in which the operating unit is configured to move closer to the user's joint (i.e., away from the endotool) as shown in Figures 1A, 1B, 1C, and 1D, the surgical instrument according to one embodiment of the present invention shown in Figures 1E and 1F is configured so that at least a portion of the operating unit is closer to the endotool (than the user's joint) relative to the user's joint at least for a certain moment during the operation process.

[0160] Explaining this separately, in the case of conventional surgical instruments such as those shown in Figures 1A, 1B, 1C, and 1D, the endotool is located forward of its center of rotation, while the operating unit is formed rearward of its center of rotation. Therefore, operating the operating unit, which moves rearward while the front is fixed, moves the endotool, which moves forward while the rear is fixed. 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 or rotational direction, which can confuse the user and make it difficult to operate the operating unit intuitively and quickly, potentially leading to errors. In contrast, in the surgical instrument according to one embodiment of the present invention, both the endotool and the operating unit move based on a center of rotation formed at the rear, so that their operations can be said to be intuitively consistent. Explaining this separately, just as the moving part of the endotool moves based on a center of rotation formed at the rear, the moving part of the operating unit also moves based on the same center of rotation formed at the rear, so that their operations can be said to be intuitively consistent. This allows the user to intuitively and quickly steer the direction of the end tool, which has the advantage of significantly reducing the possibility of mistakes. A specific mechanism that enables this function will be described below.

[0161] <First embodiment of surgical instrument>

[0162] FIG. 2 is a perspective view of a surgical instrument according to a first embodiment of the present invention. FIG. 3 is a side view of the surgical instrument of FIG. 2. FIGS. 4 and 5 are perspective views of an endotool of the surgical instrument of FIG. 2. FIG. 6 is a perspective view of an endotool hub of the endotool of the surgical instrument of FIG. 2. FIGS. 7 and 8 are plan views of the endotool of the surgical instrument of FIG. 2. FIG. 9 is a side view of the endotool of the surgical instrument of FIG. 2. FIGS. 10 and 11 are exploded perspective views of the endotool of the surgical instrument of FIG. 2. FIG. 12 is a perspective view of a first jaw pulley of the surgical instrument of FIG. 2. FIG. 13 is a plan view of a first jaw of the surgical instrument of FIG. 2. FIG. 14 is a plan view of a second jaw of the surgical instrument of FIG. 2. FIGS. 15 and 16 are exploded perspective views of a staple pulley and staple link of the surgical instrument of FIG. 2. Figures 17 and 18 are side views showing the operating state of a staple pulley in the end tool of the surgical instrument of Figure 2. Figures 19 and 20 are perspective views showing the operating state of a staple pulley in the end tool of the surgical instrument of Figure 2. Figures 21, 22, 23, and 24 are plan views showing the opening and closing operations of the first and second jaws of the surgical instrument of Figure 2. Figures 25 and 26 are perspective views showing the opening and closing operations of the end tool of the surgical instrument of Figure 2.

[0163] First, referring to FIGS. 2 and 3, a surgical instrument 4000 according to a first embodiment of the present invention includes an end tool 4100, an operating section 200, a power transmission section 300, and a connecting section 400.

[0164] Here, the connecting portion 400 may be formed in the shape of a hollow shaft, and one or more wires and electrical cables may be housed therein. The operating portion 200 is coupled to one end of the connecting portion 400, and the end tool 4100 is coupled to the other end, and the connecting portion 400 may serve to connect the operating portion 200 and the end tool 4100. Here, the connecting portion 400 of the surgical instrument 4000 according to the first embodiment of the present invention is characterized by including a straight portion 401 and a bent portion 402, with the straight portion 401 formed on the side coupled to the end tool 4100 and the bent portion 402 formed on the side coupled to the operating portion 200. As such, the end of the connecting portion 400 on the operating portion 200 side is bent, so that the pitch operating portion 201, the yaw operating portion 202, and the actuation operating portion 203 are formed on an extension line of the end tool 4100 or adjacent to the extension line. Expressed from another perspective, this can be explained as at least a portion of the pitch operation unit 201 and the yaw operation unit 202 being housed in a recess formed by the bent portion 402. Such a shape of the bent portion 402 allows the shapes and operations of the operation unit 200 and the end tool 4100 to match more intuitively.

[0165] Meanwhile, the plane on which the bent portion 402 is formed may be the pitch plane, i.e., substantially the same plane as the XZ plane in Fig. 2. In this way, by forming the bent portion 402 on substantially the same plane as the XZ plane, interference between the operating units can be reduced. Of course, for intuitive operation of the end tool and the operating unit, configurations other than the XZ plane are also possible.

[0166] Meanwhile, a connector 410 may be formed on the bending portion 402. The connector 410 may be connected to an external power source (not shown), or the connector 410 may be connected to the end tool 4100 via an electric wire, and electrical energy supplied from the external power source (not shown) may be transmitted to the end tool 4100. The electrical energy transmitted to the end tool 4100 in this manner may provide a driving force for rotating a staple pulley (see 4161 in FIG. 10 ), which will be described later, in a clockwise or counterclockwise direction.

[0167] The operating unit 200 is formed at one end of the connecting unit 400 and is provided as an interface that can be directly operated by a surgeon, for example, in the form of forceps, a stick, a lever, etc. When the surgeon operates the operating unit 200, the endotool 4100 connected to the interface and inserted into the body of the surgical patient performs a predetermined operation, thereby performing surgery. Here, while Fig. 2 shows the operating unit 200 formed in the shape of a handle that can be rotated with a finger inserted, the concept of the present invention is not limited thereto, and various types of operating units that can be connected to the endotool 4100 and operate the endotool 4100 are possible.

[0168] The endotool 4100 is formed at the other end of the connecting portion 400 and is inserted into a surgical site to perform operations required for surgery. As an example of such an endotool 4100, a pair of jaws 4103 for performing a gripping operation may be used, as shown in FIG. 2 . However, the concept of the present invention is not limited thereto, and various surgical devices may be used as the endotool 4100. For example, a single-arm cautery may also be used as the endotool. Such an endotool 4100 is connected to the operating portion 200 by the power transmission portion 300, and receives the driving force of the operating portion 200 via the power transmission portion 300 to perform operations required for surgery, such as gripping, cutting, and suturing.

[0169] Here, the end tool 4100 of the surgical instrument 4000 according to the first embodiment of the present invention is formed to be rotatable in at least one direction, for example, the end tool 4100 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.

[0170] Here, the pitch, yaw, and actuation movements used in the present invention are defined as follows.

[0171] First, the pitch movement refers to the movement of the end tool 4100 rotating up and down relative to the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), i.e., the movement of rotating around the Y-axis in FIG. 2. In other words, it refers to the movement of the end tool 4100, which is formed extending from the connecting part 400 in the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), rotating up and down relative to the connecting part 400 around the Y-axis.

[0172] Next, the yaw movement refers to the movement of the end tool 4100 rotating left and right with respect to the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), i.e., the movement of rotating around the Z-axis in FIG. 2. In other words, it refers to the movement of the end tool 4100 formed by extending from the connecting part 400 in the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2) rotating left and right with respect to the connecting part 400 around the Z-axis. In other words, it refers to the movement of two jaws 4103 formed on the end tool 4100 rotating in the same direction with each other around the Z-axis.

[0173] Meanwhile, the actuation operation refers to the movement of the end tool 4100 rotating around the same rotation axis as the yaw operation, but the two jaws 4103 rotating in opposite directions to each other, thereby closing and opening the jaws. In other words, it refers to the movement of the two jaws 4103 formed on the end tool 4100 rotating in opposite directions to each other around the Z axis.

[0174] The power transmission unit 300 connects the operating unit 200 and the end tool 4100, and serves to transmit the driving force of the operating unit 200 to the end tool 4100, and may include a plurality of wires, pulleys, links, joints, gears, etc.

[0175] The end tool 4100, the operating unit 200, the power transmission unit 300, and the like of the surgical instrument 4000 shown in FIG. 2 will be described in detail below.

[0176] (Intuitive Drive)

[0177] The following describes the intuitive operation of the surgical instrument 4000 of the present invention.

[0178] First, while holding first handle 204 in the palm of the hand, the user can rotate first handle 204 about the Y-axis (i.e., rotation axis 246 in FIG. 25) to perform a pitch movement, and can rotate first handle 204 about the Z-axis (i.e., rotation axis 243 in FIG. 43) to perform a yaw movement. In addition, the user can operate actuation operation unit 203 with their thumb and index finger inserted into first actuation extension portion 252 and / or second actuation extension portion 257, which are finger hole rings formed at one end of actuation operation unit 203, to perform an actuation movement.

[0179] The surgical instrument 4000 according to the first embodiment of the present invention is characterized in that when the operating unit 200 is rotated in one direction relative to the connecting unit 400, the end tool 4100 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 4100 also intuitively rotates in the same direction as the one direction, performing a pitch or yaw movement. Here, the intuitively same direction may be added to mean that the direction of movement of the user's finger holding the operating unit 200 and the direction of movement of the tip of the end tool 4100 are substantially the same. Of course, the same direction here does not have to be a completely identical direction in three-dimensional coordinates. For example, it may be understood to mean that when the user's finger moves left, the tip of the end tool 4100 also moves left, and when the user's finger moves down, the tip of the end tool 4100 also moves down.

[0180] For this reason, the surgical instrument 4000 according to the first embodiment of the present invention is characterized in that the operating unit 200 and the endotool 4100 are formed in the same direction based on a plane perpendicular to the extension axis (X-axis) of the connecting unit 400. That is, when viewed based on the YZ plane in FIG. 2, the operating unit 200 is formed extending in the +X-axis direction, and the endotool 4100 is also formed extending in the +X-axis direction. In other words, the forming direction of the endotool 4100 at one end of the connecting unit 400 and the forming direction of the operating unit 200 at the other end of the connecting unit 400 can be said to be the same direction based on the YZ plane. In other words, the operating unit 200 can be said to be formed in a direction away from the torso of the user holding it, i.e., in the direction in which the endotool 4100 is formed. That is, the first handle 204, the first actuation operation unit 251, the second actuation operation unit 256, etc., which are gripped and moved by the user for actuation, yaw, and pitch movements, have portions that move to perform each movement formed to extend in the +X-axis direction from the rotation center of each joint for that movement. This allows the operation unit 200 to be configured in the same way as the end tool 4100, whose moving portions are formed to extend in the +X-axis direction from the rotation center of each joint for that movement, and as described with reference to Fig. 1, the operation direction of the user and the movement direction of the end tool coincide in both the rotational direction and the left-right direction, resulting in the same intuitive operation being possible.

[0181] Specifically, in the case of conventional surgical instruments, the direction in which the user operates the operating part and the actual operating direction of the end tool are different and do not intuitively match, which makes it difficult for the surgeon to operate intuitively, takes a long time to become skilled at moving the end tool in the desired direction, and in some cases, malfunctions can occur, potentially causing injury to the patient.

[0182] To solve this problem, the surgical instrument 4000 according to the first embodiment of the present invention intuitively aligns the operation direction of the operating unit 200 with the operating direction of the end tool 4100. To this end, the operating unit 200, like the end tool 4100, is characterized in that the parts that actually move for actuation, yaw, and pitch movements extend in the +X-axis direction from the rotation center of the joint corresponding to each movement.

[0183] The end tool 4100, the operating unit 200, the power transmission unit 300, etc. of the surgical instrument 4000 in FIG. 2 will be described in more detail below.

[0184] (Power transmission section)

[0185] The power transmission section 300 of the surgical instrument 4000 of FIG. 2 will be described in more detail below.

[0186] Referring to Figures 2 to 20, 47, etc., the power transmission section 300 of the surgical instrument 4000 according to one embodiment of the present invention can include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, wire 307, wire 308, wire 309, and wire 310.

[0187] 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 jaw wires. Wire 303 and wire 304 form a pair and can serve as pitch wires. Wire 307 and wire 308 form a pair and can serve as a first staple wire. Wire 309 and wire 310 form a pair and can serve as a second staple wire. Here, a component including wire 307 and wire 308, which are the first staple wires, and wire 309 and wire 310, which are the second staple wires, can be called staple wires.

[0188] Furthermore, the power transmission unit 300 of the surgical instrument 4000 according to an embodiment of the present invention may include fastening members 321, 323, 324, 326, 327, 329, and 330 coupled to each end of each wire to connect the wire to the pulley. Here, each fastening member may have various shapes, such as a ball shape or a tube shape, as needed.

[0189] Here, on the end tool 4100 side, the fastening member 321 can play the role of a pitch wire-end tool fastening member, the fastening member 323 can play the role of a first jaw wire-end tool fastening member, the fastening member 326 can play the role of a second jaw wire-end tool fastening member, and the fastening member 329 / fastening member 330 can play the role of a staple wire-end tool fastening member.

[0190] Furthermore, on the operating unit 200 side, the fastening member 324 can serve as a first jaw wire-operating unit fastening member, and the fastening member 327 can serve as a second jaw wire-operating unit fastening member. Although not shown in the drawings, the operating unit 200 side may further be provided with a pitch wire-operating unit fastening member and a staple wire-operating unit fastening member.

[0191] The connection relationship between the wire, the fastening member, and the pulleys will be described in detail below.

[0192] First, wire 301 and wire 305, which are first jaw wires, may be one single wire. Fastening member 323, which is a first jaw wire-end tool fastening member, is sandwiched at the midpoint of the first jaw wire, which is a single wire, and fastening member 323 is crimped and fixed, and then both strands of the first jaw wire with fastening member 323 at the center can be called wire 301 and wire 305, respectively.

[0193] 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 .

[0194] Then, by connecting this fastening member 323 to the pulley 4111, the wire 301 and the wire 305 can be fixedly connected to the pulley 4111. This allows the wire 301 and the wire 305 to be pulled and unwound, causing the pulley 4111 to rotate.

[0195] On the other hand, the ends of wire 301 and wire 305 opposite to where fastening member 323 is fastened may be joined to a first jaw wire-operating portion fastening member (see 324 in FIG. 47).

[0196] By connecting the first jaw wire-operating portion fastening member (see 324 in FIG. 47) to the pulley 210 in this manner, the wire 301 and the wire 305 can be fixedly connected to the pulley 210. As a result, when the pulley 210 is rotated by a motor or by human power, the wire 301 and the wire 305 are pulled or unwound, and the pulley 4111 of the end tool 4100 can be rotated.

[0197] Similarly, wire 302 and wire 306, which are second jaw wires, are coupled to a fastening member (see 326 in FIG. 47) which is a second jaw wire-end tool fastening member and a second jaw wire-operating portion fastening member (see 327 in FIG. 47), respectively. The fastening member (see 326 in FIG. 47) is coupled to pulley 4121, and the second jaw wire-operating portion fastening member (see 327 in FIG. 47) 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 4121 of end tool 4100 can be rotated.

[0198] Similarly, pitch wires 303 and 304 are coupled to pitch wire-end tool fastening member 321 and pitch wire operating unit fastening member (not shown), respectively. Fastening member 321 is coupled to pulley 4131, and pitch wire operating unit fastening member (not shown) is coupled to pulley 231. As a result, when pulley 231 is rotated by a motor or by human power, wires 303 and 304 are pulled or unwound, allowing pulley 4131 of end tool 4100 to rotate.

[0199] Similarly, the wires 307 and 308, which are first staple wires, are coupled to a fastening member (see 329 in FIG. 66) which is a staple wire-endotool fastening member and a staple wire-operating portion fastening member (not shown), respectively. The fastening member (see 329 in FIG. 66) is coupled to a first staple pulley 4181, and the staple wire-operating portion fastening member (not shown) is coupled to a pulley (see 269 in FIG. 51). As a result, when the pulley 269 is rotated by a motor or by human power, the wires 307 and 308 are pulled or unwound, and the first staple pulley 4181 of the end tool 4100 can be rotated.

[0200] Similarly, the wires 309 and 310 which are second staple wires are respectively coupled to a fastening member (see 330 in FIG. 67) which is a staple wire-endotool fastening member and a staple wire-operating portion fastening member (not shown). The fastening member (see 330 in FIG. 67) is coupled to a second staple pulley 4191, and the staple wire-operating portion fastening member (not shown) is coupled to a pulley (see 270 in FIG. 51). As a result, when the pulley 270 is rotated by a motor or by human power, the wires 309 and 310 are pulled or unwound, and the second staple pulley 4191 of the end tool 4100 can be rotated.

[0201] (end tool)

[0202] The endotool 4100 of the surgical instrument 4000 of FIG. 2 is described in more detail below.

[0203] 4 and 5 are perspective views showing the end tool of the surgical instrument of FIG. 2, FIG. 6 is a perspective view showing the end tool hub of the end tool of the surgical instrument of FIG. 2, and FIGS. 7 and 8 are plan views showing the end tool of the surgical instrument of FIG. 2.

[0204] Here, Fig. 4 shows a state in which the end tool hub 4106 and the pitch hub 4107 are coupled, and Fig. 5 shows a state in which the end tool hub 4106 is removed. Meanwhile, Fig. 7 is a view mainly showing the wire, and Fig. 8 is a view mainly showing the pulley.

[0205] 4 to 8, an end tool 4100 according to a first embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 4101 and a second jaw 4102. Here, each of the first jaw 4101 and the second jaw 4102, or a component that collectively includes the first jaw 4101 and the second jaw 4102, can be referred to as a jaw 4103.

[0206] The end tool 4100 may also include pulleys 4111, 4112, 4113, 4114, 4115, and 4116 for rotational movement of the first jaw 4101. The end tool 4100 may also include pulleys 4121, 4122, 4123, 4124, 4125, and 4126 for rotational movement of the second jaw 4102.

[0207] Here, although the drawings show opposing pulleys formed parallel to each other, the spirit of the present invention is not limited thereto, and it can be said that each pulley can be formed in a variety of positions and sizes suitable for the configuration of the end tool.

[0208] Additionally, the end tool 4100 of the first embodiment of the present invention may include an end tool hub 4106 and a pitch hub 4107 .

[0209] The end tool hub 4106 has a rotating shaft 4141 and a rotating shaft 4142, which will be described later, inserted therethrough, and can accommodate at least a portion of a pulley 4111 and a pulley 4121 axially coupled to the rotating shaft 4141. The end tool hub 4106 can also accommodate at least a portion of a pulley 4112 and a pulley 4122 axially coupled to the rotating shaft 4142.

[0210] In particular, referring to FIG. 6, the end tool hub 4106 includes a first jaw pulley coupling portion 4106a, a second jaw pulley coupling portion 4106b, a guide portion 4106c, a pitch pulley coupling portion 4106e, and a separation prevention pulley coupling portion 4106f.

[0211] In detail, the first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b are formed to face each other, and house therein the pulley 4111, the pulley 4121, the first staple pulley 4181, and the second staple pulley 4191. Furthermore, a through hole is formed in each of the first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b, and the rotation shaft 4141 passes through the first jaw pulley coupling portion 4106a, the pulley 4111, the first staple pulley 4181, the second staple pulley 4191, the pulley 4121, and the second jaw pulley coupling portion 4106b to axially couple them together.

[0212] The first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b are connected by a guide portion 4106c. In other words, the first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b, which are parallel to each other, are coupled by a guide portion 4106c formed in a direction approximately perpendicular thereto, and the first jaw pulley coupling portion 4106a, the second jaw pulley coupling portion 4106b, and the guide portion 4106c form an approximately U-shape, inside which the pulley 4111, the pulley 4121, the first staple pulley 4181, and the second staple pulley 4191 are housed.

[0213] Here, the pulley 4111 serving as the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion 4106a of the end tool hub 4106, and the pulley 4121 serving as the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion 4106b of the end tool hub 4106, and a staple assembly accommodating portion can be formed between the first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b. At least a portion of a staple pulley assembly (see 4160 in FIG. 10) and a staple link assembly (see 4170 in FIG. 10), which will be described later, may be formed in the staple assembly accommodating portion. From another perspective, this can also be expressed as at least a portion of the first staple pulley 4181, the second staple pulley 4191, and the link member 4171 being disposed between the first jaw pulley coupling portion 4106a and the second jaw pulley coupling portion 4106b. Therefore, at least a portion of the staple pulley assembly (see 4160 in FIG. 10) and the staple link assembly (see 4170 in FIG. 10) are disposed between the pulley 4111 which is the first jaw pulley and the pulley 4121 which is the second jaw pulley, and this is one feature of the present invention that it is possible to perform stapling and cutting operations using the first staple pulley 4181 and the second staple pulley 4191 in addition to pitch and yaw movements of the end tool 4100. This will be described in more detail later.

[0214] Meanwhile, a pulley 4131 that serves as an end tool pitch pulley may be formed at one end of the end tool hub 4106. As shown in FIG. 6, the pulley 4131 may be formed integrally with the end tool hub 4106. That is, a disk-shaped pulley may be formed at one end of the end tool hub 4106, and a groove around which a wire can be wound may be formed on the outer circumferential surface of the pulley. Alternatively, the pulley 4131 may be formed as a separate member from the end tool hub 4106 and coupled to the end tool hub 4106. The wires 303 and 304 described above are coupled to the pulley 4131 that serves as an end tool pitch pulley, and the pulley 4131 performs pitch motion while rotating about the rotation axis 4143.

[0215] Meanwhile, a separation prevention pulley coupling portion 4106f may be further formed on one side of the pulley 4131. The separation prevention pulley coupling portion 4106f may be formed parallel to a rotation axis 4143 which is the end tool pitch rotation axis, and may be formed to couple pulleys 4187, 4188, 4197, and 4198, which will be described later. Here, the pulleys 4187 and 4188 can function as first staple wire separation prevention pulleys, and the pulleys 4197 and 4198 can function as second staple wire separation prevention pulleys. This will be described in more detail later.

[0216] Rotation shafts 4143 and 4144, which will be described later, are inserted through the pitch hub 4107, and the pitch hub 4107, the end tool hub 4106, and the pulley 4131 can be axially coupled by the rotation shaft 4143. Therefore, the end tool hub 4106 and the pulley 4131 can be formed to be able to pitch rotate relative to the pitch hub 4107 around the rotation shaft 4143.

[0217] The pitch hub 4107 can accommodate at least a portion of the pulleys 4113, 4114, 4123, and 4124 axially coupled to the rotation shaft 4143. The pitch hub 4107 can accommodate at least a portion of the pulleys 4115, 4116, 4125, and 4126 axially coupled to the rotation shaft 4144.

[0218] Meanwhile, the end tool 4100 according to the first embodiment of the present invention may include a rotation shaft 4141, a rotation shaft 4142, a rotation shaft 4143, and a rotation shaft 4144. As described above, the rotation shaft 4141 and the rotation shaft 4142 may be inserted through the end tool hub 4106, and the rotation shaft 4143 and the rotation shaft 4144 may be inserted through the pitch hub 4107.

[0219] The rotation shafts 4141, 4142, 4143, and 4144 can be arranged sequentially from the distal end 4104 toward the proximal end 4105 of the end tool 4100. Therefore, in order from the distal end 4104, the rotation shaft 4141 can be called pin 1, the rotation shaft 4142 can be called pin 2, the rotation shaft 4143 can be called pin 3, and the rotation shaft 4144 can be called pin 4.

[0220] Here, rotation axis 4141 can function as the end tool jaw pulley rotation axis, rotation axis 4142 can function as the end tool jaw auxiliary pulley rotation axis, rotation axis 4143 can function as the end tool pitch rotation axis, and rotation axis 4144 can function as the end tool pitch auxiliary rotation axis of the end tool 4100.

[0221] Each of these rotating shafts 4141, 4142, 4143, 4144 may have one or more pulleys fitted thereto, which will be described in detail below.

[0222] Meanwhile, a rotation shaft 4145 may be further formed on one side of the rotation shaft 4141, more specifically on the distal portion 4104 side of the rotation shaft 4141. The rotation shaft 4145 is inserted through the first jaw 4101 and the second jaw 4102 and can function as a jaw rotation shaft, which will be described in detail below.

[0223] Pulley 4111 functions as an end tool first jaw pulley, and pulley 4121 functions as an end tool second jaw pulley. Pulley 4111 is also called the first jaw pulley, and pulley 4121 is also called the second jaw pulley, and these two components are sometimes collectively referred to as end tool jaw pulleys or simply jaw pulleys.

[0224] Pulleys 4111 and 4121, which are end tool jaw pulleys, are formed to face each other and are formed to be rotatable independently of each other around a first rotation shaft 4141, which is an end tool jaw pulley rotation shaft. At this time, the pulleys 4111 and 4121 are formed to be spaced apart to a certain extent, and a staple assembly accommodating portion can be formed therebetween. At least a portion of a staple pulley assembly 4160 and a staple link assembly 4170, which will be described later, can be disposed in this staple assembly accommodating portion.

[0225] Here, in the figure, the pulley 4111 and the pulley 4121 are formed to rotate around one rotation axis 4141, but it goes without saying that each end tool jaw pulley may be formed to be rotatable around a separate axis. Here, a first jaw 4101 is fixedly connected to the pulley 4111 and rotates together with the pulley 4111, and a second jaw 4102 is fixedly connected to the pulley 4121 and rotates together with the pulley 4121. Yaw movement and actuation movement of the end tool 4100 occur in response to the rotation of the pulleys 4111 and 4121. That is, when the pulleys 4111 and 4121 rotate in the same direction around the rotation axis 4141, a yaw movement occurs, and when the pulleys 4111 and 4121 rotate in opposite directions around the rotation axis, an actuation movement occurs.

[0226] Here, the first jaw 4101 and the pulley 4111 may be formed as separate members and coupled to each other, or the first jaw 4101 and the pulley 4111 may be formed as a single body. Similarly, the second jaw 4102 and the pulley 4121 may be formed as separate members and coupled to each other, or the second jaw 4102 and the pulley 4121 may be formed as a single body.

[0227] Pulley 4112 functions as an end tool first jaw auxiliary pulley, and pulley 4122 functions as an end tool second jaw auxiliary pulley, and these two components may be collectively referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0228] Specifically, pulleys 4112 and 4122, which are end tool jaw auxiliary pulleys, may be further provided on one side of pulley 4111 and pulley 4121. That is, pulley 4112, which is an auxiliary pulley, may be disposed between pulley 4111 and pulley 4113 / pulley 4114. Furthermore, pulley 4122, which is an auxiliary pulley, may be disposed between pulley 4121 and pulley 4123 / pulley 4124. Pulleys 4112 and 4122 may be formed to be rotatable independently of each other about a rotation axis 4142. Here, although pulleys 4112 and 4122 are formed to rotate about a single rotation axis 4142 in the figure, it goes without saying that pulleys 4112 and 4122 may be formed to be rotatable about separate axes. Such auxiliary pulleys will be described in more detail later.

[0229] Pulley 4113 and pulley 4114 function as end tool first jaw pitch main pulleys, and pulley 4123 and pulley 4124 function as end tool second jaw pitch main pulleys, and these two components can also be commonly referred to as end tool jaw pitch main pulleys.

[0230] Pulleys 4115 and 4116 function as end tool first jaw pitch sub-pulleys, and pulleys 4125 and 4126 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.

[0231] The components involved in the rotation of pulley 4111 will be described below.

[0232] The pulley 4113 and the pulley 4114 function as end tool first jaw pitch main pulleys. That is, the pulley 4113 and the pulley 4114 function as main rotating pulleys for the pitch operation of the first jaw 4101. Here, the wire 301 which is the first jaw wire is wound around the pulley 4113, and the wire 305 which is the first jaw wire is wound around the pulley 4114.

[0233] The pulley 4115 and the pulley 4116 function as end tool first jaw pitch sub-pulleys. That is, the pulley 4115 and the pulley 4116 function as sub-rotating pulleys for the pitch operation of the first jaw 4101. Here, the wire 301 which is the first jaw wire is wound around the pulley 4115, and the wire 305 which is the first jaw wire is wound around the pulley 4116.

[0234] Pulleys 4113 and 4114 are disposed on one side of pulleys 4111 and 4112 so as to face each other. Pulleys 4113 and 4114 are formed so as to be able to rotate independently of each other around a rotation axis 4143, which is the end tool pitch rotation axis. Pulleys 4115 and 4116 are disposed on one side of pulleys 4113 and 4114 so as to face each other. Pulleys 4115 and 4116 are formed so as to be able to rotate independently of each other around a rotation axis 4144, which is the end tool pitch auxiliary rotation axis. Although the drawings show pulleys 4113, 4115, 4114, and 4116 as all being rotatable around the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0235] Wire 301, which is the first jaw wire, is wound around pulley 4115, pulley 4113, and pulley 4111 in sequence so that at least a portion of the wire comes into contact with pulley 4115, pulley 4113, and pulley 4111. Wire 305, which is connected to wire 301 by fastening member 323, is wound around pulley 4111, pulley 4112, pulley 4114, and pulley 4116 in sequence so that at least a portion of the wire comes into contact with pulley 4115, pulley 4113, and pulley 4111.

[0236] Explaining this from another perspective, the first jaw wires, wire 301 and wire 305, are wound sequentially around pulley 4115, pulley 4113, pulley 4111, pulley 4112, pulley 4114, and pulley 4116 so that at least a portion of them come into contact with each other, and wire 301 and wire 305 are formed to move along the pulleys while rotating them.

[0237] Therefore, when wire 301 is pulled in the direction of arrow 301 in Fig. 7, fastening member 323 to which wire 301 is coupled and pulley 4111 coupled thereto rotate in the direction of arrow L in Fig. 7. Conversely, when wire 305 is pulled in the direction of arrow 305 in Fig. 7, fastening member 323 to which wire 305 is coupled and pulley 4111 coupled thereto rotate in the direction of arrow R in Fig. 7.

[0238] Next, components related to the rotation of pulley 4121 will be described.

[0239] Pulley 4123 and pulley 4124 function as end tool second jaw pitch main pulleys. That is, pulley 4123 and pulley 4124 function as main rotating pulleys for the pitch operation of second jaw 4102. Here, wire 306, which is the second jaw wire, is wound around pulley 4123, and wire 302, which is the second jaw wire, is wound around pulley 4124.

[0240] Pulley 4125 and pulley 4126 function as end tool second jaw pitch sub-pulleys. That is, pulley 4125 and pulley 4126 function as sub-rotating pulleys for the pitch operation of second jaw 102. Here, wire 306, which is the second jaw wire, is wound around pulley 4125, and wire 302, which is the second jaw wire, is wound around pulley 4126.

[0241] Pulleys 4123 and 4124 are disposed on one side of pulley 4121 so as to face each other. Pulleys 4123 and 4124 are formed so as to be rotatable independently of each other around rotation axis 4143, which is the end tool pitch rotation axis. Pulleys 4125 and 4126 are disposed on one side of pulleys 4123 and 4124 so as to face each other. Pulleys 4125 and J15, 4123 and J25, are formed so as to be rotatable independently of each other around rotation axis 4144, which is the end tool pitch auxiliary rotation axis. Although the drawings show pulleys 4123, 4125, 4124, and 4126 as all being rotatable around the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0242] The wire 306, which is the second jaw wire, is wound around the pulley 4125, the pulley 4123, and the pulley 4121 in order so that at least a portion of the wire is in contact with the pulley 4125, the pulley 4123, and the pulley 4121. The wire 302, which is connected to the wire 306 by the fastening member 326, is wound around the pulley 4121, the pulley 4122, the pulley 4124, and the pulley 4126 in order so that at least a portion of the wire is in contact with the pulley 4125, the pulley 4123, and the pulley 4121.

[0243] Explaining this from another perspective, the second jaw wires, wire 306 and wire 302, are wound sequentially around pulley 4125, pulley 4123, pulley 4121, pulley 4122, pulley 4124, and pulley 4126 so that at least a portion of them come into contact with each other, and wire 306 and wire 302 are formed to move along the pulleys while rotating them.

[0244] Therefore, when wire 306 is pulled in the direction of arrow 306 in Fig. 7, fastening member 322 to which wire 306 is coupled and pulley 4121 coupled thereto rotate in the direction of arrow R in Fig. 7. Conversely, when wire 302 is pulled in the direction of arrow 302 in Fig. 7, fastening member 326 to which wire 302 is coupled and pulley 4121 coupled thereto rotate in the direction of arrow L in Fig. 7.

[0245] Pulley 4112 and pulley 4122, which act as auxiliary pulleys, will be described in more detail below.

[0246] Pulley 4112 and pulley 4122 can play a role in increasing the rotation angle of each of first jaw 4101 and second jaw 4102 by contacting wire 305, which is the first jaw wire, and wire 302, which is the second jaw wire, and changing the placement paths of wire 305 and wire 302 to a certain extent.

[0247] That is, without the auxiliary pulleys, each of the first and second jaws could only rotate up to a right angle. However, in one embodiment of the present invention, by further providing auxiliary pulleys 4112 and 4122, the maximum rotation angle can be increased by θ as viewed in FIG. 8 . This enables an operation in which the two jaws of the end tool 4100 must spread apart for actuation when the two jaws are yaw-rotated 90° in the L direction. This is because the second jaw 4102 can rotate by an additional angle (θ), as in FIG. 8 . Similarly, actuation is possible even when the two jaws are yaw-rotated in the L direction. In other words, the pulleys 4112 and 4122 have the advantage of expanding the range of yaw rotation within which actuation is possible.

[0248] This will be explained in more detail as follows.

[0249] When the auxiliary pulley is not provided, the first jaw wire is fixedly connected to the end tool first jaw pulley, and the second jaw wire is fixedly connected to the end tool second jaw pulley, so the end tool first jaw pulley and the end tool second jaw pulley can only rotate up to 90°. In this case, if an actuation operation is performed with the first jaw and the second jaw positioned on the 90° line, the first jaw can spread, but the second jaw cannot rotate more than 90°. Therefore, there was a problem in that the actuation operation could not be performed smoothly when the first jaw and the second jaw were performing a yaw operation more than a certain angle.

[0250] To solve this problem, in the surgical instrument 4000 of the present invention, auxiliary pulleys 4112 and 4122 are further disposed on one side of pulley 4111 and pulley 4121. By disposing pulley 4112 and pulley 4122 in this manner, the arrangement paths of wire 305 (first jaw wire) and wire 302 (second jaw wire) are changed to a certain extent, thereby changing the tangential directions of wire 305 and wire 302, and thereby allowing fastening member 323 connecting wire 301 and pulley 4111 to rotate up to line N in Figure 8. In other words, fastening member 323, which connects wire 301 and pulley 4111, can rotate until it is positioned on the common inscribed line of pulley 4112 and pulley 122. Similarly, fastening member 326, which is the connecting portion between wire 302 and pulley 4121, can rotate until it is positioned on the common inscribed line of pulleys 4121 and 4122, and the rotation range in the L direction can be expanded.

[0251] That is, wire 301 and wire 305, which are two strands of the first jaw wire wound around pulley 4111 by pulley 4112, are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis. At the same time, wire 302 and wire 306, which are two strands of the second jaw wire wound around pulley 4121 by pulley 4122, are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0252] In other words, pulleys 4113 and 4114 are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 4123 and 4124 are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0253] In other words, wire 305 is located on the inscribed line between pulley 4111 and pulley 4112, and the rotation angle of pulley 4111 is increased by pulley 4112. Wire 302 is located on the inscribed line between pulley 4121 and pulley 4122, and the rotation angle of pulley 4121 is increased by pulley 4122.

[0254] According to the present invention, the rotation radius of the jaws 4101 and 4102 is increased, which has the effect of widening the yaw operation range in which normal opening and closing actuation operations can be performed.

[0255] The pitch movement of the present invention will be described in more detail below.

[0256] On the other hand, when the wire 301 is pulled toward the arrow 301 in FIG. 7 and at the same time the wire 305 is pulled toward the arrow 305 in FIG. 7 (i.e., when both strands of the first jaw wire are pulled), as shown in FIG. 49, the wire 301 and the wire 305 are wound around the lower part of the pulley 4113 and the pulley 4114 which can rotate around the rotation axis 4143 which is the end tool pitch rotation axis, and therefore the pulley 4111 to which the wire 301 and the wire 305 are fixedly connected and the end tool hub 4106 to which the pulley 4111 is connected rotate together in the counterclockwise direction around the rotation axis 4143, and as a result the end tool 4100 rotates downward while performing a pitch motion. At this time, the second jaw 102 and the wires 302 and 306 fixedly connected thereto are wound around the upper parts of the pulleys 4123 and 4124 which can rotate around the rotation axis 4143, so that the wires 302 and 306 are unwound in the opposite direction to the wires 302 and 306, respectively.

[0257] Conversely, when wire 302 is pulled in the direction of arrow 302 in Fig. 7 and wire 306 is simultaneously pulled in the direction of arrow 306 in Fig. 7, because wire 302 and wire 306 are wound around the upper parts of pulleys 4123 and 4124 that can rotate around rotation axis 4143, which is the end tool pitch rotation axis, as shown in Fig. 49, pulley 4121 to which wire 302 and wire 306 are fixedly connected and end tool hub 4106 to which pulley 4121 is connected rotate together in the clockwise direction around rotation axis 4143, resulting in the end tool 4100 performing a pitch motion while rotating upward. At this time, first jaw 4101 and wire 301 and wire 305 fixedly connected thereto are wound around the lower parts of pulleys 4113 and 4114 that can rotate around rotation axis 4143, so wire 302 and wire 306 move in the opposite direction to wires 301 and 305, respectively.

[0258] Meanwhile, the endotool 4100 of the surgical instrument 4000 of the present invention may further include a pulley 4131 that is an endotool pitch pulley, the operating unit 200 may further include pulleys 231 and 232 that are operating unit pitch pulleys, and the power transmission unit 300 may further include wires 303 and 304 that are pitch wires. In particular, the pulley 4131 of the endotool 4100 may be rotatable around a rotation axis 4143 that is an endotool pitch rotation axis, and may be formed integrally with the endtool hub 4106 (or fixedly coupled to the endtool hub 4106). In addition, the wires 303 and 304 may serve to connect the pulley 4131 of the endotool 4100 to the pulleys 231 and 232 of the operating unit 200.

[0259] Therefore, when pulleys 231 and 232 of operating unit 200 rotate, the rotation of pulleys 231 and 232 is transmitted to pulley 4131 of end tool 4100 via wires 303 and 304, causing pulley 4131 to rotate as well, resulting in end tool 4100 performing a pitch motion while rotating.

[0260] That is, the surgical instrument 4000 according to the first embodiment of the present invention includes a pulley 4131 of the end tool 4100, pulleys 231 and 232 of the operating unit 200, and wires 303 and 304 of the power transmission unit 300 for transmitting power for pitch movement, thereby enabling the driving force of the pitch movement of the operating unit 200 to be more completely transmitted to the end tool 4100, thereby improving operational reliability.

[0261] Here, the diameters of pulleys 4113, 4114, 4123, and 4124, which are end tool jaw pitch main pulleys, may be the same as or different from the diameter of pulley 4131, which is the end tool pitch pulley. In this case, the ratio of the diameter of the end tool jaw pitch main pulley to the diameter of the end tool pitch pulley may be the same as the ratio of the diameter of the operation unit pitch pulley to the diameter of the operation unit pitch main pulley of operation unit 200, which will be described later. This will be explained in detail later.

[0262] (Staple pulley related components)

[0263] The first staple pulley 4181 and the second staple pulley 4191 of the staple pulley assembly 4160 of the endotool 4100 of the surgical instrument 4000 of Figure 2 will be described in further detail below.

[0264] Fig. 9 is a side view showing an end tool of the surgical instrument of Fig. 2, Figs. 10 and 11 are perspective views showing a first jaw of the surgical instrument of Fig. 2, Fig. 12 is a perspective view showing a first jaw pulley of the surgical instrument of Fig. 2, Fig. 13 is a plan view showing the first jaw of the surgical instrument of Fig. 2, Fig. 14 is a plan view showing the second jaw of the surgical instrument of Fig. 2, and Figs. 15 and 16 are exploded perspective views showing a staple pulley and staple link of the surgical instrument of Fig. 2.

[0265] 4 to 16, the end tool 4100 according to the first embodiment of the present invention may include a first staple pulley 4181, a first staple assist pulley 4182, a pulley 4183, a pulley 4184, a pulley 4185, and a pulley 4186, which are associated with the linear / rotational movement of each pulley and link for stapling and cutting. The end tool 4100 according to the first embodiment of the present invention may further include a pulley 4187 and a pulley 4188.

[0266] Furthermore, the end tool 4100 of the first embodiment of the present invention may include a second staple pulley 4191, a second staple assist pulley 4192, a pulley 4193, a pulley 4194, a pulley 4195, and a pulley 4196, which are associated with the linear / rotational movement of each pulley and link for stapling and cutting. Additionally, the end tool 4100 of the first embodiment of the present invention may further include a pulley 4197 and a pulley 4198.

[0267] The first staple pulley 4181 and the second staple pulley 4191 are formed to face the pulleys 4111 and 4121, which are end tool jaw pulleys, and are formed to be rotatable independently of each other around a rotation axis 4141, which is an end tool jaw pulley rotation axis. Here, in the figure, the first staple pulley 4181 and the second staple pulley 4191 are disposed between the pulley 4111 and the pulley 4121, but the spirit of the present invention is not limited thereto, and the first staple pulley 4181 and the second staple pulley 4191 can be disposed at various positions adjacent to the pulley 4111 or the pulley 4121.

[0268] Here, one feature of the present invention is that the first staple pulley 4181, the second staple pulley 4191, the pulley 4111, and the pulley 4121 are formed to rotate about substantially the same axis. In this way, by forming the first staple pulley 4181, the second staple pulley 4191, the pulley 4111, and the pulley 4121 to rotate about the same axis, pitch movement / yaw movement / actuation operation can be performed, and stapling and cutting operations can also be performed. This will be explained in more detail later. However, in the figure here, the first staple pulley 4181, the second staple pulley 4191, the pulley 4111, and the pulley 4121 are formed to rotate about a single rotation axis 4141, but it goes without saying that the respective pulleys may be formed to be rotatable about separate axes that are concentric with each other.

[0269] Explaining this from another perspective, it can also be expressed as a structure in which the pulley 4111 serving as the first jaw pulley, the first staple pulley 4181, the second staple pulley 4191, and the pulley 4121 serving as the second jaw pulley are stacked in order along the rotation shaft 4141. Alternatively, it can also be expressed as a structure in which the first staple pulley 4181 and the second staple pulley 4191 are disposed between the pulley 4111 and the pulley 4121 that face each other. Here, the pulley 4111 serving as the first jaw pulley, the first staple pulley 4181, the second staple pulley 4191, and the pulley 4121 serving as the second jaw pulley may be formed to be rotatable independently of each other.

[0270] The first staple assistant pulley 4182 may be further provided on one side of the first staple pulley 4181. That is, the first staple assistant pulley 4182 may be disposed between the first staple pulley 4181 and the pulley 4183 / pulley 4184. The first staple assistant pulley 4182 may be formed to be rotatable about the rotation axis 4142 independently of the pulley 4112 and the pulley 4122.

[0271] Meanwhile, a pulley 4187 and a pulley 4188 can be further disposed between the first staple assist pulley 4182 and the pulley 4183 / pulley 4184. The pulleys 4187 and 4188 may be formed to be rotatable around a separation prevention pulley coupling portion 4106f of the end tool hub 4106. Here, the separation prevention pulley coupling portion 4106f may be formed parallel to a rotation axis 4143 that is the central axis of the pulleys 4183 and 4184. Here, the pulleys 4187 and 4188 can function as first staple wire separation prevention pulleys.

[0272] On the other hand, pulleys 4183 and 4184 can function as staple pitch main pulleys, and pulleys 4185 and 4186 can function as staple pitch sub pulleys.

[0273] The second staple assistant pulley 4192 may be further provided on one side of the second staple pulley 4191. That is, the second staple assistant pulley 4192 may be disposed between the second staple pulley 4191 and the pulley 4193 / pulley 4194. The second staple assistant pulley 4192 may be formed to be rotatable about the rotation axis 4142 independently of the pulley 4112 and the pulley 4122.

[0274] Here, in the figures, the first staple assist pulley 4182, the second staple assist pulley 4192, the pulley 4112, and the pulley 4122 are formed to rotate around one rotation shaft 4142, but it goes without saying that the first staple assist pulley 4182, the second staple assist pulley 4192, the pulley 4112, and the pulley 4122 may each be formed to be rotatable around a separate shaft. Such staple assist pulleys will be described in more detail later.

[0275] Meanwhile, pulleys 4197 and 4198 can be further disposed between the second staple assist pulley 4192 and the pulley 4193 / pulley 4194. The pulleys 4197 and 4198 may be formed to be rotatable around a separation prevention pulley coupling portion 4106f of the end tool hub 4106. Here, the separation prevention pulley coupling portion 4106f may be formed parallel to a rotation axis 4143 which is the central axis of the pulleys 4183 and 4184. Here, the pulleys 4197 and 4198 can function as second staple wire separation prevention pulleys.

[0276] On the other hand, pulleys 4193 and 4194 can function as staple pitch main pulleys, and pulleys 4195 and 4196 can function as staple pitch sub pulleys.

[0277] The first staple assist pulley 4182 will be described in more detail below.

[0278] The first staple auxiliary pulley 4182 can play a role in enlarging the rotation angle of the first staple pulley 4181 by coming into contact with the wire 308, which is the first staple wire, and changing the arrangement path of the wire 308 to a certain extent.

[0279] That is, if no staple auxiliary pulley is provided, the staple pulley can only rotate up to a right angle, but in one embodiment of the present invention, by further providing the first staple auxiliary pulley 4182 which is an auxiliary pulley, it is possible to obtain the effect of increasing the maximum rotation angle by θ. This means that when the two jaws of the end tool 4100 are rotated 90° together in yaw, the first staple pulley 4181 rotates for stapling and cutting operations, and enables the operation of linearly moving the working member 4540, which will be described later. In other words, it has the characteristic that the range of yaw rotation in which stapling and cutting operations are possible can be expanded via the first staple auxiliary pulley 4182.

[0280] This will be explained in more detail as follows.

[0281] In the case of the surgical instrument 4000 of the present invention, a first staple assist pulley 4182 is further disposed on one side of the first staple pulley 4181. By disposing the first staple assist pulley 4182 in this manner and changing the arrangement path of the wire 308, which is the first staple wire, to a certain extent, the tangential direction of the wire 308 is changed, and therefore the rotation angle of the fastening member (see 329 in FIG. 62 ) that connects the wire 308 and the first staple pulley 4181 is increased. In other words, the fastening member (see 329 in FIG. 62 ), which is the connecting portion between the wire 308 and the first staple pulley 4181, becomes rotatable until it is positioned on the common inscribed line of the first staple pulley 4181 and the staple assist pulley 4182.

[0282] In other words, the wire 308 is located on the inscribed line between the first staple pulley 4181 and the first staple auxiliary pulley 4182, and the rotation angle of the first staple pulley 4181 is increased by the first staple auxiliary pulley 4182.

[0283] According to the present invention, the rotation radius of the first staple pulley 4181 is increased, which has the effect of widening the yaw operation range in which normal stapling and cutting operations can be performed.

[0284] The pulley 4187 and the pulley 4188, which are the first staple wire separation prevention pulleys, will be described in more detail below.

[0285] The end tool 4100 of the surgical instrument according to the first embodiment of the present invention further includes pulleys 4187 and 4188 which are first staple wire separation prevention pulleys, and can serve to prevent separation of the first staple wires, wires 307 and 308.

[0286] That is, pulleys 4187 and 4188 are disposed between the first staple assist pulley 4182 and pulleys 4183 and 4184, and the path of wire 307 heading towards first staple pulley 4181 via pulley 4183 and the path of wire 308 heading towards first staple assist pulley 4182 via pulley 4184 are changed to a certain extent. More specifically, the paths of wire 307 and wire 308 are changed to a certain extent so that wire 307 heading towards first staple pulley 4181 via pulley 4183 and wire 308 heading towards first staple assist pulley 4182 via pulley 4184 become parallel to the X-axis.

[0287] Specifically, the height in the Z-axis direction of the wire 307 wound around the pulley 4183 is different from the height in the Z-axis direction of the wire 307 heading towards the first staple pulley 4181. Similarly, the height in the Z-axis direction of the wire 308 wound around the pulley 4184 and coming out is different from the height in the Z-axis direction of the wire 308 heading towards the first staple auxiliary pulley 4182. Therefore, if the pulley 4187 / pulley 4188, which is the first staple wire separation prevention pulley, were not present, the path of the wire 307 / wire 308 would be oblique (i.e., the fleet angle of the wire relative to the pulley would be large), and therefore there is a risk that the wire 307 / wire 308 will come off the pulley, and there is also a risk that the wire 307 / wire 308 will be damaged.

[0288] Therefore, in this embodiment, a pulley 4187 / pulley 4188, which is a first staple wire slippage prevention pulley, is arranged between the first staple auxiliary pulley 4182 and the pulley 4183 / pulley 4184, and serves to change the path of the wire 307 / wire 308 to a certain extent so that after being wound around the pulley 4183 / pulley 4184, the wire 307 / wire 308 heading toward the distal portion 4104 of the end tool 4100 becomes parallel to the X-axis.

[0289] According to the present invention, the wires 307 and 308, which are the first staple wires, are prevented from coming off the pulleys, thereby making it possible to obtain the effect of making the cutting operation smoother.

[0290] The components related to the rotation of the first staple pulley 4181 will be described below.

[0291] The pulley 4183 and the pulley 4184 function as staple pitch main pulleys. Here, the wire 307 which is the first staple wire is wound around the pulley 4183, and the wire 308 which is the first staple wire is wound around the pulley 4184.

[0292] Pulley 4185 and pulley 4186 function as staple pitch sub-pulleys. Here, the wire 307 which is the first staple wire is wound around pulley 4185, and the wire 308 which is the first staple wire is wound around pulley 4186.

[0293] Here, pulleys 4183 and 4184 are arranged on one side of the first staple pulley 4181, the first staple auxiliary pulley 4182, and the pulleys 4187 and 4188 to face each other. Here, the pulleys 4183 and 4184 are formed to be rotatable independently of each other around a rotation axis 4143 that is an end tool pitch rotation axis. In addition, pulleys 4185 and 4186 are arranged on one side of the pulleys 4183 and 4184 to face each other. Here, the pulleys 4185 and 4186 are formed to be rotatable independently of each other around the rotation axis 4144 that is an end tool pitch auxiliary rotation axis. Here, although the drawings show pulleys 4183, 4185, 4184, and 4186 as all being formed so as to be rotatable about the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley can be formed in various directions as appropriate for the configuration.

[0294] As described above, the rotation shaft 4141, the rotation shaft 4142, the rotation shaft 4143, and the rotation shaft 4144 can be arranged in sequence from the distal end 4104 toward the proximal end 4105 of the end tool 4100. This allows the first staple pulley 4181, the first staple assistant pulley 4182, the pulleys 4187 and 4188, the pulleys 4183 and 4184, and the pulleys 4185 and 4186 to be arranged in sequence from the distal end 4104 toward the proximal end 4105 of the end tool 4100.

[0295] Wire 307, which is the first staple wire, is wound in this order so that at least a portion of it comes into contact with pulley 4185, pulley 4183, pulley 4187, and first staple pulley 4181. Then, wire 308, which is connected to wire 307 by a fastening member (see 329 in FIG. 62), is wound in this order so that at least a portion of it comes into contact with first staple pulley 4181, first staple assistant pulley 4182, pulley 4188, pulley 4184, and pulley 4186.

[0296] To explain this from another perspective, wires 307 and 308, which are the first staple wires, are wound around pulley 4185, pulley 4183, pulley 4187, first staple pulley 4181, first staple auxiliary pulley 4182, pulley 4188, pulley 4184, and pulley 4186 so that they are in at least partial contact with each other, and wires 307 and 308 are formed so that they can move along the pulleys while rotating the pulleys.

[0297] Therefore, when wire 307 is pulled, the fastening member (see 329 in FIG. 62) to which wire 307 is coupled and the first staple pulley 4181 coupled thereto rotate in one direction. Conversely, when wire 308 is pulled, the fastening member (see 329 in FIG. 62) to which wire 308 is coupled and the first staple pulley 4181 coupled thereto rotate in the opposite direction.

[0298] On the other hand, the second staple pulley 4191, the second staple auxiliary pulley 4192, and related components such as pulley 4193, pulley 4194, pulley 4195, pulley 4196, pulley 4197, pulley 4198, wire 309, wire 310, etc. can have the same or similar configuration as the components associated with the first staple pulley 4181 described above.

[0299] In detail, the pulley 4193 and the pulley 4194 function as staple pitch main pulleys. Here, the wire 310 which is the second staple wire is wound around the pulley 4193, and the wire 309 which is the second staple wire is wound around the pulley 4194.

[0300] Pulley 4195 and pulley 4196 function as staple pitch sub-pulleys. Here, the wire 310 which is the second staple wire is wound around pulley 4195, and the wire 309 which is the second staple wire is wound around pulley 4196.

[0301] Here, pulleys 4193 and 4194 are arranged on one side of the second staple pulley 4191, the second staple auxiliary pulley 4192, and the pulleys 4197 and 4198 to face each other. Here, the pulleys 4193 and 4194 are formed to be rotatable independently of each other around a rotation axis 4143 that is an end tool pitch rotation axis. In addition, pulleys 4195 and 4196 are arranged on one side of the pulleys 4193 and 4194 to face each other. Here, the pulleys 4195 and 4196 are formed to be rotatable independently of each other around the rotation axis 4144 that is an end tool pitch auxiliary rotation axis. Here, although the drawings show pulleys 4193, 4195, 4194, and 4196 as all being formed so as to be rotatable about the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley can be formed in various directions as appropriate for the configuration.

[0302] As described above, the rotation shaft 4141, the rotation shaft 4142, the rotation shaft 4143, and the rotation shaft 4144 can be arranged in sequence from the distal end 4104 toward the proximal end 4105 of the end tool 4100. This allows the second staple pulley 4191, the second staple assistant pulley 4192, the pulleys 4197 and 4198, the pulleys 4193 and 4194, and the pulleys 4195 and 4196 to be arranged in sequence from the distal end 4104 toward the proximal end 4105 of the end tool 4100.

[0303] Wire 310, which is the second staple wire, is wound around pulley 4195, pulley 4193, pulley 4197, and first staple pulley 4191 in that order so that at least a portion of the wire comes into contact with them. Then, wire 309, which is connected to wire 310 by a fastening member (see 330 in FIG. 62), is wound around first staple pulley 4191, first staple assistant pulley 4192, pulley 4198, pulley 4194, and pulley 4196 in that order so that at least a portion of the wire comes into contact with them.

[0304] To explain this from another perspective, the second staple wires, wire 310 and wire 309, are wound so that they are in at least partial contact with pulley 4195, pulley 4193, pulley 4197, first staple pulley 4191, first staple auxiliary pulley 4192, pulley 4198, pulley 4194, and pulley 4196, and are formed so that wire 310 and wire 309 can move along the pulleys while rotating them.

[0305] Therefore, when wire 310 is pulled, the fastening member (see 330 in FIG. 62) to which wire 310 is coupled and the first staple pulley 4191 coupled thereto rotate in one direction. Conversely, when wire 309 is pulled, the fastening member (see 330 in FIG. 62) to which wire 309 is coupled and the first staple pulley 4191 coupled thereto rotate in the opposite direction.

[0306] (staple drive assembly)

[0307] The staple drive assembly 4150 is described in more detail below.

[0308] 15 to 20, the staple drive assembly 4150 can include a staple pulley assembly 4160 and a staple link assembly 4170. Here, the staple drive assembly 4150 is characterized by being coupled to a reciprocating assembly 4550 of the cartridge 4500, which will be described later, and converting the rotational movement of the staple pulley assembly 4160 into the linear movement of the reciprocating assembly 4550. In other embodiments of the present invention, which will be described later, the staple drive assembly can also be understood as a concept including a staple pulley assembly and a staple link assembly.

[0309] The staple pulley assembly 4160 may include one or more staple pulleys. The staple pulley assembly 4160 may be formed between a pulley 4111 and a pulley 4121, with the pulleys 4111 and 4121 adjacent to each other. In the present embodiment, it is assumed that the staple pulley assembly 4160 includes two staple pulleys, a first staple pulley 4181 and a second staple pulley 4191.

[0310] The staple link assembly 4170 can include one or more link members 4171. And, the link member 4171 can include one or more links. In the first embodiment of the present invention, it is assumed that the staple link assembly 4170 includes one link member 4171, and the link member 4171 includes one link.

[0311] The end tool 4100 of the surgical instrument according to the present invention is characterized in that the staple pulley assembly 4160 and the staple link assembly 4170 form a cam / slot structure, which has the effect of amplifying the force that advances the reciprocating assembly 4550.

[0312] In particular, the staple pulley assembly 4160 can include a first staple pulley 4181 and a second staple pulley 4191 .

[0313] The first staple pulley 4181 can include a main body 4181a, a protruding member 4181b, and a shaft penetrating portion 4181c.

[0314] The main body 4181a is formed in a disk shape.

[0315] A shaft through-hole 4181c can be formed in the center of the main body 4181a. The shaft through-hole 4181c is formed in a hole shape, and the rotation shaft 4141, which is the end tool jaw pulley rotation shaft, can be inserted through the shaft through-hole 4181c.

[0316] Furthermore, a protruding member 4181b may be formed on the main body 4181a of the first staple pulley 4181. The protruding member 4181b can be coupled to the link member 4171 of the staple link assembly 4170. Here, the center of the protruding member 4181b does not coincide with the center of the first staple pulley 4181, and the protruding member 4181b can be formed to be eccentric to a certain degree with respect to the first staple pulley 4181. The protruding member 4181b can be fitted into a first slot 4171d of the link member 4171, which will be described later.

[0317] The second staple pulley 4191 can include a main body 4191a, a protruding member 4191b, and a shaft penetrating portion 4191c.

[0318] The main body 4191a is formed in a disk shape.

[0319] A shaft through-hole 4191c can be formed in the center of the main body 4191a. The shaft through-hole 4191c is formed in a hole shape, and a rotation shaft 4141, which is the rotation shaft of the end tool jaw pulley, can be inserted through the shaft through-hole 4191c.

[0320] Furthermore, a protruding member 4191b may be formed on the main body 4191a of the second staple pulley 4191. The protruding member 4191b can be coupled to the link member 4171 of the staple link assembly 4170. Here, the center of the protruding member 4191b does not coincide with the center of the second staple pulley 4191, and the protruding member 4191b can be formed to be eccentric to a certain degree with respect to the first staple pulley 4191. The protruding member 4191b can be fitted into a second slot 4171e of the link member 4171, which will be described later.

[0321] Meanwhile, the end tool 4100 of the present invention further includes a staple link assembly 4170 connected to the staple pulley assembly 4160, and the staple link assembly 4170 may include a link member 4171. Here, the staple link assembly 4170 may serve to connect the staple pulley assembly 4160 and a reciprocating assembly 4150 of the cartridge 4110, which will be described later.

[0322] This embodiment is characterized in that the staple link assembly 4170 includes one link member 4171, and the link member 4171 includes only one link. In other words, the staple pulley assembly 4160 and the staple link assembly 4170 are coupled by a cam / slot structure, so that even when the staple link assembly 4170 includes only one link, the rotational movement of the staple pulley assembly 4160 can be converted into the linear movement of the staple link assembly 4170.

[0323] In particular, the link member 4171 may be formed of a single link.

[0324] The link member 4171 may be formed by combining a thin and long bar with an oval flat plate, and may be formed in a substantially "L" shape. Here, the link member 4171 may include a first protrusion 4171a, a second protrusion 4171b, a fastening portion 4171c, a first slot 4171d, and a second slot 4171e.

[0325] A first protrusion 4171a and a second protrusion 4171b may be formed in one region of the center of the link member 4171. The first protrusion 4171a and the second protrusion 4171b can be fitted into the guide groove 4101b of the first jaw 4101.

[0326] In this manner, with the first protrusion 4171a and the second protrusion 4171b of the link member 4171 formed in a protrusion shape fitted into the groove-shaped guide groove 4101b, the first protrusion 4171a and the second protrusion 4171b move along the guide groove 4101b, causing the link member 4171 to move relative to the first jaw 4101 (and the cartridge 4500 therein). This will be described in more detail later.

[0327] Meanwhile, a fastening portion 4171c may be formed at one end of the link member 4171. This fastening portion 4171c can be coupled with the fastening portion 4551a of the reciprocating member 4551 of the cartridge 4500.

[0328] Meanwhile, a first slot 4171d and a second slot 4171e may be formed in the end of the link member 4171 opposite to the end where the fastening portion 4171c is formed.

[0329] Specifically, a first slot 4171d may be formed on a surface of the link member 4171 facing the first staple pulley 4181. Here, the first slot 4171d is formed in the shape of an elongated hole, into which the protruding member 4181b of the first staple pulley 4181 can be fitted. The first slot 4171d may be formed to have a predetermined curvature and may be formed in a substantially elliptical shape. In this case, the first slot 4171d may be formed to be larger than the protruding member 4181b to a certain extent. Therefore, when the protruding member 4181b of the first staple pulley 4181 is fitted in the first slot 4171d of the link member 4171, the protruding member 4181b is formed to be able to move within the first slot 4171d to a certain extent.

[0330] As described above, the protruding member 4181b can be formed to be eccentric to a certain degree with respect to the center of the first staple pulley 4181. Therefore, when the first staple pulley 4181 rotates, the protruding member 4181b can press the first slot 4171d while in contact with the first slot 4171d, thereby moving the link member 4171. In other words, when the first staple pulley 4181 rotates, the protruding member 4181b moves within the first slot 4171d while in contact with the first slot 4171d, thereby allowing the link member 4171 to move linearly along the guide groove 4101b of the first jaw 4101.

[0331] Here, the first slot 4171d may be formed so as to penetrate approximately half of the total thickness of the link member 4171, rather than penetrating the entire thickness of the link member 4171. From another perspective, the first slot 4171d can be formed to have substantially the same thickness as the thickness of the protruding member 4181b of the first staple pulley 4181.

[0332] Meanwhile, a second slot 4171e may be formed in the link member 4171. Specifically, the second slot 4171e may be formed in a surface of the link member 4171 facing the second staple pulley 4191. Here, the second slot 4171e is formed in the shape of an elongated hole, into which the protruding member 4191b of the second staple pulley 4191 can be fitted. The second slot 4171e may be formed to have a predetermined curvature and be formed in a substantially elliptical shape. In this case, the second slot 4171e may be formed to be larger than the protruding member 4191b to a certain extent. Therefore, when the protruding member 4191b of the second staple pulley 4191 is fitted in the second slot 4171e of the link member 4171, the protruding member 4191b is formed to be able to move within the second slot 4171e to a certain extent.

[0333] As described above, the protruding member 4191b can be formed to be eccentric to a certain degree with respect to the center of the second staple pulley 4191. Therefore, when the second staple pulley 4191 rotates, the protruding member 4191b can press the second slot 4171e while in contact with the second slot 4171e, thereby moving the link member 4171. In other words, when the second staple pulley 4191 rotates, the protruding member 4191b moves within the second slot 4171e while in contact with the second slot 4171e, thereby allowing the link member 4171 to move linearly along the guide groove 4101b of the first jaw 4101.

[0334] Here, the second slot 4171e may be formed so as to penetrate approximately half of the total thickness of the link member 4171, rather than penetrating the entire thickness of the link member 4171. From another perspective, the second slot 4171e can be formed to have substantially the same thickness as the thickness of the protruding member 4191b of the first staple pulley 4191.

[0335] Here, the first slot 4171d and the second slot 4171e may be formed to at least partially overlap each other, and the sum of the thicknesses of the first slot 4171d and the second slot 4171e in the Y-axis direction may be formed to be approximately the same as the thickness of the link member 4171 in the Y-axis direction.

[0336] Here, the first slot 4171d and the second slot 4171e may be formed symmetrically in the up and down direction with respect to the rotation shaft 4141. In this way, since the first slot 4171d and the second slot 4171e are formed symmetrically in the up and down direction with respect to the rotation shaft 4141, the protruding member 4181b of the first staple pulley 4181 coupled to the link member 4171 and the protruding member 4191b of the second staple pulley 4191 can also be arranged symmetrically with respect to each other. This will be described in more detail later.

[0337] (Displacement and movement of staple link assembly due to rotation of staple pulley)

[0338] The displacement of the staple link assembly 4170 due to the rotation of the first staple pulley 4181 and the second staple pulley 4191 will be described below.

[0339] 17, in the first embodiment of the present invention, the first staple pulley 4181 and the staple link assembly 4170 are coupled together in a cam / slot configuration. That is, a cam-shaped protruding member 4181b formed on the first staple pulley 4181 is coupled to a first slot 4171d formed on the link member 4171. Therefore, when the first staple pulley 4181 rotates in the direction of arrow A, the displacement of the protruding member 4181b of the first staple pulley 4181 in the X-axis direction is B. Then, the displacement of the staple link assembly 4170 in the X-axis direction is C.

[0340] 18, in the first embodiment of the present invention, the second staple pulley 4191 and the staple link assembly 4170 are coupled together in a cam / slot configuration. That is, a cam-shaped protruding member 4191b formed on the second staple pulley 4191 is coupled to a second slot 4171e formed on the link member 4171. Therefore, when the second staple pulley 4191 rotates in the direction of arrow D, the displacement of the protruding member 4191b of the second staple pulley 4191 in the X-axis direction is E. Then, the displacement of the staple link assembly 4170 in the X-axis direction is F.

[0341] In comparison, if the staple pulley and staple link assembly are connected by a link shaft rather than a cam / slot connection, the displacement of the staple link assembly in the X-axis direction will be much longer than in the first embodiment of the present invention.

[0342] In other words, compared to when the staple pulley and staple link assembly are axially connected, when the staple pulley and staple link assembly are cam / slot connected as in this embodiment, the displacement of the staple link assembly in the X-axis direction is reduced even if the staple pulley rotates the same amount.

[0343] On the other hand, since work is the product of force and displacement, if we assume that the work of rotating the staple pulley is the same, displacement and force are inversely proportional to each other. Therefore, if displacement decreases, force increases inversely proportional to it.

[0344] As a result, in the first embodiment of the present invention, the first staple pulley 4181 and the second staple pulley 4191 are each connected to the staple link assembly 4170 in a cam / slot form, and the displacement of the staple link assembly 4170 in the X-axis direction due to the rotation of the first staple pulley 4181 and the second staple pulley 4191 is relatively reduced compared to other embodiments, so the force that the staple link assembly 4170 receives in the X-axis direction is relatively increased compared to a simple link structure.

[0345] This first embodiment of the present invention provides an increased force for advancing the staple link assembly 4170 and the associated reciprocating assembly 4550, thereby providing the effect of more robust stapling.

[0346] In particular, since the first embodiment of the present invention includes two staple pulleys (i.e., the first staple pulley 4181 and the second staple pulley 4191) that are symmetrical to each other, the force with which the staple pulley assembly 4160 pushes the staple link assembly 4170 can be amplified by approximately twice as much as when only one staple pulley is provided.

[0347] Furthermore, since the first staple pulley 4181 and the second staple pulley 4191 are disposed symmetrically on the left and right with respect to the XZ plane, the left and right balance is achieved when stapling, and the end tool 4100 does not sway left and right as a whole, and an effect can be obtained in which stable operation is performed about the rotation axis 4141 which is the yaw rotation axis. Furthermore, by winding the wires 307 and 308 which are the first staple wires and the wires 309 and 310 which are the second staple wires in opposite directions with respect to the rotation axis 4143 which is the pitch rotation axis, an effect can be obtained in which the vibrations about the rotation axis 4143 can be mutually canceled out.

[0348] The rotation directions of the first staple pulley 4181 and the second staple pulley 4191 will be described below.

[0349] Referring to Figures 17, 18, 19, and 20, the first staple pulley 4181 advances the staple link assembly 4170 when rotated in the direction of arrow A in Figure 20 (i.e., clockwise), and the second staple pulley 4191 advances the staple link assembly 4170 when rotated in the direction of arrow D in Figure 20 (i.e., counterclockwise).

[0350] Conversely, the first staple pulley 4181 retracts the staple link assembly 4170 when rotated counterclockwise, and the second staple pulley 4191 retracts the staple link assembly 4170 when rotated clockwise.

[0351] As a result, when the first staple pulley 4181 and the second staple pulley 4191 rotate in opposite directions, the staple link assembly 4170 moves (forward or backward). Conversely, when the first staple pulley 4181 and the second staple pulley 4191 rotate in the same direction, the rotations of the two pulleys cancel each other out, and the staple link assembly 4170 does not move.

[0352] As a result, in a state similar to that shown in Figure 19, when the first staple pulley 4181 rotates clockwise and the second staple pulley 4191 rotates counterclockwise, the link member 4171 connected to the first staple pulley 4181 and the second staple pulley 4191 can move as a whole toward the distal portion of the first jaw 4101 (see 4101f in Figure 13).

[0353] Conversely, when the first staple pulley 4181 rotates counterclockwise and the second staple pulley 4191 rotates clockwise, the link member 4171 connected to the first staple pulley 4181 and the second staple pulley 4191 can move as a whole toward the proximal portion of the first jaw 4101 (see 101g in Figure 13).

[0354] Thus, bidirectional rotational motion of the staple pulley assembly 4160 can cause reciprocating linear motion of the reciprocating assembly 4550 of the cartridge 4500 via the staple link assembly 4170, as will be described in more detail below.

[0355] (First jaw, second jaw and actuation movement)

[0356] The coupling structure between the first jaw 4101 and the second jaw 4102 of the end tool 4100 of the surgical instrument 4000 in FIG. 2 will be described in more detail below.

[0357] Fig. 13 is a plan view showing a first jaw of the surgical instrument of Fig. 2, and Fig. 14 is a plan view showing a second jaw of the surgical instrument of Fig. 2. Figs. 21 and 22 are plan views showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of Fig. 2. Figs. 23 and 24 are plan views showing the opening and closing operations of the first jaw and the second jaw of the surgical instrument of Fig. 2. Figs. 25 and 26 are perspective views showing the opening and closing operations of the end tool of the surgical instrument of Fig. 2.

[0358] 9 to 26, the first jaw 4101 includes a cartridge accommodating portion 4101a, a guide groove 4101b, a movable coupling hole 4101c, a jaw pulley coupling hole 4101d, and a shaft through portion 4101e.

[0359] The first jaw 4101 is formed in an elongated rod shape overall, with the cartridge 4500 accommodated on the distal portion 4101f side, and a pulley 4111 coupled to the proximal portion 4101g so as to be rotatable around a rotation axis 4141. In other words, the first jaw 4101 is formed in a form in which one surface (top surface) of an empty box has been removed overall, and a cartridge accommodating portion 4101a capable of accommodating the cartridge 4500 can be formed inside the first jaw 4101. That is, the cross section of the first jaw 4101 may be formed in a substantially "U" shape.

[0360] In the first jaw 4101, a guide groove 4101b that guides movement of the staple link assembly 4170, which will be described later, may be formed on one side of the cartridge accommodating portion 4101a, for example, on the side of the proximal portion 4101g. The guide groove 4101b may be formed in a groove shape that is formed along a movement path of the staple link assembly 4170. Then, in a state in which the first protrusion portion 4171a and the second protrusion portion 4171b of the link member 4171 formed in a protrusion shape are fitted into the groove-shaped guide groove 4101b, the first protrusion portion 4171a and the second protrusion portion 4171b move along the guide groove 4101b, whereby the staple link assembly 4170 moves relative to the first jaw 4101 (and the cartridge 4500 therein). In other words, the staple link assembly 4170 can move along the guide groove 4101b of the first jaw 4101.

[0361] On the other hand, a movable coupling hole 4101c, a jaw pulley coupling hole 4101d, and a shaft through-hole 4101e may be formed on the proximal end side of the first jaw 4101.

[0362] Here, the movable coupling hole 4101c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 4111a of a pulley 4111, which will be described later, can be fitted into this movable coupling hole 4101c. Here, the minor radius of the movable coupling hole 4101c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 4111a. Meanwhile, the major radius of the movable coupling hole 4101c may be formed to be larger than the radius of the shaft coupling portion 4111a. Therefore, when the shaft coupling portion 4111a of the pulley 4111 is fitted into the movable coupling hole 4101c of the first jaw 4101, the shaft coupling portion 4111a is formed to be able to move within the movable coupling hole 4101c to a certain extent. This will be described in more detail later.

[0363] Meanwhile, the jaw pulley coupling hole 4101d is formed in a cylindrical hole, and a jaw coupling portion 4111b of a pulley 4111, which will be described later, can be fitted into this jaw pulley coupling hole 4101d. Here, the radius of the jaw pulley coupling hole 4101d may be formed to be substantially the same as or slightly larger than the radius of the jaw coupling portion 4111b. Therefore, the jaw coupling portion 4111b of the pulley 4111 can be formed to be rotatably coupled to the jaw pulley coupling hole 4101d of the first jaw 4101. This will be described in more detail later.

[0364] The shaft through-portion 4101e may be formed relatively closer to the distal portion 4101f of the first jaw 4101 as compared with the movable coupling hole 4101c and the jaw pulley coupling hole 4101d. The shaft through-portion 4101e is formed in a hole shape, and a rotation shaft 4145 that is a jaw rotation shaft can be inserted through the shaft through-portion 4101e.

[0365] The second jaw 4102 includes an anvil 4102a, a movable coupling hole 4102c, a jaw pulley coupling hole 4102d, and a shaft through-portion 4102e.

[0366] The second jaw 4103 is formed in an elongated rod shape overall, with an anvil 4102a formed on the distal portion 4102f side, and a pulley 4112 coupled to the proximal portion 4102g, so that it can rotate around a rotation axis 4141.

[0367] In detail, the anvil 4102a is formed in a flat plane shape, and one surface thereof may be formed with a shape corresponding to the shape of the staple 4530, which will be described later. When the working member 4540 pushes up the staple 4530 during stapling, such an anvil 4102a can support the opposite side of the working member 4540 and function as a base for bending the staple 4530.

[0368] On the other hand, a movable coupling hole 4102c, a jaw pulley coupling hole 4102d, and a shaft through-hole 4102e may be formed on the proximal end side of the second jaw 4102.

[0369] Here, the movable coupling hole 4102c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 4121a of a pulley 4121, which will be described later, can be fitted into this movable coupling hole 4102c. Here, the minor radius of the movable coupling hole 4102c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 4121a. Meanwhile, the major radius of the movable coupling hole 4102c may be formed to be larger than the radius of the shaft coupling portion 4121a. Therefore, when the shaft coupling portion 4121a of the pulley 4121 is fitted into the movable coupling hole 4102c of the second jaw 4102, the shaft coupling portion 4121a is formed to be able to move within the movable coupling hole 4102c to a certain extent. This will be described in more detail later.

[0370] Meanwhile, the jaw pulley coupling hole 4102d is formed in a cylindrical hole shape, and a jaw coupling portion 4121b of a pulley 4121, which will be described later, can be fitted into this jaw pulley coupling hole 4102d. Here, the radius of the jaw pulley coupling hole 4102d may be formed to be substantially the same as or slightly larger than the radius of the jaw coupling portion 4121b. Therefore, the jaw coupling portion 4121b of the pulley 4121 can be formed to be rotatably coupled to the jaw pulley coupling hole 4102d of the second jaw 4102. This will be described in more detail later.

[0371] On the other hand, the shaft through-portion 4102e may be formed relatively closer to the distal portion 4102f of the second jaw 4102 as compared with the movable coupling hole 4102c and the jaw pulley coupling hole 4102d. The shaft through-portion 4102e is formed in a hole shape, and the rotation shaft 4145, which is the jaw rotation shaft, can be inserted through the shaft through-portion 4102e.

[0372] The pulley 4111, which is the first jaw pulley, may include a shaft coupling portion 4111a and a jaw coupling portion 4111b. The pulley 4111 may be formed in a rotatable disk shape overall, with the shaft coupling portion 4111a and the jaw coupling portion 4111b formed to protrude to a certain extent from one surface of the pulley 4111. As described above, the shaft coupling portion 4111a of the pulley 4111 may be fitted into the movable coupling hole 4101c of the first jaw 4101, and the jaw coupling portion 4111b of the pulley 4111 may be fitted into the jaw pulley coupling hole 4101d of the first jaw 4101. The pulley 4111 may be formed to be rotatable around a rotation axis 4141, which is the end tool jaw pulley rotation axis.

[0373] Meanwhile, the pulley 4121, which is the second jaw pulley, may also include a shaft coupling portion 4121a and a jaw coupling portion 4121b. The pulley 4121 may be formed in a rotatable disk shape overall, with the shaft coupling portion 4121a and the jaw coupling portion 4121b formed to protrude to a certain extent from one surface thereof. As described above, the shaft coupling portion 4112a of the pulley 4112 may be fitted into the movable coupling hole 4102c of the second jaw 4102, and the jaw coupling portion 4112b of the pulley 4112 may be fitted into the jaw pulley coupling hole 4102d of the second jaw 4102. The pulley 4121 may be formed to be rotatable around the rotation axis 4141, which is the end tool jaw pulley rotation axis.

[0374] The coupling relationships between the above-mentioned components are as follows:

[0375] The rotating shaft 4141, which is the end tool jaw pulley rotating shaft, is inserted through the shaft coupling portion 4111a of the pulley 4111, the movable coupling hole 4101c of the first jaw 4101, the shaft through portion 4181c of the first staple pulley 4181, the movable coupling hole 4102c of the second jaw 4102, and the shaft coupling portion 4121a of the pulley 4121 in that order.

[0376] A rotary shaft 4145 that is a jaw rotary shaft is inserted through the shaft through-hole 4101e of the first jaw 4101 and the shaft through-hole 4102e of the second jaw 4102 in this order.

[0377] The shaft coupling portion 4111 a of the pulley 4111 is fitted into the movable coupling hole 4101 c of the first jaw 4101 , and the jaw coupling portion 4111 b of the pulley 4111 is fitted into the jaw pulley coupling hole 4101 d of the first jaw 4101 .

[0378] At this time, the jaw pulley coupling hole 4101d of the first jaw 4101 and the jaw coupling portion 4111b of the pulley 4111 are rotatably coupled to each other, and the movable coupling hole 4101c of the first jaw 4101 and the shaft coupling portion 4111a of the pulley 4111 are movably coupled to each other.

[0379] The shaft coupling portion 4121 a of the pulley 4121 is fitted into the movable coupling hole 4102 c of the second jaw 4102 , and the jaw coupling portion 4121 b of the pulley 4121 is fitted into the jaw pulley coupling hole 4102 d of the second jaw 4102 .

[0380] At this time, the jaw pulley coupling hole 4102d of the second jaw 4101 and the jaw coupling portion 4121b of the pulley 4121 are rotatably coupled to each other, and the movable coupling hole 4102c of the second jaw 4102 and the shaft coupling portion 4121a of the pulley 4121 are movably coupled to each other.

[0381] Here, the pulley 4111 and the pulley 4121 rotate around a rotation axis 4141 which is an end tool jaw pulley rotation axis. The first jaw 4101 and the second jaw 4102 rotate around a rotation axis 4145 which is a jaw rotation axis. In other words, the pulley 4111 and the first jaw 4101 have different rotation axes. Similarly, the pulley 4121 and the second jaw 4102 have different rotation axes.

[0382] That is, the first jaw 4101 has its rotation angle limited to a certain extent by the movable coupling hole 4101c, but basically rotates around the rotation axis 4145, which is the jaw rotation axis. Similarly, the second jaw 4102 has its rotation angle limited to a certain extent by the movable coupling hole 4102c, but basically rotates around the rotation axis 4145, which is the jaw rotation axis.

[0383] The amplification of the grip force due to the coupling relationship between the above-mentioned components will now be described.

[0384] A surgical instrument 4000 according to one embodiment of the present invention is characterized in that the coupling structure between the first jaw 4101 and the second jaw 4102 forms an X-shape, and when the first jaw 4101 and the second jaw 4102 rotate in a direction toward each other (i.e., when the first jaw 4101 and the second jaw 4102 are closed), the grip force in the closing direction of the first jaw 4101 and the second jaw 4102 becomes even greater. This will be explained in more detail as follows.

[0385] As described above, there are two axes that serve as the center of rotation when the first jaw 4101 and the second jaw 4102 open and close. That is, the first jaw 4101 and the second jaw 4102 open and close around two axes, the rotation axis 4141 and the rotation axis 4145. At this time, the center of rotation of the first jaw 4101 and the second jaw 4102 is the rotation axis 4145, and the center of rotation of the pulleys 4111 and 4121 is the rotation axis 4141. At this time, the rotation axis 4141 is an axis whose position is fixed relatively, and the rotation axis 4145 is an axis whose position moves linearly relatively. In other words, when the position of the rotation axis 4141 is fixed and the pulleys 4111 and 4121 rotate, the rotation axis 4145, which is the rotation axis of the first jaw 4101 and the second jaw 4102, moves back and forth, causing the first jaw 4101 and the second jaw 4102 to open and close.

[0386] With this configuration, when the first jaw 4101 and the second jaw 4102 are closed, the grip force becomes stronger, and the effect of enabling the surgeon to perform a strong actuation operation with less force can be obtained.

[0387] (cartridge)

[0388] The cartridge 4500 of the surgical instrument 4000 of FIG. 2 is described in more detail below.

[0389] FIG. 27 is a perspective view showing the first jaw and cartridge of the surgical instrument of FIG. 2. FIG. 28 is an exploded perspective view showing the cartridge of FIG. 27. FIG. 29 is an assembled perspective view showing the cartridge of FIG. 27. FIG. 30 is a side view showing the cartridge of FIG. 27. FIG. 31 is a perspective cross-sectional view showing the cartridge of FIG. 27. FIG. 32 is a side cross-sectional view showing the cartridge of FIG. 27. FIGS. 33 and 34 are perspective cross-sectional views showing the stapling structure of the endotool of the surgical instrument of FIG. 2. FIGS. 35, 36, and 37 are perspective views showing the working member of the cartridge of FIG. 27. FIGS. 38 and 39 are perspective views showing the working member of FIG. 35 coupled with the reciprocating member. FIGS. 40 and 41 are plan views showing the clutch drive operation of the endotool of FIG. 33. FIG. 42 is a perspective view showing the clutch drive operation of the endotool of FIG. 33 overall. FIGS. 43 and 44 are perspective views showing the stapling operation of the endotool of FIG. 33 overall.

[0390] 27 to 44, the cartridge 4500 is formed to be attachable to and detachable from the first jaw 4101, includes a plurality of staples 4530 and a blade 4542 therein, and performs suturing and cutting of tissue. Here, the cartridge 4500 may include a cover 4510, a housing 4520, the staples 4530, a pull-out member 4535, a working member 4540, and a reciprocating assembly 4550.

[0391] The housing 4520 forms the outer shape of the cartridge 4500, and may be formed in a form in which one surface (top surface) of a generally hollow box is removed, and may be formed to house the reciprocating assembly 4550, the working member 4540, and the staples 4530 therein. Here, the cross section of the housing 4520 may be formed in a substantially "U" shape.

[0392] The cover 4510 is formed to cover the upper part of the housing 4520. The cover 4510 may be formed with staple holes 4511 that can eject a plurality of staples 4530 to the outside. Before the stapling drive, the staples 4530 housed inside the housing 4520 are pushed upward by the working member 4540 during the stapling operation, and are pulled out to the outside of the cartridge 4500 through the staple holes 4511 of the cover 4510, whereupon stapling is performed.

[0393] Meanwhile, the cover 4510 may have a slit 4512 formed along its longitudinal direction. The blade 4542 of the working member 4540 can protrude to the outside of the cartridge 4500 through the slit 4512. As the blade 4542 of the working member 4540 passes along this slit 4512, it can cut the tissue after the staple fastening is completed.

[0394] A plurality of staples 4530 may be arranged inside the housing 4520. As a working member 4540, which will be described later, moves linearly in one direction, the plurality of staples 4530 are sequentially pushed up from the inside to the outside of the housing 4520 to perform suturing, i.e., stapling. Here, the material of the staples 4530 may include titanium, stainless steel, etc.

[0395] Meanwhile, a pull-out member 4535 may be further disposed between the housing 4520 and the staples 4530. In other words, it may be expressed that the staples 4530 are disposed on the upper part of the pull-out member 4535. In this case, the working member 4540 moves linearly in one direction to push up the pull-out member 4535, and the pull-out member 4535 can push up the staples 4530.

[0396] In this way, it can be said that the working member 4540 pushes up the staples 4530, including both a case where the working member 4540 directly pushes up the staples 4530 and a case where the working member 4540 pushes up the pull-out member 4535 and the pull-out member 4535 pushes up the staples 4530 (i.e., a case where the working member 4540 indirectly pushes up the staples 4530).

[0397] A reciprocating assembly 4550 may be disposed below and within the housing 4520. The reciprocating assembly 4550 may include one or more reciprocating members 4551. While this embodiment is shown with one reciprocating member 4551, in other embodiments, multiple reciprocating members 4551 may be provided.

[0398] In this embodiment, the reciprocating member 4551 may be a bar. Specifically, the reciprocating member 4551 may be formed in the shape of a substantially rectangular hexahedron, and the surface may be formed in a smooth shape without any separate uneven portions or sawtooth portions. Such a bar-shaped reciprocating member 4551 may be formed to be able to come into contact with the working member 4540, which will be described later, particularly with the contact member 4543 of the working member 4540.

[0399] Meanwhile, although not shown in the drawings, the reciprocating member 4551 may be provided as a member of various shapes other than a bar shape, which is directly or indirectly connected to the staple pulley assembly 4160 and is capable of linear reciprocating motion in response to the rotational motion of the staple pulley assembly 4160. For example, the reciprocating member 4551 may be a ratchet shape having a concave and convex portion formed thereon.

[0400] Here, the reciprocating member 4551 may not be fixedly connected to other components of the cartridge 4500, but may be formed to be movable relative to other components of the cartridge 4500. That is, the reciprocating member 4551 may perform reciprocating linear motion with respect to the housing 4520 and the cover 4510 connected to the housing 4520.

[0401] Meanwhile, a fastening portion 4551a may be formed on the reciprocating member 4551 at a proximal end 4501 side adjacent to the pulley 4111, and this fastening portion 4551a may be fastened and coupled to the staple link assembly 4170 of the end tool 4100. Therefore, when the staple link assembly 4170 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the reciprocating member 4551 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction). This will be described in more detail later.

[0402] A working member 4540 may be disposed inside the housing 4520. The working member 4540 may be formed to be able to come into contact with the reciprocating member 4551, and may be formed to move linearly in one direction in response to the reciprocating linear motion of the reciprocating member 4551. In other words, the working member 4540 interacts with the reciprocating member 4551 and performs stapling and cutting while moving along the extension direction of the connecting portion 400.

[0403] The working member 4540 may include a wedge 4541, a blade 4542, a contact member 4543, an elastic member 4544, and a body 4545. Furthermore, the working member 4540 may further include a holder 4548.

[0404] The body 4545 may be formed in the shape of a rectangular pillar and forms the base of the working member 4540 .

[0405] The main body 4545 may have a receiving portion 4546 and an inclined portion 4547 formed therein.

[0406] Specifically, a plurality of accommodating portions 4546 may be formed on the lower surface of the main body 4545, and each accommodating portion 4546 may accommodate a contact member 4543, an elastic member 4544, and a holder 4548, which will be described later.

[0407] Here, at least a portion of accommodating portion 4546 is formed in a shape that is substantially the same as or similar to holder 4548, and the position of holder 4548 can be fixed when holder 4548 is fitted into accommodating portion 4546. Then, through-hole 4548a may be formed in holder 4548, and elastic member 4544 may be fitted into this through-hole 4548a.

[0408] An inclined portion 4547 may be formed on one surface of each accommodating portion 4546. The inclined portion 4547 may be formed so that the width of the accommodating portion 4546 narrows as it advances toward the distal portion 4502 of the cartridge 4500. That is, the inclined portion 4547 may be formed so that it approaches the reciprocating member 4551 as it advances toward the distal portion 4502 of the cartridge 4500. The contact member 4543 may be formed so as to move to a certain extent within the accommodating portion 4546, and may be formed so as to be able to come into contact with the inclined portion 4547 depending on its position.

[0409] Such receiving portion 4546 and inclined portion 4547 will be described in more detail later.

[0410] The wedge 4541 may be formed on at least one side of the main body 4545 and may be formed to have a predetermined inclined surface. That is, the wedge 4541 may be formed to be inclined to a certain degree in the extension direction of the connecting portion 400. In other words, the wedge 4541 may be formed so that the height of the proximal portion 4501 side of the cartridge 4500 is higher than the height of the distal portion 4502 side. In the figures, two wedges 4541 are formed on each side of the main body 4545, but the concept of the present invention is not limited thereto, and various numbers and shapes of wedges may be formed depending on the shape of the staple 4530 or the puller member 4535 that comes into contact with the wedge 4541.

[0411] Such a wedge 4541 is formed so as to be able to sequentially come into contact with the puller member 4535 or the plurality of staples 4530, and can play a role in sequentially pushing up the staples 4530. As shown in FIG. 49 and other figures, which will be described later, as the working member 4540 moves toward the distal portion 4502, the wedge 4541 can play a role in sequentially pushing up the staples 4530 and pulling them out of the cartridge 4500.

[0412] A blade 4542 may be formed on one side of the wedge 4541, more specifically, on the proximal portion 4501 side of the wedge 4541. A sharp edge 4542a that cuts tissue is formed in one region of the blade 4542. At least a portion of this edge 4542a is drawn to the outside of the first jaw 4101 and the cartridge 4500, so that tissue disposed between the first jaw 4101 and the second jaw 4102 can be cut. The edge 4542a of the blade 4542 may always be drawn to the outside of the first jaw 4101. Alternatively, the edge 4542a of the blade 4542 may be normally housed inside the first jaw 4101 or the cartridge 4500, and may be drawn to the outside of the first jaw 4101 only when the working member 4540 moves along the longitudinal direction.

[0413] The contact member 4543 may be formed on one side of the main body 4545, more specifically, on a lower portion of the main body 4545, and may be formed to face the reciprocating member 4551, which will be described later. The contact member 4543 may be formed in the form of a roller, and may be formed to be able to come into contact with the inclined portion 4547 of the main body 4545 and the reciprocating member 4551. More specifically, the contact member 4543 may be formed to be pressed by the elastic member 4544, which will be described later, and to be constantly in contact with the reciprocating member 4551. Meanwhile, the contact member 4543 may be formed to come into contact with the inclined portion 4547 of the main body 4545, or to be spaced apart from it.

[0414] Here, when the contact member 4543 is in contact with the inclined portion 4547 of the main body 4545 and the reciprocating member 4551 at the same time, a kind of locked state is created, and when the reciprocating member 4551 moves in one direction, the entire moving member 4540 including the contact member 4543 moves in one direction together with the reciprocating member 4551.

[0415] On the other hand, when the contact member 4543 is in contact only with the reciprocating member 4551 and is spaced a certain distance from the inclined portion 4547 of the main body 4545, it is in a kind of unlocked state, and even if the reciprocating member 4551 moves in the opposite direction, the moving member 4540 remains stationary and does not move.

[0416] The elastic member 4544 is formed between the main body 4545 and the contact member 4543, and serves to apply a predetermined elastic force to the contact member 4543. For example, one region of the elastic member 4544 may be formed to contact the receiving portion 4546 of the main body 4545, and another region of the elastic member 4544 may be formed to contact the contact member 4543. In this case, in order to guide the position of the elastic member 4544, a holder 4548 may be disposed in the receiving portion 4546, and the elastic member 4544 may be fitted into the holder 4548. Here, the elastic member 4544 may apply an elastic force in a direction in which the contact member 4543 comes into close contact with the inclined portion 4547. For this purpose, the elastic member 4544 may be formed in the form of a coil spring, or may be provided in various other forms that can apply a predetermined elastic force to the contact member 4543, such as a leaf spring or a disc spring.

[0417] In the first embodiment of the present invention, the reciprocating assembly 4550 and the working member 4540 constitute a kind of one-way clutch, particularly a roller clutch.

[0418] Specifically, when the reciprocating member 4551 advances toward the distal portion 4502 of the cartridge 4500, the movement of the reciprocating member 4551 is transmitted to the working member 4540 due to the frictional force caused by the engagement, and both the reciprocating member 4551 and the working member 4540 move toward the distal portion 4502 of the cartridge 4500.

[0419] On the other hand, when the reciprocating member 4551 retracts toward the proximal portion 4501 of the cartridge 4500, the contact member 4543 rolls against the inclined portion 4547 of the working member 4540 or is spaced a certain distance from the inclined portion 4547, so that the movement of the reciprocating member 4551 is not transmitted to the working member 4540, and only the reciprocating member 4551 moves alone toward the proximal portion 4501 of the cartridge 4500, and the working member 4540 does not move.

[0420] This will be explained in more detail as follows.

[0421] The main body 4545 and the reciprocating member 4551 of the working member 4540 are formed to be movable relative to each other. That is, the reciprocating member 4551 is formed to be movable relative to the main body 4545 along the longitudinal direction of the shaft.

[0422] A contact member 4543 is arranged between the inclined portion 4547 of the main body 4545 and the reciprocating member 4551, and depending on the position of the contact member 4543, the reciprocating member 4551 can be moved relative to the working member 4540 or the relative movement can be blocked.

[0423] Here, the distance between inclined portion 4547 of main body 4545 and reciprocating member 4551 may be formed to decrease in one direction. Specifically, inclined portion 4547 of main body 4545 is disposed to face reciprocating member 4551 with contact member 4543 interposed therebetween.

[0424] Here, the inclined portion 4547, which is the upper inner surface of the receiving portion 4546 formed inside the main body 4545, may be formed to be inclined to a certain degree, and the distance between the inclined portion 4547 and the reciprocating member 4551 may be changed in a predetermined section.

[0425] As a result, in a predetermined section, contact member 4543 disposed between inclined portion 4547 and reciprocating member 4551 may be formed so as to be able to contact inclined portion 4547 and reciprocating member 4551 simultaneously.

[0426] Furthermore, except for a section where contact member 4543 simultaneously contacts inclined portion 4547 and reciprocating member 4551, contact member 4543 may be arranged to contact only one of inclined portion 4547 and reciprocating member 4551. As long as contact member 4543 does not simultaneously contact inclined portion 4547 and reciprocating member 4551, reciprocating member 4551 is formed to be movable relative to main body 4545.

[0427] Furthermore, even if the contact member 4543 contacts the inclined portion 4547 and the reciprocating member 4551 simultaneously, the contact member 4543 may only lightly contact the inclined portion 4547 of the working member 4540 so that it can roll against the inclined portion 4547, and the reciprocating member 4551 may be formed to be movable relative to the main body 4545.

[0428] Referring to FIG. 37 and other figures, the distance between one surface of the inclined portion 4547 and one surface of the reciprocating member 4551 in the surgical instrument 4000 according to the first embodiment of the present invention may decrease as it progresses toward the distal portion 4502 of the cartridge 4500.

[0429] Specifically, the distance between one surface of the inclined portion 4547 and one surface of the reciprocating member 4551 facing each other may decrease as one progresses toward the distal portion 4502 (from the right side to the left side in FIG. 37 ) based on the right end of the inclined portion 4547. In other words, the distance between the flat upper surface of the reciprocating member 4551 and the inner surface of the inclined portion 4547 facing this may decrease as one progresses from one end toward the other end.

[0430] On the other hand, the elastic member 4544 may be formed to apply pressure to the contact member 4543 in a direction in which the distance between the inclined portion 4547 and the reciprocating member 4551 decreases.

[0431] Here, in the present invention, the contact member 4543 is disposed between the inclined portion 4547 and the reciprocating member 4551, and when the reciprocating member 4551 moves toward the distal portion 4502 of the cartridge 4500, the contact member 4543 can contact the inclined portion 4547 and the reciprocating member 4551 simultaneously.

[0432] In the first embodiment of the present invention, the reciprocating member 4551 is formed flat, and when the movement direction of the reciprocating member 4551 is horizontal, the inclined portion 4547 facing the reciprocating member 4551 may be formed to form an acute angle with the horizontal axis of the reciprocating member 4551.

[0433] As an example, referring to Figure 37, the inclined portion 4547 facing the reciprocating member 4551 may be formed so as to slope downward as it progresses from the right side to the left side, based on one end of the storage portion 4546 where the holder 4548 is arranged (the right end in Figure 37).

[0434] That is, starting from one end (right end) of the accommodating portion 4546, the distance between the inclined portion 4547 and the reciprocating member 4551 decreases as one moves to the left, and when the contact member 4543 moving between the inclined portion 4547 and the reciprocating member 4551 moves toward the distal portion 4502 of the cartridge 4500, the contact member 4543 comes into contact with the inclined portion 4547 and the reciprocating member 4551 simultaneously.

[0435] At this time, a frictional force is generated between the contact member 4543 and the inclined portion 4547 and between the contact member 4543 and the reciprocating member 4551. At this time, when the reciprocating member 4551 moves toward the distal portion 4502 of the cartridge 4500 due to an external force, the frictional force between the contact member 4543 and the reciprocating member 4551 also moves the contact member 4543 together with the reciprocating member 4551 toward the distal portion 4502 of the cartridge 4500.

[0436] Furthermore, as the contact member 4543 moves toward the distal portion 4502, the frictional force between the contact member 4543, the inclined portion 4547, and the reciprocating member 4551 may increase significantly due to the inner surface of the inclined portion 4547, which is inclined downward and leftward at a predetermined angle. As a result, the force with which the reciprocating member 4551 moves toward the distal portion 4502 of the cartridge 4500 is more efficiently transmitted to the working member 4540 via the contact member 4543.

[0437] In other words, when the contact member 4543 is in contact with the inclined portion 4547 of the working member 4540 and the reciprocating member 4551 simultaneously, the more the reciprocating member 4551 moves toward the distal portion 4502, the more the working member 4540 is sandwiched between the inclined portion 4547 and the reciprocating member 4551, and as a result, the force that moves the reciprocating member 4551 toward the distal portion 4502 of the cartridge 4500 is more effectively transmitted to the working member 4540.

[0438] On the other hand, even if the contact member 4543 is in contact with the inclined portion 4547 and the reciprocating member 4551 at the same time, when the reciprocating member 4551 moves toward the proximal portion 4501 of the cartridge 4500, the frictional force between the contact member 4543 and the reciprocating member 4551 causes the contact member 4543 to also move toward the proximal portion 4501 of the cartridge 4500.

[0439] Furthermore, as the contact member 4543 moves toward the proximal portion 4501, it becomes more separated from the inner surface of the inclined portion 4547, which slopes upward to the left, and therefore, unlike the previous case, the force that moves the reciprocating member 4551 toward the distal portion 4502 is no longer transmitted effectively to the working member 4540.

[0440] That is, when the reciprocating member 4551 moves toward the distal portion 4502 of the cartridge 4500, the movement of the reciprocating member 4551 is transmitted to the working member 4540 due to the frictional force caused by the engagement, and both the reciprocating member 4551 and the working member 4540 move toward the distal portion 4502 of the cartridge 4500.

[0441] On the other hand, when the reciprocating member 4551 moves toward the proximal portion 4501 of the cartridge 4500, the contact member 4543 rolls against the inclined portion 4547 of the working member 4540 or is spaced a certain distance from the inclined portion 4547, so that the movement of the reciprocating member 4551 is not transmitted to the working member 4540, and only the reciprocating member 4551 moves toward the proximal portion 4501 of the cartridge 4500, and the working member 4540 does not move.

[0442] With this configuration, the working member 4540 including the contact member 4543 and the inclined portion 4547 and the reciprocating member 4545 form a kind of one-way clutch, and movement in only one direction is possible.

[0443] As an example, when the reciprocating member 4551 moves toward the distal portion 4502 while the contact member 4543 is in contact with the reciprocating member 4551 and the inclined portion 4547, the working member 4540 including the contact member 4543 moves toward the distal portion 4502 together with the reciprocating member 4551 by the reciprocating member 4551. In other words, the reciprocating member 4551 pushes both the contact member 4543 and the working member 4540, and the working member 4540 moves toward the distal portion 4502.

[0444] Conversely, when the reciprocating member 4551 moves toward the proximal portion 4501 while the contact member 4543 is in contact with the reciprocating member 4551 and the inclined portion 4547, the contact member 4543 remains stationary and the reciprocating member 4551 moves independently toward the proximal portion 4501. That is, when the reciprocating member 4551 moves toward the proximal portion 4501, the contact member 4543 rolls against the inclined portion 4547 of the working member 4540 or is spaced apart from the inclined portion 4547 to a certain extent, so that the movement of the reciprocating member 4551 is not transmitted to the working member 4540, and the reciprocating member 4551 moves independently toward the proximal portion 4501 of the cartridge 4500, and the working member 4540 does not move.

[0445] From another perspective, when the reciprocating member 4551 moves to the distal portion 4502 of the cartridge 4500, the contact member 4543 engages between the reciprocating member 4551 and the working member 4540, blocking the relative movement between the reciprocating member 4551 and the working member 4540.

[0446] Conversely, when the reciprocating member 4551 moves to the proximal portion 4501 of the cartridge 4500, the contact member 4543 is released from the engaged state between the reciprocating member 4551 and the working member 4540, thereby enabling relative movement between the reciprocating member 4551 and the working member 4540.

[0447] As a result, the cartridge 4500 is housed in the cartridge housing portion 4101a of the first jaw 4101, and at this time, the reciprocating member 4551 of the cartridge 4500 and the staple link assembly 4170 of the end tool 4100 are coupled together. Therefore, the rotational motion of the first staple pulley 4181 and the second staple pulley 4191 of the end tool 4100 is converted into the linear motion of the reciprocating member 4551 via the staple link assembly 4170.

[0448] At this time, the fastening portion 4551a of the reciprocating member 4551 is connected to the staple pulley assembly 4160 via the staple link assembly 4170, and when the first staple pulley 4181 and the second staple pulley 4191 of the staple pulley assembly 4160 rotate alternately clockwise and counterclockwise, the reciprocating member 4551 can repeatedly move forward and backward. When the reciprocating member 4551 moves forward, the working member 4540 moves forward together with the reciprocating member 4551, and when the reciprocating member 4551 moves backward, only the reciprocating member 4551 moves backward, and the working member 4540 may be stopped in place. By repeating this process, the working member 4540 moves forward, and the staples 4530 are stapled by the wedge 4541, and at the same time, the blade 4542 can cut the stapled tissue.

[0449] This will be explained in more detail as follows.

[0450] (stapling and cutting action)

[0451] Referring to FIG. 42, a method for operating a surgical instrument according to one embodiment of the present invention is as follows.

[0452] First, when the first staple pulley 4181 rotates clockwise and the second staple pulley 4191 rotates counterclockwise, the staple link assembly 4170 connected to the staple pulley assembly 4160 and the reciprocating assembly 4550 of the cartridge 4500 connected to the staple link assembly 4170 move toward the distal portion 4502 of the cartridge 4500.

[0453] As the reciprocating assembly 4550 moves toward the distal portion 4502 of the cartridge 4500 , the working member 4540 in contact with the reciprocating assembly 4550 moves toward the distal portion 4502 of the cartridge 4500 along with the reciprocating assembly 4550 .

[0454] Then, while the working member 4540 moves toward the distal portion 4502 of the cartridge 4500 , the working member 4540 ejects the staples 4530 out of the cartridge 4500 , and the blade 4542 of the working member 4540 moves toward the distal portion 4502 of the cartridge 4500 .

[0455] On the other hand, when the first staple pulley 4181 rotates counterclockwise and the second staple pulley 4191 rotates clockwise, the staple link assembly 4170 connected to the staple pulley assembly 4160 and the reciprocating assembly 4550 of the cartridge 4500 connected to the staple link assembly 4170 move toward the proximal portion 4501 of the cartridge 4500, and at this time the working member 4540 is stopped.

[0456] These steps are then repeated, with the stapling action by the wedge 4541 and the cutting action by the blade 4542 being performed simultaneously.

[0457] This will be explained in more detail as follows.

[0458] 42(b), when the first staple pulley 4181 rotates in the direction of arrow A1 (i.e., clockwise) and the second staple pulley 4191 rotates in the direction of arrow B1 (i.e., counterclockwise), the staple link assembly 4170 connected thereto and the reciprocating member 4551 fastened to the staple link assembly 4170 move in the direction of arrow C1 (i.e., toward the distal portion). In this state, the reciprocating member 4551 and the contact member 4543 of the working member 4540 are in close contact with each other due to the elastic member (see 4544 in FIG. 40), and therefore, when the reciprocating member 4551 moves in the direction of arrow C1, the working member 4540 also moves in the direction of arrow D1 together with the reciprocating member 4551.

[0459] On the other hand, as shown in Figure 42(c), when the first staple pulley 4181 rotates in the direction of arrow A2 (i.e., counterclockwise) and the second staple pulley 4191 rotates in the direction of arrow B2 (i.e., clockwise), the staple link assembly 4170 connected thereto and the reciprocating member 4551 fastened to the staple link assembly 4170 move in the direction of arrow C2 (i.e., toward the proximal portion). In this state, even if the reciprocating member 4551 moves in the C2 direction, the overall position of the working member 4540 is maintained as it is due to the structure of the contact member 4543 and the reciprocating member 4551, and only the contact member 4543 is spaced apart from the reciprocating member 4551 to a certain extent (see Figures 41 and 43). In other words, even if the reciprocating member 4551 moves in the direction of arrow C2, the working member 4540 remains stopped in place when viewed from the X-axis direction.

[0460] In this state, when the first staple pulley 4181 stops rotating, the staple link assembly 4170, the reciprocating member 4551, and the working member 4540 also stop, as shown in FIG. 42(a).

[0461] While repeating this process, when the first staple pulley 4181 and the second staple pulley 4191 rotate alternately in the clockwise and counterclockwise directions, the reciprocating member 4551 repeatedly moves forward and backward, and the working member 4540 repeatedly moves forward and stops, resulting in the working member 4540 moving toward the distal portion 4502. Then, while the working member 4540 moves toward the distal portion 4502, the stapling action by the wedge 4541 and the cutting action by the blade 4542 are simultaneously performed.

[0462] The stapling action of a surgical instrument according to one embodiment of the present invention will now be described.

[0463] 43 is a perspective view showing the stapling operation of the end tool of FIG. 36 in sections, and FIG. 44 is a perspective view showing the stapling operation of the end tool of FIG. 36 as a whole.

[0464] 43 and 44, while the working member 4540 moves in the direction of arrow A1 in FIG. 43(b) in the state shown in FIG. 43(a), the wedge 4541 of the working member 4540 pushes up the pull-out member 4535, and the pull-out member 4535 pushes up one side below the staple 4530. As a result, the staple 4530 is ejected to the outside of the first jaw 4101 and the cartridge 4500.

[0465] In this state, when the working member 4540 moves further in the direction of arrow A2 in Figure 43(c), the ejected staple 4530 continues to be pushed up by the working member 4540 while in contact with the anvil 4102a of the second jaw 4102, and both ends of the staple 4530 are bent and stapled.

[0466] While such an operation is continuously performed, as shown in FIG. 44, among the plurality of staples 4530, stapling is performed in order from the staples 4530 on the proximal portion 4501 side to the staples 4530 on the distal portion 4502 side.

[0467] (Operation unit)

[0468] Figures 45 and 46 are perspective views showing the operation portion of the surgical instrument of Figure 2. Figure 47 is a diagram simply showing only the configuration of pulleys and wires that form the joints of the surgical instrument shown in Figure 2.

[0469] 2 to 47, the operating unit 200 of the surgical instrument 4000 according to the first embodiment of the present invention includes a first handle 204 that can be held by a user, an actuation operating unit 203 that controls the actuation movement of the end tool 4100, a yaw operating unit 202 that controls the yaw movement of the end tool 4100, and a pitch operating unit 201 that controls the pitch movement of the end tool 4100. Here, it can be understood that only the components related to the pitch / yaw / actuation movements of the surgical instrument 4000 are shown in FIGS.

[0470] Additionally, the operating portion 200 of the surgical instrument 4000 may further include a staple operating portion 260 that controls the movement of the staple pulley assembly 4160 of the end tool 4100 to perform stapling and cutting.

[0471] The operating unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 involved in the rotational motion of the first jaw 4101. The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 involved in the rotational motion of the second jaw 4102. The operating unit 200 may also include pulleys 231, 232, 233, and 234 involved in the pitch motion. The operating unit 200 may also include pulley 235, which is an intermediate pulley, arranged in the middle of the bent portion 402 of the connecting portion 400.

[0472] Here, although the figures show the opposing pulleys formed parallel to each other, the concept of the present invention is not limited to this, and each pulley may be formed in various positions and sizes suited to the configuration of the operating unit.

[0473] Furthermore, the operation unit 200 according to the first embodiment of the present invention may include rotational shafts 241, 242, 243, 244, 245, and 246. Here, the rotational shaft 241 may function as an operation unit first jaw actuation rotational shaft, and the rotational shaft 242 may function as an operation unit second jaw actuation rotational shaft. The rotational shaft 243 may function as an operation unit yaw main rotational shaft, and the rotational shaft 244 may function as an operation unit yaw sub-rotational shaft. The rotational shaft 245 may function as an operation unit pitch sub-rotational shaft, and the rotational shaft 246 may function as an operation unit pitch main rotational shaft.

[0474] The rotation shafts 241 / 242, 243, 244, 245, and 246 may be arranged sequentially from the distal end 205 to the proximal end 206 of the operating portion 200.

[0475] Each of these rotating shafts 241, 242, 243, 244, 245, and 246 may be fitted with one or more pulleys, as will be described in more detail below.

[0476] Pulley 210 functions as an operating portion first jaw actuation pulley, and pulley 220 functions as an operating portion second jaw actuation pulley, and these components may be generally referred to as operating portion actuation pulleys.

[0477] Pulley 211 and pulley 212 function as an operating unit first jaw-yaw main pulley, and pulley 221 and pulley 222 function as an operating unit second jaw-yaw main pulley, and these components may be commonly referred to as operating unit yaw main pulleys.

[0478] Pulleys 213 and 214 function as an operating unit first jaw-yaw sub-pulley, and pulleys 223 and 224 function as an operating unit second jaw-yaw sub-pulley, and these components may be commonly referred to as operating unit yaw sub-pulleys.

[0479] Pulleys 215 and 216 function as operating unit first jaw pitch sub-pulleys, and pulleys 225 and 226 function as operating unit second jaw pitch sub-pulleys, and these components may be commonly referred to as operating unit pitch sub-pulleys.

[0480] Pulleys 217 and 218 function as the first jaw pitch main pulley of the operating unit, and pulleys 227 and 228 function as the second jaw pitch main pulley of the operating unit, and these components may be commonly referred to as the operating unit pitch main pulley.

[0481] 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.

[0482] The above components can be classified as follows from the viewpoint of the operating parts for each movement (pitch / yaw / actuation).

[0483] The pitch operation unit 201 that controls the pitch movement of the end tool 4100 may include a pulley 215, a pulley 216, a pulley 217, a pulley 218, a pulley 225, a pulley 226, a pulley 227, a pulley 228, a pulley 231, a pulley 232, and a pulley 234. The pitch operation unit 201 may also include a rotation shaft 245 and a rotation shaft 246. The pitch operation unit 201 may further include a pitch frame 208.

[0484] The yaw operation unit 202 that controls the yaw movement of the end tool 4100 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.

[0485] The actuation operation unit 203 that controls the actuation movement of the end tool 4100 may include a pulley 210, a pulley 220, a rotation shaft 241, and a rotation shaft 242. The actuation operation unit 203 may further include a first actuation operation unit 251 and a second actuation operation unit 256.

[0486] Each component of the operation unit 200 will be described in more detail below.

[0487] The first handle 204 is formed so that it can be held by a user's hand, and in particular, may be formed so that the user can wrap the palm of their hand around the first handle 204. An actuation operation unit 203 and a yaw operation unit 202 are formed on the first handle 204, and a pitch operation unit 201 is formed on one side of the yaw operation unit 202. The other end of the pitch operation unit 201 is connected to a bent portion 402 of the connecting unit 400.

[0488] The actuation operation unit 203 includes a first actuation operation unit 251 and a second actuation operation unit 256. The first actuation operation unit 251 includes a rotating shaft 241, a pulley 210, a first actuation extension unit 252, and a first actuation gear 253. The second actuation operation unit 256 includes a rotating shaft 242, a pulley 220, a second actuation extension unit 257, and a second actuation gear 258. Here, the ends of the first actuation extension unit 252 and the second actuation extension unit 257 are formed in the shape of a finger hole ring and can function as a second handle.

[0489] Here, the rotation axes 241 and 242, which are actuation rotation axes, may be formed to form a predetermined angle with the XY plane on which the coupling unit 400 is formed. For example, the rotation axes 241 and 242 may be formed in a direction parallel to the Z axis, and in this state, when the pitch operation unit 201 or the yaw operation unit 202 rotates, the coordinate system of the actuation operation unit 203 may change relatively. Of course, the concept of the present invention is not limited thereto, and the rotation axes 241 and 242 may be formed in various directions to suit the hand structure of a user holding the actuation operation unit 203 according to ergonomic design.

[0490] 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.

[0491] Similarly, pulley 220, second actuation extension 257, and second actuation gear 258 may be fixedly coupled to each other and formed to be rotatable together around rotation axis 242. Here, pulley 220 may be composed of one pulley, or may be composed of two pulleys fixedly coupled to each other.

[0492] Here, the first actuation gear 253 and the second actuation gear 258 may be formed to mesh with each other, and may be formed to rotate together in the opposite direction when either side rotates.

[0493] The yaw operation unit 202 may include a rotation shaft 243, pulleys 211 and 212 which are operation unit first jaw-yaw main pulleys, pulleys 221 and 222 which are operation unit second jaw-yaw main pulleys, and a yaw frame 207. The yaw operation unit 202 may further include pulleys 213 and 214 which are operation unit first jaw-yaw sub-pulleys formed on one side of the pulleys 211 and 212, and pulleys 223 and 224 which are operation unit second jaw-yaw sub-pulleys formed on one side of the pulleys 221 and 222. Here, the pulleys 213 and 214 and the pulleys 223 and 224 may be coupled to a pitch frame 208, which will be described later.

[0494] Here, the drawings show yaw operation unit 202 including pulleys 211 and 212 and pulleys 221 and 222, where pulleys 211 and 212 and pulleys 221 and 222 are respectively formed to face each other and are provided with two independently rotatable pulleys, but the concept of the present invention is not limited to this. In other words, one or more pulleys having the same or different diameters may be provided according to the configuration of yaw operation unit 202.

[0495] 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. At this time, the first handle 204 is formed to be rotatable around the rotation axis 243.

[0496] Here, the rotation axis 243 may be formed to form a predetermined angle with the XY plane on which the connecting unit 400 is formed. For example, the rotation axis 243 may be formed in a direction parallel to the Z axis, and when the pitch operation unit 201 rotates in this state, the coordinate system of the rotation axis 243 may change relatively as described above. Of course, the concept of the present invention is not limited thereto, and the rotation axis 243 may be formed in various directions to suit the hand structure of a user holding the operation unit 200 according to ergonomic design.

[0497] Meanwhile, pulleys 211 and 212 and pulleys 221 and 222 are coupled to a rotation shaft 243 so as to be rotatable about the rotation shaft 243. A wire 301 or 305 serving as a first jaw wire may be wound around pulleys 211 and 212, and a wire 302 or 306 serving as a second jaw wire may be wound around pulleys 221 and 222. In this case, pulleys 211 and 212 and pulleys 221 and 222 may be formed to face each other and may be configured as two pulleys that can rotate independently. Therefore, the wire to be wound and the wire to be unwound can be wound around separate pulleys, respectively, and can operate without interfering with each other.

[0498] The yaw frame 207 rigidly connects the first handle 204, the rotation axis 241, the rotation axis 242, and the rotation axis 243, allowing the first handle 204, the yaw operation unit 202, and the actuation operation unit 203 to yaw rotate as a unit around the rotation axis 243.

[0499] The pitch operation unit 201 may include a rotating shaft 246, pulleys 217 and 218 which are operation unit first jaw pitch main pulleys, pulleys 227 and 228 which are operation unit second jaw pitch main pulleys, and a pitch frame 208. The pitch operation unit 201 may further include a rotating shaft 245, pulleys 215 and 216 which are operation unit first jaw pitch sub-pulleys formed on one side of the pulleys 217 and 218, and pulleys 225 and 226 which are operation unit second jaw pitch sub-pulleys formed on one side of the pulleys 227 and 228. The pitch operation unit 201 may be connected to a bending portion 402 of the connection unit 400 via the rotating shaft 246.

[0500] 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.

[0501] As described above, the yaw frame 207 connects the first handle 204, the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242, and the yaw frame 207 is also axially coupled to the pitch frame 208. Therefore, when the pitch frame 208 pitches around the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, which are connected to the pitch frame 208, all rotate in pitch. In other words, when the pitch operation unit 201 rotates around the rotation shaft 246, the actuation operation unit 203 and the yaw operation unit 202 rotate together with the pitch operation unit 201. In other words, when the user pitches the first handle 204 around the rotation shaft 246, the actuation operation unit 203, the yaw operation unit 202, and the pitch operation unit 201 move together.

[0502] 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 .

[0503] Here, pulleys 217 and 218 may be formed to face each other and to be rotatable independently. Therefore, the winding wire and the unwinding wire can be wound around the separate pulleys, respectively, and can operate without interfering with each other. Similarly, pulleys 227 and 228 may be formed to face each other and to be rotatable independently. Therefore, the winding wire and the unwinding wire can be wound around the separate pulleys, respectively, and can operate without interfering with each other.

[0504] Next, the operation of the pitch wires, wire 303 and wire 304, is as follows.

[0505] The end tool 4100 is formed with a pulley 4131, which is an end tool pitch pulley, fixedly coupled to the end tool hub 180, and the operation unit 200 is formed with pulleys 231 and 232, which are operation unit pitch pulleys, fixedly coupled to the pitch frame 208. These pulleys are connected to each other by wires 303 and 304, which are pitch wires, so that the pitch movement of the end tool 4100 can be more easily performed in response to the pitch operation of the operation unit 200. Here, the wire 303 is fixedly coupled to the pitch frame 208 via the pulleys 231 and 233, and the wire 304 is fixedly coupled to the pitch frame 208 via the pulleys 232 and 234. In other words, the pitch rotation of the operating unit 200 causes the pitch frame 208 and the pulleys 231 and 232 to rotate together around the rotation axis 246, and as a result, the wires 303 and 304 also move, and additional pitch rotation power can be transmitted in addition to the pitch movement of the end tool caused by the jaw wires, wires 301, 302, 305, and 306.

[0506] The connection relationships between the first handle 204 and the pitch operation unit 201, the yaw operation unit 202, and the actuation operation unit 203 can be summarized as follows: Rotational shafts 241 and 242, and rotational shafts 243, 244, 245, and 246 may be formed on the first handle 204. In this case, since rotational shafts 241 and 242 are formed directly on the first handle 204, the first handle 204 and the actuation operation unit 203 may be directly connected. On the other hand, since rotational shaft 243 is formed directly on the first handle 204, the first handle 204 and the yaw operation unit 202 may be directly connected. Meanwhile, since the pitch operation unit 201 is formed on one side of the yaw operation unit 202 so as to be connected to the yaw operation unit 202, the pitch operation unit 201 may not be directly connected to the first handle 204, and the pitch operation unit 201 and the first handle 204 may be formed so as to be indirectly connected via the yaw operation unit 202.

[0507] Continuing to refer to the figures, in the surgical instrument 4000 according to the first embodiment of the present invention, the pitch control unit 201 and the end tool 4100 may be formed on the same or parallel axis (X axis). That is, the rotation axis 246 of the pitch control unit 201 is formed at one end of the bending portion 402 of the connecting portion 400, and the end tool 4100 is formed at the other end of the connecting portion 400.

[0508] One or more intermediate pulleys 235 for changing or guiding the path of the wire may be arranged in the middle of the connecting portion 400, particularly in the portion of the bent portion 402. By guiding the path of the wire by winding at least a portion of the wire around such intermediate pulleys 235, the wire may be arranged along the bent shape of the bent portion 402.

[0509] Here, in the figure, the connecting portion 400 is shown as having a bent portion 402 and being curved to have a predetermined curvature, but the concept of the present invention is not limited thereto, and the connecting portion 400 may be formed straight or bent one or more times as necessary, and even in such cases, the pitch control portion 201 and the end tool 4100 can be said to be formed on substantially the same or parallel axes. Also, in Fig. 3, the pitch control portion 201 and the end tool 4100 are shown as being formed on axes parallel to the X-axis, but the concept of the present invention is not limited thereto, and the pitch control portion 201 and the end tool 4100 may be formed on different axes.

[0510] The staple operating unit 260 is connected to a first staple pulley 4181 of the end tool 4100 by first staple wires, wires 307 and 308, and can serve to alternately rotate the first staple pulley 4181 in a clockwise or counterclockwise direction. The staple operating unit 260 is connected to a second staple pulley 4191 of the end tool 4100 by second staple wires, wires 309 and 310, and can serve to alternately rotate the second staple pulley 4191 in a clockwise or counterclockwise direction.

[0511] For this reason, although not shown in the figures, the staple operating portion 260 may include a motor (not shown). That is, while a user is pressing the staple operating portion 260 formed in a button shape, the motor (not shown) is driven to rotate the operating portion staple pulley (see 269 in FIG. 45) alternately in a clockwise or counterclockwise direction. This allows the first staple pulley 4181 and the second staple pulley 4191 of the end tool 4100 to rotate alternately in a clockwise or counterclockwise direction.

[0512] (actuation, yaw, pitch)

[0513] The actuation operation, yaw operation, and pitch operation in this embodiment will be described below.

[0514] First, the actuation operation is as follows.

[0515] When a user places his / her index finger in the finger hole ring formed in first actuation extension 252 and his / her thumb in the finger hole ring formed in second actuation extension 257 and rotates actuation extensions 252, 257 with one or both fingers, pulley 210 and first actuation gear 253, which are fixedly connected to first actuation extension 252, rotate about rotation axis 241, and pulley 220 and second actuation gear 258, which are fixedly connected to second actuation extension 257, rotate about rotation axis 242. At this time, pulley 210 and pulley 220 rotate in opposite directions, and therefore wires 301 and 305, one end of which is fixedly connected and wound around pulley 210, and wires 302 and 306, one end of which is fixedly connected and wound around pulley 220, also move in opposite directions. Such a rotational force is transmitted to the end tool 4100 via the power transmission unit 300, and the two jaws 4103 of the end tool 4100 perform an actuation operation.

[0516] Here, as described above, the actuation operation refers to the operation of opening and closing the two jaws 4101, 4102 as the jaws 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 4101 rotates counterclockwise and the second jaw 4102 rotates clockwise, closing the end tool 4100. Conversely, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated away from each other, the first jaw 4101 rotates clockwise and the second jaw 4102 rotates counterclockwise, opening the end tool 4100.

[0517] In this embodiment, for the above-described actuation operation, the second handle is provided with the first actuation extension 252 and the second actuation extension 257, and can be gripped and operated with two fingers. However, the configuration of the actuation operation unit 203 for the actuation operation of opening and closing the two jaws of the end tool 4100 from each other is different from that described above, and other modified examples are also possible, such as a configuration in which two actuation pulleys (pulley 210, pulley 220) operate in opposite directions with one actuation rotating unit.

[0518] Next, the yaw motion is as follows:

[0519] When a user rotates first handle 204 about rotation axis 243 while gripping first handle 204, actuation operation unit 203 and yaw operation unit 202 will yaw rotate about rotation axis 243. That is, when pulley 210 of first actuation operation unit 251, to which wires 301 and 305 are fixedly coupled, rotates about rotation axis 243, wires 301 and 305 wound around pulleys 211 and 212 will move. Similarly, when pulley 220 of second actuation operation unit 256, to which wires 302 and 306 are fixedly coupled, rotates about rotation axis 243, wires 302 and 306 wound around pulleys 221 and 222 will move. At this time, the wires 301 and 305 connected to the first jaw 4101 and the wires 302 and 306 connected to the second jaw 4102 are wound around the pulleys 211 and 212 and the pulleys 221 and 222 so that the first jaw 4101 and the second jaw 4102 rotate in the same direction during yaw rotation. Then, this rotational force is transmitted to the end tool 4100 via the power transmission unit 300, and the two jaws 4103 of the end tool 4100 perform a yaw operation in which they rotate in the same direction.

[0520] 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.

[0521] Next, the pitch operation is as follows:

[0522] When the user rotates first handle 204 about rotation axis 246 while gripping first handle 204, actuation operation unit 203, yaw operation unit 202, and pitch operation unit 201 pitch rotate about rotation axis 246. That is, when pulley 210 of first actuation operation unit 251, to which wires 301 and 305 are fixedly coupled, rotates about rotation axis 246, wires 301 and 305 wound around pulleys 217 and 218 move. Similarly, when pulley 220 of second actuation operation unit 256, to which wires 302 and 306 are fixedly coupled, rotates about rotation axis 246, wires 302 and 306 wound around pulleys 227 and 228 move. 5, the wires 301 and 305 serving as the first jaw wires move in the same direction, and the wires 302 and 306 serving as the second jaw wires move in the same direction, so that the first jaw 4101 and the second jaw 4102 can pitch rotate. The jaw wires, wires 301, 305, wire 302, and wire 306, are wound around pulleys 217, 218, 227, and 228, which are the operation unit pitch main pulleys. Such a rotational force is then transmitted to the end tool 4100 via the power transmission unit 300, and the two jaws 4103 of the end tool 4100 perform pitch movement.

[0523] 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.

[0524] In summary, the surgical instrument 4000 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), a wire (first jaw wire or second jaw wire) is wound around this pulley, and rotational operation (actuation rotation, yaw rotation, pitch rotation) of the operating unit causes movement of each wire, thereby inducing a desired movement of the end tool 4100. Furthermore, an auxiliary pulley may be formed on one side of each pulley, and these auxiliary pulleys prevent the wire from being wound multiple times around one pulley.

[0525] Figure 47 is a simplified diagram showing only the configuration of pulleys and wires that constitute the joints of the surgical instrument 4000 according to one embodiment of the present invention shown in Figure 2. In Figure 43, the intermediate pulleys for changing the path of the wires regardless of joint movement are omitted.

[0526] Referring to FIG. 47, the operating unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 that are involved in the rotational movement of the first jaw 4101.

[0527] The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 involved in the rotational movement of the second jaw 4102. (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 4100, so some of the specific reference numerals in the drawings will be omitted.)

[0528] Pulleys 211 and 212, and pulleys 221 and 222 may be formed to be rotatable independently of each other around the same axis, rotation axis 243. In this case, pulleys 211 and 212, and pulleys 221 and 222, respectively, may be formed to face each other and may be formed as two pulleys formed to be rotatable independently of each other.

[0529] Pulleys 213 and 214, and pulleys 223 and 224 may be formed to be independently rotatable about the same axis, rotation axis 244. In this case, pulleys 213 and 214 may be formed to face each other and be formed as two pulleys formed to be independently rotatable, and in this case, the two pulleys may be formed to have different diameters. Similarly, pulleys 223 and 224 may be formed to face each other and be formed as two pulleys formed to be independently rotatable, and in this case, the two pulleys may be formed to have different diameters.

[0530] Pulleys 215 and 216 and pulleys 225 and 226 may be formed to be rotatable independently of each other around the same axis, rotation axis 245. In this case, pulleys 215 and 216 may be formed to have different diameters. Also, pulleys 225 and 226 may be formed to have different diameters.

[0531] Pulleys 217 and 218 and pulleys 227 and 228 may be formed to be rotatable independently of each other about the same rotation axis 246 .

[0532] The wire 301 passes through pulleys 217, 215, 213, and 211 of the operating unit 200 in this order, and is wound around pulley 210, and then is coupled to pulley 210 by a fastening member 324. On the other hand, the wire 305 passes through pulleys 218, 216, 214, and 212 of the operating unit 200 in this order, and is coupled to pulley 210 by a fastening member 324. Therefore, when the pulley 210 rotates, the wires 301 and 305 are wound around or unwound from the pulley 210 accordingly, and the first jaw 4101 rotates.

[0533] The wire 306 passes through pulleys 227, 225, 223, and 221 of the operating unit 200 in this order, and is wound around pulley 220, and then is coupled to pulley 220 by a fastening member 327. On the other hand, the wire 302 passes through pulleys 228, 226, 224, and 222 of the operating unit 200 in this order, and is coupled to pulley 220 by a fastening member 327. Therefore, when pulley 220 rotates, the wires 302 and 306 are wound or unwound around pulley 220 accordingly, and the second jaw 4102 rotates.

[0534] (Conceptual diagram of pulley and wire)

[0535] 49 and 50 are views illustrating the configurations of pulleys and wires associated with the actuation and yaw operations of the surgical instrument 4000 according to one embodiment of the present invention shown in FIG. 2, with the first and second jaws disassembled. FIG. 49 is a view illustrating only the pulleys and wires associated with the second jaw, and FIG. 50 is a view illustrating only the pulleys and wires associated with the first jaw. FIG. 50 is a perspective view illustrating the yaw operation of the surgical instrument of FIG. 2. Note that components associated with the stapling and cutting operations have been omitted from FIG. 50.

[0536] First, the wire operation of the actuation operation will be described.

[0537] Referring to Figure 50, 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 4101 of the end tool 4100 rotating in the direction of arrow EPA1.

[0538] 49, 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 4102 of end tool 4100 rotating in the direction of arrow EPA2. Therefore, when a user operates first actuation extension 252 and second actuation extension 257 in directions that bring them closer together, first jaw 4101 and second jaw 4102 of the end tool move closer to each other.

[0539] Next, the wire operation for yaw movement will be described.

[0540] First, the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 are connected by a yaw frame (see 207 in FIG. 30), so the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 rotate together as a unit.

[0541] Referring to Figure 50, when the first handle 204 is rotated in the direction of the arrow OPY1 around the rotation axis 243, the pulleys 210, 211, and 212, along with the wires 301 and 305 wound around them, rotate as a whole around the rotation axis 243, and as a result, the wires 301 and 305 wound around the pulleys 211 and 212 move in the directions W1a and W1b, respectively, and as a result, the first jaw 4101 of the end tool 4100 rotates in the direction of the arrow EPY1.

[0542] Referring to Figure 49, when the first handle 204 is rotated in the direction of the arrow OPY2 around the rotation axis 243, pulleys 220, 221, and 222, along with the wires 302 and 306 wound thereon, rotate as a whole around the rotation axis 243, and as a result, the wires 302 and 306 wound around pulleys 221 and 222 move to the opposite side of W1a and the opposite side of W1b, respectively, and as a result, the first jaw 4101 of the end tool 4100 rotates in the direction of the arrow EPY2.

[0543] Figures 51, 52, and 53 are views showing the configurations of pulleys and wires associated with the stapling and cutting operations of the surgical instrument 4000 according to one embodiment of the present invention shown in Figure 2, with the first jaw and the second jaw disassembled. Here, Figures 51 to 53 are views mainly showing the pulleys and wires associated with the second jaw.

[0544] Here, FIGS. 51 and 52 show the actuation process for closing the two jaws, and FIGS. 52 and 53 show the process for stapling and cutting the tissue interposed between the two jaws.

[0545] First, the wire operation of the actuation operation will be described.

[0546] Referring to Figures 51 and 52, when the first actuation extension 252 of the first actuation operating unit 251 rotates in the direction of arrow OPA1 around the rotation axis 241, the pulley 210 connected to the first actuation extension 252 rotates, causing the wire (see 301 in Figure 47) and wire (see 305 in Figure 47) wound around the pulley 210 to move, resulting in the first jaw 4101 of the end tool 4100 rotating in the direction of arrow EPA1.

[0547] At this time, the operation portion staple pulley 269 of the staple operation portion 260 is formed to be rotatable around the rotation shaft 241 together with the first actuation operation portion 251. Therefore, when the first actuation extension portion 252 rotates around the rotation shaft 241, the staple operation portion 260 also rotates around the rotation shaft 241 together with the first actuation operation portion 251.

[0548] As a result, when the pulley 111 rotates with the end tool 4100 during actuation, the staple pulley 161 also rotates together with the pulley 111 .

[0549] The wire action of the stapling and cutting operation will now be described.

[0550] Referring to Figure 53(a), when the staple operating unit 260 is rotated in the direction of arrow OPC1 around the rotation axis 247, which is the operating unit cutting rotation axis, the operating unit staple pulley 269 and the wires 307 and 308, which are the first staple wires wound thereon, rotate around the rotation axis 247, and as a result, the wires 307 and 308 wound around the operating unit staple pulley 269 move, respectively, and as a result, the first staple pulley 4181 of the end tool 4100 rotates in the direction of arrow EPC1.

[0551] Referring to Figure 53(b), when the staple operating unit 260 is rotated in the direction of arrow OPC1 around the rotation axis 247, which is the operating unit cutting rotation axis, the operating unit staple pulley 269 and the second staple wires 309 and 310 wound thereon rotate around the rotation axis 247, and as a result, the wires 309 and 310 wound around the operating unit staple pulley 269 move, and as a result, the second staple pulley 4191 of the end tool 4100 rotates in the direction of arrow EPC1.

[0552] On the other hand, when the staple operating portion 260 rotates, the operating portion staple pulley 269 rotates about the rotation axis 247 , and at this time, the rotation of the staple operating portion 260 does not affect the first actuation operating portion 251 .

[0553] As a result, when the operating portion staple pulley 269 rotates, the first staple pulley 4181 and the second staple pulley 4191 of the end tool 4100 rotate independently of the first jaw 4101. Then, when the first staple pulley 4181 and the second staple pulley 4191 rotate alternately in the clockwise / counterclockwise direction, the staple link assembly 4170 connected to the first staple pulley 4181 and the second staple pulley 4191 and the reciprocating assembly 4550 of the cartridge 4500 connected thereto perform reciprocating linear motion, whereby the working member 4540 of the cartridge 4500 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0554] At this time, as described above, the first staple pulley 4181 and the second staple pulley 4191 can rotate in directions opposite to each other. For example, when the staple operating portion 260 rotates in one direction, the first staple pulley 4181 rotates clockwise and the second staple pulley 4191 rotates counterclockwise, allowing the staple link assembly 4170 to move toward the distal portion 4104 of the end tool 4100. On the other hand, when the staple operating portion 260 rotates in the opposite direction, the first staple pulley 4181 rotates counterclockwise and the second staple pulley 4191 rotates clockwise, allowing the staple link assembly 4170 to move toward the proximal portion 4105 of the end tool 4100.

[0555] Here, in the figures, the staple operating portion 260 is shown as being formed in a bar shape and rotated manually by a user, but the spirit of the present invention is not limited thereto. That is, as described above, the staple operating portion 260 may include a motor (not shown), and while a user presses the staple operating portion 260 formed in a button shape, the motor (not shown) is driven to rotate the operating portion staple pulley 269 alternately in a clockwise or counterclockwise direction. This allows the first staple pulley 4181 and the second staple pulley 4191 of the end tool 4100 to rotate alternately in a clockwise or counterclockwise direction.

[0556] 55, 56, and 57 are views showing the configuration of pulleys and wires associated with the pitch operation of the surgical instrument 4000 according to one embodiment of the present invention shown in FIG. 2, with the first and second jaws disassembled. FIG. 55 is a view showing only the pulleys and wires associated with the second jaw, and FIG. 56 is a view showing only the pulleys and wires associated with the first jaw. FIG. 57 is a view showing only the pulleys and wires associated with the staple pulleys. As shown in FIG. 9 and other figures, there are two pulleys associated with the pitch operation, and both strands of each wire are wound along the same path, which is shown by a single line in FIGS. 55 and 57. FIG. 54 is a perspective view showing the pitch operation of the surgical instrument of FIG. 2. Note that components associated with the stapling and cutting operations have been omitted from FIG. 54.

[0557] 55, when first handle 204 is rotated in the direction of arrow OPP1 around rotation axis 246, pulleys 210, 215, 217, etc., and wire 301 wound thereon, etc., rotate as a whole around rotation axis 246. At this time, wires 301 and 305, which are first jaw wires, are wound above pulleys 217 and 218, as shown in FIG. 55, and therefore move toward the arrow W1 side. As a result, as described with reference to FIG. 5, first jaw 4101 of end tool 4100 rotates in the direction of arrow EPP1.

[0558] 56, when first handle 204 is rotated in the direction of arrow OPP2 around rotation axis 246, pulleys 220, 225, and 227, etc., and wire 302 wound thereon, etc., rotate as a whole around rotation axis 246. At this time, wires 302 and 306, which are second jaw wires, are wound below pulleys 227 and 228, as shown in FIG. 56, and therefore move toward the arrow W2 side. As a result, as described with reference to FIG. 5, second jaw 4102 of end tool 4100 rotates in the direction of arrow EPP2.

[0559] 57, when the first handle 204 is rotated in the direction of the arrow OPC1 around the rotation shaft 246, the operation section staple pulley 269, pulley 265, pulley 267, etc., and the wires 307 and 308 wound thereon, etc., rotate as a whole around the rotation shaft 246. At this time, the wires 307 and 308, which are the first staple wires, are wound below the pulleys 267 and 268, and therefore move to the side of the arrow W3. As a result, as described with reference to FIG. 5, the first staple pulley 4181 of the end tool 4100 rotates in the direction of the arrow EPC1.

[0560] As a result, when the pulley 4111 of the end tool 4100 rotates around the rotation shaft 4143 during pitching, the first staple pulley 4181 also rotates around the rotation shaft 4143 together with the pulley 4111 .

[0561] Therefore, actuation, yaw, and pitch operations can be performed independently of each other.

[0562] As explained with reference to Figure 1, the actuation operation unit 203, yaw operation unit 202, and pitch operation unit 201 have their rotation axes located behind each operation unit, and are configured in the same manner as the joint configuration of the end tool, allowing the user to intuitively perform the same operations.

[0563] In particular, the surgical instrument 4000 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), and a wire (first jaw wire or second jaw wire) is wound around this pulley, and rotational operation of the operating unit (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, thereby inducing a desired movement of the end tool 4100. Furthermore, an auxiliary pulley may be formed on one side of each pulley, and these auxiliary pulleys prevent the wire from being wound around one pulley multiple times, prevent the wires wound around the pulleys from contacting each other, and safely form a path for the wire being wound around the pulley and the wire being unwound, thereby improving the safety and efficiency of power transmission of the wire.

[0564] On the other hand, as described above, the yaw operation unit 202 and the actuation operation unit 203 are formed directly on the first handle 204. Therefore, when the first handle 204 rotates around the rotation axis 246, the yaw operation unit 202 and the actuation operation unit 203 also rotate together with the first handle 204. As a result, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 is not fixed, but continues to change relatively as the first handle 204 rotates. That is, in FIG. 2 and other figures, the yaw operation unit 202 and the actuation operation unit 203 are shown as being parallel to the Z axis. However, when the first handle 204 rotates, the yaw operation unit 202 and the actuation operation unit 203 are no longer parallel to the Z axis. That is, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 changes in response to the rotation of the first handle 204. However, for the sake of convenience, unless otherwise specified, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 is described in this specification based on the state in which the first handle 204 is positioned perpendicular to the connecting unit 400, as shown in Figure 2.

[0565] (Correlation of stapling and cutting operations with other operations)

[0566] The correlation between the stapling and cutting motions and the other motions (pitch, yaw and actuation motions) is described below.

[0567] First, during the pitch movement of the end tool 4100, the first staple pulley 4181 and the second staple pulley 4191 also perform a pitch movement. That is, when the pulley 4111 and the pulley 4121 perform a pitch movement in which they rotate in the same direction around the rotation shaft 4143, the first staple pulley 4181 and the second staple pulley 4191 must also rotate in the same direction together with the pulleys 4111 and 4121. If the first staple pulley 4181 and the second staple pulley 4191 do not rotate together when the pulleys 4111 and 4121 rotate around the rotation shaft 4143, there is a risk that the cartridge 4500 connected to the first staple pulley 4181 and the second staple pulley 4191 will move relative to the first jaw 4101 and be separated from the first jaw 4101. Furthermore, rotation of the first staple pulley 4181 and the second staple pulley 4191 out of synchronization with the pulley 4111 can cause unintended advancement of the reciprocating member 4551, which can result in unintended stapling.

[0568] Next, when the end tool 4100 yaws, the first staple pulley 4181 and the second staple pulley 4191 also yaw. That is, when the pulley 4111 and the pulley 4121 perform a yaw motion in which they rotate in the same direction around the rotation shaft 4141, the first staple pulley 4181 and the second staple pulley 4191 must also rotate in the same direction as the pulleys 4111 and 4121. If the first staple pulley 4181 and the second staple pulley 4191 do not rotate together when the pulleys 4111 and 4121 rotate around the rotation shaft 4141, there is a risk that the cartridge 4500 connected to the first staple pulley 4181 and the second staple pulley 4191 will move relatively to the first jaw 4101 and be separated from the first jaw 4101. Furthermore, rotation of the first staple pulley 4181 and the second staple pulley 4191 out of synchronization with the pulley 4111 can cause unintended advancement of the reciprocating member 4551, which can result in unintended stapling.

[0569] Next, during actuation of the end tool 4100, the first staple pulley 4181 and the second staple pulley 4191 rotate together with the pulley 4111. That is, when the pulley 4111 and the pulley 4121 perform actuation motion in which they rotate in opposite directions about the rotation shaft 4141, the first staple pulley 4181 and the second staple pulley 4191 must rotate together with the pulley 4111. If the first staple pulley 4181 and the second staple pulley 4191 do not rotate together when the pulley 4111 rotates about the rotation shaft 4143, there is a risk that the cartridge 4500 connected to the first staple pulley 4181 and the second staple pulley 4191 will move relative to the first jaw 4101 and be separated from the first jaw 4101. Furthermore, rotation of the first staple pulley 4181 and the second staple pulley 4191 out of synchronization with the pulley 4111 can cause unintended advancement of the reciprocating member 4551, which can result in unintended stapling.

[0570] On the other hand, the pulley 4111 and the pulley 4121 do not rotate during the stapling and cutting operations of the end tool 4100. In other words, if the link member 4171 and the reciprocating member 4551 of the cartridge 4500 connected thereto perform linear reciprocating motion while the first staple pulley 4181 and the second staple pulley 4191 rotate about the rotation shaft 4141, the pulley 4111 and the pulley 4121 must not rotate. Otherwise, the first jaw 4101 or the second jaw 4102 would rotate during the stapling and cutting operations, preventing the stapling and cutting operations from being performed normally.

[0571] As a result, when the pulley 4111, which is the first jaw pulley, rotates, the first staple pulley 4181 and the second staple pulley 4191 housed inside the first jaw 4101 must also rotate together with the pulley 4111. On the other hand, when the first staple pulley 4181 and the second staple pulley 4191 rotate for stapling and cutting, the pulleys 4111 and 4121 must be formed so as to maintain their positions without rotating. The correlation between such stapling and cutting operations and other operations (yawing operation and actuation operation) has been described above.

[0572] From another perspective, this can be expressed as the pulley 4111 and the pulley 4121 being independent of the rotation of the first staple pulley 4181 and the second staple pulley 4191. In other words, even if the first staple pulley 4181 and the second staple pulley 4191 are rotated by the staple wire, the pulleys 4111 and 4121 do not have to rotate. Conversely, the first staple pulley 4181 and the second staple pulley 4191 can be expressed as being dependent on the rotation of the pulley 4111. In other words, when the pulley 4111 is rotated by the jaw wire, the first staple pulley 4181 and the second staple pulley 4191 can be formed so that they also rotate together with the pulley 4111.

[0573] Figures 58 and 60 are diagrams showing a state in which the jaw has yaw rotated by -90°, and Figures 59 and 61 are diagrams showing the process of performing an actuation operation in a state in which the jaw has yaw rotated by -90°. Here, Figures 58 and 59 are diagrams showing the pulley 4111, and Figures 60 and 61 are diagrams in which the pulley 4111 is omitted.

[0574] Figures 62 and 64 are diagrams showing a state in which the jaw has yaw rotated by +90°, and Figures 63 and 65 are diagrams showing the process of performing an actuation operation in a state in which the jaw has yaw rotated by +90°. Here, Figures 62 and 63 are diagrams showing the pulley 4111, and Figures 64 and 65 are diagrams in which the pulley 4111 is omitted.

[0575] As shown in Figures 58 to 65, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal actuation even when the jaw is yaw rotated by +90° or -90°.

[0576] 66 and 67 are plan views showing the stapling and cutting operations of the endotool of the surgical instrument of Fig. 2, illustrating the process of performing the stapling and cutting operations with the jaw rotated by +90° in a yaw direction. As shown in Fig. 66, the endotool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal stapling and cutting operations even with the jaw rotated by +90° in a yaw direction.

[0577] In detail, when the pulley 4111, the pulley 4121, the first staple pulley 4181, and the second staple pulley 4191 rotate +90° around the rotation shaft 4141, and the first staple pulley 4181 and the second staple pulley 4191 rotate alternately in the clockwise and counterclockwise directions, the link member 4171 and the reciprocating member 4551 connected thereto repeatedly move forward and backward. When the reciprocating member 4551 moves forward, the working member 4540 moves forward together with the reciprocating member 4551, and when the reciprocating member 4551 moves backward, only the reciprocating member 4551 moves backward, and the working member 4540 remains stationary. While repeating this process, the working member 4540 moves toward the distal portion 502, performing stapling and cutting operations.

[0578] 68 and 69 are plan views showing the stapling and cutting operations of the endotool of the surgical instrument of Fig. 2, illustrating the process of performing the stapling and cutting operations with the jaws rotated by -90° in a yaw direction. As shown in Fig. 68, the endotool of the surgical instrument according to the first embodiment of the present invention is formed so that it can perform normal stapling and cutting operations even with the jaws rotated by -90° in a yaw direction.

[0579] In detail, when the pulley 4111, the pulley 4121, the first staple pulley 4181, and the second staple pulley 4191 rotate −90° around the rotation shaft 4141, and the first staple pulley 4181 and the second staple pulley 4191 rotate alternately in the clockwise and counterclockwise directions, the link member 4171 and the reciprocating member 4551 connected thereto repeatedly move forward and backward. When the reciprocating member 4551 moves forward, the working member 4540 moves forward together with the reciprocating member 4551, and when the reciprocating member 4551 moves backward, only the reciprocating member 4551 moves backward, and the working member 4540 remains stationary. While repeating this process, the working member 4540 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0580] Figure 70 shows a state in which the jaw has been pitch rotated by -90°, Figure 71 shows a process of performing an actuation operation in which the jaw has been pitch rotated by -90°, Figure 72 shows a state in which the jaw has been pitch rotated by +90°, and Figure 73 shows a process of performing an actuation operation in which the jaw has been pitch rotated by +90°.

[0581] 70 to 73, it can be seen that the operations of the operating unit 200 and the end tool 4100 intuitively match when performing pitch operation. That is, when the operating unit 200 rotates in the positive direction based on the pitch rotation axis (Y axis), the end tool 4100 also rotates in the positive direction based on the pitch rotation axis (Y axis). Also, when the operating unit 200 rotates in the negative direction based on the pitch rotation axis (Y axis), the end tool 4100 also rotates in the negative direction based on the pitch rotation axis (Y axis). Here, the rotation angles of the operating unit 200 and the end tool 4100 can be set in various ways depending on the ratio of the pulleys.

[0582] Figure 74 shows a state in which the jaw has yaw rotated by +90°, Figure 75 shows a process of performing an actuation operation in which the jaw has yaw rotated by +90°, Figure 76 shows a state in which the jaw has yaw rotated by -90°, and Figure 77 shows a process of performing an actuation operation in which the jaw has yaw rotated by -90°.

[0583] 74 to 77, it can be seen that the operations of the operating unit 200 and the end tool 4100 intuitively match when performing yaw operation. That is, when the operating unit 200 rotates in the positive direction based on the yaw rotation axis (Z axis), the end tool 4100 also rotates in the positive direction based on the yaw rotation axis (Z axis). Furthermore, when the operating unit 200 rotates in the negative direction based on the yaw rotation axis (Z axis), the end tool 4100 also rotates in the negative direction based on the yaw rotation axis (Z axis). Here, the rotation angles of the operating unit 200 and the end tool 4100 can be set in various ways depending on the ratio of the pulleys.

[0584] Figure 78 is a diagram showing a state in which the jaw has pitch rotated by -90° and simultaneously rotated in a yaw direction by +90°, Figure 79 is a diagram showing a process in which an actuation operation is performed when the jaw has pitch rotated by -90° and simultaneously rotated in a yaw direction by +90°, Figure 80 is a diagram showing a state in which the jaw has pitch rotated by +90° and simultaneously rotated in a yaw direction by -90°, and Figure 81 is a diagram showing a process in which an actuation operation is performed when the jaw has pitch rotated by +90° and simultaneously rotated in a yaw direction by -90°.

[0585] 78 to 81, it can be seen that the operations of the operating unit 200 and the end tool 4100 intuitively match even when pitch and yaw operations are performed simultaneously.

[0586] <First Modification of First Embodiment>

[0587] The following describes a working member 4540 of a surgical instrument according to a first modified example of the first embodiment of the present invention. The working member 4540 of the surgical instrument according to the first modified example of the first embodiment of the present invention is characteristically different from the working member of the surgical instrument according to the first embodiment of the present invention described above (see 4540 in FIG. 35 etc.) in that it further includes a side wall 4549. The following describes in detail the configuration that differs from the first embodiment.

[0588] Figures 82, 83, and 84 are perspective views showing a working member of a surgical instrument according to a first modified example of the first embodiment of the present invention. Figures 85 and 86 are perspective views showing the working member of Figure 82 coupled with a reciprocating member.

[0589] 82 to 86, a working member 4540 according to a first modified example of the first embodiment of the present invention may include a wedge 4541, a blade 4542, a contact member 4543, an elastic member 4544, a main body 4545, and a holder 4548. The main body 4545 may be formed with a receiving portion 4546 and an inclined portion 4547. Furthermore, the working member 454 of this modified example may further include a side wall 4549.

[0590] Specifically, a side wall 4549 may be further formed on the lower surface of the main body 4545 on the side opposite to the side where the receiving portion 4546 and the inclined portion 4547 are formed. The side wall 4549 may be formed to be able to come into contact with the reciprocating member 4551.

[0591] From another perspective, the first surface of the reciprocating member 4551 may be formed to contact the contact member 4543, and the second surface, which is the surface opposite to the first surface of the reciprocating member 4551, may be formed to contact the side wall 4549.

[0592] In this way, by further providing side wall 4549 that contacts the second surface of reciprocating member 4551, it is possible to obtain the effect of preventing reciprocating member 4551 or contact member 4543 from coming off.

[0593] <Second Modification of First Embodiment>

[0594] The following describes a working member 4640 of a surgical instrument according to a second modified example of the first embodiment of the present invention. The working member 4640 of the surgical instrument according to the second modified example of the first embodiment of the present invention is characteristically different from the working member of the surgical instrument according to the first embodiment of the present invention described above (see 4540 in FIG. 35 etc.) in the configurations of the contact member 4643 and the elastic member 4644. The following describes in detail these different configurations compared to the first embodiment.

[0595] Figures 87, 88, and 89 are perspective views showing a working member of a surgical instrument according to a second modified example of the first embodiment of the present invention. Figure 90 is a plan view showing in more detail the elastic member and contact member of the working member of Figure 87. Figures 91 and 92 are plan views showing the operating states of the elastic member and contact member of the working member of Figure 87. Figures 93 and 94 are plan views showing the clutch driving operation of the end tool of Figure 87.

[0596] 87 to 94, a working member 4640 according to a second modified example of the first embodiment of the present invention may include a wedge 4641, a blade 4642, a contact member 4643, an elastic member 4644, and a main body 4645. The main body 4645 may have a receiving portion 4646 formed therein.

[0597] The body 4645 may be formed in the shape of a rectangular pillar and forms the base of the working member 4640 .

[0598] The main body 4645 may have a receiving portion 4646. Specifically, a plurality of receiving portions 4646 may be formed on the lower surface of the main body 4645, and each receiving portion 4646 may receive a contact member 4643 and an elastic member 4644, which will be described later.

[0599] Here, at least a portion of the accommodating portion 4646 is formed in a shape substantially identical to or similar to at least a portion of the contact member 4643, and when the contact member 4643 is fitted into the accommodating portion 4646, the position of the contact member 4643 can be fixed. Specifically, a portion of the accommodating portion 4646 is formed in a shape substantially identical to or similar to a main body portion 4643c of the contact member 4643, which will be described later, and the main body portion 4643c of the contact member 4643 can be fitted into the accommodating portion 4646. In this way, the contact member 4643 may be formed to be rotatable without a separate rotation axis when a portion of the contact member 4643 is fitted into the accommodating portion 4646.

[0600] The wedge 4641 may be formed on at least one side of the body 4645 and may be formed to have a predetermined inclined surface.

[0601] One side of the wedge 4641, more particularly the proximal portion 4601 side of the wedge 4641, may be formed with a blade 4642.

[0602] The contact member 4643 may be formed on one side of the main body 4645, more specifically, on the lower part of the main body 4645, and may be formed to face the reciprocating member 4651. Here, in this modified example, the contact member 4643 may be formed in the form of a sprag, and may be formed to be able to come into contact with the inner surface forming the receiving portion 4646 of the main body 4645 and the reciprocating member 4651.

[0603] More specifically, the contact member 4643 may be configured to be in contact with or spaced apart from the reciprocating member 4651 and the body 4645 .

[0604] Here, when the contact member 4643 is in contact with the main body 4645 and the reciprocating member 4651 at the same time, a kind of locked state is created in which the movement of the reciprocating member 4651 relative to the working member 4540 is restricted, and when the reciprocating member 4651 moves in one direction, the entire moving member 4640 including the contact member 4643 moves in one direction together with the reciprocating member 4651.

[0605] On the other hand, when the contact member 4643 is spaced apart to a certain extent from the reciprocating member 4651 and / or the main body 4645, a kind of unlocked state is established, allowing the reciprocating member 4651 to move relative to the working member 4540. Therefore, even if the reciprocating member 4651 moves in one direction, the moving member 4640 remains stationary and does not move.

[0606] The elastic member 4644 is formed between the main body 4645 and the contact member 4643, and serves to apply a predetermined elastic force to the contact member 4643. For example, one region of the elastic member 4644 may be formed to contact the main body 4645, and another region of the elastic member 4644 may be formed to contact the contact member 4643. Here, the elastic member 4644 can apply an elastic force in a direction to press the contact member 4643. For this purpose, the elastic member 4644 can be provided in various forms capable of applying a predetermined elastic force to the contact member 4643, such as a leaf spring, a coil spring, or a disc spring.

[0607] In this second modification of the first embodiment of the present invention, the reciprocating assembly 4650 and the working member 4640 form a type of one-way clutch, in particular a sprag clutch.

[0608] Specifically, when the reciprocating member 4651 advances toward the distal portion 4602 of the cartridge 4600, the movement of the reciprocating member 4651 is transmitted to the working member 4640 due to the frictional force caused by the engagement, and both the reciprocating member 4651 and the working member 4640 move toward the distal portion 4602 of the cartridge 4600.

[0609] On the other hand, when the reciprocating member 4651 retreats toward the proximal portion 4601 of the cartridge 4600, the contact member 4643 is spaced a certain distance from the main body 4645 and the reciprocating member 4651, so the movement of the reciprocating member 4651 is not transmitted to the working member 4640, and only the reciprocating member 4651 moves independently toward the proximal portion 4601 of the cartridge 4600, and the working member 4640 does not move.

[0610] This will be explained in more detail as follows.

[0611] The main body 4645 and the reciprocating member 4651 of the working member 4640 are formed to be movable relative to each other. That is, the reciprocating member 4651 is formed to be movable relative to the main body 4645 along the longitudinal direction of the shaft.

[0612] The sprag-like contact member 4643 includes a main body portion 4643c, a first protrusion portion 4643a, and a second protrusion portion 4643b.

[0613] The main body 4643c is formed to have a substantially circular cross section. Such a main body 4643c may be fitted into the housing 4646 and formed to be rotatable within the housing 4646.

[0614] The first protrusion 4643a is formed to protrude in either direction from the main body 4643c. Here, the first protrusion 4643a may be formed so as to be able to come into contact with the inner surface of the main body 4645 that forms the storage portion 4646. On the other hand, the first protrusion 4643a may be formed so that the distance from the center of the main body 4643c increases as the protrusion progresses counterclockwise. In other words, the first protrusion 4643a may be formed asymmetrically. From another perspective, this can also be expressed as the first protrusion 4643a being formed so that the distance from the center of the main body 4643c to the end of the first protrusion 4643a increases as the protrusion progresses toward the distal portion (see 4502 in FIG. 29) of the cartridge 4640.

[0615] The second protrusion 4643b is formed to protrude in the other direction from the main body 4643c. Here, the second protrusion 4643b may be formed to be able to come into contact with the reciprocating member 4651. On the other hand, the second protrusion 4643b may be formed so that its distance from the center of the main body 4643c increases as it progresses counterclockwise. In other words, the second protrusion 4643b may be formed asymmetrically. From another perspective, this can also be expressed as the distance from the center of the main body 4643c to the end of the second protrusion 4643b increasing as it progresses toward the proximal portion (see 4501 in FIG. 29) of the cartridge 4640.

[0616] Here, when a transverse line is drawn that connects one end of the first protrusion 4643a through the center of the main body 4643c to one end of the second protrusion 4643c, this transverse line may be formed so that it becomes longer as it progresses in the counterclockwise direction, as shown in Fig. 90. Here, the length of the transverse line can be defined as the center distance.

[0617] Here, the region where the center distance is relatively long can be defined as the long axis portion, and the region where the center distance is relatively short can be defined as the short axis portion. That is, in Figure 90, the region where the center distance is a1 can be called the long axis portion, and the region where the center distance is a3 can be called the short axis portion.

[0618] At this time, the contact member 4643 has a shape in which the center distance increases as it advances counterclockwise. That is, the relationship a1>a2>a3 is established.

[0619] Therefore, when the contact member 4643 rotates clockwise to a certain extent, the contact member 4643 comes into contact with the working member 4640 and the reciprocating member 4651. In other words, the contact member 4643 is sandwiched between the working member 4640 and the reciprocating member 4651. When the contact member 4643 further rotates clockwise in this state, a kind of lock state is established in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted by the contact member 4643.

[0620] Conversely, when the contact member 4643 rotates counterclockwise to a certain extent, the contact member 4643 is separated from the working member 4640 and the reciprocating member 4651. This state is an unlocked state in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted by the contact member 4643.

[0621] Here, the elastic member 4644 applies a predetermined elastic force to the contact member 4643 in a direction that rotates the contact member 4643 clockwise. Therefore, in the absence of an external force, the elastic member 4644 causes the contact member 4643 to rotate clockwise to a certain extent, and the contact member 4643 enters a locking state in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted.

[0622] 91 and 92 are plan views showing the operating states of the elastic members and sprags of the working member of FIG.

[0623] 91 (i.e., toward the distal portion (see 4502 in FIG. 29) of the cartridge 4640), the elastic force applied by the elastic member 4644 to the contact member 4643 and the frictional force between the reciprocating member 4651 and the contact member 4643 cause the contact member 4643 to rotate in the direction of arrow B1 in FIG. 91 (i.e., clockwise). When the contact member 4643 rotates in the direction of arrow B1 in FIG. 91 (i.e., clockwise), the major axis portion (i.e., the region where the center distance is A1) of the contact member 4643 is positioned vertically, and the contact member 4643 enters a kind of locked state in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted. In other words, the contact member 4643 restricts the relative movement between the working member 4640 and the reciprocating member 4651, so that the reciprocating member 4651 cannot move independently and the working member 4640 and the reciprocating member 4651 move together as a unit. Therefore, when the reciprocating member 4651 moves in the A1 direction in FIG. 91, the working member 4640 also moves in the A1 direction.

[0624] On the other hand, when the reciprocating member 4651 moves in the direction A2 in FIG. 92 (i.e., toward the proximal portion (see 4501 in FIG. 29) of the cartridge 4640), the frictional force between the reciprocating member 4651 and the contact member 4643 causes the contact member 4643 to rotate in the direction of arrow B2 in FIG. 92 (i.e., counterclockwise). When the contact member 4643 rotates in the direction of arrow B2 in FIG. 92 (i.e., counterclockwise), the short axis portion of the contact member 4643 (i.e., the region with a center distance of A3) is positioned vertically, and the contact member 4643 is spaced apart to a certain extent from the working member 4640 and the reciprocating member 4651. In other words, an unlocked state is reached in which the working member 4640 and the reciprocating member 4651 can move relative to each other. Therefore, even if the reciprocating member 4651 moves in the A2 direction in FIG. 92, the working member 4540 does not move together with the reciprocating member 4651 and remains stationary.

[0625] From another perspective, when the reciprocating member 4651 moves to the distal portion 4602 of the cartridge 4600, the contact member 4643 engages between the reciprocating member 4651 and the working member 4640, blocking the relative movement between the reciprocating member 4651 and the working member 4640.

[0626] Conversely, when the reciprocating member 4651 moves to the proximal portion 4601 of the cartridge 4600, the contact member 4643 is released from the engagement state between the reciprocating member 4651 and the working member 4640, thereby enabling relative movement between the reciprocating member 4651 and the working member 4640.

[0627] 93 and 94 are plan views showing the clutch driving operation of the end tool of FIG.

[0628] 93(a), when the reciprocating member 4651 moves in the direction of arrow A1 in FIG. 93(b) (i.e., toward the distal portion), the contact member 4643 rotates clockwise, and a kind of lock state is established in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted by the contact member 4643. That is, since the working member 4640 and the reciprocating member 4651 move together, when the reciprocating member 4651 moves in the A1 direction, the working member 4640 also moves in the B1 direction.

[0629] In this state, when the movement direction of the reciprocating member 4651 is switched as shown by arrow A2 in Fig. 93(c) (i.e., when movement toward the distal portion is switched to movement toward the proximal portion), the contact member 4643 rotates in the direction of arrow C2 in Fig. 93(c) (i.e., counterclockwise), and an unlocked state is reached in which relative movement is possible between the working member 4640 and the reciprocating member 4651. Therefore, even if the reciprocating member 4651 moves in the A2 direction in Fig. 93(c), the working member 4640 remains stopped.

[0630] In this state, if the reciprocating member 4651 continues to move in the direction of arrow A3 in Figure 93(d) (i.e., toward the proximal portion), the contact member 4643 will maintain a state in which it is spaced apart from the reciprocating member 4651 and the working member 4640. That is, an unlocked state in which the working member 4640 and the reciprocating member 4651 can move relative to each other is maintained. Therefore, even if the reciprocating member 4651 moves in the direction of arrow A3 in Figure 93(d), the working member 4640 will maintain a stopped state.

[0631] In this state, when the movement direction of the reciprocating member 4651 is switched as shown by arrow A4 in Fig. 93(e) (i.e., when movement toward the proximal portion is switched to movement toward the distal portion), the contact member 4643 rotates in the direction of arrow C4 in Fig. 93(e) (i.e., clockwise), and a kind of locked state is established in which the relative movement between the working member 4640 and the reciprocating member 4651 is restricted by the contact member 4643. In this state, when the reciprocating member 4651 moves toward the distal portion, the working member 4640 also moves toward the distal portion.

[0632] This process is repeated as the working member 4640 advances distally, cutting and stapling in the process.

[0633] From another perspective, as shown in Figure 94, when the reciprocating member 4640 moves in the direction of arrow A1 in Figure 94(b) (i.e., toward the distal portion), the working member 4640 also moves in the direction of arrow B1 in Figure 94(b) (i.e., toward the distal portion). On the other hand, when the reciprocating member 4640 moves in the direction of arrow A2 in Figure 94(d) (i.e., toward the proximal portion), the working member 4640 does not move and remains stationary. As a result, while the reciprocating member 4641 repeatedly moves forward and backward, the working member 4640 moves toward the distal portion while repeatedly moving forward and stopping.

[0634] <Third Modification of First Embodiment>

[0635] The following describes a working member 4640 of a surgical instrument according to a third modified example of the first embodiment of the present invention. The working member 4640 of the surgical instrument according to the third modified example of the first embodiment of the present invention is characteristically different from the working member of the surgical instrument according to the second modified example of the first embodiment of the present invention (see 4640 in FIG. 87 etc.) described above in that it further includes a side wall 4649. The following describes in detail the configuration that differs from the second modified example.

[0636] Figures 95 and 96 are perspective views showing a working member of a surgical instrument according to a third modified example of the first embodiment of the present invention, and Figure 97 is a perspective view showing the working member of Figure 95 coupled with a reciprocating member.

[0637] 95 to 97, a working member 4640 according to a third modified example of the first embodiment of the present invention may include a wedge 4641, a blade 4642, a contact member 4643, an elastic member 4644, and a main body 4645. A receiving portion 4646 may be formed in the main body 4645. Furthermore, the working member 4640 of this modified example may further include a side wall 4649.

[0638] Specifically, a side wall 4649 may be further formed on the lower surface of the main body 4645 on the side opposite to the side where the receiving portion 4646 is formed. The side wall 4649 may be formed to be able to come into contact with the reciprocating member 4651.

[0639] From another perspective, the first surface of the reciprocating member 4651 may be formed to contact the contact member 4643, and the second surface, which is the surface opposite to the first surface of the reciprocating member 4651, may be formed to contact the side wall 4649.

[0640] In this way, by further providing the side wall 4649 that contacts the second surface of the reciprocating member 4651, it is possible to obtain the effect of preventing the reciprocating member 4651 or the contact member 4643 from coming off.

[0641] <Fourth Modification of First Embodiment>

[0642] The following describes a working member 4740 of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. The working member 4740 of the surgical instrument according to the fourth modified example of the first embodiment of the present invention is characteristically different from the working member of the surgical instrument according to the second modified example of the first embodiment of the present invention (see 4640 in Figure 87, etc.) in the configuration of the contact member 4743. The following describes in detail the configuration that differs from the second modified example.

[0643] Figures 98, 99, and 100 are perspective views showing a working member of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. Figure 101 is a plan view showing in more detail the elastic member and contact member of the working member of Figure 98. Figures 102 and 103 are plan views showing the operating states of the elastic member and contact member of the working member of Figure 98. Figures 104 and 105 are plan views showing the clutch driving operation of the end tool of Figure 98.

[0644] 98 to 105, a working member 4740 according to the fourth modified example of the first embodiment of the present invention may include a wedge 4741, a blade 4742, a contact member 4743, an elastic member 4744, and a main body 4745. The main body 4745 may have a housing portion 4746 formed therein. Here, the other components except for the contact member 4743 are the same as the working member of the surgical instrument according to the second modified example of the first embodiment (see 4640 in FIG. 87 etc.), and therefore detailed description thereof will be omitted.

[0645] The contact member 4743 may be formed on one side of the main body 4745, more specifically, on the lower part of the main body 4745, and may be formed to face the reciprocating member 4751. Here, in this modified example, the contact member 4743 may be formed in the form of a sprag, and may be formed to be able to come into contact with the reciprocating member 4751.

[0646] That is, in the modified example shown in Figure 87 etc., the contact member 4643 is formed so as to be able to come into contact with the inner surface forming the storage section 4646 of the main body 4645 and the reciprocating member 4651 at the same time, whereas in this modified example shown in Figure 98 etc., the contact member 4743 is formed so as to be able to come into contact only with the reciprocating member 4751, which is a characteristic difference.

[0647] More specifically, the contact member 4743 may be formed so as to be in contact with or spaced apart from the reciprocating member 4751 .

[0648] Here, when the contact member 4743 is in contact with the reciprocating member 4751, a kind of locked state is created in which the movement of the reciprocating member 4751 relative to the working member 4540 is restricted, and when the reciprocating member 4751 moves in one direction, the entire moving member 4740 including the contact member 4743 moves in one direction together with the reciprocating member 4751.

[0649] On the other hand, when the contact member 4743 is spaced apart from the reciprocating member 4751 to a certain extent, a kind of unlocked state is reached, allowing the reciprocating member 4751 to move relative to the working member 4540. Therefore, even if the reciprocating member 4751 moves in one direction, the moving member 4740 remains stationary and does not move.

[0650] In this fourth modification of the first embodiment of the present invention, the reciprocating assembly 4750 and the working member 4740 form a type of one-way clutch, in particular a sprag clutch.

[0651] Specifically, the main body 4745 and the reciprocating member 4751 of the working member 4740 are formed to be movable relative to each other. That is, the reciprocating member 4751 is formed to be movable relative to the main body 4745 along the longitudinal direction of the shaft.

[0652] The sprag-like contact member 4743 includes a main body portion 4743c, a first protruding portion 4743a, and a second protruding portion 4743b.

[0653] The main body portion 4743c is formed to have a substantially circular cross section. Such a main body portion 4743c may be fitted into the accommodation portion 4746 and formed to be rotatable within the accommodation portion 4746.

[0654] The first protrusion 4743a is formed to protrude in either direction from the main body 4743c. Here, the first protrusion 4743a may be formed so as not to come into contact with the inner surface of the main body 4745 that forms the receiving portion 4746.

[0655] The second protrusion 4743b is formed to protrude in the other direction from the main body 4743c. Here, the second protrusion 4743b may be formed to be able to come into contact with the reciprocating member 4751. Meanwhile, the second protrusion 4743b may be formed so that its distance from the center of the main body 4743c increases as it progresses counterclockwise. In other words, the second protrusion 4743b may be formed asymmetrically. From another perspective, this can also be expressed as the distance from the center of the main body 4743c to the end of the second protrusion 4743b increasing as it progresses toward the proximal portion (see 4501 in FIG. 29) of the cartridge 4740.

[0656] Here, when a transverse line is drawn connecting the center of main body portion 4743c to one end of second protrusion portion 4743b, this transverse line may be formed so that it becomes longer as it progresses counterclockwise, as shown in Fig. 101. Here, the length of the transverse line can be defined as the center distance.

[0657] Here, the region where the center distance is relatively long can be defined as the long axis portion, and the region where the center distance is relatively short can be defined as the short axis portion. That is, in Figure 101, the region where the center distance is a1 can be called the long axis portion, and the region where the center distance is a3 can be called the short axis portion.

[0658] At this time, the contact member 4743 has a shape in which the center distance increases as it advances counterclockwise. In other words, the relationship a1>a2>a3 holds.

[0659] Therefore, when the contact member 4743 rotates clockwise to a certain extent, the contact member 4743 comes into contact with the reciprocating member 4751. When the contact member 4743 rotates further clockwise in this state, a kind of lock state is established in which the relative movement between the working member 4740 and the reciprocating member 4751 is restricted by the contact member 4743.

[0660] Conversely, when the contact member 4743 rotates counterclockwise by a certain amount, the contact member 4743 moves away from the reciprocating member 4751. This state is an unlocked state in which the relative movement between the working member 4740 and the reciprocating member 4751 is restricted by the contact member 4743.

[0661] Here, the elastic member 4744 applies a predetermined elastic force to the contact member 4743 in a direction that rotates the contact member 4743 clockwise. Therefore, in the absence of an external force, the ...

Claims

1. A surgical instrument cartridge having an end tool that can be rotated in at least one direction, housing, a cover covering one surface of the housing and having a slit formed along a first direction that is a longitudinal direction of the housing; a plurality of staples disposed within the housing along the first direction; a reciprocating member disposed inside the housing and configured to be movable relative to the housing along the first direction; and a contact member formed on one side of the reciprocating member and configured to be able to come into contact with the reciprocating member, and a working member configured to be able to move along the first direction by the reciprocating member, When the reciprocating member moves to the distal portion of the cartridge, the contact member restricts the relative movement between the working member and the reciprocating member, and the reciprocating member and the working member move together; A surgical instrument cartridge characterized in that when the reciprocating member moves to the proximal portion of the cartridge, relative movement between the working member and the reciprocating member becomes possible, and only the reciprocating member moves.

2. 2. The surgical instrument cartridge of claim 1, wherein the reciprocating member is coupled to a staple drive assembly formed on the end tool, and when a staple pulley of the staple drive assembly rotates, the reciprocating member moves along the first direction.

3. When the staple pulley rotates alternately in the clockwise and counterclockwise directions, 3. The surgical instrument cartridge according to claim 2, wherein the reciprocating member coupled to the staple drive assembly alternates between moving toward a distal end and a proximal end of the cartridge.

4. When the reciprocating member moves to the distal portion of the cartridge, the contact member and the reciprocating member are engaged with each other, restricting the relative movement between the working member and the reciprocating member; 2. The surgical instrument cartridge according to claim 1, wherein when the reciprocating member moves to a proximal portion of the cartridge, the engagement between the contact member and the reciprocating member is released, allowing relative movement between the working member and the reciprocating member.

5. 2. The surgical instrument cartridge according to claim 1, wherein the working member is movable only toward a distal portion of the cartridge and is restricted from moving toward a proximal portion of the cartridge.

6. 2. The surgical instrument cartridge according to claim 1, wherein the working member and the reciprocating member form a one-way clutch that allows movement in only one direction and restricts movement in the opposite direction.

7. The working member is Main body, one or more wedges formed on one side of the body, the wedges including a sloped surface formed to have a height that is greater on a proximal side of the cartridge than on a distal side of the cartridge; a blade formed on one side of the wedge and including a sharply formed edge; 2. The surgical instrument cartridge according to claim 1, wherein the contact member is disposed in a receiving portion formed on one surface of the main body.

8. When the reciprocating member moves toward the distal portion of the cartridge, 8. The surgical instrument cartridge according to claim 7, wherein the contact member and the reciprocating member are engaged with each other, and the reciprocating member pushes the working member including the contact member, thereby moving the working member toward the distal end of the cartridge.

9. When the reciprocating member moves toward the proximal portion of the cartridge, 8. The surgical instrument cartridge according to claim 7, wherein the working member is stationary in the one direction.

10. When the reciprocating member moves toward the proximal portion of the cartridge, 8. The surgical instrument cartridge according to claim 7, wherein the contact member is formed to be spaced apart from the reciprocating member by a certain amount.

11. 8. The surgical instrument cartridge according to claim 7, further comprising an elastic member formed between the body and the contact member, for providing an elastic force to press the contact member in either direction.

12. The housing portion formed in the main body has an inclined portion formed on a surface facing the reciprocating member, 12. A surgical instrument cartridge according to claim 11, wherein the width of the receiving portion narrows as it moves towards the distal end of the cartridge.

13. 13. The surgical instrument cartridge according to claim 12, wherein the distance between the inclined portion and the reciprocating member is formed to decrease toward the distal end of the cartridge.

14. 14. The surgical instrument cartridge according to claim 13, wherein when the contact member is pressed in a direction that decreases the distance between the inclined portion and the reciprocating member, the contact member and the reciprocating member enter an engaged state, and relative movement between the reciprocating member and the working member is blocked.

15. When the contact member simultaneously contacts the working member and the reciprocating member to enter an engaged state, a locked state is entered in which relative movement between the working member and the reciprocating member is blocked, 13. The surgical instrument cartridge according to claim 12, wherein when the contact member separates from at least one of the working member and the reciprocating member to release the engaged state, the cartridge is in an unlocked state in which the working member and the reciprocating member are capable of moving relative to each other.

16. 13. The surgical instrument cartridge according to claim 12, wherein the elastic member presses the contact member in a direction that decreases the distance between the inclined portion and the reciprocating member.

17. 12. The surgical instrument cartridge according to claim 11, wherein the contact member is formed so that a center distance, which is a distance from the center of rotation to an end, differs in each region.

18. When the region of the contact member where the center distance is relatively long comes into contact with the reciprocating member, the contact member and the reciprocating member are fitted together, and the relative movement between the working member and the reciprocating member is restricted, 18. A surgical instrument cartridge according to claim 17, wherein when the region of the contact member where the center distance is relatively short comes into contact with the reciprocating member, the engagement between the contact member and the reciprocating member is released, thereby enabling relative movement between the working member and the reciprocating member.

19. the contact member includes a main body portion and a protrusion portion that protrudes from the main body portion and is capable of contacting the reciprocating member, 18. The surgical instrument cartridge according to claim 17, wherein the protrusion includes a long shaft portion having the relatively long center distance and a short shaft portion having the relatively short center distance.

20. When torque is applied to the contact member in a direction in which the long shaft portion contacts the reciprocating member, the contact member and the reciprocating member come into an engaged state, 20. The surgical instrument cartridge according to claim 19, wherein when torque is applied to the contact member in a direction in which the shortened portion contacts the reciprocating member, the engagement between the contact member and the reciprocating member is released.

21. 20. A surgical instrument cartridge according to claim 19, characterized in that the contact member is formed so that the center distance from the center of the main body portion to the end of the protrusion increases as the contact member progresses toward the proximal portion of the cartridge.

22. 20. The surgical instrument cartridge according to claim 19, wherein the elastic member presses the contact member in a direction in which the long shaft portion contacts the reciprocating member.

23. 2. The surgical instrument cartridge according to claim 1, wherein said contact members are sprags.

24. 2. The surgical instrument cartridge according to claim 1, wherein the contact member is a cam that rotates around a predetermined rotation axis.

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