End tool for surgical instrument and surgical instrument equipped with same

Abstract

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.

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 has an end tool that can rotate in two or more directions and operates in a manner that intuitively matches the operation of the operating part, and a surgical instrument equipped with the same. [Background technology]

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

[0003] When performing such laparoscopic surgery, a suturing 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 rotate in two or more directions and that operates in a manner that intuitively matches the operation of the operating part. [Means for solving the problem]

[0008] One embodiment of the present invention provides a surgical instrument including: 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 rotatable about a first axis, a second jaw pulley coupled to the second jaw and rotatable about an axis substantially the same as or parallel to the first axis and spaced a certain distance from the first jaw pulley, and one or more staple pulleys at least a portion of which is formed between the first jaw pulley and the second jaw pulley; a reciprocating assembly connected to the staple drive assembly and moving linearly when the staple pulley rotates; and a cartridge including a working member that comes into contact with the reciprocating assembly and is moved in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction.

[0009] Other aspects, features, and advantages beyond those described above will become apparent from the following drawings, claims, and detailed description of the invention. [Effects of the Invention]

[0010] 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]

[0011] [Figure 1A] FIG. 1 is a conceptual diagram of the pitch movement of a conventional surgical instrument. [Figure 1B] FIG. 1 is a conceptual diagram of the yaw motion of a conventional surgical instrument. [Figure 1C] FIG. 10 is a conceptual diagram of the pitch movement of another conventional surgical instrument. [Figure 1D] FIG. 10 is a conceptual diagram of the yaw motion of another conventional surgical instrument. [Figure 1E] 1 is a conceptual diagram of the pitch movement of a surgical instrument according to the present invention. [Figure 1F] 1 is a conceptual diagram of the yaw movement 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 an exploded perspective view showing a staple pulley and a staple link of the surgical instrument of FIG. 2. FIG. [Figure 14] 3 is a plan view showing a first jaw of the surgical instrument of FIG. 2. FIG. [Figure 15] 3 is a plan view showing a second jaw of the surgical instrument of FIG. 2. FIG. [Figure 16] 3 is a plan view showing the opening and closing operation of a first jaw of the surgical instrument of FIG. 2. [Figure 17] 3 is a plan view showing the opening and closing operation of a second jaw of the surgical instrument of FIG. 2. [Figure 18] 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 19] 3 is a perspective view showing the opening and closing operation of an end tool of the surgical instrument of FIG. 2. [Figure 20] 3 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 2. [Figure 21] 3 is a perspective view showing a first jaw and a cartridge of the surgical instrument of FIG. 2. FIG. [Figure 22] FIG. 22 is an exploded perspective view showing the cartridge of FIG. 21. [Figure 23] FIG. 22 is an assembled perspective view showing the cartridge of FIG. 21. [Figure 24] FIG. 22 is a side view showing the cartridge of FIG. 21. [Figure 25] FIG. 22 is a perspective cross-sectional view showing the cartridge of FIG. 21. [Figure 26] FIG. 22 is a side cross-sectional view showing the cartridge of FIG. 21. [Figure 27] FIG. 22 is a perspective view showing a working member of the cartridge of FIG. 21. [Figure 28] FIG. 22 is a perspective view showing a working member of the cartridge of FIG. 21. [Figure 29] 3 is a side cross-sectional view showing a structure relating to stapling of an end tool of the surgical instrument of FIG. 2. FIG. [Figure 30] 3 is a perspective cross-sectional view showing the stapling structure of the end tool of the surgical instrument of FIG. 2. FIG. [Figure 31] 3 is a perspective cross-sectional view showing the stapling structure of the end tool of the surgical instrument of FIG. 2. FIG. [Figure 32] 31 is a perspective view showing the ratchet drive operation of the end tool of FIG. 30. [Figure 33] 31 is a perspective view showing the ratchet drive operation of the end tool of FIG. 30. [Figure 34] 31 is a perspective view showing the ratchet drive operation of the end tool of FIG. 30. [Figure 35]31 is a perspective view showing the ratchet drive operation of the end tool of FIG. 30. [Figure 36] 31 is a plan view showing the ratchet driving operation of the end tool of FIG. 30. FIG. [Figure 37] 31 is a plan view showing the ratchet driving operation of the end tool of FIG. 30. FIG. [Figure 38] 31 is a perspective view generally illustrating the ratchet drive operation of the end tool of FIG. 30. FIG. [Figure 39] FIG. 31 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 30. [Figure 40] FIG. 31 is a perspective view generally illustrating the stapling operation of the end tool of FIG. 30. [Figure 41] FIG. 3 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. [Figure 42] FIG. 3 is a perspective view showing an operating portion of the surgical instrument of FIG. 2. [Figure 43] 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 44] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 45] 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 46] 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 47] 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 48] 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 49]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 50] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 51] 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 52] 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 53] 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 54] 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 55] 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 56] 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 57] 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 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 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 jaw is yaw-rotated by +90°. FIG. [Figure 63] 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 jaw is yaw-rotated by −90°. FIG. [Figure 64] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 65] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 66] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 67] FIG. 3 is a perspective view showing a pitch movement of the surgical instrument of FIG. 2. [Figure 68] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 69] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 70] FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 71]FIG. 3 is a perspective view showing the yaw movement of the surgical instrument of FIG. 2. [Figure 72] 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 73] 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 74] 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 75] 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 76] FIG. 10 is a view showing a cartridge of a surgical instrument according to a first modified example of the first embodiment of the present invention. [Figure 77] FIG. 10 is a view showing a cartridge of a surgical instrument according to a first modified example of the first embodiment of the present invention. [Figure 78] FIG. 10 is a view showing a cartridge of a surgical instrument according to a second modified example of the first embodiment of the present invention. [Figure 79] FIG. 10 is a view showing a cartridge of a surgical instrument according to a second modified example of the first embodiment of the present invention. [Figure 80] FIG. 10 is a view showing a cartridge of a surgical instrument according to a third modified example of the first embodiment of the present invention. [Figure 81] FIG. 10 is a view showing a cartridge of a surgical instrument according to a third modified example of the first embodiment of the present invention. [Figure 82] FIG. 10 is a view showing a cartridge of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. [Figure 83] FIG. 10 is a view showing a cartridge of a surgical instrument according to a fourth modified example of the first embodiment of the present invention. [Figure 84] FIG. 10 is a view showing a cartridge of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. [Figure 85]FIG. 10 is a view showing a cartridge of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. [Figure 86] 85 is a diagram showing the operating state of the cartridge of FIG. 84. FIG. [Figure 87] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a second embodiment of the present invention. [Figure 88] FIG. 88 is an enlarged view of the end tool of the surgical instrument of FIG. 87. [Figure 89] FIG. 88 is an enlarged view of the end tool of the surgical instrument of FIG. 87. [Figure 90] 88 is an enlarged view showing the end tool of the surgical instrument of FIG. 87 from another angle. [Figure 91] 88 is an enlarged view showing the end tool of the surgical instrument of FIG. 87 from another angle. [Figure 92] FIG. 88 shows a state in which the jaw of the end tool of the surgical instrument of FIG. 87 has been yaw-rotated by 90° counterclockwise. [Figure 93] FIG. 88 shows a state in which the jaw of the end tool of the surgical instrument of FIG. 87 has been yaw-rotated by 90° counterclockwise. [Figure 94] FIG. 88 is an enlarged perspective view showing an end tool hub of the surgical instrument of FIG. 87. [Figure 95] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a third embodiment of the present invention. [Figure 96] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a third embodiment of the present invention. [Figure 97] 97 is a perspective view showing the end tool of the surgical instrument of FIG. 96 in an open state. [Figure 98] 97 is a perspective view showing the end tool of the surgical instrument of FIG. 96 in a closed state. [Figure 99] 97 is a side view showing the end tool of the surgical instrument of FIG. 96. FIG. [Figure 100]FIG. 97 is an exploded perspective view of the end tool of the surgical instrument of FIG. 96. [Figure 101] FIG. 97 is an exploded perspective view of the end tool of the surgical instrument of FIG. 96. [Figure 102] 97 is a plan view showing the state in which the first jaw of the end tool of the surgical instrument of FIG. 96 is fully opened. [Figure 103] 97 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 96. [Figure 104] 97 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 96. [Figure 105] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a fourth embodiment of the present invention. [Figure 106] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a fourth embodiment of the present invention. [Figure 107] 106 is a perspective view of the end tool of the surgical instrument of FIG. 105 viewed from another angle. [Figure 108] 106 is a perspective view of the end tool of the surgical instrument of FIG. 105 viewed from another angle. [Figure 109] 106 is a side view showing the end tool of the surgical instrument of FIG. 105. [Figure 110] FIG. 106 is an exploded perspective view of the end tool of the surgical instrument of FIG. 105. [Figure 111] FIG. 106 is an exploded perspective view of the end tool of the surgical instrument of FIG. 105. [Figure 112] FIG. 106 is an exploded perspective view of a staple link assembly of the surgical instrument of FIG. 105; [Figure 113] 106A and 106B are side and plan views showing various operating states of the staple link assembly of FIG. 105. [Figure 114] 106A and 106B are side and plan views showing various operating states of the staple link assembly of FIG. 105. [Figure 115] FIG. 106 is a perspective view showing the internal structure of the end tool of the surgical instrument of FIG. 105. [Figure 116] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 117] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 118] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 119] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 120] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 121] 116 is a perspective view showing each operating state of the end tool of FIG. 115. [Figure 122] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a fifth embodiment of the present invention. [Figure 123] FIG. 123 is an enlarged view of the end tool of the surgical instrument of FIG. 122. [Figure 124] 123 is a side view showing the end tool of the surgical instrument of FIG. 122. [Figure 125] 123 is an exploded perspective view of the end tool of the surgical instrument of FIG. 122. [Figure 126] 123 is an exploded perspective view of the end tool of the surgical instrument of FIG. 122. [Figure 127] 123 is an exploded perspective view of a staple pulley assembly of the surgical instrument of FIG. 122; [Figure 128] FIG. 123 is a plan view showing an operating state of a staple pulley in the end tool of FIG. 122. [Figure 129] 123 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 122. [Figure 130] FIG. 129 is a plan view of FIG. [Figure 131] 123 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 122. [Figure 132] 123 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 122. [Figure 133]123 is a diagram showing the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state. [Figure 134] 123 is a diagram showing the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state. [Figure 135] 123 is a diagram illustrating the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state and performs stapling and cutting operations. [Figure 136] 123 is a diagram illustrating the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state and performs stapling and cutting operations. [Figure 137] 123 is a diagram illustrating the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state and performs stapling and cutting operations. [Figure 138] 123 is a diagram illustrating the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state and performs stapling and cutting operations. [Figure 139] 123 is a diagram illustrating the process in which the end tool of the surgical instrument of FIG. 122 changes from an inactive state to an active state and performs stapling and cutting operations. [Figure 140] FIG. 10 is a perspective view showing an end tool of a surgical instrument according to a sixth embodiment of the present invention. [Figure 141] FIG. 141 is an enlarged view of the end tool of the surgical instrument of FIG. 140. [Figure 142] 141 is a side view showing the end tool of the surgical instrument of FIG. 140. [Figure 143] FIG. 141 is an exploded perspective view of an end tool of the surgical instrument of FIG. 140. [Figure 144] FIG. 141 is an exploded perspective view of an end tool of the surgical instrument of FIG. 140. [Figure 145] FIG. 141 is an exploded perspective view of a staple pulley assembly of the surgical instrument of FIG. 140; [Figure 146]FIG. 141 is a side view showing an operating state of a staple pulley in the end tool of FIG. 140. [Figure 147] 141 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 140. [Figure 148] 141 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 140. [Figure 149] 141 is a perspective view showing the process in which the end tool of the surgical instrument of FIG. 140 changes from an inactive state to an active state. [Figure 150] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to a seventh embodiment of the present invention. [Figure 151] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to a seventh embodiment of the present invention. [Figure 152] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to a seventh embodiment of the present invention. [Figure 153] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to a seventh embodiment of the present invention. [Fig. 154] 151 is a side view showing the end tool of the surgical instrument of FIG. 150. FIG. [Figure 155] 151 is a side view showing the end tool of the surgical instrument of FIG. 150. FIG. [Figure 156] 151 is a plan view showing the end tool of the surgical instrument of FIG. 150. FIG. [Figure 157] 151 is a plan view showing the end tool of the surgical instrument of FIG. 150. FIG. [Figure 158] 151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by +90° in yaw. FIG. [Figure 159] 151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by +90° in yaw. FIG. [Figure 160]151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by +90° in yaw. FIG. [Figure 161] 151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by −90° in yaw. FIG. [Figure 162] 151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by −90° in yaw. FIG. [Figure 163] 151 is a plan view showing the stapling operation of the end tool of the surgical instrument of FIG. 150, showing the process of performing the stapling operation with the jaw rotated by −90° in yaw. FIG. [Fig. 164] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to an eighth embodiment of the present invention. [Figure 165] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to an eighth embodiment of the present invention. [Figure 166] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to an eighth embodiment of the present invention. [Figure 167] FIG. 165 is a perspective view showing the cartridge of the surgical instrument of FIG. 164. [Figure 168] FIG. 165 is a perspective view showing the cartridge of the surgical instrument of FIG. 164. [Figure 169] FIG. 168 is a bottom view of the cartridge of FIG. 167. [Figure 170] 165 is a perspective view showing each operating state of the end tool of FIG. 164. [Figure 171] 165 is a perspective view showing each operating state of the end tool of FIG. 164. [Fig. 172] FIG. 13 is a perspective view showing an end tool of a surgical instrument according to a ninth embodiment of the present invention. [Figure 173]FIG. 173 is a side cross-sectional view showing the cartridge of the surgical instrument of FIG. 172. [Fig. 174] 173 is a perspective view showing a working member of a cartridge of the surgical instrument of FIG. 172. [Figure 175] FIG. 173 is an enlarged perspective view showing the cartridge of the surgical instrument of FIG. 172. [Figure 176] 10A to 10C are diagrams illustrating a process in which a working member moves. [Figure 177] 10A to 10C are diagrams illustrating a process in which a working member moves. [Figure 178] 10A to 10C are diagrams illustrating a process in which a working member moves. [Figure 179] 10A to 10C are diagrams illustrating a process in which a working member moves. [Figure 180] 10A and 10B are views showing a process in which a working member is coupled to a second jaw. [Figure 181] 10A and 10B are views showing a process in which a working member is coupled to a second jaw. [Figure 182] 10A and 10B are views showing a process in which a working member is coupled to a second jaw. [Figure 183] 10A to 10C are views showing a process in which the working member is separated from the second jaw. [Figure 184] 10A and 10B are views showing a process in which the working member is separated from the second jaw. [Figure 185] 10A to 10C are views showing a process in which the working member is separated from the second jaw. BEST MODE FOR CARRYING OUT THE INVENTION

[0012] According to an embodiment of the present invention, a surgical instrument includes an end tool 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 a staple drive assembly including one or more staple pulleys at least a portion of which is formed between the first jaw pulley and the second jaw pulley; a reciprocating assembly connected to the staple drive assembly and moving linearly when the staple pulley rotates; and a cartridge including a working member that comes into contact with the reciprocating assembly and is moved in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction.

[0013] 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.

[0014] 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.

[0015] 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.

[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 assembly 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, the staple drive assembly includes a link member connecting the staple pulley and the reciprocating assembly.

[0019] 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.

[0020] 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.

[0021] 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.

[0022] 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.

[0023] In the present invention, the staple drive assembly includes a first link member connected to one region of the staple pulley and a second link member connected to another region of the staple pulley, and the reciprocating assembly includes a first reciprocating member connected to the first link member and a second reciprocating member connected to the second link member.

[0024] In the present invention, the working member includes a ratchet member having a first ratchet and a second ratchet formed thereon, the first ratchet being formed to be able to come into contact with the first reciprocating member, and the second ratchet being formed to be able to come into contact with the second reciprocating member.

[0025] The present invention is characterized in that when the staple pulley rotates in one direction, the first ratchet and the first reciprocating member come into contact with each other, and when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member come into contact with each other.

[0026] In the present invention, when the staple pulley rotates in a first direction of clockwise and counterclockwise, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the working member in contact with the first reciprocating member move toward the distal portion of the cartridge.

[0027] In the present invention, when the staple pulley rotates in the clockwise or counterclockwise direction opposite to the first direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the working member in contact with the second reciprocating member move toward the distal portion of the cartridge.

[0028] In the present invention, the stapler further includes a staple wire coupled with the staple pulley to rotate the staple pulley.

[0029] The present invention is characterized in that there are a non-activated state in which the staple drive assembly and the reciprocating assembly are separated, and an activated state in which the staple drive assembly and the reciprocating assembly are fastened together.

[0030] In the present invention, when the staple pulley rotates only in the activated state, the reciprocating assembly moves linearly.

[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 staple pulley, and the second jaw pulley are laminated in this order.

[0034] According to an embodiment of the present invention, an end tool of a surgical instrument includes: a first jaw capable of accommodating a cartridge; a second jaw formed to face the first jaw; a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis; a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced a certain distance from the first jaw pulley; a staple drive assembly including one or more staple pulleys at least a portion of which is formed between the first jaw pulley and the second jaw pulley; and a staple wire at least a portion of which contacts the staple pulley to transmit a driving force required to rotate the staple pulley to the staple pulley, wherein the staple drive assembly is connected to a reciprocating assembly of the cartridge, and rotational motion of the staple pulley is converted into linear motion of the reciprocating assembly.

[0035] The present invention is characterized in that the staple drive assembly further includes an end tool hub including a first jaw pulley coupling portion and a second jaw pulley coupling portion formed to face each other, and a guide portion connecting the first jaw pulley coupling portion and the second jaw pulley coupling portion, wherein the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion of the end tool hub, and the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion of the end tool hub, and at least a portion of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

[0036] In the present invention, the first shaft is inserted through the first jaw pulley connecting portion, the first jaw pulley, the staple pulley, the second jaw pulley, and the second jaw pulley connecting portion in this order.

[0037] The present invention is characterized in that the first jaw pulley, the staple pulley, and the second jaw pulley are stacked in this order within the end tool hub.

[0038] In the present invention, the first jaw pulley, the staple pulley, and the second jaw pulley are formed to be rotatable independently of each other.

[0039] In the present invention, a staple assisting pulley is further included, which is disposed between the staple pulley and the guide portion.

[0040] 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.

[0041] In the present invention, in the guide portion, the areas adjacent to the first jaw pulley, the staple pulley, and the second jaw pulley are formed to be curved so that the cross section has a predetermined curvature.

[0042] In the present invention, the staple wire is located on a common inscribed line of the staple pulley and the guide portion, and the rotation angle of the staple pulley is expanded by the guide portion.

[0043] In the present invention, the staple drive assembly includes a staple link assembly connecting the staple pulley and the reciprocating assembly.

[0044] In the present invention, the staple link assembly includes a first link coupled to the staple pulley and a second link coupled to the first link and the reciprocating assembly, respectively.

[0045] In the present invention, when the staple pulley rotates alternately in 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.

[0046] The present invention is characterized in that the staple link assembly converts the bidirectional rotational movement of the staple pulley into the reciprocating linear movement of the reciprocating assembly connected to the staple link assembly.

[0047] 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.

[0048] In the present invention, the jaw rotation shaft may further include a jaw rotation shaft that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and the first shaft is a jaw pulley rotation shaft that is inserted through the first jaw pulley and the second jaw pulley and serves as a rotation center between the first jaw pulley and the second jaw pulley, and when the first jaw pulley and the second jaw pulley rotate around the jaw pulley rotation shaft, the jaw rotation shaft moves relative to the jaw pulley rotation shaft.

[0049] The present invention is characterized in that when the first jaw and the second jaw are closed, the jaw rotation axis moves toward the distal portion of the end tool, and when the first jaw and the second jaw are opened, the jaw rotation axis moves toward the proximal portion of the end tool.

[0050] 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.

[0051] 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.

[0052] In the present invention, the end tool further includes a first jaw wire at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0053] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw and a second jaw that are rotatable independently of each other; a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis; a second jaw pulley coupled to the second jaw and formed to be rotatable about an axis that is substantially the same as or parallel to the first axis; a staple pulley formed to be rotatable about an axis that is substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley or the second jaw pulley; and a staple link assembly connected to the staple pulley and reciprocating in response to bidirectional rotation of the staple pulley.

[0054] 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.

[0055] 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 staple pulley.

[0056] In the present invention, a protrusion is formed on one side of the staple pulley and the staple link assembly, and a hole is formed on the other side, and the protrusion is axially coupled to the hole.

[0057] In the present invention, a protruding member is formed on the staple pulley, a slot is formed on the staple link assembly, and when the staple pulley rotates, the protruding member moves within the slot while contacting the slot.

[0058] In the present invention, the staple link assembly is characterized by including a single link.

[0059] In the present invention, the staple link assembly includes a link member.

[0060] In the present invention, the link member includes a first link connected to the staple pulley and a second link connected to the first link.

[0061] In the present invention, the staple link assembly includes a first link member and a second link member.

[0062] In the present invention, the cartridge housed in the first jaw includes a first reciprocating member and a second reciprocating member, the first link member being connected to the first reciprocating member, and the second link member being connected to the second reciprocating member.

[0063] In the present invention, a guide groove is formed in the first jaw along its longitudinal direction, and the staple link assembly moves along the guide groove.

[0064] In the present invention, the end tool includes a pair of 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 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.

[0065] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction around the second axis, the staple pulley rotates together with the first jaw pulley and the second jaw pulley.

[0066] In the present invention, when the first jaw pulley and the second jaw pulley rotate in the same direction around the first axis, the staple pulley rotates together with the first jaw pulley and the second jaw pulley.

[0067] In the present invention, when the first jaw pulley and the second jaw pulley rotate in different directions around the first axis, the staple pulley rotates together with either the first jaw pulley or the second jaw pulley.

[0068] The present invention is characterized in that while the staple pulley rotates around the first shaft by the staple wire, the first jaw pulley and the second jaw pulley do not need to rotate.

[0069] 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.

[0070] In the present invention, the surgical instrument further includes a first jaw wire at least partially wound around the first jaw pulley, a second jaw wire at least partially wound around the second jaw pulley, and a staple wire at least partially wound around the staple pulley.

[0071] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw and a second jaw that are rotatable independently of each other, a first jaw pulley coupled to the first jaw and formed to be rotatable about a first axis, a first jaw wire at least a portion of which is wound around the first jaw pulley, a second jaw pulley coupled to the second jaw and formed to be rotatable about the first axis, a second jaw wire at least a portion of which is wound around the second jaw pulley, a staple pulley formed to be rotatable about the first axis and disposed between the first jaw pulley and the second jaw pulley, a staple link assembly connected to the staple pulley and reciprocating in response to bidirectional rotation of the staple pulley, and a staple wire that contacts at least a portion of the staple pulley to transmit a driving force required for rotating the staple pulley to the staple pulley.

[0072] The present invention is characterized in that the bidirectional rotational motion of the staple pulley is converted into the reciprocating linear motion of the staple link assembly.

[0073] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and the rotational motion of the staple pulley is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

[0074] The present invention is characterized in that the staple link assembly converts the bidirectional rotational movement of the staple pulley into the reciprocating linear movement of the reciprocating assembly connected to the staple link assembly.

[0075] In the present invention, the jaw rotation shaft may further include a jaw rotation shaft that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and the first shaft is a jaw pulley rotation shaft that is inserted through the first jaw pulley and the second jaw pulley and serves as a rotation center between the first jaw pulley and the second jaw pulley, and when the first jaw pulley and the second jaw pulley rotate around the jaw pulley rotation shaft, the jaw rotation shaft moves relative to the jaw pulley rotation shaft.

[0076] The present invention is characterized in that when the first jaw and the second jaw are closed, the jaw rotation axis moves toward the distal portion of the end tool, and when the first jaw and the second jaw are opened, the jaw rotation axis moves toward the proximal portion of the end tool.

[0077] In the present invention, a movable coupling hole is formed in the first jaw or the second jaw, and a shaft coupling portion is formed in the first jaw pulley or the second jaw pulley, and the shaft coupling portion is formed so as to be movable within the movable coupling hole to a certain extent when the shaft coupling portion is fitted into the movable coupling hole.

[0078] 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.

[0079] 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.

[0080] In the present invention, the end tool further includes an end tool hub including a first jaw pulley connecting portion and a second jaw pulley connecting portion formed to face each other, and a guide portion connecting the first jaw pulley connecting portion and the second jaw pulley connecting portion, and regions of the guide portion adjacent to the first jaw pulley, the staple pulley, and the second jaw pulley are curved so that their cross sections have a predetermined curvature.

[0081] In the present invention, the staple wire is located on a common inscribed line of the staple pulley and the guide portion, and the rotation angle of the staple pulley is expanded by the guide portion.

[0082] In the present invention, the first jaw, the first jaw pulley, the second jaw, and the second jaw pulley are formed to rotate around the same rotation axis.

[0083] In the present invention, the first jaw pulley, the staple pulley, and the second jaw pulley are formed by stacking them in order.

[0084] The present invention is characterized in that a guide groove is formed in the anvil of the second jaw along its longitudinal direction, and a clamp of a cartridge housed in the first jaw is formed to be movable along the guide groove.

[0085] In the present invention, coupling grooves are formed at both ends of the guide groove of the anvil, allowing the clamp to be pulled in or out of the anvil.

[0086] 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.

[0087] 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.

[0088] In the present invention, the end tool further includes a first jaw wire at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0089] In the present invention, the stapler further includes a staple second auxiliary pulley that is disposed between the first jaw pulley and the end tool first jaw pitch main pulley or between the second jaw pulley and the end tool second jaw pitch main pulley, and is formed to be rotatable around an axis that is substantially the same as or parallel to the second axis, and that guides a path of the first jaw wire or the second jaw wire.

[0090] 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 first jaw pulley coupled to the first jaw and formed rotatable around a first axis, a second jaw pulley coupled to the second jaw and formed rotatable around an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first jaw pulley to a certain extent, one or more staple pulleys at least a portion of which is formed between the first jaw pulley and the second jaw pulley, a staple link assembly including a first link member coupled to one region of the staple pulley and a second link member coupled to another region of the staple pulley, and a staple wire at least a portion of which is wound around the staple pulley.

[0091] In the present invention, the first link member is connected to a first reciprocating member of a cartridge housed in the first jaw, and the second link member is connected to a second reciprocating member of a cartridge housed in the first jaw.

[0092] In the present invention, a first link coupling portion and a second link coupling portion are formed on the staple pulley, the first link member is coupled to the first link coupling portion, and the second link member is coupled to the second link coupling portion.

[0093] In the present invention, the first link connecting portion and the second link connecting portion are disposed on opposite sides of the central axis of the staple pulley.

[0094] In the present invention, when the staple pulley rotates in one direction, the first link member and the second link member move in opposite directions.

[0095] In the present invention, when the staple pulley rotates in one direction, the first link member moves toward the distal side of the end tool, and the second link member moves toward the proximal side of the end tool.

[0096] In the present invention, the cartridge housed in the first jaw includes a reciprocating assembly including a first reciprocating member and a second reciprocating member formed to face each other, and a ratchet member formed to be movable along the reciprocating assembly and having a first ratchet and a second ratchet formed thereon.

[0097] In the present invention, the first ratchet is formed to be able to come into contact with the first reciprocating member, and the second ratchet is formed to be able to come into contact with the second reciprocating member.

[0098] The present invention is characterized in that when the staple pulley rotates in one direction, the first ratchet and the first reciprocating member come into contact with each other, and when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member come into contact with each other.

[0099] In the present invention, when the staple pulley rotates in one direction, the first reciprocating member comes into close contact with the first ratchet and pushes out the first ratchet, thereby moving the ratchet member toward the distal portion of the cartridge, and when the staple pulley rotates in the other direction, the second reciprocating member comes into close contact with the second ratchet and pushes out the second ratchet, thereby moving the ratchet member toward the distal portion of the cartridge.

[0100] In the present invention, when the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the ratchet member in contact with the first reciprocating member move toward the distal portion of the cartridge, and when the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the ratchet member in contact with the second reciprocating member move toward the distal portion of the cartridge.

[0101] In the present invention, the first link member includes a first link and a second link, and the second link member includes a third link and a fourth link.

[0102] In the present invention, the height of the fastening portion formed on the first link member and connected to the first reciprocating member and the height of the fastening portion formed on the second link member and connected to the second reciprocating member on the first axis are substantially the same.

[0103] In the present invention, the fourth link is formed in the shape of a bar that is bent one or more times.

[0104] In the present invention, the first ratchet is formed on one side of the ratchet member, and the second ratchet is formed on the other side of the ratchet member.

[0105] In the present invention, when the first reciprocating member moves toward the proximal portion of the end tool, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves toward the proximal portion of the end tool, the second reciprocating member pushes the second ratchet toward the first reciprocating member.

[0106] In the present invention, the ratchet member includes a first ratchet member having the first ratchet formed on one surface thereof, and a second ratchet member having the second ratchet formed on one surface thereof.

[0107] In the present invention, when the first reciprocating member moves toward the proximal portion of the end tool, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves toward the proximal portion of the end tool, the second reciprocating member pushes the second ratchet toward the first reciprocating member.

[0108] In the present invention, the device includes a first elastic member that is interposed between the first ratchet member and the first reciprocating member and applies an elastic force in a direction in which the first ratchet member comes into close contact with the first reciprocating member, and a second elastic member that is interposed between the first ratchet member and the second reciprocating member and applies an elastic force in a direction in which the second ratchet member comes into close contact with the second reciprocating member.

[0109] 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.

[0110] 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.

[0111] In the present invention, the end tool further includes a first jaw wire at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0112] 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 first jaw pulley coupled to the first jaw and formed rotatable around a first axis, a second jaw pulley coupled to the second jaw and formed rotatable around an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first jaw pulley to a certain extent, a staple pulley disposed between the first jaw pulley and the second jaw pulley and having a protruding member formed in one region, a link formed in one region with a slot into which the protruding member of the staple pulley is inserted, and a staple wire at least partially wound around the staple pulley.

[0113] In the present invention, when the staple pulley rotates, the protruding member moves within the slot while contacting the slot, thereby moving the link.

[0114] In the present invention, the link is characterized by being formed of a single member.

[0115] In the present invention, when the staple pulley rotates, the link moves in one direction, and the link moves in accordance with the width of the slot in the one direction.

[0116] In the present invention, the protruding member is formed in a pin shape, and as the protruding member rotates, it presses the slot of the link, causing the link to move.

[0117] In the present invention, the slot is formed obliquely and not concentrically with the staple pulley, and the pin moves along the slot.

[0118] In the present invention, the protruding member is formed in a cam shape, and as the protruding member rotates, it presses the slot of the link, causing the link to move.

[0119] In the present invention, the center of the protruding member does not coincide with the center of the staple pulley, and the protruding member is formed to be eccentric to a certain degree with respect to the staple pulley.

[0120] In the present invention, the cartridge housed in the first jaw includes a reciprocating assembly and a working member, and is characterized by having an inactive state in which the link and the reciprocating assembly are separated, and an active state in which the link and the reciprocating assembly are fastened together.

[0121] In the present invention, when the staple pulley rotates only in the activated state, the reciprocating assembly moves linearly.

[0122] In the present invention, when the first jaw and the second jaw are opened, the reciprocating assembly moves toward the proximal portion of the end tool.

[0123] In the present invention, when the first jaw and the second jaw are closed, the reciprocating assembly and the link come into contact with each other.

[0124] In the present invention, when the staple pulley rotates in a state where the first jaw and the second jaw are closed, the link and the reciprocating assembly are fastened to each other in an activated state.

[0125] The present invention is characterized in that the link converts the bidirectional rotational movement of the staple pulley into the reciprocating linear movement of the reciprocating assembly connected to the link.

[0126] The present invention is characterized in that the bidirectional rotational motion of the staple pulley is converted into the reciprocating linear motion of the link.

[0127] In the present invention, the first jaw pulley, the staple pulley, and the second jaw pulley are formed by stacking them in order.

[0128] 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.

[0129] 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.

[0130] In the present invention, the end tool further includes a first jaw wire at least a portion of which is wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys, and a second jaw wire at least a portion of which is wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

[0131] According to an embodiment of the present invention, a surgical instrument cartridge having an end tool rotatable in at least one direction includes a housing, a cover covering one surface of the housing and having a slit formed along a first direction which is the longitudinal direction of the housing, a plurality of staples arranged inside the housing, a reciprocating assembly arranged inside the housing and formed to be movable along the first direction relative to the housing, and having a plurality of uneven portions formed on at least one surface, and a working member formed on one side of the reciprocating assembly, formed to be contactable with the reciprocating assembly, and formed to be movable along the first direction by the reciprocating assembly.

[0132] In the present invention, the reciprocating assembly is connected to a staple drive assembly formed on the end tool, and when a staple pulley of the staple drive assembly rotates, the reciprocating assembly moves along the first direction.

[0133] 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.

[0134] In the present invention, the reciprocating assembly moves the working member in contact with the reciprocating assembly in the first direction while moving toward the distal portion of the cartridge.

[0135] In the present invention, the working member includes a main body, one or more wedges formed on one side of the main body and including an inclined surface formed so that the height of the proximal side of the cartridge is higher than that of the distal side, a blade formed on one side of the wedge and including a sharply formed edge, and a ratchet member formed on one side of the main body and including one or more ratchets that can come into contact with the uneven portion of the reciprocating assembly.

[0136] The present invention further includes an elastic member formed between the body or the wedge and the ratchet member, for providing an elastic force that presses the ratchet toward the reciprocating assembly.

[0137] In the present invention, when the reciprocating assembly moves toward the distal end of the cartridge, the reciprocating assembly comes into close contact with the ratchet and pushes out the ratchet, thereby moving the working member toward the distal end of the cartridge.

[0138] In the present invention, when the reciprocating assembly moves toward the proximal portion of the cartridge, the working member is stationary in the one direction.

[0139] In the present invention, when the reciprocating assembly moves toward the proximal portion of the cartridge:

[0140] The inclined surface of the reciprocating assembly presses the inclined surface of the ratchet in a direction in which the ratchet member moves away from the reciprocating assembly.

[0141] In the present invention, the reciprocating assembly includes a first reciprocating member and a second reciprocating member formed to face each other, and the ratchet member includes a first ratchet formed to be able to contact the first reciprocating member and a second ratchet formed to be able to contact the second reciprocating member.

[0142] In the present invention, when the first reciprocating member moves toward the distal portion of the cartridge, the first reciprocating member comes into close contact with the first ratchet and pushes out the first ratchet, thereby moving the working member toward the distal portion of the cartridge, and when the second reciprocating member moves toward the distal portion of the cartridge, the second reciprocating member comes into close contact with the second ratchet and pushes out the second ratchet, thereby moving the working member toward the distal portion of the cartridge.

[0143] In the present invention, the first reciprocating member and the second reciprocating member are characterized in that they alternately move toward the distal portion of the cartridge.

[0144] In the present invention, the first reciprocating member is connected to a first link member connected to one region of a staple pulley of the end tool, and the second reciprocating member is connected to a second link member connected to another region of the staple pulley, and when the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the ratchet member in contact with the first reciprocating member move toward the distal portion of the cartridge, and when the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the ratchet member in contact with the second reciprocating member move toward the distal portion of the cartridge.

[0145] In the present invention, the first ratchet is formed on one side of the ratchet member, and the second ratchet is formed on the other side of the ratchet member.

[0146] In the present invention, when the first reciprocating member moves toward the proximal portion of the cartridge, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves toward the proximal portion of the cartridge, the second reciprocating member pushes the second ratchet toward the first reciprocating member.

[0147] In the present invention, the ratchet member includes a first ratchet member having the first ratchet formed on one surface thereof, and a second ratchet member having the second ratchet formed on one surface thereof.

[0148] In the present invention, when the first reciprocating member moves toward the proximal portion of the cartridge, the first reciprocating member pushes the first ratchet toward the second reciprocating member, and when the second reciprocating member moves toward the proximal portion of the cartridge, the second reciprocating member pushes the second ratchet toward the first reciprocating member.

[0149] In the present invention, the device further includes a first elastic member interposed between the first ratchet member and the first reciprocating member, which applies an elastic force in a direction in which the first ratchet member comes into close contact with the first reciprocating member, and a second elastic member interposed between the first ratchet member and the second reciprocating member, which applies an elastic force in a direction in which the second ratchet member comes into close contact with the second reciprocating member.

[0150] In the present invention, one or more protrusions are formed on the inner surface of the housing in an area that can come into contact with the working member, and the working member is formed with a snap that can come into contact with the protrusion.

[0151] In the present invention, when the reciprocating assembly moves toward the proximal side of the cartridge, the snap and the protrusion come into contact, preventing the working member from moving toward the proximal side of the cartridge.

[0152] In the present invention, one end of the snap is coupled to the working member and is formed to be elastically deformable to a certain degree.

[0153] In the present invention, the one or more protrusions include an inclined surface formed so that the height of the distal side of the cartridge is higher than that of the proximal side.

[0154] In the present invention, a clamp is formed on one side of the blade of the working member, extending along the first direction.

[0155] In the present invention, a guide groove is formed in the anvil of the second jaw of the end tool along the first direction, and the clamp moves along the guide groove.

[0156] In the present invention, a coupling groove is formed at both ends of the anvil, allowing the clamp to be pulled in or out of the anvil.

[0157] 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 in a first direction about a first axis, a staple link assembly connected to the staple pulley and a reciprocating assembly 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 assembly moves toward the distal portion of the cartridge, a working member in contact with the reciprocating assembly moves together with the reciprocating assembly toward a distal portion of the cartridge; (c) while the working member moves toward the distal portion of the cartridge, the working member ejects staples within the cartridge to the outside of the cartridge, and at the same time, a blade of the working member moves toward the distal portion of the cartridge; and (d) when the staple pulley rotates in a second direction about the first axis, which is opposite to the first direction, the staple link assembly connected to the staple pulley and the reciprocating assembly of the cartridge connected to the staple link assembly move toward a proximal portion of the cartridge.

[0158] In the present invention, when the staple pulley rotates in the first direction or the second direction, the reciprocating assembly moves toward the distal end of the cartridge or toward the proximal end of the cartridge.

[0159] The present invention is characterized in that bidirectional rotational motion of the staple pulley about the first axis is converted into reciprocating linear motion along the second axis of the reciprocating assembly connected to the staple pulley.

[0160] In the present invention, the reciprocating linear motion of the reciprocating assembly causes the working member to move toward the distal portion of the cartridge.

[0161] In the present invention, a rack is formed on one surface of the reciprocating assembly, the working member includes a ratchet member having a ratchet formed thereon, and the ratchet member is moved toward the distal portion of the cartridge by pushing out the ratchet member while the rack is in close contact with the ratchet member.

[0162] The present invention is characterized in that in step (d), the working member is stationary in the second axial direction.

[0163] 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.

[0164] In the present invention, the staple drive assembly includes a first link member connected to one region of the staple pulley and a second link member connected to another region of the staple pulley, the reciprocating assembly includes a first reciprocating member connected to the first link member and a second reciprocating member connected to the second link member, and the working member includes a ratchet member having a first ratchet and a second ratchet formed thereon.

[0165] The present invention is characterized in that in the step (a), the first ratchet and the first reciprocating member come into contact with each other, and in the step (b), the second ratchet and the second reciprocating member come into contact with each other.

[0166] In the present invention, in step (a), the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the working member in contact with the first reciprocating member move toward the distal portion of the cartridge, and the second link member connected to the staple pulley and the second reciprocating member connected to the second link member move toward the proximal portion of the cartridge.

[0167] In the present invention, in step (d), the first link member connected to the staple pulley and the first reciprocating member connected to the first link member move toward the distal portion of the cartridge, and the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the working member in contact with the second reciprocating member move toward the distal portion of the cartridge.

[0168] In the present invention, in the step (d), the working member is moved toward the distal portion of the cartridge.

[0169] The present invention is characterized in that the staple pulley further comprises a staple wire coupled with the staple pulley to rotate the staple pulley, and bidirectional rotation of the staple pulley by the staple wire is converted into reciprocating linear motion of the reciprocating assembly.

[0170] In the present invention, the wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge while the working member moves toward the distal portion of 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.

[0171] The present invention is characterized in that the steps (a) to (d) are repeatedly performed. DETAILED DESCRIPTION OF THE INVENTION

[0172] 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.

[0173] 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.

[0174] 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.

[0175] 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.

[0176] 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.

[0177] 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.

[0178] FIG. 1A is a conceptual diagram of pitch motion of a conventional surgical instrument, and FIG. 1B is a conceptual diagram of yaw motion.

[0179] 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.

[0180] FIG. 1C is a conceptual diagram of pitch motion of another conventional surgical instrument, and FIG. 1D is a conceptual diagram of yaw motion.

[0181] 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.

[0182] 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.

[0183] <First embodiment of surgical instrument>

[0184] FIG. 2 is a perspective view showing a surgical instrument according to a first embodiment of the present invention, and FIG. 3 is a side view of the surgical instrument of FIG. 2. FIGS. 4 and 5 are perspective views showing an end tool of the surgical instrument of FIG. 2. FIG. 6 is a perspective view showing an end tool hub of the end tool of the surgical instrument of FIG. 2. FIGS. 7 and 8 are plan views showing the end tool of the surgical instrument of FIG. 2. FIG. 9 is a side view showing the end tool of the surgical instrument of FIG. 2. FIGS. 10 and 11 are exploded perspective views of the end tool of the surgical instrument of FIG. 2. FIG. 12 is a perspective view showing a first jaw pulley of the surgical instrument of FIG. 2. FIG. 13 is an exploded perspective view showing a staple pulley and staple link of the surgical instrument of FIG. 2. FIG. 14 is a plan view showing the first jaw of the surgical instrument of FIG. 2, and FIG. 15 is a plan view showing the second jaw of the surgical instrument of FIG. 2. Fig. 16 is a plan view showing the opening and closing operation of a first jaw of the surgical instrument of Fig. 2, Fig. 17 is a plan view showing the opening and closing operation of a second jaw of the surgical instrument of Fig. 2, Fig. 18 is a plan view showing the opening and closing operation of the first jaw and the second jaw of the surgical instrument of Fig. 2. Fig. 19 is a perspective view showing the opening and closing operation of an end tool of the surgical instrument of Fig. 2, and Fig. 20 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of Fig. 2.

[0185] First, referring to FIGS. 2 and 3, a surgical instrument 10 according to a first embodiment of the present invention includes an end tool 100, an operating section 200, a power transmission section 300, and a connecting section 400.

[0186] 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 100 is coupled to the other end, and the connecting portion 400 may serve to connect the operating portion 200 and the end tool 100. Here, the connecting portion 400 of the surgical instrument 10 according to the first embodiment of the present invention 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 100 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 100 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 100 to match more intuitively.

[0187] 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.

[0188] Meanwhile, a connector 410 may be formed at 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 100 via an electric wire, and may transmit electrical energy supplied from the external power source (not shown) to the end tool 100. The electrical energy transmitted to the end tool 100 in this manner may provide a driving force for rotating a staple pulley (see 161 in FIG. 5 ), which will be described later, in a clockwise or counterclockwise direction.

[0189] 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, the endotool 100, which is connected to the interface and inserted into the body of the surgical patient, performs a predetermined operation, thereby performing surgery. Here, in Fig. 2, the operating unit 200 is shown as being formed in the shape of a handle that can be rotated with a finger inserted, but the concept of the present invention is not limited thereto, and various types of operating units that can be connected to the endotool 100 and operate the endotool 100 are possible.

[0190] The endotool 100 is formed at the other end of the continuous portion 400 and is inserted into the surgical site to perform the operations required for surgery. As an example of such an endotool 100, a pair of jaws 103 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 100. For example, a single-arm cautery may also be used as the endotool. The endotool 100 is connected to the operating unit 200 by the power transmission unit 300, and receives the driving force of the operating unit 200 via the power transmission unit 300 to perform the operations required for surgery, such as gripping, cutting, and suturing.

[0191] Here, the end tool 100 of the surgical instrument 10 according to the first embodiment of the present invention is formed to be rotatable in at least one direction. For example, the end tool 100 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.

[0192] Here, the pitch, yaw, and actuation movements used in the present invention are defined as follows.

[0193] First, the pitch movement refers to the movement of the end tool 100 rotating up and down relative to the direction in which the connecting part 400 extends (the X-axis direction in FIG. 2), that is, the movement of rotating around the Y-axis in FIG. 2. In other words, it refers to the movement of the end tool 100 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 up and down relative to the connecting part 400 around the Y-axis.

[0194] Next, yaw movement refers to the movement of the end tool 100 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 100 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 around the Z-axis with respect to the connecting part 400. In other words, it refers to the movement of two jaws 103 formed on the end tool 100 rotating in the same direction with each other around the Z-axis.

[0195] Meanwhile, the actuation operation refers to the movement of the end tool 100 rotating around the same rotation axis as the yaw operation, but the two jaws 103 rotating in opposite directions to each other, thereby closing and opening the jaws. That is, it refers to the movement of the two jaws 103 formed on the end tool 100 rotating in opposite directions to each other around the Z axis.

[0196] The power transmission unit 300 connects the operating unit 200 and the end tool 100 and serves to transmit the driving force of the operating unit 200 to the end tool 100, and may include a plurality of wires, pulleys, links, joints, gears, etc.

[0197] The end tool 100, the operating section 200, the power transmission section 300, and the like of the surgical instrument 10 shown in FIG. 2 will be described in detail below.

[0198] (Intuitive Drive)

[0199] The following describes the intuitive operation of the surgical instrument 10 of the present invention.

[0200] 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.

[0201] The surgical instrument 10 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 100 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 100 also intuitively rotates in the same direction as the one direction, performing a pitch or yaw movement. Here, "intuitively the 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 100 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 100 also moves left, and when the user's finger moves down, the tip of the end tool 100 also moves down.

[0202] For this reason, the surgical instrument 10 according to the first embodiment of the present invention is characterized in that the operating unit 200 and the endotool 100 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 100 is also formed extending in the +X-axis direction. In other words, the forming direction of the endotool 100 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 100 is formed. That is, the first handle 204, the first actuation operation unit 251, the second actuation operation unit 256, etc., which are gripped and moved by the user for actuation, yaw, and pitch movements, have portions that move to perform each movement formed to extend in the +X-axis direction from the rotation center of each joint for that movement. This allows the operation unit 200 to be configured in the same way as the moving portions of the end tool 100 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 with each other in both the rotational direction and the left-right direction, resulting in the same intuitive operation being possible.

[0203] 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.

[0204] To solve this problem, the surgical instrument 10 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 100. To this end, the operating unit 200, like the end tool 100, 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.

[0205] The end tool 100, the operating unit 200, the power transmission unit 300, etc. of the surgical instrument 10 shown in FIG. 2 will be described in more detail below.

[0206] (Power transmission section)

[0207] The power transmission section 300 of the surgical instrument 10 of FIG. 2 will be described in more detail below.

[0208] Referring to Figures 2 to 20 and Figure 43, the power transmission section 300 of the surgical instrument 10 according to one embodiment of the present invention may include wire 301, wire 302, wire 303, wire 304, wire 305, wire 306, wire 307, and wire 308.

[0209] Here, wire 301 and wire 305 form a pair and can serve as a first jaw wire. Wire 302 and wire 306 form a pair and can serve as a second jaw wire. Here, a component including wire 301 and wire 305, which are the first jaw wires, and wire 302 and wire 306, which are the second jaw wires, can be called a jaw wire. Then, wire 303 and wire 304 form a pair and can serve as a pitch wire. Then, wire 307 and wire 308 form a pair and can serve as a staple wire.

[0210] Furthermore, the power transmission unit 300 of the surgical instrument 10 according to one embodiment of the present invention may include fastening members (see 321 in FIG. 7), fastening members 323, 324, 326, 327, and fastening member (see 329 in FIG. 62) coupled to each end of each wire to couple the wire to the pulley. Here, each fastening member may have various shapes, such as a ball shape or a tube shape, as needed.

[0211] Here, on the end tool 100 side, the fastening member (see 321 in FIG. 7) 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 (see 329 in FIG. 62) can play the role of a staple wire-end tool fastening member.

[0212] Also, 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. Also, 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.

[0213] The connection relationship between the wire, the fastening member, and each pulley will be described in detail below.

[0214] 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 fitted into the midpoint of the first jaw wire, which is a single wire, and this fastening member 323 is crimped and fixed, and then both strands of the first jaw wire centered on fastening member 323 can be called wire 301 and wire 305, respectively.

[0215] Alternatively, the first jaw wires 301 and 305 may be formed of separate wires, and the wires 301 and 305 may be connected by a fastening member 323 .

[0216] Then, by connecting this fastening member 323 to the pulley 111, the wire 301 and the wire 305 can be fixedly connected to the pulley 111. As a result, the wire 301 and the wire 305 can be pulled and unwound, allowing the pulley 111 to rotate.

[0217] Meanwhile, a first jaw wire-operating portion fastening member (see 324 in FIG. 43) may be coupled to the end of wire 301 and wire 305 opposite to the portion where fastening member 323 is fastened.

[0218] In this manner, the first jaw wire-operating portion fastening member (see 324 in FIG. 43) is coupled to the pulley 210, so that the wires 301 and 305 can be fixedly coupled to the pulley 210. As a result, when the pulley 210 is rotated by a motor or by human power, the wires 301 and 305 are pulled and unwound, allowing the pulley 111 of the end tool 100 to rotate.

[0219] Similarly, wire 302 and wire 306, which are second jaw wires, are coupled to a fastening member (see 326 in FIG. 43) which is a second jaw wire-end tool fastening member, and a second jaw wire-operating portion fastening member (see 327 in FIG. 43), respectively. The fastening member (see 326 in FIG. 43) is coupled to pulley 121, and the second jaw wire-operating portion fastening member (see 327 in FIG. 43) 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 and unwound, allowing pulley 121 of end tool 100 to rotate.

[0220] Similarly, wires 303 and 304, which are pitch wires, are coupled to a fastening member (see 321 in FIG. 7) which is a pitch wire-end tool fastening member, and a pitch wire-operating unit fastening member (not shown), respectively. The fastening member (see 321 in FIG. 7) is coupled to pulley 131, and the 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 and unwound, allowing pulley 131 of end tool 100 to rotate.

[0221] Similarly, wires 307 and 308, which are staple wires, are coupled to a fastening member (see 329 in FIG. 62) 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. 62) is coupled to staple pulley 161, and the staple wire-operating portion fastening member (not shown) is coupled to a pulley (see 269 in FIG. 47). As a result, when pulley 269 is rotated by a motor or by human power, wires 307 and 308 are pulled and unwound, thereby allowing staple pulley 161 of end tool 100 to rotate.

[0222] (end tool)

[0223] The endotool 100 of the surgical instrument 10 of FIG. 2 is described in more detail below.

[0224] 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.

[0225] Here, Fig. 4 shows a state in which the end tool hub 180 and the pitch hub 107 are coupled, and Fig. 5 shows a state in which the end tool hub 180 is detached. Meanwhile, Fig. 7 is a view mainly showing the wire, and Fig. 8 is a view mainly showing the pulley.

[0226] 4 to 8, an end tool 100 according to a first embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw 101 and a second jaw 102. Here, each of the first jaw 101 and the second jaw 102, or a component that collectively includes the first jaw 101 and the second jaw 102, can be referred to as a jaw 103.

[0227] The end tool 100 may also include pulleys 111, 112, 113, 114, 115, and 116 involved in the rotational movement of the first jaw 101. The end tool 100 may also include pulleys 121, 122, 123, 124, 125, and 126 involved in the rotational movement of the second jaw 102.

[0228] Here, although the figures show 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 end tool.

[0229] The end tool 100 of the first embodiment of the present invention may also include an end tool hub 180 and a pitch hub 107.

[0230] The end tool hub 180 has a rotary shaft 141 and a rotary shaft 142, which will be described later, inserted therethrough, and can accommodate at least a portion of the pulley 111 and the pulley 121 axially coupled to the rotary shaft 141. The end tool hub 180 can also accommodate at least a portion of the pulley 112 and the pulley 122 axially coupled to the rotary shaft 142.

[0231] Specifically, with reference to FIG. 6, the end tool hub 180 includes a first jaw pulley coupling portion 181, a second jaw pulley coupling portion 182, a guide portion 183, and a pitch pulley coupling portion 185.

[0232] Specifically, the first jaw pulley coupling portion 181 and the second jaw pulley coupling portion 182 are formed to face each other, and the pulley 111, the pulley 121, and the staple pulley 161 are housed therein. Furthermore, a through hole is formed in each of the first jaw pulley coupling portion 181 and the second jaw pulley coupling portion 182, and the rotation shaft 141 passes through the first jaw pulley coupling portion 181, the pulley 111, the staple pulley 161, the pulley 121, and the second jaw pulley coupling portion 182 to axially couple them together.

[0233] The first jaw pulley connecting portion 181 and the second jaw pulley connecting portion 182 are connected by a guide portion 183. That is, the first jaw pulley connecting portion 181 and the second jaw pulley connecting portion 182, which are parallel to each other, are connected by the guide portion 183 formed in a direction approximately perpendicular thereto, and the first jaw pulley connecting portion 181, the second jaw pulley connecting portion 182, and the guide portion 183 form an approximately U-shape, inside which the pulleys 111, 121, and staple pulley 161 are housed.

[0234] Here, pulley 111, which is the first jaw pulley, is disposed adjacent to first jaw pulley coupling portion 181 of end tool hub 180, and pulley 121, which is the second jaw pulley, is disposed adjacent to second jaw pulley coupling portion 182 of end tool hub 180, and a staple assembly accommodating portion may be formed between first jaw pulley coupling portion 181 and second jaw pulley coupling portion 182. At least a portion of a staple pulley assembly (see 160 in FIG. 13 ) and a staple link assembly (see 170 in FIG. 13 ), which will be described later, may be formed inside the staple assembly accommodating portion. From another perspective, this may be expressed as at least a portion of staple pulley 161 and link member 171 being disposed between first jaw pulley coupling portion 181 and second jaw pulley coupling portion 182. In this manner, by disposing at least a part of the staple pulley assembly (see 160 in FIG. 13) and the staple link assembly (see 170 in FIG. 13) between the pulley 111 which is the first jaw pulley and the pulley 121 which is the second jaw pulley, it is possible to perform the stapling operation and cutting operation using the staple pulley 161 in addition to the pitch movement and yaw movement of the end tool 100. This will be described in more detail later.

[0235] Meanwhile, a pulley 131 that serves as an end tool pitch pulley may be formed at one end of the end tool hub 180. As shown in FIG. 6, the pulley 131 may be formed integrally with the end tool hub 180. That is, a disk-shaped pulley may be formed at one end of the end tool hub 180, and a groove around which a wire can be wound may be formed on the outer circumferential surface of the pulley. Alternatively, the pulley 131 may be formed as a separate member from the end tool hub 180 and connected to the end tool hub 180. The wires 303 and 304 described above are connected to the pulley 131 that serves as the end tool pitch pulley, and the pulley 131 performs a pitch movement while rotating about the rotation axis 143.

[0236] Rotation shafts 143 and 144, which will be described later, are inserted through the pitch hub 107, and the pitch hub 107 and the end tool hub 180 (and the pulley 131) can be axially coupled by the rotation shaft 143. Therefore, the end tool hub 180 and the pulley 131 may be formed to be rotatable relative to the pitch hub 107 around the rotation shaft 143.

[0237] Furthermore, pitch hub 107 can accommodate at least a portion of pulleys 113, 114, 123, and 124 axially coupled to rotation shaft 143. Pitch hub 107 can accommodate at least a portion of pulleys 115, 116, 125, and 126 axially coupled to rotation shaft 144.

[0238] Furthermore, the end tool 100 according to the first embodiment of the present invention may include the rotation shaft 141, the rotation shaft 142, the rotation shaft 143, and the rotation shaft 144. As described above, the rotation shaft 141 and the rotation shaft 142 may be inserted through the end tool hub 180, and the rotation shaft 143 and the rotation shaft 144 may be inserted through the pitch hub 107.

[0239] The rotation shafts 141, 142, 143, and 144 may be arranged sequentially from the distal end 104 toward the proximal end 105 of the end tool 100. Thus, sequentially from the distal end 104, the rotation shaft 141 may be called the first pin, the rotation shaft 142 the second pin, the rotation shaft 143 the third pin, and the rotation shaft 144 the fourth pin.

[0240] Here, rotation axis 141 may function as the end tool jaw pulley rotation axis, rotation axis 142 may function as the end tool jaw auxiliary pulley rotation axis, rotation axis 143 may function as the end tool pitch rotation axis, and rotation axis 144 may function as the end tool pitch auxiliary rotation axis of end tool 100.

[0241] Each such rotating shaft 141, 142, 143, and 144 may be fitted with one or more pulleys, as will be described in more detail below.

[0242] Meanwhile, a rotation shaft 145 may be further formed on one side of the rotation shaft 141, specifically on the distal portion 104 side of the rotation shaft 141. The rotation shaft 145 may be inserted through the first jaw 101 and the second jaw 102 and function as a jaw rotation shaft, which will be described in detail below.

[0243] Pulley 111 functions as an end tool first jaw pulley, and pulley 121 functions as an end tool second jaw pulley. Pulley 111 may be referred to as the first jaw pulley, pulley 121 may be referred to as the second jaw pulley, and the two components may be collectively referred to as end tool jaw pulleys or simply jaw pulleys.

[0244] Pulleys 111 and 121, which are end tool jaw pulleys, are formed to face each other and are formed to be rotatable independently of each other around a rotation axis 141, which is the end tool jaw pulley rotation axis. At this time, pulleys 111 and 121 may be formed to be spaced apart to a certain extent, and a staple assembly accommodating portion may be formed therebetween. At least a portion of a staple pulley assembly 160 and a staple link assembly 170, which will be described later, may be disposed in this staple assembly accommodating portion.

[0245] Here, in the figure, the pulley 111 and the pulley 121 are configured to rotate around one rotation axis 141, but it goes without saying that each end tool jaw pulley may be configured to rotate around a separate axis. Here, a first jaw 101 is fixedly connected to the pulley 111 and rotates together with the pulley 111, and a second jaw 102 is fixedly connected to the pulley 121 and rotates together with the pulley 121. Yaw movement and actuation movement of the end tool 100 occur in response to the rotation of the pulleys 111 and 121. That is, when the pulleys 111 and 121 rotate in the same direction around the rotation axis 141, a yaw movement occurs, and when the pulleys 111 and 121 rotate in opposite directions around the rotation axis 141, an actuation movement occurs.

[0246] Here, the first jaw 101 and the pulley 111 may be formed of separate members and coupled to each other, or the first jaw 101 and the pulley 111 may be formed as a single body. Similarly, the second jaw 102 and the pulley 121 may be formed of separate members and coupled to each other, or the second jaw 102 and the pulley 121 may be formed as a single body.

[0247] Pulley 112 functions as an end tool first jaw auxiliary pulley and pulley 122 functions as an end tool second jaw auxiliary pulley, and the two components may be collectively referred to as end tool jaw auxiliary pulleys or simply auxiliary pulleys.

[0248] Specifically, the end tool jaw auxiliary pulleys, pulleys 112 and 122, may be further provided on one side of pulley 111 and pulley 121. In other words, pulley 112, which is an auxiliary pulley, may be disposed between pulley 111 and pulleys 113 and 114. Furthermore, pulley 122, which is an auxiliary pulley, may be disposed between pulley 121 and pulleys 123 and 124. Pulleys 112 and 122 may be formed to be rotatable independently of each other around a rotation shaft 142. Here, although pulleys 112 and 122 are formed to rotate around a single rotation shaft 142 in the drawing, it goes without saying that pulleys 112 and 122 may be formed to be rotatable around separate axes. Such auxiliary pulleys will be described in more detail later.

[0249] Pulleys 113 and 114 function as end tool first jaw pitch main pulleys, and pulleys 123 and 124 function as end tool second jaw pitch main pulleys, and these two components may be collectively referred to as end tool jaw pitch main pulleys.

[0250] Pulleys 115 and 116 function as end tool first jaw pitch sub-pulleys, and pulleys 125 and 126 function as end tool second jaw pitch sub-pulleys, and these two components may be collectively referred to as end tool jaw pitch sub-pulleys.

[0251] The components involved in the rotation of the pulley 111 will be described below.

[0252] Pulley 113 and pulley 114 function as end tool first jaw pitch main pulleys. That is, they function as main rotating pulleys for the pitch operation of first jaw 101. Here, a wire 301 serving as a first jaw wire is wound around pulley 113, and a wire 305 serving as a first jaw wire is wound around pulley 114.

[0253] Pulley 115 and pulley 116 function as end tool first jaw pitch sub-pulleys. That is, they function as sub-rotating pulleys for the pitch operation of first jaw 101. Here, a wire 301 serving as a first jaw wire is wound around pulley 115, and a wire 305 serving as a first jaw wire is wound around pulley 116.

[0254] Here, pulleys 113 and 114 are disposed on one side of pulleys 111 and 112 so as to face each other. Here, pulleys 113 and 114 are formed to be rotatable independently of each other about a rotation axis 143, which is an end tool pitch rotation axis. In addition, pulleys 115 and 116 are disposed on one side of pulleys 113 and 114 so as to face each other. Here, pulleys 115 and 116 are formed to be rotatable independently of each other about a rotation axis 144, which is an end tool pitch auxiliary rotation axis. Here, in the drawing, pulleys 113, 115, 114, and 116 are all shown to be rotatable about the Y-axis direction, but the concept of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0255] Wire 301, which is the first jaw wire, is wound in sequence so as to be in at least partial contact with pulley 115, pulley 113, and pulley 111. Wire 305, which is connected to wire 301 by fastening member 323, is wound in sequence so as to be in at least partial contact with pulley 111, pulley 112, pulley 114, and pulley 116.

[0256] Explaining this from another perspective, wire 301 and wire 305, which are the first jaw wires, are wound sequentially around pulley 115, pulley 113, pulley 111, pulley 112, pulley 114, and pulley 116 so that at least a portion of them come into contact with each other, and wire 301 and wire 305 are formed so that they can move along the pulleys while rotating the pulleys.

[0257] Therefore, when wire 301 is pulled in the direction of arrow 301 in Fig. 13, fastening member 323 to which wire 301 is connected and pulley 111 connected thereto rotate in the direction of arrow L in Fig. 13. Conversely, when wire 305 is pulled in the direction of arrow 305 in Fig. 6, fastening member 323 to which wire 305 is connected and pulley 111 connected thereto rotate in the direction of arrow R in Fig. 6.

[0258] Pulleys 112 and 122, which act as auxiliary pulleys, will be described in more detail below.

[0259] Pulley 112 and pulley 122 come into contact with wire 305, which is the first jaw wire, and wire 302, which is the second jaw wire, and change the placement paths of wire 305 and wire 302 to a certain extent, thereby serving to expand the rotation angles of first jaw 101 and second jaw 102, respectively.

[0260] That is, without the auxiliary pulleys, the first and second jaws could only rotate up to a right angle. However, by further providing auxiliary pulleys 112 and 122 in one embodiment of the present invention, the maximum rotation angle can be increased by θ, as shown in FIG. 8 . This enables an operation in which both jaws of the end tool 100 must open for actuation when both jaws have rotated together in yaw by 90° in the L direction. This is because the second jaw 102 can rotate by an additional angle θ, as shown in FIG. 8 . Similarly, actuation is possible even when both jaws have rotated in yaw in the L direction. In other words, the range of yaw rotation within which actuation is possible can be expanded via pulleys 112 and 122.

[0261] This will be explained in more detail as follows.

[0262] 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 that 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 open, 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 movement of more than a certain angle.

[0263] To solve this problem, in the surgical instrument 10 of the present invention, auxiliary pulleys 112 and 122 are further disposed on one side of pulley 111 and pulley 121. By disposing pulleys 112 and 122 in this manner and changing the arrangement paths of wire 305 (the first jaw wire) and wire 302 (the second jaw wire), the tangential directions of wire 305 and wire 302 are changed to a certain extent, thereby allowing fastening member 323 connecting wire 301 and pulley 111 to rotate up to line N in FIG. 8. That is, fastening member 323, which connects wire 301 and pulley 111, can rotate until it is positioned on the common inscribed line of pulleys 111 and 112. Similarly, fastening member 326, which connects wire 302 and pulley 121, can rotate until it is positioned on the common inscribed line of pulleys 121 and 122, thereby expanding the rotation range in the L direction.

[0264] In other words, wire 301 and wire 305, which are two strands of the first jaw wire wound around pulley 111 by pulley 112, 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 121 by pulley 122, are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0265] In other words, pulleys 113 and 114 are arranged on either side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 123 and 124 are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0266] In other words, the wire 305 is located on the inscribed line between the pulleys 111 and 112, and the rotation angle of the pulley 111 is expanded by the pulley 112. The wire 302 is located on the inscribed line between the pulleys 121 and 122, and the rotation angle of the pulley 121 is expanded by the pulley 122.

[0267] According to the present invention, the rotation radius of the jaws 101 and 102 is increased, which has the effect of widening the yaw operation range in which normal opening and closing actuation operations can be performed.

[0268] Next, the components involved in the rotation of the pulley 121 will be described.

[0269] Pulley 123 and pulley 124 function as end tool second jaw pitch main pulleys. That is, they function as main rotating pulleys for the pitch operation of second jaw 102. Here, a wire 306 serving as the second jaw wire is wound around pulley 123, and a wire 302 serving as the second jaw wire is wound around pulley 124.

[0270] Pulley 125 and pulley 126 function as end tool second jaw pitch sub-pulleys. That is, they function as sub-rotating pulleys for the pitch operation of second jaw 102. Here, a wire 306 serving as the second jaw wire is wound around pulley 125, and a wire 302 serving as the second jaw wire is wound around pulley 126.

[0271] Pulleys 123 and 124 are disposed on one side of pulley 121 so as to face each other. Pulleys 123 and 124 are formed to be rotatable independently of each other around rotation axis 143, which is the end tool pitch rotation axis. Pulleys 125 and 126 are disposed on one side of pulleys 123 and 124 so as to face each other. Pulleys 125 and 126 are formed to be rotatable independently of each other around rotation axis 144, which is the end tool pitch auxiliary rotation axis. Although the drawing shows pulleys 123, 125, 124, and 126 as all being rotatable around the Y-axis direction, the concept of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0272] Wire 306, which is the second jaw wire, is wound in sequence so as to be in at least partial contact with pulley 125, pulley 123, and pulley 121. Wire 302, which is connected to wire 306 by fastening member 326, is wound in sequence so as to be in at least partial contact with pulley 121, pulley 122, pulley 124, and pulley 126.

[0273] Explaining this from another perspective, wire 306, which is the second jaw wire, and wire 302 are wound sequentially so that they are in at least partial contact with pulley 125, pulley 123, pulley 121, pulley 122, pulley 124, and pulley 126, and wire 306 and wire 302 are formed so that they can move along the pulleys while rotating the pulleys.

[0274] Therefore, when wire 306 is pulled in the direction of arrow 306 in Fig. 13, fastening member 322 to which wire 306 is connected and pulley 121 connected thereto rotate in the direction of arrow R in Fig. 13. Conversely, when wire 302 is pulled in the direction of arrow 302 in Fig. 13, fastening member 326 to which wire 302 is connected and pulley 121 connected thereto rotate in the direction of arrow L in Fig. 13.

[0275] The pitch movement of the present invention will be described in more detail below.

[0276] 7 (i.e., when both strands of the first jaw wire are pulled), as shown in Fig. 43, the wires 301 and 305 are wound around the pulleys 113 and 114 that are rotatable around the rotation axis 143, which is the end tool pitch rotation axis, and therefore the pulley 111 to which the wires 301 and 305 are fixedly connected and the end tool hub 180 to which the pulley 111 is connected rotate together counterclockwise around the rotation axis 143, resulting in the end tool 100 performing a pitch motion while rotating downward. At this time, the second jaw 102 and the wires 302 and 306 fixedly connected thereto are wound around the pulleys 123 and 124 that are rotatable around the rotation axis 143, and therefore the wires 302 and 306 are unwound in the directions opposite to the wires 302 and 306, respectively.

[0277] Conversely, when the wire 302 is pulled toward the arrow 302 in Fig. 7 and the wire 306 is simultaneously pulled toward the arrow 306 in Fig. 7, the wires 302 and 306 are wound above the pulleys 123 and 124 that are rotatable about the rotation axis 143, which is the end tool pitch rotation axis, as shown in Fig. 43, so the pulley 121 to which the wires 302 and 306 are fixedly coupled and the end tool hub 180 to which the pulley 121 is coupled rotate together in the clockwise direction about the rotation axis 143 as a whole, resulting in the end tool 100 performing a pitch motion while rotating upward. At this time, the first jaw 101 and the wires 301 and 305 fixedly coupled thereto are wound below the pulleys 113 and 114 that are rotatable about the rotation axis 143, so the wires 302 and 306 move in the opposite direction to the wires 301 and 305, respectively.

[0278] Meanwhile, the endotool 100 of the surgical instrument 10 of the present invention may further include a pulley 131 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. Specifically, the pulley 131 of the endotool 100 may be rotatable around a rotation axis 143 that is an endotool pitch rotation axis, and may be formed integrally with the endotool hub 180 (or fixedly coupled to the endotool hub 180). In addition, the wires 303 and 304 may serve to connect the pulley 131 of the endotool 100 to the pulleys 231 and 232 of the operating unit 200.

[0279] Therefore, when pulleys 231 and 232 of the operating unit 200 rotate, the rotation of pulleys 231 and 232 is transmitted to pulley 131 of the end tool 100 via wires 303 and 304, causing pulley 131 to rotate together, resulting in the end tool 100 performing a pitch motion while rotating.

[0280] That is, the surgical instrument 10 according to the first embodiment of the present invention includes a pulley 131 of the end tool 100, 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, and the driving force of the pitch movement of the operating unit 200 is more completely transmitted to the end tool 100, thereby improving operational reliability.

[0281] Here, the diameters of pulleys 113, 114, 123, and 124, which are end tool jaw pitch main pulleys, and the diameter of pulley 131, which is the end tool pitch pulley, may be equal to or different from each other. 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 of operation unit 200, which will be described later, to the diameter of the operation unit pitch main pulley. This will be described in detail later.

[0282] (Components related to staple pulley)

[0283] The staple pulley 161 of the endotool 100 of the surgical instrument 10 of FIG. 2 will be described in more detail below.

[0284] Fig. 9 is a side view showing an end tool of the surgical instrument of Fig. 2, and 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, and Fig. 13 is an exploded perspective view showing a staple pulley and staple link of the surgical instrument of Fig. 2.

[0285] Referring to Figures 4 to 13, the end tool 100 of the first embodiment of the present invention may include a staple pulley 161, a staple assist pulley 162, a pulley 163, a pulley 164, a pulley 165, and a pulley 166, which are involved in the linear / rotational movement of each pulley and link for stapling and cutting.

[0286] The staple pulley 161 is formed to face the pulleys 111 and 121, which are end tool jaw pulleys, and is formed to be rotatable independently of each other around the rotation axis 141, which is the rotation axis of the end tool jaw pulley. Here, in the drawing, the staple pulley 161 is shown to be disposed between the pulleys 111 and 121, but the idea of ​​the present invention is not limited thereto, and the staple pulley 161 may be disposed at various positions adjacent to the pulleys 111 or 121.

[0287] Here, the present invention is characterized in that the staple pulley 161, pulley 111, and pulley 121 are formed to rotate substantially around the same axis. By forming the staple pulley 161, pulley 111, and pulley 121 to rotate around the same axis in this way, pitch movement / yaw movement / actuation operations can be performed, and even stapling and cutting operations can be performed. This will be explained in more detail later. However, although the staple pulley 161, pulley 111, and pulley 121 are formed to rotate around a single rotation axis 141 in the figure, it goes without saying that the respective jaw pulleys may be formed to be rotatable around separate axes that are concentric with each other.

[0288] From another perspective, this may be expressed as a structure in which the pulley 111 serving as the first jaw pulley, the staple pulley 161, and the pulley 121 serving as the second jaw pulley are stacked in order along the rotation shaft 141. Alternatively, it may be expressed as a structure in which the staple pulley 161 is disposed between the pulleys 111 and 121 that face each other. Here, the pulley 111 serving as the first jaw pulley, the staple pulley 161, and the pulley 121 serving as the second jaw pulley may be formed to be rotatable independently of each other.

[0289] The staple assist pulley 162 may be further provided on one side of the staple pulley 161. In other words, the staple assist pulley 162 may be disposed between the staple pulley 161 and the pulley 163 / pulley 164. The staple assist pulley 162 may be formed to be rotatable independently of the pulleys 112 and 122 about the rotation shaft 142. Here, in the drawing, the staple assist pulley 162, the pulley 112, and the pulley 122 are formed to rotate about one rotation shaft 142, but it goes without saying that the staple assist pulley 162, the pulley 112, and the pulley 122 may each be formed to be rotatable about separate axes. Such a staple assist pulley will be described in more detail later.

[0290] Pulleys 163 and 164 may function as staple pitch main pulleys, and pulleys 165 and 166 may function as staple pitch sub pulleys.

[0291] The components involved in the rotation of the staple pulley 161 will be described below.

[0292] The pulley 163 and the pulley 164 function as staple pitch main pulleys. Here, a wire 307 which is a staple wire is wound around the pulley 163, and a wire 308 which is a staple wire is wound around the pulley 164.

[0293] Pulley 165 and pulley 166 function as staple pitch sub-pulleys. Here, a wire 307 which is a staple wire is wound around pulley 165, and a wire 308 which is a staple wire is wound around pulley 166.

[0294] Here, pulleys 163 and 164 are disposed on one side of staple pulley 161 and staple auxiliary pulley 162 so as to face each other. Here, pulleys 163 and 164 are formed to be rotatable independently of each other about rotation axis 143, which is the end tool pitch rotation axis. In addition, pulleys 165 and 166 are disposed on one side of pulleys 163 and 164 so as to face each other. Here, pulleys 165 and 166 are formed to be rotatable independently of each other about rotation axis 144, which is the end tool pitch auxiliary rotation axis. Here, in the drawing, pulleys 163, 165, 164, and 166 are all shown to be rotatable about the Y-axis direction, but the concept of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions as appropriate for the configuration.

[0295] As described above, the rotation shafts 141, 142, 143, and 144 may be arranged sequentially from the distal end 104 toward the proximal end 105 of the end tool 100. As a result, the staple pulley 161, the staple assist pulley 162, the pulleys 163 and 164, and the pulleys 165 and 166 may be arranged sequentially from the distal end 104 toward the proximal end 105 of the end tool 100.

[0296] Wire 307, which is a staple wire, is wound around pulley 165, pulley 163, staple assist pulley 162, and staple pulley 161 in order so that at least a portion of wire 307 comes into contact with them. Then, wire 308, which is connected to wire 307 by a fastening member (see 329 in FIG. 62), is wound around staple pulley 161, staple assist pulley 162, pulley 164, and pulley 166 in order so that at least a portion of wire 308 comes into contact with them.

[0297] To explain this from another perspective, wires 307 and 308, which are staple wires, are wound sequentially around pulley 165, pulley 163, staple auxiliary pulley 162, staple pulley 161, staple auxiliary pulley 162, pulley 164, and pulley 166 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.

[0298] Therefore, when the wire 307 is pulled, the fastening member (see 329 in FIG. 62) to which the wire 307 is connected and the staple pulley 161 connected thereto rotate in one direction. Conversely, when the wire 308 is pulled, the fastening member (see 329 in FIG. 62) to which the wire 308 is connected and the staple pulley 161 connected thereto rotate in the opposite direction.

[0299] The staple assist pulley 162 is described in more detail below.

[0300] The staple assist pulley 162 can play a role in enlarging the rotation angle of the staple pulley 161 by coming into contact with the wires 307 and 308, which are staple wires, and changing the arrangement paths of the wires 307 and 308 to a certain extent.

[0301] 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 staple auxiliary pulley 162, which is an auxiliary pulley, it is possible to obtain the effect of increasing the maximum rotation angle by θ in both directions. This means that when both jaws of the end tool 100 are rotated together in yaw by 90°, the staple pulley 161 rotates for stapling and cutting operations, and enables the operation of linearly moving the working member 540, which will be described later. In other words, the staple auxiliary pulley 162 has the feature of expanding the range of yaw rotation in which stapling and cutting operations are possible.

[0302] This will be explained in more detail as follows.

[0303] In the case of the surgical instrument 10 of the present invention, a staple assist pulley 162 is further disposed on one side of the staple pulley 161. By disposing the staple assist pulley 162 in this manner and changing the arrangement paths of the wires 307 and 308, which are staple wires, to a certain extent, the tangential directions of the wires 307 and 308 are changed, and therefore the rotation angle of the fastening member (see 329 in FIG. 62) that connects the wires 307 and 308 to the staple pulley 161 is increased. In other words, the fastening member (see 329 in FIG. 62), which is the connecting portion between the wires 307 and 308 and the staple pulley 161, becomes rotatable until it is positioned on the common inscribed line of the staple pulley 161 and the staple assist pulley 162.

[0304] In other words, the wires 307 and 308 are located on the inscribed line between the staple pulley 161 and the staple assist pulley 162, and the rotation angle of the staple pulley 161 is expanded by the staple assist pulley 162.

[0305] According to the present invention, the rotation radius of the staple pulley 161 is increased, which has the effect of widening the yaw operation range in which normal stapling and cutting operations can be performed.

[0306] (staple drive assembly)

[0307] Staple drive assembly 150 is described in more detail below.

[0308] 13 and the like, staple drive assembly 150 may include a staple pulley assembly 160 and a staple link assembly 170. Here, staple drive assembly 150 is characterized in that it is coupled to a reciprocating assembly 550 of cartridge 500, which will be described later, and converts the rotational movement of staple pulley 161 into the linear movement of reciprocating assembly 550. In other embodiments of the present invention, which will be described later, the staple drive assembly can also be understood as a concept including a staple pulley assembly and a staple link assembly.

[0309] Staple pulley assembly 160 may include one or more staple pulleys 161. Staple pulley assembly 160 may be formed between pulley 111 and pulley 121, adjacent to pulley 111 and pulley 121. In this embodiment, it is assumed that staple pulley assembly 160 includes one staple pulley 161.

[0310] The staple pulley 161 may be formed with a shaft through-hole 161a. The shaft through-hole 161a may be formed in a hole shape, and the rotation shaft 141, which is the end tool jaw pulley rotation shaft, may be inserted through the shaft through-hole 161a. Further, the staple pulley 161 may be formed with a link coupling portion 161b. A staple link assembly 170, which will be described later, may be coupled to the link coupling portion 161b. This will be described in more detail later.

[0311] Meanwhile, the end tool 100 according to the first embodiment of the present invention may further include a staple link assembly 170 connected to the staple pulley assembly 160. The staple link assembly 170 may include one or more link members 171. The staple link assembly 170 can serve to connect the staple pulley assembly 160 to a reciprocating assembly 550 of the cartridge 500, which will be described later. In this embodiment, it is assumed that the staple link assembly 170 includes one link member 171, and the link member 171 includes a first link 172 and a second link 173.

[0312] The first link 172 may be formed in the shape of a long, thin bar, with through holes formed at both ends. The link connecting portion 161b of the staple pulley 161 may be inserted through the through hole at one end of the first link 172. The second link 173 may be inserted through the through hole at the other end of the first link 172.

[0313] The second link 173 may be formed in the shape of a long, thin bar and may be coupled to the first link 172. The second link 173 may include a first protrusion 173a, a second protrusion 173b, and a fastening portion 173c.

[0314] Specifically, a first protrusion 173a may be formed on one end of the second link 173. This first protrusion 173a is fitted into a through-hole of the first link 172 for axial coupling, thereby enabling the second link 173 to be coupled to the first link 172. Furthermore, the first protrusion 173a may be fitted into a guide groove 101b of the first jaw 101, which will be described later.

[0315] Meanwhile, a second protrusion 173b may be formed in one region of the center of the second link 173. The second protrusion 173b may be fitted into a guide groove 101b of the first jaw 101, which will be described later.

[0316] In this manner, with the first protruding portion 173a and the second protruding portion 173b of the second link 173 formed in a protrusion shape fitted into the groove-shaped guide groove 101b, the first protruding portion 173a and the second protruding portion 173b move along the guide groove 101b, whereby the staple link assembly 170 moves relative to the first jaw 101 (and the cartridge 500 therein). This will be described in more detail later.

[0317] Meanwhile, a fastening portion 173c may be formed at the other end of the second link 173. This fastening portion 173c may be coupled to a fastening portion 551a of a reciprocating assembly 550 of the cartridge 500, which will be described later.

[0318] 13, when the staple pulley 161 rotates clockwise, the link member 171 connected to the staple pulley 161 can move generally toward the distal portion (see 101f in FIG. 14) of the first jaw 101. Conversely, when the staple pulley 161 rotates counterclockwise, the link member 171 connected to the staple pulley 161 can move generally toward the proximal portion (see 101g in FIG. 14) of the first jaw 101.

[0319] Thus, bidirectional rotational movement of staple pulley assembly 160 can cause reciprocating linear movement of reciprocating assembly 550 of cartridge 500 through staple link assembly 170, as will be described in more detail below.

[0320] (First jaw, second jaw and actuation movement)

[0321] The coupling structure between the first jaw 101 and the second jaw 102 of the end tool 100 of the surgical instrument 10 in FIG. 2 will be described in more detail below.

[0322] Fig. 14 is a plan view showing a first jaw of the surgical instrument of Fig. 2, and Fig. 15 is a plan view showing a second jaw of the surgical instrument of Fig. 2. Fig. 16 is a plan view showing the opening and closing operation of the first jaw of the surgical instrument of Fig. 2, Fig. 17 is a plan view showing the opening and closing operation of the second jaw of the surgical instrument of Fig. 2, and Fig. 18 is a plan view showing the opening and closing operation of the first and second jaws of the surgical instrument of Fig. 2. Fig. 19 is a perspective view showing the opening and closing operation of the endotool of the surgical instrument of Fig. 2, and Fig. 20 is a plan view showing the opening and closing operation of the endotool of the surgical instrument of Fig. 2.

[0323] 9 to 20, the first jaw 101 includes a cartridge accommodating portion 101a, a guide groove 101b, a movable coupling hole 101c, a jaw pulley coupling hole 101d, and a shaft through portion 101e.

[0324] The first jaw 101 is formed in an elongated rod shape overall, with the cartridge 500 housed on the distal portion 101f side and a pulley 111 coupled to the proximal portion 101g, so as to be rotatable around a rotation axis 141. In other words, the first jaw 101 may be formed in a form in which one surface (top surface) of a hollow box is removed overall, and a cartridge housing portion 101a capable of housing the cartridge 500 may be formed inside the first jaw 101. In other words, the cross section of the first jaw 101 may be formed in a substantially "U" shape.

[0325] A guide groove 101b for guiding movement of a staple link assembly 170, which will be described later, may be formed on one side of the cartridge accommodating portion 101a of the first jaw 101, for example, on the side of the proximal portion 101g. The guide groove 101b may be formed in a groove shape along a movement path of the staple link assembly 170. Then, in a state in which a first protruding portion 173a and a second protruding portion 173b of the second link 173 formed in a protrusion shape are fitted into the groove-shaped guide groove 101b, the first protruding portion 173a and the second protruding portion 173b move along the guide groove 101b, whereby the staple link assembly 170 moves relative to the first jaw 101 (and the cartridge 500 therein). In other words, the staple link assembly 170 can move along the guide groove 101b of the first jaw 101.

[0326] Meanwhile, a movable coupling hole 101c, a jaw pulley coupling hole 101d, and a shaft through-hole 101e may be formed on the proximal end side of the first jaw 101.

[0327] Here, the movable coupling hole 101c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 111a of a pulley 111, which will be described later, may be fitted into this movable coupling hole 101c. Here, the minor radius of the movable coupling hole 101c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 111a. Meanwhile, the major radius of the movable coupling hole 101c may be formed to be larger than the radius of the shaft coupling portion 111a. Therefore, when the shaft coupling portion 111a of the pulley 111 is fitted into the movable coupling hole 101c of the first jaw 101, the shaft coupling portion 111a is formed to be able to move within the movable coupling hole 101c to a certain extent. This will be described in more detail later.

[0328] Meanwhile, the jaw pulley coupling hole 101d is formed in a cylindrical hole, and a jaw coupling portion 111b of a pulley 111, which will be described later, may be fitted into the jaw pulley coupling hole 101d. Here, the radius of the jaw pulley coupling hole 101d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 111b. Therefore, the jaw coupling portion 111b of the pulley 111 may be formed to be rotatably coupled to the jaw pulley coupling hole 101d of the first jaw 101. This will be described in more detail later.

[0329] The shaft through-hole 101e may be formed relatively closer to the distal portion 101f of the first jaw 101 than the movable coupling hole 101c and the jaw pulley coupling hole 101d. The shaft through-hole 101e may be formed in a hole shape, and a rotation shaft 145 that is a jaw rotation shaft may be inserted through the shaft through-hole 101e.

[0330] The second jaw 102 includes an anvil 102a, a movable coupling hole 102c, a jaw pulley coupling hole 102d, and a shaft through-portion 102e.

[0331] The second jaw 102 is formed in an elongated rod shape overall, with an anvil 102a formed on the distal portion 102f side, and a pulley 112 coupled to the proximal portion 102g, and is formed to be rotatable around a rotation axis 141.

[0332] Specifically, the anvil 102a is formed in a flat plane shape, and one surface thereof may be formed with a shape corresponding to the shape of the staple 530, which will be described later. Such an anvil 102a can play the role of a base that supports the opposite side of the working member 540 when the working member 540 pushes up the staple 530 during the stapling operation, thereby allowing the staple 530 to be bent.

[0333] On the other hand, a movable coupling hole 102c, a jaw pulley coupling hole 102d, and a shaft through-hole 102e may be formed on the proximal end side of the second jaw 102.

[0334] Here, the movable coupling hole 102c may be formed to have a predetermined curvature and may be formed into a substantially elliptical shape. A shaft coupling portion 121a of a pulley 121, which will be described later, may be fitted into this movable coupling hole 102c. Here, the minor radius of the movable coupling hole 102c may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion 121a. Meanwhile, the major radius of the movable coupling hole 102c may be formed to be larger than the radius of the shaft coupling portion 121a. Therefore, when the shaft coupling portion 121a of the pulley 121 is fitted into the movable coupling hole 102c of the second jaw 102, the shaft coupling portion 121a is formed to be able to move within the movable coupling hole 102c to a certain extent. This will be described in more detail later.

[0335] Meanwhile, the jaw pulley coupling hole 102d is formed in a cylindrical hole, and a jaw coupling portion 121b of the pulley 121, which will be described later, may be fitted into the jaw pulley coupling hole 102d. Here, the radius of the jaw pulley coupling hole 102d may be substantially the same as or slightly larger than the radius of the jaw coupling portion 121b. Therefore, the jaw coupling portion 121b of the pulley 121 may be formed to be rotatably coupled to the jaw pulley coupling hole 102d of the second jaw 102. This will be described in more detail later.

[0336] Meanwhile, the shaft through-hole 102e may be formed relatively closer to the distal portion 102g of the second jaw 102 than the movable coupling hole 102c and the jaw pulley coupling hole 102d. The shaft through-hole 102e may be formed in a hole shape, and a rotation shaft 145 that is a jaw rotation shaft may be inserted through the shaft through-hole 102e.

[0337] The pulley 111, which is the first jaw pulley, may include a shaft coupling portion 111a and a jaw coupling portion 111b. The pulley 111 may be formed in a rotatable disk shape overall, with the shaft coupling portion 111a and the jaw coupling portion 111b formed to protrude to a certain extent from one surface of the pulley 111. As described above, the shaft coupling portion 111a of the pulley 111 may be fitted into the movable coupling hole 101c of the first jaw 101, and the jaw coupling portion 111b of the pulley 111 may be fitted into the jaw pulley coupling hole 101d of the first jaw 101. The pulley 111 may be formed to be rotatable around a rotation axis 141, which is an end tool jaw pulley rotation axis.

[0338] Meanwhile, the pulley 121, which is the second jaw pulley, may also include a shaft coupling portion 121a and a jaw coupling portion 121b. The pulley 121 may be formed in a rotatable disk shape as a whole, and the shaft coupling portion 121a and the jaw coupling portion 121b may be formed to protrude to a certain extent from one surface of the pulley 121. As described above, the shaft coupling portion 112a of the pulley 112 may be fitted into the movable coupling hole 102c of the second jaw 102, and the jaw coupling portion 112b of the pulley 112 may be fitted into the jaw pulley coupling hole 102d of the second jaw 102. The pulley 121 may be formed to be rotatable around the rotation axis 141, which is the end tool jaw pulley rotation axis.

[0339] The connection relationships between the above components are as follows:

[0340] The rotating shaft 141, which is the end tool jaw pulley rotating shaft, is inserted through the shaft coupling portion 111a of the pulley 111, the movable coupling hole 101c of the first jaw 101, the shaft through portion 161a of the staple pulley 161, the movable coupling hole 102c of the second jaw 102, and the shaft coupling portion 121a of the pulley 121 in that order.

[0341] A rotary shaft 145 that is a jaw rotary shaft is inserted through the shaft through-hole 101e of the first jaw 101 and the shaft through-hole 102e of the second jaw 102 in this order.

[0342] The shaft coupling portion 111 a of the pulley 111 is fitted into the movable coupling hole 101 c of the first jaw 101 , and the jaw coupling portion 111 b of the pulley 111 is fitted into the jaw pulley coupling hole 101 d of the first jaw 101 .

[0343] At this time, the jaw pulley coupling hole 101d of the first jaw 101 and the jaw coupling portion 111b of the pulley 111 are rotatably coupled to each other, and the movable coupling hole 101c of the first jaw 101 and the shaft coupling portion 111a of the pulley 111 are movably coupled to each other.

[0344] The shaft coupling portion 121a of the pulley 121 is fitted into the movable coupling hole 102c of the second jaw 102, and the jaw coupling portion 121b of the pulley 121 is fitted into the jaw pulley coupling hole 102d of the second jaw 102.

[0345] At this time, the jaw pulley coupling hole 102d of the second jaw 101 and the jaw coupling portion 121b of the pulley 121 are rotatably coupled to each other, and the movable coupling hole 102c of the second jaw 102 and the shaft coupling portion 121a of the pulley 121 are movably coupled to each other.

[0346] Here, the pulley 111 and the pulley 121 rotate around a rotation axis 141 which is an end tool jaw pulley rotation axis. The first jaw 101 and the second jaw 102 rotate around a rotation axis 145 which is a jaw rotation axis. That is, the pulley 111 and the first jaw 101 have different rotation axes. Similarly, the pulley 121 and the second jaw 102 have different rotation axes.

[0347] That is, the first jaw 101 has its rotation angle limited to a certain extent by the movable coupling hole 101c, but basically rotates around the rotation axis 145, which is the jaw rotation axis. Similarly, the second jaw 102 has its rotation angle limited to a certain extent by the movable coupling hole 102c, but basically rotates around the rotation axis 145, which is the jaw rotation axis.

[0348] The amplification of the grip force due to the coupling relationship between the above-mentioned components will now be described.

[0349] The surgical instrument 10 according to one embodiment of the present invention is characterized in that the coupling structure between the first jaw 101 and the second jaw 102 forms an X-shape, and when the first jaw 101 and the second jaw 102 rotate in a direction toward each other (i.e., when the first jaw 101 and the second jaw 102 are closed), the grip force in the direction in which the first jaw 101 and the second jaw 102 are closed increases. This will be explained in more detail as follows.

[0350] As described above, there are two axes that serve as rotation centers when the first jaw 101 and the second jaw 102 open and close. That is, the first jaw 101 and the second jaw 102 open and close around two axes, the rotation axis 141 and the rotation axis 145. At this time, the rotation center between the first jaw 101 and the second jaw 102 is the rotation axis 145, and the rotation center between the pulley 111 and the pulley 121 is the rotation axis 141. At this time, the rotation axis 141 serves as an axis whose position is fixed relative to the pulley 111, and the rotation axis 145 serves as an axis whose position moves linearly relative to the pulley 121. In other words, when the pulley 111 and the pulley 121 rotate with the position of the rotation axis 141 fixed, the rotation axis 145, which is the rotation axis between the first jaw 101 and the second jaw 102, moves back and forth, and the first jaw 101 and the second jaw 102 open and close. This will be explained in more detail as follows.

[0351] 17, r1 is the distance from jaw coupling portion 121b to shaft coupling portion 121a of pulley 121, and this length is constant. Therefore, the distance from rotating shaft 141 inserted into shaft coupling portion 121a to jaw coupling portion 121b is also constant at r1.

[0352] 17 is the distance from the jaw pulley coupling hole 102d of the second jaw 102 to the shaft penetrating portion 102e, and this length is constant. Therefore, the distance from the jaw coupling portion 121b of the pulley 121 inserted into the jaw pulley coupling hole 102d to the rotation shaft 145 inserted into the shaft penetrating portion 102e is also constant at r2.

[0353] That is, the lengths of r1 and r2 are maintained constant. Therefore, when the pulleys 111 and 121 rotate around the rotation axis 141 in the directions of arrow A1 in Fig. 16 and arrow A2 in Fig. 17 to perform a closing operation, the first jaw 101 and the second jaw 102 rotate around the rotation axis 145 while the angle between r1 and r2 changes with the lengths of r1 and r2 maintained constant, and at this time, the rotation axis 145 itself also moves linearly (i.e., forward / backward) by the amount of arrow B1 in Fig. 16 and arrow B2 in Fig. 17.

[0354] That is, assuming that the position of the rotation axis 141, which is the rotation axis of the end tool jaw pulley, is fixed, when the first jaw 101 and the second jaw 102 are closed, the rotation axis 145, which is the jaw rotation axis, receives a force in the forward direction (i.e., toward the distal end), and therefore the grip force in the direction in which the first jaw 101 and the second jaw 102 are closed becomes even greater.

[0355] From another perspective, when the second jaw 102 rotates around the jaw rotation axis 145, the length of r1 and r2 is maintained constant, and therefore when the pulley 121 rotates around the rotation axis 141, the angle between r1 and r2 changes while the lengths of r1 and r2 are maintained constant. That is, compared with θ1, which is the angle between r1 and r2 when the second jaw 102 is in an open state as shown in Figure 17(a), θ2, which is the angle between r1 and r2 when the second jaw 102 is in a closed state as shown in Figure 17(b), becomes larger.

[0356] Therefore, when the second jaw 102 rotates from an open state to a closed state, the angle between r1 and r2 changes, and the rotation shaft 145 receives a force in the forward direction.

[0357] At this time, since the rotation axis 141 is an axis whose position is relatively fixed, the jaw rotation axis 145 advances in the direction of arrow B1 in FIG. 16 and arrow B2 in FIG. 17, and the grip force increases in the direction in which the second jaw 102 is closed.

[0358] From another perspective, when pulley 111 and pulley 121 rotate around rotation axis 141, which is an axis whose relative position is fixed, the angle θ between r1 and r2 changes while the distance between r1 and r2 remains constant. When the angle θ changes, first jaw 101 and second jaw 102 push and pull rotation axis 145, causing rotation axis 145 to move forward or backward. When first jaw 101 and second jaw 102 rotate in a direction to close, rotation axis 145 moves forward in the direction of arrow B1 in FIG. 16 and arrow B2 in FIG. 17, increasing the grip force. Conversely, when first jaw 101 and second jaw 102 rotate in a direction to open, rotation axis 145 moves backward in the direction opposite to arrow B1 in FIG. 16 and arrow B2 in FIG. 17.

[0359] With this configuration, when the first jaw 101 and the second jaw 102 are closed, the grip force becomes stronger, and the surgeon can obtain the effect of performing a strong actuation operation with less force.

[0360] (cartridge)

[0361] The cartridge 500 of the surgical instrument 10 of FIG. 2 will be described in more detail below.

[0362] FIG. 21 is a perspective view showing the first jaw and cartridge of the surgical instrument of FIG. 2. FIG. 22 is an exploded perspective view showing the cartridge of FIG. 21, FIG. 23 is an assembled perspective view showing the cartridge of FIG. 21, FIG. 24 is a side view showing the cartridge of FIG. 21, FIG. 25 is a perspective sectional view showing the cartridge of FIG. 21, and FIG. 26 is a side sectional view showing the cartridge of FIG. 21. FIGS. 27 and 28 are perspective views showing a working member of the cartridge of FIG. 21. FIG. 29 is a side sectional view showing the structure related to stapling of the endotool of the surgical instrument of FIG. 2, and FIGS. 30 and 31 are perspective sectional views showing the structure related to stapling of the endotool of the surgical instrument of FIG. 2. FIGS. 32 to 35 are perspective views showing the ratchet drive operation of the endotool of FIG. 30, and FIGS. 36 and 37 are plan views showing the ratchet drive operation of the endotool of FIG. 30. Figure 38 is a perspective view generally illustrating a ratchet driving operation of the end tool of Figure 30. Figures 39 and 40 are perspective views generally illustrating a stapling operation of the end tool of Figure 30.

[0363] 21 to 40, the cartridge 500 is formed to be attachable to and detachable from the first jaw 101, includes a plurality of staples 530 and a blade 542 therein, and performs suturing and cutting of tissue. Here, the cartridge 500 may include a cover 510, a housing 520, the staples 530, a puller member 535, a working member 540, and a reciprocating assembly 550.

[0364] The housing 520 forms the outer shape of the cartridge 500, and may be formed in a form in which one surface (top surface) of a generally hollow box is removed, and may be formed to accommodate the reciprocating assembly 550, the working member 540, and the staples 530 therein. Here, the cross section of the housing 520 may be formed in a substantially "U" shape.

[0365] The cover 510 is formed to cover the upper part of the housing 520. The cover 510 may be formed with staple holes 511 through which a plurality of staples 530 can be ejected to the outside. Before the stapling drive, the staples 530 housed inside the housing 520 are pushed up by the working member 540 during the stapling operation, pass through the staple holes 511 in the cover 510, and are pulled out to the outside of the cartridge 500, where the stapling is performed.

[0366] Meanwhile, a slit 512 may be formed in the cover 510 along its longitudinal direction. The blade 542 of the working member 540 may protrude to the outside of the cartridge 500 through the slit 512. As the blade 542 of the working member 540 passes along this slit 512, it can cut the tissue after the staple fastening is completed.

[0367] A plurality of staples 530 may be disposed inside the housing 520. As a working member 540 (described later) moves linearly in one direction, the plurality of staples 530 are sequentially pushed up from the inside to the outside of the housing 520 to perform suturing, i.e., stapling. Here, the material of the staples 530 may include titanium, stainless steel, etc.

[0368] Meanwhile, a pull-out member 535 may be further disposed between the housing 520 and the staples 530. In other words, it may be expressed that the staples 530 are disposed on the upper part of the pull-out member 535. In this case, the working member 540 moves linearly in one direction to push up the pull-out member 535, and the pull-out member 535 can push up the staples 530.

[0369] In this way, it can be said that the working member 540 pushes up the staples 530, including both a case where the working member 540 directly pushes up the staples 530 and a case where the working member 540 pushes up the pull-out member 535 and the pull-out member 535 pushes up the staples 530 (i.e., a case where the working member 540 indirectly pushes up the staples 530).

[0370] A reciprocating assembly 550 may be disposed below and within the housing 520. The reciprocating assembly 550 may include one or more reciprocating members 551. While the present embodiment is shown as including one reciprocating member 551, in embodiments described below, multiple reciprocating members 551 may be included.

[0371] In this embodiment, the reciprocating member 551 may be a rack. The reciprocating member 551 may include a concave-convex portion 551b and a fastening portion 551a. Specifically, the reciprocating member 551 may be formed in a long bar shape, and may have a plurality of sawtooth-like concave-convex portions 551b formed on one surface. The concave-convex portion 551b may be formed to be able to come into contact with a working member 540, which will be described later, in particular, a ratchet member 543 of the working member 540. In other words, the reciprocating member 551 may include a plurality of concave-convex portions 551b shaped to mesh with a ratchet 543a of the ratchet member 543.

[0372] Meanwhile, although not shown in the drawings, the reciprocating member 551 may be provided as a member of various shapes other than a rack shape, which is directly or indirectly connected to the staple pulley 161 and can perform linear reciprocating motion according to the rotational motion of the staple pulley 161. For example, the reciprocating member 551 may be in the form of a clutch without any uneven portions.

[0373] Here, the reciprocating member 551 may not be fixedly connected to other components of the cartridge 500, but may be formed to be movable relative to other components of the cartridge 500. That is, the reciprocating member 551 may perform a reciprocating linear motion with respect to the housing 520 and the cover 510 connected to the housing 520.

[0374] Meanwhile, a fastening portion 551a may be formed on the reciprocating member 551 at a proximal end 501 side adjacent to the pulley 111, and this fastening portion 551a may be fastened and coupled to the staple link assembly 170 of the end tool 100. Therefore, when the staple link assembly 170 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the reciprocating member 551 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction). This will be described in more detail later.

[0375] A working member 540 may be disposed inside the housing 520. The working member 540 may be formed to be able to come into contact with the reciprocating member 551 and to move linearly in one direction in response to the reciprocating linear movement of the reciprocating member 551. In other words, the working member 540 interacts with the reciprocating member 551 and performs stapling and cutting while moving along the extension direction of the connecting portion 400.

[0376] The working member 540 may include a wedge 541 , a blade 542 , a ratchet member 543 , a resilient member 544 , and a body 545 .

[0377] The body 545 may be formed in the shape of a rectangular pillar and forms the base of the working member 540 .

[0378] The wedge 541 may be formed on at least one side of the main body 545 and may be formed to have a predetermined inclined surface. That is, the wedge 541 may be formed to be inclined to a certain degree in the extending direction of the connecting portion 400. In other words, the wedge 541 may be formed so that the height of the proximal portion 501 side of the cartridge 500 is higher than the height of the distal portion 502 side. Although the figures show two wedges 541 formed on each side of the main body 545, the concept of the present invention is not limited thereto, and various numbers and shapes of wedges may be formed depending on the shape of the staple 530 or the puller member 535 that comes into contact with the wedges 541.

[0379] Such a wedge 541 is formed so as to be able to sequentially come into contact with the puller member 535 or the plurality of staples 530, and can play a role in sequentially pushing up the staples 530. As shown in FIG. 40 etc., which will be described later, as the working member 540 moves toward the distal portion 502, the wedge 541 can play a role in sequentially pushing up the staples 530 and pulling them out of the cartridge 500.

[0380] A blade 542 may be formed on one side of the wedge 541, more specifically, on the proximal portion 501 side of the wedge 541. A sharp edge 542a that cuts tissue is formed in one region of the blade 542. At least a portion of this edge 542a is drawn to the outside of the first jaw 101 and the cartridge 500, so that tissue disposed between the first jaw 101 and the second jaw 102 can be cut. The edge 542a of the blade 542 may always be drawn to the outside of the first jaw 101. Alternatively, the edge 542a of the blade 542 may be normally housed inside the first jaw 101 or the cartridge 500, and may be drawn to the outside of the first jaw 101 only when the working member 540 moves along the longitudinal direction.

[0381] The ratchet member 543 may be formed on one side of the wedge 541, more specifically, on a lower portion of the wedge 541, and may be formed to face the reciprocating member 551 described below. The ratchet member 543 may be formed in a bar shape and may include a plurality of ratchets 543a on one surface. The ratchet member 543 causes the working member 540 to move only in one direction (i.e., toward the distal end) relative to the reciprocating member 551. The ratchet 543a of the ratchet member 543 may be formed to be able to come into contact with the uneven portion 551b of the reciprocating member 551 described above.

[0382] The elastic member 544 is formed on either side of the main body 545 or the wedge 541 and serves to apply a predetermined elastic force to the ratchet member 543. For example, one region of the elastic member 544 may be connected to the wedge 541 or the main body 545, and another region of the elastic member 544 may be connected to the ratchet member 543, so that the elastic member 544 connects the wedge 541 or the main body 545 to the ratchet member 543. Here, the elastic member 544 can apply an elastic force in a direction in which the ratchet member 543 comes into close contact with the reciprocating member 551. For this reason, the elastic member 544 may be formed in the form of a leaf spring, or may be provided in various other forms that can apply a predetermined elastic force to the ratchet member 543, such as a coil spring or a disc spring.

[0383] Here, the ratchet 543a of the ratchet member 543 may have a first surface 543a1 (specifically, the side surface of the distal portion 502) formed to have a predetermined angle and a gentle slope, and a second surface 543a2 (specifically, the side surface of the proximal portion 501) formed to be vertical or nearly vertical.

[0384] In order to engage with the ratchet 543a of the ratchet member 543, the uneven portion 551b of the reciprocating member 551 may also be formed such that the first surface 551b1 (more specifically, the side surface of the proximal portion 501) has a gentle slope at a predetermined angle, and the second surface 551b2 (more specifically, the side surface of the distal portion 502) is vertical or nearly vertical.

[0385] When reciprocating member 551 and ratchet member 543 are fastened (or engaged, or in close contact) with each other, inclined first surface 543a1 of ratchet 543a and inclined first surface 551b1 of uneven portion 551b may be arranged to face each other (i.e., to abut). Also, vertical second surface 543a2 of ratchet 543a and vertical second surface 551b2 of uneven portion 551b may be arranged to face each other (i.e., to abut).

[0386] With this configuration, when ratchet 543a and concave / convex portion 551b are fastened (or meshed) with each other, they act as a kind of ratchet, and movement in only one direction is possible.

[0387] As an example, assuming that the reciprocating member 551 is fixed, the working member 540 can move in a direction in which the vertically formed second surfaces 543a2 and 551b2 move away from each other, but cannot move in a direction in which the second surfaces 543a2 and 551b2 move toward each other while in contact with each other.

[0388] From another perspective, when the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other and the reciprocating member 551 moves toward the distal portion 502, the ratchet member 543 moves together with the reciprocating member 551 toward the distal portion 502. That is, the vertical second surface 551b2 of the reciprocating member 551 presses the vertical second surface 543a2 of the working member 540, and the ratchet member 543 moves together with the reciprocating member 551 toward the distal portion 502.

[0389] Conversely, when the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other and the reciprocating member 551 moves toward the proximal part 501, the ratchet member 543 remains fixed and only the reciprocating member 551 moves independently toward the proximal part 501. That is, with the working member 540 remaining fixed, the inclined first surface 551b1 of the reciprocating member 551 moves along the inclined first surface 543a1 of the working member 540, and only the reciprocating member 551 moves independently toward the proximal part 501.

[0390] 34 to 37, when the reciprocating member 551 moves toward the proximal portion 501 (in the direction of arrow K1 in FIGS. 35 and 37) in the same state as in FIGS. 34 and 36, the inclined first surface 551b1 of the reciprocating member 551 moves along the inclined first surface 543a1 of the working member 540, and the ratchet member 543 is pressed and pushed as a whole in the direction of arrow K2 in FIG. 35. At this time, the elastic member 544 also elastically deforms to a certain extent.

[0391] In this state, when reciprocating member 551 moves further toward proximal portion 501 and inclined first surface 551b1 of reciprocating member 551 passes the tip of inclined first surface 543a1 of working member 540, uneven portion 551b of reciprocating member 551 comes into contact with the next ratchet 543a of ratchet member 543. At this time, elastic member 544 applies an elastic force in a direction in which ratchet member 543 comes into close contact with reciprocating member 551, and therefore reciprocating member 551 and ratchet member 543 again come into close contact with each other at their front faces.

[0392] As a result, the cartridge 500 is housed in the cartridge housing portion 101a of the first jaw 101, and at this time, the reciprocating member 551 of the cartridge 500 and the staple link assembly 170 of the end tool 100 are coupled together. Therefore, the rotational motion of the staple pulley 161 of the end tool 100 is converted into the linear motion of the reciprocating member 551 via the staple link assembly 170.

[0393] At this time, the fastening portion 551a of the reciprocating member 551 is connected to the staple pulley 161 via the staple link assembly 170, and when the staple pulley 161 rotates alternately clockwise and counterclockwise, the reciprocating member 551 can repeatedly move forward and backward. When the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551, and when the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward, and the working member 540 can remain stationary. By repeating this process, the working member 540 moves forward, and the staples 530 are stapled by the wedge 541, and at the same time, the blade 542 can cut the stapled tissue.

[0394] This will be explained in more detail as follows.

[0395] (stapling and cutting action)

[0396] Referring to FIG. 38, a method for operating a surgical instrument according to one embodiment of the present invention is as follows.

[0397] First, when the staple pulley 161 rotates in one of the clockwise and counterclockwise directions, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating assembly 550 of the cartridge 500 connected to the staple link assembly 170 move toward the distal portion 502 of the cartridge 500.

[0398] As the reciprocating assembly 550 moves toward the distal portion 502 of the cartridge 500 , the working member 540 in contact with the reciprocating assembly 550 moves toward the distal portion 502 of the cartridge 500 along with the reciprocating assembly 550 .

[0399] Then, while the working member 540 moves toward the distal portion 502 of the cartridge 500, the working member 540 ejects the staples 530 out of the cartridge 500, and at the same time, the blade 542 of the working member 540 moves toward the distal portion 502 of the cartridge 500.

[0400] On the other hand, when the staple pulley 161 rotates in one of the clockwise and counterclockwise directions, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating assembly 550 of the cartridge 500 connected to the staple link assembly 170 move toward the proximal part 501 of the cartridge 500, and at this time the working member 540 is stopped.

[0401] These steps are then repeated, with the stapling action by the wedge 541 and the cutting action by the blade 542 being performed simultaneously.

[0402] This will be explained in more detail as follows.

[0403] First, in the state shown in Figure 38(a), when the staple pulley 161 rotates in the direction of arrow A1 (i.e., clockwise) as shown in Figure 38(b), the staple link assembly 170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 170 move in the direction of arrow B1 (i.e., toward the distal portion). In this state, the reciprocating member 551 and the working member 540 are in close contact with each other due to the elastic member (see 544 in Figure 37), so when the reciprocating member 551 moves in the direction of arrow B1, the working member 540 also moves in the direction of arrow B1 together with the reciprocating member 551.

[0404] Next, when the staple pulley 161 further rotates in the direction of arrow A2 as shown in Figure 38(c), the staple link assembly 170, the reciprocating member 551, and the working member 540 connected thereto move further in the direction of arrow B2.

[0405] In this state, when the staple pulley 161 stops rotating, the staple link assembly 170, the reciprocating member 551, and the working member 540 also stop, as shown in FIG. 38(d).

[0406] In this state, as shown in Figure 38(e), when the staple pulley 161 starts to rotate in the direction of arrow A3 (i.e., counterclockwise), the staple link assembly 170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 170 move in the direction of arrow B3 (i.e., toward the proximal portion). In this state, even if the reciprocating member 551 moves in the B3 direction, the overall position of the working member 540 is maintained as it is due to the fastening structure between the ratchet member 543 and the reciprocating member 551, and only the ratchet member 543 repeatedly moves away from and into contact with the reciprocating member 551 to a certain extent as the elastic member 544 repeatedly elastically deforms and restores (see Figures 35 and 37). In other words, even if the reciprocating member 551 moves in the direction of arrow B3, the working member 540 remains stopped in place when viewed from the X-axis direction.

[0407] As shown in FIG. 38(f), when the staple pulley 161 rotates further in the direction of the arrow A4, only the staple link assembly 170 and the reciprocating member 551 connected thereto move further in the direction of the arrow B4.

[0408] In this state, when the staple pulley 161 stops rotating, the staple link assembly 170, the reciprocating member 551, and the working member 540 also stop, as shown in FIG. 38(a).

[0409] While repeating this process, the staple pulley 161 rotates alternately in the clockwise and counterclockwise directions, causing the reciprocating member 551 to repeatedly move forward and backward, and the working member 540 to repeatedly move forward and stop, resulting in the working member 540 moving toward the distal portion 502. Then, while the working member 540 moves toward the distal portion 502, the stapling action by the wedge 541 and the cutting action by the blade 542 are simultaneously performed.

[0410] The stapling action of a surgical instrument according to one embodiment of the present invention will now be described.

[0411] 39 is a perspective view showing the stapling operation of the end tool of FIG. 30 in sections, and FIG. 40 is a perspective view showing the stapling operation of the end tool of FIG. 30 as a whole.

[0412] 39 and 40, while the working member 540 moves in the direction of arrow A1 in FIG. 39(b) in the state shown in FIG. 39(a), the wedge 541 of the working member 540 pushes up the pull-out member 535, and the pull-out member 535 pushes up one side below the staple 530. As a result, the staple 530 is ejected to the outside of the first jaw 101 and the cartridge 500.

[0413] In this state, when the working member 540 moves further in the direction of arrow A2 in Figure 39(c), the ejected staple 530 continues to be pushed up by the working member 540 while in contact with the anvil 102a of the second jaw 102, and the staple 530 is stapled while both ends of the staple 530 are bent.

[0414] While such an operation is continuously performed, as shown in FIG. 40, among the plurality of staples 530, stapling is performed in order from the staples 530 on the proximal portion 501 side to the staples 530 on the distal portion 502 side.

[0415] (Operation unit)

[0416] Figures 41 and 42 are perspective views showing the operation portion of the surgical instrument of Figure 2. Figure 43 is a diagram simply showing only the configuration of pulleys and wires that form the joints of the surgical instrument shown in Figure 2.

[0417] 2 to 42, the operating unit 200 of the surgical instrument 10 according to the first embodiment of the present invention includes a first handle 204 that can be held by the user, an actuation operating unit 203 that controls the actuation movement of the end tool 100, a yaw operating unit 202 that controls the yaw movement of the end tool 100, and a pitch operating unit 201 that controls the pitch movement of the end tool 100. Here, it can be understood that only the components related to the pitch / yaw / actuation movements of the surgical instrument 10 are shown in FIGS.

[0418] Additionally, the operating portion 200 of the surgical instrument 10 may further include a staple operating portion 260 that controls the movement of the staple pulley assembly 160 of the endotool 100 to perform stapling and cutting.

[0419] The operating unit 200 may include pulleys 210, 211, 212, 213, 214, 215, 216, 217, and 218 involved in the rotational movement of the first jaw 101. 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 102. The operating unit 200 may also include pulleys 231, 232, 233, and 234 involved in the pitch movement. 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.

[0420] Here, although the figures show 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.

[0421] 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.

[0422] 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.

[0423] 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.

[0424] 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.

[0425] 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.

[0426] 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.

[0427] 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.

[0428] 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.

[0429] 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.

[0430] The above components can be classified as follows from the viewpoint of the operating parts for each movement (pitch / yaw / actuation).

[0431] The pitch operation unit 201 that controls the pitch movement of the end tool 100 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.

[0432] The yaw operation unit 202 that controls the yaw movement of the end tool 100 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.

[0433] The actuation operation unit 203 that controls the actuation movement of the end tool 100 may include a pulley 210, a pulley 220, a 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.

[0434] Each component of the operation unit 200 will be described in more detail below.

[0435] 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.

[0436] The actuation operation unit 203 includes a first actuation operation unit 251 and a second actuation operation unit 256. The first actuation operation unit 251 includes a rotating shaft 241, a pulley 210, a first actuation extension 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.

[0437] 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.

[0438] 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.

[0439] 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.

[0440] Here, the first actuation gear 253 and the second actuation gear 258 may be formed to mesh with each other, and may be formed to rotate together in the opposite direction when either side rotates.

[0441] 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.

[0442] 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.

[0443] Specifically, a rotation axis 243, which is the operation unit yaw main rotation axis, is formed on one side of the actuation operation unit 203 on the first handle 204. In this case, the first handle 204 is formed to be rotatable around the rotation axis 243.

[0444] 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.

[0445] 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.

[0446] 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.

[0447] 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.

[0448] 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.

[0449] 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.

[0450] 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 .

[0451] 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.

[0452] Next, the operation of the pitch wires, wire 303 and wire 304, is as follows.

[0453] The end tool 100 is formed with a pulley 131, which is an end tool pitch pulley, fixedly coupled to the end tool hub 180, and the operating unit 200 is formed with pulleys 231 and 232, which are operating unit pitch pulleys, fixedly coupled to the pitch frame 208. These pulleys are connected to each other by wires 303 and 304, which are pitch wires, so that the pitch movement of the end tool 100 can be more easily performed in response to the pitch operation of the operating unit 200. Here, the wire 303 is fixedly coupled to the pitch frame 208 via the pulleys 231 and 233, and the wire 304 is fixedly coupled to the pitch frame 208 via the pulleys 232 and 234. In other words, the pitch rotation of the operating unit 200 causes the pitch frame 208 and the pulleys 231 and 232 to rotate together around the rotation axis 246, and as a result, the wires 303 and 304 also move, and additional pitch rotation power can be transmitted in addition to the pitch movement of the end tool caused by the jaw wires, wires 301, 302, 305, and 306.

[0454] 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.

[0455] Continuing to refer to the drawings, in the surgical instrument 10 according to the first embodiment of the present invention, the pitch control unit 201 and the end tool 100 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 100 is formed at the other end of the connecting portion 400.

[0456] 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.

[0457] 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 100 can be said to be formed on substantially the same or parallel axes. Also, in Figure 3, the pitch control portion 201 and the end tool 100 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 100 may be formed on different axes.

[0458] The staple operating portion 260 is connected to the staple pulley 161 of the end tool 100 by wires 307 and 308, which are staple wires, and can serve to rotate the staple pulley 161 alternately in a clockwise or counterclockwise direction.

[0459] For this reason, although not shown in the figures, the staple operating portion 260 may include a motor (not shown). That is, while a user is pressing the staple operating portion 260 formed in a button shape, the motor (not shown) is driven to rotate the operating portion staple pulley (see 269 in FIG. 47) alternately in a clockwise or counterclockwise direction. This allows the staple pulley 161 of the end tool 100 to rotate alternately in a clockwise or counterclockwise direction.

[0460] (actuation, yaw, pitch)

[0461] The actuation operation, yaw operation, and pitch operation in this embodiment will be described below.

[0462] First, the actuation operation is as follows.

[0463] 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 100 via the power transmission unit 300, and the two jaws 103 of the end tool 100 perform an actuation operation.

[0464] As described above, the actuation operation here refers to the operation of opening and closing the two jaws 101, 102 as they rotate in opposite directions. That is, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated toward each other, the first jaw 101 rotates counterclockwise and the second jaw 102 rotates clockwise, closing the end tool 100. Conversely, when the actuation extensions 252, 257 of the actuation operating unit 203 are rotated away from each other, the first jaw 121 rotates clockwise and the second jaw 122 rotates counterclockwise, opening the end tool 100.

[0465] 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 100 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.

[0466] Next, the yaw motion is as follows:

[0467] 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 101 and the wires 302 and 306 connected to the second jaw 102 are wound around the pulleys 211 and 212 and the pulleys 221 and 222 so that the first jaw 101 and the second jaw 102 rotate in the same direction during yaw rotation. Then, such a rotational force is transmitted to the end tool 100 via the power transmission unit 300, and the two jaws 103 of the end tool 100 perform a yaw operation in which they rotate in the same direction.

[0468] 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.

[0469] Next, the pitch operation is as follows:

[0470] 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 101 and the second jaw 102 can pitch rotate. The jaw wires 301, 305, 302, and 306 are wound around the operation unit pitch main pulleys 217, 218, 227, and 228, respectively. Such a rotational force is then transmitted to the end tool 100 via the power transmission unit 300, and the two jaws 103 of the end tool 100 perform pitch movement.

[0471] At this time, the pitch frame 208 is connected to the yaw frame 207, and the yaw frame 207 connects the first handle 204, the rotation 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.

[0472] In summary, the surgical instrument 10 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), 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 100. 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.

[0473] Figure 43 is a simplified diagram showing only the configuration of pulleys and wires that constitute the joints of the surgical instrument 10 according to one embodiment of the present invention shown in Figure 2. In Figure 43, an intermediate pulley for changing the path of the wire regardless of joint movement is omitted.

[0474] Referring to FIG. 43, the operating unit 200 may include a pulley 210, a pulley 211, a pulley 212, a pulley 213, a pulley 214, a pulley 215, a pulley 216, a pulley 217, and a pulley 218 that are involved in the rotational movement of the first jaw 101.

[0475] 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 122. (The arrangement and configuration of each pulley in the operating unit 200 are fundamentally the same as the arrangement and configuration of each pulley in the end tool 100, so some of the specific reference numerals in the drawings will be omitted.)

[0476] 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.

[0477] 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.

[0478] 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.

[0479] 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 .

[0480] 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 pulley 210 rotates, the wires 301 and 305 are wound around or unwound from pulley 210 accordingly, and the first jaw 101 rotates.

[0481] 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 the pulley 220 rotates, the wires 302 and 306 are wound around or unwound from the pulley 220 accordingly, and the second jaw 102 rotates.

[0482] (Conceptual diagram of pulley and wire)

[0483] 45 and 46 are views showing the configurations of pulleys and wires associated with the actuation and yaw operations of the surgical instrument 10 according to one embodiment of the present invention shown in Fig. 2, resolved for the first and second jaws, respectively. Fig. 45 is a view showing only the pulleys and wires associated with the second jaw, and Fig. 46 is a view showing only the pulleys and wires associated with the first jaw. Fig. 44 is a perspective view showing 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. 44.

[0484] First, the wire operation of the actuation operation will be described.

[0485] Referring to Figure 46, 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 101 of the end tool 100 rotating in the direction of arrow EPA1.

[0486] 45, 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 102 of end tool 100 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 101 and second jaw 102 of the end tool move closer to each other.

[0487] Next, the wire operation for yaw movement will be described.

[0488] 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.

[0489] Referring to Figure 46, 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 101 of the end tool 100 rotates in the direction of the arrow EPY1.

[0490] Referring to Figure 45, 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 101 of the end tool 100 rotates in the direction of the arrow EPY2.

[0491] Figures 47, 48, and 49 are diagrams illustrating the configurations of pulleys and wires associated with the stapling and cutting operations of the surgical instrument 10 according to the embodiment of the present invention shown in Figure 2, with the first jaw and the second jaw disassembled. Here, Figures 47 to 49 mainly illustrate the pulleys and wires associated with the second jaw.

[0492] Here, FIGS. 47 and 48 show the actuation process for closing the two jaws, and FIGS. 48 and 49 show the process for stapling and cutting the tissue interposed between the two jaws.

[0493] First, the wire operation of the actuation operation will be described.

[0494] Referring to Figures 47 and 48, 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 43) and wire (see 305 in Figure 43) wound around the pulley 210 to move, resulting in the first jaw 101 of the end tool 100 rotating in the direction of arrow EPA1.

[0495] 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.

[0496] As a result, when the pulley 111 rotates in the end tool 100 during actuation, the staple pulley 161 also rotates together with the pulley 111 .

[0497] The wire action of the stapling and cutting operation will now be described.

[0498] Referring to Figures 48 and 49, when the staple operating unit 260 is rotated in the direction of the 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 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, and as a result, the staple pulley 161 of the end tool 100 rotates in the direction of the arrow EPC1.

[0499] 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 .

[0500] As a result, when the operating portion staple pulley 269 rotates, the staple pulley 161 of the end tool 100 rotates independently, regardless of the first jaw 101. When the staple pulley 161 rotates alternately in the clockwise and counterclockwise directions, the staple link assembly 170 connected to the staple pulley 161 and the reciprocating assembly 550 of the cartridge 500 connected thereto perform reciprocating linear motions, whereby the working member 540 of the cartridge 500 moves toward the distal portion 502, thereby performing stapling and cutting operations.

[0501] 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 concept 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 staple pulley 161 of the end tool 100 to rotate alternately in a clockwise or counterclockwise direction.

[0502] 51, 52, and 53 are views showing the configuration of pulleys and wires associated with the pitch operation of the surgical instrument 10 according to one embodiment of the present invention shown in FIG. 2, with the first and second jaws disassembled. FIG. 51 shows only the pulleys and wires associated with the second jaw, and FIG. 52 shows only the pulleys and wires associated with the first jaw. FIG. 53 shows only the pulleys and wires associated with the staple pulleys. As shown in FIG. 9 and other figures, there are two pulleys associated with the pitch operation, and both strands of each wire are wound along the same path, which is shown by a single line in FIGS. 51 and 53. FIG. 50 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. 50.

[0503] 51, 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. 51, and therefore move toward the arrow W1 side. As a result, as described with reference to FIG. 5, first jaw 101 of end tool 100 rotates in the direction of arrow EPP1.

[0504] 52, when first handle 204 is rotated in the direction of arrow OPP2 around rotation axis 246, pulleys 220, 225, 227, etc., and wire 302 wound thereon, etc., rotate as a whole around rotation axis 246. At this time, wires 302 and 306, which are second jaw wires, are wound below pulleys 227 and 228, as shown in FIG. 52, and therefore move toward the arrow W2 side. As a result, as described with reference to FIG. 5, second jaw 102 of end tool 100 rotates in the direction of arrow EPP2.

[0505] 53, 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 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 staple pulley 161 of the end tool 100 rotates in the direction of the arrow EPC1.

[0506] As a result, when the pulley 111 of the end tool 100 rotates around the rotation axis 143 during pitch operation, the staple pulley 161 also rotates around the rotation axis 143 together with the pulley 111 .

[0507] Therefore, actuation, yaw, and pitch operations can be performed independently of each other.

[0508] 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.

[0509] In particular, the surgical instrument 10 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), and a wire (first jaw wire or second jaw wire) is wound around this pulley, and rotation of the operating unit (actuation rotation, yaw rotation, pitch rotation) causes movement of each wire, thereby inducing a desired movement of the end tool 100. 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.

[0510] 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.

[0511] (Correlation of Stapling and Cutting Operations with Other Operations)

[0512] The correlation between the stapling and cutting motions and other motions (pitch, yaw and actuation motions) is described below.

[0513] First, when the end tool 100 pitches, the staple pulley 161 also pitches. That is, when the pulleys 111 and 121 perform a pitch motion in which they rotate in the same direction about the rotation axis 143, the staple pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. If the staple pulley 161 does not rotate together with the pulleys 111 and 121 when they rotate about the rotation axis 143, there is a risk that the cartridge 500 connected to the staple pulley 161 will move relative to the first jaw 101 and be separated from the first jaw 101. Furthermore, rotation of the staple pulley 161 that is not synchronized with the pulley 111 may cause the reciprocating member 551 to move unintentionally forward, which may result in an unintentional stapling operation.

[0514] Next, when the end tool 100 yaws, the staple pulley 161 also yaws. That is, when the pulleys 111 and 121 yaw to rotate in the same direction around the rotation axis 141, the staple pulley 161 must also rotate in the same direction together with the pulleys 111 and 121. If the staple pulley 161 does not rotate together with the pulleys 111 and 121 when they rotate around the rotation axis 141, there is a risk that the cartridge 500 connected to the staple pulley 161 will move relative to the first jaw 101 and be separated from the first jaw 101. Furthermore, rotation of the staple pulley 161 that is not synchronized with the rotation of the pulley 111 may cause the reciprocating member 551 to advance unintentionally, which may result in an unintentional stapling operation.

[0515] Next, during actuation of the end tool 100, the staple pulley 161 rotates together with the pulley 111. That is, when the pulleys 111 and 121 perform actuation movements in which they rotate in opposite directions about the rotation axis 141, the staple pulley 161 must rotate in the same direction as the pulley 111. If the staple pulley 161 does not rotate together with the pulley 111 when the pulley 111 rotates about the rotation axis 143, there is a risk that the cartridge 500 coupled to the staple pulley 161 will move relative to the first jaw 101 and become separated from the first jaw 101. Furthermore, rotation of the staple pulley 161 out of synchronization with the pulley 111 may cause unintended advancement of the reciprocating member 551, which may result in unintended stapling.

[0516] Meanwhile, the pulleys 111 and 121 do not rotate during the stapling and cutting operations of the end tool 100. In other words, when the staple pulley 161 rotates around the rotation shaft 141 and the link member 171 and the reciprocating member 551 of the cartridge 500 connected thereto make linear reciprocating motions, the pulleys 111 and 121 must not rotate. Otherwise, the first jaw 101 or the second jaw 102 would rotate during the stapling and cutting operations, preventing normal stapling and cutting operations.

[0517] As a result, when the first jaw pulley, pulley 111, rotates, the staple pulley 161 housed inside the first jaw 101 must also rotate together with the pulley 111. On the other hand, when the staple pulley 161 rotates for stapling and cutting, the pulleys 111 and 121 must be configured to maintain their positions without rotating. The correlation between such stapling and cutting operations and other operations (yaw operation and actuation operation) has been described above.

[0518] From another perspective, this can be expressed as the pulley 111 and the pulley 121 being independent of the rotation of the staple pulley 161. In other words, even if the staple pulley 161 is rotated by the staple wire, the pulleys 111 and 121 do not have to rotate. Conversely, the staple pulley 161 can be expressed as being dependent on the rotation of the pulley 111. In other words, the staple pulley 161 may be formed so that when the pulley 111 is rotated by the jaw wire, the staple pulley 161 also rotates together with the pulley 111.

[0519] Figures 54 and 56 are diagrams showing a state in which the jaw has yaw rotated by -90°, and Figures 55 and 57 are diagrams showing the process of performing an actuation operation in a state in which the jaw has yaw rotated by -90°. Here, Figures 54 and 55 are diagrams showing the pulley 111, and Figures 56 and 57 are diagrams in which the pulley 111 is omitted.

[0520] 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 111, and Figures 60 and 61 are diagrams in which the pulley 111 is omitted.

[0521] As shown in Figures 54 to 61, the end tool of the surgical instrument according to the first embodiment of the present invention is configured to be able to perform normal actuation even when the jaw is yaw rotated by +90° or -90°.

[0522] Figure 62 is a plan view showing the stapling and cutting operations of the endotool of the surgical instrument of Figure 2, and shows the process of performing the stapling and cutting operations with the jaw rotated by +90° in yaw. As shown in Figure 62, 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 yaw.

[0523] Specifically, when the staple pulley 161 rotates alternately clockwise and counterclockwise in a state in which the pulley 111, the pulley 121, and the staple pulley 161 are rotated +90 degrees around the rotation shaft 141, the link member 171 and the reciprocating member 551 connected thereto repeatedly move forward and backward. When the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551, and when the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward, and the working member 540 stops in place. While repeating this process, the working member 540 moves toward the distal portion 502, thereby performing the stapling and cutting operations.

[0524] Figure 63 is a plan view showing the stapling and cutting operations of the endotool of the surgical instrument of Figure 2, and shows the process of performing the stapling and cutting operations with the jaw rotated by -90°. As shown in Figure 63, 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°.

[0525] Specifically, when the staple pulley 161 rotates alternately clockwise and counterclockwise in a state in which the pulley 111, the pulley 121, and the staple pulley 161 are rotated −90 degrees around the rotation shaft 141, the link member 171 and the reciprocating member 551 connected thereto repeatedly move forward and backward. When the reciprocating member 551 moves forward, the working member 540 moves forward together with the reciprocating member 551, and when the reciprocating member 551 moves backward, only the reciprocating member 551 moves backward, and the working member 540 remains stationary. While repeating this process, the working member 540 moves toward the distal portion 502, thereby performing the stapling and cutting operations.

[0526] Figure 64 shows a state in which the jaw has been pitch rotated by -90°, Figure 65 shows a process of performing an actuation operation in which the jaw has been pitch rotated by -90°, Figure 66 shows a state in which the jaw has been pitch rotated by +90°, and Figure 67 shows a process of performing an actuation operation in which the jaw has been pitch rotated by +90°.

[0527] 64 to 67, it can be seen that the operations of the operating unit 200 and the end tool 100 intuitively match when performing pitch movement. That is, when the operating unit 200 rotates in the positive direction based on the pitch rotation axis (Y axis), the end tool 100 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 100 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 100 may be set in various ways depending on the ratio of the pulleys.

[0528] Figure 68 shows a state in which the jaw has yaw rotated by +90°, Figure 69 shows a process of performing an actuation operation in which the jaw has yaw rotated by +90°, Figure 70 shows a state in which the jaw has yaw rotated by -90°, and Figure 71 shows a process of performing an actuation operation in which the jaw has yaw rotated by -90°.

[0529] 68 to 71, it can be seen that the operations of the operating unit 200 and the end tool 100 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 100 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 100 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 100 may be set in various ways depending on the ratio of the pulleys.

[0530] Figure 72 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 73 is a diagram showing a process of performing an actuation operation when the jaw has pitch rotated by -90° and simultaneously rotated in a yaw direction by +90°, Figure 74 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 75 is a diagram showing a process of performing an actuation operation when the jaw has pitch rotated by +90° and simultaneously rotated in a yaw direction by -90°.

[0531] 72 to 75, it can be seen that the operations of the operating unit 200 and the end tool 100 intuitively match even when pitch and yaw operations are performed simultaneously.

[0532] <Second embodiment - engraving>

[0533] The following describes an endotool 700 of a surgical instrument according to a second embodiment of the present invention. The endotool 700 of a surgical instrument according to the second embodiment of the present invention is characterized by a different configuration of an endotool hub 780 that serves as an auxiliary pulley compared to the endotool 100 of a surgical instrument according to the first embodiment of the present invention (see FIG. 2, etc.). This difference in configuration compared to the first embodiment will be described in detail later.

[0534] Figure 87 is a perspective view showing an endotool of a surgical instrument according to a second embodiment of the present invention, and Figures 88 and 89 are enlarged views of the endotool of the surgical instrument of Figure 87. Figures 90 and 91 are enlarged views showing the endotool of the surgical instrument of Figure 87 from another angle. Figures 92 and 93 are views showing a state in which the jaw of the endotool of the surgical instrument of Figure 87 has been yaw-rotated by 90° counterclockwise. Figure 94 is an enlarged perspective view showing the endotool hub of the surgical instrument of Figure 87.

[0535] Here, Figures 89 and 91 show the state where the wires are removed, and Figure 93 shows the state where the jaw pulley connection portion of the end tool hub and the jaw pulley are removed.

[0536] Referring to Figures 87 to 94, an end tool 700 according to a second embodiment of the present invention includes a pair of jaws, i.e., a first jaw 701 and a second jaw 702, for performing a gripping operation, where each of the first jaw 701 and the second jaw 702, or a component encompassing the first jaw 701 and the second jaw 702, can be referred to as jaw 703.

[0537] On the other hand, the end tool 700 includes a plurality of pulleys including pulley 711, pulley 713, and pulley 714 related to the rotational motion of the first jaw 701. In this embodiment, the pulleys related to the rotational motion of the first jaw 701 are substantially the same as the pulleys 113, 114, 115, and 116 described in Fig. 8 and other figures of the first embodiment, and therefore detailed description thereof will be omitted here.

[0538] On the other hand, the end tool 700 includes a plurality of pulleys including a pulley 721 related to the rotational motion of the second jaw 702. In this embodiment, the pulleys related to the rotational motion of the second jaw 702 are substantially the same as the pulleys 123, 124, 125, and 126 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0539] Furthermore, the end tool 700 according to the second embodiment of the present invention may include a rotation shaft 741, a rotation shaft 743, and a rotation shaft 744. Here, the rotation shaft 741 may be inserted through the end tool hub 780, and the rotation shafts 743 and 744 may be inserted through the pitch hub 707. The rotation shafts 741, 743, and 744 may be arranged sequentially from the distal end 704 of the end tool 700 toward the proximal end 705.

[0540] Additionally, the end tool 700 of the second embodiment of the present invention may include an end tool hub 780 and a pitch hub 707 .

[0541] A rotary shaft 741 (described later) is inserted through the end tool hub 780, and pulleys 711 and 721 axially coupled to the rotary shaft 741 and at least a portion of the first jaw 701 and the second jaw 702 coupled thereto may be housed inside the end tool hub 780. Here, one embodiment of the present invention is characterized in that a guide portion 783 functioning as an auxiliary pulley is formed in the end tool hub 780. That is, the end tool hub 780 may be formed with a guide portion 783 that guides the paths of the wires 305 and 302. The guide portion 783 of the end tool hub 780 may function as the auxiliary pulley (see 112, 122, and 162 in FIG. 9 ) in the first embodiment to change the paths of the wires. The guide portion 783 of the end tool hub 780 that functions as an auxiliary pulley will be described in more detail later.

[0542] Meanwhile, a pulley 731 that serves as an end tool pitch pulley may be formed at one end of the end tool hub 780. The pulley 731 may be formed as a separate member from the end tool hub 780 and coupled to the end tool hub 780. Alternatively, the pulley 731 may be formed as a single body with the end tool hub 780. A wire (see 303 in FIG. 5 ) and a wire (see 304 in FIG. 5 ) are coupled to the pulley 731 that serves as the end tool pitch pulley, and the pulley 731 performs a pitch movement while rotating about the rotation axis 743.

[0543] Rotation shafts 743 and 744 are inserted through the pitch hub 707, and the pitch hub 707 can be axially coupled to the end tool hub 780 and the pulley 731 via the rotation shaft 743. Therefore, the end tool hub 780 and the pulley 731 may be formed to be pitch rotatable relative to the pitch hub 707 around the rotation shaft 743.

[0544] On the other hand, the end tool 700 of the second embodiment of the present invention may further include components such as a staple drive assembly (see 150 in FIG. 13) including a staple pulley assembly (see 160 in FIG. 13) and a staple link assembly (see 170 in FIG. 13) for performing stapling and cutting operations.

[0545] A staple pulley assembly (see 160 in FIG. 13) may be formed between pulley 711 and pulley 721 and adjacent to pulley 711 and pulley 721. In this embodiment, it is assumed that the staple pulley assembly (see 160 in FIG. 13) includes one staple pulley 761.

[0546] The staple link assembly (see 170 in FIG. 13) may include one or more link members 771. The staple link assembly (see 170 in FIG. 13) can serve to connect the staple pulley assembly 760 and the reciprocating assembly (see 550 in FIG. 22) of the cartridge (see 500 in FIG. 22). In this embodiment, it is assumed that the staple link assembly (see 170 in FIG. 13) includes one link member 771, and the link member 771 includes a first link 772 and a second link 773.

[0547] On the other hand, the second embodiment of the present invention is characterized in that a staple pulley assembly (see 160 in FIG. 13) and a staple link assembly (see 170 in FIG. 13) are disposed between a pulley 711 that is a first jaw pulley and a pulley 721 that is a second jaw pulley, thereby enabling stapling and cutting operations using a cartridge (see 500 in FIG. 22) in addition to pitch and yaw movements of the end tool 700. In this embodiment, the components for performing the stapling and cutting operations are substantially the same as the components described in the first embodiment, and therefore detailed description thereof will be omitted here.

[0548] The surgical instrument according to the second embodiment of the present invention may include wires 301, 302, 303, 304, 305, 306, 307, and 308, similar to the first embodiment of the present invention shown in Figure 7, etc.

[0549] Furthermore, the surgical instrument according to this second embodiment may include fastening members 321, 323, 324, 326, 327, and 329 coupled to each end of each wire to couple the wire to the pulley, similar to the first embodiment of the present invention shown in FIG. 7 etc.

[0550] The end tool hub 780 according to the second embodiment of the present invention will be described in more detail below, with particular emphasis on the guide portion 783 of the end tool hub 780 that serves as an auxiliary pulley.

[0551] The end tool hub 780 includes a first jaw pulley coupling portion 781 , a second jaw pulley coupling portion 782 , a guide portion 783 , a guide groove 784 , and a pitch pulley coupling portion 785 .

[0552] Specifically, the first jaw pulley coupling portion 781 and the second jaw pulley coupling portion 782 are formed to face each other, and accommodate the pulley 711, the pulley 721, and the staple pulley 761 therein. A through hole is formed in each of the jaw pulley coupling portions 781 and 782, and the rotation shaft 741 passes through the jaw pulley coupling portions 781 and 782, the pulley 711, the pulley 721, and the staple pulley 761 to axially couple them together.

[0553] First jaw pulley coupling portion 781 and second jaw pulley coupling portion 782 are connected by guide portion 783. In other words, first jaw pulley coupling portion 781 and second jaw pulley coupling portion 782, which are parallel to each other, are coupled by guide portion 783 formed in a direction approximately perpendicular thereto, and first jaw pulley coupling portion 781, second jaw pulley coupling portion 782, and guide portion 783 form an approximately U-shape, inside which pulley 711, pulley 721, and staple pulley 761 are housed.

[0554] From another perspective, this can be expressed as the first jaw pulley coupling portion 781 and the second jaw pulley coupling portion 782 being formed extending in the X-axis direction from both ends of the guide portion 783 which is formed long in the Z-axis direction.

[0555] Here, guide portion 783 may be formed in a cylindrical shape with a substantially semicircular cross section. This semicircular section may be disposed so as to protrude toward pulley 711, pulley 721, and staple pulley 761. From another perspective, this may be expressed as guide portion 783 being formed to protrude toward the space formed by first jaw pulley coupling portion 781, second jaw pulley coupling portion 782, and guide portion 783. From another perspective, this may be expressed as the area of ​​guide portion 783 adjacent to jaw pulley coupling portions 781 and 782 being curved so that its cross section has a predetermined curvature.

[0556] Alternatively, from another perspective, the guide portion 783 has the wires 305, 302, 307, and 308 wound around its outer circumferential surface, and can be said to function as a kind of pulley member that guides the paths of the wires 305, 302, 307, and 308. However, the guide portion 783 is not a member that rotates around a predetermined axis like a pulley in the original sense, but is formed to be fixed as part of the end tool hub 780, and can be said to perform some of the functions of a pulley by having the wires wound around it.

[0557] Here, the figure shows guide portion 783 as being formed in a cylindrical shape with a semicircular cross section. That is, at least a portion of the cross section of guide portion 783 on the XY plane is shown as being in the shape of a predetermined arc. However, the concept of the present invention is not limited to this, and it can be said that the cross section may be formed to have a predetermined curvature such as an ellipse or parabola, or the corners of a polygonal prism may be rounded to a certain extent, and various shapes and sizes suitable for guiding the paths of wires 305, 302, 307, and 308 may be used.

[0558] Here, guide grooves 784 may be further formed in portions of guide portion 783 that come into contact with wires 305, 302, 307, and 308 to better guide the paths of wires 305, 302, 307, and 308. Guide grooves 784 may be formed in the shape of grooves recessed to a certain extent from the protruding surface of guide portion 783.

[0559] Here, although the figure shows that guide groove 784 is formed over the entire arcuate surface of guide portion 783, the concept of the present invention is not limited to this, and it can be said that guide groove 784 can also be formed over only a portion of the arcuate surface of guide portion 783 if necessary.

[0560] By further forming guide groove 784 in guide portion 783 in this way, the durability of the wire can be improved.

[0561] A pitch pulley coupling portion 785 may be further formed in the guide portion 783 in a direction opposite to the direction in which the jaw pulley coupling portions 781 and 782 are formed. The pitch pulley coupling portion 785 may be formed in a direction parallel to the pitch pulley 731, i.e., on the XZ plane. A through hole through which the rotation shaft 743 can be inserted may be formed in the pitch pulley coupling portion 785, and the rotation shaft 743 may pass through the pitch pulley coupling portion 785 and the pulley 731 to couple these two components together. Here, the pitch pulley coupling portion 785 may be formed to be offset to one side from the center when viewed from the XY plane so as to achieve overall balance when the pulley 731 is coupled.

[0562] The role and function of the guide portion 783 will be described in more detail below.

[0563] The guide portion 783 can play a role in increasing the rotation radius of each of the first jaw 701 and the second jaw 702 by coming into contact with the wires 305 and 302 and changing the placement paths of the wires 305 and 302 to a certain extent.

[0564] Furthermore, the guide portion 783 can play a role in expanding the rotation radius of the staple pulley 761 by coming into contact with the wires 307 and 308, which are braid wires, and changing the arrangement path of the wires 307 and 308 to a certain extent.

[0565] In other words, if an auxiliary pulley is not provided, each of the first jaw pulley 711, the second jaw pulley 721, and the staple pulley 761 can only rotate up to a right angle. However, in the second embodiment of the present invention, by further providing a guide portion 783 on the end tool hub 780, the maximum rotation angle of each pulley can be increased.

[0566] This enables an operation in which both jaws of the end tool 700 must be opened for actuation when both jaws are rotated in yaw by 90°. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the characteristic of being able to expand the range of yaw rotation in which actuation is possible. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the characteristic of being able to expand the range of yaw rotation in which actuation is possible.

[0567] In addition, the guide portion 783 of the end tool hub 780, which serves as an auxiliary pulley, allows the staple pulley 761 to further rotate for the cutting operation when both jaws have yaw rotated by 90°. In other words, the configuration of the guide portion 783 of the end tool hub 780 has the characteristic of being able to expand the range of yaw rotation in which the cutting operation is possible.

[0568] Furthermore, by forming the guide portion 783 on the existing end tool hub 780 without adding a separate structure such as an auxiliary pulley, the rotation range can be expanded without adding any additional parts or manufacturing processes.

[0569] In this way, there is no need to install a separate structure for expanding the rotation angle, the number of parts is reduced, the manufacturing process is simplified, and the length of the end tool is shortened by the size of the auxiliary pulley, which shortens the length of the end tool when performing pitch movement, thereby making it easier to perform surgical operations in a narrow space.

[0570] This will be explained in more detail as follows.

[0571] The endotool 700 of the surgical instrument according to the second embodiment of the present invention is characterized in that the wire arrangement path can be changed without a separate structure by forming a guide portion 783 that can change the path of the wire on the inner wall of the endotool hub 780. In this way, by forming the guide portion 783 on the endotool hub 780 and changing the arrangement paths of the wires 305, 302, 307, and 308 to a certain extent, the tangential directions of the wires 305, 302, 307, and 308 are changed, and therefore the rotation angles of the fastening members 323, 326, and 329 that connect each wire to a pulley are expanded.

[0572] That is, the fastening member 326 that connects the wire 302 and the pulley 721 can rotate until it is positioned on the common inscribed line of the pulley 721 and the guide portion 783. Similarly, the fastening member (see 323 in FIG. 8) that connects the wire 305 and the pulley 711 can rotate until it is positioned on the common inscribed line of the pulley 711 and the guide portion 783, and the rotation angle of the fastening member (see 323 in FIG. 8) can be expanded. Similarly, the fastening member 329 that connects the wire 307 and the wire 308 and the pulley 761 can rotate until it is positioned on the common inscribed line of the pulley 761 and the guide portion 783, and the rotation angle of the fastening member 329 can be expanded.

[0573] From another perspective, wire 301 and wire 305 wound around pulley 711 by guide unit 783 are arranged on one side of a plane that is perpendicular to the Y axis and passes through the X axis. At the same time, wire 302 and wire 306 wound around pulley 721 by guide unit 783 are arranged on the other side of a plane that is perpendicular to the Y axis and passes through the X axis.

[0574] In other words, pulleys 713 and 714 are arranged on one side of a plane perpendicular to the Y axis and passing through the X axis, and pulleys 723 and 724 are arranged on the other side of a plane perpendicular to the Y axis and passing through the X axis.

[0575] In other words, the wire 305 is located on the inscribed line between the pulley 711 and the guide portion 783, and the rotation angle of the pulley 711 is expanded by the guide portion 783. In addition, the wire 302 is located on the inscribed line between the pulley 721 and the guide portion 783, and the rotation angle of the pulley 721 is expanded by the guide portion 783.

[0576] Compared to the surgical instrument of the first embodiment, which has a separate auxiliary pulley, the length of the endotool of the surgical instrument of this modification can be shortened because it does not have an auxiliary pulley but has a guide portion 783 that can change the wire path on the inner wall of the endotool hub 780. This shortened length of the endotool makes it easier for the surgeon to operate when performing surgery in a narrow surgical space inside the human body, and reduces side effects of surgery.

[0577] According to the present invention, the rotation radius of the first jaw pulley 711, the second jaw pulley 721, and the staple pulley 761 is increased, thereby achieving the effect of expanding the yaw operation range in which normal opening / closing actuation operations and cutting operations can be performed.

[0578] <Third embodiment - direct connection type>

[0579] The following describes an endotool 800 of a surgical instrument according to a third embodiment of the present invention. The endotool 800 of a surgical instrument according to the third embodiment of the present invention is characterized by a difference in the configuration and coupling relationship between the first jaw 801 and the second jaw 802 compared to the endotool 100 of a surgical instrument according to the first embodiment of the present invention (see FIG. 2, etc.). The following describes in detail the configuration that differs from the first embodiment.

[0580] 95 and 96 are perspective views showing an endotool of a surgical instrument according to a third embodiment of the present invention. Here, FIG. 96 shows a state in which the endotool hub is removed. FIG. 97 is a perspective view showing the endotool of the surgical instrument of FIG. 96 in an open state, and FIG. 98 is a perspective view showing the endotool of the surgical instrument of FIG. 96 in a closed state. FIG. 99 is a side view showing the endotool of the surgical instrument of FIG. 96. FIGS. 100 and 101 are exploded perspective views of the endotool of the surgical instrument of FIG. 96. FIG. 102 is a plan view showing a state in which the first jaw of the endotool of the surgical instrument of FIG. 96 is fully opened. FIGS. 103 and 104 are plan views showing the opening and closing operations of the endotool of the surgical instrument of FIG. 96.

[0581] 95 to 104, an end tool 800 according to a third embodiment of the present invention includes a pair of jaws 803 for performing a gripping operation, namely, a first jaw 801 and a second jaw 802. Here, each of the first jaw 801 and the second jaw 802, or a component including the first jaw 801 and the second jaw 802, can be referred to as a jaw 803.

[0582] On the other hand, the end tool 800 includes a plurality of pulleys including a pulley 811 and a pulley 812 involved in the rotational motion of the first jaw 801. In this embodiment, the pulleys involved in the rotational motion of the first jaw 801 are substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0583] On the other hand, the end tool 800 includes a plurality of pulleys including a pulley 821 and a pulley 822 related to the rotational motion of the second jaw 802. In this embodiment, the pulleys related to the rotational motion of the second jaw 802 are substantially the same as the pulleys 121, 122, 123, 124, 125, and 126 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0584] Furthermore, the end tool 800 according to the third embodiment of the present invention may include a rotation shaft 841, a rotation shaft 842, a rotation shaft 843, and a rotation shaft 844. Here, the rotation shafts 841 and 842 may be inserted through the end tool hub 880, and the rotation shafts 843 and 844 may be inserted through the pitch hub 807. The rotation shafts 841, 842, 843, and 844 may be arranged sequentially from the distal end 804 of the end tool 800 toward the proximal end 805.

[0585] Additionally, the end tool 800 of the third embodiment of the present invention may include an end tool hub 880 and a pitch hub 807 .

[0586] The end tool hub 880 has the rotating shafts 841 and 842, which will be described later, inserted therethrough, and further, the pulleys 811 and 821 axially connected to the rotating shaft 841, and at least a portion of the first jaw 801 and second jaw 802 connected thereto, may be housed inside the end tool hub 880.

[0587] A rotation shaft 843 and a rotation shaft 844 are inserted through the pitch hub 807, and the pitch hub 807 can be axially coupled to the end tool hub 880 by the rotation shaft 843. Therefore, the end tool hub 880 may be formed to be pitch rotatable with respect to the pitch hub 807 around the rotation shaft 843.

[0588] On the other hand, the end tool 800 of the third embodiment of the present invention may further include components such as a staple pulley assembly (see 160 in FIG. 13) for performing stapling and cutting operations.

[0589] The staple pulley assembly (see 160 in FIG. 13) may be formed between the pulley 811 and the pulley 821 and adjacent to the pulley 811 and the pulley 821. In this embodiment, it is assumed that the staple pulley assembly (see 160 in FIG. 13) includes one staple pulley 861.

[0590] On the other hand, the third embodiment of the present invention is characterized in that a staple pulley assembly (see 160 in FIG. 13) is disposed between a first jaw pulley, pulley 811, and a second jaw pulley, pulley 821, thereby enabling stapling and cutting operations using a cartridge (see 500 in FIG. 22) in addition to pitch and yaw movements of the end tool 800. In this embodiment, the components for performing the stapling and cutting operations are substantially the same as those described in the first embodiment, and therefore detailed description thereof will be omitted here.

[0591] In the following, the first jaw 801 and the second jaw 802 of the end tool 800 of the surgical instrument according to the third embodiment of the present invention will be described in more detail.

[0592] The end tool 800 of the surgical instrument according to the third embodiment of the present invention is characterized in that it does not have a jaw pulley rotation shaft and a jaw rotation shaft separately, but rather a single rotation shaft 841 simultaneously serves as both the jaw pulley rotation shaft and the jaw rotation shaft. In other words, this embodiment is characterized in that a direct connection structure is adopted to connect the first jaw 801 and the second jaw 802, instead of the X-shaped structure in the first embodiment.

[0593] That is, in the first embodiment of the present invention, a rotation shaft (see 141 in FIG. 17) that is the jaw pulley rotation shaft and a rotation shaft (see 145 in FIG. 17) that is the jaw rotation shaft are separately provided to further strengthen the gripping force when the jaws are closed. In contrast, in the third embodiment of the present invention, a rotation shaft 841 serves as both the jaw rotation shaft and the jaw pulley rotation shaft, and is characterized in that the jaws and jaw pulleys rotate together as a unit.

[0594] Specifically, the first jaw 801 includes a cartridge accommodating portion (see 101a in FIG. 14) and a guide groove 801b. The first jaw 801 is formed in an elongated rod shape overall, and the cartridge 500 is accommodated on the distal portion 801f side. A pulley 811 is coupled to the proximal portion 801g, and the first jaw 801 is formed to be rotatable around a rotation shaft 841.

[0595] Here, although the figure shows the first jaw 801 and the pulley 811 as being formed as a single unit, it can also be said that a configuration is possible in which the first jaw 801 and the pulley 811 are formed as separate members and then joined together.

[0596] The second jaw 802 includes an anvil 802a. The second jaw 802 is formed in an elongated rod shape overall, with the anvil 802a formed on the distal portion 802f side and a pulley 812 coupled to a proximal portion 802g, and formed to be rotatable around a rotation axis 841.

[0597] Here, although the figure shows the second jaw 802 and the pulley 821 as being formed as a single unit, it can also be said that a configuration is possible in which the second jaw 802 and the pulley 821 are formed as separate members and then joined together.

[0598] The rotation axis 841, which is the end tool jaw pulley rotation axis, is inserted sequentially through a pulley 811 connected to (or formed integrally with) the first jaw 801, a staple pulley 861, and a pulley 821 connected to (or formed integrally with) the second jaw 802.

[0599] Therefore, the pulley 811 connected to (or formed integrally with) the first jaw 801, the staple pulley 861, and the pulley 821 connected to (or formed integrally with) the second jaw 802 all rotate around the rotation axis 841.

[0600] The third embodiment of the present invention also includes an auxiliary pulley 812. The auxiliary pulley 812 comes into contact with the wires 305 and 302 to change the arrangement paths of the wires 305 and 302 to a certain extent, thereby serving to increase the rotation radius of each of the first jaw 801 and the second jaw 802.

[0601] As a result, unlike the first embodiment, in this embodiment, there is no separate jaw rotation axis that constrains the first jaw 801 and the second jaw 802, so the rotation angle between the first jaw 801 and the second jaw 802 is expanded to about 120 degrees. Also, since the first jaw 801 and the second jaw 802 are connected by one axis without a separate connection structure for connecting the first jaw 801 and the second jaw 802 in an X-shaped structure, the number of parts can be reduced and manufacturing can be simplified.

[0602] <Fourth embodiment - dual rack>

[0603] The following describes an endotool 900 of a surgical instrument according to a fourth embodiment of the present invention. The endotool 900 of a surgical instrument according to the fourth embodiment of the present invention is characterized by a staple link assembly 970 and a reciprocating assembly 950 of a cartridge 910, as compared with the endotool 100 of a surgical instrument according to the first embodiment of the present invention described above (see FIG. 2, etc.). The following describes in detail the configurations that differ from the first embodiment.

[0604] 105 and 106 are perspective views showing an end tool of a surgical instrument according to a fourth embodiment of the present invention. Here, FIG. 106 shows a state in which the end tool hub has been removed. FIGS. 107 and 108 are perspective views of the end tool of the surgical instrument of FIG. 105 seen from another angle. Here, FIG. 108 shows a state in which the end tool hub has been removed. FIG. 109 is a side view showing the end tool of the surgical instrument of FIG. 105. FIGS. 110 and 111 are exploded perspective views of the end tool of the surgical instrument of FIG. 105. FIG. 112 is an exploded perspective view of a staple link assembly of the surgical instrument of FIG. 105. FIGS. 113 and 114 are a side view and a plan view showing each operating state of the staple link assembly of FIG. 105. FIG. 115 is a perspective view showing the internal structure of the end tool of the surgical instrument of FIG. 105. Figures 116 and 117 are perspective views showing various operating states of the end tool of Figure 115. Figures 118 and 119 are perspective views showing various operating states of the end tool of Figure 115. Here, Figures 118 and 119 mainly show the operations of the reciprocating assembly and the staple link assembly. Figures 120 and 121 are perspective views showing various operating states of the end tool of Figure 115. Here, Figures 120 and 121 mainly show the operations of the reciprocating assembly and the working member.

[0605] 105 to 121, an end tool 900 according to a fourth embodiment of the present invention includes a pair of jaws 903 for performing a gripping operation, namely, a first jaw 901 and a second jaw 902. Here, each of the first jaw 901 and the second jaw 902, or a component including the first jaw 901 and the second jaw 902, can be referred to as jaw 903.

[0606] On the other hand, the end tool 900 includes a plurality of pulleys including a pulley 911 and a pulley 912 involved in the rotational movement of the first jaw 901. In this embodiment, the pulleys involved in the rotational movement of the first jaw 901 are substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0607] On the other hand, the end tool 900 includes a plurality of pulleys including a pulley 921 and a pulley 922 related to the rotational motion of the second jaw 902. In this embodiment, the pulleys related to the rotational motion of the second jaw 902 are substantially the same as the pulleys 121, 122, 123, 124, 125, and 126 described in Fig. 8 and other drawings of the first embodiment, and therefore detailed description thereof will be omitted here.

[0608] Furthermore, the end tool 900 according to the fourth embodiment of the present invention may include a rotation shaft 941, a rotation shaft 942, a rotation shaft 933, and a rotation shaft 944. Here, the rotation shafts 941 and 942 may be inserted through the end tool hub 980, and the rotation shafts 933 and 944 may be inserted through the pitch hub 907. The rotation shafts 941, 942, 933, and 944 may be arranged sequentially from the distal end 904 of the end tool 900 toward the proximal end 905.

[0609] Additionally, the end tool 900 of the fourth embodiment of the present invention may include an end tool hub 980 and a pitch hub 907 .

[0610] The end tool hub 980 has a rotating shaft 941 and a rotating shaft 942 inserted therethrough, and further, the pulley 911 and the pulley 921 axially connected to the rotating shaft 941, and at least a portion of the first jaw 901 and the second jaw 902 connected thereto, may be housed inside the end tool hub 980.

[0611] A rotation shaft 933 and a rotation shaft 944 are inserted through the pitch hub 907, and the pitch hub 907 can be axially coupled to the end tool hub 980 by the rotation shaft 933. Therefore, the end tool hub 980 may be formed to be pitch rotatable with respect to the pitch hub 907 around the rotation shaft 933.

[0612] On the other hand, the end tool 900 of the fourth embodiment of the present invention may further include components such as a staple drive assembly (see 150 in FIG. 13) including a staple pulley assembly 960 and a staple link assembly 970 to perform stapling and cutting operations.

[0613] The staple pulley assembly 960 may be formed between the pulley 911 and the pulley 921 and adjacent to the pulley 911 and the pulley 921. In the present embodiment, it is assumed that the staple pulley assembly 960 includes one staple pulley 961.

[0614] The fourth embodiment of the present invention is characterized in that a staple pulley assembly 960 is disposed between a first jaw pulley, pulley 911, and a second jaw pulley, pulley 921, thereby enabling the end tool 900 to perform pitch and yaw movements as well as stapling and cutting operations using the cartridge 910.

[0615] The staple pulley assembly 960, staple link assembly 970 and reciprocating assembly 950 of the cartridge 910 of the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention will now be described in more detail.

[0616] The end tool 900 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that the staple link assembly 970 includes a first link member 971 and a second link member 976, and the reciprocating assembly 950 of the cartridge 910 includes a first reciprocating member 951 and a second reciprocating member 952, forming a kind of dual rack structure.

[0617] 105 to 121, etc., staple pulley assembly 960 may include one or more staple pulleys 961.

[0618] A shaft through-hole 961a may be formed in the staple pulley 961. The shaft through-hole 961a may be formed in a hole shape, and the rotation shaft 941, which is the end tool jaw pulley rotation shaft, may be inserted through the shaft through-hole 961a.

[0619] Further, a first link coupling portion 961b and a second link coupling portion 961c may be formed on the staple pulley 961. A first link member 971 of the staple link assembly 970 may be coupled to the first link coupling portion 961b, and a second link member 976 of the staple link assembly 970 may be coupled to the second link coupling portion 961c. Here, the first link coupling portion 961b and the second link coupling portion 961c may be disposed on opposite sides of each other with respect to the central axis of the staple pulley 961.

[0620] Meanwhile, the end tool 900 according to the fourth embodiment of the present invention may further include a staple link assembly 970 connected to the staple pulley assembly 960. Here, the staple link assembly 970 may serve to connect the staple pulley assembly 960 to a reciprocating assembly 950 of the cartridge 910, which will be described later. The end tool 900 according to the fourth embodiment of the present invention is characterized in that the staple link assembly 970 includes two pairs of link members, namely, a first link member 971 and a second link member 976.

[0621] The first link member 971 may include a first link 972 and a second link 973 .

[0622] The first link 972 may be formed in the shape of a long, thin bar, with through holes formed at both ends. The first link coupling portion 961b of the staple pulley 961 may be inserted through the through hole at one end of the first link 972. The second link 973 may be inserted through the through hole at the other end of the first link 972.

[0623] The second link 973 may be formed in the shape of a long, thin bar and may be coupled to the first link 972. The second link 973 may include a first protrusion 973a, a second protrusion 973b, and a fastening portion 973c.

[0624] Specifically, a first protrusion 973a may be formed on one end of the second link 973. This first protrusion 973a fits into a through-hole of the first link 972 for axial coupling, thereby enabling the second link 973 to be coupled to the first link 972. Furthermore, the first protrusion 973a may fit into a first guide groove 901b of the first jaw 901, which will be described later.

[0625] Meanwhile, a second protrusion 973b may be formed in one region of the center of the second link 973. The second protrusion 973b may be fitted into a first guide groove 901b of the first jaw 901, which will be described later.

[0626] In this manner, with the first protrusion 973a and second protrusion 973b of the second link 973 formed in a protrusion shape fitted into the groove-shaped first guide groove 901b, the first protrusion 973a and the second protrusion 973b move along the first guide groove 901b, causing the first link member 971 to move relative to the first jaw 901 (and the cartridge 910 therein). This will be described in more detail later.

[0627] Meanwhile, a fastening portion 973c may be formed at the other end of the second link 973. This fastening portion 973c may be coupled to a fastening portion 951a of a first reciprocating member 951 of the cartridge 910, which will be described later.

[0628] 113, when the staple pulley 961 rotates in the direction of arrow A1 in FIG. 114 (i.e., clockwise), the first link member 971 connected to the staple pulley 961 can move in the direction of arrow B1 in FIG. 114, in other words, toward the distal portion 901f of the first jaw 901. Conversely, when the staple pulley 961 rotates counterclockwise, the first link member 971 connected to the staple pulley 961 can move in the direction of arrow C1 in FIG. 114, in other words, toward the proximal portion 901g of the first jaw 901.

[0629] Thus, bidirectional rotational movement of staple pulley assembly 960 can cause reciprocating linear movement of first reciprocating member 951 of cartridge 910 via first link member 971 of staple link assembly 970, as will be described in more detail below.

[0630] The second link member 976 may include a third link 977 and a fourth link 978 .

[0631] The third link 977 may be formed in the shape of a long, thin bar, with through holes formed at both ends. The second link coupling portion 961c of the staple pulley 961 may be inserted through the through hole at one end of the third link 977. The fourth link 978 may be inserted through the through hole at the other end of the third link 977.

[0632] The fourth link 978 may be formed in a bar shape that is bent one or more times and may be connected to the third link 977. The fourth link 978 may include a first protrusion 978a, a second protrusion 978b, and a fastening portion 978c.

[0633] Specifically, a first protrusion 978a may be formed on one end of the fourth link 978. This first protrusion 978a fits into a through-hole in the third link 977 for axial coupling, thereby enabling the fourth link 978 to be coupled to the third link 977. Furthermore, the first protrusion 978a may fit into a second guide groove 901c of the first jaw 901, which will be described later.

[0634] Meanwhile, a second protrusion 978b may be formed in one region of the center of the fourth link 978. The second protrusion 978b may be fitted into a second guide groove 901c of the first jaw 901, which will be described later.

[0635] In this manner, with the first protrusion 978a and the second protrusion 978b of the fourth link 978 formed in a protrusion shape fitted into the groove-shaped second guide groove 901c, the first protrusion 978a and the second protrusion 978b move along the second guide groove 901c, causing the second link member 976 to move relative to the first jaw 901 (and the cartridge 910 therein). This will be described in more detail later.

[0636] Meanwhile, a fastening portion 978c may be formed at the other end of the fourth link 978. This fastening portion 978c may be coupled to a fastening portion 952a of a second reciprocating member 952 of the cartridge 910, which will be described later.

[0637] Here, the fourth link 978 may include two horizontal regions and one vertical region connecting them.

[0638] Specifically, since the first link connection portion 961b and the second link connection portion 961c are positioned on opposite sides of each other with respect to the central axis of the staple pulley 961, there is a height difference (based on the Z-axis direction) between the first link 972 connected to the first link connection portion 961b and the third link 977 connected to the second link connection portion 961c.

[0639] In contrast, it is structurally easy to position a first reciprocating member 951 and a second reciprocating member 952 of a reciprocating assembly 950 (described later) at the same height (based on the Z-axis direction).

[0640] Therefore, in order to connect the third link 977 and the second reciprocating member 952, the fourth link 978 may be formed in the shape of a bar that is bent one or more times.

[0641] Here, a first protrusion 978a and a second protrusion 978b may be formed in the first horizontal region, and a fastening portion 978c may be formed in the second horizontal region.

[0642] 113, when the staple pulley 961 rotates in the direction of arrow A1 in FIG. 114 (i.e., clockwise), the second link member 976 connected to the staple pulley 961 can move in the direction of arrow C1 in FIG. 114, in other words, toward the proximal portion 901g of the first jaw 901. Conversely, when the staple pulley 961 rotates counterclockwise, the second link member 976 connected to the staple pulley 961 can move in the direction of arrow B1 in FIG. 114, in other words, toward the distal portion 901f of the first jaw 901.

[0643] Thus, bidirectional rotational movement of staple pulley assembly 960 can cause reciprocating linear movement of second reciprocating member 952 of cartridge 910 via second link member 976 of staple link assembly 970, as will be described in more detail below.

[0644] As described above, the first link coupling portion 961b and the second link coupling portion 961c may be disposed on opposite sides of each other with respect to the central axis of the staple pulley 961. The first link member 971 is coupled to the first link coupling portion 961b, and the second link member 976 is coupled to the second link coupling portion 961c.

[0645] Therefore, when the staple pulley 961 rotates in one direction (for example, clockwise), the first link member 971 moves forward and the second link member 976 moves backward. On the other hand, when the staple pulley 961 rotates in another direction (for example, counterclockwise), the first link member 971 moves backward and the second link member 976 moves forward.

[0646] With this configuration, when the staple pulley 961 rotates alternately in the clockwise and counterclockwise directions, the first link member 971 and the second link member 976 perform a linear reciprocating motion, and at this time, the first link member 971 and the second link member 976 move in opposite directions. That is, when the first link member 971 moves forward (i.e., moves toward the distal portion), the second link member 976 moves backward (i.e., moves toward the proximal portion). Conversely, when the first link member 971 moves backward (i.e., moves toward the proximal portion), the second link member 976 moves forward (i.e., moves toward the distal portion).

[0647] (cartridge)

[0648] In the following, the cartridge 910 of the endotool 900 of the surgical instrument according to the fourth embodiment of the invention will be described in more detail.

[0649] The cartridge 910 of the end tool 900 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that the reciprocating assembly 950 includes a first reciprocating member 951 and a second reciprocating member 952 .

[0650] Specifically, referring to Figures 115 to 117, the cartridge 910 is formed so as to be attachable to and detachable from the first jaw 101, and contains a plurality of staples (see 530 in Figure 22) and a working member 940 therein, and is used to suture and cut tissue.

[0651] Here, the cartridge 910 may include a cover (see 510 in FIG. 22), a housing 920, a staple (see 530 in FIG. 22), a working member 940, and a reciprocating assembly 950.

[0652] The housing 920 forms the outer shape of the cartridge 910, and may be formed in a form in which one surface (top surface) of a generally hollow box is removed, and may be formed to accommodate the reciprocating assembly 950, the working member 940, and the staples (see 530 in FIG. 22) therein. Here, the cross section of the housing 920 may be formed in a substantially "U" shape.

[0653] A plurality of staples (see 530 in FIG. 22) may be arranged inside the housing 920. As a working member 940, which will be described later, moves linearly in one direction, the plurality of staples (see 530 in FIG. 22) are sequentially pushed up from the inside to the outside of the housing 920 to perform suturing, i.e., stapling.

[0654] A reciprocating assembly 950 may be disposed below and inside the housing 920. In this embodiment, the reciprocating assembly 950 includes a first reciprocating member 951 and a second reciprocating member 952.

[0655] In this embodiment, the first reciprocating member 951 and the second reciprocating member 952 may be racks. The first reciprocating member 951 may include a concave-convex portion 951b and a fastening portion 951a.

[0656] Specifically, the first reciprocating member 951 may be formed in the shape of an elongated bar, and may have a plurality of sawtooth-like uneven portions 951b formed on one surface. The uneven portion 951b may be formed so as to be able to come into contact with a working member 940, which will be described later, in particular a ratchet member 943 of the working member 940. In other words, the first reciprocating member 951 may include a plurality of uneven portions 951b shaped to mesh with a first ratchet 943a of the ratchet member 943.

[0657] Similarly, the second reciprocating member 952 may include a concave-convex portion 952b and a fastening portion 952a. That is, the second reciprocating member 952 may include a plurality of concave-convex portions 952b shaped to mesh with the second ratchet 943b of the ratchet member 943.

[0658] Here, the first reciprocating member 951 and the second reciprocating member 952 may not be fixedly connected to other components of the cartridge 910, but may be formed to be movable relative to other components of the cartridge 910. That is, the first reciprocating member 951 and the second reciprocating member 952 may perform reciprocating linear motion with respect to the housing 920 and the cover 510 connected to the housing 920.

[0659] Meanwhile, a fastening portion 951a may be formed on the proximal end of the first reciprocating member 951 adjacent to the pulley 911, and this fastening portion 951a may be fastened and coupled to a first link member 971 of the staple link assembly 970 of the end tool 900. Therefore, when the first link member 971 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the first reciprocating member 951 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction).

[0660] Similarly, a fastening portion 952a may be formed on the proximal end of the second reciprocating member 952 adjacent to the pulley 911, and this fastening portion 952a may be fastened and coupled to a second link member 976 of the staple link assembly 970 of the end tool 900. Therefore, when the second link member 976 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the second reciprocating member 952 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction).

[0661] A working member 940 may be disposed inside the housing 920. The working member 940 may be formed to be able to come into contact with the first reciprocating member 951 and the second reciprocating member 952, and may be formed to move linearly in one direction in response to the reciprocating linear motion of the first reciprocating member 951 and the second reciprocating member 952. In other words, the working member 940 interacts with the first reciprocating member 951 and the second reciprocating member 952, and performs stapling and cutting while moving along the extension direction of the connecting portion 400.

[0662] The working member 940 may include a wedge (see 541 in FIG. 22), a blade (see 542 in FIG. 22), a ratchet member 943, an elastic member (see 544 in FIG. 22), etc. Here, in the figure, the remaining components of the working member 940 excluding the ratchet member 943, i.e., the wedge, blade, etc., are omitted, but it goes without saying that such components may also be included in the working member 940.

[0663] The ratchet member 943 may include a first ratchet 943a and a second ratchet 943b. Here, the first ratchet 943a may be formed to be able to mesh with the first reciprocating member 951, and the second ratchet 943b may be formed to be able to mesh with the second reciprocating member 952. That is, an operation in which the first ratchet 943a meshes with (or comes into close contact with) the first reciprocating member 951 and the working member 940 moves forward by the first reciprocating member 951 and an operation in which the second ratchet 943b meshes with (or comes into close contact with) the second reciprocating member 952 and the working member 940 moves forward by the second reciprocating member 952 are alternately performed.

[0664] Here, the structural shape of the ratchet member 943 itself allows the ratchet member 943 to alternately come into close contact with the first reciprocating member 951 and the second reciprocating member 952 without the need for a separate elastic member, as will be described in more detail below.

[0665] (Operation of the reciprocating assembly and working member)

[0666] The operation of the reciprocating assembly 950 and work member 940 is described in more detail below.

[0667] Figures 120 and 121 are diagrams showing various operating states of the reciprocating assembly 950 and the working member 940. Here, Figure 120(a) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact with each other, Figure 120(e) is a diagram showing a state in which the second ratchet 943b of the ratchet member 943 and the second reciprocating member 952 are in close contact with each other, and Figure 120(i) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are again in close contact with each other.

[0668] Figures 120(a) to 120(e) show the operating state while the staple pulley 961 rotates counterclockwise (the opposite direction to the arrow A1 in Figure 114) and the second reciprocating member 952 moves forward, and Figures 120(e) to 120(i) show the operating state while the staple pulley 961 rotates clockwise (the direction of the arrow A1 in Figure 114) and the first reciprocating member 951 moves forward.

[0669] First, the operations shown in Figures 120(a) to 120(e) will be described.

[0670] FIG. 120(a) shows a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact with each other.

[0671] In this state, when the staple pulley 961 rotates counterclockwise (the direction opposite to the arrow A1 in FIG. 114), the first reciprocating member 951 moves in the direction of arrow b1 (i.e., moves backward), and the second reciprocating member 952 moves in the direction of arrow b2 (i.e., moves forward), as shown in FIG. 120(b). Then, the uneven portion 951b of the first reciprocating member 951 presses the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, causing the ratchet member 943 to rotate as a whole in the direction of arrow b3. Then, when the ratchet member 943 rotates in the direction of arrow b3, the first ratchet 943a of the ratchet member 943 begins to move away from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 begins to contact the uneven portion 952b of the second reciprocating member 952.

[0672] In this state, when the staple pulley 961 further rotates counterclockwise (the opposite direction to the arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of the arrow c1 (i.e., moves backward), and the second reciprocating member 952 further moves in the direction of the arrow c2 (i.e., moves forward), as shown in FIG. 120(c). Then, the uneven portion 951b of the first reciprocating member 951 further presses the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, and as a result, the ratchet member 943 as a whole further rotates in the direction of the arrow c3. Then, when the ratchet member 943 rotates in the direction of arrow c3, the first ratchet 943a of the ratchet member 943 moves further away from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 comes into further contact with the uneven portion 952b of the second reciprocating member 952.

[0673] In this state, when the staple pulley 961 further rotates counterclockwise (the opposite direction to arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of arrow d1 (i.e., moves backward), and the second reciprocating member 952 further moves in the direction of arrow d2 (i.e., moves forward), as shown in FIG. 120(d). Then, the uneven portion 951b of the first reciprocating member 951 further presses the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, causing the ratchet member 943 as a whole to further rotate in the direction of arrow d3. Then, when the ratchet member 943 rotates in the direction of arrow d3, the first ratchet 943a of the ratchet member 943 completely separates from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 comes into close contact with the uneven portion 952b of the second reciprocating member 952.

[0674] In this state, when the staple pulley 961 further rotates counterclockwise (the opposite direction to arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of arrow e1 (i.e., moves backward), and the second reciprocating member 952 further moves in the direction of arrow e2 (i.e., moves forward), as shown in FIG. 120(e). Then, because the second ratchet 943b of the ratchet member 943 is in close contact with the uneven portion 952b of the second reciprocating member 952, the second reciprocating member 952 moves the ratchet member 943 linearly in the direction of arrow e4.

[0675] Next, the operations shown in Figures 120(e) to 120(i) will be described.

[0676] FIG. 120(e) shows a state in which the second ratchet 943b of the ratchet member 943 and the second reciprocating member 952 are in close contact with each other.

[0677] In this state, when the staple pulley 961 rotates clockwise (in the direction of arrow A1 in FIG. 114), as shown in FIG. 120(f), the first reciprocating member 951 moves in the direction of arrow f1 (i.e., moves forward), and the second reciprocating member 952 moves in the direction of arrow f2 (i.e., moves backward). Then, the uneven portion 952b of the second reciprocating member 952 presses the second ratchet 943b of the ratchet member 943 toward the first reciprocating member 951, causing the ratchet member 943 to rotate as a whole in the direction of arrow f3. Then, when the ratchet member 943 rotates in the direction of arrow f3, the second ratchet 943b of the ratchet member 943 begins to move away from the uneven portion 952b of the second reciprocating member 952, and the first ratchet 943a of the ratchet member 943 begins to contact the uneven portion 951b of the first reciprocating member 951.

[0678] In this state, when the staple pulley 961 further rotates clockwise (in the direction of arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of arrow g1 (i.e., moves forward), and the second reciprocating member 952 further moves in the direction of arrow g2 (i.e., moves backward), as shown in FIG. 120(g). Then, the uneven portion 952b of the second reciprocating member 952 further presses the second ratchet 943b of the ratchet member 943 toward the first reciprocating member 951, which causes the ratchet member 943 as a whole to further rotate in the direction of arrow g3. Then, when the ratchet member 943 rotates in the direction of arrow g3, the second ratchet 943b of the ratchet member 943 moves further away from the uneven portion 952b of the second reciprocating member 952, and the first ratchet 943a of the ratchet member 943 comes into further contact with the uneven portion 951b of the first reciprocating member 951.

[0679] In this state, when the staple pulley 961 further rotates clockwise (in the direction of arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of arrow h1 (i.e., moves forward), and the second reciprocating member 952 further moves in the direction of arrow h2 (i.e., moves backward), as shown in FIG. 120(h). Then, the uneven portion 952b of the second reciprocating member 952 further presses the second ratchet 943b of the ratchet member 943 toward the first reciprocating member 951, which causes the ratchet member 943 as a whole to further rotate in the direction of arrow h3. Then, when the ratchet member 943 rotates in the direction of arrow h3, the second ratchet 943b of the ratchet member 943 completely separates from the uneven portion 952b of the second reciprocating member 952, and the first ratchet 943a of the ratchet member 943 comes into close contact with the uneven portion 951b of the first reciprocating member 951.

[0680] In this state, when the staple pulley 961 further rotates clockwise (in the direction of arrow A1 in FIG. 114), the first reciprocating member 951 further moves in the direction of arrow i1 (i.e., moves forward), and the second reciprocating member 952 further moves in the direction of arrow i2 (i.e., moves backward), as shown in FIG. 120(i). Then, because the first ratchet 943a of the ratchet member 943 is in close contact with the uneven portion 951b of the first reciprocating member 951, the first reciprocating member 951 moves the ratchet member 943 linearly in the direction of arrow i4.

[0681] FIG. 121 is a diagram illustrating a part of the operation of FIG. 120, focusing on the forward movement of the working member 940.

[0682] Figure 121(a) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are in close contact, Figure 121(e) is a diagram showing a state in which the second ratchet 943b of the ratchet member 943 and the second reciprocating member 952 are in close contact, and Figure 121(i) is a diagram showing a state in which the first ratchet 943a of the ratchet member 943 and the first reciprocating member 951 are again in close contact.

[0683] In the state shown in Figure 121(a), when the staple pulley 961 rotates counterclockwise (the opposite direction to the arrow A1 in Figure 114), the first reciprocating member 951 moves in the direction of the arrow e1 (i.e., moves backward), and the second reciprocating member 952 moves in the direction of the arrow e2 (i.e., moves forward), as shown in Figure 121(e).

[0684] As a result, the uneven portion 951b of the first reciprocating member 951 pushes the first ratchet 943a of the ratchet member 943 toward the second reciprocating member 952, causing the ratchet member 943 to rotate as a whole in the direction of arrow e3, the first ratchet 943a of the ratchet member 943 moving away from the uneven portion 951b of the first reciprocating member 951, and the second ratchet 943b of the ratchet member 943 coming into close contact with the uneven portion 952b of the second reciprocating member 952.

[0685] In this state, when the staple pulley 961 further rotates counterclockwise (opposite the direction of arrow A1 in Figure 114), the second ratchet 943b of the ratchet member 943 is in close contact with the uneven portion 952b of the second reciprocating member 952, so that the second reciprocating member 952 moves the ratchet member 943 linearly in the direction of arrow e4.

[0686] On the other hand, when the staple pulley 961 rotates clockwise (in the direction of arrow A1 in Figure 114) in the state shown in Figure 121(e), the first reciprocating member 951 moves in the direction of arrow i1 (i.e., moves forward), and the second reciprocating member 952 moves in the direction of arrow i2 (i.e., moves backward), as shown in Figure 121(i).

[0687] As a result, the uneven portion 952b of the second reciprocating member 952 pushes the second ratchet 943b of the ratchet member 943 toward the first reciprocating member 951, causing the ratchet member 943 to rotate overall in the direction of arrow i3, the second ratchet 943b of the ratchet member 943 moving away from the uneven portion 952b of the second reciprocating member 952, and the first ratchet 943a of the ratchet member 943 coming into close contact with the uneven portion 951b of the first reciprocating member 951.

[0688] In this state, when the staple pulley 961 further rotates clockwise (in the direction of arrow A1 in Figure 114), the f...

Claims

1. First Joe, a second jaw formed opposite to the first jaw; a first jaw pulley coupled to the first jaw and configured to be rotatable about a first axis; a second jaw pulley coupled to the second jaw and rotatable about an axis that is the same as or parallel to the first axis and spaced apart from the first jaw pulley to a certain extent; an end tool including a staple drive assembly including one or more staple pulleys formed at least in part between said first jaw pulley and said second jaw pulley; a reciprocating assembly coupled to the staple drive assembly for linear movement in response to rotational movement of the staple pulley; and A surgical instrument comprising: a cartridge including a working member that contacts the reciprocating assembly and is moved in one direction by the reciprocating assembly when the reciprocating assembly moves in the one direction.

2. 2. The surgical instrument of claim 1, wherein the staple pulley rotates to move the reciprocating assembly coupled to the staple drive assembly toward a distal or proximal side of the cartridge.

3. When the staple pulley rotates alternately in a clockwise and counterclockwise direction, 3. The surgical instrument of claim 2, wherein the reciprocating assembly coupled to the staple drive assembly alternates between distal and proximal sides of the cartridge.

4. 4. The surgical instrument of claim 3, wherein the working member is moved distally of the cartridge by the reciprocating assembly as the reciprocating assembly moves distally of the cartridge.

5. 2. The surgical instrument of claim 1, wherein said staple drive assembly converts bidirectional rotational motion of said staple pulley into reciprocating linear motion of said reciprocating assembly coupled to said staple drive assembly.

6. 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, 2. The surgical instrument according to claim 1, wherein a cutting operation is performed while a blade formed on one side of the wedge portion of the working member moves in the one direction.

7. The surgical instrument of claim 1 , wherein the staple drive assembly includes a link member connecting the staple pulley and the reciprocating assembly.

8. The working member includes a ratchet member having a ratchet formed on at least one surface, The surgical instrument according to claim 7, wherein the ratchet of the ratchet member is configured to be contactable with the reciprocating assembly.

9. 9. The surgical instrument of claim 8, wherein the working member moves with the reciprocating assembly toward the distal end of the cartridge only when the reciprocating assembly moves toward the distal end of the cartridge.

10. The surgical instrument of claim 8, characterized in that when the staple pulley rotates in a first direction among a clockwise and a counterclockwise direction, 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.

11. The surgical instrument of claim 10, characterized in that when the staple pulley rotates in a clockwise or counterclockwise direction opposite to the first direction, 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.

12. the staple drive assembly includes a first link member coupled to one region of the staple pulley and a second link member coupled to another region of the staple pulley; The surgical instrument of claim 1 , wherein the reciprocating assembly includes a first reciprocating member coupled to the first link member and a second reciprocating member coupled to the second link member.

13. The working member includes a ratchet member having a first ratchet and a second ratchet formed thereon, The surgical instrument according to claim 12, wherein the first ratchet is configured to be able to come into contact with the first reciprocating member, and the second ratchet is configured to be able to come into contact with the second reciprocating member.

14. When the staple pulley rotates in one direction, the first ratchet and the first reciprocating member come into contact with each other, 14. The surgical instrument according to claim 13, wherein when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member come into contact with each other.

15. The surgical instrument of claim 13, characterized in that when the staple pulley rotates in a first direction among a clockwise direction and a counterclockwise direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the working member in contact with the first reciprocating member move toward the distal portion of the cartridge.

16. The surgical instrument of claim 15, characterized in that when the staple pulley rotates in a clockwise or counterclockwise direction opposite to the first direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the working member in contact with the second reciprocating member move toward the distal portion of the cartridge.

17. The surgical instrument of claim 1 , further comprising a staple wire coupled to said staple pulley to rotate said staple pulley.

18. 2. The surgical instrument of claim 1, further comprising: an inactivated state in which the staple drive assembly and the reciprocating assembly are spaced apart; and an activated state in which the staple drive assembly and the reciprocating assembly are fastened together.

19. 20. The surgical instrument of claim 18, wherein only in said activated state does rotational movement of said staple pulley result in linear movement of said reciprocating assembly.

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

21. The surgical instrument according to claim 20, wherein the end tool is configured to be capable of yaw rotation about the first axis and pitch rotation about the second axis.

22. 2. The surgical instrument according to claim 1, wherein the first jaw pulley, the staple pulley, and the second jaw pulley are arranged sequentially along a rotation axis.

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