End tool of a surgical instrument and a surgical instrument including the 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 that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various surgeries, and that has an end tool that can be rotated 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 that can be attached to a robotic arm or manually operated for use in laparoscopic surgery or various surgeries, and that has an end tool that can be rotated 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 post-operative recovery time and complications by making small incisions, has been widely used. Laparoscopic surgery is a method in which multiple small holes are made in the patient's abdomen and the inside of the abdominal cavity is observed through these holes while performing the surgery. It is widely used in general surgery and other fields.

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

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

[0005] Surgical staplers have the advantage of being able to cut the surgical site and anastomose the organ at the same time, thereby shortening the surgical time as well as realizing accurate suturing of the surgical site. Furthermore, surgical staplers are widely used in modern surgical operations due to the advantage of faster recovery and less scarring than when surgical sutures are used for tissue cutting and suturing. In particular, surgical staplers are widely used in cancer surgery to cut cancer 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 / she acquired in the process of deriving the present invention, and is not necessarily publicly known art that was disclosed to the general public prior to the filing of the application of the present invention. Summary of the Invention [Problem to be solved by the invention]

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

[0008] The present invention provides a surgical instrument comprising: an end tool including a staple drive assembly including a first jaw, a second jaw formed to face the first jaw, a first jaw pulley formed to be rotatable about a first axis by being coupled to the first jaw, a second jaw pulley formed to be rotatable about an axis substantially the same as or parallel to the first axis by being coupled to the second jaw and formed to be spaced apart from the first jaw pulley to a certain extent, and a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a reciprocating assembly connected to the staple drive assembly and moving linearly when the first staple pulley and the second staple pulley rotate and move; 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. Effect of the Invention

[0009] With the present invention, the direction in which the surgeon operates the operating part 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 description of the drawings]

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

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

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

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

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

[0015] In the present invention, the staple drive assembly converts the bidirectional rotational motion of the first staple pulley or the second staple pulley into the reciprocating linear motion of the reciprocating assembly connected to the staple drive assembly.

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

[0017] In the present invention, the staple drive assembly includes a link member connecting the first and second staple pulleys to the reciprocating assembly.

[0018] In the present invention, the working member includes a ratchet member having a ratchet formed on at least one surface, and the ratchet of the ratchet member is formed so as to be able to come into contact with the reciprocating assembly.

[0019] In the present invention, the working member is characterized in that it moves toward the distal side of the cartridge together with the reciprocating assembly only when the reciprocating assembly moves toward the distal side of the cartridge.

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

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

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

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

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

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

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

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

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

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

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

[0031] According to an embodiment of the present invention, an end tool of a surgical instrument includes a first jaw capable of accommodating a cartridge, a second jaw formed to face the first jaw, a first jaw pulley coupled to the first jaw and formed rotatable about a first axis, a second jaw pulley coupled to the second jaw and formed rotatable about an axis substantially the same as or parallel to the first axis and formed at a certain distance from the first jaw pulley, and a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley. the staple drive assembly including a staple pulley, a first staple wire at least partially contacting the first staple pulley to transmit a driving force required for rotating the first staple pulley to the first staple pulley, and a second staple wire at least partially contacting the second staple pulley to transmit a driving force required for rotating the second staple pulley to the second staple pulley, wherein the staple drive assembly is connected to a reciprocating assembly of the cartridge, and rotational motion of the staple pulley is converted into linear motion of the reciprocating assembly.

[0032] The present invention further includes an end tool hub including a first jaw pulley connection portion and a second jaw pulley connection portion formed opposite each other, and a guide portion connecting the first jaw pulley connection portion and the second jaw pulley connection portion, wherein the first jaw pulley is disposed adjacent to the first jaw pulley connection portion of the end tool hub, and the second jaw pulley is disposed adjacent to the second jaw pulley connection portion of the end tool hub, and at least a portion of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

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

[0034] The present invention is characterized in that the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are stacked in order within the end tool hub.

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

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

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

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

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

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

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

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

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

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

[0045] In the present invention, the jaw pulley further includes a jaw rotation axis that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and the first axis is a jaw pulley rotation axis that is inserted through the first jaw pulley and the second jaw pulley and serves as 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 axis, the jaw rotation axis moves relative to the jaw pulley rotation axis.

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

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

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

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

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

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

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

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

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

[0055] In the present invention, the staple link assembly is characterized in that it includes a single link.

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

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

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

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

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

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

[0062] and a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis.

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

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

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

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

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

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

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

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

[0071] In the present invention, the staple link assembly is coupled to a reciprocating assembly of a cartridge housed in the first jaw, and the rotational motion of the first staple pulley or the second staple pulley is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

[0072] In the present invention, the staple link assembly converts the bidirectional rotational motion of the first staple pulley or the second staple pulley into the reciprocating linear motion of the reciprocating assembly connected to the staple link assembly.

[0073] In the present invention, the jaw pulley further includes a jaw rotation axis that is inserted through the first jaw and the second jaw and serves as a rotation center between the first jaw and the second jaw, and the first axis is a jaw pulley rotation axis that is inserted through the first jaw pulley and the second jaw pulley and serves as 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 axis, the jaw rotation axis moves relative to the jaw pulley rotation axis.

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

[0075] In the present invention, a movable connecting hole is formed in the first jaw or the second jaw, and a shaft connecting portion is formed in the first jaw pulley or the second jaw pulley, and the shaft connecting portion is formed so as to be able to move to a certain degree within the movable connecting hole when the shaft connecting portion is fitted into the movable connecting hole.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0096] In the present invention, the bidirectional rotational motion of the first staple pulley or the second staple pulley about the first axis is converted into reciprocating linear motion along the second axis of the reciprocating assembly connected to the first staple pulley and the second staple pulley.

[0097] In the present invention, the working member is moved toward the distal portion of the cartridge by the reciprocating linear motion of the reciprocating assembly.

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

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

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

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

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

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

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

[0105] Since the present invention can be modified in various ways and can have various embodiments, a specific embodiment is shown in the drawings and will be described in detail. However, this is not intended to limit the present invention to the specific embodiment, and it should be understood that the present invention includes all modifications, equivalents, and alternatives 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 deemed to obscure the gist of the present invention, the detailed description will be omitted.

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

[0107] The terms used in this application are merely used to describe certain embodiments and are not intended to limit the present invention. A singular expression includes a plural expression unless the context clearly indicates otherwise. In this application, the terms "include" 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 presence or additional possibility of one or more other features, numbers, steps, operations, components, parts, or combinations thereof.

[0108] Hereinafter, an embodiment 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 are given the same drawing numbers, and duplicate descriptions thereof will be omitted.

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

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

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

[0112] 1A, when performing a pitch operation of a conventional surgical instrument, the end tool 120a is formed forward of the rotation center 121a of the end tool, and the operating unit 110a is formed rearward of the rotation center 111a of the operating unit, and 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 performing a yaw operation of a conventional surgical instrument, the end tool 120a is formed forward of the rotation center 121a of the end tool, and the operating unit 110a is formed rearward of the rotation center 111a of the operating unit, and 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 viewpoint of the left-right direction of the user, 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 an error on the part of the user, and there has been a problem that the user's operation is not easy.

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

[0114] Referring to FIG. 1C, some of the conventional surgical instruments are formed in a mirror symmetrical form, and in performing a pitch operation, the end tool 120b is formed in front of the rotation center 121b of the end tool, and the operation unit 110b is formed behind the rotation center 111b of the operation unit. In this state, when the operation unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operation unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the viewpoint of the rotation direction of the operation unit and the end tool, the rotation direction in which the user rotates the operation 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 cause mistakes. Also, referring to FIG. 1D, when performing a yaw operation, the end tool 120b is formed in front of the rotation center 121b of the end tool, and the operation unit 110b is formed behind the rotation center 111b of the operation unit. When the operation unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and when the operation unit 110b is rotated counterclockwise, the end tool 120b rotates clockwise. In this case, from the viewpoint of the rotation direction of the operation unit and the end tool, the rotation direction in which the user rotates the operation 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 operation of the joint is not intuitive and may cause mistakes. Thus, in the pitch or yaw operation of a user of a conventional surgical instrument, the operation direction of the user and the movement direction of the end tool do not match each other in either the viewpoint of the rotation direction or the viewpoint of the left and right direction. This is because the joint configuration of the endotool and the operating part are different from each other in the joint configuration of the conventional surgical instruments, that is, the endotool is formed forward of the rotation center of the endotool, whereas the operating part is formed rearward of the rotation center of the operating part.In order to solve such a problem, the surgical instrument according to an 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 operation of the operating unit 110c and the endotool 120c intuitively coincide with each other. In other words, unlike the existing example in which the operating unit approaches the user's side with respect to the user's joint (i.e., moves away from the endotool) as shown in Figures 1A, 1B, 1C, and 1D, the surgical instrument according to an embodiment of the present invention shown in Figures 1E and 1F is formed so that at least a part of the operating unit approaches the endotool (rather than the user's joint) based on the user's joint at a certain moment or more during the operation process.

[0115] To explain this separately, in the case of conventional surgical instruments as shown in Figures 1A, 1B, 1C, and 1D, the end tool is located forward of its own center of rotation, while the operating unit is formed rearward of its own center of rotation, and the operation of the operating unit, which moves the rearward while the front is fixed, moves the end tool, which moves forward while the rear is fixed, so that the structure is not intuitively consistent. As a result, there is a mismatch between the operation of the operating unit and the operation of the end tool in terms of the left-right direction or the rotation direction, which may confuse the user, making it difficult to intuitively and quickly operate the operating unit, and there is a possibility of making an error. In contrast, in the surgical instrument according to one embodiment of the present invention, since both the end tool and the operating unit move based on a rotation center formed at the rear, it can be said that the operations are intuitively consistent with each other in terms of structure. To explain this separately, just as the moving part of the end tool moves based on a rotation center formed at the rear, the moving part of the operating unit also moves based on the rotation center formed at the rear, so that it can be said that the operations are intuitively consistent with each other in terms of structure. This allows the user to intuitively and quickly steer the end tool direction, and has the advantage of significantly reducing the possibility of mistakes being made. A specific mechanism that enables such a function will be described below.

[0116] <First embodiment of surgical instrument>

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

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

[0119] Here, the connecting part 400 may be formed in a hollow shaft shape, and one or more wires and electric cables may be housed therein. The operating part 200 is connected to one end of the connecting part 400, and the end tool 2100 is connected to the other end, and the connecting part 400 may play a role of connecting the operating part 200 and the end tool 2100. Here, the connecting part 400 of the surgical instrument 2000 according to the first embodiment of the present invention is characterized in that it includes a straight part 401 and a bent part 402, and the straight part 401 is formed on the side where the end tool 2100 is connected, and the bent part 402 is formed on the side where the operating part 200 is connected. As a result of the end of the connecting part 400 on the operating part 200 side being bent, the pitch operating part 201, the yaw operating part 202, and the actuation operating part 203 are formed on an extension line of the end tool 2100 or adjacent to the extension line. In other words, at least a part of the pitch operation unit 201 and the yaw operation unit 202 is accommodated in a recess formed by the bent portion 402. Due to such a shape of the bent portion 402, the shapes and operations of the operation unit 200 and the end tool 2100 can be more intuitively consistent.

[0120] Meanwhile, the plane on which the bent portion 402 is formed may be a pitch plane, i.e., a plane substantially the same as the XZ plane in Fig. 2. In this way, the bent portion 402 is formed on a plane substantially the same as the XZ plane, so that interference between the operation parts can be reduced. Of course, for intuitive operation of the end tool and the operation part, configurations of other shapes besides the XZ plane are also possible.

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

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

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

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

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

[0126] First, the pitch motion means a motion of the end tool 2100 rotating up and down with respect to the extending direction of the connecting part 400 (X-axis direction in FIG. 2), i.e., a motion of rotating around the Y-axis in FIG. 2. In other words, it means a motion of the end tool 2100 formed extending from the connecting part 400 in the extending direction of the connecting part 400 (X-axis direction in FIG. 2) rotating up and down with respect to the connecting part 400 around the Y-axis.

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

[0128] Meanwhile, the actuation operation means an operation in which the end tool 2100 rotates around the same rotation axis as the yaw operation, but the two jaws 2103 rotate in opposite directions to each other, closing and opening the jaws. That is, it means a movement in which the two jaws 2103 formed on the end tool 2100 rotate in opposite directions to each other around the Z axis.

[0129] The power transmission unit 300 connects the operation unit 200 and the end tool 2100 and plays a role in transmitting the driving force of the operation unit 200 to the end tool 2100, and may include a plurality of wires, pulleys, links, joints, gears, etc.

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

[0131] (Intuitive Drive)

[0132] In the following, the intuitive operation of the surgical instrument 2000 of the present invention will be described.

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

[0134] Here, the surgical instrument 2000 according to the first embodiment of the present invention is characterized in that when the operating unit 200 is rotated in a certain direction relative to the connecting unit 400, the end tool 2100 rotates in the intuitively 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 a certain direction, the end tool 2100 also rotates in the intuitively same direction as the one direction to perform a pitch motion or a yaw motion. Here, the intuitively same direction may be added to mean that the moving direction of the finger of the user holding the operating unit 200 and the moving direction of the tip of the end tool 2100 are substantially the same direction. Of course, the same direction here does not have to be a direction that completely coincides on the three-dimensional coordinate system, and may be understood to be the sameness to the extent that, for example, when the user's finger moves left, the tip of the end tool 2100 also moves left, and when the user's finger moves down, the tip of the end tool 2100 also moves down.

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

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

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

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

[0139] (Power transmission section)

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

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

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

[0143] Furthermore, the power transmission unit 300 of the surgical instrument 2000 according to an embodiment of the present invention may include fastening members 321, 323, 324, 326, 327, 329, and 330 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 necessary.

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

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

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

[0147] First, the first jaw wire, wire 301 and wire 305, may be one single wire. After clamping fastening member 323, which is a first jaw wire-end tool fastening member, at the midpoint of the first jaw wire, which is a single wire, and crimping and fixing the fastening member 323, both strands of the first jaw wire can be called wire 301 and wire 305, respectively, with fastening member 323 at the center.

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

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

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

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

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

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

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

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

[0156] (End Tool)

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

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

[0159] Here, Fig. 4 shows the end tool hub 2106 and the pitch hub 2107 in a coupled state, and Fig. 5 shows the end tool hub 2106 in a detached state, while Fig. 7 is a view focusing on the wires, and Fig. 8 is a view focusing on the pulleys.

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

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

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

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

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

[0165] In particular, with reference to FIG. 6, the end tool hub 2106 includes a first jaw pulley coupling portion 2106a, a second jaw pulley coupling portion 2106b, a guide portion 2106c, a pitch pulley coupling portion 2106e, and an anti-disengagement pulley coupling portion 2106f.

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

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

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

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

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

[0171] The pitch hub 2107 has a rotation shaft 2143 and a rotation shaft 2144, which will be described later, inserted therethrough, and the pitch hub 2107, the end tool hub 2106, and the pulley 2131 can be axially coupled to each other by the rotation shaft 2143. Therefore, the end tool hub 2106 and the pulley 2131 can be formed to be capable of pitch rotation relative to the pitch hub 2107 around the rotation shaft 2143.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0198] Explaining this from another perspective, wire 306, which is the second jaw wire, and wire 302 are wound sequentially so as to be in at least partial contact with pulley 2125, pulley 2123, pulley 2121, pulley 2122, pulley 2124, and pulley 2126, and wire 306 and wire 302 are formed to move along the pulleys while rotating the pulleys.

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

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

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

[0202] That is, when the auxiliary pulley is not arranged, each of the first jaw and the second jaw can only rotate up to a right angle, but in one embodiment of the present invention, by further providing the auxiliary pulleys 2112 and 2122, the effect of increasing the maximum rotation angle by θ as seen in FIG. 8 can be obtained. This enables an operation in which the two jaws of the end tool 2100 must be spread apart for actuation operation when the two jaws are yaw-rotated 90° in the L direction. This is because the second jaw 2102 can rotate by an additional angle (θ) as in FIG. 8. Similarly, actuation operation is possible even when the two jaws are yaw-rotated in the L direction. That is, it has a feature that the range of yaw rotation in which actuation operation is possible can be expanded through the pulleys 2112 and 2122.

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

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

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

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

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

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

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

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

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

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

[0213] Meanwhile, the end tool 2100 of the surgical instrument 2000 of the present invention may further include a pulley 2131 which is an end tool pitch pulley, the operation unit 200 may further include pulleys 231 and 232 which are operation unit pitch pulleys, and the power transmission unit 300 may further include wires 303 and 304 which are pitch wires. In detail, the pulley 2131 of the end tool 2100 may be rotatable around a rotation axis 2143 which is an end tool pitch rotation axis, and may be formed integrally with the end tool hub 2106 (or fixedly connected to the end tool hub 2106). In addition, the wires 303 and 304 may play a role in connecting the pulley 2131 of the end tool 2100 and the pulleys 231 and 232 of the operation unit 200.

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

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

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

[0217] (Staple pulley related components)

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

[0219] Fig. 9 is a side view showing an end tool of the surgical instrument of Fig. 2, Figs. 10 and 11 are perspective views showing a first jaw of the surgical instrument of Fig. 2. Fig. 12 is a perspective view showing a first jaw pulley of the surgical instrument of Fig. 2, Fig. 13 is a plan view showing the first jaw of the surgical instrument of Fig. 2, Fig. 14 is a plan view showing the second jaw of the surgical instrument of Fig. 2, and Figs. 15 and 16 are exploded perspective views showing a staple pulley and a staple link of the surgical instrument of Fig. 2.

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

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

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

[0223] Here, one of the features of the present invention is that the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 are formed so as to rotate substantially around the same axis. In this way, the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 are formed so as to rotate around the same axis, so that the pitch movement / yaw movement / actuation operation can be performed, and the staple fastening and cutting operation can be performed at the same time. This will be described in more detail later. However, in the figure, the first staple pulley 2181, the second staple pulley 2191, the pulley 2111, and the pulley 2121 are formed so as to rotate around one rotation axis 2141, but it goes without saying that each pulley may be formed so as to be rotatable around a separate axis that is concentric with each other.

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

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

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

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

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

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

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

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

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

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

[0234] That is, if the staple auxiliary pulley is not provided, the staple pulley can only rotate up to a right angle, but in one embodiment of the present invention, by further providing the first staple auxiliary pulley 2182 which is an auxiliary pulley, it is possible to obtain the effect of increasing the maximum rotation angle by θ. This enables the first staple pulley 2181 to rotate for stapling and cutting operations in a state where the two jaws of the end tool 2100 are rotated together by 90° in yaw, and to perform the operation of linearly moving the working member 540 described later. In other words, it has a feature that the range of yaw rotation in which stapling and cutting operations are possible can be expanded via the first staple auxiliary pulley 2182.

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

[0236] In the case of the surgical instrument 2000 of the present invention, a first staple assistant pulley 2182 is further disposed on one side of the first staple pulley 2181. By disposing the first staple assistant pulley 2182 in this manner and changing the arrangement path of the wire 308, which is the first staple wire, to a certain extent, the tangential direction of the wire 308 is changed, and therefore the rotation angle of the fastening member (see 329 in FIG. 62) that connects the wire 308 and the first staple pulley 2181 is increased. In other words, the fastening member (see 329 in FIG. 62) that is the connecting portion between the wire 308 and the first staple pulley 2181 becomes rotatable until it is positioned on the common inscribed line of the first staple pulley 2181 and the staple assistant pulley 2122.

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

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

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

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

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

[0242] Specifically, the height in the Z-axis direction of the wire 307 wound around the pulley 2183 is different from the height in the Z-axis direction of the wire 307 heading toward the first staple pulley 2181. Similarly, the height in the Z-axis direction of the wire 308 wound around the pulley 2184 is different from the height in the Z-axis direction of the wire 308 heading toward the first staple auxiliary pulley 2182. Therefore, if the pulley 2187 / pulley 2188, which is the first staple wire separation prevention pulley, does not exist, the path of the wire 307 / wire 308 will be oblique (i.e., the fleet angle of the wire with respect to the pulley will be large), and therefore there is a risk that the wire 307 / wire 308 will be removed from the pulley, and there is also a risk that the wire 307 / wire 308 will be damaged.

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

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

[0245] In the following, components related to the rotation of the first staple pulley 2181 will be described.

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

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

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

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

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

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

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

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

[0254] In detail, pulley 2193 and pulley 2194 function as staple pitch main pulleys. Here, pulley 2193 has wire 310 wound thereon, which is the second staple wire, and pulley 2194 has wire 309 wound thereon, which is the second staple wire.

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

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

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

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

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

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

[0261] (staple drive assembly)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0300] According to this first embodiment of the present invention, the force for advancing the staple link assembly 2170 and the reciprocating assembly 550 connected thereto is amplified, thereby providing the effect of more robust stapling.

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

[0302] In addition, since the first staple pulley 2181 and the second staple pulley 2191 are disposed symmetrically with respect to each other on the left and right with respect to the XZ plane, the left and right balance is adjusted when stapling, and an effect can be obtained in which the end tool 2100 does not swing left and right as a whole and operates stably about the rotation axis 2141 which is the yaw rotation axis. In addition, by reversing the winding directions of the wire 307 / wire 308 which is the first staple wire and the wire 309 / wire 310 which is the second staple wire with respect to the rotation axis 2143 which is the pitch rotation axis, an effect can be obtained in which the swings about the rotation axis 2143 can be offset by each other.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0321] The second jaw 2103 is formed generally in a long and thin rod shape, with an anvil 2102a formed on the distal portion 2102f side and a pulley 2112 coupled to a proximal portion 2102g so as to be rotatable around a rotation axis 2141.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0342] (cartridge)

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

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

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

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

[0347] The cover 510 is formed so as to cover the upper part of the housing 520. The cover 510 may be formed with staple holes 511 through which a plurality of staples 530 can be discharged to the outside. Before the stapling drive, the staples 530 housed inside the housing 520 are pushed up by the working member 540 during the stapling operation, and are pulled out to the outside of the cartridge 500 through the staple holes 511 of the cover 510, whereupon stapling is performed.

[0348] Meanwhile, a slit 512 may be formed in the cover 510 along its longitudinal direction. A 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 the slit 512, it is possible to cut the tissue after the staple fastening has been completed.

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

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

[0351] In this manner, it can be said that the working member 540 pushes up the staples 530, including both a case in which the working member 540 directly pushes up the staples 530 and a case in which 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 in which the working member 540 indirectly pushes up the staples 530).

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

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

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

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

[0356] Meanwhile, a fastening portion 551a may be formed on the proximal end 501 side of the reciprocating member 551 adjacent to the pulley 2111, and this fastening portion 551a may be fastened and coupled to the staple link assembly 2170 of the end tool 2100. Therefore, when the staple link assembly 2170 performs a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction), the reciprocating member 551 fastened thereto can also perform a reciprocating linear motion along the extending direction of the connecting portion 400 (i.e., the Y-axis direction). This will be described in more detail later.

[0357] A working member 540 may be disposed inside the housing 520. The working member 540 may be formed so as to be able to come into contact with the reciprocating member 551, and may be formed so as to move linearly in one direction in response to the reciprocating linear motion of the reciprocating member 551. In other words, the working member 540 interacts with the reciprocating member 551 and performs stapling and cutting while moving along the extension direction of the connecting portion 400.

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

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

[0360] The wedge 541 may be formed on at least one side of the main body 545 and 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 part 400. In other words, the wedge 541 may be formed to be higher on the proximal part 501 side of the cartridge 500 than on the distal part 502 side. In the drawings, two wedges 541 are formed on each of the left and right sides of the main body 545, but the idea of ​​the present invention is not limited thereto, and the wedge 541 may be formed in various numbers and shapes according to the shapes of the staple 530 or the pull-out member 535 that contacts the wedge 541.

[0361] Such a wedge 541 is formed to be capable of sequentially coming into contact with the pull-out member 535 or the plurality of staples 530, and can play a role of sequentially pushing up the staples 530. As shown in FIG. 40 etc. described later, while the working member 540 moves toward the distal portion 502 side, it can play a role of sequentially pushing up the staples 530 and pulling them out of the cartridge 500.

[0362] A blade 542 may be formed on one side of the wedge 541, more specifically, on the proximal portion 501 side of the wedge 541. A sharp edge 542a is formed in one region of the blade 542 to cut tissue. At least a part of the edge 542a is drawn to the outside of the first jaw 2101 and the cartridge 500, and tissue disposed between the first jaw 2101 and the second jaw 2102 can be cut. The edge 542a of the blade 542 may be always drawn to the outside of the first jaw 2101. Alternatively, the edge 542a of the blade 542 may be normally housed inside the first jaw 2101 or inside the cartridge 500, and may be drawn to the outside of the first jaw 2101 only when the working member 540 moves along the longitudinal direction.

[0363] The ratchet member 543 may be formed on one side of the wedge 541, more specifically, on a lower portion of the wedge 541, and may be formed to face the reciprocating member 551 described below. The ratchet member 543 may be formed in a bar shape and may include a plurality of ratchets 543a on one surface. The ratchet member 543 causes the working member 540 to move only in one direction (i.e., toward the distal portion) relative to the reciprocating member 551. The ratchet 543a of the ratchet member 543 may be formed to be capable of contacting the uneven portion 551b of the reciprocating member 551 described above.

[0364] The elastic member 544 is formed on either side of the main body 545 or the wedge 541, and serves to apply a predetermined elastic force to the ratchet member 543. As an 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 forms such as a coil spring, a disc spring, etc., capable of providing a predetermined elastic force to the ratchet member 543.

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

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

[0367] In a state where the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other, the first surface 543a1 inclined by the ratchet 543a and the first surface 551b1 inclined by the uneven portion 551b may be arranged to face each other (i.e., to abut). Also, the second surface 543a2 perpendicular to the ratchet 543a and the second surface 551b2 perpendicular to the uneven portion 551b may be arranged to face each other (i.e., to abut).

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

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

[0370] From another perspective, when the reciprocating member 551 and the ratchet member 543 are fastened (or meshed, or in close contact) with each other, if the reciprocating member 551 moves toward the distal part 502, the ratchet member 543 moves together with the reciprocating member 551 toward the distal part 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 part 502.

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

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

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

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

[0375] At this time, the fastening portion 551a of the reciprocating member 551 is connected to the staple pulley 161 via the staple link assembly 170, and when the staple pulley 161 rotates alternately in the clockwise / counterclockwise direction, the reciprocating member 551 can repeatedly advance and retreat. When the reciprocating member 551 advances, the working member 540 advances together with the reciprocating member 551, and when the reciprocating member 551 retreats, only the reciprocating member 551 retreats, and the working member 540 can stop at the spot. By repeating this process, the working member 540 advances forward, and the staple 530 is stapled by the wedge 541, and at the same time, the blade 542 can cut the stapled tissue.

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

[0377] (stapling and cutting action)

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

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

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

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

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

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

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

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

[0386] On the other hand, as shown in FIG. 44(c), when the first staple pulley 2181 rotates in the direction of the arrow A2 (i.e., counterclockwise) and the second staple pulley 2191 rotates in the direction of the arrow B2 (i.e., clockwise), the staple link assembly 2170 connected thereto and the reciprocating member 551 fastened to the staple link assembly 2170 move in the direction of the arrow C2 (i.e., toward the proximal part). In this state, even if the reciprocating member 551 moves in the C2 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 repeats separation and contact with the reciprocating member 551 to a certain extent while the elastic member 544 repeats elastic deformation and restoration (see FIG. 41 and FIG. 43). That is, even if the reciprocating member 551 moves in the direction of the arrow C2, the working member 540 stops at that position when viewed from the X-axis direction.

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

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

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

[0390] The stapling of a surgical instrument according to one embodiment of the present invention will be described below.

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

[0392] 45 and 46, while the working member 540 moves in the direction of arrow A1 in FIG. 45(b) in the same state as in FIG. 45(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 discharged to the outside of the first jaw 2101 and the cartridge 500.

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

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

[0395] (Operation unit)

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

[0397] 2 to 49, the operation unit 200 of the surgical instrument 2000 according to the first embodiment of the present invention includes a first handle 204 that can be held by a user, an actuation operation unit 203 that controls the actuation motion of the end tool 2100, a yaw operation unit 202 that controls the yaw motion of the end tool 2100, and a pitch operation unit 201 that controls the pitch motion of the end tool 2100. Here, it can be understood that only components related to the pitch / yaw / actuation motions of the surgical instrument 2000 are shown in Figs. 47 and 48.

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

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

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

[0401] Moreover, the operation unit 200 of the first embodiment of the present invention may include a rotation shaft 241, a rotation shaft 242, a rotation shaft 243, a rotation shaft 244, a rotation shaft 245, and a rotation shaft 246. Here, the rotation shaft 241 may function as an operation unit first jaw actuation rotation shaft, and the rotation shaft 242 may function as an operation unit second jaw actuation rotation shaft. Then, the rotation shaft 243 may function as an operation unit yaw main rotation shaft, and the rotation shaft 244 may function as an operation unit yaw sub rotation shaft. Then, the rotation shaft 245 may function as an operation unit pitch sub rotation shaft, and the rotation shaft 246 may function as an operation unit pitch main rotation shaft.

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

[0403] Each such rotating shaft 241, 242, 243, 244, 245, and 246 may be fitted with one or more pulleys, which will be described in more detail below.

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

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

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

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

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

[0409] Pulley 231 and pulley 232 function as an operating section pitch wire main pulley, and pulley 233 and pulley 234 function as an operating section pitch wire sub pulley.

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

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

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

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

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

[0415] The first handle 204 is formed so that it can be held by the user's hand, and in particular, may be formed so that the user can wrap the palm of his or her 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 connection unit 400.

[0416] The actuation operation unit 203 includes a first actuation operation unit 251 and a second actuation operation unit 256. The first actuation operation unit 251 includes a rotating shaft 241, a pulley 210, a first actuation extension unit 252, and a first actuation gear 253. The second actuation operation unit 256 includes a rotating shaft 242, a pulley 220, a second actuation extension unit 257, and a second actuation gear 258. Here, the ends of the first actuation extension unit 252 and the second actuation extension unit 257 are formed in a finger hole ring shape and can operate as a second handle.

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

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

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

[0420] Here, the first actuation gear 253 and the second actuation gear 258 may be formed to mesh with each other and rotate together in the opposite direction when either side rotates.

[0421] The yaw operation unit 202 may include a rotating shaft 243, pulleys 211 and 212 which are the first jaw-yo main pulleys of the operation unit, pulleys 221 and 222 which are the second jaw-yo main pulleys of the operation unit, and a yaw frame 207. The yaw operation unit 202 may further include pulleys 213 and 214 which are the first jaw-yo sub pulleys of the operation unit formed on one side of the pulleys 211 and 212, and pulleys 223 and 224 which are the second jaw-yo sub pulleys of the operation unit formed on one side of the pulleys 221 and 222. Here, the pulleys 213 and 214 and the pulleys 223 and 224 may be coupled to a pitch frame 208 which will be described later.

[0422] Here, in the drawings, the yaw operation unit 202 includes pulleys 211 and 212 and pulleys 221 and 222, and the pulleys 211 and 212 and the pulleys 221 and 222 are shown as being formed to face each other and equipped with two pulleys that can rotate independently, but the idea 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 the yaw operation unit 202.

[0423] Specifically, a rotation shaft 243 that is an operation unit yaw main rotation shaft is formed on one side of the actuation operation unit 203 on the first handle 204. At this time, the first handle 204 is formed to be rotatable about the rotation shaft 243.

[0424] Here, the rotation axis 243 may be formed to form a predetermined angle with the XY plane on which the connecting unit 400 is formed. For example, the rotation axis 243 may be formed in a direction parallel to the Z axis, and when the pitch operation unit 201 rotates in this state, the coordinate system of the rotation axis 243 may relatively change as described above. Of course, the idea 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 an ergonomic design.

[0425] Meanwhile, pulleys 211 and 212 and pulleys 221 and 222 are coupled to a rotating shaft 243 so as to be rotatable about the rotating 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 composed of two pulleys that can rotate independently. Therefore, the wire to be wound and the wire to be unwound can be wound around separate pulleys, respectively, and can operate without interfering with each other.

[0426] The yaw frame 207 rigidly connects the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 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 shaft 243.

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

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

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

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

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

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

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

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

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

[0436] One or more intermediate pulleys 235 for changing or guiding the path of the wire may be disposed in the middle of the connecting portion 400, particularly in the bent portion 402. By guiding the path of the wire by winding at least a part of the wire around such intermediate pulleys 235, the wire may be disposed along the bent shape of the bent portion 402.

[0437] Here, in the figure, the connecting part 400 is shown to have a bent part 402 and be curved to have a predetermined curvature, but the idea of ​​the present invention is not limited thereto, and the connecting part 400 may be formed in a straight line or bent one or more times as necessary, and even in such a case, it can be said that the pitch operation part 201 and the end tool 2100 are formed on substantially the same or parallel axes. Also, in Fig. 3, the pitch operation part 201 and the end tool 2100 are shown to be formed on axes parallel to the X-axis, but the idea of ​​the present invention is not limited thereto, and the pitch operation part 201 and the end tool 2100 may be formed on different axes.

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

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

[0440] (actuation movement, yaw movement, pitch movement)

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

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

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

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

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

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

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

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

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

[0450] When a 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 rotate in pitch 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 which are the first jaw wires move in the same direction, and the wires 302 and 306 which are the second jaw wires move in the same direction, so that the first jaw 2101 and the second jaw 2102 can pitch rotate, and the wires 301, 305, 302, and 306 which are the jaw wires are wound around the pulleys 217, 218, 227, and 228 which are the operation unit pitch main pulleys. Then, such a rotational force is transmitted to the end tool 2100 via the power transmission unit 300, and the two jaws 2103 of the end tool 2100 perform the pitch movement.

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

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

[0453] Fig. 49 is a diagram simply illustrating only the configuration of pulleys and wires that configure the joints of the surgical instrument 2000 according to one embodiment of the present invention shown in Fig. 2. In Fig. 43, an intermediate pulley for changing the path of the wire regardless of the joint movement is omitted.

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

[0455] The operating unit 200 may also include pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 related to the rotational motion of the second jaw 2102. (Since the arrangement and configuration of each pulley in the operating unit 200 are essentially the same as the arrangement and configuration of each pulley in the end tool 2100, some of the specific notations of the reference symbols in the drawings will be omitted.)

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

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

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

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

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

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

[0462] (Conceptual diagram of pulley and wire)

[0463] 51 and 52 are views showing the configurations of pulleys and wires related to the actuation and yaw operations of the surgical instrument 2000 according to one embodiment of the present invention shown in FIG. 2, with the first and second jaws resolved. FIG. 51 is a view showing only the pulleys and wires related to the second jaw, and FIG. 52 is a view showing only the pulleys and wires related to the first jaw. And FIG. 50 is a perspective view showing the yaw operation of the surgical instrument of FIG. 2. Here, components related to the stapling and cutting operations are omitted in FIG. 50.

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

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

[0466] 51, when second actuation extension 257 rotates in the direction of arrow OPA2 around rotation axis 242, pulley 220 connected to second actuation extension 257 rotates, and both strands of wire 302 and wire 306 wound around pulley 220 move in the directions of W2a and W2b, respectively, resulting in second jaw 2102 of end tool 2100 rotating in the direction of arrow EPA2. Therefore, when a user operates first actuation extension 252 and second actuation extension 257 in directions in which they approach each other, an operation is performed in which first jaw 2101 and second jaw 2102 of the end tool approach each other.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0488] As a result, during pitch movement, when the pulley 2111 of the end tool 2100 rotates about the rotation shaft 2143 , the first staple pulley 2181 also rotates about the rotation shaft 2143 together with the pulley 2111 .

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

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

[0491] In particular, the surgical instrument 2000 according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), a wire (first jaw wire or second jaw wire) is wound around the pulley, and a rotation operation (actuation rotation, yaw rotation, pitch rotation) of the operation unit causes the movement of each wire, thereby inducing a desired operation of the end tool 2100. Furthermore, an auxiliary pulley may be formed on one side of each pulley, and these auxiliary pulleys prevent the wire from being wound around one pulley multiple times, the wires wound around the pulleys do not come into contact with each other, and a path between the wire wound around the pulley and the wire unwound from the pulley is safely formed, thereby improving the safety and efficiency of power transmission of the wire.

[0492] On the other hand, as described above, the yaw operation unit 202 and the actuation operation unit 203 are formed directly on the first handle 204. Therefore, when the first handle 204 rotates around the rotation axis 246, the yaw operation unit 202 and the actuation operation unit 203 also rotate together with the first handle 204. As a result, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 is not fixed, but continues to change relatively with the rotation of the first handle 204. That is, in FIG. 2 and the like, 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 convenience of explanation in this specification, unless otherwise specified, the coordinate system of the yaw operation unit 202 and the actuation operation unit 203 has been described based on the state in which the first handle 204 is positioned perpendicular to the connection unit 400, as shown in Figure 2.

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

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

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

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

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

[0498] On the other hand, during the stapling and cutting operations of the end tool 2100, the pulleys 2111 and 2121 do not rotate. That is, when the link member 2171 and the reciprocating member 551 of the cartridge 500 connected thereto perform linear reciprocating motion while the first staple pulley 2181 and the second staple pulley 2191 rotate about the rotation shaft 2141, the pulleys 2111 and 2121 must not rotate. Otherwise, the first jaw 2101 or the second jaw 2102 will rotate during the stapling and cutting operations, and the stapling and cutting operations cannot be performed normally.

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

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

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

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

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

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

[0505] In detail, when the first staple pulley 2181 rotates alternately in the clockwise / counterclockwise directions in a state where the pulley 2111, the pulley 2121, and the first staple pulley 2181 are rotated +90° around the rotation shaft 2141, the link member 2171 and the reciprocating member 551 connected thereto repeatedly advance and retreat. When the reciprocating member 551 advances, the working member 540 advances together with the reciprocating member 551, and when the reciprocating member 551 retreats, only the reciprocating member 551 retreats, and the working member 540 stops at the spot. While repeating such a process, the working member 540 moves toward the distal portion 502 side, and the stapling and cutting operations are performed.

[0506] Figures 70 and 71 are plan views showing the stapling and cutting operations of the end tool of the surgical instrument of Figure 2, and are views showing the process of performing the stapling and cutting operations with the jaw rotated by -90°. As shown in Figure 70, the end tool 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 when the jaw is rotated by -90°.

[0507] In detail, when the first staple pulley 2181 rotates alternately in the clockwise / counterclockwise directions in a state where the pulley 2111, the pulley 2121, and the first staple pulley 2181 are rotated −90° around the rotation shaft 2141, the link member 2171 and the reciprocating member 551 connected thereto repeatedly advance and retreat. When the reciprocating member 551 advances, the working member 540 advances together with the reciprocating member 551, and when the reciprocating member 551 retreats, only the reciprocating member 551 retreats, and the working member 540 stops at the spot. While repeating such a process, the working member 540 moves toward the distal portion 502 side, and the stapling and cutting operations are performed.

[0508] Fig. 72 is a diagram showing a state where the jaw is pitch rotated by -90°, Fig. 73 is a diagram showing a process of performing an actuation operation when the jaw is pitch rotated by -90°, Fig. 74 is a diagram showing a state where the jaw is pitch rotated by +90°, and Fig. 75 is a diagram showing a process of performing an actuation operation when the jaw is pitch rotated by +90°.

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

[0510] Fig. 76 is a diagram showing a state where the jaw has been yaw-rotated by +90°, Fig. 77 is a diagram showing a process of performing an actuation operation when the jaw has been yaw-rotated by +90°, Fig. 78 is a diagram showing a state where the jaw has been yaw-rotated by -90°, and Fig. 79 is a diagram showing a process of performing an actuation operation when the jaw has been yaw-rotated by -90°.

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

[0512] Fig. 80 is a diagram showing a state where the jaws are pitch rotated by -90° and yaw rotated by +90° at the same time, Fig. 81 is a diagram showing a process of performing an actuation operation when the jaws are pitch rotated by -90° and yaw rotated by +90° at the same time, Fig. 82 is a diagram showing a state where the jaws are pitch rotated by +90° and yaw rotated by -90° at the same time, and Fig. 83 is a diagram showing a process of performing an actuation operation when the jaws are pitch rotated by +90° and yaw rotated by -90° at the same time.

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

[0514] <One variation - pin slot type>

[0515] The following describes an end tool 2200 of a surgical instrument according to a modified example of the present invention. Here, the end tool 2200 of a surgical instrument according to a modified example of the present invention has characteristically different configurations of a staple pulley assembly 2260 and a staple link assembly 2270 compared to the end tool of a surgical instrument according to the first embodiment of the present invention described above (see 100 in FIG. 2, etc.). The following describes in detail the configurations that are different from the first embodiment.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0541] The link member 2271 may be formed in a shape of a long and thin bar and an elliptical plate combined together to have a substantially "L" shape. Here, the link member 2271 may include a first protrusion 2272a, a second protrusion 2272b, a fastening portion 2272c, a first slot 2272d, and a second slot 2272e.

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

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

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

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

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

[0547] Here, the first slot 2272d may be formed obliquely instead of concentrically. Therefore, when the first staple pulley 2281 rotates, the protruding member 2281b can push the first slot 2272d in a state of contact with the first slot 2272d to move the link member 2271. That is, when the first staple pulley 2281 rotates, the protruding member 2281b moves in the first slot 2272d while contacting the first slot 2272d, and thus the link member 2271 can move linearly along the guide groove 2201b of the first jaw 2201.

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

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

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

[0551] As described above, the second slot 2272e can be formed obliquely, not concentrically. Therefore, when the second staple pulley 2291 rotates, the protruding member 2291b can push the second slot 2272e in a state of contact with the second slot 2272e to move the link member 2271. That is, when the second staple pulley 2291 rotates, the protruding member 2291b moves in the second slot 2272e while contacting the second slot 2272e, and thus the link member 2271 can move linearly along the guide groove 2201b of the first jaw 2201.

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

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

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

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

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

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

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

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

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

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

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

[0563] This variation of the present invention provides the advantage that the force exerted on the staple link assembly 2270 and associated shuttle assembly 550 is increased, thus providing a more robust stapling effect.

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

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

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

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

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

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

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

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

[0572] Thus, the present invention has been described with reference to one embodiment shown in the drawings, but this is merely illustrative, and those skilled in the art will appreciate that various modifications and variations of the embodiment are possible. Therefore, the true technical scope of the present invention should be determined by the technical ideas of the appended claims. [Industrial Applicability]

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

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 substantially 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 a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a reciprocating assembly coupled to the first staple drive assembly and adapted to move linearly in response to rotational movement of the first and second staple pulleys; and a cartridge including a working member in contact with the reciprocating assembly and moved in one direction by the reciprocating assembly as the reciprocating assembly moves in the one direction.

2. The surgical instrument of claim 1, wherein when the first staple pulley or the second staple pulley rotates, the reciprocating assembly connected to the staple drive assembly moves toward the distal or proximal side of the cartridge.

3. When the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a 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 the staple drive assembly converts bidirectional rotational motion of the first staple pulley or the second staple pulley into reciprocating linear motion of the reciprocating assembly coupled to the 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 staple them, 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 first and second staple pulleys to the reciprocating assembly.

8. The working member includes a ratchet member having a ratchet formed on at least one surface, 8. 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. 9. The surgical instrument of claim 8, wherein when the first staple pulley rotates in a first direction of either a clockwise or counterclockwise direction and the second staple pulley rotates in a direction opposite to the first direction of either a clockwise or counterclockwise direction, the link member connected to the first staple pulley and the second staple pulley, the reciprocating assembly connected to the link member, and the working member in contact with the reciprocating assembly move toward the distal portion of the cartridge.

11. 11. The surgical instrument of claim 10, wherein when the first staple pulley rotates in a direction opposite to the first direction among clockwise and counterclockwise directions and the second staple pulley rotates in the first direction among clockwise and counterclockwise directions, the link member connected to the staple pulley and the reciprocating assembly connected to the link member move toward a proximal portion of the end tool, and the working member is stopped in the one direction.

12. The first staple pulley is formed with a first protruding member, The second staple pulley is formed with a second protruding member, 8. The surgical instrument according to claim 7, wherein a first slot is formed on a surface of the link member facing the first staple pulley, and a second slot is formed on a surface of the link member facing the second staple pulley.

13. The first protruding member and the second protruding member are formed in a cam shape, 13. The surgical instrument of claim 12, wherein the first protruding member rotates to press against the first slot of the link member, and the second protruding member rotates to press against the second slot of the link member, thereby moving the link member.

14. The center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree with respect to the first staple pulley, The surgical instrument according to claim 12, characterized in that the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed so as to be eccentric to a certain degree relative to the second staple pulley.

15. When the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, 13. The surgical instrument according to claim 12, wherein when the first staple pulley and the second staple pulley rotate in the same direction, the link member is stopped in the one direction.

16. a first staple wire coupled to the first staple pulley to rotate the first staple pulley; The surgical instrument of claim 1 , further comprising a second staple wire coupled to said second staple pulley to rotate said second staple pulley.

17. a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis that forms a predetermined angle with the first axis; 2. The surgical instrument of 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 about an axis substantially the same as or parallel to the second axis.

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

19. 2. The surgical instrument according to claim 1, wherein the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are laminated in sequence.

20. 2. The surgical instrument of claim 1, wherein the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

21. a first jaw capable of accommodating a cartridge; A second jaw formed to face the first jaw; a first jaw pulley coupled to the first jaw and configured to be rotatable around a first axis; a second jaw pulley coupled to the second jaw and rotatable about an axis substantially the same as or parallel to the first axis, the second jaw pulley being spaced apart from the first jaw pulley by a certain distance; a staple drive assembly including a first staple pulley and a second staple pulley formed adjacent to the first jaw pulley or the second jaw pulley; a first staple wire that is at least partially in contact with the first staple pulley to transmit a driving force required for rotating the first staple pulley to the first staple pulley; a second staple wire that is in at least partial contact with the second staple pulley to transmit a driving force required for rotating the second staple pulley to the second staple pulley, The staple drive assembly is coupled to a reciprocating assembly of the cartridge such that rotational motion of the staple pulley is converted into linear motion of the reciprocating assembly.

22. The end tool hub further includes a first jaw pulley coupling portion and a second jaw pulley coupling portion formed to face each other, and a guide portion connecting the first jaw pulley coupling portion and the second jaw pulley coupling portion, the first jaw pulley is disposed adjacent the first jaw pulley interface of the end tool hub; The second jaw pulley is disposed adjacent to the second jaw pulley interface of the end tool hub; 22. The surgical instrument end tool of claim 21, wherein at least a portion of the staple drive assembly is formed between the first jaw pulley and the second jaw pulley.

23. 23. The end tool of a surgical instrument according to claim 22, wherein the first shaft is inserted through the first jaw pulley connection portion, the first jaw pulley, the first staple pulley, the second staple pulley, the second jaw pulley and the second jaw pulley connection portion in that order.

24. 23. The end tool of a surgical instrument according to claim 22, wherein the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are stacked in sequence within the end tool hub.

25. 23. The end tool of a surgical instrument according to claim 22, wherein the first jaw pulley, the first staple pulley, the second staple pulley, and the second jaw pulley are formed to be rotatable independently of each other.

26. The surgical instrument end tool of claim 22, further comprising a first staple assist pulley disposed between the first staple pulley and the guide portion.

27. The end tool of a surgical instrument according to claim 26, characterized in that the first staple wire is located on a common inscribed line of the first staple pulley and the first staple assistant pulley, and the rotation angle of the first staple pulley is expanded by the first staple assistant pulley.

28. The surgical instrument end tool of claim 21 , wherein the staple drive assembly includes a staple link assembly connecting the first and second staple pulleys and the reciprocating assembly.

29. The staple link assembly includes:

30. The surgical instrument end tool of claim 28, including a link member respectively coupling the first staple pulley, the second staple pulley, and the reciprocating assembly.

30. The first staple pulley is formed with a first protruding member, The second staple pulley is formed with a second protruding member, The link member has a first slot to which the first protruding member is coupled and a second slot to which the second protruding member is coupled, When the first staple pulley rotates, the first protruding member moves within and contacts the first slot; 30. The surgical instrument end tool of claim 29, wherein as the second staple pulley rotates, the second protruding member moves within and in contact with the second slot.

31. The first slot and the second slot are formed symmetrically to each other on the link member, When the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, 31. The end tool of a surgical instrument according to claim 30, wherein when the first staple pulley and the second staple pulley rotate in the same direction as each other, the link member is stationary in the one direction.

32. When the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, 29. The surgical instrument end tool of claim 28, wherein the staple link assembly coupled to the first staple pulley or the second staple pulley alternates between a distal side and a proximal side of the end tool.

33. 29. The end tool of a surgical instrument according to claim 28, characterized in that the staple link assembly converts bidirectional rotational motion of the first staple pulley or the second staple pulley into reciprocating linear motion of the reciprocating assembly coupled to the staple link assembly.

34. The first jaw has a guide groove formed along its longitudinal direction, 30. The surgical instrument end tool of claim 28, wherein the staple link assembly moves along the guide groove.

35. The jaw rotation shaft is inserted through the first jaw and the second jaw to become a rotation center between the first jaw and the second jaw, the first shaft is a jaw pulley rotation shaft that is inserted through the first jaw pulley and the second jaw pulley and serves as a rotation center of the first jaw pulley and the second jaw pulley, 22. The end tool of a surgical instrument according to claim 21, wherein when the first jaw pulley and the second jaw pulley rotate about the jaw pulley rotation axis, the jaw rotation axis moves relative to the jaw pulley rotation axis.

36. when the first jaw and the second jaw are closed, the jaw axis of rotation moves toward a distal portion of the end tool; 36. The surgical instrument endotool of claim 35, wherein when the first jaw and the second jaw open, the jaw axis of rotation moves toward a proximal portion of the endotool.

37. 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; 22. The end tool of the surgical instrument according to claim 21, further comprising a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable around an axis substantially the same as or parallel to the second axis.

38. The end tool of the surgical instrument according to claim 37, characterized in that the end tool is configured to be capable of yaw rotation about the first axis and pitch rotation about the second axis at the same time.

39. a first jaw wire at least partially wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys; 38. The surgical instrument end tool of claim 37, further comprising: a second jaw wire at least partially wound around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

40. a first jaw and a second jaw that are rotatable independently of each other; a first jaw pulley coupled to the first jaw and configured to be rotatable around a first axis; a second jaw pulley coupled to the second jaw and configured to be rotatable about an axis substantially the same as or parallel to the first axis; a first staple pulley that is rotatable about an axis that is substantially the same as or parallel to the first axis and that is disposed adjacent to the first jaw pulley; a second staple pulley that is rotatable about an axis that is substantially the same as or parallel to the first axis and that is disposed adjacent to the second jaw pulley; a staple link assembly connected to the first staple pulley and the second staple pulley, respectively, and adapted to reciprocate in response to bidirectional rotation of the first staple pulley or the second staple pulley.

41. 41. The surgical instrument end tool of claim 40, wherein the staple link assembly couples with a reciprocating assembly of a cartridge housed within the first jaw to reciprocate the reciprocating assembly.

42. The end tool of a surgical instrument according to claim 40, characterized in that the staple link assembly moves to a distal side or a proximal side of the end tool depending on a direction of rotation of the first staple pulley or the second staple pulley.

43. The first staple pulley is formed with a first protruding member, The second staple pulley is formed with a second protruding member, The end tool of a surgical instrument according to claim 40, characterized in that the staple link assembly has a first slot formed on a surface facing the first staple pulley, and a second slot formed on a surface facing the second staple pulley.

44. When the first staple pulley rotates, the first protruding member moves within and contacts the first slot; 44. The surgical instrument end tool of claim 43, wherein as the second staple pulley rotates, the second protruding member moves within and in contact with the second slot.

45. 44. The surgical instrument end tool of claim 43, wherein the staple link assembly includes a single link.

46. The first protruding member and the second protruding member are formed in a cam shape, 44. The end tool of a surgical instrument according to claim 43, wherein the first protruding member rotates to press against the first slot of the staple link assembly and the second protruding member rotates to press against the second slot of the staple link assembly to move the staple link assembly.

47. The center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree with respect to the first staple pulley, The end tool of a surgical instrument according to claim 43, characterized in that the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed so as to be eccentric to a certain degree relative to the second staple pulley.

48. 44. The surgical instrument end tool of claim 43, wherein the first slot and the second slot are formed symmetrically above and below each other on the staple link assembly.

49. When the first staple pulley and the second staple pulley rotate in opposite directions, the staple link assembly moves in one direction; 44. The surgical instrument end tool of claim 43, wherein when the first staple pulley and the second staple pulley rotate in the same direction relative to one another, the staple link assembly is stationary in the one direction.

50. The first jaw has a guide groove formed along its longitudinal direction, 41. The surgical instrument end tool of claim 40, wherein the staple link assembly moves along the guide groove.

51. 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; 41. The end tool of a surgical instrument according to claim 40, further comprising: a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis.

52. 52. The end tool of a surgical instrument according to claim 51, wherein the first and second staple pulleys rotate with the first and second jaw pulleys when the first and second jaw pulleys rotate in the same direction about the second axis.

53. 41. The end tool of a surgical instrument according to claim 40, wherein the first and second staple pulleys rotate with the first and second jaw pulleys when the first and second jaw pulleys rotate in the same direction about the first axis.

54. 41. The end tool of a surgical instrument according to claim 40, wherein when the first jaw pulley and the second jaw pulley rotate in different directions about the first axis, the first staple pulley and the second staple pulley rotate together with either the first jaw pulley or the second jaw pulley.

55. 41. The end tool of a surgical instrument according to claim 40, wherein the first jaw pulley and the second jaw pulley do not have to rotate while the first staple pulley and the second staple pulley rotate about the first axis by a staple wire.

56. The first jaw is formed with a cartridge accommodating portion capable of accommodating a cartridge, 41. The end tool of a surgical instrument according to claim 40, wherein the second jaw is formed with an anvil that can be contacted by staples of the cartridge.

57. a first jaw wire at least a portion of which is wound around the first jaw pulley; a second jaw wire at least a portion of which is wound around the second jaw pulley; a first staple wire at least partially wound around the first staple pulley; 41. The surgical instrument end tool of claim 40, further comprising a second staple wire at least partially wound around the second staple pulley.

58. a first jaw and a second jaw that are rotatable independently of each other; a first jaw pulley coupled to the first jaw and configured to be rotatable around 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 configured to be rotatable around the first axis; a second jaw wire at least a portion of which is wound around the second jaw pulley; a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and rotatable about a second axis that forms a predetermined angle with the first axis; a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis; a first staple pulley and a second 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 first staple pulley and the second staple pulley and reciprocating in accordance with bidirectional rotation of the first staple pulley or the second staple pulley; a first staple wire that is at least partially in contact with the first staple pulley to transmit a driving force required for rotating the first staple pulley to the first staple pulley; and a second staple wire that contacts at least a portion of the second staple pulley to transmit to the second staple pulley a driving force required to rotate the second staple pulley.

59. 60. The surgical instrument end tool of claim 58, wherein bidirectional rotational motion of the first staple pulley or the second staple pulley is translated into reciprocating linear motion of the staple link assembly.

60. the staple link assembly is coupled to a reciprocating assembly of a cartridge housed within the first jaw; 59. The end tool of a surgical instrument according to claim 58, characterized in that rotational motion of the first staple pulley or the second staple pulley is transmitted to the working member of the cartridge via the staple link assembly and the reciprocating assembly.

61. The end tool of a surgical instrument according to claim 60, characterized in that the staple link assembly converts bidirectional rotational motion of the first staple pulley or the second staple pulley into reciprocating linear motion of the reciprocating assembly coupled to the staple link assembly.

62. The jaw rotation shaft is inserted through the first jaw and the second jaw to become a rotation center between the first jaw and the second jaw, the first shaft is a jaw pulley rotation shaft that is inserted through the first jaw pulley and the second jaw pulley and serves as a rotation center of the first jaw pulley and the second jaw pulley, 59. The end tool of a surgical instrument according to claim 58, wherein when the first jaw pulley and the second jaw pulley rotate about the jaw pulley axis of rotation, the jaw axis of rotation moves relative to the jaw pulley axis of rotation.

63. when the first jaw and the second jaw are closed, the jaw axis of rotation moves toward a distal portion of the end tool; 63. The surgical instrument endotool of claim 62, wherein as the first and second jaws open, the jaw axis of rotation moves toward a proximal portion of the endotool.

64. A movable coupling hole is formed in the first jaw or the second jaw, The first jaw pulley or the second jaw pulley is formed with a shaft coupling portion, The end tool of a surgical instrument according to claim 62, characterized in that the axial coupling portion is formed so that it can move to a certain extent within the movable coupling hole when the axial coupling portion is fitted into the movable coupling hole.

65. When the first staple pulley or the second staple pulley rotates alternately in a clockwise direction and a counterclockwise direction, 59. The surgical instrument end tool of claim 58, wherein the staple link assembly coupled to the first staple pulley or the second staple pulley alternates between a distal side and a proximal side of the end tool.

66. The first jaw has a guide groove formed along its longitudinal direction, 59. The surgical instrument end tool of claim 58, wherein the staple link assembly moves along the guide groove.

67. The staple link assembly includes:

60. The surgical instrument end tool of claim 58, including a link member respectively coupled to the first staple pulley and the second staple pulley.

68. The first staple pulley is formed with a first protruding member, The second staple pulley is formed with a second protruding member, An end tool of a surgical instrument as described in claim 67, characterized in that a first slot is formed on a surface of the link member facing the first staple pulley, and a second slot is formed on a surface of the link member facing the second staple pulley.

69. The first protruding member and the second protruding member are formed in a cam shape, 69. The end tool of a surgical instrument as described in claim 68, characterized in that the first protruding member rotates to press against the first slot of the link member, and the second protruding member rotates to press against the second slot of the link member, causing the link member to move.

70. The center of the first protruding member does not coincide with the center of the first staple pulley, and the first protruding member is formed to be eccentric to a certain degree with respect to the first staple pulley, The end tool of a surgical instrument according to claim 68, characterized in that the center of the second protruding member does not coincide with the center of the second staple pulley, and the second protruding member is formed so as to be eccentric to a certain degree relative to the second staple pulley.

71. 69. The end tool of a surgical instrument according to claim 68, wherein the thickness of the first slot and the thickness of the second slot are each formed thinner than the thickness of the link member.

72. 69. The end tool of a surgical instrument according to claim 68, wherein the sum of the thickness of the first slot and the thickness of the second slot is formed substantially the same as the thickness of the link member.

73. When the first staple pulley rotates, the first protruding member moves within and contacts the first slot; 69. The surgical instrument end tool of claim 68, wherein as the second staple pulley rotates, the second protruding member moves within and in contact with the second slot.

74. The first slot and the second slot are formed symmetrically to each other on the link member, When the first staple pulley and the second staple pulley rotate in opposite directions, the link member moves in one direction, 69. The end tool of a surgical instrument according to claim 68, wherein when the first staple pulley and the second staple pulley rotate in the same direction as each other, the link member is stationary in the one direction.

75. The protruding member is formed in a pin shape, 69. The surgical instrument end tool of claim 68, wherein the protruding member rotates and presses against the slot in the link to cause the link to move.

76. 76. The end tool of a surgical instrument according to claim 75, wherein the slot is formed obliquely rather than concentrically with the staple pulley, and the pin moves along the slot.

77. 68. The surgical instrument end tool of claim 67, wherein the link member is formed of a single member.

78. 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; 59. The end tool of a surgical instrument according to claim 58, further comprising a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and rotatable about an axis substantially the same as or parallel to the second axis.

79. The end tool of a surgical instrument according to claim 78, characterized in that the end tool is configured to be capable of yaw rotation about the first axis while simultaneously being capable of pitch rotation about the second axis.

80. a first jaw wire at least partially wound around the first jaw pulley and the pair of end tool first jaw pitch main pulleys; 80. The surgical instrument end tool of claim 78, further comprising a second jaw wire wound at least partially around the second jaw pulley and the pair of end tool second jaw pitch main pulleys.

81. a pair of first staple pitch main pulleys formed on one side of the first staple pulley and rotatable about a second shaft that forms a predetermined angle with the first shaft; 59. The end tool of a surgical instrument according to claim 58, further comprising a pair of second staple pitch main pulleys formed on one side of the second staple pulley and rotatable around an axis substantially the same as or parallel to the second axis.

82. The end tool of a surgical instrument according to claim 81, further comprising a staple wire slippage prevention pulley arranged between the first staple pulley and the first staple pitch main pulley or between the second staple pulley and the second staple pitch main pulley, formed to be rotatable around an axis substantially identical to or parallel to the second axis, and guiding a path of the first staple wire or the second staple wire.

83. (a) when a first staple pulley of a staple drive assembly rotates about a first axis in a first direction and a second staple pulley rotates about the first axis in a second direction opposite the first direction, a staple link assembly coupled to said first staple pulley and said second staple pulley, and a cartridge shuttle assembly coupled to said staple link assembly, move along a second axis toward a distal portion of said cartridge; (b) as the reciprocating assembly moves toward a distal portion of the cartridge, a working member in contact with the reciprocating assembly moves with the reciprocating assembly toward a distal portion of the cartridge; (c) while the working member is moving toward the distal portion of the cartridge, the working member ejects staples within the cartridge out of the cartridge while simultaneously moving a blade of the working member toward the distal portion of the cartridge; (d) when the first staple pulley rotates in the second direction about the first axis and the second staple pulley rotates in the first direction about the first axis, the staple link assembly connected to the first staple pulley and the second staple pulley, and the reciprocating assembly of the cartridge connected to the staple link assembly move toward a proximal portion of the cartridge.

84. A method of driving a surgical instrument as described in claim 83, characterized in that when the first staple pulley or the second staple pulley rotates in the first direction or the second direction, the reciprocating assembly moves toward the distal portion of the cartridge or toward the proximal portion of the cartridge.

85. 84. The method of driving a surgical instrument according to claim 83, characterized in that bidirectional rotational motion of the first staple pulley or the second staple pulley about the first axis is converted into reciprocating linear motion along the second axis of the reciprocating assembly connected to the first staple pulley and the second staple pulley.

86. 86. The method of claim 85, wherein the reciprocating linear motion of the reciprocating assembly causes the working member to move toward a distal portion of the cartridge.

87. A rack is formed on one surface of the reciprocating assembly, The working member includes a ratchet member having a ratchet formed thereon, 84. A method for driving a surgical instrument as described in claim 83, characterized in that the ratchet member is moved toward the distal portion of the cartridge by pushing the ratchet member while the rack is in close contact with the ratchet member.

88. In the step (d), 84. The method of claim 83, wherein the working member is stationary in the second axial direction.

89. 84. The method of claim 83, wherein 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.

90. a first staple wire coupled to the first staple pulley to rotate the first staple pulley, and a second staple wire coupled to the second staple pulley to rotate the second staple pulley, 84. A method of driving a surgical instrument as described in claim 83, characterized in that bidirectional rotation of the first staple pulley or the first staple pulley by the first staple wire or the second staple wire is converted into reciprocating linear motion of the reciprocating assembly.

91. While the working member is moving toward a distal portion of the cartridge, The wedge portion of the working member sequentially pushes up the plurality of staples in the cartridge to staple them, and at the same time, 84. The method of claim 83, wherein a cutting operation is performed while a blade formed on one side of the wedge portion of the working member moves toward a distal portion of the cartridge.

92. 84. The method for driving a surgical instrument according to claim 83, wherein the steps (a) to (d) are repeated.

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