CN117615728A

CN117615728A - End tool for a surgical instrument and electrocautery surgical instrument comprising such an end tool

Info

Publication number: CN117615728A
Application number: CN202280049524.2A
Authority: CN
Inventors: 李政周; 金熹辰; 张东圭
Original assignee: Livsmed Inc
Current assignee: Livsmed Inc
Priority date: 2021-07-16
Filing date: 2022-07-15
Publication date: 2024-02-27

Abstract

The present invention relates to an electrocautery surgical instrument, and in particular to an electrocautery surgical instrument mounted on a robotic arm or manually operable for laparoscopic surgery or various procedures.

Description

End tool for a surgical instrument and electrocautery surgical instrument comprising such an end tool

Technical Field

The present invention relates to an end tool of a surgical instrument and an electrocautery surgical instrument having the same, and more particularly, to an end tool of a surgical instrument having an end tool and an electrocautery surgical instrument having the same, wherein the end tool is rotatable in two or more directions and operated to intuitively coincide with the movement of an operation portion in a surgical instrument mounted on a robot arm or manually operable for laparoscopic surgery or various kinds of surgery.

Background

In many cases, surgery requires cutting and bonding of body tissue including organs, muscle tissue, connective tissue, and blood vessels. Cutting and bonding with sharp blades and sutures has been in progress for centuries. However, during surgical procedures, bleeding can occur when cutting body tissue, particularly tissue that is relatively highly vascularized. Accordingly, there is a continuing need for a surgical instrument and method for slowing or reducing bleeding during a surgical procedure.

Recently, specific surgical procedures have become available with electrosurgical instruments that use electrical energy. For example, in surgical instruments such as graspers, scissors, forceps, blades, needles, hooks, and the like, electrosurgical instruments have been developed that include one or more electrodes configured to provide electrical energy. The electrical energy provided by the electrodes may be used to coagulate, bind or cut body tissue of the patient. In particular, when electrical energy is used, it may be possible to cut and stop bleeding simultaneously.

Electrosurgical instruments are generally divided into two types: monopolar and bipolar. In monopolar electrosurgical instruments, electrical energy of a particular polarity is provided to one or more electrodes of the instrument. Moreover, the different polarity electrical is electrically connected to the patient. In a bipolar electrosurgical instrument, one or more electrodes are electrically connected to a first polarity power source and one or more electrodes are electrically connected to a second polarity power source that is opposite the first polarity.

The above background art is technical information possessed by the inventor in order to derive the present invention or technical information obtained in the course of deriving the present invention, and thus is not necessarily a known technology that has been disclosed to the public prior to applying the present invention.

Disclosure of Invention

Technical problem

It is an object of the present invention to provide an electrocautery surgical instrument with an end tool, wherein the end tool is rotatable in two or more directions and operated to intuitively coincide with the action of an operating portion in an electrocautery surgical instrument mounted on a robotic arm or manually operable for laparoscopic surgery or various kinds of surgery.

Technical proposal

An embodiment of the present invention provides an end tool for a surgical instrument, comprising: a first jaw and a second jaw rotatable independently of each other; a first jaw pulley formed to be connected to the first jaw and rotatable about a first rotation axis; a second jaw pulley formed to be connected to the second jaw and rotatable about the first rotation axis, and spaced apart from the first jaw pulley by a distance; a blade assembly including a blade that moves between a proximal end and a distal end of the first jaw, and at least a portion of which is formed between the first jaw pulley and the second jaw pulley; and a blade wire, at least a portion of which is in contact with the blade assembly, to transmit a driving force required to move the blade to the blade.

Advantageous effects

According to the present invention as described above, since the operation direction of the operator to the operation portion and the running direction of the end tool are intuitively the same, not only the convenience of the operator is improved, but also the accuracy, reliability, speed, and the like of the operation are improved.

Drawings

Fig. 1a is a conceptual diagram of a pitching operation of a conventional surgical instrument, and fig. 1b is a conceptual diagram of a yawing operation.

Fig. 1c is a conceptual diagram of a pitch motion of another conventional surgical instrument, and fig. 1d is a conceptual diagram of a yaw motion.

Fig. 1e is a conceptual diagram of a pitch motion of a surgical instrument according to the present invention, and fig. 1f is a conceptual diagram of a yaw motion.

Fig. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention.

Fig. 3, 4, 5 and 6 are perspective views illustrating an end tool of the electrocautery surgical instrument of fig. 2.

Fig. 7-8 are plan views illustrating an end tool of the electrocautery surgical instrument of fig. 2.

Fig. 9 and 10 are perspective views showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 2.

Fig. 11 is a cut-away perspective view of the tip tool center of fig. 9.

Fig. 12 is a side view showing the end tool center and each connector of the end tool of the electrocautery surgical instrument of fig. 2.

Fig. 13 is a plan view showing the end tool center and each connector of the end tool of the electrocautery surgical instrument of fig. 2.

Fig. 14 is an exploded perspective view of a jaw-connector-jaw pulley showing an end tool of the electrocautery surgical instrument of fig. 2.

Fig. 15 and 16 are perspective views illustrating opening and closing actions of a tip tool of the electrocautery surgical instrument of fig. 2.

Fig. 17, 18 and 19 are perspective views illustrating a cutting action of an end tool of the electrocautery surgical instrument of fig. 2.

Fig. 20 and 21 are perspective views showing an operation portion of the electrocautery surgical instrument of fig. 2.

Fig. 22 is a diagram schematically showing only the arrangement of pulleys and wires constituting the joint of the electrocautery surgical instrument shown in fig. 2.

Fig. 23 is a perspective view illustrating the deflection action of the electrocautery surgical instrument of fig. 2.

Fig. 24 and 25 are diagrams showing the configuration of pulleys and wires associated with the actuation and deflection actions, respectively, of the electrocautery surgical instrument shown in fig. 2 according to an exploded view of the first and second jaws.

Fig. 26 is a perspective view illustrating a pitching motion of the electrocautery instrument of fig. 2.

Fig. 27 and 28 are diagrams showing the configuration of pulleys and wires associated with the pitching action of the electrocautery surgical instrument shown in fig. 2, according to first and second jaws exploded, respectively.

Fig. 29 and 30 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in a deflected state.

Fig. 31 and 32 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 2 is rotated +90° with deflection.

Fig. 33 and 34 are diagrams illustrating a procedure for performing a cutting action in a state in which the end tool of the electrocautery surgical instrument of fig. 2 is rotated +90° with deflection.

Fig. 35 is a view showing a state in which the end tool of the electrocautery instrument of fig. 2 is rotated-90 ° in pitch.

Fig. 36 is a view showing a state in which the end tool of the electrocautery instrument of fig. 2 is rotated +90° in pitch.

Fig. 37 is a cut-away perspective view of an end tool of the electrocautery instrument of fig. 35.

Fig. 38 and 39 are diagrams showing a procedure of performing a cutting action in a state in which the tip tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in pitch.

Fig. 40 is a plan view showing a state of pitching rotation and yaw rotation of the end tool of the electrocautery surgical instrument of fig. 2.

Fig. 41, 42 and 43 are views showing a state in which a cutting action is performed in a state in which the tip tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in pitch while being rotated +90° in yaw.

Fig. 44, 45, 46 and 47 are diagrams showing an end tool of an electrocautery surgical instrument according to a first variation of the first embodiment of the present invention.

Fig. 48 is an exploded perspective view of a jaw-connector-jaw pulley showing an end tool of the electrocautery surgical instrument of fig. 44.

Fig. 49 and 50 are diagrams illustrating a procedure for performing a cutting action by the end tool of the electrocautery surgical instrument of fig. 44.

Fig. 51 and 52 are diagrams showing an end tool of an electrocautery surgical instrument according to a second variation of the first embodiment of the present invention.

Fig. 53 is a perspective view showing the end tool center of the end tool of the electrocautery instrument of fig. 51.

Fig. 54 and 55 are cut-away perspective views of the tip tool center of fig. 53.

Fig. 56 and 57 are perspective views of the end tool center of fig. 53.

Fig. 58 and 59 are diagrams showing an end tool of an electrocautery surgical instrument according to a third variation of the first embodiment of the present invention.

Fig. 60 is a perspective view showing the end tool center of the end tool of the electrocautery instrument of fig. 58.

Fig. 61 is a cut-away perspective view of the tip tool center of fig. 60.

Fig. 62 is a perspective view illustrating an electrocautery surgical instrument according to a second embodiment of the present invention.

Fig. 63, 64, 65, 66, 67 and 68 are perspective views showing an end tool of the electrocautery surgical instrument of fig. 62.

Fig. 69 and 70 are plan views showing an end tool of the electrocautery surgical instrument of fig. 62.

Fig. 71 and 72 are perspective views showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 62.

Fig. 73 is a cut-away perspective view of the tip tool center of fig. 71.

Fig. 74 is an exploded perspective view of a jaw-connector-jaw pulley showing an end tool of the electrocautery instrument of fig. 62.

Fig. 75, 76, 77 and 78 are perspective views showing a second jaw pulley of the end tool of the electrocautery surgical instrument of fig. 62.

Fig. 79 and 80 are plan views showing opening and closing actions of the end tool of the electrocautery surgical instrument of fig. 62.

Fig. 81 is a diagram showing a jaw opening and closing process of the first embodiment of the present invention shown in fig. 2 and the like, and fig. 82 is a diagram showing a jaw opening and closing process of the second embodiment of the present invention.

Fig. 83 is a view showing a case where the pin groove structure of the second embodiment of the present invention is provided in a general pulley instead of a multi-layered pulley.

Fig. 84, 85, 86 and 87 are perspective views illustrating the opening and closing action of the end tool of the electrocautery surgical instrument of fig. 62.

Fig. 88, 89 and 90 are perspective views illustrating a cutting action of an end tool of the electrocautery surgical instrument of fig. 62.

Fig. 91 and 92 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 62 is rotated-90 ° in a deflected state.

Fig. 93 and 94 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 62 is rotated by +90° in a deflected state.

Fig. 95 and 96 are diagrams showing a procedure of performing a cutting action in a state in which the end tool of the electrocautery surgical instrument of fig. 62 is rotated +90° with deflection.

Fig. 97 is a view showing a state in which the end tool of the electrocautery instrument of fig. 62 is rotated-90 ° in pitch.

Fig. 98 is a view showing a state in which the end tool of the electrocautery instrument of fig. 62 is rotated by +90° in pitch.

Fig. 99 is a cut-away perspective view of an end tool of the electrocautery instrument of fig. 97.

Fig. 100, 101 and 102 are diagrams illustrating a procedure for performing a cutting action in a state in which the tip tool of the electrocautery surgical instrument of fig. 62 is rotated-90 ° in pitch.

Fig. 103 is a plan view showing a state of pitching rotation and yaw rotation of the end tool of the electrocautery instrument of fig. 62.

Fig. 104, 105 and 106 are diagrams showing a state in which a cutting action is performed in a state in which the tip tool of the electrocautery surgical instrument of fig. 62 is rotated-90 ° in pitch while being rotated +90° in yaw.

Fig. 107, 108, 109 and 110 are diagrams showing an end tool of an electrocautery surgical instrument according to a first variation of the second embodiment of the present invention.

Fig. 111, 112 and 113 are diagrams illustrating the procedure of a cutting action by the end tool of the electrocautery surgical instrument of fig. 107.

Fig. 114 is a diagram illustrating an end tool of the electrocautery instrument of fig. 107.

Fig. 115 and 116 are diagrams showing an end tool of an electrocautery surgical instrument according to a second variation of the second embodiment of the present invention.

Fig. 117 is a perspective view showing an end tool center of the end tool of the electrocautery instrument of fig. 115.

Fig. 118 and 119 are cut-away perspective views of the tip tool center of fig. 117.

Fig. 120 and 121 are perspective views of the end tool center of fig. 117.

Fig. 122 and 123 are diagrams showing an end tool of an electrocautery surgical instrument according to a third variation of the second embodiment of the present invention.

Fig. 124 is a perspective view showing an end tool center of the end tool of the electrocautery instrument of fig. 121.

Detailed Description

As the present invention is applicable to various variations and has various embodiments, specific embodiments are illustrated in the drawings and described in detail below. It is not intended, however, to limit the invention to the particular embodiments, but rather should be understood to include all changes, equivalents, and alternatives falling within the spirit and technical scope of the invention. In describing the present invention, if it is determined that detailed descriptions of related known techniques may obscure the gist of the present invention, detailed descriptions thereof will be omitted.

Although the terms first, second, etc. may be used to describe various elements, these elements should not be limited by these terms. These terms are only used for the purpose of distinguishing one component element from another.

The terminology used in the present application is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In this application, it should be understood that the terms "comprises" or "comprising" are intended to specify the presence of stated features, integers, steps, actions, components, or groups thereof, but do not preclude the presence or addition of one or more other features or integers, steps, actions, components, or groups thereof.

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings, and the same or corresponding constituent elements are given the same reference numerals and are not described in detail.

In addition, with respect to the description of the various embodiments of the present invention, it should be understood that each embodiment does not have to be interpreted or implemented independently, and the technical ideas described in the embodiments may be interpreted or implemented in combination with other embodiments described separately.

The electrocautery surgical instrument according to the present invention is characterized in that, for at least one of the pitch, yaw and actuation actions, when the operation portion is rotated in either direction, the end tool intuitively rotates in the same direction as the operation direction of the operation portion.

Referring to fig. 1a, when the pitching operation of the conventional surgical instrument is performed, in a state in which the end tool 120a is disposed farther forward than the rotation center 121a of the end tool and the operation portion 110a is disposed farther rearward than the rotation center 111a of the operation portion, if the operation portion 110a is rotated clockwise, the end tool 120a is also rotated clockwise, and if the operation portion 120a is rotated counterclockwise, the end tool 120a is also rotated counterclockwise. On the other hand, referring to fig. 1b, when the deflecting action of the existing surgical instrument is performed, in a state in which the end tool 120a is disposed more forward than the rotation center 121a of the end tool and the operation portion 110a is disposed more rearward than the rotation center 111a of the operation portion, if the operation portion 110a is rotated clockwise, the end tool 120a is also rotated clockwise, and if the operation portion 110a is rotated counterclockwise, the end tool 120a is also rotated counterclockwise. At this time, if the user moves the operation part 110a to the left, the end tool 120a moves to the right, and if the user moves the operation part 110a to the right, the end tool 120a moves to the left, as viewed from the left-right direction of the user. As a result, since the operation direction of the user and the action direction of the end tool are opposite, user errors may be caused, and there is a problem in that the user operation is inconvenient.

Referring to fig. 1c, some existing surgical instruments are formed in a mirror-symmetrical form, when performing a pitching motion, in a state in which the end tool 120b is disposed more forward than the rotation center 121b of the end tool and the operation portion 110b is disposed more rearward than the rotation center 111b of the operation portion, if the operation portion 110b is rotated clockwise, the end tool 120b is rotated counterclockwise, and if the operation portion 110b is rotated counterclockwise, the end tool 120b is rotated clockwise. At this time, from the perspective of the rotational directions of the operation portion and the end tool, the rotational direction of the user rotating the operation portion 110b and the rotational direction of the corresponding end tool 120b are opposite to each other. As a result, there is a problem in that the user may confuse the operation direction, the movement of the joint is not intuitive, and an error may be caused. In addition, referring to fig. 1d, when the deflecting action is performed, in a state in which the end tool 120b is disposed more forward than the rotation center 121b of the end tool and the operation portion 110b is disposed more rearward than the rotation center 111b of the operation portion, if the operation portion 110b is rotated clockwise, the end tool 120b is rotated counterclockwise, and if the operation portion 110b is rotated counterclockwise, the end tool 120b is rotated clockwise. At this time, from the perspective of the rotational directions of the operation portion and the end tool, the rotational direction of the user rotating the operation portion 110b and the rotational direction of the corresponding end tool 120b are opposite to each other. As a result, there is a problem in that the user may confuse the operation direction, the movement of the joint is not intuitive, and an error may be caused. In this way, in the pitch or yaw operation of the conventional surgical instrument by the user, the operation direction of the user and the operation direction of the end tool do not coincide with each other in the rotation direction or the left-right direction. This is because, in the joint configuration of the existing surgical instrument, the configurations of the end tool and the operation portion are different from each other. That is, this is because the end tool is disposed further forward than the rotation center of the end tool, and the operation portion is disposed further rearward than the rotation center of the operation portion. To solve this problem, as shown in fig. 1e and 1f, the surgical instrument according to an embodiment of the present invention is characterized in that the end tool 120c is disposed further forward than the rotation center 121c of the end tool, and the operation portion 110c is also disposed further forward than the rotation center 111c of the operation portion, so that the actions of the operation portion 110c and the end tool 120c are intuitively coincident. These features are expressed differently, i.e. as shown in fig. 1a, 1b, 1c and 1d, unlike the prior art examples of the configuration of the operating portion on the user side (i.e. away from the end tool) relative to its own joint, as shown in fig. 1e and 1f, at least a portion of the operating portion may be closer to the end tool (than its own joint) based on at least one time during operation of the surgical instrument according to an embodiment of the invention.

In other words, with the conventional surgical instrument shown in fig. 1a, 1b, 1c and 1d, the tip tool is positioned farther forward than the rotation center of itself, and the operation portion is disposed farther rearward than the rotation center of itself, so that the tip tool moving forward with the rear fixed is operated by the action of the operation portion moving backward with the front fixed, and thus this is a intuitively inconsistent structure. As a result, there is a problem in that, in the operation of the operation portion and the operation of the end tool, there is a possibility that the viewpoint of the left-right direction or the viewpoint of the rotation direction is inconsistent, which causes confusion to the user, makes it difficult to intuitively and promptly perform the operation of the operation portion, and causes errors. In contrast, according to the surgical instrument of the embodiment of the present invention, the tip tool and the operation portion are both moved based on the rotation center formed at the rear, and therefore, from the structural point of view, it can be said that the actions thereof are intuitively uniform. In other words, just as the movable portion of the end tool moves based on the rotation center formed at the rear, the movable portion of the operation portion also moves based on the rotation center formed at the rear, and therefore, from the structural point of view, it can be said that the actions thereof are intuitively uniform. As a result, there are advantages in that the user can intuitively and rapidly perform the manipulation of the end tool direction, and the possibility of errors is significantly reduced. Next, detailed mechanisms for realizing such functions will be described.

Fig. 2 is a perspective view of an electrocautery surgical instrument according to a first embodiment of the present invention, and fig. 3 is a side view of the electrocautery surgical instrument of fig. 2. In addition, fig. 4 and 5 are perspective views of an end tool of the electrocautery surgical instrument of fig. 2, fig. 6 is an exploded perspective view of the end tool of the electrocautery surgical instrument of fig. 2, and fig. 7 and 8 are bottom perspective views of the end tool of the electrocautery surgical instrument of fig. 2. In addition, fig. 9 and 10 are side views of the end tool of the electrocautery surgical instrument of fig. 2, fig. 11 is a perspective view of a guide of the end tool of the electrocautery surgical instrument of fig. 2, fig. 12 is a perspective view of the center of the end tool of the electrocautery surgical instrument of fig. 2, and fig. 13-14 are plan views of the end tool of the electrocautery surgical instrument of fig. 2.

First, referring to fig. 2 and 3, an electrocautery surgical instrument 10 according to a first embodiment of the present invention includes an end tool 100, an operating portion 200, and a power transmission portion 300 and a connection portion 400.

Wherein the connection 400 is in the shape of a hollow shaft (shaft) and may house one or more wires and electrical lines therein. The connection part 400 has one end portion coupled to the operation part 200 and the other end portion coupled to the end tool 100, and the connection part 400 may be used to connect the operation part 200 and the end tool 100. Wherein the electrocautery surgical instrument 10 according to a first embodiment of the present invention is characterized in that the connecting portion 400 has a straight portion 401 and a bent portion 402, the straight portion 401 being formed on the coupling side of the tip tool 100, and the bent portion 402 being formed on the coupling side of the operating portion 200. In this way, since the end portion of the connecting portion 400 on the operating portion 200 side is bent, the pitch operating portion 201, the yaw operating portion 202, and the actuation operating portion 203 are formed on or adjacent to the extension line of the end tool 100. In another point of view, it can be described that at least a part of the pitch operation portion 201 and the yaw operation portion 202 are accommodated in the concave portion formed by the curved portion 402. The shape and action of the manipulation portion 200 and the end tool 100 can be more intuitively matched by the shape of such a curved portion 402.

On the other hand, the plane in which the curved portion 402 is formed may be substantially the same plane as the pitch plane, i.e., the XZ plane of fig. 2. In this way, since the bent portion 402 is formed on substantially the same plane as the XZ plane, interference between the operation portions can be reduced. Of course, other forms of configuration other than the XZ plane may be employed for intuitive action of the end tool and the operation portion.

In addition, the connector 410 may be formed at the bent portion 402. The connector 410 may be connected to an external power source (not shown), and the connector 410 may be connected to the jaws 103 through electric wires (electric wires) 411 and 412 to transfer electric power supplied from the external power source (not shown) to the jaws 103. The connector 410 may be a bipolar type having two electrodes or a unipolar type having one electrode.

The operating part 200 is formed at one end of the connection part 400 and has an interface, such as a pincer shape, a bar shape, a lever shape, etc., which can be directly manipulated by a doctor, and is connected to the corresponding interface when the doctor manipulates, so that the end tool 100 inserted into the body of the surgical patient performs a predetermined operation, thereby performing a surgery. Although fig. 2 shows the operation unit 200 in the form of a handle that can be rotated in a state in which a finger is inserted, the idea of the present invention is not limited thereto, and various types of operation units may be employed as long as the operation unit can be connected to the end tool 100 to operate the end tool 100.

The end tool 100 is formed at the other end of the connection part 400 and is inserted into a surgical site to perform a desired action for a surgery. As an example of such an end tool 100, as shown in fig. 2, a pair of jaws (jaw) 103 for performing a clamping (grip) action may be used. However, the concept of the present invention is not limited thereto, and various surgical devices may be used as the end tool 100. For example, a configuration such as a single-arm cautery may also be used as the end tool. Such an end tool 100 is connected through the operation part 200 and the power transmission part 300, and receives a driving force of the operation part 200 through the power transmission part 300, thereby performing actions required for a surgery, such as grasping (grip), cutting (fastening), suturing (fastening), and the like.

Wherein the end tool 100 may be rotated in at least one direction in accordance with the electrocautery surgical instrument 10 of the first embodiment of the present invention, for example, the end tool 100 may perform a pitch (pitch) motion about the Y-axis in FIG. 2 while performing a yaw (yaw) motion and an actuation (actuation) motion about the Z-axis in FIG. 2.

Among them, pitch (pitch), yaw (yaw) and actuation (actuation) actions used in the present invention are defined as follows, respectively.

First, the pitch (pitch) motion refers to a motion in which the end tool 100 rotates in the up-down direction with respect to the extending direction of the joint 400 (X-axis direction in fig. 2), that is, a motion in which it rotates about the Y-axis in fig. 2. In other words, it means a movement in which the end tool 100 rotates up and down about the Y axis with respect to the joint 400, wherein the end tool 100 extends from the joint 400 in the extending direction (X axis direction in fig. 2) of the joint 400.

Next, the yaw (yaw) motion refers to a motion in which the tip tool 100 rotates in the left-right direction with respect to the extending direction of the connecting portion 400 (X-axis direction in fig. 2), that is, a motion in which it rotates about the Z-axis in fig. 2. In other words, it means a movement in which the end tool 100 rotates left and right about the Z axis with respect to the joint 400, wherein the end tool 100 extends from the joint 400 in the extending direction (X axis direction in fig. 2) of the joint 400. That is, it means a movement in which jaws (jaw) 103 formed in two end tools 100 rotate in the same direction about the Z axis.

On the other hand, the actuation action refers to an action in which the end tool 100 rotates about the same rotation axis as the deflection (yaw) action, but the two jaws (jaw) 103 rotate in opposite directions to each other to contract or expand the jaws (jaw). That is, it means a movement in which jaws (jaw) 103 formed in two end tools 100 rotate about the Z axis in directions opposite to each other.

The power transmission part 300 is for transmitting the driving force of the operation part 200 to the tip tool 100 by connecting the operation part 200 and the tip tool 100, and may include a plurality of wires, pulleys, connectors, joints, gears, and the like.

Hereinafter, the end tool 100, the operating portion 200, the power transmission portion 300, and the like of the electrocautery surgical instrument 10 in fig. 2 are described in more detail.

(intuitive drive)

The intuitive driving of the electrocautery instrument 10 according to the present invention will be described below.

First, in a state where the first handle 204 is grasped by hand, the user can rotate the first handle 204 about the Y axis (i.e., the rotation axis 246 of fig. 25) to perform a pitching motion, and rotate the first handle 204 about the Z axis (i.e., the rotation axis 243 of fig. 25) to perform a yawing motion. In addition, in a state in which the thumb and the index finger are inserted into the first actuation extension 252 and/or the second actuation extension 257 of the ring shape formed in one end portion of the actuation operation portion 203, the user can operate the operation portion 203 to perform the actuation action.

Wherein the electrocautery surgical instrument 10 according to a first embodiment of the present invention is characterized in that when the operation part 200 is rotated in either direction with respect to the connection part 400, the end tool 100 is rotated in the intuitively same direction as the operation direction of the operation part 200. In other words, when the first handle 204 of the operation portion 200 is rotated in either direction, the end tool 100 is also rotated in intuitively the same direction as the direction to perform a pitching motion or a yawing motion. It can be further explained that the intuitively identical direction means that the movement direction of the finger of the user grasping the operation section 200 and the movement direction of the distal end portion of the end tool 100 are substantially in the same direction. Of course, the same direction here is not necessarily a perfectly uniform direction in three-dimensional coordinates, and can be understood as the degree of identity as follows, for example: when the user's finger moves to the left, the distal end portion of the end tool 100 also moves to the left, and when the user's finger moves downward, the distal end portion of the end tool 100 also moves downward.

In addition, for this purpose, the electrocautery surgical instrument 10 according to the first embodiment of the present invention is characterized in that the operating portion 200 and the end tool 100 are formed in the same direction with respect to a plane perpendicular to the extension axis (X-axis) of the connecting portion 400. That is, when viewed on the YZ plane of fig. 2, the operation unit 200 extends in the +x axis direction, and the end tool 100 also extends in the +x axis direction. In other words, the forming direction of the end tool 100 in one end portion of the connecting portion 400 and the forming direction of the operation portion 200 in the other end portion of the connecting portion 400 are in the same direction with reference to the YZ plane. Or, in other words, it can be said that the operation portion 200 is formed in a direction away from the trunk of the user who grips it, i.e., in a direction in which the end tool 100 is formed. That is, in the first handle 204, the first actuation operation portion 251, the second actuation operation portion 256, and the like, which are gripped and moved by the user for performing the actuation operation, the yaw operation, and the pitch operation, the movable portions thereof for performing the respective operations are formed to extend in the +x axis direction with respect to the rotation center of the respective joints for performing the respective operations. Thus, the operation unit 200 can be configured in the same manner as the movable portion of the end tool 100 is formed to extend in the +x axis direction with respect to the rotation center of each joint for performing the corresponding operation, and as described with reference to fig. 1, the operation direction of the user and the operation direction of the end tool coincide in both the rotation direction point of view and the left-right direction point of view, and as a result, the same operation can be intuitively performed.

In particular, in the case of the existing surgical instrument, since the direction in which the user operates the operation portion and the actual operation direction of the tip tool are different from each other and intuitively inconsistent, there is a problem in that the operator is not easy to intuitively operate, a skilled operation is required to move the tip tool in a desired direction for a long time, and in some cases, a malfunction may occur to cause injury to the patient.

In order to solve the above-described problems, according to the electrocautery surgical instrument 10 of an embodiment of the present invention, the operation direction of the operation unit 200 and the operation direction of the tip tool 100 are intuitively in the same direction, and for this purpose, the portion of the operation unit 200 that is actually moved for performing the actuation, yaw, and pitch motions is formed to extend in the +x axis direction with respect to the rotation center of the corresponding joint for performing each motion, like the tip tool 100.

(Power transmitting section)

Hereinafter, the power transmission portion 300 of the electrocautery surgical instrument 10 of fig. 2 will be described in more detail.

Referring to fig. 2-25, etc., a power transmission portion 300 of an electrocautery surgical instrument 10 according to an embodiment of the present invention may include a wire 301, a wire 302, a wire 303, a wire 304, a wire 305, a wire 306, and a blade wire 307.

Here, the wire 301 and the wire 305 may be used as a pair of first jaw wires. Wire 302 and wire 306 may be used in pairs as a second jaw wire. Here, the constituent elements that include the wire 301 and the wire 305 as the first jaw wire, and the wire 302 and the wire 306 as the second jaw wire may be referred to as jaw wires (jawwire). In addition, the wire 303 and the wire 304 may be used as a pair of pitch wires.

In addition, the power transmission portion 300 of the electrocautery surgical instrument 10 according to an embodiment of the present invention may include fasteners 321, 322, 323, 324, 326, and 327 coupled to respective ends of each wire to couple the wire and the pulley. Here, each fastener may have various shapes, for example, a ball shape (ball) or a tube shape (tube) or the like, as required.

Here, on the end tool 100 side, fastener 321/fastener 322 acts as a pitch wire-end tool fastener, fastener 323 acts as a first jaw wire-end tool fastener, and fastener 326 can act as a second jaw wire-end tool fastener.

Further, on the operating portion 200 side, the fastener 324 serves as a first jaw wire-operating portion fastener, and the fastener 327 can serve as a second jaw wire-operating portion fastener. Further, although not shown in the drawings, a pitch wire-operating part fastener and a blade wire-operating part fastener may be further formed on the operating part 200 side.

The coupling relationship between each wire and each fastener and each pulley will be described in detail below.

First, the wire 301 and the wire 305 as the first jaw wire may be one single wire. After inserting a fastener 323, which is a first jaw wire-end tool fastener, into the middle position of a first jaw wire, which is a single wire, and fixing the fastener 323 by Crimping (Crimping), two branches of the first jaw wire may be referred to as a wire 301 and a wire 305, respectively, centering on the fastener 323.

Alternatively, the wire 301 and the wire 305 as the first jaw wire are formed as separate wires, respectively, and the wire 301 and the wire 305 may be connected by the fastener 323.

In addition, since the fastener 323 is coupled to the pulley 111, the wire 301 and the wire 305 can be fixedly coupled to the pulley 111. Thus, the pulley 111 can rotate as the wire 301 and the wire 305 are pulled and released.

In one aspect, a first jaw wire-operator fastener 324 can be incorporated at an end of the wire 301 and the wire 305 opposite where the fastener 323 is fastened.

In addition, as described above, since the first jaw wire-operating portion fastener 324 is coupled to the pulley 211, the wire 301 and the wire 305 can be fixedly coupled with the pulley 211. As a result, when the pulley 211 is rotated by a motor or a human force, the wire 301 and the wire 305 are pulled and released, so that the pulley 111 of the end tool 100 can be rotated.

Similarly, the lead 302 and the lead 306, which are second jaw lead, are coupled with a fastener 326 and a second jaw lead-operator fastener 327, respectively, which are second jaw lead-end tool fasteners. In addition, a fastener 326 is coupled to the pulley 121 and a second jaw wire-operating portion fastener 327 is coupled to the pulley 220. As a result, when the pulley 220 is rotated by a motor or a human force, the wire 302 and the wire 306 are pulled and released, so that the pulley 121 of the end tool 100 can be rotated.

Similarly, the wire 304, which is a pitch wire, is combined with the fastener 321, which is a pitch wire-end tool fastener, and a pitch wire-operating part fastener (not shown). In addition, the wire 303 as the pitch wire is combined with a fastener 322 as a pitch wire-end tool fastener and a pitch wire-operating part fastener (not shown).

In addition, the fastener 321 is coupled to the first elevation sheave portion 163a of the end tool center 160, the fastener 322 is coupled to the second elevation sheave portion 163b of the end tool center 160, and the elevation wire-operating portion fastener (not shown) is coupled to the sheave 231. As a result, when the pulley 231 is rotated by a motor or a human force, the wire 303 and the wire 304 are pulled and released, so that the end tool center 160 of the end tool 100 can be rotated.

On the one hand, one end portion of the blade wire 307 is coupled to a blade 175 described later, and the other end portion thereof is coupled to the blade operation portion 260 of the operation portion 200. By the operation of the blade operation portion 260, the blade wire 307 performs a cutting action while moving from the proximal end portion 105 to the distal end portion 104 of the tip tool 100, or the blade wire 307 may be returned from the distal end portion 104 to the proximal end portion 105 of the tip tool 100.

At this time, at least a portion of the blade wire 307 may be accommodated inside a guide tube 171 described later. Accordingly, when the guide tube 171 is bent according to the pitching motion or the deflecting motion of the end tool 100, the blade wire 307 accommodated therein may also be bent together with the guide tube 171. The guide tube 171 as described above will be described in more detail later.

Further, the blade wire 307 is formed to linearly move along the longitudinal direction of the connection part 400 within the connection part 400. In addition, since one end of the blade wire 307 is coupled to the blade 175, when the blade wire 307 is linearly moved in the longitudinal direction of the connection part 400, the blade 175 connected thereto also linearly moves. That is, when the blade wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 175 connected thereto moves toward the distal end 104 side or the proximal end 105 side of the tip tool 100, and simultaneously performs a cutting operation. As will be described in more detail later.

(end tool)

Hereinafter, the end tool 100 of the electrocautery surgical instrument 10 of fig. 2 will be described in more detail.

Fig. 2 is a perspective view showing an electrocautery surgical instrument according to a first embodiment of the present invention, and fig. 3, 4, 5 and 6 are perspective views showing an end tool of the electrocautery surgical instrument of fig. 2. Fig. 9 and 10 are perspective views showing an end tool center of the end tool of the electrocautery instrument of fig. 2, fig. 11 is a cut-away perspective view showing the end tool center of fig. 9, and fig. 12 is a side view showing the end tool center of the end tool of the electrocautery instrument of fig. 2 and each connector. Fig. 13 is a plan view showing the end tool center and each connector of the end tool of the electrocautery surgical instrument of fig. 2. Fig. 14 is an exploded perspective view of a jaw-connector-jaw pulley showing an end tool of the electrocautery surgical instrument of fig. 2.

Here, fig. 3 shows a state in which the tip tool center 160 is combined with the pitch center 150, and fig. 4 shows a state in which the tip tool center 160 is removed. Fig. 5 shows a state in which the first jaw 101 and the second jaw 102 are removed, and fig. 6 shows a state in which the first jaw 101, the second jaw 102, the pulley 111, the pulley 121, and the like are removed. Fig. 7 is a diagram mainly illustrating each wire, and fig. 8 is a diagram mainly illustrating each pulley.

Referring to fig. 2 to 14, etc., an end tool (end tool) 100 of a first embodiment of the present invention has a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 101 and a second jaw 102. The first jaw 101 and the second jaw 102, or the constituent elements that comprise the first jaw 101 and the second jaw 102, respectively, may be referred to herein as jaws (jaw) 103.

Further, the end tool 100 may include pulleys 111, 112, 113, 114, 115, and 116 associated with the rotational movement of the first jaw (jaw) 101. Further, pulleys 121, 122, 123, 124, 125, and 126 may be included in connection with the rotational movement of the second jaw (jaw) 102.

Here, although the drawings show that each of the pulleys facing each other is formed in parallel with each other, the spirit of the present invention is not limited thereto, and each of the pulleys may be formed at various positions suitable for the arrangement of the end tool, and may be formed in various sizes suitable for the arrangement of the end tool.

In addition, the end tool (end tool) 100 of the first embodiment of the present invention may include an end tool center 160 and a pitch center 150.

The first and second rotation shafts 141 and 142 described later are inserted through the end tool center 160, and at least a portion of the pulleys 111 and 121 shaft-coupled to the first rotation shaft 141 may be accommodated inside the end tool center 160. Further, the end tool center 160 may house at least a portion of the pulley 112 and the pulley 122, which are shaft-coupled to the second rotation shaft 142, inside. The end tool center 160 as described above will be described in more detail later.

The third rotation shaft 143 and the fourth rotation shaft 144, which will be described later, are inserted through the pitch center 150, and the pitch center 150 is shaft-coupled with the first pitch sheave portion 163a and the second pitch sheave portion 163b of the end tool center 160 through the third rotation shaft 143. Thus, the end tool center 160 may be formed rotatable about the third rotational axis 143 with respect to the pitch center 150.

Further, at least a portion of the pulleys 113, 114, 123, and 124 shaft-coupled to the third rotation shaft 143 may be accommodated inside the pitch center 150. Further, pitch center 150 may house at least a portion of pulleys 115, 116, 125, and 126 that are shaft coupled to fourth rotational shaft 144.

One end of pitch center 150 is connected to end tool center 160 and the other end of pitch center 150 is connected to connection 400.

Here, the end tool 100 of the first embodiment of the present invention may include a first rotation shaft 141, a second rotation shaft 142, a third rotation shaft 143, and a fourth rotation shaft 144. As described above, the first and second rotation shafts 141 and 142 are inserted through the end tool center 160, and the third and fourth rotation shafts 143 and 144 may be inserted through the pitch center 150.

The first, second, third and fourth rotation shafts 141, 142, 143, 144 may be sequentially provided from the distal end (104) to the proximal end (105) of the end tool 100. Accordingly, the first rotation axis 141 may be referred to as a first pin, the second rotation axis 142 as a second pin, the third rotation axis 143 as a third pin, and the fourth rotation axis 144 as a fourth pin, in this order from the distal end 104.

Here, the first rotation shaft 141 serves as an end tool jaw pulley rotation shaft, the second rotation shaft 142 serves as an end tool jaw auxiliary pulley rotation shaft, the third rotation shaft 143 serves as an end tool pitch rotation shaft, and the fourth rotation shaft may serve as an end tool pitch auxiliary rotation shaft of the end tool 100.

Here, each rotation shaft may include two shafts of a first sub-shaft and a second sub-shaft. Alternatively, it may be described that each rotation axis is formed by being divided into two.

For example, the first rotary shaft 141 may include two shafts of a first counter shaft 141a and a second counter shaft 141 b. In addition, the second rotation shaft 142 may include two shafts, a first counter shaft 142a and a second counter shaft 142 b. In addition, the third rotation shaft 143 may include two shafts of the first sub-shaft 143a and the second sub-shaft 143 b. In addition, the fourth rotation shaft 144 may include two shafts, a first counter shaft 144a and a second counter shaft 144 b.

Each rotation shaft is formed in such a way as to be divided into two in order to pass a guide tube 171 described later through the tip tool center 160 and the pitch center 150. That is, the guide tube 171 may pass between the first counter shaft and the second counter shaft of each rotation shaft. As will be described in more detail later. Here, the first counter shaft and the second counter shaft may be provided on the same shaft, or may be provided with a certain degree of offset (offset).

In one aspect, although each rotation shaft is illustrated as being formed in two in the drawing, the spirit of the present invention is not limited thereto. That is, by forming each rotation shaft to be curved at the center, a retreat path of the guide tube 171 can be formed.

One or more pulleys may be inserted into the rotation shafts 141, 142, 143, and 144 as will be described in detail below.

In one aspect, the end tool 100 may further have an actuation rotation shaft 145. In detail, the joint portion of the first jaw 101 and the second jaw 102 may have an actuation rotation axis 145, and the second jaw 102 may perform an actuation operation while rotating about the actuation rotation axis 145 in a state where the first jaw 101 is fixed. Here, the actuation rotation shaft 145 may be disposed closer to the distal end portion 104 side than the first rotation shaft 141.

Here, one feature of the end tool 100 of the first embodiment of the present invention is that the first rotation shaft 141 and the actuation rotation shaft 145, which are rotation axes of deflection, are provided separately, not as the same shaft. That is, since the first rotation shaft 141 and the actuation rotation shaft 145 are formed to be spaced apart from each other by a predetermined distance, a space for gradually bending the guide tube 171 and the blade wire 307 accommodated therein can be ensured, wherein the first rotation shaft 141 is a rotation shaft of the pulley 111/112 serving as a jaw pulley and is also a rotation shaft of a deflection (yaw) operation, and the actuation rotation shaft 145 is a rotation shaft of the second jaw 102 relative to the first jaw 101 and is also a rotation shaft of an actuation operation. The actuation rotation shaft 145 as described above will be described in more detail later.

Pulley 111 serves as the end tool first jaw pulley and pulley 121 serves as the end tool second jaw pulley. Pulley 111 may be referred to as a first jaw pulley, pulley 121 may be referred to as a second jaw pulley, or both of these components may also be collectively referred to as an end tool jaw pulley or simply a jaw pulley.

The pulley 111 and the pulley 121 as the end tool jaw pulley are formed to face each other and are formed to be rotatable independently of each other about the first rotation shaft 141 as the end tool jaw pulley rotation shaft. At this time, the pulleys 111 and 121 may be formed to be spaced apart from each other by a certain distance, and a blade assembly receiving part may be formed therebetween. In addition, at least a portion of the blade assembly 170 described later may be provided in the blade assembly accommodating portion. In other words, the blade assembly 170 including the guide tube 171 is disposed between the pulley 111 and the pulley 121.

Here, the pulley 111 is coupled with the first jaw (jaw) 101 by a first link 180 described later, so that when the pulley 111 rotates about the first rotation axis 141, the first jaw 101 may also rotate together about the first rotation axis 141.

On the one hand, the pulley 121 is connected with the second jaw (jaw) 102 through a second link 190 described later, so that when the pulley 121 rotates about the first rotation axis 141, the second jaw 102 connected therewith can rotate about the first rotation axis 141 or the actuation rotation axis 145.

Here, the pulley 111, the first connector 180, and the first jaw 101 are fixedly coupled to each other, thereby acting as one-body. That is, when the pulley 111 rotates about the first rotation axis 141, the first link 180 and the first jaw 101 may also rotate about the first rotation axis 141 as a unit with the pulley 111.

In contrast, the pulley 121, the second link 190, and the second jaw 102, while coupled together, are formed such that one component element is relatively movable or rotatable with respect to the other component element. That is, the second link 190 is formed to be movable or rotatable with respect to the pulley 121, and the second jaw 102 is formed to be movable or rotatable with respect to the second link 190.

In addition, the deflecting action and the actuating action of the end tool (end tool) 100 are performed according to the rotation of the pulleys 111 and 121. That is, when the pulley 111 and the pulley 121 rotate in the same direction about the first rotation axis 141, the first jaw 101 and the second jaw 102 rotate about the first rotation axis 141 while performing the deflecting action. On the other hand, when the pulley 121 is rotated individually about the first rotation axis 141 in a predetermined direction, the second jaw 102 is rotated about the actuation rotation axis 145 with respect to the first jaw 101 while performing the actuation action.

Pulley 112 serves as an end tool first jaw auxiliary pulley and pulley 122 serves as an end tool second jaw auxiliary pulley, which may be collectively referred to as an end tool jaw auxiliary pulley or simply an auxiliary pulley.

In detail, the pulleys 112 and 122 as the end tool jaw auxiliary pulleys may be additionally provided at one side of the pulleys 111 and 121, in other words, the pulleys 112 as the auxiliary pulleys may be provided between the pulleys 111 and 113/114. In addition, a pulley 122 as an auxiliary pulley may be provided between the pulley 121 and the pulley 123/pulley 124. The pulley 112 and the pulley 122 may be formed to be rotatable independently of each other about the second rotation shaft 142. The auxiliary pulley as described above will be described in more detail later.

Pulleys 113 and 114 serve as the end tool first jaw pitch master pulleys, pulleys 123 and 124 serve as the end tool second jaw pitch master pulleys, which may be collectively referred to as the end tool jaw pitch master pulleys.

Pulleys 115 and 116 serve as the end tool first jaw pitch sub-pulley and pulleys 125 and 126 serve as the end tool second jaw pitch sub-pulley, which may be collectively referred to as the end tool jaw pitch sub-pulleys.

Hereinafter, description is made regarding constituent elements related to rotation of the pulley 111.

Pulleys 113 and 114 serve as the end tool first jaw pitch master pulley. I.e. as the main rotary pulley for the pitching action of the first jaw 101. Here, the wire 301 as the first jaw wire is wound around the pulley 113, and the wire 305 as the first jaw wire is wound around the pulley 114.

Pulleys 115 and 116 serve as the end tool first jaw pitch sub-pulleys. Namely, as a secondary rotary pulley for the pitching action of the first jaw 101. Here, the wire 301 as the first jaw wire is wound on the pulley 115, and the wire 305 as the first jaw wire is wound on the pulley 116.

Here, the pulley 113 and the pulley 114 are disposed at one side of the pulley 111 and the pulley 112 in a manner facing each other. Here, the pulley 113 and the pulley 114 are formed to be rotatable independently of each other about a third rotation axis 143 as a tip tool pitch rotation axis. In addition, a pulley 115 and a pulley 116 are provided on one side of the pulley 113 and the pulley 114, respectively, in such a manner as to face each other. Here, the pulley 115 and the pulley 116 are formed to be rotatable independently of each other about a fourth rotation axis 144 as an end tool pitch assist rotation axis. Here, although the pulleys 113, 115, 114 and 116 are shown in the drawings as being formed rotatable about the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in a plurality of directions suitable for its arrangement.

The wire 301 as the first jaw wire is wound thereon in order to be at least partially in contact with the pulley 115, the pulley 113, and the pulley 111. In addition, in order to at least partially contact the pulley 111, the pulley 112, the pulley 114, and the pulley 116, the wire 305 connected to the wire 301 through the fastener 323 is sequentially wound thereon.

This will be described from another point of view, namely, in order for at least a portion to be in contact with the pulley 115, the pulley 113, the pulley 111, the pulley 112, the pulley 114 and the pulley 116, the wire 301 and the wire 305 as the wires of the first jaw are wound thereon in sequence, and the wire 301 and the wire 305 are formed to be movable with the each pulley while being rotatable with the each pulley.

Accordingly, when the wire 301 is pulled in the direction of arrow 301 in fig. 7, the fastener 323 coupled to the wire 301 and the pulley 111 coupled thereto are rotated in the direction of arrow L in fig. 7. Conversely, when the wire 305 is pulled in the direction of arrow 305 in fig. 7, the fastener 323 coupled to the wire 305 and the pulley 111 coupled thereto are rotated in the direction of arrow R in fig. 7.

Hereinafter, description is made regarding constituent elements related to rotation of the pulley 121.

Pulleys 123 and 124 serve as the end tool second jaw pitch master pulley. I.e., as the primary rotary pulley for the pitching action of the second jaw 102. Here, the wire 306 as the second jaw wire is wound around the pulley 123, and the wire 302 as the second jaw wire is wound around the pulley 124.

Pulleys 125 and 126 serve as the end tool second jaw pitch sub-pulleys. That is, pulleys 125 and 126 act as secondary rotational pulleys for the pitching action of the second jaw 102. Here, wire 306, which is the second jaw wire, is wound around pulley 125, and wire 302, which is the second jaw wire, is wound around pulley 126.

Here, the pulleys 123 and 124 are disposed at one sides of the pulleys 121 and 122 in a manner facing each other. Here, the pulley 123 and the pulley 124 are formed to be rotatable independently of each other about a third rotation axis 143 as a tip tool pitch rotation axis. In addition, the pulleys 125 and 126 are provided on one sides of the pulleys 123 and 124, respectively, in such a manner as to face each other. Here, the pulleys 125 and 126 are formed to be rotatable independently of each other about a fourth rotation axis 144 as an end tool pitch assist rotation axis. Here, although the pulleys 123, 125, 124 and 126 are illustrated in the drawings as being formed to be rotatable about the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in a plurality of directions suitable for its arrangement.

The wire 306, which is the second jaw wire, is wound thereon in sequence in order to be at least partially in contact with the pulleys 125, 123 and 121. In addition, the wire 302 connected to the wire 306 by the fastener 326 is wound thereon in order to be at least partially in contact with the pulley 121, the pulley 122, the pulley 124, and the pulley 126.

This will be described from another point of view, namely, in order for at least a portion to be in contact with the pulleys 125, 123, 121, 122, 124 and 126, the wire 306 and the wire 302 as the second jaw wire are wound thereon in sequence, and the wire 306 and the wire 302 are formed to be movable with the each pulley while being rotatable with the each pulley.

Thus, as the wire 306 is pulled in the direction of arrow 306 in fig. 7, the fastener 326 coupled to the wire 306 and the pulley 121 coupled thereto rotate in the direction of arrow R in fig. 7. Conversely, when the wire 302 is pulled in the direction of arrow 302 in fig. 7, the fastener 326 coupled to the wire 302 and the pulley 121 coupled thereto rotate in the direction of arrow L in fig. 7.

Hereinafter, the pulley 112 and the pulley 122 serving as auxiliary pulleys will be described in more detail.

The pulleys 112 and 122 are in contact with the wire 305 as the wire of the first jaw and the wire 302 as the wire of the second jaw, and the setting paths of the wire 305 and the wire 302 are changed to some extent, thereby serving to enlarge the respective rotation angles of the first jaw 101 and the second jaw 102.

That is, when the auxiliary pulley is not provided, the first jaw and the second jaw can each be rotated only to a right angle, but in an embodiment of the present invention, by additionally providing the pulley 112 and the pulley 122 as the auxiliary pulley, an effect of expanding the maximum rotation angle by θ as seen in fig. 7 can be obtained. This makes it possible to realize an action requiring opening of the two jaws for the actuation action in a state where the two jaws of the end tool 100 are deflected together by 90 ° in the L direction. This is because the second jaw 102 can be rotated by an additional angle θ as shown in FIG. 7. Similarly, the two jaws can be rotated in the L direction by being deflected, and the actuation operation can be performed. In other words, there is a feature that the range of the yaw rotation, which can perform the actuation action, can be enlarged by the pulleys 112 and 122.

This is described in more detail below.

When the auxiliary pulley is not provided, since the first jaw wire is fixedly coupled to the end tool first jaw pulley and the second jaw wire is fixedly coupled to the end tool second jaw pulley, the end tool first jaw pulley and the end tool second jaw pulley can each be rotated only to 90 °. In this case, when the first jaw and the second jaw are actuated in a state of being positioned at a line of 90 °, the first jaw may be opened, but the rotation of the second jaw cannot exceed 90 °. Therefore, in a state where the first jaw and the second jaw perform a deflection operation at a certain angle or more, there is a problem that the actuation operation cannot be smoothly performed.

In order to solve the problems described above, the electrocautery instrument 10 of the present invention is additionally provided with pulleys 112 and 122 as auxiliary pulleys on one side of the pulleys 111 and 121. As described above, by providing the pulley 112 and the pulley 122, the setting paths of the wire 305 as the first jaw wire and the wire 302 as the second jaw wire are changed to some extent to change the tangential directions of the wire 305 and the wire 302, so that the fastener 326 that combines the wire 302 and the pulley 121 can be rotated up to the N line of fig. 7. That is, the fastener 326, which is the junction of the wire 302 and the pulley 121, may be rotated until it is located on the inner common tangent of the pulley 121 and the pulley 122. Similarly, the fastener 323, which is the joint of the wire 305 and the pulley 111, can be rotated until it is located on the inner common tangent line of the pulley 111 and the pulley 112, thereby expanding the rotation range in the R direction.

In other words, the wires 301 and 305 are disposed on either side of the pulley 112 with respect to a plane perpendicular to the Y-axis and passing through the X-axis, wherein the wires 301 and 305 are two branches of the first jaw wire wound on the pulley 111. Meanwhile, the wire 302 and the wire 306 are disposed on the other side with respect to a plane perpendicular to the Y axis and passing through the X axis by the pulley 122, wherein the wire 302 and the wire 306 are two branches of the second jaw wire wound around the pulley 121.

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

In other words, the wire 305 is located on the inscribed line of the pulley 111 and the pulley 112, and the rotation angle of the pulley 111 is enlarged by the pulley 112. Further, the wire 302 is located on an inscribed line of the pulley 121 and the pulley 122, and the rotation angle of the pulley 121 is enlarged by the pulley 122.

According to the present invention as described above, as the radius of rotation of the jaws 101 and 102 is widened, an effect of widening the range of the deflection motion that can perform the normal opening/closing actuation motion can be obtained.

Hereinafter, the pitching motion of the present invention will be described in more detail.

Meanwhile, when the wire 301 is pulled in the direction of arrow 301 in fig. 7 while the wire 305 is pulled in the direction of arrow 305 in fig. 7 (i.e., when both branches of the first jaw wire are pulled), as shown in fig. 6, since the wire 301 and the wire 305 are wound under the pulleys 113 and 114, the pulley 111 fixedly coupled with the wire 301 and the wire 305, the end tool center 160 coupled with the pulley 111 are rotated together in the counterclockwise direction as a unit about the third rotation axis 143, thereby finally allowing the end tool 100 to be rotated downward while performing the pitching motion, wherein the pulleys 113 and 114 are rotatable about the third rotation axis 143 as the end tool pitching rotation axis. At this time, since the second jaw 102 and the wire 302 and the wire 306 fixedly coupled thereto are wound over the pulleys 123 and 124 rotatable about the third rotation axis 143, the wire 302 and the wire 306 are released in opposite directions of 302 and 306, respectively.

Conversely, when the wire 302 is pulled in the direction of arrow 302 in fig. 7 while the wire 306 is pulled in the direction of arrow 306 in fig. 7, as shown in fig. 6, since the wire 302 and the wire 306 are wound over the pulleys 123 and 124, the pulley 121 fixedly coupled to the wire 302 and the wire 306, the end tool center 160 coupled to the pulley 121 as a whole rotates together in the clockwise direction about the third rotation axis 143, thereby eventually causing the end tool 100 to perform a pitching motion while rotating upward, wherein the pulleys 123 and 124 are rotatable about the third rotation axis 143 as an end tool pitching rotation axis. At this time, since the first jaw 101 and the wires 301 and 305 fixedly coupled thereto are wound under the pulleys 113 and 114 rotatable about the third rotation axis 143, the wires 302 and 306 are moved in opposite directions of the wires 301 and 305, respectively.

In one aspect, the tip tool center 160 of the tip tool 100 of the electrocautery surgical instrument 10 of the present invention further has a first elevation pulley portion 163a and a second elevation pulley portion 163b serving as tip tool elevation pulleys, the operating portion 200 further has pulleys 231 and 232 serving as operating portion elevation pulleys, and the power transmission portion 300 may further have a wire 303 and a wire 304 serving as elevation wires.

In detail, the end tool center 160 including the first and second elevation sheave portions 163a and 163b may be formed to be rotatable about the third rotation axis 143 as an end tool elevation rotation axis. In addition, the wires 303 and 304 may be used to connect the first and second elevation pulley portions 163a and 163b of the end tool 100 with the pulleys 231 and 232 of the operation portion 200.

Accordingly, when the pulleys 231 and 232 of the operation part 200 are rotated, the rotation of the pulleys 231 and 232 is transmitted to the tip tool center 160 of the tip tool 100 through the wires 303 and 304, so that the tip tool center 160 is also rotated together, thereby finally rotating the tip tool 100 while performing a pitching motion.

That is, the electrocautery surgical instrument 10 according to the first embodiment of the present invention has the first and second elevation pulley portions 163a and 163b of the tip tool 100, the pulleys 231 and 232 of the operation portion 200, the wires 303 and 304 of the power transmission portion 300 for transmitting power for performing an elevation motion, so that the driving force of an elevation motion of the operation portion is more perfectly transmitted to the tip tool 100, whereby the reliability of the motion can be improved.

(blade lead and guide tube)

Hereinafter, the blade wire 307 and the guide tube 171 of the present invention will be described in more detail.

The guide tube 171 according to the present invention is formed to wrap the blade wire 307 within a predetermined interval, at which time the blade wire 307 can move inside the guide tube 171. In other words, the blade wire 307 is movable with respect to the guide tube 171 in a state where the blade wire 307 is inserted into the guide tube 171.

Here, when the blade wire 307 is pushed or pulled, the guide tube 171 prevents the blade wire 307 from being bent in an unexpected direction, thereby serving to guide a path of the blade wire 307. The guide tube 171 described above allows smooth cutting operation.

In one aspect, one end portion of the guide tube 171 may be fixedly coupled to a first coupling portion (not shown) inside the end tool center 160 or the first connector 180, which will be described later. In addition, the other end portion of the guide tube 171 may be fixedly coupled to a second coupling portion (not shown) inside the connection portion 400. As described above, since both ends of the guide tube 171 are fixedly coupled to predetermined points (first coupling portion and second coupling portion), respectively, the entire length of the guide tube 171 can be maintained constant. Therefore, the length of the blade wire 307 inserted into the inside of the guide tube 171 can also be kept constant.

In one aspect, the guide tube 171 according to the present invention may be formed of a flexible material so as to be capable of being formed in a curved manner. Accordingly, when the end tool 100 performs a yaw motion about the first rotation axis 141 or a pitch motion about the third rotation axis 143, the shape of the guide tube 171 may be bent while being deformed in response to these motions. In addition, when the guide tube 171 is bent, the blade wire 307 inside the guide tube is also bent.

Here, the length of the guide tube 171 is constant, but the relative position and distance of the first coupling portion (not shown) and the second coupling portion (not shown) may be changed with the pitch rotation or the yaw rotation of the end tool 100, and thus, a space in which the guide tube 171 moves is required in accordance with the change of the corresponding distance. To this end, a Pitch Slit (Pitch Slit) 164 and a Yaw Slit (Yaw Slit) 165 may be provided on the end tool center 160 to form a space in which the guide tube 171 can move. The configuration of the end tool center 160 as described above will be described in detail later.

In one aspect, as described above, the blade wire 307 is inserted through the inside of the guide tube 171, and the blade wire 307 is movable relative to the guide tube 171 inside the guide tube 171. That is, when the blade wire 307 is pulled in a state where the guide tube 171 is fixed, the blade 175 connected to the blade wire 307 moves toward the proximal end portion 105, and when the blade wire 307 is pushed, the blade 175 connected to the blade wire 307 moves toward the distal end portion 104.

This is described in more detail below.

In order to perform the cutting action using the blade 175, it is most reliable to push and pull the blade 175 with the blade wire 307. In addition, in order for the blade wire 307 to push and pull the blade 175, a guide tube 171 that can guide the path of the blade wire 307 needs to be provided. If the guide tube 171 does not guide the path of the blade wire 307 (i.e., if the blade wire 307 is not grasped), cutting is not performed even if the blade wire 307 is pushed, and a phenomenon in which the middle portion of the blade wire 307 is bent may occur. Therefore, in order to perform the cutting operation using the blade 175, the blade wire 307 and the guide tube 171 must be included.

However, in order to use the blade wire 307 to drive the cutting action, it is necessary to perform cutting while pushing the blade wire 307, and therefore, a wire having relatively rigidity (i.e., not easily bendable) is necessary as the blade wire 307 at this time so that the blade wire 307 can withstand the force. However, a wire having rigidity (i.e., not easily bendable) has a small bendable range, and may be permanently deformed if a force of a certain degree or more is applied thereto.

This is described from another perspective, i.e., a wire that is rigid (i.e., not easily bendable) has a minimum radius of curvature that is permanently undeformed while also being able to bend and then straighten. In other words, if the bending of the wire or guide tube is smaller than a certain radius of curvature, both the wire and guide tube are permanently deformed while being bent, so that cutting cannot be performed while moving forward and backward. Therefore, it is necessary to make the blade wire 307 have a gentle curvature while maintaining bending.

Therefore, in order to prevent the blade wire 307 from being bent suddenly while passing over the respective pulleys, a space in which the blade wire 307 can be bent gently is required between the jaw 103 (i.e., the actuation rotation shaft 145) and the end tool center 160 (i.e., the first rotation shaft 141 as a deflection shaft).

To this end, one feature of the present invention is to have a first connector 180 and a second connector 190, which are connectors connecting the pulley 111/112, which is a jaw pulley, with the jaw 103, such that the jaw 103 (i.e., the actuation rotation shaft 145) and the end tool center 160 (i.e., the first rotation shaft 141, which is a deflection shaft) are spaced apart by a certain distance, thereby forming a space in which the blade wire 307 and the guide tube 171 can be gently bent. At the same time, rotation of pulley 111/112, which is a jaw pulley, is transmitted to jaw 103 via first link 180 and second link 190.

In addition, the blade wire 307 and the guide tube 171 need to pass through the end tool center 160 to be connected to the blade 175, and a space having the blade wire 307 and the guide tube 171 bendable is required inside the end tool center 160, so the following condition needs to be formed: 1) Inside the end tool center 160 there is room for the blade wire 307/guide tube 171 to pass through while being bendable, i.e., forming a pitch slit 164 and a yaw slit 165; 2) Each rotation shaft is formed by dividing into two parts; 3) The pitch arc portion 166 and the yaw arc portion 167 are additionally formed to guide the blade wire 307 and the guide tube 171 to bend.

This is described from another point of view, that is, when one end portion of the guide tube 171 is fixed inside the connection portion 400 and the other end portion thereof moves while undergoing a pitching motion and a yawing motion, the guide tube 171 is bent in a direction that can achieve the most gentle curvature (hereinafter referred to as "the most gentle curvature") according to a change in the distance of the both end portions. As described above, the movement of the blade wire 307 is gentle and no permanent deformation occurs only when the maximum gentle curvature in the natural state is reached.

Accordingly, in order to secure the maximum gentle curvature, a pitch slit 164 and a yaw slit 165 are formed on the path of the guide tube 171, and further, a pitch arc portion 166 and a yaw arc portion 167 are additionally formed on the end tool center 160. As a result, the guide tube 171 can be formed into a shape closest to the maximum gentle curvature (even if the maximum gentle curvature is not reached).

Hereinafter, the connection structure of the end tool center 160 and the jaw-link-jaw pulley as described above will be described in more detail.

(end tool center)

Referring to fig. 9 to 14, the tip tool center 160 includes a main body portion 161, a first jaw pulley coupling portion 162a, a second jaw pulley coupling portion 162b, a first elevation pulley portion 163a, a second elevation pulley portion 163b, an elevation slit 164, a yaw slit 165, an elevation arc portion 166, and a yaw arc portion 167.

The distal end side of the tip tool center 160 may be formed with a first jaw pulley coupling 162a and a second jaw pulley coupling 162b. Here, the first jaw pulley coupling 162a and the second jaw pulley coupling 162b are formed to face each other, and the pulleys 111 and 121 are accommodated therein. Here, the first jaw pulley coupling 162a and the second jaw pulley coupling 162b may be formed substantially parallel to a plane perpendicular to the first rotation axis 141 as a deflection rotation axis.

First jaw pulley coupling 162a and second jaw pulley coupling 162b are connected by a body portion 161. That is, the first jaw pulley coupling portion 162a and the second jaw pulley coupling portion 162b, which are parallel to each other, are coupled by the body portion 161 formed in a direction substantially perpendicular thereto, and therefore, the first jaw pulley coupling portion 162a, the second jaw pulley coupling portion 162b, and the body portion 161 are substantially formedThe figure is shaped to house pulley 111 and pulley 121 therein.

This is described from another angle, that is, it can be described that the first jaw pulley coupling portion 162a and the second jaw pulley coupling portion 162b are formed to extend from the main body portion 161 in the X-axis direction.

Here, the pulley 111 as the first jaw pulley is disposed adjacent to the first jaw pulley coupling portion 162a of the tip tool center 160, and the pulley 121 as the second jaw pulley is disposed adjacent to the second jaw pulley coupling portion 162b of the tip tool center 160, and thus, the deflection slit 165 may be formed between the first jaw pulley coupling portion 162a and the second jaw pulley coupling portion 162b. In addition, at least a portion of the blade assembly 170 described later may be disposed inside the deflection slit 165. Describing this from another perspective, at least a portion of the guide tube 171, which can be described as a blade assembly 170, is disposed between the first jaw pulley coupling 162a and the second jaw pulley coupling 162b. As described above, one feature of the present invention is that since the blade assembly 170 including the guide tube 171 is disposed between the pulley 111 as the first jaw pulley and the pulley 121 as the second jaw pulley, the end tool 100 can perform a cutting action using the blade 175 while performing a pitching action and a yawing action. As will be described in more detail later.

On the one hand, a through hole is formed on the first jaw pulley coupling 162a such that the first rotation shaft 141 passes through the first jaw pulley coupling 162a and the pulley 111 to shaft-couple them. Further, a through hole is formed on the second jaw pulley coupling 162b such that the first rotation shaft 141 passes through the second jaw pulley coupling 162b and the pulley 121 to shaft-couple them.

At this time, as described above, the first rotation shaft 141, which is a yaw rotation shaft, may be formed in two, that is, a first sub-shaft 141a and a second sub-shaft 141b, and the guide tube 171 may pass between the first sub-shaft 141a and the second sub-shaft 141b of the first rotation shaft 141.

In addition, a deflection slit 165 may be formed between the first jaw pulley coupling 162a and the second jaw pulley coupling 162 b. Since the deflection slit 165 is formed inside the end tool center 160 in this way, the guide tube 171 can pass through the inside of the end tool center 160.

This is described from another angle that the first rotation axis 141 is separated up and down and does not pass through the end tool center 160, and the deflection slit 165 may be formed on a plane perpendicular to the first rotation axis 141 near the first rotation axis 141. Accordingly, the guide tube 171 can move (i.e., move left and right) inside the deflection slit 165 while passing through the vicinity of the first rotation axis 141.

In one aspect, the deflection circular arc portion 167 may be further formed on the main body portion 161. The deflection circular arc portion 167 may be formed in a circular arc shape to have a predetermined curvature. In detail, the deflection arc portion 167 may be formed in a circular arc shape to have a predetermined curvature when viewed on a plane perpendicular to the first rotation axis 141 as a deflection rotation axis. For example, the deflection arc portion 167 may be formed in a fan shape so that the guide tube 171 may be formed along a curved path on the XY plane. The deflection arc 167 described above may be used to guide the path of the guide tube 171 when the end tool 100 is deflected for rotation.

The first and second elevation sheave portions 163a and 163b may be formed at a proximal end side of the tip tool center 160 for the tip tool elevation sheave. Here, the first and second elevation sheave portions 163a and 163b may be formed to face each other. Here, the first and second elevation sheave portions 163a and 163b may be formed substantially parallel to a plane perpendicular to the third rotation axis 143 (elevation rotation axis).

In detail, one end of the end tool center 160 is formed in a disc shape like a pulley, and a groove around which a wire can be wound is formed on the outer circumferential surface thereof, so that a first elevation pulley part 163a and a second elevation pulley part 163b can be formed. The above-described wire 303 and wire 304 are coupled to the first and second elevation sheave portions 163a and 163b serving as elevation sheaves of the end tool, and the end tool center 160 performs an elevation motion while rotating about the third rotation axis 143.

In one aspect, although not shown in the drawings, the elevation sheave may be formed as a separate member from the end tool center 160 to be combined with the end tool center 160.

The first and second elevation sheave portions 163a and 163b are connected by the main body portion 161. That is, since the first and second tilt pulley portions 163a and 163b parallel to each other are coupled by the main body portion 161 formed in a direction substantially perpendicular thereto, the first and second tilt pulley portions 163a and 163b and the main body portion 161 are substantially formedThe font type.

This is described from another angle, that is, it may be described that the first and second elevation sheave portions 163a and 163b are formed to extend from the main body portion 161 in the-X axis direction.

On the one hand, a through hole is formed on the first elevation sheave portion 163a so that the third rotation shaft 143 can pass through the first elevation sheave portion 163a. Further, a through hole is formed on the second elevation sheave portion 163b so that the third rotation shaft 143 can pass through the second elevation sheave portion 163b.

At this time, as described above, the third rotation shaft 143 as the pitch rotation shaft may be formed in two, that is, the first sub-shaft 143a and the second sub-shaft 143b, and the guide pipe 171 may pass between the first sub-shaft 143a and the second sub-shaft 143b of the third rotation shaft 143.

The pitch slit 164 may be formed between the first and second pitch pulley portions 163a and 163 b. Since the pitch slit 164 is formed inside the end tool center 160 in this way, the guide tube 171 can pass through the inside of the end tool center 160.

This is described from another angle that the third rotation axis 143 is separated left and right without passing through the end tool center 160, and the pitch slit 164 may be formed on a plane perpendicular to the third rotation axis 143 near the third rotation axis 143. Accordingly, the guide tube 171 can move (i.e., move up and down) while passing through the vicinity of the third rotation axis 143, inside the pitch slit 164.

In one aspect, the pitch arc portion 166 may be further formed on the body portion 161. The pitch arc portion 166 may be formed in a circular arc shape to have a predetermined curvature. In detail, the pitch arc portion 166 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the third rotation axis 143 as a pitch rotation axis. For example, the pitch arc portion 166 is formed in a fan shape so that the guide tube 171 may be formed along a curved path on the XZ plane. The pitch arc 166 as described above may be used to guide the path of the guide tube 171 as the end tool 100 performs pitch rotation.

Here, the pitch slit 164 and the yaw slit 165 may be formed to be connected to each other. Thus, the guide tube 171 and the blade wire 307 inside thereof may be disposed completely through the inside of the end tool center 160. In addition, the blade 175 thus coupled to one end of the blade wire 307 can reciprocate linearly inside the first jaw 101 and the second jaw 102.

As described above, the present invention is characterized in that the blade wire 307 and the guide tube 171 need to pass through the end tool center 160 to be connected to the blade 175, and a space having the blade wire 307 and the guide tube 171 bendable is required inside the end tool center 160, so that the following conditions need to be formed: 1) Inside the end tool center 160 there is a space through which the blade wire 307/guide tube 171 passes and is bendable, i.e., a pitch slit 164 and a yaw slit 165 are formed; 2) Each rotation shaft is formed by dividing into two parts; 3) The pitch arc portion 166 and the yaw arc portion 167 are additionally formed to guide the blade wire 307/guide tube 171 to bend.

(jaw-connecting piece-connecting structure of jaw pulley)

With continued reference to fig. 9-14, etc., the end tool 100 of the present invention includes a first jaw 101, a second jaw 102, a first connector 180, a second connector 190, a pulley 111 that is a first jaw pulley, a pulley 112 that is a second jaw pulley. Hereinafter, the pulley 111 is referred to as a first jaw pulley 111, and the pulley 121 is referred to as a second jaw pulley 121.

The first jaw pulley 111 is fixedly coupled to the first link 180.

In detail, the first jaw pulley 111 is formed with a protrusion 111a thereon, and the first connector 180 is formed with a through hole (not shown), so that the protrusion 111a of the first jaw pulley 111 may be inserted into the through hole (not shown) of the first connector 180. In addition, the first auxiliary shaft 141a of the first rotary shaft 141 may be sequentially inserted through the first jaw pulley 111 and the first connector 180. As a result, the first jaw pulley 111 and the first link 180 are coupled at two points, thereby fixedly coupling the first jaw pulley 111 and the first link 180.

That is, the first link 180 does not rotate with respect to the first jaw pulley 111, but when the first jaw pulley 111 rotates about the first rotation axis 141, the first link 180 also rotates about the first rotation axis 141 together with the first jaw pulley 111.

In one aspect, the first connector 180 and the first jaw 101 are fixedly coupled by a securing member (pin, etc.).

In other words, the first jaw 101 and the first jaw pulley 111 are connected by the first connector 180, and they are fixed relative to each other, so that either one member cannot rotate/move relative to the other member.

As a result, when the first jaw pulley 111 rotates about the first auxiliary shaft 141a of the first rotary shaft 141, the first link 180 and the first jaw 101 coupled thereto also rotate about the first auxiliary shaft 141a of the first rotary shaft 141 together with the first jaw pulley 111.

In one aspect, the second jaw pulley 121 and the second link 190 are pivotally coupled at a point such that the second link 190 is rotatably coupled to the second jaw pulley 121.

In detail, the second jaw pulley 121 is formed with a protrusion 121a thereon, and the second link 190 is formed with a through-hole 190a thereon, so that the protrusion 121a of the second jaw pulley 121 may be inserted into the through-hole 190a of the second link 190. Thus, when the second jaw pulley 121 rotates, the second link 190 moves while rotating about the protrusion 121 a.

In addition, the second link 190 and the second jaw 102 are coupled at one point shaft, and thus, the second link 190 is rotatably coupled to the second jaw pulley 121.

In detail, the second link 190 is formed with a through hole 190b, the second jaw 102 is also formed with a through hole 102a, and the pin-shaped fixing member 146 is inserted through the through hole 190b and the through hole 102a, so that the second link 190 can be coupled with the second jaw 102 shaft.

Additionally, the actuation rotation shaft 145 can be inserted through the second jaw 102, the first connector 180, the first jaw 101 in sequence. Here, the actuation rotation shaft 145 may be formed in two pieces, as with the other rotation shafts.

As a result, when only the second jaw pulley 121 rotates about the first rotation shaft 141 in a state where the first jaw pulley 111 is fixed, the second link 190 coupled to the second jaw pulley 121 shaft moves. In addition, when the second link 190 is moved, the second jaw 102, which is axially coupled to the second link 190, is also actuated by the second link 190, and at this time, the second jaw 102 is rotated about the actuation rotation axis 145.

Hereinafter, the deflecting action and the actuating action of the end tool 100 will be described.

First, when the first jaw pulley 111 and the second jaw pulley 121 are rotated together, 1) the first link 180 and the first jaw 101 coupled thereto are also rotated together with the first jaw pulley 111 about the first rotation axis 141, and 2) the second link 190 and the second jaw 102 coupled thereto are also rotated together with the second jaw pulley 121 about the first rotation axis 141, thereby performing a deflecting operation.

On the one hand, in a state where the jaw 103 is closed as shown in fig. 16, when only the second jaw pulley 121 is rotated in the direction of arrow a in fig. 15, the second link 190 connected to the second jaw pulley 121 is moved in the direction of arrow B in fig. 15 by the second jaw pulley 121. In addition, the second link 190 is moved in the direction of arrow B in fig. 15, and simultaneously, the second jaw 102 connected to the second link 190 is pulled in the direction of arrow C in fig. 15, whereby the second jaw 102 performs a rotational motion about the actuation rotational shaft 145 in the direction of arrow C in fig. 15, thereby performing an opening actuation motion of the jaws 103.

In other words, when the operation portion 200 performs the actuation motion, only the second jaw pulley 121 rotates, and when the operation portion 200 performs the deflection motion, the first jaw pulley 111 and the second jaw pulley 121 rotate together in the same direction.

This is described from another angle, that is, when the operation portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 111 and the second jaw pulley 121 rotate together, so that rotation of the second jaw 102 relative to the first jaw 101 does not occur.

On the one hand, when the operation portion 200 performs the actuation motion, only the second jaw wire is pulled, whereby in a state where the first jaw pulley 111 is fixed, only the second jaw pulley 121 is rotated, so that in a state where the actuation rotation shaft 145 is fixed, the second link 190 is pulled, so that the second jaw 102 is rotated about the actuation rotation shaft 145.

(constituent elements related to cautery and cutting)

With continued reference to fig. 4-16, etc., an end tool 100 of a first embodiment of the present invention may include a first jaw 101, a second jaw 102, a first electrode 151, a second electrode 152, a guide tube 171, and a blade 175 to perform cautery and cutting actions.

Here, the constituent elements of the guide tube 171, the blade 175, and the like related to blade driving may be collectively referred to as a blade assembly 170. One feature of an embodiment of the present invention is that since the blade assembly 170 including the guide tube 171 and the blade 175 is disposed between the pulley 111 as the first jaw pulley and the pulley 121 as the second jaw pulley, the cutting action using the blade 175 can be performed while the tip tool 100 performs the pitching action and the yawing action. This will be described in more detail.

As described above, since the first jaw 101 is connected with the first connector 180 and the first jaw pulley 111, when the first jaw pulley 111 rotates about the first rotation axis 141, the first jaw pulley 111 and the first connector 180 rotate as a unit about the first rotation axis 141.

In one aspect, the first electrode 151 can be formed on a surface of the first jaw 101 facing the second jaw 102. In addition, the second electrode 152 can be formed on a surface of the second jaw 102 facing the first jaw 101.

At this time, a slit 151a may be formed on the first electrode 151, and the blade 175 may be moved through the slit 151 a. In addition, a slit 152a may be formed on the second electrode 152, and the blade 175 may be moved through the slit 152 a.

In one aspect, a spacer 153 can be formed between the first jaw 101 and the first electrode 151 and a spacer 154 can be formed between the second jaw 102 and the second electrode 152. The gasket 153 and the gasket 154 may include an insulating material such as ceramic. Alternatively, the first jaw 101 and the second jaw 102 themselves may be composed of insulators such that the first electrode 151 and the second electrode 152 may remain insulated from each other until they contact each other without separate insulators.

In one aspect, although not shown in the figures, one or more sensors (not shown) can be further formed on at least one of the first jaw 101 or the second jaw 102. The placement of tissue between the first jaw 101 and the second jaw 102, and the current flow through the first electrode 151 and the second electrode 152, creates a current, voltage, resistance, impedance (Impedance), temperature during cauterization, and the sensor may be configured to measure at least a portion thereof.

Alternatively, without a separate sensor, the generator (not shown) powering the electrodes may itself directly monitor at least a portion of the current, voltage, resistance, impedance (Impedance) and temperature, and control accordingly.

In one region of the blade 175, a sharp and cut tissue edge may be formed. As at least a portion of the blade 175 moves between the distal end 104 and the proximal end 105 of the end tool 100, tissue disposed between the first jaw 101 and the second jaw 102 may be cut.

Here, one feature of the end tool 100 of the electrocautery instrument 10 according to an embodiment of the present invention is to have a guide tube 171 and a blade 175 disposed between the pulley 111 and the pulley 121. Another feature is that by having the guide tube 171 and blade 175 as described above, a multi-joint/multi-degree of freedom surgical instrument that can perform pitch/yaw/actuation motions can also perform cautery and cutting. This is described in more detail below.

Heretofore, various types of electrocautery surgical instruments have been developed. Among them, a vessel cutter called Advanced Energy Device or "vascular sealer" has an increased sensing function compared to the existing bipolar cautery method, and thus, it supplies power of different polarities to both electrodes, denatures blood vessels to stop bleeding by the heat generated thereby, and then cuts out the hemostatic portion using a blade. The method adopted at this time is to measure the impedance of the tissue (or blood vessel) during the current flow to determine whether the cauterization is completed, automatically stop the power supply when the cauterization is completed, and then cut the tissue using a blade.

The bipolar vessel resectoscope as described above cannot perform articulation such as pitch/yaw motions in most cases because it is necessary to have a blade for cutting tissue after cauterization and it is necessary to additionally have a structural member for linear reciprocation of such a blade on the end tool.

On the other hand, there have been attempts to realize joint movement using a flexion type joint connecting a plurality of joints in a bipolar vessel resectoscope, but there are problems in that the rotation angle is limited and it is difficult to control the correct action of the end tool.

On the other hand, unlike the above-described method, that is, the method of hemostasis and cutting by ultrasonic vibration, the joint itself cannot be provided due to the physical characteristics of ultrasonic waves.

To address the above, one feature of the end tool 100 of the electrocautery surgical instrument 10 according to an embodiment of the present invention is to have a guide tube 171 disposed between the pulleys 111 and 121 and a blade 175 that moves between a first position and a second position with movement of a blade wire 307 disposed inside the guide tube 171. Another feature is that by having the guide tube 171 and blade 175 as described above, pitch/yaw/actuation motions can also be performed in a pulley/wire fashion in a bipolar surgical instrument for cauterizing and cutting tissue.

Fig. 15 is a view showing a state in which an end tool of the electrocautery surgical instrument of fig. 2 is open, and fig. 16 is a view showing a state in which the end tool of the electrocautery surgical instrument of fig. 2 is closed. Fig. 17 is a diagram showing a state where the blade wire 307 and the blade 175 are located at the first position, fig. 18 is a diagram showing a state where the blade wire 307 and the blade 175 are located at the second position, and fig. 19 is a diagram showing a state where the blade wire 307 and the blade 175 are located at the third position.

Referring to fig. 15 to 19, it can be described that the cutting action of fig. 17 to 19 is performed in a state where the first jaw 101 and the second jaw are closed (close) as shown in fig. 16, so that the tissue between the first jaw 101 and the second jaw 102 is cut.

Here, the first position shown in fig. 17 may be defined as a state in which the blade 175 is maximally introduced to the proximal end 105 side of the end tool 100. Alternatively, the blade 175 may be defined as being positioned on the side adjacent to the pulley 111/112.

In one aspect, the third position shown in fig. 19 may be defined as a state in which the blade 175 is maximally drawn toward the distal end 104 side of the end tool 100. Alternatively, the blade 175 may be defined as being positioned at a position spaced apart from the pulley 111/112 to the maximum extent.

First, as shown in fig. 15, in a state where the first jaw 101 and the second jaw 102 are opened (open), a tissue to be cut is placed between the first jaw 101 and the second jaw 102, and then an actuation action is performed to close (close) the first jaw 101 and the second jaw 102 (as shown in fig. 16).

Then, as shown in fig. 17, in a state where the blade wire 307 and the blade 175 are located at the first position, by applying electric currents of different polarities to the first electrode 151 and the second electrode 152, the tissue located between the first jaw 101 and the second jaw 102 is cauterized. At this time, a generator (not shown) supplying power to the electrode itself monitors at least a part of current, voltage, resistance, impedance (Impedance), and temperature, and when cauterization is completed, power supply may be stopped.

As described above, in the state where the cauterization is completed, when the blade wire 307 is sequentially moved in the arrow A1 direction in fig. 18 and the arrow A2 direction in fig. 19, the blade 175 combined with the blade wire 307 is sequentially moved from the first position of the proximal end portion 105 of the tip tool 100 to the third position of the distal end portion 104 of the tip tool 100 to the positions of fig. 18 and 19.

As described above, the blade 175 cuts the tissue between the first jaw 101 and the second jaw 102 while moving in the X-axis direction.

However, the linear movement of the blade 175 herein does not mean a complete straight line, but may mean that even if not a complete straight line, for example, a middle portion of the straight line is bent at a predetermined angle, or a section having a gentle curvature exists at a certain section, or the like, it is understood that the linear movement is performed and the movement of the degree of cutting the tissue is performed at the same time as the linear movement.

On the one hand, when the blade wire 307 is pulled in the opposite direction in this state, the blade 175 combined with the blade wire 307 will also return to the first position.

According to the present invention as described above, the effect that the multi-joint/multi-degree of freedom surgical instrument capable of performing pitch/yaw/actuation motions can also perform cautery and cutting can be obtained.

(operation section)

Fig. 20 and 21 are perspective views showing an operation portion of the surgical instrument of fig. 2. Fig. 22 is a diagram schematically showing only the arrangement of pulleys and wires constituting the joint of the electrocautery surgical instrument shown in fig. 2.

Referring to fig. 2-22, the operating portion 200 of the electrocautery surgical instrument 10 according to a first embodiment of the present invention includes a first handle 204 that is graspable by a user, an actuation operating portion 203 for controlling the actuation movement of the end tool 100, a deflection operating portion 202 for controlling the deflection movement of the end tool 100, and a pitch operating portion 201 for controlling the pitch movement of the end tool 100. Here, it is understood that only the constituent elements associated with the pitch/yaw/actuation movement of the electrocautery surgical instrument 10 are shown in fig. 20 and 21.

Furthermore, the operation portion 200 of the electrocautery surgical instrument 10 further includes: a blade operating part 260 for performing cutting by controlling the movement of the blade 175 of the end tool 100; a cauterization operation part 270 which supplies electric power to the first electrode 151 and the second electrode 152 of the end tool 100 to perform cauterization.

The operating portion 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 the first jaw (jaw) 101. Further, pulleys 220, 221, 222, 223, 224, 225, 226, 227, and 228 associated with the rotational movement of the second jaw (jaw) 102 may be included. Further, the operation portion 200 may include a pulley 231, a pulley 232, a pulley 233, and a pulley 234 related to the pitching motion. Further, a pulley 235, which is an intermediate pulley provided at every interval of the gap in the bent portion 402 of the connection portion 400, may be included.

Here, although the drawings show that each of the pulleys facing each other is formed in parallel with each other, the spirit of the present invention is not limited thereto, and each of the pulleys may be formed at various positions suitable for the arrangement of the operation parts, or may be formed in various sizes suitable for the arrangement of the operation parts.

Further, the operation portion 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 serves as an operation portion first jaw actuation rotation shaft, and the rotation shaft 242 may serve as an operation portion second jaw actuation rotation shaft. In addition, the rotation shaft 243 serves as an operation portion deflection main rotation shaft, and the rotation shaft 244 may serve as an operation portion deflection sub rotation shaft. In addition, the rotation shaft 245 serves as an operation section pitch sub rotation shaft, and the rotation shaft 246 may serve as an operation section pitch main rotation shaft.

The rotation shaft 241/rotation shaft 242, rotation shaft 243, rotation shaft 244, rotation shaft 245, and rotation shaft 246 may be provided in order from the distal end 205 toward the proximal end 206 of the operation portion 200.

One or more pulleys may be interposed on such rotation shafts 241, 242, 243, 244, 245, and 246, which will be described in detail below.

The pulley 210 serves as an operating portion first jaw actuation pulley and the pulley 220 serves as an operating portion second jaw actuation pulley, which may be collectively referred to as an operating portion actuation pulley.

The pulleys 211 and 212 serve as an operation portion first jaw deflecting main pulley, and the pulleys 221 and 222 serve as an operation portion second jaw deflecting main pulley, which may be collectively referred to as an operation portion deflecting main pulley.

The pulleys 213 and 214 serve as operation portion first jaw deflection sub-pulleys, and the pulleys 223 and 224 serve as operation portion second jaw deflection sub-pulleys, which may be collectively referred to as operation portion deflection sub-pulleys.

Pulleys 215 and 216 serve as the operating portion first jaw pitch sub-pulleys, pulleys 225 and 226 serve as the operating portion second jaw pitch sub-pulleys, which may be collectively referred to as the operating portion pitch sub-pulleys.

The pulleys 217 and 218 serve as the operating portion first jaw pitch main pulley, and the pulleys 227 and 228 serve as the operating portion second jaw pitch main pulley, which may be collectively referred to as the operating portion pitch main pulley.

The pulleys 231 and 232 serve as the operating section pitch wire main pulley, and the pulleys 233 and 234 serve as the operating section pitch wire sub-pulley.

The above-described constituent elements are classified from the viewpoint of the operation portion for each movement (pitch/yaw/actuation) as follows.

The pitch operation part 201 for controlling the pitch movement of the tip tool 100 may include a pulley 215, a pulley 216, a pulley 217, a pulley 218, a pulley 225, a pulley 226, a pulley 227, a pulley 228, a pulley 231, a pulley 232, a pulley 233, and a pulley 234. Further, the pitch operation part 201 may include a rotation shaft 245 and a rotation shaft 246. Further, the pitch operation section 201 may further include a pitch frame 208.

The deflection operation portion 202 for controlling the deflection movement of the tip tool 100 may include a pulley 211, a pulley 212, a pulley 213, a pulley 214, a pulley 221, a pulley 222, a pulley 223, and a pulley 224. Further, the deflection operation portion 202 may include a rotation shaft 243 and a rotation shaft 244. Further, the deflection operation portion 202 may further include a deflection frame 207.

The actuation operation portion 203 for controlling the actuation movement of the tip tool 100 may include a pulley 210, a pulley 220, a rotation shaft 241, and a rotation shaft 242. Further, the actuation operation portion 203 may further include a first actuation operation portion 251 and a second actuation operation portion 256.

Hereinafter, each constituent element of the operation section 200 will be described in more detail.

The first handle 204 is formed for grasping by a user's hand, and may be formed in particular for grasping by a user to be able to wrap the first handle 204 with the palm of the user's hand. In addition, an actuation operation portion 203 and a yaw operation portion 202 are formed on the first handle 204, and a pitch operation portion 201 is formed on one side of the yaw operation portion 202. In addition, the other end portion of the pitch operation portion 201 is connected to the bent portion 402 of the connection portion 400.

The actuation operation portion 203 includes a first actuation operation portion 251 and a second actuation operation portion 256. The first actuation operation portion 251 includes a rotation shaft 241, a pulley 210, a first actuation extension 252, and a first actuation gear 253. The second actuation operative portion 256 includes a rotational shaft 242, a pulley 220, a second actuation extension 257, and a second actuation gear 258. Here, the ends of the first and second actuating extensions 252 and 257 are formed in a finger ring shape to act as a second handle.

Here, the rotation shafts 241 and 242, which are actuation rotation shafts, may be formed to have a predetermined angle with the XY plane in which the connection part 400 is formed. For example, the rotation shafts 241 and 242 may be formed in a direction parallel to the Z axis, in which state the coordinate system of the actuation operation portion 203 may relatively change when the pitch operation portion 201 or the yaw operation portion 202 rotates. Of course, the spirit of the present invention is not limited thereto, and the rotation shafts 241 and 242 may be formed in a plurality of directions to accommodate the structure of the hand of the user grasping the actuation operation portion 203 according to an ergonomic (erganomic) design.

In one aspect, the pulley 210, the first actuating extension 252, and the first actuating gear 253 may be formed to be fixedly coupled to each other so as to be rotatable together about 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.

Similarly, the pulley 220, the second actuation extension 257, and the second actuation gear 258 may be formed in fixed engagement with one another so as to be rotatable together about the rotation axis 242. Here, the pulley 220 may be composed of one pulley, or may be composed of two pulleys fixedly coupled to each other.

Here, the first actuating gear 253 and the second actuating gear 258 are formed to be engaged with each other, and rotate together in opposite directions to each other when either side rotates.

Here, either the first actuation operation portion 251 or the second actuation operation portion 256 may be a dummy operation portion to which no wire is connected. In the present invention, the actuation motion may be a motion in which the second jaw 102 rotates about the actuation rotation axis 145 in a state in which the first jaw 101 is stopped. Thus, upon actuation, only the wire 302/306 connected to the second jaw 102 is moved, while the wire 301/305 connected to the first jaw 101 may not be moved. Thus, the wire 302/wire 306 may be coupled to either the first actuation handle portion 251 or the second actuation handle portion 256, while the wire 301/wire 305 may not be coupled to the actuation handle portion 203, wherein the wire 302/wire 306 is the second jaw wire connected to the second jaw 102 and the wire 301/wire 305 is the first jaw wire connected to the first jaw 101. In addition, at this time, another actuation operating portion that is not wire-bonded to the second jaw may be a dummy (dummy) operating portion.

In the drawing, the wire 302/306 as the second jaw wire is connected to the pulley 220 of the second actuation operation portion 256, and the pulley 210 of the first actuation operation portion 251 is shown as being unconnected, but may be of an opposite configuration.

As a result, only the wire 302/306 as the second jaw wire is coupled to the actuation operation portion 203, and therefore, when the actuation operation portion 203 is operated, the second jaw 102 alone rotates about the actuation rotation axis 145 in a state where the first jaw 101 is fixed.

On the one hand, although the actuation operation portion 203 is shown as including the first actuation operation portion 251 and the second actuation operation portion 256 in the drawings, this is one example of the actuation operation portion 203 of the present invention, and the actuation operation portion 203 may include only any one of the first actuation operation portion 251 and the second actuation operation portion 256. Further, the actuation operation portion 203 may be formed in a ring shape that rotates around another axis (for example, Y axis) instead of rotating around a rotation axis parallel to the Z axis.

On the other hand, the deflection operation portion 202 may include a rotation shaft 243, pulleys 211 and 212 as operation portion first jaw deflection main pulleys, pulleys 221 and 222 as operation portion second jaw deflection main pulleys, and a deflection frame (yaw frame) 207. Further, the deflection operation portion 202 may further include: pulley 213 and pulley 214 which are operation portion first jaw deflection sub-pulleys formed at one sides of pulley 211 and pulley 212; pulley 223 and pulley 224, which are operation portion second jaw deflection sub-pulleys formed at one side of pulley 221 and pulley 222. Here, the pulleys 213 and 214 and the pulleys 223 and 224 may be coupled to a pitch frame 208 described later.

Here, although the deflection operation portion 202 is shown to include the pulleys 211 and 212 and the pulleys 221 and 222, and the pulleys 211 and 212 and 221 and 222 have two pulleys facing each other and rotatable independently, respectively, the spirit of the present invention is not limited thereto. That is, one or more pulleys having the same or different diameters may be provided according to the arrangement of the deflection operation portion 202.

Specifically, a rotation shaft 243 serving as a main rotation shaft for deflecting the operation portion is formed on the first handle 204 on the side where the operation portion 203 is actuated. At this time, the first handle 204 is formed to be rotatable about the rotation shaft 243.

Here, the rotation shaft 243 may be formed to have a predetermined angle with the XY plane in which the connection part 400 is formed. For example, the rotation shaft 243 may be formed in a direction parallel to the Z axis, and in this state, when the pitch operation section 201 rotates, as described above, the coordinate system of the rotation shaft 243 may be relatively changed. Of course, the spirit of the present invention is not limited thereto, and the rotation shaft 243 may be formed in a plurality of directions to accommodate the structure of the hand of the user gripping the operation part 200 according to an ergonomic (ergonomic) design.

In one aspect, the pulleys 211 and 212 and 221 and 222 are coupled to the rotation shaft 243 to be rotatable about the rotation shaft 243. In addition, the wire 301 or the wire 305 as the first jaw wire is wound around the pulley 211 or the pulley 212, and the wire 302 or the wire 306 as the second jaw wire is wound around the pulley 221 and the pulley 222. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be composed of two pulleys respectively formed to face each other and to be rotatable independently. Thus, the wound-in wire and the unwound wire can be wound around separate pulleys, respectively, so that they can act without interference with each other.

Here, the wire 301 and the wire 305 as the first jaw wire may be fixedly coupled to the pulley 211/212, respectively, by fasteners 324. In detail, the wire 305 as the first jaw wire is fixedly coupled to the pulley 211 by the fastener 324, and the wire 301 as the first jaw wire is fixedly coupled to the pulley 212 by the fastener 324.

Conversely, the wire 302 and the wire 306 as the second jaw wire may be fixedly coupled to the pulley 220 of the actuation operation portion 203 via the pulley 221/pulley 222.

The deflecting frame 207 is rigidly connected to the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, so that the first handle 204, the deflecting operation portion 202, and the actuation operation portion 203 are deflected and rotated as a whole about the rotation shaft 243.

Here, the pulley 211 or the pulley 212 may be formed to be fixedly coupled with the deflecting frame 207, and rotate together with the deflecting frame 207 when the deflecting frame 207 rotates.

The pitch operation part 201 may include a rotation shaft 246, pulleys 217 and 218 as an operation part first jaw pitch main pulley, pulleys 227 and 228 as an operation part second jaw pitch main pulley, and a pitch frame 208. The pitch operation unit 201 may further include a rotation shaft 245, a pulley 215, and a pulley 216, and a pulley 225 and a pulley 226, wherein the pulley 215 and the pulley 216 are formed on one side of the pulley 217 and the pulley 218 as an operation unit first jaw pitch sub-pulley, and the pulley 225 and the pulley 226 are formed on one side of the pulley 227 and the pulley 228 as an operation unit second jaw pitch sub-pulley. The pitch operation part 201 may be connected to the bending part 402 of the connection part 400 through a rotation shaft 246.

In detail, the pitch frame 208 becomes a base frame of the pitch operation part 201, and the rotation shaft 243 is rotatably coupled to one end portion thereof. That is, the yaw frame 207 is formed rotatable about the rotation axis 243 with respect to the pitch frame 208.

As described above, since the yaw frame 207 is connected to the first handle 204, the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242, and the yaw frame 207 is coupled to the pitch frame 208 by the shaft, when the pitch frame 208 is rotated in pitch about the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243 connected to the pitch frame 208 are also rotated in pitch. That is, when the pitch operation section 201 rotates around the rotation axis 246, the actuation operation section 203 and the yaw operation section 202 rotate together with the pitch operation section 201. In other words, when the user performs pitch rotation of the first handle 204 about the rotation axis 246, the actuation operation portion 203, the yaw operation portion 202, and the pitch operation portion 201 move together.

Pulleys 217 and 218 and 227 and 228 are coupled to rotation shaft 246 to be rotatable about rotation shaft 246 of pitch frame 208.

Here, the pulley 217 and the pulley 218 may be formed to face each other to be rotatable independently. Thus, the wound-in wire and the unwound wire can be wound around separate pulleys, respectively, so that they can act without interference with each other. Similarly, the pulley 227 and the pulley 228 may be formed to face each other so as to be rotatable independently. Thus, the wound-in wire and the unwound wire can be wound around separate pulleys, respectively, so that they can act without interference with each other.

Next, the wires 303 and 304 as pitch wires operate as follows.

In the tip tool 100, a first pitch sheave portion 1163a and a second pitch sheave portion 1163b serving as tip tool pitch sheaves are formed on the tip tool center 160, and in the operation portion 200, sheaves 231 and 232 serving as operation portion pitch sheaves are formed to be fixedly coupled with the pitch frame 208. In addition, the pulleys are connected to each other by a wire 303 and a wire 304 as pitch wires, so that the pitch action of the end tool 100 can be more easily performed according to the pitch operation of the operation portion 200. Here, the wire 303 is fixedly coupled to the pitch frame 208 through the pulleys 231 and 233, and the wire 304 is fixedly coupled to the pitch frame 208 through the pulleys 232 and 234. That is, the pitch frame 208, the pulley 231, and the pulley 232 are rotated together about the rotation shaft 246 by the pitch rotation of the operation portion 200, and as a result, the wires 303 and 304 are also moved, so that the power of the pitch rotation can be additionally transmitted, unlike the pitch action of the end tool by the wires 301, 302, 305, and 306 as jaw wires, finally.

The connection relationship between the comb first handle 204 and each of the pitch operation section 201, yaw operation section 202, and actuation operation section 203 is as follows. The first handle 204 may have 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 formed thereon. At this time, since the rotation shaft 241 and the rotation shaft 242 are directly formed on the first handle 204, the first handle 204 and the actuation operation portion 203 may be directly connected. On the one hand, since the rotation shaft 243 is directly formed on the first handle 204, the first handle 204 and the yaw manipulation portion 202 may be directly connected. In contrast, since the pitch operation section 201 is formed to be connected to the yaw operation section 202 on one side of the yaw operation section 202, the pitch operation section 201 is not directly connected to the first handle 204, but may be formed to be indirectly connected to the first handle 204 through the yaw operation section 202.

With continued reference to the drawings, in the electrocautery surgical instrument 10 according to a first embodiment of the present invention, the pitch operation part 201 and the end tool (end tool) 100 may be formed on the same or parallel axes (X-axis). That is, the rotation shaft 246 of the pitch operation part 201 is formed at one end of the bent part 402 of the connection part 400, and the end tool 100 is formed at the other end of the connection part 400.

In addition, one or more intermediate pulleys 235 for changing or guiding the path of each wire may be provided at every interval of the connection part 400, particularly at the bent part 402. At least a portion of each wire is wound around each intermediate pulley 235 to guide the path of each wire so that the wires can be disposed along the curved shape of the curved portion 402.

Here, although the connecting portion 400 is shown in the drawings as having the bent portion 402 to be bent to have a predetermined curvature, the spirit of the present invention is not limited thereto, and the connecting portion 400 may be formed as a straight line or bent one or more times as necessary, and even in this case, the pitch operation portion 201 and the end tool (end tool) 100 may be considered to be formed on substantially the same or parallel axes. In addition, although the pitch operation part 201 and the end tool (end tool) 100 are formed on axes parallel to the X axis in fig. 2, the spirit of the present invention is not limited thereto, and the pitch operation part 201 and the end tool (end tool) 100 may be formed on axes different from each other.

(actuation action, yaw action, pitch action)

The actuation actions, yaw actions, and pitch actions in this embodiment are described below.

First, the actuation action is as follows.

In a state where the user puts the index finger into the finger ring formed on the first actuating extension 252 and puts the thumb into the finger ring formed on the second actuating extension 257, when the actuating extension 252, the actuating extension 257 is rotated with either or both fingers, the pulley 210 and the first actuating gear 253 fixedly coupled with the first actuating extension 252 are rotated around the rotation axis 241, and the pulley 220 and the second actuating gear 258 fixedly coupled with the second actuating extension 257 are rotated around the rotation axis 242. At this time, the pulley 210 and the pulley 220 are rotated in mutually opposite directions to each other. In addition, when the pulley 220 rotates, the wire 302 and the wire 306, which are fixedly coupled to the pulley 220 at one end thereof by the fastener 327, rotate together with the pulley 220, thereby moving the wire 302 and the wire 306. In addition, the above-described rotational force is transmitted to the end tool 100 through the power transmission portion 300, so that the second jaw 102 of the end tool 100 performs an actuation motion.

Here, the actuation motion refers to a motion in which the second jaw 102 rotates about the actuation rotation axis 145 in a state in which the first jaw 101 is stopped, as described above. That is, when the actuation extension 252, 257 of the actuation operation portion 203 are rotated in a direction approaching each other, the second jaw (jaw) 102 is rotated clockwise while the first jaw 101 is in a fixed state, closing the end tool 100. Conversely, when the actuation extension 252, 257 of the actuation handle 203 are rotated in a direction away from each other, the second jaw (jaw) 102 opens the end tool 100 while rotating counterclockwise with the first jaw 101 in a fixed state.

In the present embodiment, the second handle is constituted by having the first actuation extension 252 and the second actuation extension 257 for performing the actuation operation described above, and can be operated by grasping with two fingers. However, the arrangement of the actuation operation portion 203 for performing the actuation operation of opening and closing the two jaws of the end tool 100 may be different from the above-described other modifications, for example, the arrangement in which the two actuation pulleys (the pulley 210, the pulley 220) are operated in opposition to each other with one actuation rotation portion, and the like.

Next, the deflecting operation is as follows.

When the user rotates the first handle 204 about the rotation axis 243 in a state of holding the first handle 204, the actuation operation portion 203 and the yaw operation portion 202 are rotated in yaw about the rotation axis 243. That is, when the pulley 211 and the pulley 212 of the deflection operation section 202 fixedly coupled with the wire 301 and the wire 305 rotate around the rotation shaft 243, the wire 301 and the wire 305 wound around the pulley 211 and the pulley 212 move. On the one hand, when the pulley 220 of the second actuating operation 256 fixedly coupled with the wire 302 and the wire 306 rotates about the rotation shaft 243, the wire 302 and the wire 306 wound around the pulley 221 and the pulley 222 move. At this time, the wire 301 and the wire 305 connected to the first jaw 101 and the wire 302 and the wire 306 connected to the second jaw 102 are wound around the pulley 211 or the pulley 212 and the pulley 221 and the pulley 222 to rotate the first jaw 101 and the second jaw 102 in the same direction when performing the yaw rotation. The above-described rotational force is transmitted to the end tool 100 by the power transmission unit 300, and the two jaws (jaw) 103 of the end tool 100 are deflected by rotating in the same direction.

At this time, since the deflecting frame 207 connects the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, the first handle 204, the deflecting operation portion 202, and the actuating operation portion 203 rotate together about the rotation shaft 243.

Next, the pitching action is as follows.

When the first handle 204 is rotated about the rotation axis 246 in a state where the user holds the first handle 204, the actuation operation portion 203, the yaw operation portion 202, and the pitch operation portion 201 are rotated in pitch about the rotation axis 246. That is, when the pulley 211 and the pulley 212 of the deflection operation section 202 fixedly coupled with the wire 301 and the wire 305 rotate around the rotation shaft 246, the wire 301 and the wire 305 wound around the pulley 217 and the pulley 218 move. Similarly, when the pulley 220 of the second actuating operation 256 fixedly coupled with the wire 302 and the wire 306 rotates about the rotation axis 246, the wire 302 and the wire 306 wound around the pulley 227 and the pulley 228 move. At this time, as described with reference to fig. 5, the wire 301 and the wire 305 as the first jaw wire are moved in the same direction, and the wire 302 and the wire 306 as the second jaw wire are moved in the same direction, so that the wire 301, the wire 305, the wire 302, and the wire 306 as the jaw wires are wound around the pulley 217, the pulley 218, the pulley 227, and the pulley 228 as the operation portion deflection main pulley, respectively, thereby causing the first jaw 101 and the second jaw 102 to perform pitching rotation. In addition, the above-described rotational force is transmitted to the end tool 100 through the power transmission portion 300, thereby causing the two jaws (jaw) 103 of the end tool 100 to perform a pitching motion.

At this time, the pitch frame 208 is connected to the yaw frame 207, and since the yaw frame 207 is connected to the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, when the pitch frame 208 rotates around the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243 connected to the pitch frame 208 also rotate together. That is, when the pitch operation section 201 rotates around the rotation axis 246, the actuation operation section 203 and the yaw operation section 202 rotate together with the pitch operation section 201.

In summary, the electrocautery instrument 10 according to an embodiment of the present invention is characterized in that pulleys are formed at each articulation point (actuation joint, yaw joint, pitch joint) around which wires (first jaw wire or second jaw wire) are wound, and rotation operation (actuation rotation, yaw rotation, pitch rotation) of the operation portion causes each wire to move, thereby finally guiding the end tool 100 to perform a desired motion. Further, auxiliary pulleys may be formed at one side of each pulley, and the wire may not be wound around one pulley multiple times by the auxiliary pulleys.

Fig. 22 is a diagram that schematically illustrates only the configuration of pulleys and wires that make up the joint of the electrocautery surgical instrument 10 shown in fig. 2, in accordance with an embodiment of the present invention. In fig. 22, intermediate pulleys for changing the path of the lead wire, which are not related to the joint motion, are omitted.

Referring to fig. 22, the operating portion 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 the first jaw (jaw) 101.

Further, the operating portion 200 may include a pulley 220, a pulley 221, a pulley 222, a pulley 223, a pulley 224, a pulley 225, a pulley 226, a pulley 227, and a pulley 228 related to the rotational movement of the second jaw (jaw) 122. (since the arrangement and configuration of each pulley in the operation portion 200 is in principle the same as that of each pulley in the end tool 100, the specific reference numerals of the reference numerals in the drawings are partially omitted.)

The pulleys 211 and 212 and the pulleys 221 and 222 may be formed to be rotatable independently of each other about a rotation shaft 243 which is the same axis. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be formed of two pulleys formed to face each other and to be rotatable independently, respectively.

The pulleys 213 and 214 and the pulleys 223 and 224 may be formed to be rotatable independently of each other about a rotation axis 244 which is the same axis. At this time, the pulley 213 and the pulley 214 may be formed of two pulleys formed to face each other and to be rotatable independently, in which case the two pulleys may be formed to have different diameters. Similarly, the pulleys 223 and 224 may be formed of two pulleys formed to face each other and to be rotatable independently, in which case the two pulleys may be formed to have different diameters.

The pulleys 215 and 216 and 225 and 226 may be formed to be rotatable independently of each other about a rotation shaft 245 as the same axis. At this time, the pulley 215 and the pulley 216 may be formed to have different diameters. Further, the pulley 225 and the pulley 226 may be formed to have different diameters.

The pulleys 217 and 218 and the pulleys 227 and 228 may be formed to be rotatable independently of each other about a rotation axis 246 which is the same axis.

The wire 301 sequentially passes through the pulley 217, the pulley 215, and the pulley 213 of the operation part 200, and then is wound around the pulley 211, and then is coupled with the pulley 212 by the fastener 324. In one aspect, the wire 305 is coupled to the pulley 211 by a fastener 324, passing sequentially over the pulley 218, the pulley 216, and the pulley 214 of the operating portion 200. Thus, as the pulley 211 rotates, the wire 301 and the wire 305 are thereby also wound around the pulley 211 or unwound from the pulley 211, thereby rotating the first jaw 101.

The wire 306 sequentially passes through the pulleys 227, 225, 223, 221 of the operation part 200 and is wound around the pulley 220, and then is coupled with the pulley 220 by the fastener 327. In one aspect, the wire 302 is passed through the pulleys 228, 226, 224, 222 of the operating portion 200 in sequence and then coupled to the pulley 220 by the fastener 327. Thus, as the pulley 220 rotates, the wire 302 and the wire 306 are thereby also wound around the pulley 220 or unwound from the pulley 220, thereby rotating the second jaw 102.

(conceptual diagram of pulleys and wires)

Fig. 24 and 25 are diagrams showing, in an exploded manner, the configuration of pulleys and wires associated with the actuation and deflection actions, respectively, of the electrocautery surgical instrument 10 shown in fig. 2 according to one embodiment of the present invention. Fig. 24 is a diagram showing only the pulley and wire associated with the second jaw, and fig. 25 is a diagram showing only the pulley and wire associated with the first jaw. In addition, fig. 23 is a perspective view illustrating a deflecting action of the surgical instrument of fig. 2. Here, constituent elements related to the cutting action are omitted in fig. 23.

First, a wire action of the actuation action will be described.

Referring to fig. 24, when the second actuating extension 257 rotates about the rotation axis 242 in the direction of arrow OPA2, the pulley 220 connected to the second actuating extension 257 rotates, and the two branches of the wire 302 and the wire 306 wound around the pulley 220 move in the directions W2a, W2b, respectively, as a result of which the second jaw 102 of the end tool 100 rotates in the direction of arrow EPA 2. Thus, when the user manipulates the first and second actuation extensions 252, 257 toward each other, the second jaw 102 of the end tool performs an action of approaching the first jaw 101.

At this time, since the wire 301 and the wire 305 as the first jaw wires are not connected to the actuation operation portion 203, the wire 301 and the wire 305 do not move even if the actuation operation portion 203 is operated, and thus the first jaw 101 does not rotate.

Next, the action of the wire of the deflecting action will be described.

First, since the rotation shafts 243, 241, and 242 are connected by the deflection frame (see 207 in fig. 30), the rotation shafts 243, 241, and 242 are rotated together as a whole.

Referring to fig. 25, when the first handle 204 is rotated in the arrow OPY1 direction about the rotation axis 243, the pulley 211 rotates as a whole with the wire 301 and the wire 305 wound thereon about the rotation axis 243, as a result of which the wire 301 and the wire 305 wound on the pulley 211 are moved in the W1a, W1b directions, respectively, thereby finally rotating the first jaw 101 of the end tool 100 in the arrow EPY1 direction.

Referring to fig. 24, when the first handle 204 is rotated in the arrow OPY2 direction about the rotation axis 243, the pulleys 220, 221, 222 are rotated as a unit about the rotation axis 243 with the wires 302 and 306 wound thereon, as a result of which the wires 302 and 306 wound on the pulleys 221 and 222 are moved in the opposite directions of W1a, W1b, respectively, thereby finally rotating the first jaw 101 of the end tool 100 in the arrow EPY2 direction.

Fig. 27 and 28 are diagrams showing, in an exploded manner, the configuration of pulleys and wires, respectively, associated with the pitching action of the electrocautery surgical instrument 10 illustrated in fig. 2, according to one embodiment of the present invention. Fig. 27 is a diagram showing only the pulleys and wires associated with the first jaw, and fig. 28 is a diagram showing only the pulleys and wires associated with the second jaw. Since there are two pulleys associated with the pitching operation, respectively, as shown in fig. 9, etc., the two branches of each wire are wound along the same path, they are represented by one line in fig. 27 and 28. In addition, fig. 26 is a perspective view showing a pitching motion of the surgical instrument of fig. 2. Here, constituent elements related to the cutting action are omitted in fig. 26.

Referring to fig. 27, when the first handle 204 is rotated about the rotation axis 246 in the arrow OPP1 direction, the pulley 211, the pulley 215, the pulley 217, and the like, and the wire 301 and the like wound thereon are rotated as a whole about the rotation axis 246. At this time, as shown in fig. 22, since the wire 301 and the wire 305 as the first jaw wire are wound over the pulleys 217 and 218, the wire 301 and the wire 305 move in the arrow W1 direction. As a result, the first jaw 101 of the end tool 100 rotates in the direction of arrow EPP1, as described with reference to fig. 5.

Referring to fig. 28, when the first handle 204 is rotated about the rotation axis 246 in the arrow OPP2 direction, the pulley 220, the pulley 225, the pulley 227, and the like, and the wire 302 and the like wound thereon are rotated as a whole about the rotation axis 246. At this time, as shown in fig. 22, the wire 302 and the wire 306 as the second jaw wire are wound under the pulleys 227 and 228, and thus, the wire 302 and the wire 306 are moved in the arrow W2 direction. As a result, the second jaw 102 of the end tool 100 rotates in the direction of arrow EPP2, as described with reference to fig. 5.

Thus, the actuation operation, the yaw operation, and the pitch operation can be operated independently of each other.

As described with reference to fig. 1, the respective rotation axes of the actuation operation portion 203, the yaw operation portion 202, and the pitch operation portion 201 are located behind each operation portion, and therefore, their settings are the same as the joint configuration of the end tool, so that the user can perform intuitively uniform operations.

In particular, the electrocautery surgical instrument 10 according to an embodiment of the present invention is characterized in that pulleys are formed at respective articulation points (actuation joints, yaw joints, pitch joints) around which wires (first jaw wires or second jaw wires) are wound, and a rotational operation (actuation rotation, yaw rotation, pitch rotation) of the operation section causes each wire to move, thereby finally guiding the end tool 100 to perform a desired motion. Further, auxiliary pulleys may be formed at one side of each pulley, and the wires may not be wound around one pulley a plurality of times by the auxiliary pulleys, so that the wires wound around the pulleys do not contact each other and a path of the wires wound into and unwound from the pulleys is safely formed, thereby improving safety and efficiency of the wire transmission power.

On the one hand, as described above, the deflection operation portion 202 and the actuation operation portion 203 are directly formed on the first handle 204. Thus, when the first handle 204 rotates about the rotation axis 246, the yaw manipulation portion 202 and the actuation manipulation portion 203 also rotate together with the first handle 204. Thus, the coordinate systems of the deflection operation portion 202 and the actuation operation portion 203 are not fixed, but relatively change with the rotation of the first handle 204. That is, in fig. 2 and the like, the deflection operation portion 202 and the actuation operation portion 203 are shown parallel to the Z axis. However, when the first handle 204 is rotated, the yaw manipulation portion 202 and the actuation manipulation portion 203 are not parallel to the Z axis. That is, the coordinate systems of the deflection operation portion 202 and the actuation operation portion 203 are changed with the rotation of the first handle 204. In this specification, however, unless otherwise specified, the coordinate systems of the deflection operation portion 202 and the actuation operation portion 203 are described with reference to a position state in which the first handle 204 is perpendicular to the connection portion 400 as shown in fig. 2 for convenience of description.

(Pitch, yaw, and cutting action of end tool)

Fig. 29 and 30 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in a deflected state. Fig. 31 and 32 are views showing a procedure of opening and closing operations in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated by +90° in a deflected state.

As shown in fig. 29 to 32, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed so as to normally perform an opening and closing operation, i.e., an actuation operation, even in a state where the jaws (jaw) are rotated by +90 to-90° in a deflected manner.

As shown in fig. 33 and 34, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed to perform a cutting action normally even in a state in which the jaws (jaw) are rotated by +90° in a deflected manner.

Fig. 35 is a view showing a state in which the end tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in pitch, and fig. 36 is a view showing a state in which the end tool of the electrocautery surgical instrument of fig. 2 is rotated +90° in pitch. In addition, fig. 37 is a cut-away perspective view of the end tool of the electrocautery instrument of fig. 36. Fig. 38 and 39 are views showing a process of performing a cutting operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated at-90 ° in pitch.

As shown in fig. 35 to 39, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed to perform a cutting action normally even in a state where the jaws (jaw) are rotated at-90 ° pitch.

In one aspect, fig. 40 is a diagram showing a state in which the jaw (jaw) is rotated-90 ° in pitch while being rotated +90° in yaw, and fig. 41, 42 and 43 are perspective views showing a cutting action performed in a state in which the jaw (jaw) is rotated-90 ° in pitch while being rotated +90° in yaw as a cutting action of the end tool of the electrocautery surgical instrument of fig. 2.

As shown in fig. 40 to 43, the end tool of the electrocautery surgical instrument according to the first embodiment of the present invention is formed to normally perform a cutting action even in a state in which the jaws (jaw) are rotated-90 ° in pitch while being rotated +90° in yaw.

(first modification of the first embodiment-vertical direction of opening/closing of jaws)

Hereinafter, an end tool 1100 of a surgical instrument according to a first modification of the first embodiment of the present invention is described. Here, the opening and closing directions of the jaws 103 are characteristically different from the end tool 1100 of the surgical instrument according to the first modification of the first embodiment of the present invention described above (see 100 in fig. 2 and the like). As described above, a configuration different from the first embodiment will be described in detail later.

Fig. 44, 45, 46 and 47 are diagrams showing an end tool of the electrocautery surgical instrument of a first variation of the first embodiment of the present invention, fig. 48 is an exploded perspective view of the end tool of fig. 44, and fig. 49 and 50 are diagrams showing a procedure in which the end tool of the electrocautery surgical instrument of fig. 44 performs a cutting action. Here, fig. 47 shows a state in which the first jaw and the second jaw are removed.

Referring to fig. 44 to 50, an end tool (end tool) 1100 of a first modification of the first embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 1101 and a second jaw 1102, and herein, the first jaw 1101 and the second jaw 1102 or constituent elements that enclose the first jaw 1101 and the second jaw 1102 are referred to as jaws (jaw) 1103, respectively.

In one aspect, the end tool 1100 includes a plurality of pulleys including a pulley 1111 associated with the rotational movement of the first jaw (jaw) 1101. In the present embodiment, since each pulley related to the rotational movement of the first jaw (jaw) 1101 is substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in fig. 8 and the like of the first embodiment, a detailed description thereof will be omitted herein.

In one aspect, the end tool 1100 includes a plurality of pulleys including pulley 1121 associated with the rotational movement of the second jaw (jaw) 1102. In the present embodiment, since each pulley related to the rotational movement of the second jaw (jaw) 1102 is substantially the same as the pulleys 121, 122, 123, 124, 125 and 126 described in fig. 8 and the like of the first embodiment, a description thereof will be omitted herein.

Further, the end tool 1100 of the first modification of the first embodiment of the present invention may include a rotation shaft 1141, a rotation shaft 1142, a rotation shaft 1143, and a rotation shaft 1144. Here, the rotational axis 1141 and rotational axis 1142 are inserted through the end tool center 1160, while the rotational axis 1143 and rotational axis 1144 may be inserted through the pitch center 1150. The rotation shaft 1141, the rotation shaft 1142, the rotation shaft 1143, and the rotation shaft 1144 may be sequentially provided from the distal end (distal end) 1104 to the proximal end (proximal end) 1105 of the end tool 1100.

In addition, an end tool 1100 of the first modification of the first embodiment of the present invention may include an end tool center 1160 and a pitch center 1150.

The rotary shaft 1141 and the rotary shaft 1142 are inserted through the end tool center 1160, and at least a portion of the pulley 1111 and the pulley 1121 shaft-coupled to the rotary shaft 1141 and the first jaw 1101 and the second jaw 1102 coupled thereto may be accommodated inside the end tool center 1160.

In one aspect, a first pitch sheave portion 1163a and a second pitch sheave portion 1163b may be formed at an end of the end tool center 1160 to function as an end tool pitch sheave. The wire (see 303 in fig. 6) and the wire (see 304 in fig. 6) are coupled to the first and second tilt pulley portions 1163a and 1163b serving as the tip tool tilt pulley, and the tip tool center 1160 performs a tilting action while rotating about the rotation axis 1143.

Rotation axis 1143 and rotation axis 1144 are inserted through pitch center 1150, and pitch center 1150 may be coupled to end tool center 1160 by rotation axis 1143. Thus, the end tool center 1160 may be formed to be pitching rotatable about the rotational axis 1143 relative to the pitch center 1150.

In one aspect, the end tool 1100 of the first variation of the first embodiment of the present invention may further include a first electrode 1151, a second electrode 1152, and constituent elements such as a guide tube 1171 and a blade 1175 for performing cautery (cautery) and cutting (cutting) actions. The constituent elements of the guide tube 1171, blade 1175, etc. that are related to blade drive may be collectively referred to herein as a blade assembly (see 170 in fig. 6). A first modification of the present invention is characterized in that a blade unit (see 170 in fig. 6) including a blade 1175 is provided between a pulley 1111 as a first jaw pulley and a pulley 1121 as a second jaw pulley, so that the tip tool 1100 can perform a pitching motion and a yawing motion and simultaneously perform a cutting motion using the blade. Since the constituent elements for performing the cautery (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the first embodiment, a detailed description thereof will be omitted herein.

As in the first embodiment of the present invention shown in fig. 13 and the like, the electrocautery surgical instrument according to a first variation of the first embodiment of the present invention may include a wire 301, a wire 302, a wire 303, a wire 304, a wire 305, a wire 306, and a blade wire 307.

Further, as in the first embodiment of the present invention shown in fig. 13 and the like, the electrocautery surgical instrument according to a first modification of the first embodiment of the present invention may include a fastener 321, a fastener 322, a fastener 323, a fastener 324, a fastener 326, and a fastener 327 coupled to respective ends of each wire to couple the wire and the pulley.

Hereinafter, the first connector 1180 and the second connector 1190 of the first modification of the first embodiment of the present invention will be described in more detail.

One feature of the end tool 1100 according to the first modification of the first embodiment of the present invention is that the actuation rotation shaft 1145 and the deflection rotation shaft 1141 are disposed perpendicular to each other. Accordingly, the opening and closing direction of the jaw 1103 is a vertical direction. In addition, the arrangement direction of the blade 1175 is also a vertical direction, accordingly.

That is, in the first embodiment of the present invention shown in fig. 3 and the like, the actuation rotation shaft 145 and the deflection rotation shaft 141 are formed parallel to each other, and these two shafts may be formed parallel to the Z-axis. Accordingly, the jaw 103 is opened and closed on an XY plane perpendicular to the Z axis.

In contrast, in the end tool 1100 of the first modification of the first embodiment of the present invention, the yaw rotation axis 1141 is formed parallel to the Z axis, and the actuation rotation axis 1145 is formed parallel to the Y axis in contrast. That is, the actuation rotation shaft 1145 and the deflection rotation shaft 1141 are disposed perpendicular to each other. The jaw 1103 is opened and closed in an XZ plane perpendicular to the Y axis.

In detail, the end tool 1100 of the present invention includes a first jaw 1101, a second jaw 1102, a first connector 1180, a second connector 1190, a pulley 1111 as a first jaw pulley, and a pulley 1121 as a second jaw pulley. Hereinafter, the pulley 1111 is referred to as a first jaw pulley 1111, and the pulley 1121 is referred to as a second jaw pulley 1121.

The first jaw pulley 1111 is fixedly coupled to the first connector 1180.

In detail, the first jaw pulley 1111 is formed with a protrusion 1111a, and the first connector 1180 is formed with a through hole (not shown), so that the protrusion 1111a of the first jaw pulley 1111 may be inserted into the through hole (not shown) of the first connector 1180. In addition, the first rotary shaft 1141 may be sequentially inserted through the first jaw pulley 1111 and the first connector 1180. As a result, the first jaw pulley 1111 and the first connector 1180 are coupled at two points, thereby fixedly coupling the first jaw pulley 1111 and the first connector 1180.

That is, the first connector 1180 does not rotate relative to the first jaw pulley 1111, but rather when the first jaw pulley 1111 rotates about the first rotational axis 1141, the first connector 1180 also rotates about the first rotational axis 1141 with the first jaw pulley 1111.

In one aspect, the first connector 1180 and the first jaw 1101 are fixedly coupled by a securing member (pin, etc.).

In other words, the first jaw 1101 and the first jaw pulley 1111 are connected by the first connector 1180 and they are fixed relative to each other, so that either member cannot rotate/move relative to the other member.

As a result, when the first jaw pulley 1111 rotates about the first rotational axis 1141, the first connector 1180 and the first jaw 1101 coupled thereto also rotate about the first rotational axis 1141 together with the first jaw pulley 1111.

In one aspect, the second jaw pulley 1121 and the second connection 1190 are coupled at a point axis, such that the second connection 1190 is rotatably or movably coupled to the second jaw pulley 1121.

In detail, the second jaw pulley 1121 is formed with a protrusion 1121a and the second connection member 1190 is formed with a through hole 1190a, so that the protrusion 1121a of the second jaw pulley 1121 may be inserted into the through hole 1190a of the second connection member 1190. Thus, as the second jaw pulley 1121 rotates, the second link 1190 moves while rotating about the protrusion 1121 a.

The second connector 1190 and the second jaw 1102 are pivotally coupled at a point such that the second connector 1190 is rotatably or movably coupled to the second jaw pulley 1121.

In detail, a guide pin 1190b is formed on the second connection member 1190, a through hole 1102a is also formed on the second jaw 1102, and the guide pin 1190b is inserted through the through hole 1102a, so that the second connection member 1190 and the second jaw 1102 can be shaft-coupled.

Additionally, an actuation rotary shaft 1145 can be inserted through the second jaw 1102, the first connector 1180, and the first jaw 1101 in sequence. Here, the actuation rotation shaft 1145 may be formed in two pieces, as with the other rotation shafts.

Here, the deflection rotation axis 1141 is formed parallel to the Z axis, and the actuation rotation axis 1145 may be formed parallel to the Y axis, on the contrary. That is, the actuation rotation shaft 1145 and the deflection rotation shaft 1141 are disposed perpendicular to each other. The jaw 1103 is opened and closed in an XZ plane perpendicular to the Y axis.

As a result, when only the second jaw pulley 1121 rotates about the first rotation shaft 1141 in a state where the first jaw pulley 1111 is fixed, the second link 1190 coupled to the second jaw pulley 1121 moves. In addition, when the second link 1190 is moved, the second jaw 1102, which is axially coupled to the second link 1190, also moves through the second link 1190, and at this time, the second jaw 1102 rotates about the actuation rotation axis 1145.

Hereinafter, the deflecting action and the actuating action of the end tool 1100 will be described.

First, when the first jaw pulley 1111 and the second jaw pulley 1121 rotate together, 1) the first connector 1180 and the first jaw 1101 coupled thereto also rotate together with the first jaw pulley 1111 about the first rotation axis 1141, and 2) the second connector 1190 and the second jaw 1102 coupled thereto also rotate together with the second jaw pulley 1121 about the first rotation axis 1141, thereby performing a deflecting action.

On the one hand, in a state in which the jaws 1103 are closed as shown in fig. 44, when only the second jaw pulley 1121 is rotated in the direction of arrow a in fig. 45, the second link 1190 connected to the second jaw pulley 1121 is moved in the direction of arrow B in fig. 45 by the second jaw pulley 1121. In addition, the second connection member 1190 is moved in the direction of arrow B in fig. 45, and simultaneously, the second jaw 1102 connected to the second connection member 1190 is pulled in the direction of arrow C in fig. 45, whereby the second jaw 1102 performs a rotational motion about the actuation rotational shaft 1145 in the direction of arrow C in fig. 45, thereby performing an actuation motion of opening the jaw 1103.

In other words, when the operating portion 200 performs an actuating action, only the second jaw pulley 1121 rotates, and when the operating portion 200 performs a deflecting action, the first jaw pulley 1111 and the second jaw pulley 1121 rotate together in the same direction.

This is described from another angle, i.e., when the operating portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 1111 and the second jaw pulley 1121 rotate together, so that no rotation of the second jaw 1102 relative to the first jaw 1101 occurs.

On the one hand, when the operation portion 200 performs the actuation action, only the second jaw wire is pulled, whereby in the state where the first jaw pulley 1111 is fixed, only the second jaw pulley 1121 is rotated, so that in the state where the actuation rotation shaft 1145 is fixed, the second link 1190 is pulled, so that the second jaw 1102 is rotated about the actuation rotation shaft 1145.

As described above, one feature of the end tool 1100 according to the first modification of the first embodiment of the present invention is that the actuation rotation shaft 1145 and the deflection rotation shaft 1141 are disposed perpendicular to each other. In addition, correspondingly, the opening and closing direction of the jaw 1103 and the setting direction of the blade 1175 also become vertical directions, so that the user can operate the end tool similarly to the existing surgical instrument.

(second modification of the first embodiment-engraving)

Hereinafter, the distal end tool 1200 of the surgical instrument of the second modification of the first embodiment will be described. Here, the end tool 1200 of the surgical instrument according to the third modification of the first embodiment of the present invention is different in configuration in feature from the end tool center 1360 serving as the auxiliary pulley as compared with the end tool (see 100 in fig. 2 and the like) of the surgical instrument according to the first embodiment of the present invention described above. As described above, a configuration different from the first embodiment will be described in detail later.

Fig. 51 and 52 are diagrams showing an end tool of an electrocautery surgical instrument according to a second variation of the first embodiment of the present invention. Fig. 53 is a perspective view showing an end tool center of the end tool of the electrocautery instrument of fig. 51, fig. 54 and 55 are cut-away perspective views showing the end tool center of fig. 53, and fig. 56 and 57 are perspective views of the end tool center of fig. 53. Here, fig. 52 shows a state in which the end tool center is removed.

Referring to fig. 51 to 57, an end tool (end tool) 1200 of a second modification of the first embodiment of the present invention includes a pair of jaws (jaw) for performing a gripping (grip) action, i.e., a first jaw 1201 and a second jaw 1202, and herein, the first jaw 1201 and the second jaw 1202 or constituent elements that enclose the first jaw 1201 and the second jaw 1202 are referred to as a jaw (jaw) 1203, respectively.

In one aspect, the end tool 1200 includes a plurality of pulleys including pulley 1211 associated with the rotational movement of the first jaw (jaw) 1201. In the present embodiment, since each pulley related to the rotational movement of the first jaw (jaw) 1201 is substantially the same as the pulleys 113, 114, 115, 116 described in fig. 8 and the like of the first embodiment, a detailed description thereof will be omitted herein.

In one aspect, the tip tool 1200 includes a plurality of pulleys including pulley 1221 associated with rotational movement of the second jaw (jaw) 1202. In the present embodiment, since each pulley related to the rotational movement of the second jaw (jaw) 1202 is substantially the same as the pulleys 123, 124, 125, 126 described in fig. 8 and the like of the first embodiment, a detailed description thereof will be omitted herein.

Further, the end tool 1200 of the second modification of the first embodiment of the present invention may include a rotation shaft 1241, a rotation shaft 1243, and a rotation shaft 1244. Here, rotation axis 1241 may be inserted through end tool center 1260, while rotation axis 1243 and rotation axis 1244 may be inserted through pitch center 1250. The rotation shafts 1241, 1243, 1244 may be provided in order from the distal end 1204 (distal end) to the proximal end 1205 (proximal end) of the distal tool 1200.

In addition, the end tool 1200 of the second modification of the first embodiment of the present invention may further include a first connector 1280 and a second connector 1290.

The pulley 1211 is connected to the first jaw 1201 by a first connector 1280 such that when the pulley 1211 is rotated about the first rotational axis 1241, the first jaw 1201 is also rotated about the first rotational axis 1241.

In one aspect, the pulley 1221 is coupled to the second jaw 1202 by a second link 1290 such that, when the pulley 1221 is rotated about the first axis of rotation 1241, the coupled second jaw 1202 can be rotated about either the first axis of rotation 1241 or the actuation axis of rotation 1245.

Further, the end tool 1200 of the second modification of the first embodiment of the present invention may include an end tool center 1260 and a pitch center 1250.

A rotation shaft 1241, which will be described later, is inserted through the end tool center 1260, and the pulley 1211 and the pulley 1221, which are shaft-coupled to the rotation shaft 1241, and at least a portion of the first jaw 1201 and the second jaw 1202 coupled thereto, may be accommodated inside the end tool center 1260. Here, one feature of an embodiment of the present invention is that a wire guide 1268 serving as an auxiliary pulley is formed on the end tool center 1260. That is, a first wire guide 1268a and a second wire guide 1268b for guiding the path of the wires 305 and 302 may be formed on the end tool center 1260. The wire guide 1268 of the end tool center 1260 as described above is used as an auxiliary pulley (see 112, 122 in fig. 9) in the first embodiment so that the path of the wire can be changed, and the first wire guide 1268a and the second wire guide 1268b of the end tool center 1260 as described above are described in more detail later.

In one aspect, a first tilt pulley portion 1263a and a second tilt pulley portion 1263b may be formed at an end of the tip tool center 1260 to act as tip tool tilt pulleys. The wire (see 303 in fig. 6) and the wire (see 304 in fig. 6) are coupled to the first and second elevation sheave portions 1263a and 1263b serving as the end tool elevation sheaves, and the end tool center 1260 performs an elevation motion while rotating about the rotation axis 1243.

Rotation shafts 1243 and 1244 are inserted through pitch center 1250, and pitch center 1250 is coupled to end tool center 1260 and pulley 1231 by rotation shafts 1243. Accordingly, the end tool center 1260 and the pulley 1231 may be formed to be pitching rotatable relative to the pitch center 1250 about a rotation axis 1243.

In one aspect, the end tool 1200 of the second variation of the first embodiment of the present invention may further include constituent elements such as a first electrode 1251, a second electrode 1252, a guide tube 1271, and a blade (see 175 in fig. 6) for performing cautery (ablation) and cutting (cutting) actions. Here, the constituent elements of the guide tube 1271, the blade (see 175 in fig. 6), etc. related to the blade drive may be collectively referred to as a blade assembly (see 170 in fig. 6). A modification of the present invention is characterized in that since a blade assembly (see 170 in fig. 6) including a blade (see 175 in fig. 6) is provided between the pulley 1211 as the first jaw pulley and the pulley 1221 as the second jaw pulley, the tip tool 1200 can perform a pitch motion and a yaw motion while performing a cutting motion using the blade. Since the constituent elements for performing the cautery (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the first embodiment, a detailed description thereof will be omitted herein.

As in the first embodiment of the present invention shown in fig. 13 and the like, the electrocautery surgical instrument according to a second variation of the first embodiment of the present invention may include a wire 301, a wire 302, a wire 303, a wire 304, a wire 305, a wire 306, and a blade wire 307.

Further, as in the first embodiment of the present invention shown in fig. 13 and the like, the electrocautery surgical instrument according to a second variation of the first embodiment of the present invention may include a fastener 321, a fastener 322, a fastener 323, a fastener 324, a fastener 326, and a fastener 327 coupled to respective ends of each wire to couple the wire and the pulley.

Hereinafter, the end tool center 1260 of the second modification of the first embodiment of the present invention will be described in more detail, and particularly, the wire guide 1268 serving as the end tool center 1260 of the auxiliary pulley will be described with emphasis.

Referring to fig. 51-57, tip tool center 1260 includes a body portion 1261, a first jaw pulley coupling 1262a, a second jaw pulley coupling 1262b, a first pitch pulley portion 1263a, a second pitch pulley portion 1263b, a pitch slit 1264, a yaw slit 1265, a pitch arc portion 1266, a yaw arc portion 1267, and a wire guide portion 1268. In addition, the wire guide 1268 may include a first wire guide 1268a and a second wire guide 1268b.

The distal side of the tip tool center 1260 may be formed with a first jaw pulley coupling 1262a and a second jaw pulley coupling 1262b. Here, the first jaw pulley coupling 1262a and the second jaw pulley coupling 1262b are formed to face each other, and internally house the pulley 1211 and the pulley 1221. Here, the first jaw pulley coupling 1262a and the second jaw pulley coupling 1262b may be formed substantially parallel to a plane perpendicular to the first rotation axis 1241 as a deflection rotation axis.

The first jaw pulley coupling 1262a and the second jaw pulley coupling 1262b are connected by a body portion 1261. That is, the first jaw pulley coupling portion 1262a and the second jaw pulley coupling portion 1262b, which are parallel to each other, are coupled by the main body portion 1261 formed in a direction substantially perpendicular thereto, and therefore, the first jaw pulley coupling portion 1262a, the second jaw pulley coupling portion 1262b, and the main body portion 1261 are substantially formedThe figure, which houses pulley 1211 and pulley 1221 inside.

This is described from another point of view, namely, it can be described that the first jaw pulley coupling 1262a and the second jaw pulley coupling 1262b are formed to extend from the main body portion 1261 in the X-axis direction.

Here, the pulley 1211 as the first jaw pulley is disposed adjacent to the first jaw pulley coupling 1262a of the tip tool center 1260, and the pulley 1221 as the second jaw pulley is disposed adjacent to the second jaw pulley coupling 1262b of the tip tool center 1260, so that the deflecting slit 1265 may be formed between the first jaw pulley coupling 1262a and the second jaw pulley coupling 1262b. In addition, at least a portion of the blade assembly 1270 described later may be provided inside the deflecting slit 1265. Describing this from another perspective, at least a portion of the guide tube 1271, which can be described as a blade assembly 1270, is disposed between a first jaw pulley coupling 1262a and a second jaw pulley coupling 1262b. As described above, one feature of the present invention is that since the blade assembly 1270 including the guide tube 1271 is provided between the pulley 1211 as the first jaw pulley and the pulley 1221 as the second jaw pulley, the tip tool 1200 can perform a cutting action using the blade 1275 while performing a pitching action and a yawing action.

On the one hand, a through hole is formed on the first jaw pulley coupling 1262a such that the first rotation shaft 1241 passes through the first jaw pulley coupling 1262a and the pulley 1211 to shaft-couple them. Further, a through hole is formed on the second jaw pulley coupling 1262b such that the first rotation shaft 1241 passes through the second jaw pulley coupling 1262b and the pulley 1221 to shaft-couple them.

At this time, as described above, the first rotation shaft 1241, which is a yaw rotation shaft, may be formed in two, that is, formed as the first sub-shaft 1241a and the second sub-shaft 1241b, and the guide tube 1271 may pass between the first sub-shaft 1241a and the second sub-shaft 1241b of the first rotation shaft 1241.

In addition, a deflection slit 1265 may be formed between the first jaw pulley coupling 1262a and the second jaw pulley coupling 1262 b. Since the deflecting slit 1265 is formed inside the end tool center 1260 in this way, the guide tube 1271 may pass through the inside of the end tool center 1260.

This is described from another angle that the first rotation axis 1241 is separated up and down and does not pass through the end tool center 1260, and the deflection slit 1265 may be formed on a plane perpendicular to the first rotation axis 1241 near the first rotation axis 1241. Thus, the guide tube 1271 may move (i.e., move left and right) while deflecting the inside of the slit 1265 while passing near the first rotation axis 1241.

In one aspect, the deflecting arc portion 1267 may be further formed on the body portion 1261. The deflecting circular arc portion 1267 may be formed in a circular arc shape to have a predetermined curvature. In detail, the deflecting arc portion 1267 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the first rotation axis 1241 as a deflecting rotation axis. The deflecting arc 1267 as described above may be used to guide the path of the guide tube 1271 as the end tool 1200 is deflected for rotation.

A wire guide 1268 for guiding a path of a wire passing through the inside of the end tool center 1260 is formed at one side of the main body 1261. Here, the wire guide 1268 includes a first wire guide 1268a and a second wire guide 1268b. Here, the first wire guide 1268a may be formed on an inner surface of the first jaw pulley coupling 1262 a. In addition, a second wire guide 1268b may be formed on an inner surface of the second jaw pulley coupling 1262 b.

Here, the wire guide 1268 may be formed in a cylindrical shape having an approximately semicircular cross section. In addition, the semicircular portion may be provided to protrude toward the pulley 1211 and the pulley 1221. This is described from another perspective, namely, it can be described that the wire guide 1268 is formed to protrude into the space formed by the first jaw pulley coupling 1262a, the second jaw pulley coupling 1262b, and the body portion 1261. This is described from another perspective, namely, a region adjacent to the first and second jaw pulley couplings 1262a, 1262b in the wire guide 1268, which is curved in cross-section to have a predetermined curvature.

Alternatively, this may be described from another point of view, that is, it may be described that the outer circumferential surface of the wire guide 1268 is wound with the wire 305 and the wire 302, and thus, it serves as a pulley member guiding the paths of the wire 305 and the wire 302. However, the wire guide 1268 is not a member rotated about a predetermined axis, but is fixedly formed as a part of the end tool center 1260, and only a wire is wound around the periphery thereof, unlike the pulley, and thus may be described as a portion thereof functioning like a pulley.

As shown in this figure, the wire guide 1268 is formed in a cylindrical shape having an approximately semicircular cross section. That is, at least a portion of the cross section of the wire guide 1268 on the XY plane is shown as having a predetermined circular arc shape. However, the spirit of the present invention is not limited thereto, and the cross section may be formed in various shapes and sizes to fit the path of the guide wire 305, the wire 302, for example, an ellipse, a parabola, or the like to have a predetermined curvature, or a corner of a polygonal body is formed to have a circular arc shape or the like to some extent.

Here, a guide groove for better guiding the paths of the wires 305 and 302 may be further formed in the wire guide 1268 at a portion in contact with the wires 305 and 302. The guide groove may be formed in the form of a groove (groove) recessed from the protruding surface of the wire guide 1268 to some extent.

Here, although the drawing shows the guide groove formed on the entire arc surface of the wire guide 1268, the spirit of the present invention is not limited thereto, and the guide groove may be formed on a part of the arc surface of the wire guide 1268 as needed.

As described above, since the guide groove is further formed on the wire guide 1268, unnecessary friction with each wire can be reduced to improve the durability of the wire.

A first elevation sheave portion 1263a and a second elevation sheave portion 1263b may be formed on the proximal end side of the tip tool center 1260 to serve as tip tool elevation sheaves. Here, the first and second elevation sheave portions 1263a and 1263b may be formed to face each other. Here, the first and second elevation sheave portions 1263a and 1263b may be formed substantially parallel to a plane perpendicular to the third rotation axis 1243 as an elevation rotation axis.

In detail, one end of the end tool center 1260 is formed in a disc shape like a pulley, and a groove around which a wire can be wound is formed on an outer circumferential surface thereof, so that a first elevation pulley portion 1263a and a second elevation pulley portion 1263b can be formed. The wire 303 and the wire 304 described above are coupled to the first and second elevation sheave portions 1263a and 1263b serving as elevation sheaves of the end tool, and the end tool center 1260 performs an elevation motion while rotating about the third rotation axis 1243.

In one aspect, although not shown in the drawings, the pitch pulleys may be formed as separate members from the end tool center 1260 to be combined with the end tool center 1260.

The first and second tilt pulley portions 1263a, 1263b pass through the bodyThe portion 1261 is connected. That is, since the first and second tilt pulley portions 1263a and 1263b parallel to each other are coupled by the main body portion 1261 formed in a direction substantially perpendicular to them, the first tilt pulley portion 1263a, the second tilt pulley portion 1263b, and the main body portion 1261 are substantially formedThe font type. />

This is described from another angle, that is, it can be described that the first and second tilt pulley portions 1263a and 1263b are formed to extend from the main body portion 1261 in the X-axis direction.

On the one hand, a through hole is formed on the first elevation sheave portion 1263a so that the third rotation shaft 1243 can pass through the first elevation sheave portion 1263a. Further, a through hole is formed on the second elevation sheave portion 1263b so that the third rotation shaft 1243 may pass through the second elevation sheave portion 1263b.

At this time, as described above, the third rotation shaft 1243, which is a pitch rotation shaft, may be formed in two, that is, formed as the first and second auxiliary shafts 1243a and 1243b, and the guide tube 1271 may pass between the first and second auxiliary shafts 1243a and 1243b of the third rotation shaft 1243.

A pitch slit 1264 may be formed between the first and second pitch sheave portions 1263a, 1263 b. Since the pitch slit 1264 is formed inside the end tool center 1260 in this way, the guide tube 1271 may pass through the inside of the end tool center 1260.

This is described from another angle that the third rotation axis 1243 is separated left and right and does not pass through the end tool center 1260, and the pitch slit 1264 may be formed on a plane perpendicular to the third rotation axis 1243 near the third rotation axis 1243. Thus, guide tube 1271 may move (i.e., up and down) inside pitch slit 1264 while passing near third rotational axis 1243.

In one aspect, pitch arc 1266 may be further formed on body 1261. The pitch arc part 1266 may be formed in a circular arc shape to have a predetermined curvature. In detail, the pitch arc part 1266 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the third rotation axis 1243 as a pitch rotation axis. As tip tool 1200 is pitched, pitch arc 1266 as described above may be used to guide the path of guide tube 1271.

Here, the pitch slit 1264 and the yaw slit 1265 may be formed to be connected to each other. Thus, the guide tube 1271 and the blade wire 307 inside thereof may be disposed completely through the inside of the end tool center 1260. In addition, thereby, the blade 1275 coupled to one end of the blade wire 307 can reciprocate linearly inside the first jaw 1201 and the second jaw 1202.

As described above, the present invention is characterized in that the blade wire 307 and the guide tube 1271 need to pass through the end tool center 1260 to be connected to the blade 1275, and a space inside the end tool center 1260 where the blade wire 307 and the guide tube 1271 can be bent is required, so that the following conditions need to be formed: 1) Inside the end tool center 1260 there is a space through which the blade wire 307/guide tube 1271 passes and can bend, i.e. a pitch slit 1264 and a yaw slit 1265 are formed; 2) Each rotation shaft is formed by dividing into two parts; 3) Pitch arc 1266 and yaw arc 1267 are additionally formed to guide bending of blade wire 307/guide tube 1271.

Hereinafter, the function and function of the wire guide 1268 will be described in more detail.

The wire guide 1268 is in contact with the wire 305 and the wire 302 to change the setting paths of the wire 305 and the wire 302 to some extent, so that it can be used to enlarge the respective rotation radii of the first jaw 1201 and the second jaw 1202.

That is, when the auxiliary pulley is not provided, the pulley 1211 as the first jaw pulley and the pulley 1221 as the second jaw pulley can be rotated only to right angles, respectively, but in the second modification of the first embodiment of the present invention, by additionally having the wire guide 1268 on the tip tool center 1260, an effect of enlarging the maximum rotation angle of each pulley can be obtained.

This makes it possible to realize an action that requires opening the two jaws for the actuation action in a state in which the two jaws of the end tool 1200 are rotated by 90 ° in deflection. In other words, the present invention is characterized in that the range of deflection rotations in which actuation actions can be performed can be enlarged by the arrangement of the wire guide 1268 of the end tool center 1260.

Further, the present invention is characterized in that since the wire guide 1268 is formed on the existing end tool center 1260 without additionally providing a separate structure such as an auxiliary pulley, a rotation range can be enlarged even without adding components and processes.

As described above, since there is no additional structure for enlarging the rotation angle alone, the number of parts is reduced, the process is simplified, and the length of the tip tool is shortened to the size of the auxiliary pulley, so that the length of the tip tool when performing the pitching motion is shortened, and thus, the effect of easier performing of the surgical motion in a narrow space can be obtained.

This is described in more detail below.

The distal tool 1200 of the surgical instrument according to the second modification of the first embodiment of the present invention is characterized in that since the wire guide 1268 that changes the path of the wire is formed on the inner side wall of the distal tool center 1260, the setting path of the wire can be changed even without a separate structure. As described above, the wire guide 1268 is formed on the end tool center 1260 to change the setting paths of the wires 305 and 302 to some extent, and change the tangential directions of the wires 305 and 302, thereby enlarging the rotation angle of the fastener 323 and the fastener 326 combining each wire and the pulley.

That is, the fastener 326 that engages the wire 302 and the pulley 1221 may be rotated until it is located on the inner tangent of the pulley 1221 and the wire guide 1268. Similarly, the fastener (see 323 in fig. 6) that combines the wire 305 and the pulley 1211 can be rotated until it is located on the inner common tangent of the pulley 1211 and the wire guide 1268, so that the rotation angle of the fastener (see 323 in fig. 6) can be enlarged.

This is described from another angle that the wire 301 and the wire 305 are disposed on one side with respect to a plane perpendicular to the Y axis and passing through the X axis, wherein the wire 301 and the wire 305 are wound on the pulley 1211 by the wire guide 1268. Meanwhile, the wire 302 and the wire 306 are disposed on the other side with respect to a plane perpendicular to the Y axis and passing through the X axis, wherein the wire 302 and the wire 306 are wound around the pulley 1221 by the wire guide 1268.

In other words, pulley 1213 and pulley 1214 are disposed on one side with respect to a plane perpendicular to the Y-axis and passing through the X-axis, and pulley 1223 and pulley 1224 are disposed on the other side with respect to a plane perpendicular to the Y-axis and passing through the X-axis.

In other words, the wire 305 is positioned on the inscribed line of the pulley 1211 and the wire guide 1268, and the rotation angle of the pulley 1211 is enlarged by the wire guide 1268. Further, the wire 302 is positioned on an inscribed line of the pulley 1221 and the wire guide 1268, and the rotation angle of the pulley 1221 is enlarged by the wire guide 1268.

The length of the end tool of the surgical instrument of the present modification, which is not formed with the auxiliary pulley and the wire guide 1268, which can change the path of the wire, is formed on the inner side wall of the end tool center 1260, can be shortened as compared with the surgical instrument of the first embodiment, which forms the separate auxiliary pulley. As described above, since the length of the end tool is shortened, it is possible to obtain an effect of reducing side effects of the operation by making the operation staff easy to operate when the operation is performed in a narrow operation space inside the human body.

According to the present invention as described above, since the rotation radius of the pulley 1211 as the first jaw pulley and the pulley 1221 as the second jaw pulley is widened, an effect of widening the range of the deflecting action which can perform the normal opening and closing actuation action and the cutting action can be obtained.

(third modification of the first embodiment-vertical direction of opening/closing of jaws engraving)

Hereinafter, the end tool 1300 of the surgical instrument of the third modification of the first embodiment will be described. Here, the opening and closing directions of the jaws 1303 are characteristically different from the end tool 1300 of the surgical instrument according to the third modification of the first embodiment of the present invention described above (see 100 in fig. 2 and the like). Further, the end tool 1300 of the surgical instrument according to the first modification of the first embodiment of the present invention is different in configuration in feature from the end tool center 1260 serving as the auxiliary pulley as compared to the end tool (see 100 in fig. 2 and the like) of the surgical instrument according to the first embodiment of the present invention described above.

In other words, it can be considered that the end tool 1300 of the surgical instrument according to the third modification of the first embodiment of the present invention combines the features of the first modification shown in fig. 44 and the like with the features of the second modification shown in fig. 51 and the like. As described above, a configuration different from the first embodiment will be described in detail later.

Fig. 58 and 59 are diagrams showing an end tool of an electrocautery surgical instrument according to a third variation of the first embodiment of the present invention, fig. 60 is a perspective view showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 58, and fig. 61 is a cut-away perspective view of the end tool center of fig. 60.

Hereinafter, the first connector 1380 and the second connector 1390 of the third modification of the first embodiment of the present invention will be described in more detail.

One feature of the end tool 1300 according to the third modification of the first embodiment of the present invention is that the actuation rotation shaft 1345 and the deflection rotation shaft 1341 are disposed perpendicular to each other. Accordingly, the opening/closing direction of the jaw 1303 is a vertical direction. In addition, the arrangement direction of the blades 1375 is also a vertical direction, accordingly.

In contrast, in the end tool 1300 of the third modification of the first embodiment of the present invention, the yaw rotation axis 1341 is formed parallel to the Z axis, and the actuation rotation axis 1345 is formed parallel to the Y axis in contrast. That is, the actuation rotation shaft 1345 and the deflection rotation shaft 1341 are disposed perpendicular to each other. The jaw 1303 is opened and closed in an XZ plane perpendicular to the Y axis.

Here, the end tool 1300 of the present invention includes a first jaw 1301, a second jaw 1302, a first connector 1380, a second connector 1390, a pulley 1311 as a first jaw pulley, and a pulley 1321 as a second jaw pulley. Since the specific configuration of each constituent element is the same as that of the first modification shown in fig. 44 and the like, a detailed description thereof will be omitted.

Hereinafter, the deflecting action and the actuating action of the end tool 1300 will be described.

First, when the first jaw pulley 1311 and the second jaw pulley 1321 are rotated together, 1) the first connector 1380 and the first jaw 1301 coupled thereto are also rotated together with the first jaw pulley 1311 about the first rotation axis 1341, and 2) the second connector 1390 and the second jaw 1302 coupled thereto are also rotated together with the second jaw pulley 1321 about the first rotation axis 1341, thereby performing a deflecting action.

On the one hand, when only the second jaw pulley 1321 rotates, the second connector 1390 connected to the second jaw pulley 1321 moves with the second jaw pulley 1321. In addition, the second link 1390 pulls the second jaw 1302 connected to the second link 1390 while moving, whereby the second jaw 1302 performs a rotational motion about the actuation rotational axis 1345, thereby performing an actuation motion.

In other words, when the operating portion 200 performs an actuating action, only the second jaw pulley 1321 rotates, and when the operating portion 200 performs a deflecting action, the first jaw pulley 1311 and the second jaw pulley 1321 rotate together in the same direction.

This is described from another angle, that is, when the operating portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 1311 and the second jaw pulley 1321 rotate together, so that rotation of the second jaw 1302 relative to the first jaw 1301 does not occur.

On the one hand, when the operation portion 200 performs the actuation motion, only the second jaw wire is pulled, whereby in a state where the first jaw pulley 1311 is fixed, only the second jaw pulley 1321 is rotated, so that in a state where the actuation rotation shaft 1345 is fixed, the second link 1390 is pulled, so that the second jaw 1302 is rotated about the actuation rotation shaft 1345.

As described above, the end tool 1300 according to the third modification of the first embodiment of the present invention is characterized in that the actuation rotation shaft 1345 and the deflection rotation shaft 1341 are disposed perpendicular to each other. In addition, correspondingly, the opening and closing direction of the jaw 1303 and the setting direction of the blade 1375 also become perpendicular directions, so that the user can operate the end tool similarly to the existing surgical instrument.

Hereinafter, the end tool center 1360 of the third modification of the first embodiment of the present invention will be described in more detail, and in particular, the first wire guide portion 1368a and the second wire guide portion 1368b serving as the end tool center 1360 of the auxiliary pulley will be described with emphasis.

Referring to fig. 58-61, the tip tool center 1360 includes a body portion 1361, a first jaw pulley coupling portion 1362a, a second jaw pulley coupling portion 1362b, a first pitch pulley portion 1363a, a second pitch pulley portion 1363b, a pitch slit 1364, a yaw slit 1365, a pitch arc portion 1366, a yaw arc portion 1367, and a wire guide portion 1368. Here, the wire guide 1368 includes a first wire guide 1368a and a second wire guide 1368b. Since the specific configuration of each constituent element is the same as that of the second modification shown in fig. 51 and the like, a detailed description thereof will be omitted.

Hereinafter, the function and function of the wire guide 1368 will be described in more detail.

The wire guide 1368 is in contact with the wire 305 and the wire 302 to change the setting paths of the wire 305 and the wire 302 to some extent so as to be usable to enlarge the rotation radius of each of the first jaw 1301 and the second jaw 1302.

That is, when the auxiliary pulleys are not provided, the pulley 1311 as the first jaw pulley and the pulley 1321 as the second jaw pulley can be rotated only to right angles, respectively, but in the third modification of the first embodiment of the present invention, by additionally having the wire guide 1368 on the tip tool center 1360, an effect of enlarging the maximum rotation angle of each pulley can be obtained.

This makes it possible to realize an action requiring opening of the two jaws for the actuation action in a state in which the two jaws of the end tool 1300 are rotated by 90 ° in deflection. In other words, the present invention is characterized in that the range of deflection rotations in which actuation actions can be performed can be enlarged by the arrangement of the wire guide 1368 of the end tool center 1360. In other words, the present invention is characterized in that the range of deflection rotations in which actuation actions can be performed can be enlarged by the arrangement of the wire guide 1368 of the end tool center 1360.

Further, the present invention is characterized in that since the wire guide 1368 is formed on the existing end tool center 1360 without providing a separate structure such as an auxiliary pulley additionally, a rotation range can be enlarged even without adding components and processes.

As described above, since there is no additional structure for enlarging the rotation angle alone, the number of parts is reduced, the process is simplified, and the length of the tip tool is shortened to the size of the auxiliary pulley, so that the length of the tip tool for performing the pitching motion is shortened, thereby obtaining the effect that the surgical motion is easier to perform in a narrow space.

According to the present invention as described above, since the rotation radius of the pulley 1311 as the first jaw pulley and the pulley 1321 as the second jaw pulley is widened, an effect of widening the range of the deflecting action which can perform the normal opening and closing actuation action and the cutting action can be obtained.

< second embodiment of electrocautery surgical instrument >

Hereinafter, an end tool 500 of a surgical instrument according to a second embodiment of the present invention is described. Here, the opening and closing directions of the jaws 503 are characteristically different from the end tool 500 of the surgical instrument according to the second embodiment of the present invention described above (see 100 in fig. 2 and the like) of the surgical instrument according to the first embodiment of the present invention. As described above, a configuration different from the first embodiment will be described in detail later.

Fig. 62 is a perspective view showing an electrocautery surgical instrument according to a second embodiment of the present invention, fig. 63, 64, 65, 66, 67 and 68 are perspective views showing an end tool of the electrocautery surgical instrument of fig. 62, and fig. 69 to 70 are plan views showing the end tool of the electrocautery surgical instrument of fig. 62. Fig. 71 and 72 are perspective views showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 62, and fig. 73 is a cut-away perspective view of the end tool center of fig. 71. Fig. 74 is an exploded perspective view of a jaw-connector-jaw pulley showing an end tool of the electrocautery instrument of fig. 62, and fig. 75, 76, 77 and 78 are perspective views of a second jaw pulley showing an end tool of the electrocautery instrument of fig. 62. Fig. 79 and 80 are plan views showing opening and closing actions of the end tool of the electrocautery surgical instrument of fig. 62, fig. 81 is a view showing a jaw opening and closing process of a first embodiment of the present invention shown in fig. 2 and the like, and fig. 82 is a view showing a jaw opening and closing process of a second embodiment of the present invention. Fig. 83 is a view showing a case where the pin groove structure of the second embodiment of the present invention is provided in a general pulley instead of a multi-layered pulley. Fig. 84, 85, 86 and 87 are perspective views showing the opening and closing actions of the end tool of the electrocautery instrument of fig. 62, and fig. 88, 89 and 90 are perspective views showing the cutting actions of the end tool of the electrocautery instrument of fig. 62.

Referring to fig. 62 to 90, an end tool (end tool) 500 of the second embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 501 and a second jaw 502, and herein, the first jaw 501 and the second jaw 502 or constituent elements that enclose the first jaw 501 and the second jaw 502 are referred to as jaws (jaw) 503, respectively.

In one aspect, the end tool 500 includes a plurality of pulleys including a pulley 511 associated with the rotational movement of the first jaw (jaw) 501. In the present embodiment, since each pulley related to the rotational movement of the first jaw (jaw) 501 is substantially the same as the pulleys 111, 112, 113, 114, 115, and 116 described in fig. 8 and the like of the first embodiment, a detailed description thereof will be omitted herein.

In one aspect, the end tool 500 includes a plurality of pulleys including a pulley 521 associated with the rotational movement of the second jaw (jaw) 502. In the present embodiment, since each pulley related to the rotational movement of the second jaw (jaw) 502 is substantially the same as the pulleys 121, 122, 123, 124, 125 and 126 described in fig. 8 and the like of the first embodiment, a detailed description thereof will be omitted herein.

Further, the end tool 500 of the second embodiment of the present invention may include a rotation shaft 541, a rotation shaft 542, a rotation shaft 543, and a rotation shaft 544. Here, rotation axes 541 and 542 are inserted through end tool center 560, while rotation axes 543 and 544 may be inserted through pitch center 550. The rotation shaft 541, the rotation shaft 542, the rotation shaft 543, and the rotation shaft 544 may be sequentially provided from the distal end portion (distal end) 504 of the end tool 500 toward the proximal end portion (proximal end) 505.

In one aspect, end tool 500 can further have an actuation rotation shaft 545. In detail, the coupling portion of the first jaw 501 and the second jaw 502 may have an actuation rotation shaft 545, and the second jaw 502 may perform an actuation motion while rotating about the actuation rotation shaft 545 in a state where the first jaw 501 is fixed. Here, the actuation rotation shaft 545 may be disposed closer to the distal end portion 504 side than the first rotation shaft 541.

Here, each rotation shaft may include two shafts of a first sub-shaft and a second sub-shaft. Alternatively, it may be described that each rotation axis is formed by being divided into two. Since each rotation shaft in the present embodiment has substantially the same configuration as that of the rotation shaft of the first embodiment, a detailed description thereof will be omitted here.

Further, the end tool 500 of the second embodiment of the present invention may include an end tool center 560 and a pitch center 550.

The rotation shaft 541 and the rotation shaft 542 are inserted through the end tool center 560, and at least a portion of the pulleys 511 and 521 shaft-coupled to the rotation shaft 541 and the first jaw 501 and the second jaw 502 coupled thereto may be accommodated inside the end tool center 560.

In one aspect, a first pitch sheave portion 563a and a second pitch sheave portion 563b may be formed at an end of the end tool center 560 to function as an end tool pitch sheave. The wires 303 and 304 are coupled to the first and second tilt pulley portions 563a and 563b serving as the tip tool tilt pulleys, and the tip tool center 560 performs a tilt action while rotating about the rotation shaft 543.

Rotation shaft 543 and rotation shaft 544 are inserted through pitch center 550, and pitch center 550 may be axially coupled with end tool center 560 by rotation shaft 543. Thus, the end tool center 560 may be formed to be pitching rotatable about the rotation axis 543 with respect to the pitching center 550.

In the present embodiment, since the tip tool center 560 and the pitch center 550 are substantially the same as the constituent elements described in the first embodiment, a detailed description thereof will be omitted here.

In one aspect, the end tool 500 of the second embodiment of the present invention may further include components such as a first electrode 551, a second electrode 552, and a guide tube 571 and a blade 575 for performing cautery (ablation) and cutting (cutting) actions. Here, the constituent elements of the guide tube 571, the blade 575, etc. related to the blade driving may be collectively referred to as a blade assembly 570. A modification of the present invention is characterized in that the blade assembly 570 including the blade 575 is provided between the pulley 511 as the first jaw pulley and the pulley 521 as the second jaw pulley, so that the tip tool 500 can perform a pitch operation and a yaw operation and simultaneously perform a cutting operation using the blade. Since the constituent elements for performing the cautery (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the first embodiment, a detailed description thereof will be omitted herein.

As with the first embodiment of the present invention shown in fig. 13 and the like, the electrocautery surgical instrument according to the second embodiment of the present invention may include a wire 301, a wire 302, a wire 303, a wire 304, a wire 305, a wire 306, and a blade wire 307.

(jaw-connecting piece-pulley connecting Structure)

Hereinafter, the jaw-link-pulley connection structure of the second embodiment of the present invention will be described in detail.

Referring to fig. 64 to 70, etc., an end tool 500 of a second embodiment of the present invention includes a first jaw 501, a second jaw 502, a first link 580, a second link 590, a pulley 511 as a first jaw pulley, and a pulley 521 as a second jaw pulley. Hereinafter, the pulley 511 is referred to as a first jaw pulley 511, and the pulley 521 is referred to as a second jaw pulley 521.

In detail, the second jaw pulley 521 may be formed as a multi-layered pulley. In other words, the second jaw pulley 521 is formed by combining two pulleys, and two grooves may be formed on the outer circumferential surface thereof.

Here, the first coupling portion 521a may be formed on any one surface of the second jaw pulley 521, and the second coupling portion 521b may be formed on the other surface of the second jaw pulley 521. At this time, the positions of the first bonding portion 521a and the second bonding portion 521b are positions where the wire 302 and the wire 306 overlap each other. In other words, at least a portion of the wire 302 and the wire 306 wound on the second jaw pulley 521 may be formed to overlap.

This is described from another point of view, i.e., the first and second engaging portions 521a and 521b are asymmetrically disposed in view of the XY plane so as to be positionable so as to be biased toward any one region of the second jaw pulley 521.

Describing this from another angle, the first coupling portion 521a may be formed at a position where the wire 302 can be wound on the outer circumferential surface of the second jaw pulley 521 at an angle between the center angle 90 ° and 360 °. Similarly, the second coupling portion 521b may be formed at a position where the wire 306 can be wound on the outer circumferential surface of the second jaw pulley 521 at an angle between the center angle 90 ° and 360 °.

In addition, a fastener 332 is coupled to an end of the wire 302, and the fastener 332 may be coupled to the first coupling portion 521a of the second jaw pulley 521. The fastener 333 is coupled to an end of the wire 306, and the fastener 333 may be coupled to the second coupling portion 521b of the second jaw pulley 521.

This is described from another perspective as follows.

When the wire 306 is referred to as a second jaw wire R and the wire 302 is referred to as a second jaw wire L, a first coupling portion 521a coupled with the second jaw wire R306 is formed at the opposite side to the side where the second jaw wire R306 is input, and the rotation angle of the second jaw pulley 521 is enlarged by extending the length of the second jaw wire R306 wound around the second jaw pulley 521.

Further, a second coupling portion 521b coupled with the second jaw wire L302 is formed at the opposite side of the other side of the input second jaw wire L302, and the rotation angle of the second jaw pulley 521 is enlarged by extending the length of the second jaw wire L302 wound around the second jaw pulley 521.

The rotation radius of the second jaw pulley 521 can be enlarged by the first and second coupling parts 521a and 521b as described above. Further, as described above, by elongating the length of the wire 302/306 wound on the second jaw pulley 521, a long Stroke (Stroke) of the second connection 590 can be ensured. As will be described in more detail later.

The first jaw pulley 511 and the first link 580 may be formed as one body.

In detail, the first jaw pulley 511 is formed at one end of the first link 580. In addition, a slot (slot) 580a may be formed at the other end of the first connecting member 580 in the longitudinal direction. In addition, a guide pin 590b of a second coupling member 590, which will be described later, may be inserted into the groove 580 a. In addition, one side of the groove 580a may be formed with a through hole 580b through which the actuating rotation shaft 545 is inserted and a coupling hole 580c coupled with the first jaw 501.

Here, although not shown in the drawings, the first jaw pulley 511 and the first link 580 are formed as separate members, respectively, and the first jaw pulley 511 and the first link 580 may be fixedly coupled.

In addition, the first auxiliary shaft 541a of the first rotation shaft 541 may be sequentially inserted through the first jaw pulley 511.

As described above, since the first jaw pulley 511 and the first link 580 are formed as one body or fixedly coupled, the first link 580 does not rotate with respect to the first jaw pulley 511, and when the first jaw pulley 511 rotates about the first rotation axis 541, the first link 580 also rotates about the first rotation axis 541 together with the first jaw pulley 511.

In one aspect, the first connector 580 and the first jaw 501 are fixedly coupled by a securing member (pin, etc.).

In other words, the first jaw 501 and the first jaw pulley 511 are connected by the first connector 580 and they are fixed relative to each other, so that either member cannot rotate/move relative to the other member.

As a result, when the first jaw pulley 511 rotates about the first auxiliary shaft 541a of the first rotation shaft 541, the first link 580 and the first jaw 501 coupled thereto also rotate about the first auxiliary shaft 541a of the first rotation shaft 541 together with the first jaw pulley 511.

In one aspect, a slot (slot) 502a can be formed on the second jaw 502 in the longitudinal direction. In addition, a guide pin 590b of a second coupling member 590, which will be described later, may be inserted into the groove 502 a.

In one aspect, a through hole 590a may be formed at one end of the second connection member 590. In addition, a guide pin 590b may be formed protruding at the other end portion of the second connection member 590.

The second jaw pulley 521 and the second link 590 are coupled at a point shaft, and thus, the second link 590 is rotatably coupled to the second jaw pulley 521. In detail, a protrusion 521c is formed on the second jaw pulley 521, and the protrusion 521c of the second jaw pulley 521 may be inserted into the through hole 590a of the second connection 590. Thus, when the second jaw pulley 521 is rotated, the second link 590 moves while rotating about the protrusion 521 c.

In one aspect, a guide pin 590b formed at the other end of the second connection piece 590 may be inserted into the groove 580a of the first connection piece 580 and the groove 502a of the second jaw 502.

Here, the second jaw 502 is shaft-coupled with the first link 580, the second jaw 502 is pin-grooved-coupled with the second link 590, and when the second jaw pulley 521 is rotated, the second jaw 502 is formed to be rotatable about the rotation shaft 545 as an actuation rotation shaft by the second link 590 connected thereto.

In detail, the first connecting member 580 is formed with a through hole 580b, the second jaw 502 is formed with a through hole 502b, and the actuating rotation shaft 545 is sequentially inserted through the second jaw 502 and the first connecting member 580, so that the first connecting member 580 and the second jaw 502 can be coupled by the shaft. Here, like the other respective rotation shafts, actuation rotation shaft 545 may be formed as a split into two.

As a result, in a state where the first jaw pulley 511 is fixed, when only the second jaw pulley 521 rotates about the first rotation shaft 541, the second link 590 shaft-coupled with the second jaw pulley 521 moves. At this time, the guide pin 590b of the second link 590 pushes the groove 502a of the second jaw 502 while the guide pin 590b of the second link 590 moves straight along the groove 580a of the first link 580, thereby performing a rotating action of the second jaw 502 about the actuation rotation axis 545.

Hereinafter, the deflecting action and the actuating action of the end tool 500 will be described.

First, when the first jaw pulley 511 and the second jaw pulley 521 are rotated together, 1) the first link 580 and the first jaw 501 coupled thereto are also rotated together with the first jaw pulley 511 about the first rotation axis 541, and 2) the second link 590 and the second jaw 502 coupled thereto are also rotated together with the second jaw pulley 521 about the first rotation axis 541, thereby performing a deflecting operation.

On the one hand, in a state where the jaw 503 is closed as shown in fig. 80, when only the second jaw pulley 521 is rotated in the direction of arrow a in fig. 79, the second link 590 connected to the second jaw pulley 521 is moved in the direction of arrow B in fig. 79 by the second jaw pulley 521. In addition, the second link 590 is moved in the direction of arrow B in fig. 79, and simultaneously, the second jaw 502 connected to the second link 590 is pulled in the direction of arrow C in fig. 79, whereby the second jaw 502 performs a rotational motion about the actuation rotational axis 545 in the direction of arrow C in fig. 79, thereby causing the jaws 503 to perform an opening actuation motion.

In other words, when the operating portion 200 performs an actuating action, only the second jaw pulley 521 rotates, and when the operating portion 200 performs a deflecting action, the first jaw pulley 511 and the second jaw pulley 521 rotate together in the same direction.

Describing this from another point of view, when the operating portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 511 and the second jaw pulley 521 rotate together, so that rotation of the second jaw 502 relative to the first jaw 501 does not occur.

On the one hand, when the operation part 200 performs the actuation motion, only the second jaw wire is pulled, whereby in a state where the first jaw pulley 511 is fixed, only the second jaw pulley 521 is rotated, so that in a state where the actuation rotation shaft 545 is fixed, the second link 590 is pulled, so that the second jaw 502 is rotated around the actuation rotation shaft 545.

Here, one feature of the end tool 500 of the second embodiment of the present invention is that a pin groove structure is employed to ensure a clamping Force (clip Force) upon actuation.

In detail, in the pin-slot structure, the second link 590 needs to be moved a longer distance to rotate the second jaw 502 by the same distance. (i.e., a long Stroke (Stroke) of the second link 590 is required) in addition, the second jaw pulley 521 needs to be rotated more to move the second link 590 a longer distance. Describing this from another point of view, i.e., if the second jaw pulley 521 is rotated more to rotate the second jaw 502 the same distance, the clamping Force (clip Force) upon actuation may be increased because more Force is applied to the second jaw 502 by rotating the second jaw pulley 521 more.

In addition, in order to rotate the second jaw pulley 521 more in this way, as described above, the second jaw pulley 521 is formed in a multi-layered structure to lengthen the length of the wire 302 and the wire 306 wound around the second jaw pulley 521, thereby securing a long Stroke (Stroke) of the second link 590.

In the second embodiment of the present invention, the rotation angle of the second jaw pulley 521 is increased when the jaws are opened and closed, as compared with the first embodiment of the present invention, due to such a structure.

Referring to fig. 81 and 82, in order to rotate the second jaw 502 by the same angle θ1, the second jaw pulley 121 of the first embodiment only needs to be rotated by θ2, and the second jaw pulley 521 of the second embodiment only needs to be rotated by θ3, and thus, the second jaw pulley 521 of the second embodiment needs to be rotated more than the first embodiment. In other words, the operating angle of the second jaw pulley 521 in the second embodiment can be described as being greater than the operating angle of the second jaw pulley 121 in the first embodiment.

As described above, since the second jaw pulley 521 in the second embodiment rotates more than in the first embodiment, the moving distance of the second link 590 is elongated. Therefore, to rotate the second jaw 502 by the same angle θ1, the second jaw pulley 521 needs to be rotated more, thereby exerting a greater force on the second jaw 502.

In one aspect, fig. 83 is a diagram showing a case where the pin groove structure of the second embodiment of the present invention is provided in a general pulley instead of a multi-layered pulley.

When the pin-and-groove structure of the second embodiment of the present invention is provided on a general pulley instead of a multi-layered pulley, as shown in fig. 83a and 83b, the jaw 503 can be opened and closed in a neutral state (i.e., a state in which the end tool is parallel to the connection portion). However, as shown in fig. 83c, when the deflection (yaw) action is performed in a state where the jaw 503 is opened, the action range (angle) thereof may be limited. In other words, in the state of fig. 83c, the jaw pulley is limited in its rotation angle because it cannot be rotated any further because it contacts the auxiliary pulley.

In contrast, when the pin groove structure of the second embodiment of the present invention is applied to a multi-layered pulley, as shown in fig. 91 or the like, even in a state in which the jaws (jaw) are rotated in a deflected manner by +90° to-90 °, the opening and closing operations, that is, the actuation operations, can be performed normally.

(Pitch, yaw, and cutting action of end tool)

Fig. 91 and 92 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 62 is rotated-90 ° in a deflected state. Fig. 93 and 94 are views showing a procedure of opening and closing operations in a state in which the distal tool of the electrocautery surgical instrument of fig. 62 is rotated by +90° in a deflected state.

As shown in fig. 91 to 94, the end tool of the electrocautery surgical instrument according to the second embodiment of the present invention is formed so that the opening and closing actions, i.e. the actuation actions, can be normally performed even in a state where the jaws (jaw) are rotated by +90° to-90 °.

As shown in fig. 95 and 96, the end tool of the electrocautery surgical instrument according to the second embodiment of the present invention is formed to perform a cutting action normally even in a state in which the jaws (jaw) are rotated by +90° in a deflected manner.

Fig. 97 is a view showing a state in which the end tool of the electrocautery surgical instrument of fig. 62 is rotated-90 ° in pitch, and fig. 98 is a view showing a state in which the end tool of the electrocautery surgical instrument of fig. 62 is rotated +90° in pitch. In addition, fig. 99 is a cut-away perspective view of the end tool of the electrocautery instrument of fig. 98. Fig. 100, 101 and 102 are views showing the process of performing a cutting operation in a state in which the distal tool of the electrocautery surgical instrument of fig. 62 is rotated at-90 ° in pitch.

As shown in fig. 97 to 102, the end tool of the electrocautery surgical instrument according to the second embodiment of the present invention is formed to perform a cutting action normally even in a state where the jaws (jaw) are rotated at-90 ° pitch.

In one aspect, fig. 103 is a diagram showing a state in which the jaw (jaw) is rotated-90 ° in pitch while being rotated +90° in yaw, and fig. 104, 105 and 106 are perspective views showing a cutting action of the end tool of the electrocautery surgical instrument of fig. 62 in a state in which the jaw (jaw) is rotated-90 ° in pitch while being rotated +90° in yaw.

As shown in fig. 103 to 106, the end tool of the electrocautery surgical instrument according to the second embodiment of the present invention is formed to normally perform a cutting action even in a state in which the jaws (jaw) are rotated-90 ° in pitch while being rotated +90° in yaw.

(first modification of the second embodiment-vertical direction of opening/closing of jaws)

Hereinafter, the end tool 2100 of the surgical instrument according to the first modification of the second embodiment of the present invention is described. Here, the opening and closing directions of the jaws 2103 are characteristically different from the tip tool 2100 of the surgical instrument according to the first modification of the second embodiment of the present invention described above (see 500 in fig. 62 and the like).

In other words, it can be considered that the end tool 2100 of the surgical instrument according to the first modification of the second embodiment of the present invention combines the features of the second embodiment of the present invention shown in fig. 62 and the like and the first modification of the first embodiment of the present invention shown in fig. 44 and the like.

Fig. 107, 108, 109 and 110 are diagrams showing an end tool of an electrocautery surgical instrument according to a first variation of the second embodiment of the present invention, fig. 111, 112 and 113 are diagrams showing a procedure in which the end tool of the electrocautery surgical instrument of fig. 107 performs a cutting action, and fig. 114 is a diagram showing the end tool of the electrocautery surgical instrument of fig. 107.

Hereinafter, the first and second connection members 2180 and 2190 of the first modification of the second embodiment of the present invention will be described in more detail.

One feature of the end tool 2100 according to the first modification of the second embodiment of the present invention is that the actuation rotation axis 2145 and the deflection rotation axis 2141 are disposed perpendicular to each other. Accordingly, the opening/closing direction of the jaw 2103 is a vertical direction. In addition, the direction in which the blades 2175 are disposed is also a vertical direction, accordingly.

That is, in the second embodiment of the present invention shown in fig. 62 and the like, the actuation rotation shaft 545 and the deflection rotation shaft 541 are formed parallel to each other, and these two shafts may be formed parallel to the Z-axis. Accordingly, the opening and closing of the jaw 503 is performed on an XY plane perpendicular to the Z axis.

In contrast, in the end tool 2100 according to the first modification of the second embodiment of the present invention, the yaw rotation axis 2141 is formed parallel to the Z axis, and the actuation rotation axis 2145 is formed parallel to the Y axis in contrast. That is, the actuation rotation shaft 2145 and the deflection rotation shaft 2141 are disposed perpendicular to each other. The jaw 2103 is opened and closed in an XZ plane perpendicular to the Y axis.

Here, the end tool 2100 of the present invention includes a first jaw 2101, a second jaw 2102, a first connector 2180, a second connector 2190, a pulley 2111 as a first jaw pulley, and a pulley 2121 as a second jaw pulley. Since the specific configuration of each constituent element is the same as the first modification of the first embodiment of the present invention shown in fig. 44 and the like, a detailed description thereof will be omitted.

Hereinafter, the deflecting action and the actuating action of the end tool 2100 will be described.

First, when the first jaw pulley 2111 and the second jaw pulley 2121 rotate together, 1) the first link 2180 and the first jaw 2101 coupled thereto also rotate together with the first jaw pulley 2111 about the first rotation axis 2141, and 2) the second link 2190 and the second jaw 2102 coupled thereto also rotate together with the second jaw pulley 2121 about the first rotation axis 2141, thereby performing a deflecting operation.

On the one hand, when only the second jaw pulley 2121 rotates, the second link 2190 connected to the second jaw pulley 2121 moves with the second jaw pulley 2121. In addition, the second link 2190 pulls the second jaw 2102 connected to the second link 2190 while moving, whereby the second jaw 2102 performs a rotational motion about the actuation rotation shaft 2145, thereby performing an actuation motion.

In other words, when the operating portion 200 performs an actuating action, only the second jaw pulley 2121 rotates, and when the operating portion 200 performs a deflecting action, the first jaw pulley 2111 and the second jaw pulley 2121 rotate together in the same direction.

Describing this from another point of view, i.e., when the operating portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 2111 and the second jaw pulley 2121 rotate together, so that rotation of the second jaw 2102 relative to the first jaw 2101 does not occur.

On the one hand, when the operation portion 200 performs the actuation motion, only the second jaw wire is pulled, whereby in a state where the first jaw pulley 2111 is fixed, only the second jaw pulley 2121 is rotated, so that in a state where the actuation rotation shaft 2145 is fixed, the second link 2190 is pulled, so that the second jaw 2102 is rotated about the actuation rotation shaft 2145.

As described above, one feature of the end tool 2100 according to the first modification of the second embodiment of the present invention is that the actuation rotation axis 2145 and the deflection rotation axis 2141 are disposed perpendicular to each other. In addition, correspondingly, the opening and closing direction of the jaws 2103 and the setting direction of the blades 2175 also become perpendicular directions, so that the user can operate the end tool similarly to the existing surgical instrument.

(second modification of the second embodiment-engraving)

Hereinafter, an end tool 2200 of a surgical instrument according to a second modification of the second embodiment of the present invention is described. Here, the end tool 2200 of the surgical instrument according to the second modification of the second embodiment of the present invention is different in configuration in characteristic from the end tool center 2260 serving as the auxiliary pulley, compared to the end tool (see 500 in fig. 62 and the like) of the surgical instrument according to the second embodiment of the present invention described above.

In other words, it can be considered that the end tool 2200 of the surgical instrument according to the second modification of the second embodiment of the present invention combines the features of the second embodiment of the present invention shown in fig. 62 and the like and the second modification of the first embodiment of the present invention shown in fig. 51 and the like.

Fig. 115 and 116 are diagrams showing an end tool of an electrocautery surgical instrument of a second variation of the second embodiment of the present invention, fig. 117 is a perspective view showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 115, fig. 118 and 119 are cut-away perspective views of the end tool center of fig. 117, and fig. 120 and 121 are perspective views of the end tool center of fig. 117.

Hereinafter, the end tool center 2260 of the second modification of the second embodiment of the present invention will be described in more detail, and in particular, the first wire guide portion 2268a and the second wire guide portion 2268b serving as the end tool center 2260 of the auxiliary pulley will be described with emphasis.

Referring to fig. 115 to 120, the tip tool center 2260 includes a main body portion 2261, a first jaw pulley coupling portion 2262a, a second jaw pulley coupling portion 2262b, a first pitch pulley portion 2263a, a second pitch pulley portion 2263b, a pitch slit 2264, a yaw slit 2265, a pitch arc portion 2266, a yaw arc portion 2267, and a wire guide portion 2268. Here, the wire guide 2268 includes a first wire guide 2268a and a second wire guide 2268b. Since the specific configuration of each constituent element is the same as that of the second modification of the first embodiment of the present invention shown in fig. 51 and the like, a detailed description thereof will be omitted.

Hereinafter, the function and function of the wire guide 2268 will be described in more detail.

The wire guide 2268 is in contact with the wire 305 and the wire 302 to change the setting paths of the wire 305 and the wire 302 to some extent, and thus can be used to expand the respective radius of rotation of the first jaw 2201 and the second jaw 2202.

That is, when the auxiliary pulley is not provided, the pulley 2211 as the first jaw pulley and the pulley 2221 as the second jaw pulley can be rotated only to right angles, respectively, but in the second modification of the second embodiment of the present invention, by additionally having the wire guide portion 2268 on the tip tool center 2260, an effect of enlarging the maximum rotation angle of each pulley can be obtained.

This allows for an action that requires opening of the two jaws for actuation action in a state where the two jaw deflection of end tool 2200 is rotated 90 °. In other words, the present invention is characterized in that the range of deflection rotations in which actuation actions can be performed can be enlarged by the arrangement of the wire guide 2268 of the end tool center 2260.

Further, since the wire guide 2268 is formed on the existing end tool center 2260 without providing a separate structure, the rotation range can be enlarged without adding components and processes.

As described above, since there is no additional structure for enlarging the rotation angle alone, the number of parts is reduced, the process is simplified, and the length of the tip tool is shortened to the size of the auxiliary pulley, so that the length of the tip tool when performing the pitching motion is shortened, and thus the effect of easier performing the surgical motion in a narrow space can be obtained.

According to the present invention as described above, since the rotation radius of the pulley 2211 as the first jaw pulley and the pulley 2221 as the second jaw pulley is widened, an effect of widening the range of the deflecting action which can perform the normal opening and closing actuation action and the cutting action can be obtained.

(third modification of the second embodiment-vertical direction of opening and closing of jaws engraving)

Hereinafter, the end tool 2300 of the surgical instrument according to the third modification of the second embodiment of the present invention is described. Here, the opening and closing directions of the jaws 2303 are characteristically different from the end tool 2300 of the surgical instrument according to the third modification of the second embodiment of the present invention described above (see 500 in fig. 62 and the like). Here, the end tool 2300 of the surgical instrument according to the third modification of the second embodiment of the present invention is different in the configuration of the end tool center 2360 serving as the auxiliary pulley from the end tool (see 500 in fig. 62 and the like) of the surgical instrument according to the second embodiment of the present invention described above.

In other words, it can be considered that the end tool 2300 of the surgical instrument according to the third modification of the second embodiment of the present invention combines the features of the first modification of the second embodiment shown in fig. 107 and the like with the features of the second modification of the second embodiment shown in fig. 115 and the like. As described above, a configuration different from the second embodiment will be described in detail later.

Fig. 122 and 123 are diagrams showing an end tool of an electrocautery surgical instrument according to a third variation of the second embodiment of the present invention, and fig. 124 is a perspective view showing an end tool center of the end tool of the electrocautery surgical instrument of fig. 122.

Hereinafter, the first and second connection members 2380 and 2390 of the third modification of the second embodiment of the present invention will be described in more detail.

One feature of the end tool 2300 according to the third modification of the second embodiment of the present invention is that the actuation rotation shaft 2345 and the deflection rotation shaft 2341 are disposed perpendicular to each other. Accordingly, the opening/closing direction of the jaw 2303 is a vertical direction. In addition, the arrangement direction of the blade 2375 is also a vertical direction, accordingly.

In contrast, in the end tool 2300 of the third modification of the second embodiment of the present invention, the deflection rotation axis 2341 is formed parallel to the Z axis, and the actuation rotation axis 2345 is formed parallel to the Y axis in contrast. That is, the actuation rotation shaft 2345 and the deflection rotation shaft 2341 are disposed perpendicular to each other. Further, the jaw 2303 is opened and closed in an XZ plane perpendicular to the Y axis.

Here, the end tool 2300 of the present invention includes a first jaw 2301, a second jaw 2302, a first connector 2380, a second connector 2390, a pulley 2311 as a first jaw pulley, and a pulley 2321 as a second jaw pulley. Since the specific configuration of each constituent element is the same as the first modification of the second embodiment of the present invention shown in fig. 107 and the like, a detailed description thereof will be omitted.

Hereinafter, the deflecting action and the actuating action of the end tool 2300 will be described.

First, when the first jaw pulley 2311 and the second jaw pulley 2321 are rotated together, 1) the first link 2380 and the first jaw 2301 coupled thereto are also rotated together with the first jaw pulley 2311 about the first rotation axis 2341, and 2) the second link 2390 and the second jaw 2302 coupled thereto are also rotated together with the second jaw pulley 2321 about the first rotation axis 2341, thereby performing a deflecting operation.

On the one hand, when only the second jaw pulley 2321 rotates, the second link 2390 connected with the second jaw pulley 2321 moves with the second jaw pulley 2321. Further, the second connector 2390 pulls the second jaw 2302 connected to the second connector 2390 while moving, whereby the second jaw 2302 performs a rotational motion about the actuation rotation shaft 2345, thereby performing an actuation motion.

In other words, when the operating portion 200 performs an actuating action, only the second jaw pulley 2321 rotates, and when the operating portion 200 performs a deflecting action, the first jaw pulley 2311 and the second jaw pulley 2321 rotate together in the same direction.

This is described from another point of view, i.e., when the operating portion 200 performs a deflecting action, the first jaw wire and the second jaw wire are pulled together, whereby the first jaw pulley 2311 and the second jaw pulley 2321 rotate together, so that rotation of the second jaw 2302 relative to the first jaw 2301 does not occur.

On the one hand, when the operation portion 200 performs the actuation motion, only the second jaw wire is pulled, whereby in a state where the first jaw pulley 2311 is fixed, only the second jaw pulley 2321 is rotated, so that in a state where the actuation rotation shaft 2345 is fixed, the second link 2390 is pulled, so that the second jaw 2302 is rotated about the actuation rotation shaft 2345.

As described above, the end tool 2300 according to the third modification of the second embodiment of the present invention is characterized in that the actuation rotation shaft 2345 and the deflection rotation shaft 2341 are disposed perpendicular to each other. In addition, accordingly, the opening and closing direction of the jaws 2303 and the setting direction of the blades 2375 also become perpendicular directions, so that the user can operate the end tool similarly to the existing surgical instrument.

Hereinafter, the end tool center 2360 of the third modification of the second embodiment of the present invention will be described in more detail, and in particular, the first wire guide portion 2368a and the second wire guide portion 2368b serving as the end tool center 2360 of the auxiliary pulley will be described with emphasis.

Referring to fig. 122 to 124, the tip tool center 2360 includes a main body portion 2361, a first jaw pulley coupling portion 2362a, a second jaw pulley coupling portion 2362b, a first pitch pulley portion 2363a, a second pitch pulley portion 2363b, a pitch slit 2364, a yaw slit 2365, a pitch arc portion 2366, a yaw arc portion 2367, and a wire guide portion 2368. Here, the wire guide portion 2368 includes a first wire guide portion 2368a and a second wire guide portion 2368b. Since the specific configuration of each constituent element is the same as that of the second modification of the second embodiment of the present invention shown in fig. 115 and the like, a detailed description thereof will be omitted.

Hereinafter, the function and function of the wire guide 2368 will be described in more detail.

The wire guide 2368 contacts the wire 305 and the wire 302 to change the setting paths of the wire 305 and the wire 302 to some extent, so that it can be used to enlarge the respective turning radii of the first jaw 2301 and the second jaw 2302.

That is, when the auxiliary pulley is not provided, the pulley 2311 as the first jaw pulley and the pulley 2321 as the second jaw pulley can be rotated only to right angles, respectively, but in the third modification of the second embodiment of the present invention, the effect of enlarging the maximum rotation angle of each pulley can be obtained by additionally providing the wire guide portion 2368 on the tip tool center 2360.

This allows for an action that requires opening of the two jaws of the end tool 2300 for the actuation action in a state where the two jaws are rotated 90 ° in deflection. In other words, the present invention is characterized in that the range of deflection rotations in which actuation operations can be performed can be enlarged by the arrangement of the wire guide portion 2368 of the end tool center 2360.

Further, since the wire guide 2368 is formed on the existing end tool center 2360 without providing a separate structure, the rotation range can be enlarged without increasing components and processes.

According to the present invention, the rotation radius of the pulley 2311 as the first pulley and the pulley 2321 as the second jaw pulley is widened, and an effect of widening the range of the deflecting action which can perform the normal opening and closing actuation action and the cutting action can be obtained.

As described above, the present invention has been described with reference to an embodiment shown in the drawings, but this is merely exemplary, and those skilled in the art will understand that various modifications and embodiments can be made thereto. Therefore, the true technical scope of the present invention should be determined according to the technical ideas of the claims.

Industrial applicability

Claims

1. An end tool of a surgical instrument, comprising: a first jaw and a second jaw rotatable independently of each other; a first jaw pulley formed to be connected to the first jaw and rotatable about a first rotation axis; a second jaw pulley formed to be connected to the second jaw and rotatable about the first rotation axis, and spaced apart from the first jaw pulley by a distance; a blade assembly including a blade that moves between a proximal end and a distal end of the first jaw, and at least a portion of which is formed between the first jaw pulley and the second jaw pulley; and a blade wire, at least a portion of which is in contact with the blade assembly, to transmit a driving force required to move the blade to the blade.

2. The end tool of claim 1, wherein the blade assembly includes a guide tube that houses at least a portion of the blade wire therein and is formed to be bendable to a degree.

3. The end tool of claim 2, wherein the blade wire passes through the interior of the guide tube to connect with the blade.

4. The end tool of a surgical instrument of claim 2, wherein when the guide tube is bent to a certain extent, the blade wire inside the guide tube is also bent along with the guide tube.

5. The end tool of claim 2, wherein the blade guide is formed to be movable along the guide tube inside the guide tube.

6. The end tool of a surgical instrument of claim 2, further comprising: a first connecting member having one end coupled to the first jaw and the other end coupled to the first jaw pulley to connect the first jaw and the first jaw pulley; and a second connecting member having one end coupled to the second jaw and the other end coupled to the second jaw pulley to connect the second jaw and the second jaw pulley.

7. The end tool of claim 6, wherein the first connector is fixedly coupled to the first jaw and the first jaw pulley, respectively, such that when the first jaw pulley rotates about the first axis of rotation, the first connector and the first jaw rotate with the first jaw pulley as a unit about the first axis of rotation.

8. A surgical instrument as recited in claim 6, wherein the guide tube extends through the first connector toward the blade side.

9. The end tool of claim 6, wherein one end of the second link is connected to the second jaw pulley such that the second link is rotatable relative to the second jaw pulley and the other end of the second link is connected to the second jaw such that the second jaw is movable relative to the second link.

10. The end tool of a surgical instrument of claim 9, wherein when the second jaw pulley rotates, rotation of the second jaw pulley is transmitted to the second jaw through the second connector connected to the second jaw pulley.

11. The end tool of a surgical instrument of claim 9, further comprising an actuation rotation shaft inserted through the first connector and the second jaw, and wherein the second jaw is formed rotatable about the actuation rotation shaft relative to the first connector.

12. The end tool of claim 11, wherein rotational movement of the second jaw pulley about the first rotational axis is translated into rotational movement of the second jaw about the actuation rotational axis by the second link.

13. The end tool of claim 11, wherein when the second jaw pulley rotates, the second connector connected to the second jaw pulley applies a force to the second jaw such that the second jaw rotates about the actuation axis of rotation.

14. The end tool of claim 11, wherein the first axis of rotation and the actuation axis of rotation are formed substantially parallel.

15. The end tool of claim 11, wherein the first axis of rotation and the actuation axis of rotation are formed to be substantially perpendicular.

16. The end tool of a surgical instrument of claim 2, further comprising an end tool center including first and second jaw pulley couplings formed to face each other and a guide connecting the first and second jaw pulley couplings, the first jaw pulley being disposed adjacent the first jaw pulley coupling of the end tool center and the second jaw pulley being disposed adjacent the second jaw pulley coupling of the end tool center such that at least a portion of the blade assembly is formed between the first and second jaw pulleys.

17. The end tool of claim 16, wherein the guide tube passes through the end tool center to extend to the first jaw or the second jaw side.

18. The end tool of a surgical instrument of claim 1, wherein the deflection action of the first jaw and the second jaw rotating in the same direction is performed when the first jaw pulley and the second jaw pulley rotate in the same direction about the first axis of rotation.

19. The end tool of a surgical instrument of claim 1, wherein the actuation of the rotation of the second jaw relative to the first jaw is performed as the second jaw pulley rotates relative to the first jaw pulley about the first axis of rotation.

20. The end tool of a surgical instrument of claim 1, comprising: a pair of end tool first jaw pitch main pulleys formed at one side of the first jaw pulley and formed to be rotatable about a third rotation axis having a predetermined angle with the first rotation axis; a pair of end tool second jaw pitch main pulleys formed at one side of the second jaw pulley and formed rotatably about the third rotation axis.

21. A surgical instrument according to claim 20, wherein the end tool is formed to be deflectable and rotatable about the first axis of rotation while being pitching rotatable about the third axis of rotation.

22. The surgical instrument end tool of claim 20, further comprising: a first jaw wire, at least a portion of which is wrapped 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.

23. The end tool of claim 1, wherein the blade is movable between a proximal end and a distal end of the end tool by the blade guide wire.

24. An end tool of a surgical instrument, comprising: a first jaw and a second jaw rotatable independently of each other; a first jaw pulley connected with the first jaw and formed rotatably about a first rotation axis; a second jaw pulley connected to the second jaw and formed to be rotatable about an axis substantially identical to or parallel to the first rotation axis; an end tool center having one end inserted through the first rotation shaft and the other end inserted through a third rotation shaft different from the first rotation shaft and accommodating at least a portion of the first and second jaw pulleys therein; a blade, at least a portion of which is housed inside the first jaw or the second jaw, and is formed to be movable between a proximal end portion and a distal end portion of the first jaw or the second jaw; a guide tube extending through the tip tool center toward the blade side; a blade wire having one end connected to the blade to transmit a driving force required for movement of the blade to the blade, and at least a portion thereof is disposed inside the guide tube.

25. The surgical instrument end tool of claim 24, wherein the end tool center comprises: a main body portion; a first jaw pulley coupling portion and a second jaw pulley coupling portion formed extending from the main body portion in one direction and formed to face each other; a first and a second pitch sheave portion formed extending from the main body portion in a direction opposite to the one direction and formed to face each other.

26. The end tool of claim 25, wherein the first jaw pulley is disposed adjacent the first jaw pulley joint of the end tool center and the second jaw pulley is disposed adjacent the second jaw pulley joint of the end tool center such that at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

27. The end tool of claim 25, wherein a deflection slit through which the guide tube can pass is formed between the first jaw pulley coupling and the second jaw pulley coupling.

28. The end tool of a surgical instrument according to claim 27, wherein one side of the deflection slit is formed with a deflection circular arc portion having a predetermined curvature to guide a curved path of the deflection direction of the guide tube.

29. The end of instrument tool of claim 27, wherein the first rotary shaft includes a first counter shaft formed on the first jaw pulley joint side and a second counter shaft formed on the second jaw pulley joint side, the deflection slit being formed between the first counter shaft and the second counter shaft of the first rotary shaft.

30. A surgical instrument end tool according to claim 25, wherein a pitch slit through which the guide tube can pass is formed between the first and second pitch pulley portions.

31. The end tool of a surgical instrument according to claim 30, wherein one side of the pitch slit is formed with a pitch arc portion having a predetermined curvature to guide a curved path of the pitch direction of the guide tube.

32. The end of instrument tool of claim 30, wherein the third rotational axis includes a first secondary axis formed on the first pitch sheave portion side and a second secondary axis formed on the second pitch sheave portion side, the pitch slit being formed between the first secondary axis and the second secondary axis of the third rotational axis.

33. The end of instrument tool of claim 25, wherein a deflection slit through which the guide tube can be passed is formed between the first jaw pulley coupling and the second jaw pulley coupling, and a pitch slit through which the guide tube can be passed is formed between the first pitch pulley portion and the second pitch pulley portion, the deflection slit and the pitch slit being formed to be connected to each other.

34. The surgical instrument end tool of claim 25, further comprising: a first jaw wire, at least a portion of which is wound on the first jaw pulley; and a second jaw wire, at least a portion of which is wound around the second jaw pulley.

35. The surgical instrument end tool of claim 34, further comprising: a first jaw auxiliary pulley and a second jaw auxiliary pulley disposed between the first and second jaw pulleys and the body portion of the end tool center.

36. The end of instrument tool of claim 35, wherein the first jaw wire is located on an internal tangent of the first jaw pulley and the first jaw auxiliary pulley, and the angle of rotation of the first jaw pulley is enlarged by the first jaw auxiliary pulley.

37. The end tool of a surgical instrument according to claim 34, wherein first and second wire guides are formed in regions of the body portion adjacent to the first and second jaw pulleys, and wherein the cross-sections thereof are curved to have a predetermined curvature.

38. The end tool of claim 37, wherein the first jaw wire is located on an internal tangent of the first jaw pulley and the first wire guide, and wherein the angle of rotation of the first jaw pulley is enlarged by the first wire guide.

39. The end tool of claim 24, wherein a first electrode is formed on a surface of the first jaw facing the second jaw and a second electrode is formed on a surface of the second jaw facing the first jaw.

40. The end tool of claim 39, wherein tissue is cauterized when current flows through the first and second electrodes.

41. The surgical instrument of claim 40, wherein the blade guide wire moves when the cauterization is completed, whereby the blade cuts the tissue while moving from the proximal side of the first jaw to the distal side.

42. The end tool of claim 24, wherein at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

43. The end tool of claim 24, wherein the guide tube houses at least a portion of the blade wire therein and is formed to be bendable to some extent.

44. An end tool of a surgical instrument, comprising: a first jaw and a second jaw rotatable independently of each other; a first jaw pulley coupled with the first jaw and formed to be rotatable about a first rotation axis; a first connecting member having one end coupled to the first jaw and the other end coupled to the first jaw pulley to connect the first jaw and the first jaw pulley; a first jaw wire, at least a portion of which is wound on the first jaw pulley; a second jaw pulley coupled with the second jaw and formed to be rotatable about the first rotation axis; a second connecting member having one end coupled to the second jaw and the other end coupled to the second jaw pulley to connect the second jaw and the second jaw pulley; a second jaw wire, at least a portion of which is wound on the second jaw pulley; a pair of end tool first jaw pitch main pulleys formed at one side of the first jaw pulley and formed to be rotatable about a third rotation axis having a predetermined angle with the first rotation axis; a pair of end tool second jaw pitch main pulleys formed at one side of the second jaw pulley and formed to be rotatable about an axis substantially identical to or parallel to the third rotation axis; an end tool center having one end inserted through the first rotation shaft and the other end inserted through the third rotation shaft and having an interior accommodating at least a portion of the first and second jaw pulleys; a guide tube disposed through the center of the end tool and formed to be bendable to some extent; a blade lead, at least a portion of which is inserted through the guide tube; and a blade connected to the blade wire and at least a portion of which is received in the first jaw or the second jaw and moves between a proximal end and a distal end of the first jaw or the second jaw as the blade wire moves.

45. The end tool of claim 44, wherein the first connector is fixedly coupled to the first jaw and the first jaw pulley, respectively, such that when the first jaw pulley rotates about the first axis of rotation, the first connector and the first jaw rotate with the first jaw pulley as a unit about the first axis of rotation.

46. The end tool of claim 45, wherein the first jaw pulley and the first connector are formed as one piece.

47. The end tool of claim 45, wherein one end of the second connector is connected to the second jaw pulley such that the second connector is rotatable relative to the second jaw pulley and the other end of the second connector is connected to the second jaw such that the second jaw is movable relative to the second connector.

48. The end tool of claim 47, further comprising: an actuation rotation shaft, which serves as a central shaft for rotation of the second jaw relative to the first jaw or the first connector.

49. The end tool of claim 48, wherein rotational movement of the second jaw pulley about the first axis of rotation is translated into rotational movement of the second jaw about the actuation axis of rotation by the second connector.

50. The end tool of claim 48, wherein when the second jaw pulley rotates relative to the first jaw pulley, the second connector connected to the second jaw pulley applies a force to the second jaw such that the second jaw rotates about the actuation axis of rotation.

51. The end tool of claim 48, wherein the first axis of rotation is an axis of rotation of the first jaw pulley and the second jaw pulley, and wherein the actuation axis of rotation is an axis of rotation of the second jaw relative to the first jaw.

52. The end tool of claim 48, wherein the first rotational axis and the actuation rotational axis are formed to be spaced apart a distance by the first connector and the second connector.

53. The end tool of claim 48, wherein one end shaft of the second connector is coupled to the second jaw pulley and the other end shaft of the second connector is coupled to the second jaw.

54. The end tool of claim 48, wherein the second connector has a guide pin formed at an end thereof and the first connector and the second jaw have slits formed therein, respectively, such that the guide pin is inserted into the slits of the first connector and the second jaw.

55. The end tool of claim 54, wherein the guide pin of the second connector coupled thereto moves linearly along the slot of the first connector as the second jaw pulley rotates.

56. The end tool of claim 55, wherein the guide pin applies a force to the second jaw while moving along the slot of the first connector such that the second jaw rotates about the actuation axis of rotation.

57. The end tool of claim 54, wherein the second jaw wire comprises a second jaw wire R and a second jaw wire L, wherein either side of the second jaw pulley is formed with a first bond with the second jaw wire R, and wherein the other side of the second jaw pulley is formed with a second bond with the second jaw wire L.

58. The end tool of claim 57, wherein on one side and the other side of a plane passing through the first rotation axis and perpendicular to the third rotation axis, the first coupling portion coupled with the second jaw wire R is formed on the other side opposite to the one side where the second jaw wire R is input to extend a length by which the second jaw wire R is wound around the second jaw pulley to expand a rotation angle of the second jaw pulley, and the second coupling portion coupled with the second jaw wire L is formed on the one side opposite to the other side where the second jaw wire L is input to extend a length by which the second jaw wire L is wound around the second jaw pulley to expand a rotation angle of the second jaw pulley.

59. The end tool of claim 44, wherein the first rotational shaft comprises a first secondary shaft and a second secondary shaft, the guide tube passing between the first secondary shaft and the second secondary shaft of the first rotational shaft.

60. The end tool of claim 44, wherein the third rotational shaft comprises a first secondary shaft and a second secondary shaft, the guide tube passing between the first secondary shaft and the second secondary shaft of the third rotational shaft.

61. The end tool of claim 44, wherein the first jaw pulley and the second jaw pulley rotate about the first axis of rotation in the same direction to perform a deflection action of the end tool.

62. The end tool of claim 44, wherein the second jaw pulley rotates about the first axis of rotation relative to the first jaw pulley to perform an actuation motion of the end tool.

63. An electrocautery surgical instrument, comprising: an end tool including a first jaw and a second jaw formed to be rotatable, respectively, and formed to be rotatable in two or more directions; an operation section that controls rotation of the end tool in the two or more directions; a power transmission part including a first jaw wire connected with the operating part to transmit rotation of the operating part to the first jaw, and a second jaw wire connected with the operating part to transmit rotation of the operating part to the second jaw; and a connecting portion formed extending in a first direction (X-axis), one end portion of which is coupled to the end tool, and the other end portion of which is coupled to the operating portion to connect the operating portion and the end tool, wherein the end tool includes: a first electrode coupled to the first jaw; a second electrode coupled with the second jaw and formed to face the first jaw; a first jaw pulley coupled with the first jaw and formed to be rotatable about a first rotation axis; a second jaw pulley coupled with the second jaw and formed to be rotatable about an axis substantially identical to or parallel to the first rotation axis; a blade assembly including a blade that moves between a proximal end and a distal end of the tip tool and is disposed adjacent to the first jaw pulley or the second jaw pulley; and a blade wire, at least a portion of which is in contact with the blade assembly, to transmit a driving force required to move the blade to the blade.

64. The electrocautery surgical instrument of claim 63, wherein at least a portion of the handle portion is formed extending in the direction of the end tool.

65. The electrocautery surgical instrument of claim 64, wherein when the operating portion is rotated in two or more directions, respectively, the end tool rotates in substantially the same direction as the operating direction of the operating portion.

66. The electrocautery surgical instrument of claim 64, wherein a direction in which the end tool is formed at the one end portion of the connecting portion and a direction in which the operating portion is formed at the other end portion of the connecting portion are the same direction with respect to an extension axis (X-axis) of the connecting portion.

67. The electrocautery surgical instrument as set forth in claim 64, wherein the operating portion is formed extending away from a user grasping the electrocautery surgical instrument.

68. The electrocautery surgical instrument of claim 64, wherein an end of the handle portion is formed toward the tip tool such that a tip of a finger of a user holding the handle portion is directed toward the tip tool.

69. The electrocautery surgical instrument of claim 68, wherein the connection portion comprises a bend portion that is formed to bend one or more times while connecting the end tool and the handle portion.

70. The electrocautery surgical instrument of claim 69, wherein the curved portion is formed substantially semicircular in cross-section and is formed such that a direction of formation of the operating portion at an end of the curved portion is substantially the same as a direction of formation of the end tool at a junction of the connecting portion and the end tool.

71. The electrocautery surgical instrument according to claim 69, wherein at least a portion of the operation portion is formed to be accommodated inside the bent portion in a state where at least any one of the operations of the operation portion is performed.

72. The electrocautery surgical instrument of claim 63, further comprising: an end tool jaw auxiliary pulley formed at one side of the first jaw pulley and the second jaw pulley and formed to be rotatable about a second rotation axis.

73. The electrocautery surgical instrument of claim 72, wherein two branches of the first jaw wire wrapped around the first jaw pulley pass through the end tool jaw auxiliary pulley on one side with respect to an extension axis (X-axis) of the connection and two branches of the second jaw wire wrapped around the second jaw pulley pass through the end tool jaw auxiliary pulley on the other side with respect to the extension axis (X-axis) of the connection.

74. The electrocautery surgical instrument of claim 72, wherein any one of the first jaw wires wrapped around the first jaw pulley is formed to pass between the first jaw pulley and the end tool jaw auxiliary pulley, and any one of the second jaw wires wrapped around the second jaw pulley is formed to pass between the second jaw pulley and the end tool jaw auxiliary pulley.

75. The electrocautery surgical instrument of claim 72, wherein the first jaw wire is located on an inscription line of the first jaw pulley and the end tool jaw auxiliary pulley and the second jaw wire is located on an inscription line of the second jaw pulley and the end tool jaw auxiliary pulley.

76. The end tool of claim 63, wherein the blade assembly includes a guide tube that houses at least a portion of the blade wire therein and is formed to be bendable to some extent.

77. A surgical instrument as recited in claim 76, wherein the blade wire passes through an interior of the guide tube and is connected to the blade.

78. The end tool of claim 76 wherein when the guide tube is bent to a certain extent, the blade wire inside the guide tube is also bent with the guide tube.

79. A surgical instrument as recited in claim 76, wherein the blade guide wire is movable along the guide tube inside the guide tube.

80. The end tool of claim 76, further comprising: a first connecting member having one end coupled to the first jaw and the other end coupled to the first jaw pulley to connect the first jaw and the first jaw pulley; and a second connecting member having one end coupled to the second jaw and the other end coupled to a second jaw pulley to connect the second jaw and the second jaw pulley.

81. The end tool of claim 80, wherein the first connector is fixedly coupled to the first jaw and the first jaw pulley, respectively, such that when the first jaw pulley rotates about the first axis of rotation, the first connector and the first jaw rotate with the first jaw pulley as a unit about the first axis of rotation.

82. The end tool of claim 80, wherein one end of the second connector is connected to a second jaw pulley such that the second connector is rotatable relative to the second jaw pulley and the other end of the second connector is connected to the second jaw such that the second jaw is movable relative to the second connector.

83. The end tool of claim 76, further comprising: an end tool center including first and second jaw pulley couplings formed to face each other, the first jaw pulley being disposed adjacent to the first jaw pulley coupling of the end tool center, and a guide connecting the first and second jaw pulley couplings, the second jaw pulley being disposed adjacent to the second jaw pulley coupling of the end tool center such that at least a portion of the blade assembly is formed between the first and second jaw pulleys.

84. The end tool of claim 83 wherein the guide tube extends through the center of the end tool to the side of the first jaw or the second jaw.

85. The electrocautery surgical instrument of claim 63, wherein tissue is cauterized when current flows through the first electrode and the second electrode.

86. The electrocautery surgical instrument of claim 85, wherein when the cautery is completed, the blade wire moves whereby the blade cuts the tissue while moving between the proximal and distal portions of the first jaw.

87. The electrocautery surgical instrument of claim 63, comprising: a pair of end tool first jaw pitch main pulleys formed at one side of the first jaw pulley and formed to be rotatable about a third rotation axis having a predetermined angle with the first rotation axis; a pair of end tool second jaw pitch main pulleys formed at one side of the second jaw pulley and formed to be rotatable about an axis substantially identical to or parallel to the third rotation axis.

88. The electrocautery surgical instrument of claim 87, wherein the end tool is configured to be yaw rotatable about the first axis of rotation while being pitch rotatable about the third axis of rotation.

89. A surgical method using an electrocautery surgical instrument, comprising the steps of: placing tissue between a first jaw and a second jaw of an end tool of an electrocautery surgical instrument; rotating a second jaw pulley relative to a first jaw pulley about a first axis of rotation, thereby closing the second jaw relative to the first jaw, wherein the second jaw pulley is connected to the second jaw and the first jaw pulley is connected to the first jaw; cauterizing the tissue between the first jaw and the second jaw by passing an electrical current through a first electrode connected to the first jaw and a second electrode connected to the second jaw; the tissue is cut while a blade of a blade assembly, at least a portion of which is disposed between the first jaw pulley and the second jaw pulley, is moved from a proximal end portion to a distal end portion side of the first jaw by a blade guide wire.

90. The surgical method of using an electrocautery surgical instrument of claim 89, wherein the blade assembly further comprises a guide tube housing at least a portion of the blade wire therein and formed to be bendable to a degree, the step of cutting tissue comprising: the blade guide wire inside the guide tube moves from the proximal end portion to the distal end portion side of the first jaw; the blade wire-bonded to the blade moves from the proximal end portion to the distal end portion side of the first jaw.

91. A surgical method of using an electrocautery surgical instrument as set forth in claim 90 wherein the blade wire is passed through the interior of the guide tube and connected to the blade.

92. A surgical method of using an electrocautery instrument as set forth in claim 90, wherein when the guide tube is bent to some extent, the blade wires inside the guide tube are also bent along with the guide tube.

93. A surgical method of using an electrocautery surgical instrument as defined in claim 90, wherein in the step of cutting tissue, the blade wire is moved along the guide tube through an interior of the guide tube.

94. The surgical method of using an electrocautery surgical instrument of claim 89, further comprising: a first connecting member having one end coupled to the first jaw and the other end coupled to the first jaw pulley to connect the first jaw and the first jaw pulley; and a second connecting member having one end coupled to the second jaw and the other end coupled to the second jaw pulley to connect the second jaw and the second jaw pulley.

95. A surgical method of using an electrocautery surgical instrument as defined in claim 89, wherein the first and second jaw pulleys are formed at a distance apart and the blade assembly is formed between the first and second jaw pulleys.

96. The surgical method of using an electrocautery surgical instrument of claim 89, wherein the end tool further comprises: a pair of end tool first jaw pitch main pulleys formed at one side of the first jaw pulley and formed to be rotatable about a third rotation axis having a predetermined angle with the first rotation axis; a pair of end tool second jaw pitch main pulleys formed at one side of the second jaw pulley and formed to be rotatable about an axis substantially identical to or parallel to the third rotation axis.

97. A surgical method of using an electrocautery instrument as defined in claim 96, wherein the end tool is formed to be deflectable and rotatable about the first axis of rotation while being pitching rotatable about the third axis of rotation.