CN117915849A

CN117915849A - End tool for surgical instrument and electrocautery surgical instrument provided with same

Info

Publication number: CN117915849A
Application number: CN202380013477.0A
Authority: CN
Inventors: 李政周; 金熹辰; 张东圭
Original assignee: Livsmed Inc
Current assignee: Livsmed Inc
Priority date: 2022-05-23
Filing date: 2023-05-23
Publication date: 2024-04-19

Abstract

The present invention relates to an electrocautery surgical instrument, and more particularly, to an electrocautery surgical instrument that is mounted on a robot arm or manually operable for laparoscopic surgery or various kinds of surgery.

Description

End tool for surgical instrument and electrocautery surgical instrument provided with same

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 which can be mounted on a robot arm or can be manually operated for laparoscopic surgery or various other operations, and has an end tool which can be rotated in two or more directions and whose action intuitively coincides with the action of an operation portion, and an electrocautery surgical instrument having the same.

Background

In many cases, surgery requires cutting and bonding of body tissue, including organs, muscle tissue, connective tissue, and blood vessels. For centuries, sharp blades and sutures have been used for cutting and bonding. However, during surgery, the cutting of body tissue, particularly tissue with a relatively high degree of vascularization, can lead to bleeding. Accordingly, there is a need for a surgical instrument and method for reducing or minimizing bleeding during surgery.

Recently, electrosurgical instruments have been available that use electrical energy to perform specific surgical procedures. For example, among surgical instruments such as graspers (grasper), scissors, forceps, blades, needles, and hooks, electrosurgical instruments have been developed that include one or more electrodes that supply 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, cutting and hemostasis may also be performed simultaneously.

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

The above background art is technical information possessed by the inventor for deriving the present invention or obtained in the derivation process of the present invention, and is not necessarily known to be disclosed to the public before submitting the present invention.

Disclosure of Invention

Technical problem

The object of the present invention is to provide an electrocautery surgical instrument which can be mounted on a robotic arm or can be operated manually for laparoscopic surgery or various other procedures and which has an end tool which can be rotated in two or more directions and whose action intuitively coincides with the action of the operating portion.

Technical proposal

(Second embodiment of the instrument for electrocautery-first jaw and second jaw form an X-shaped structure)

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

Referring to fig. 41, an electrocautery surgical instrument 10 according to a second embodiment of the present invention includes an end tool 700, an operation portion 200, a power transmission portion 300, and a connection portion 400.

Since the configuration of the end tool 700 is different from that of the electrocautery surgical instrument 10 according to the first embodiment, the configuration of the end tool 700 will be described in detail below.

An end tool 700 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 the end tool 700 described above, a pair of jaws (jaw) 703 shown in fig. 41 may be used to perform a clamping (grip) action.

However, the spirit of the present invention is not limited thereto, and various surgical devices may be used as the end tool 700. For example, a configuration such as a single-arm cautery or the like may also be used as the end tool 700. The end tool 700 as described above is connected to the operation unit 200 through the power transmission unit 300, and receives the driving force of the operation unit 200 through the power transmission unit 300, thereby performing operations required for surgery, such as clamping, cutting, and suturing operations.

Here, the end tool 700 of the electrocautery surgical instrument 10 according to the second embodiment of the present invention is formed rotatable in one or more directions, for example, the end tool 700 may be formed to perform a yaw motion and an actuation motion around the Z-axis of fig. 41 while performing a pitch motion around the Y-axis of fig. 41.

Referring to fig. 42 to 47, 55 and 56, the end tool 700 of the electrocautery instrument 10 according to the second embodiment of the present invention has formed thereon a jaw rotation shaft 701e, a tube through hole 701f, a jaw pulley coupling hole 701d and a movable coupling hole 701c formed on a first jaw 701, and a second jaw 702 facing and connectable to the first jaw 701 has formed thereon a shaft penetrating portion 702e, a movable coupling hole 702c, a hole 702d as a jaw pulley coupling hole through which the rotation shaft 701e as a jaw rotation shaft formed on the first jaw 701 passes, except for this, the arrangement and effect of the first electrode 751, the second electrode 752, the pitch center 750, the end tool center 760, the plurality of rotation shafts (741, 743, 744) and the like are the same.

Fig. 48 is a perspective view showing the end tool center of the electrocautery instrument of fig. 41. Fig. 49 and 50 are cut-away perspective views of the tip tool center of fig. 48. Fig. 51 and 52 are perspective views illustrating the center of the end tool of fig. 48. Fig. 53 is a side view showing the end tool center and guide tube of fig. 48. Fig. 54 is a plan view showing the end tool center and guide tube of fig. 48.

Referring to fig. 48 to 54, an end tool center 760 provided on the end tool 700 of the electrocautery surgical instrument 10 of fig. 41 may be formed with a yaw arc 767 and a pitch arc 766 having a predetermined radius of curvature and a curved shape on an inner circumferential surface of the end tool center 760 for guiding a gentle curved movement of the tube 670.

Further, a yaw slit 765 may be formed on a plane perpendicular to the first rotation axis 741 to enable the guide tube 770 to stably pass through the end tool center 760 to move, wherein the guide tube 770 passes through the end tool center 760 and guides the moving path of the blade 775 and the blade wire 307 connected to the blade 775.

Further, a pitch slit 764 as a space is also formed between the first pitch sheave portion 763a and the second pitch sheave portion 763b to allow the guide pipe 670 to pass, and thus, the guide pipe 770 can be stably moved in the pitch slit 764.

Referring to fig. 51, the yaw rotation shafts 741 may be formed in one and the same as the yaw slit 765 formed on the end tool center 760 and have one pair, and the guide tube 670 may be moved by a space formed between the one and the two yaw rotation shafts 741.

Referring to fig. 51 to 54, since the end tool center 760 of the electrocautery instrument according to the second embodiment is the same as the end tool center 660 of the electrocautery instrument of the first embodiment, the contents within the scope of repetition will not be described in detail.

Fig. 55 is a perspective view showing a first jaw of an end tool of the electrocautery instrument of fig. 41. Fig. 56 is a perspective view showing a second jaw of an end tool of the electrocautery instrument of fig. 41.

Referring to fig. 55, the first jaw 701 of the end tool 700 of the electrocautery instrument of fig. 41 may include a jaw rotation shaft 701e formed with a tube through hole 701f and protruding, a movable coupling hole 701c, and a jaw pulley coupling hole 701d.

The first jaw 701 is formed in an elongated rod shape as a whole, and a path through which the blade 775 can move is formed on a distal end side (left side in fig. 55) thereof, and a pulley 711 as a first jaw pulley can be coupled on a proximal end side (right side in fig. 55) thereof so as to be rotatable about the rotation axis 741.

Referring to fig. 55, a movable coupling hole 701c and a jaw pulley coupling hole 701d may be formed at a proximal end side of the first jaw 701. Here, the movable coupling hole 701c is formed to have a predetermined curvature, and may be formed substantially in an elliptical shape.

The shaft coupling part 711a formed on the first jaw pulley 711 may be inserted into the movable coupling hole 701c formed on the first jaw 701. Here, the short radius of the active coupling hole 701c may be formed to be substantially equal to or slightly larger than the radius of the shaft coupling part 711 a.

Referring to fig. 55, the long radius of the movable coupling hole 701c may be formed to be larger than the radius of the shaft coupling part 711 a. Accordingly, in a state where the shaft coupling portion 711a of the pulley 711 is inserted into the movable coupling hole 701c of the first jaw 701, a path may be formed such that the shaft coupling portion 711a moves to some extent inside the movable coupling hole 701 c. In this regard, it will be described in more detail below.

Referring to fig. 55, a jaw pulley coupling hole 701d formed on the first jaw 701 is formed in a cylindrical hole shape, and a jaw coupling portion 711b of a pulley 711 may be inserted into the jaw pulley coupling hole 701 d.

Here, the radius of the jaw pulley coupling hole 101d may be formed to be substantially equal to or relatively larger than the radius of the jaw coupling 711 b. Accordingly, the jaw coupling portion 711b of the pulley 711 may be formed to be rotatably coupled to the jaw pulley coupling hole 701d of the first jaw 701. As will be described in more detail later.

Referring to fig. 56, a second jaw 702 disposed facing the first jaw 701 may include a shaft penetration portion 702e, a movable coupling hole 702c, and a jaw pulley coupling hole 702d. The second jaw 702 may be formed in an elongated rod shape as a whole, with a shaft penetration portion 702e formed at a distal end portion thereof and a jaw pulley coupling hole 702d formed at a proximal end portion thereof.

Referring to fig. 59, the movable coupling hole 702c formed on the second jaw 702 is formed to have a predetermined curvature, and may be formed generally in an elliptical shape. The shaft coupling portion 721a of the pulley 721 may be inserted into the movable coupling hole 702 c. Here, the short radius of the movable coupling hole 702c may be formed to be substantially equal to or slightly larger than the radius of the shaft coupling part 721 a.

In addition, the long radius of the movable coupling hole 702c may be formed to be relatively larger than the radius of the shaft coupling part 721 a. Therefore, in a state where the shaft coupling portion 721a of the pulley 721 is inserted into the movable coupling hole 702c of the second jaw 702, the shaft coupling portion 721a is formed to be movable to some extent inside the movable coupling hole 702 c. As will be described in more detail later.

On the one hand, the jaw pulley coupling hole 702d is formed in a cylindrical hole shape, and the jaw coupling portion 721b of the pulley 721 can be inserted into the jaw pulley coupling hole 702d. Here, the radius of the jaw pulley coupling hole 702d may be formed to be substantially equal to or slightly larger than the radius of the jaw coupling 721 b. Accordingly, the jaw coupling portion 721b of the pulley 721 may be formed to be rotatably coupled to the jaw pulley coupling hole 702d of the second jaw 702.

In one aspect, the shaft penetration portion 702e may be formed opposite to the distal end portion side of the second jaw 702 as compared to the movable coupling hole 702c and the jaw pulley coupling hole 702 d.

Referring to fig. 55 and 56, a shaft penetration portion 702e formed on the second jaw 702 is formed in a hole shape, and a jaw rotation shaft 701e formed on the first jaw 701 may be inserted through the shaft penetration portion 702e.

Referring to fig. 57, a pulley 711 as a first jaw pulley may include a shaft coupling portion 711a and a jaw coupling portion 711b. The pulley 711 is formed in a rotatable disc shape as a whole, and the shaft engaging portion 711a and the jaw engaging portion 711b may be formed protruding to some extent on one surface (lower surface of fig. 57) of the pulley 711.

As described above, the shaft coupling portion 711a of the pulley 711 can be inserted into the movable coupling hole 701c of the first jaw 701, and the jaw coupling portion 711b of the pulley 711 can be inserted into the jaw pulley coupling hole 701d of the first jaw 701. The pulley 711 may be formed to be rotatable about a rotation shaft 741 which is a rotation shaft of the end tool jaw pulley.

In one aspect, the pulley 721 as the second jaw pulley may also include a shaft coupling 721a and a jaw coupling 721b.

The pulley 721 as the second jaw pulley is integrally formed in a rotatable disc shape, and the shaft coupling portion 721a and the jaw coupling portion 721b may be formed to protrude to some extent on one surface of the pulley 721. As described above, the shaft coupling portion 712a of the pulley 712 can be inserted into the movable coupling hole 702c of the second jaw 702, and the jaw coupling portion 712b of the pulley 712 can be inserted into the jaw pulley coupling hole 702d of the second jaw 702. The pulley 721 may be formed to be rotatable about a rotation shaft 741 which is a rotation shaft of the end tool jaw pulley.

The bonding relationships between the respective constituent elements described above are as follows.

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

A rotation shaft 701e as a jaw rotation shaft is inserted through the shaft penetration portion 702e of the second jaw 702.

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

At this time, the jaw pulley coupling hole 701d of the first jaw 701 is rotatably coupled with the jaw coupling portion 711b of the pulley 711, and the movable coupling hole 701c of the first jaw 701 is movably coupled with the shaft coupling portion 711a of the pulley 711.

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

At this time, the jaw pulley coupling hole 702d of the second jaw 702 is rotatably coupled with the jaw coupling portion 721b of the pulley 721, and the movable coupling hole 702c of the second jaw 702 is movably coupled with the shaft coupling portion 721a of the pulley 721.

Here, the pulley 711 and the pulley 721 are rotated about a rotation shaft 741 which is a rotation shaft of the end tool jaw pulley. The first jaw 701 and the second jaw 702 rotate about a rotation shaft 701e as a jaw rotation shaft. That is, the rotation axis of the pulley 711 and the rotation axis of the first jaw 701 are different from each other. Similarly, the rotation axis of the pulley 721 and the rotation axis of the second jaw 702 are different from each other.

That is, although the rotation angle of the first jaw 701 is limited to some extent by the movable coupling hole 701c, it is rotated substantially about the rotation axis 701e as the jaw rotation axis. Similarly, although the rotation angle of the second jaw 702 is limited to some extent by the movable coupling hole 702c, it is rotated substantially about the rotation axis 701e as the jaw rotation axis.

The increase in the clamping force (grip force) caused by the bonding relationship between the above-described constituent elements will be described.

Fig. 58 is a plan view illustrating an opening and closing operation of a first jaw of the end tool of the electrocautery instrument of fig. 41. Fig. 59 is a plan view showing an opening and closing operation of a second jaw of the end tool of the electrocautery instrument of fig. 41. Fig. 60 is a plan view showing opening and closing operations of the first jaw and the second jaw of the distal end tool of the electrocautery instrument of fig. 41.

Referring to fig. 58 to 60, one feature of the electrocautery surgical instrument 10 according to the second embodiment is that the combined structure of the first and second jaws 701 and 702 forms an X-shaped structure, and when the first and second jaws 701 and 702 are rotated in a direction approaching each other (i.e., when the first and second jaws 701 and 702 are closed (close), a clamping force (grip force) in a direction in which the first and second jaws 701 and 702 are closed (close) further increases. A more detailed description of this is as follows.

As described above, in the operation of opening and closing the first jaw 701 and the second jaw 702, there are two shafts as the rotation centers thereof.

That is, the first jaw 701 and the second jaw 702 are opened and closed about two axes of the rotation axis 741 and the rotation axis 701 e. At this time, the rotation shaft 701e becomes the rotation centers of the first jaw 701 and the second jaw 702, and the rotation shaft 741 becomes the rotation centers of the pulley 711 and the pulley 721.

At this time, the rotation shaft 741 is a shaft whose position is relatively fixed, and the rotation shaft 701e is a shaft whose position is relatively linearly moved. In other words, in a state where the position of the rotation shaft 741 is fixed, when the pulley 711 and the pulley 721 are rotated, the rotation shaft 701e, which is the rotation shaft of the first jaw 701 and the second jaw 702, is moved back and forth while opening (open)/closing (close) the first jaw 701 and the second jaw 702. A more detailed description of this is as follows.

R1 of fig. 58 is a distance from the jaw engaging portion 711b of the pulley 711 to the shaft engaging portion 711a, and the length thereof is constant. Therefore, the distance from the rotation shaft 741 inserted into the shaft coupling portion 711a to the jaw coupling portion 711b is also constant as r1.

On the one hand, r2 in fig. 58 is a distance from the jaw pulley coupling hole 701d of the first jaw 701 to the rotation shaft 701e as a jaw rotation shaft, and the length thereof is constant. Therefore, the distance from the jaw coupling portion 711b of the pulley 711 inserted into the jaw pulley coupling hole 701d to the jaw rotation shaft 701e is also constant as r2.

Referring to fig. 58, the lengths of r1 and r2 remain constant. Therefore, when the pulley 711 and the pulley 721 are rotated about the rotation shaft 741 in the arrow A1 in fig. 58 and the arrow A2 in fig. 59, respectively, to perform a closing (close) action, while the angle between r1 and r2 is changed in a state where the lengths of r1 and r2 remain constant, the first jaw 701 and the second jaw 702 are rotated about the rotation shaft 701e, and at this time, the rotation shaft 701e itself is also linearly moved (i.e., moved forward/backward) with the arrow C1 in fig. 58 and the arrow C2 in fig. 59.

That is, assuming that the position of the rotation shaft 741, which is the rotation shaft of the end tool jaw pulley, is fixed, at this time, when the first jaw 701 and the second jaw 702 are closed (close), the rotation shaft 701e, which is the rotation shaft of the jaws, is forced in the forward moving direction (i.e., the distal end direction), and therefore, the clamping force (clip force) in the direction in which the first jaw 701 and the second jaw 702 are closed (close) is further increased.

This is described from another angle, that is, since the lengths of r1 and r2 remain constant when the second jaw 702 rotates about the jaw rotation axis 701e, the angle between r1 and r2 changes in a state where the lengths of r1 and r2 remain constant when the pulley 721 rotates about the rotation axis 741. That is, the angle between r1 and r2 in the closed (close) state of the second jaw 702 as shown in fig. 59 (b) is relatively further increased than the angle between r1 and r2 in the open (open) state of the second jaw 702 as shown in fig. 59 (a).

Accordingly, when the second jaw 702 is rotated from the open state to the closed state, the angle between r1 and r2 is changed, and at the same time, the jaw rotation shaft 701e is forced in the forward moving direction, wherein the jaw rotation shaft 701e passes through the shaft penetration portion 702e formed on the second jaw 702.

At this time, since the rotation shaft 741 is a shaft whose position is relatively fixed, the jaw rotation shaft 701e moves forward in the arrow C1 in fig. 58 and the arrow C2 in fig. 59, and the gripping force (grip force) in the direction in which the second jaw 702 is closed (close) further increases.

Describing this from another angle, when the pulley 711 and the pulley 721 rotate about the rotation axis 741 that is a shaft whose relative position is fixed, the angle between r1 and r2 changes in a state where the distance between r1 and r2 is constant. In addition, when the angle is changed as described above, the first jaw 701 and the second jaw 702 push or pull the jaw rotation shaft 701e, and thus, the rotation shaft 701e moves forward or backward.

At this time, when the first jaw 701 and the second jaw 702 are rotated in the closing (close) direction, the grip force (grip force) further increases while the rotation shaft 701e is moved forward in the arrow C1 in fig. 58 and the arrow C2 in fig. 59.

Conversely, when the first jaw 701 and the second jaw 702 are rotated in the opening (open) direction, the rotation shaft 701e moves rearward in the opposite direction of the arrow C1 in fig. 58 and the arrow C2 in fig. 59.

According to the configuration described above, when the first jaw 701 and the second jaw 702 are closed (close), the clamping force (grip force) becomes stronger, so that an effect that the operator can perform the actuation action strongly even with a small force can be obtained.

That is, as shown in fig. 60, when the first jaw 701 and the second jaw 702 having the X-shaped structure relatively rotate about the first rotation shaft 741 as a fixed shaft, the rotation shaft 701e as a jaw rotation shaft moves forward toward the distal end portion side of the end tool 700, thereby having an effect of increasing the gripping force.

Fig. 61 and 62 are plan views showing opening and closing operations of the first jaw 701 and the second jaw 702 in accordance with an actuation operation of the end tool 700 of the electrocautery surgical instrument of fig. 41.

Referring to fig. 61 and 62, as the first jaw 701 and the second jaw 702 are connected in an X-shaped structure, the pulley 711 as a first jaw pulley and the pulley 721 as a second jaw pulley rotate about the fixed rotation shaft 741, and the first jaw 701 and the second jaw 702 can perform an actuation action while rotating relatively.

In the end tool 700 of the electrocautery instrument 10 according to the second embodiment of the present invention, as the first jaw 701 and the second jaw 702 are relatively rotated, the jaw rotation shaft 701e can be moved forward/backward while, in particular, the gripping force at the time of forward movement is increased.

Referring to fig. 62, since the pulley 711 and the pulley 721 rotate the first rotation shaft 741 as the rotation center shaft in opposite directions, the first jaw 701 and the second jaw 702 respectively connected to the pulley 711 and the pulley 721 are separated from each other while rotating in opposite directions to each other, and the end tool 700 may have an opened state.

Referring to fig. 61 to 65, it can be described that the cutting action of fig. 63 to 65 is performed in a state where the first jaw 701 and the second jaw 702 are closed (close) as shown in fig. 61, so that the tissue between the first jaw 701 and the second jaw 702 is cut.

Here, the first position shown in fig. 63 may be defined as a state in which the blade 775 is maximally introduced to the proximal end portion 705 side of the tip tool. Or may be defined as a state in which the blade 775 is located at a side adjacent to the pulley 711/712.

In one aspect, the third position shown in fig. 65 may be defined as a state in which the blade 775 is maximally pulled out toward the distal end 704 side of the end tool 700. Alternatively, the blade 775 may be defined as being positioned at a position spaced most apart from the pulley 711/712.

First, as shown in fig. 62, in a state where the first jaw 701 and the second jaw 702 are opened, a tissue to be cut is placed between the first jaw 701 and the second jaw 702, and then an actuation motion is performed to close the first jaw 701 and the second jaw 702 (as shown in fig. 61).

Then, as shown in fig. 63, in a state where the blade wire 307 and the blade 775 are located at the first position, by applying electric currents of different polarities to the first electrode 751 and the second electrode 752, tissue located between the first jaw 701 and the second jaw 702 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. 64 and the arrow A2 direction in fig. 65, the blade 775 combined with the blade wire 307 is sequentially moved from the first position of the proximal end portion 705 of the tip tool to the third position of the distal end portion 704 of the tip tool, while sequentially reaching the positions of fig. 64 and 65.

As described above, the blade 775 cuts tissue located between the first jaw 701 and the second jaw 702 while moving in the X-axis direction.

However, the linear motion of the blade 775 herein does not mean a complete straight line, but may be understood as a motion to the extent that the tissue is cut while the linear motion is performed, 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 in a certain section, or the like.

On the one hand, when the blade wire 307 is pulled in the opposite direction in this state, the blade 775 combined with the blade wire 307 will also return to the first position.

According to the present invention as described above, the effect of cauterizing and cutting can be obtained even with a multi-joint/multi-degree-of-freedom surgical instrument capable of performing pitch/yaw/actuation motions.

Referring to fig. 66 and 67, the end tool 700 of the electrocautery surgical instrument 10 of fig. 41 is shown in a yaw rotated +90° state, and is shown in a process of opening and closing the end tool.

Referring to fig. 66, the pulley 711 and the pulley 721 facing each other with the pulley 711 may be rotated about the first rotation shaft 741 by the wire power transmission portion 300 on the operation portion 200. When the pulley 711 and the pulley 721 are rotated in opposite directions as shown in fig. 66, the first jaw 701 and the second jaw 702 coupled to the pulley 711 and the pulley 721 are relatively rotated in directions approaching each other while performing an actuation action, and the first jaw 701 and the second jaw 702 can be brought into a closed state as shown in fig. 67.

Fig. 66 and 67 are views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 41 is rotated by-90 ° in yaw.

Referring to fig. 66 and 67, the first rotation shaft 741 may be yaw-rotated by-90 ° as a rotation center shaft, and when the pulley 711 and the pulley 721 are rotated in mutually different directions, the first jaw 701 and the second jaw 702 respectively connected to the pulley 711 and the pulley 721 may perform an actuation motion in directions approaching or separating from each other.

Referring to fig. 66 to 69, the blade assembly, in particular, the guide tube 770, whose other end opposite to the one end to which the connection part 400 is connected to the end tool 700, and whose length may be kept constant.

When the tip tool 700, specifically, when the first jaw 701 and the second jaw 702 rotate about the first rotation axis 741 as a rotation center axis, the guide tube 770 also has a predetermined radius of curvature and can be gently curved, and can provide a stable moving path for the blade wire 307 that can move between the distal end portion 704 and the proximal end portion 705 of the tip tool 700.

Fig. 70 and 71 are diagrams showing the path of the guide tube 770 and the movement path of the blade 775 during the cutting operation in the state in which the end tool 700 of the electrocautery surgical instrument of fig. 41 is yaw-rotated +90°.

Referring to fig. 70 and 71, the end tool 700 of the electrocautery surgical instrument 10 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), i.e., the first jaw 701 and the second jaw 702 are yaw-rotated +90°.

Specifically, the blade wire 307 comes out of the inside of the guide tube 770, and the blade 775 connected to the blade wire 307 moves in the a direction from the proximal end portion 705 of the end tool 700 to the distal end portion 704 side while performing the cutting action.

Fig. 72 and 73 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 41 in a state of being rotated-90 ° in pitch. Fig. 74 and 75 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 41 in a state of being rotated up to +90°. Fig. 76 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 41 is rotated-90 ° in pitch. Fig. 77 and 78 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the tip tool of the electrocautery surgical instrument of fig. 41 is rotated-90 ° in pitch. Fig. 79 is a perspective view showing a state in which the electrocautery instrument of fig. 41 performs pitch rotation and yaw rotation. Fig. 80 to 82 are views showing a state in which a cutting operation is performed in a state in which the distal end tool of the electrocautery surgical instrument of fig. 41 is rotated by-90 ° in pitch while being rotated by +90° in yaw.

Fig. 74 and 75 are views showing the process of opening and closing operations in a state where the distal end tool 700 of the electrocautery surgical instrument of fig. 41 is rotated up to +90°. Fig. 76 is a view showing a path of the guide tube 770 in a state where the end tool 700 of the electrocautery instrument of fig. 41 is rotated-90 ° in pitch. Fig. 77 and 78 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the tip tool of the electrocautery surgical instrument of fig. 41 is rotated-90 ° in pitch.

Referring to fig. 72 to 78, the end tool 700 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 where the jaws (jaw), i.e., the first jaw 701 and the second jaw 702 are rotated in pitch by-90 °, +90°.

On the other hand, fig. 79 is a view showing a state in which the jaw (jaw) is rotated in pitch by-90 ° while being rotated in yaw by +90°, and fig. 80 to 82 are views showing a state in which the cutting operation is performed in a state in which the end tool 700 of the electrocautery instrument of fig. 41 is rotated in pitch by-90 ° while being rotated in yaw by +90°.

Referring to fig. 79 to 82, the end tool 700 of the electrocautery surgical instrument 10 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), i.e., the first jaw 701 and the second jaw 702 are rotated in pitch by-90 ° while being rotated in yaw by +90°.

(Modification of the second embodiment-providing an auxiliary pulley at the center of the end tool)

Hereinafter, an end tool 700 of a surgical instrument according to a modification of the second embodiment of the present invention will be described. Here, the arrangement of the end tool center 760', the arrangement of the auxiliary pulley 712, and the auxiliary pulley 722 of the surgical instrument 700 according to the modification of the second embodiment of the present invention are characteristically different from those of the surgical instrument according to the second embodiment of the present invention described above. As described above, a configuration different from the second embodiment will be described in detail later.

Fig. 83 to 85 are diagrams showing an end tool of an electrocautery surgical instrument according to a modification of the second embodiment of the present invention.

Referring to fig. 83 to 85, an end tool 700 of a modification of the second embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping (clip) action, that is, a first jaw 701 and a second jaw 702, and herein, the first jaw 701 and the second jaw 702 or constituent elements that include the first jaw 701 and the second jaw 702 may be referred to as jaws (jaw) 703, respectively.

The end tool 700 according to a modification of the second embodiment may include a pulley 711, a pulley 712, a pulley 713, a pulley 714, a pulley 715, and a pulley 716 in connection with the rotational movement of the first jaw 701. Further, pulleys 721, 722, 723, 724, 725, and 726 associated with the rotational movement of second jaw 702 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 end tool, or may be formed in various sizes suitable for the arrangement of the end tool.

Compared to the end tool 700 according to the second embodiment of the present invention shown in fig. 43, the end tool 700 according to the modification of the second embodiment of the present invention may further include a pulley 712 and a pulley 722.

Referring to fig. 84 and 85, pulley 712 serves as an end tool first jaw auxiliary pulley and pulley 722 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 pulley 712 and the pulley 722 as the end tool jaw auxiliary pulley may be additionally provided at one side of the pulley 711 and the pulley 721, in other words, the pulley 712 as the auxiliary pulley may be disposed between the pulley 711 and the pulley 713/714. In addition, a pulley 722 as an auxiliary pulley may be provided between the pulley 721 and the pulley 723/724.

The pulley 712 and the pulley 722 may be formed to be rotatable independently of each other about the second rotation shaft 742.

The pulleys 712 and 722 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, to change the setting paths of the wire 305 and the wire 302 to some extent, thereby serving to enlarge the respective rotation angles of the first jaw 701 and the second jaw 702.

That is, when the auxiliary pulleys are not provided, the first jaw 701 and the second jaw 702 can be rotated only to right angles, but in the modification of the second embodiment of the present invention, by additionally having the pulleys 712 and 722 as the auxiliary pulleys, an effect of enlarging the maximum rotation angle by a certain angle can be obtained.

This allows the two jaws of the end tool 700 to be rotated 90 degrees together in a clockwise or counter-clockwise yaw direction to perform the action that requires the two jaws to be opened for actuation action.

In other words, the following features are provided: the range of yaw rotation that can be actuated can be expanded by the pulleys 712 and 722. A more detailed description of this is as follows.

When the auxiliary pulley is not provided, since the first jaw wire 305 is fixedly coupled to the end tool first jaw pulley 711 and the second jaw wire 302 is fixedly coupled to the end tool second jaw pulley 721, the end tool first jaw pulley 711 and the end tool second jaw pulley 721 may be rotated only up to 90 ° respectively.

In this case, when the first jaw 701 and the second jaw 702 are actuated in a state of being located at a line of 90 °, the first jaw 701 may be opened, but the second jaw 702 cannot be rotated more than 90 °. Therefore, the first jaw 701 and the second jaw 702 have a problem that the actuation operation cannot be smoothly performed in a state where the yaw operation is performed at a certain angle or more.

In order to solve the above-described problems, the electrocautery instrument 10 of the present invention is additionally provided with pulleys 712 and 722 as auxiliary pulleys on one side of the pulleys 711 and 721. As described above, by providing the pulley 712 and the pulley 722, 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, thereby changing the tangential directions of the wire 305 and the wire 302, so that the fastener 324 joining the wire 302 and the pulley 721 can be additionally rotated by a certain angle.

That is, the fastener 326, which is the junction of the wire 302 and the pulley 721, may be rotated until it is located on the inner common tangent of the pulley 721 and the pulley 722. Similarly, the fastener 323, which is the joint of the wire 305 and the pulley 711, can be rotated until it is located on the inner common tangent line of the pulley 711 and the pulley 712, so that the rotation range can be enlarged.

In other words, the wire 301 and the wire 305 are disposed on either side by a pulley 712 as an auxiliary pulley, 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 two branches of the first jaw wire wound around the pulley 712. Meanwhile, the wire 302 and the wire 306 are disposed on the other side by a pulley 722, 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 two branches of the second jaw wire wound around the pulley 721.

In other words, the pulleys 713 and 714 are disposed on either side with respect to a plane perpendicular to the Y axis and passing through the X axis, and the pulleys 723 and 724 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 located on the inscribed line of the pulley 711 and the pulley 712, and the rotation angle of the pulley 711 is enlarged by the pulley 712. Further, the wire 302 is located on an inscribed line of the pulley 721 and the pulley 722, and the rotation angle of the pulley 721 is enlarged by the pulley 722.

According to the present invention as described above, as the rotation radius of the first jaw 701 and the second jaw 702 is widened, an effect of widening the range of the yaw motion that can perform the normal opening and closing actuation motion can be obtained.

Referring to fig. 38, a first rotation shaft 741 and a second rotation shaft 742 may be inserted through an end tool center 760' according to a modification of the second embodiment of the present invention. Unlike the end tool center 760 according to the second embodiment of the present invention, the first and second wire guides are not formed on the respective surfaces of the first and second jaw pulley coupling parts 762a and 762b facing each other, and the pulleys 712 and 722 may be additionally provided to serve as auxiliary pulleys, wherein the pulleys 712 and 722 are separately configured as separate members from the end tool center 760 'and may be shaft-coupled with the second rotation shaft 742 inserted through the end tool center 760'.

The second rotation shaft 742 inserted into the end tool center 760' may include two shafts: a first auxiliary shaft and a second auxiliary shaft which are arranged to face each other and are spaced apart from each other by a certain distance. Since the second rotation shaft 742 is divided into two and disposed at a distance from each other, the guide tube 770 can pass through the end tool center 760' and the pitch center 750 therebetween.

Referring to fig. 83, a first rotation shaft 741, a second rotation shaft 742, a third rotation shaft 743, and a fourth rotation shaft 744 are sequentially provided from the distal end portion (DISTAL END) 704 toward the proximal end portion (proximal end) 705 of the end tool 700. Accordingly, the first rotation axis 741 may be referred to as a first pin, the second rotation axis 742 as a second pin, the third rotation axis 743 as a third pin, and the fourth rotation axis 744 as a fourth pin, in this order from the distal end 704.

A modification of the second embodiment of the present invention is identical to the end tool 700 according to the second embodiment except that the pulleys 721 and 722 are used as auxiliary pulleys, in which the pulleys 721 and 722 are not formed as one body with the body portion 761 at the end tool center 760 'but are provided as separate members and are shaft-coupled to the end tool center 760' through the second rotation shaft 742, and thus, the contents within the repetition range will not be described in detail.

(Third embodiment of instrument for electrocautery)

Fig. 86 is a perspective view showing an electrocautery instrument according to a third embodiment of the present invention. Fig. 87 to 92 are diagrams showing an end tool of the electrocautery surgical instrument of fig. 86.

Referring to fig. 86, an electrocautery surgical instrument 10 according to a third embodiment of the present invention includes an end tool 800, an operation portion 200, a power transmission portion 300, and a connection portion 400.

The configuration of the end tool 800, specifically, the yaw center 880, the actuation link 892, and the like, is different from that of the electrocautery surgical instrument 10 according to the third embodiment of the present invention, and thus, will be described in detail below.

Referring to fig. 86 and 87, an end tool 800 according to a third embodiment of the present invention is formed at the other end of the connection part 400 and is inserted into a surgical site to perform a required action for a surgery. As an example of the end tool 800 described above, a pair of jaws (jaw) 803 shown in fig. 86 may be used to perform a clamping (grip) action.

However, the spirit of the present invention is not limited thereto, and various surgical devices may be used as the end tool 800. For example, a configuration such as a single-arm cautery or the like may also be used as the end tool 800.

The end tool 800 as described above is connected to the operation unit 200 through the power transmission unit 300, and receives the driving force of the operation unit 200 through the power transmission unit 300, thereby performing operations required for surgery, such as clamping, cutting, and suturing operations.

Here, the end tool 800 of the electrocautery surgical instrument 10 according to the third embodiment of the present invention may be formed rotatable in one or more directions, for example, the end tool 800 may be formed to perform a yaw motion and an actuation motion about the Z-axis of fig. 86 while performing a pitch motion about the Y-axis of fig. 86.

(End tool according to the third embodiment)

Hereinafter, the end tool 800 of the electrocautery surgical instrument 10 of fig. 86 will be described in more detail.

Fig. 87 shows the end tool center 860 in combination with pitch center 850, and fig. 88 shows the end tool center 860, yaw center 880, and pitch center 850 removed. Fig. 89 shows a state in which yaw center 880 is connected to end tool center 860, and fig. 90 shows a state in which first jaw 801 and second jaw 802 are removed. On the other hand, fig. 91 is a diagram mainly illustrating each wire, and fig. 92 is a diagram mainly illustrating each pulley.

Referring to fig. 87, 88, 91 and 92, an end tool 800 according to a third embodiment of the present invention has a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 801 and a second jaw 802. The first jaw 801 and the second jaw 802 or the constituent elements that comprise the first jaw 801 and the second jaw 802 may be referred to herein as jaws (jaw) 803, respectively.

In addition, the end tool 800 can include a pulley 891, a pulley 813, a pulley 814, a pulley 815, and a pulley 816 that are related to the rotational movement of the first jaw (jaw) 801. Further, pulleys 881, 823, 824, 825, and 826 may be included in connection with the rotational movement of second jaw (jaw) 802.

Referring to fig. 87, an end tool 800 of a third embodiment of the present invention may include an end tool center 860, a pitch center 850, and a yaw center 880.

A first rotation shaft 841, which will be described later, is inserted through the end tool center 860, and at least a portion of the pulley 891 and the pulley 881, which are shaft-coupled to the first rotation shaft 841, may be accommodated inside the end tool center 860.

Since the end tool center 860 according to the third embodiment of the present invention is the same as the end tool center 660 and the end tool center 760 according to the first and second embodiments, contents within the repetition range will not be described in detail.

Referring to fig. 87, third and fourth rotational shafts 843 and 844, which will be described later, are inserted through the pitch center 850, and the pitch center 850 may be coupled to the first and second pitch sheave portions 863a and 863b of the end tool center 860 by the third rotational shaft 843. Thus, end tool center 860 may be formed rotatable about third rotational axis 843 relative to pitch center 850.

Further, at least a portion of the pulley 813, the pulley 814, the pulley 823, and the pulley 824, which are shaft-coupled to the third rotation shaft 843, may be accommodated inside the pitch center 850. In addition, at least a portion of pulley 815, pulley 816, pulley 825, and pulley 826, which are shaft coupled to fourth rotational shaft 844, may be housed inside pitch center 850.

One end of pitch center 850 is connected to end tool center 860 and the other end of pitch center 850 is connected to connection 400.

Referring to fig. 87, the first rotation axis 841 serves as an end tool jaw pulley rotation axis, the third rotation axis 843 serves as an end tool pitch rotation axis, and the fourth rotation axis 844 can serve as an end tool pitch auxiliary rotation axis for the end tool 100.

Here, each rotation shaft may be formed in two, and the respective rotation shafts in two may be disposed to be spaced apart from each other. Each rotation axis is thus formed in half in order to pass guide tube 870 through end tool center 860 and pitch center 850.

That is, the guide pipe 870 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, each rotation shaft is formed to be curved at the center, so that a retreat path of the guide tube 870 can be formed.

Referring to fig. 87 and 88, an end tool 800 according to a third embodiment of the present invention may further have an actuation rotational axis 845. In detail, the joint portion between the first jaw 801 and the second jaw 802 may have an actuation rotation shaft 845, and the second jaw 802 may perform an actuation operation while rotating about the actuation rotation shaft 845 in a state where the first jaw 801 is fixed. Here, the actuation rotation shaft 845 may be disposed closer to the distal end portion 804 side than the first rotation shaft 841.

Here, one feature of the end tool 800 of the third embodiment of the present invention is that the first rotation shaft 841 and the actuation rotation shaft 845, which are yaw rotation shafts, are separately provided, not provided as the same shaft.

That is, since the first rotation shaft 841 and the actuation rotation shaft 845 are formed to be spaced apart from each other to some extent, a space for gently bending the guide tube 870 and the blade wire 307 housed therein can be ensured, wherein the first rotation shaft 841 is a rotation shaft of the pulley 881/891 serving as the jaw pulley, and is a rotation shaft of the yaw (yaw) operation, and the actuation rotation shaft 845 is a rotation shaft of the second jaw 802 with respect to the first jaw 801, and is a rotation shaft of the actuation operation. The actuation rotary shaft 845 as described above will be described in more detail later.

Pulley 891 serves as an end tool first jaw pulley and pulley 881 serves as an end tool second jaw pulley. Pulley 891 may be referred to as a first jaw pulley and pulley 881 may be referred to as a second jaw pulley, these two components may also be collectively referred to as an end tool jaw pulley or simply a jaw pulley.

The pulley 891 and the pulley 881 as the end tool jaw pulley are formed to face each other and are disposed side by side, and are formed to be rotatable independently of each other about a first rotation shaft 841 as a rotation shaft of the end tool jaw pulley.

At this time, the pulley 891 and the pulley 881 may be formed to be spaced apart to some extent, and the blade assembly may be accommodated therebetween.

In other words, a blade assembly including guide tube 870 may be disposed between pulley 891 and pulley 881.

In one aspect, the end tool 800 of the third embodiment of the present invention may further include first electrode 851, second electrode 852, guide tube 870, and blade 875, among other components, for performing cauterizing (cautery) and cutting (cutting) actions.

The constituent elements of guide tube 870, blade 875, etc. associated with blade actuation may be collectively referred to herein as a blade assembly. A modification of the present invention is characterized in that a blade assembly including a blade 875 is provided between a pulley 891 as a first jaw pulley and a pulley 881 as a second jaw pulley, so that the tip tool 800 can perform a pitching operation and a yawing operation and a cutting operation using the blade. Since the constituent elements for performing the cauterizing (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the first and second embodiments, a detailed description thereof will be omitted herein.

As with the first embodiment of the present invention, the electrocautery surgical instrument 10 according to the third 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-chain-pulley connecting Structure)

Hereinafter, the jaw-link-pulley connection structure in the end tool 800 of the third embodiment of the present invention will be described in more detail.

Referring to fig. 87-101, an end tool 800 of a third embodiment of the present invention includes a first jaw 801, a second jaw 802, a yaw center 880, an actuating link 592, a pulley 891 as a first jaw pulley, and a pulley 881 as a second jaw pulley. Hereinafter, the pulley 891 is referred to as a first jaw pulley 891 and the pulley 881 is referred to as a second jaw pulley 881.

Referring to fig. 97-100, the first jaw pulley 891 can be formed as a multi-layered pulley. In other words, the first jaw pulley 891 is formed by combining two pulleys, and two grooves may be formed on an outer circumferential surface thereof.

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

At this time, the positions of the first bonding portion 891a and the second bonding portion 891b are positions where the wire 301 and the wire 305 overlap each other. In other words, at least a portion of the wire 302 and the wire 306 wrapped around the first jaw pulley 891 may be formed overlapping.

This is described from another perspective, i.e., the first and second engaging portions 891a, 891b are asymmetrically disposed in the XY plane, and thus may be disposed to be biased toward either region of the first jaw pulley 891.

Describing this from another angle, the first coupling portion 891a may be formed at a position where the wire 301 can be wound on the outer circumferential surface of the first jaw pulley 891 at an angle between the center angle 90 ° and 360 °. Similarly, the second coupling portion 891b may be formed at a position where the wire 305 can be wound on the outer circumferential surface of the first jaw pulley 891 at an angle between the center angle 90 ° and 360 °.

In addition, a fastener 334a is coupled to an end of the wire 301, and the fastener 334a may be coupled to the first coupling portion 891a of the first jaw pulley 891. The fastener 334b is coupled to an end of the wire 305, and the fastener 334b may be coupled to the second coupling portion 891b of the first jaw pulley 891.

When the wire 301 is referred to as a first jaw wire R and the wire 305 is referred to as a first jaw wire L, a first coupling portion 891a coupled to the first jaw wire R301 is formed at the opposite side to the side where the first jaw wire R301 is input, and the rotation angle of the first jaw pulley 891 is enlarged by extending the length of the first jaw wire R305 wound around the first jaw pulley 891.

Further, a second coupling portion 891b coupled to the first jaw wire L302 is formed at the opposite side of the other side of the input first jaw wire L302, and the rotation angle of the first jaw pulley 891 is enlarged by extending the length of the first jaw wire L302 wound around the first jaw pulley 891.

The radius of rotation of the first jaw pulley 891 can be enlarged by the first and second coupling portions 891a, 891b as described above. In addition, as described above, by further elongating the length of wire 301/305 wrapped around the first jaw pulley 891, a long Stroke (Stroke) of the actuating link 892 can be ensured. As will be described in more detail later.

Referring to fig. 90, a yaw center 880 is located between first and second jaws 801, 802 and first and second jaw pulleys 891, 881, which may include a yaw center body 882.

A first jaw pulley 891 may be formed on one end of the yaw center 880. On the other end portion of the yaw center 880, a guide slit 883 may be formed in the longitudinal direction. A guide pin 893 formed to protrude on an actuating link 892 described later may be inserted into the guide slit 883.

Referring to fig. 90 and 93, a through hole through which the actuation rotation shaft 845 is inserted may be formed at one side of the guide slit 883 on the yaw center 880. Referring to fig. 93, the second jaw pulley 881 is formed integrally with one side of the yaw center 880, but is not limited thereto, and various modifications may be made.

Although not shown in the drawings, the second jaw pulley 881 and the yaw center 880 are each formed as a separate member, and the second jaw pulley 881 may be fixedly coupled with the yaw center 880, and in particular, with the yaw center body 882.

In addition, a plurality of first rotation shafts 841 divided into two may be inserted through the first jaw pulley 891 and the second jaw pulley 881, respectively.

As described above, since the second jaw pulley 881 is formed as a single body or fixedly coupled with the yaw center 880,

Thus, the yaw center 880 does not rotate relative to the second jaw pulley 881, and as the second jaw pulley 881 rotates about the first rotational axis 841, the yaw center 580 may also rotate about the first rotational axis 841 with the second jaw pulley 881.

Referring to fig. 90 and 91, an actuation rotation shaft 845 may be provided on the yaw center 880. The actuating rotation shaft 845 may be divided into two, and the plurality of actuating rotation shafts 845 divided into two may be disposed at intervals to some extent, and the guide tube 870 and the blade wire 307 and the blade 875 accommodated therein may pass through the space formed between the plurality of actuating rotation shafts 845.

Referring to fig. 90, a guide slit 883 formed at a yaw center 880, specifically, a yaw center body 882, may be formed to extend in a longitudinal direction between an actuation rotation axis 845 and a yaw rotation axis 841.

Referring to fig. 90, the guide slits 883 may be formed to have the same width in the longitudinal direction, and guide pins 893 protruding on the actuating links 892 may move within the guide slits 883, particularly may move linearly.

Referring to fig. 93, an actuating pulley coupling portion 885 may be protrusively formed on the other side opposite to the side where the yaw center 880 of the second jaw pulley 881 is formed to be coupled with the first jaw pulley 891.

The actuating pulley coupling 885 may share a central axis with the yaw rotation axis 841. However, the present invention is not limited thereto, and various modifications may be made, for example, being disposed side by side with a space therebetween.

Referring to fig. 101, an actuating link 892 may be formed extending in a longitudinal direction. The actuation link 892 may include a link body 892a and a bend 892b. The link main body 892a is a portion extending in the longitudinal direction, and the bent portion 892b is bent at least one more time and may be connected to the link main body 892a.

Accordingly, the side of the actuating link 892 where the bent portion 892b is located may be formed in a "U" shape.

Referring to fig. 101, a pin coupling hole (reference numeral not set) may be formed on one surface of the bent portion 892b, wherein the bent portion 892b is disposed side by side with the link body 892a and is disposed to be spaced apart to some extent.

In order to correspond to the pin coupling hole, a pin coupling hole may be formed on one surface of the link body 892a facing the bent portion 892 b. The guide pin 893 may be coupled to the pin coupling hole. The guide pin 893 has a plurality and may be coupled to a pin coupling hole formed on each surface of the bent portion 892b and the link body 892a facing each other.

A plurality of guide pins 893 may be provided at intervals to some extent, and a side region of the actuating link 892 may provide a moving path to enable the guide tube 870 to pass therethrough, wherein the actuating link 892 is formed in a "U" shape with the link body 892a by the bent portion 892 b. The actuating link 892 moves linearly in the "U" shaped region formed by the bent portion 892b and the link body 892a, and thus has an effect of not interfering with the movement path of the guide tube 870 moving inside the yaw center 880 and the end tool center 860.

Referring to fig. 101, a link through hole 892c may be formed on the other side opposite to one side of the link body 892a to which the bent portion 892b is connected. The protruding portion 891c formed on the first jaw pulley 891 may be inserted into the link through-hole 892c while being shaft-coupled to the link through-hole 892c.

Thus, as the first jaw pulley 891 rotates, the actuation link 892 moves while rotating about the tab 891 c.

The guide pin 893 provided on the actuating link 892 is inserted into a guide slit 883 formed on the yaw center 880 and is movable along the shape of the guide slit 883.

The guide pin 893 passing through the guide slit 883 may be inserted into grooves 801a and 802a formed on the first jaw 801 and the second jaw 802, respectively. The first jaw 801 and the second jaw 802 have an X-shaped structure, and the guide pin 893 may be inserted into both a groove 801a formed on the first jaw 801 and a groove 801b formed on the second jaw 802.

The first jaw 801 and the second jaw 802 can perform an actuation motion while moving the actuation rotation shafts 845 away from each other or toward each other as the rotation centers.

Referring to fig. 102 to 104, when the first jaw pulley 891 rotates in the A1 direction, the actuating link 892 coupled to the protruding portion 891c axis formed on the first jaw pulley 891 moves in the B1 direction. Specifically, the guide pin 893 provided on the actuating link 892 moves linearly along the guide slit 883 formed on the yaw center 880, and the guide pin 893 is inserted into the grooves 801a and 802a formed on the first jaw 801 and the second jaw 802, so that the guide pin 893 pushes the first jaw 801 and the second jaw 802. Thus, as actuation link 892 moves, first jaw 801 and second jaw 802 may perform an actuation action while rotating about actuation rotational axis 845.

Referring to fig. 103, as actuation link 892 moves toward the distal end, first jaw 801 and second jaw 802 perform an actuation motion in the C1 direction along the C1 direction based on actuation rotational axis 845.

Referring to fig. 104, when the guide pin 893 moves to the distal end side to the maximum on the groove 801a and the groove 802a, which are formed on the first jaw 801 and the second jaw 802, respectively, there is an effect of further expanding the first jaw 801 and the second jaw 802 in the C2 direction.

Further, since the first jaw pulley 891 is formed in a multi-layered structure such that the first jaw wire 301 and the first jaw wire 305 are wound in overlapping manner on different layers, it is possible to extend the length of the first jaw pulley 891 wound therearound and expand the rotation angle of the first jaw pulley 891.

Fig. 105-108 are perspective views illustrating actuation of an end tool of the electrocautery instrument of fig. 86. The guide pin 893 provided on the actuation link 892 is movable along the groove 801a and the groove 802a, which are formed on the first jaw 801 and the second jaw 802, respectively, whereby the first jaw 801 and the second jaw 802 perform an actuation action with the actuation rotation shaft 845 as a rotation center axis.

Fig. 109-111 are partial cross-sectional views illustrating the action of the blades of the end tool of the electrocautery surgical instrument of fig. 86. Since the content related to the action of the blade 875 is the same as that in the first and second embodiments, the content within the scope of repetition will not be described in detail.

Fig. 112 and 113 are bottom views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 86 in a state of yaw rotation by +90°.

The guide slits 883 formed on the yaw center 880 are formed along a straight line direction, and the actuation rotation shaft 845 may be disposed along a central axis of the longitudinal direction of the guide slits 883.

The grooves 801a and 802a formed on the first jaw 801 and the second jaw 802, respectively, may be formed at an angle and inclined to the central axis of the longitudinal direction of the guide slit 883 formed on the yaw center 880.

Thus, when the actuation rotational axis 845 is in a fixed state, the actuation link 892, and in particular the guide pin 893, moves forward toward the actuation rotational axis 845, as shown in fig. 113, the first jaw 801 and the second jaw 803 are separated from each other, wherein the actuation link 892 receives power from the first jaw pulley 891 to move.

As shown in fig. 114 and 115, in a state in which the distal end tool of the electrocautery surgical instrument of fig. 86 is yaw-rotated by +90°, the first jaw pulley 891 is rotated, and the guide pin 893 is moved through the guide slit 883 formed in the yaw center 880, and the grooves 801a and 802a formed in the first jaw 801 and the second jaw 802, respectively, so that the actuation operation is possible also in a yaw-rotated state, wherein the guide pin 893 is provided on the actuation link 892 connected to the first jaw pulley 891.

Referring to fig. 116 to 125, in a state in which tip tool 800 is yaw-rotated, there is a possibility that guide tube 870 is in contact with actuating link 892, but in actuating link 892 of the present invention, bent portion 892b connected to link main body 892a may be formed in a "U" shape, preventing contact with guide tube 870, and simultaneously, allowing blade wire 307 and guide tube 870 to stably move with respect to yaw, pitch, and actuation actions of tip tool 800.

Referring to fig. 126 to 136, the end tool 800 of the electrocautery surgical instrument 10 according to the third embodiment of the present invention is formed so that a cutting action can be normally performed even in a state in which the jaws (jaw), i.e., the first jaw 801 and the second jaw 802 are rotated in pitch while being rotated in yaw.

One feature of the end tool 800 of the third embodiment of the present invention is that a pin and slot configuration is employed to ensure a clamping Force (clip Force) during actuation.

In detail, in the pin-slot configuration, the actuation link 892 needs to move a longer distance to rotate the first jaw 801 the same distance. (i.e., a long Stroke (Stroke) of the actuation link 892 is required) in addition, the first jaw pulley 891 needs to be rotated more to move the actuation link 590 a longer distance. Describing this from another perspective, i.e., if first jaw pulley 891 is rotated more to rotate first jaw 801 the same distance, then the clamping Force (Grip Force) upon actuation may be increased because more Force is applied to first jaw 801 by rotating first jaw pulley 891 more.

In addition, in order to rotate the first jaw pulley 891 more in this way, as described above, the first jaw pulley 891 is formed in a multi-layered structure to lengthen the length of the wire 301 and the wire 305 wound around the first jaw pulley 891, thereby ensuring a long Stroke (Stroke) of the actuating link 892.

(Modification of the third embodiment-providing an auxiliary sheave at the tip tool center)

Hereinafter, an end tool 800 of a surgical instrument according to a modification of the third embodiment of the present invention will be described. Here, the arrangement of the end tool center 860' and the arrangement of the auxiliary pulley 812 and the auxiliary pulley 822 of the end tool 300 of the surgical instrument according to the modification of the third embodiment of the present invention are characteristically different from those of the end tool of the surgical instrument according to the third embodiment of the present invention described above. As described above, a configuration different from the third embodiment will be described in detail later.

Fig. 137 to 139 are diagrams showing an end tool of an electrocautery surgical instrument according to a modification of the third embodiment of the present invention.

Referring to fig. 137 to 138, an end tool (end tool) 800 of a modification of the third embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping action, that is, a first jaw 801 and a second jaw 802, and herein, the first jaw 801 and the second jaw 802 or constituent elements that include the first jaw 801 and the second jaw 802 may be referred to as jaws (jaw) 803, respectively.

The end tool 800 according to the modification of the third embodiment may include a pulley 811, a pulley 812, a pulley 813, a pulley 814, a pulley 815, and a pulley 816 in association with the rotational movement of the first jaw 801. Further, pulleys 821, 822, 823, 824, 825, and 826 may be included in connection with the rotational movement of second jaw 802.

Compared to the end tool 800 according to the third embodiment of the present invention shown in fig. 86, the end tool 800 according to the modification of the third embodiment of the present invention may further include a pulley 812 and a pulley 822.

Referring to fig. 137-139, pulley 812 serves as an end tool first jaw auxiliary pulley and pulley 822 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 812 and 822 as the end tool jaw auxiliary pulleys may be additionally provided at one side of the pulleys 811 and 821, in other words, the pulley 812 as the auxiliary pulley may be provided between the pulleys 811 and 813/814. In addition, a pulley 822 as an auxiliary pulley may be provided between the pulley 821 and the pulley 823/the pulley 824.

The pulleys 812 and 822 may be formed to be rotatable independently of each other about the second rotation axis 842.

The pulleys 812 and 822 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 change the setting paths of the wire 305 and the wire 302 to some extent, thereby serving to enlarge the respective rotation angles of the first jaw 801 and the second jaw 802.

That is, when the auxiliary pulley is not provided, the first jaw 801 and the second jaw 802 can be rotated only to a right angle, but in the modification of the third embodiment of the present invention, the effect of enlarging the maximum rotation angle by a certain angle can be obtained by additionally providing the pulley 812 and the pulley 822 as the auxiliary pulley.

This allows the two jaws of the end tool 800 to perform an action that requires opening the two jaws for actuation action in a state of being rotated 90 ° together in a clockwise or counter-clockwise direction.

In other words, the following features are provided: the range of yaw rotation that can be actuated can be expanded by the pulleys 812 and 822. A more detailed description of this is as follows.

When the auxiliary pulley is not provided, since the first jaw wire 305 is fixedly coupled to the end tool first jaw pulley 811 and the second jaw wire 302 is fixedly coupled to the end tool second jaw pulley 821, the end tool first jaw pulley 811 and the end tool second jaw pulley 821 are respectively rotatable only up to 90 °.

In this case, when the first jaw 801 and the second jaw 802 are actuated in a state of being located at a line of 90 °, the first jaw 801 may be opened, but the second jaw 802 cannot be rotated more than 90 °. Therefore, the first jaw 801 and the second jaw 802 have a problem that the actuation operation cannot be smoothly performed in a state where the yaw operation is performed at a predetermined angle or more.

In order to solve the above-described problems, the electrocautery surgical instrument 10 of the present invention is additionally provided with a pulley 812 and a pulley 822 as auxiliary pulleys on one side of the pulleys 811 and 821. As described above, by providing the pulley 812 and the pulley 822, 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, thereby changing the tangential directions of the wire 305 and the wire 302, so that the fastener 324 joining the wire 302 and the pulley 821 can be additionally rotated by a certain angle.

That is, the fastener 326, which is the junction of the wire 302 and the pulley 821, can be rotated until it is located on the inner common tangent of the pulley 821 and the pulley 822. Similarly, the fastener 323, which is the joint of the wire 305 and the pulley 811, can be rotated until it is located on the inner common tangent line of the pulley 811 and the pulley 812, so that the rotation range can be widened.

In other words, the wire 301 and the wire 305 are disposed on either side by a pulley 812 as an auxiliary pulley, 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 two branches of the first jaw wire wound around the pulley 812. Meanwhile, the wire 302 and the wire 306 are disposed on the other side by a pulley 822 in a plane perpendicular to the Y axis and passing through the X axis, wherein the wire 302 and the wire 306 are two branches of the second jaw wire wound around the pulley 821.

In other words, pulley 813 and pulley 814 are disposed on either side with respect to a plane perpendicular to the Y axis and passing through the X axis, and pulley 823 and pulley 824 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 located on the inscribed line of the pulley 811 and the pulley 812, and the rotation angle of the pulley 811 is enlarged by the pulley 812. Further, the wire 302 is located on an inscribed line of the pulley 821 and the pulley 822, and the rotation angle of the pulley 821 is enlarged by the pulley 822.

According to the present invention as described above, as the rotation radius of the first jaw 801 and the second jaw 802 is widened, an effect of widening the range of the yaw motion that can perform the normal opening and closing actuation motion can be obtained.

A modification of the third embodiment of the present invention is identical to the end tool 800 according to the third embodiment except that the pulleys 821 and 822 are used as auxiliary pulleys, in comparison with the third embodiment, in which the pulleys 821 and 822 are not formed as one body part 861 in the end tool center 860 'but are provided as separate members and are coupled to the end tool center 860' by the second rotation shaft 842 shaft, and therefore, the contents within the repetition range will not be described in detail.

< Fourth embodiment of instrument for electrocautery surgery >

Fig. 140 is a perspective view showing an electrocautery instrument according to a fourth embodiment of the present invention. Fig. 141 to 146 are views showing an end tool of the electrocautery surgical instrument of fig. 140. Fig. 147 is a perspective view showing the end tool center of the electrocautery instrument of fig. 140. Fig. 148 and 149 are cut-away perspective views of the end tool center of fig. 147. Fig. 150 and 151 are perspective views illustrating the end tool center of fig. 147. Fig. 152 is a side view showing the end tool center and guide tube of fig. 147. Fig. 153 is a plan view showing the end tool center and guide tube of fig. 147. Fig. 154 is a perspective view illustrating an actuation center of the electrocautery surgical instrument of fig. 140 of fig. 147. Fig. 155 is a cut-away perspective view of the actuation center of fig. 154. Fig. 156 is an exploded perspective view showing an end tool of the electrocautery instrument of fig. 140. Fig. 157 is a perspective view illustrating a first jaw of an end tool of the electrocautery instrument of fig. 140. Fig. 158 is a perspective view showing a second jaw of an end tool of the electrocautery instrument of fig. 140. Fig. 159 is a perspective view showing a first jaw pulley of the electrocautery instrument of fig. 140. Fig. 160 is a plan view illustrating an opening and closing operation of a first jaw of the end tool of the electrocautery instrument of fig. 140. Fig. 161 is a plan view illustrating an opening and closing operation of a second jaw of the end tool of the electrocautery instrument of fig. 140. Fig. 162 is a plan view illustrating opening and closing operations of the first jaw and the second jaw of the end tool of the electrocautery instrument of fig. 140.

Referring to fig. 140 to 162, etc., an electrocautery surgical instrument 10 according to a fourth embodiment of the present invention includes an end tool 1100, an operating portion 200, a power transmitting portion 300, and a connecting portion 400.

Here, the connection part 400 is formed in a hollow shaft (shaft) shape, and one or more wires and lines may be accommodated therein. The operation part 200 is coupled to one end of the connection part 400, and the end tool 1100 is coupled to the other end of the connection part 400, so that the connection part 400 can be used to connect the operation part 200 and the end tool 1100. Here, one feature of the connecting portion 400 of the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention is that it has a straight portion 401 and a bent portion 402, and the straight portion 401 is formed on the side to which the end tool 1100 is coupled and the bent portion 402 is formed on the side to which the operation portion 200 is coupled. As described above, the end portion of the connecting portion 400 on the side of the operating portion 200 is formed to be bent such that 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 1100. This is described from another point of view, namely, it can be described that at least a part of the pitch operation section 201 and the yaw operation section 202 is accommodated in the recess formed by the bent section 402. The shape and action of the manipulation portion 200 and the end tool 1100 can be more intuitively consistent by the shape of the curved portion 402 as described above.

In one aspect, the plane forming the bend 402 may be substantially the same plane as the pitch plane, i.e., the XZ plane of fig. 140. As described above, 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 arrangements than the XZ plane may be employed for intuitive operation of the end tool and the operation portion.

In one aspect, the connector 410 may be formed on the bend 402. The connector 410 may be connected to an external power source (not shown), and the connector 410 is connected to the jaws 1103 by a wire (ELECTRIC WIRE) 411 and a wire 412, so that power supplied from the external power source (not shown) may be transmitted to the jaws 1103. Here, the connector 410 may be a bipolar type in which two electrodes are formed, or may be a unipolar type in which one electrode is formed.

The operation part 200 is formed at one end of the connection part 400, and has an interface, such as a pincer-shaped, bar-shaped, lever-shaped, etc., which can be directly operated by a doctor, and is connected to a corresponding interface when the doctor controls it, and the end tool 1100 inserted into the body of the surgical patient performs a surgery by performing a predetermined operation. Here, although the operation portion 200 is shown in fig. 140 as being formed in a handle shape rotatable by inserting a finger, the spirit of the present invention is not limited thereto, and it may be various kinds of operation portions as long as it can be connected to the end tool 1100 to control the end tool 1100.

An end tool 1100 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 the end tool 1100 described above, a pair of jaws (jaw) 1103 shown in fig. 140 may be used to perform a clamping (grip) action. However, the spirit of the present invention is not limited thereto, and various surgical devices may be used as the end tool 1100. For example, a configuration such as a single-arm cautery or the like may also be used as the end tool. The end tool 1100 described above is connected to the operation unit 200 through the power transmission unit 300, and receives the driving force of the operation unit 200 through the power transmission unit 300, thereby performing operations required for surgery, such as a clamping (grip), cutting (cutting), and suturing (suturing) operations.

Here, the end tool 1100 of the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention may be formed to be rotatable in one or more directions, for example, the end tool 1100 may be formed to perform a yaw (yaw) motion and an actuation (actuation) motion about the Z-axis of fig. 140 while performing a pitch (pitch) motion about the Y-axis of fig. 140.

The power transmission part 300 connects the operation part 200 and the end tool 1100, thereby functioning to transmit the driving force of the operation part 200 to the end tool 1100, and may include a plurality of wires, pulleys, links, joints, gears, and the like.

The end tool 1100, the operating portion 200, the power transmission portion 300, and the like of the electrocautery surgical instrument 10 of fig. 140 as described above will be described in detail later.

(Power transmitting section)

Hereinafter, the power transmission part 300 of the electrocautery surgical instrument 10 of fig. 140 will be described in more detail.

Referring to fig. 140-146, 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 1100 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 the 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.

Or 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.

Further, since the fastener 323 is coupled to the pulley 1111, the wire 301 and the wire 305 can be fixedly coupled with the pulley 1111. Thus, pulley 1111 can rotate as wire 301 and 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 1111 of the end tool 1100 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 1121, 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 1121 of the end tool 1100 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 a first pitch sheave portion 1163a of the end tool center 1160, the fastener 322 is coupled to a second pitch sheave portion 1163b of the end tool center 1160, and a pitch wire-handling 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 1160 of the end tool 1100 can be rotated.

On the one hand, one end portion of the blade wire 307 is joined to a blade 1175 described later, and the other end portion thereof is joined 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 1105 to the distal end portion 1104 of the tip tool 1100, or the blade wire 307 may be returned from the distal end portion 1104 to the proximal end portion 1105 of the tip tool 1100.

At this time, at least a portion of the blade wire 307 may be accommodated inside a guide tube 1170 described later. Thus, when the guide tube 1170 is bent according to the pitching or yawing motion of the end tool 1100, the blade wire 307 housed inside thereof can also be bent together with the guide tube 1170. The guide tube 1170 as described above will be described in more detail later.

Further, the blade wire 307 is formed to be linearly movable along the longitudinal direction of the connection part 400 within the connection part 400. In addition, since one end portion of the blade wire 307 is coupled to the blade 1175, when the blade wire 307 is linearly moved in the longitudinal direction of the connection portion 400, the blade 1175 connected thereto is also linearly moved. That is, when the blade wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 1175 connected thereto moves toward the distal end 1104 side or the proximal end 1105 side of the end tool 1100, and simultaneously performs a cutting operation. As will be described in more detail later.

(End tool)

Hereinafter, the end tool 1100 of the electrocautery surgical instrument 10 of fig. 140 will be described in more detail.

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

Here, fig. 141 shows a state in which the end tool center 1160 is combined with the pitch center 1150, and fig. 142 shows a state in which the end tool center 1160 and the pitch center 1150 are removed. Fig. 143 shows a state in which the first jaw 1101 and the second jaw 1102 are removed, and fig. 144 shows a state in which the first jaw 1101, the second jaw 1102, the pulley 1111, the pulley 1121, and the like are removed. In one aspect, fig. 145 is a diagram mainly illustrating each wire, and fig. 146 is a diagram mainly illustrating each pulley.

Referring to fig. 140 to 162, etc., an end tool 1100 of a fourth embodiment of the present invention has a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 1101 and a second jaw 1102. The first jaw 1101 and the second jaw 1102, or the constituent elements that comprise the first jaw 1101 and the second jaw 1102, respectively, may be referred to herein as jaws (jaw) 1103.

In addition, the end tool 1100 can include a pulley 1111, a pulley 1113, a pulley 1114, a pulley 1115, and a pulley 1116 associated with the rotational movement of the first jaw (jaw) 1101. Further, pulleys 1121, 1123, 1124, 1125, and 1126 may be included in connection with the rotational movement of the second jaw (jaw) 1102.

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

A rotation shaft 1141 described later is inserted through the end tool center 1160, and a pulley 1111 and a pulley 1121 shaft-coupled to the first rotation shaft 1141 and at least a portion of the first jaw 1101 and the second jaw 1102 coupled thereto may be accommodated inside the end tool center 1160. Here, one feature of an embodiment of the present invention is that a wire guide 1168 serving as an auxiliary pulley is formed on the end tool center 1160. That is, a first wire guide 1168a and a second wire guide 1168b for guiding the paths of the wires 305 and 302 may be formed on the end tool center 1160. The wire guide 1168 of the end tool center 1160 as described above is used as an auxiliary pulley (see 612, 622 in fig. 39) in the modification of the first embodiment so that the path of the wire can be changed, and the first wire guide 1168a, the second wire guide 1168b of the end tool center 1160 as described above, which is used as an auxiliary pulley, will be described in more detail later.

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. Wires 303 and 304 as pitch wires are coupled to the first and second pitch sheave portions 1163a and 1163b serving as tip tool pitch sheaves, and the tip tool center 1160 performs a pitch motion while rotating about the third rotation axis 1143.

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

Further, at least a portion of pulleys 1113, 1114, 1123, and 1124 that are shaft-coupled to third rotary shaft 1143 may be housed inside pitch center 1150. In addition, at least a portion of pulleys 1115, 1116, 1125, and 1126 that are shaft-coupled to fourth rotational shaft 1144 may be housed inside pitch center 1150.

One end of pitch center 1150 is connected to end tool center 1160 and the other end of pitch center 1150 is connected to connection 400.

Here, the end tool 1100 of the fourth embodiment of the present invention may include a first rotation shaft 1141, a third rotation shaft 1143, and a fourth rotation shaft 1144. As described above, the first rotational axis 1141 is inserted through the end tool center 1160 and the third rotational axis 1143 and the fourth rotational axis 1144 may be inserted through the pitch center 1150.

The first, third and fourth rotational axes 1141, 1143, 1144 may be sequentially disposed from the distal end (DISTAL END) 1104 to the proximal end (proximal end) 1105 of the end tool 1100. Thus, the first rotational axis 1141 may be referred to as a first pin, the third rotational axis 1143 as a third pin, and the fourth rotational axis 1144 as a fourth pin, in order from the distal end portion 1104.

Here, the first rotational axis 1141 serves as an end tool jaw pulley rotational axis, the third rotational axis 1143 serves as an end tool pitch rotational axis, and the fourth rotational axis 1144 may serve as an end tool pitch auxiliary rotational axis of the end tool 1100.

Here, each rotation shaft may include two shafts of a first sub-shaft and a second sub-shaft. Or may be described as being formed in two parts per rotation axis.

For example, the first rotary shaft 1141 may include two shafts, a first auxiliary shaft 1141a and a second auxiliary shaft 1141 b. In addition, the third rotary shaft 1143 may include two shafts, a first auxiliary shaft 1143a and a second auxiliary shaft 1143 b. In addition, the fourth rotary shaft 1144 may include two shafts, a first counter shaft and a second counter shaft.

Each rotation shaft is formed in such a way as to be divided into two in order to pass a guide tube 1170 described later through the tip tool center 1160 and the pitch center 1150. That is, the guide tube 1170 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, each rotation shaft is formed to be curved at the center, so that a retreat path of the guide tube 1170 can be formed.

One or more pulleys may be inserted into the rotation shafts 1141, 1143, and 1144 as such, which will be described in detail below.

In one aspect, the end tool 1100 may further have an actuation rotation shaft 1145. In detail, the first jaw 1101 and the second jaw 1102 may be coupled by an actuation rotation shaft 1145, and in this state, the first jaw 1101 and the second jaw 1102 may perform an actuation action while rotating about the actuation rotation shaft 1145. Here, the actuation rotation shaft 1145 may be disposed closer to the distal end portion 1104 side than the first rotation shaft 1141.

Here, one feature of the end tool 1100 of the fourth embodiment of the present invention is that the first rotation shaft 1141 and the actuation rotation shaft 1145, which are yaw rotation shafts, are separately provided, not provided as the same shaft. That is, since the first rotation shaft 1141 and the actuation rotation shaft 1145 are formed to be spaced apart from each other to some extent, a space for gently bending the guide tube 1170 and the blade wire 307 housed therein can be ensured, wherein the first rotation shaft 1141 is a rotation shaft of the pulley 1111/1121 as a jaw pulley, and a yaw (yaw) operation, and the actuation rotation shaft 1145 is a rotation shaft of the second jaw 1102 with respect to the first jaw 1101, and an actuation operation. The actuation rotary shaft 1145 as described above will be described in more detail later.

Pulley 1111 acts as an end tool first jaw pulley and pulley 1121 acts as an end tool second jaw pulley. Pulley 1111 may be referred to as a first jaw pulley and pulley 1121 may be referred to as a second jaw pulley, these two components may also be collectively referred to as an end tool jaw pulley or simply a jaw pulley.

The pulley 1111 and the pulley 1121 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 1141 as the end tool jaw pulley rotation shaft. At this time, the pulleys 1111 and 1121 may be formed to be spaced apart to some extent, and a blade assembly receiving part may be formed therebetween. In addition, at least a part of a blade assembly described later may be provided in the blade assembly accommodating portion. In other words, a blade assembly including a guide tube 1170 is disposed between the pulley 1111 and the pulley 1121.

Here, the pulley 1111 is coupled to the first jaw (jaw) 1101, and thus, when the pulley 1111 rotates about the first rotational axis 1141, the first jaw 1101 may also rotate together about the first rotational axis 1141.

In one aspect, the pulley 1121 is coupled to the second jaw (jaw) 1102 such that, when the pulley 1121 rotates about the first rotational axis 1141, the coupled second jaw 1102 may rotate about the first rotational axis 1141.

In addition, the yaw and actuation actions of the end tool 1100 are performed according to the rotation of the pulleys 1111 and 1121. That is, when the pulley 1111 and the pulley 1121 rotate in the same direction about the first rotation axis 1141, the yaw motion is performed while the first jaw 1101 and the second jaw 1102 rotate about the first rotation axis 1141. On the one hand, when the pulley 1111 and the pulley 1121 rotate in opposite directions about the first rotational axis 1141, the actuation motion is performed while the first jaw 1101 and the second jaw 1102 rotate about the actuation rotational axis 1145.

Pulleys 1113 and 1114 serve as the end tool first jaw pitch master and pulleys 1123 and 1124 serve as the end tool second jaw pitch master, which may be collectively referred to as the end tool jaw pitch master.

Pulleys 1115 and 1116 serve as end tool first jaw pitch sub-pulleys, and pulleys 1125 and 1126 serve as end tool second jaw pitch sub-pulleys, which may be collectively referred to as end tool jaw pitch sub-pulleys.

Hereinafter, description is made regarding constituent elements related to rotation of the pulley 1111.

Pulleys 1113 and 1114 serve as the end tool first jaw pitch master pulley. That is, it acts as the primary rotary pulley for the pitching action of the first jaw 1101. Here, wire 301 as the first jaw wire is wound around pulley 1113, and wire 305 as the first jaw wire is wound around pulley 1114.

Pulleys 1115 and 1116 serve as the end tool first jaw pitch sub-pulleys. I.e., it acts as a secondary rotating pulley for the pitching action of the first jaw 1101. Here, the wire 301 as the first jaw wire is wound around the pulley 1115, and the wire 305 as the first jaw wire is wound around the pulley 1116.

Here, on the side of the pulley 1111, the pulley 1113 and the pulley 1114 are disposed to face each other. Here, the pulley 1113 and the pulley 1114 are formed to be rotatable independently of each other about a third rotation axis 1143 as a pitch rotation axis of the end tool. In addition, pulleys 1115 and 1116 are provided on one side of pulleys 1113 and 1114, respectively, in a manner facing each other. Here, the pulley 1115 and the pulley 1116 are formed to be rotatable independently of each other about a fourth rotation axis 1144 as an end tool pitch assist rotation axis. Here, although the pulleys 1113, 1115, 1114, and 1116 are shown 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 various directions suitable for its arrangement.

Wire 301, which is the first jaw wire, is wound thereon in sequence in order to contact at least a portion of pulley 1115, pulley 1113, and pulley 1111. In addition, in order for at least a portion to be in contact with the pulley 1111, the first wire guide 1168a of the end tool center 1160, the pulley 1114, and the pulley 1116, the wire 305 connected to the wire 301 by the fastener 323 is sequentially wound thereon.

This is described from another point of view, i.e., to at least partially contact the pulley 1115, the pulley 1113, the pulley 1111, the first wire guide 1168a of the end tool center 1160, the pulley 1114, and the pulley 1116, the wire 301 and the wire 305 as the first jaw wires are wound thereon in sequence, and the wire 301 and the wire 305 are formed to be movable with each of the pulleys while rotating the each pulley.

Accordingly, when the wire 301 is pulled in the direction of the arrow 301 in fig. 145, the fastener 323 combined with the wire 301 and the pulley 1111 combined therewith are rotated in the counterclockwise direction. Conversely, when the wire 305 is pulled in the direction of arrow 305 in fig. 145, the fastener 323 combined with the wire 305 and the pulley 1111 combined therewith rotate in the clockwise direction in fig. 145.

Hereinafter, description is made with respect to constituent elements related to rotation of the pulley 1121.

Pulley 1123 and pulley 1124 act as an end tool second jaw pitch master pulley. I.e. it acts as the main rotary pulley for the pitching action of the second jaw 1102. Here, wire 306 as the second jaw wire is wound on pulley 1123, and wire 302 as the second jaw wire is wound on pulley 1124.

Pulleys 1125 and 1126 serve as end tool second jaw pitch sub-pulleys. I.e. it acts as a secondary rotating pulley for the pitching action of the second jaw 1102. Here, the wire 306 as the second jaw wire is wound on the pulley 1125, and the wire 302 as the second jaw wire is wound on the pulley 1126.

Here, on the side of the pulley 1121, a pulley 1123 and a pulley 1124 are provided so as to face each other. Here, the pulley 1123 and the pulley 1124 are formed to be rotatable independently of each other about a third rotation axis 1143 which is a pitch rotation axis of the end tool. Further, pulleys 1125 and 1126 are provided on one side of pulleys 1123 and 1124, respectively, in a manner facing each other. Here, the pulley 1125 and the pulley 1126 are formed rotatable independently of each other about a fourth rotation shaft 1144 as an end tool pitch assist rotation shaft. Here, although the pulleys 1123, 1125, 1124, and 1126 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 various directions suitable for the arrangement thereof.

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 pulley 1125, the pulley 1123, and the pulley 1121. 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 1121, the second wire guide 1168b of the end tool center 1160, the pulley 1124, and the pulley 1126.

This is described from another point of view, i.e., to be in contact at least in part with the pulley 1125, the pulley 1123, the pulley 1121, the second wire guide 1168b of the end tool center 1160, the pulley 1124, and the pulley 1126, 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 each of the pulleys while rotating the each pulley.

Thus, as the wire 306 is pulled in the direction of arrow 306 in fig. 145, the fastener 326 coupled to the wire 306 and the pulley 1121 coupled thereto rotate in a clockwise direction in fig. 145. Conversely, when the wire 302 is pulled in the direction of arrow 302 in fig. 145, the fastener 326 coupled to the wire 302 and the pulley 1121 coupled thereto rotate in a counterclockwise direction in fig. 145.

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

On the one hand, when the wire 301 is pulled in the direction of arrow 301 in fig. 145 while the wire 305 is pulled in the direction of arrow 305 in fig. 145 (i.e., when both branches of the first jaw wire are pulled), as shown in fig. 144, since the wire 301 and the wire 305 are wound under the pulleys 1113 and 1114, the pulley 1111 fixedly combined with the wire 301 and the wire 305, the end tool center 1160 combined with the pulley 1111 as a whole rotates together in the counterclockwise direction about the third rotation axis 1143, thereby eventually causing the end tool 1100 to perform a pitching motion while rotating downward, wherein the pulleys 1113 and 1114 can rotate about the third rotation axis 1143 as an end tool pitching rotation axis. At this time, since the second jaw 1102 and the wire 302 and the wire 306 fixedly coupled thereto are wound over the pulleys 1123 and 1124 rotatable about the third rotation shaft 1143, the wire 302 and the wire 306 are released in opposite directions of the wires 302 and 306, respectively.

Conversely, when wire 302 is pulled in the direction of arrow 302 in fig. 145 while wire 306 is pulled in the direction of arrow 306 in fig. 145, as shown in fig. 144, since wire 302 and wire 306 are wound over pulleys 1123 and 1124, pulley 1121 fixedly coupled to wire 302 and wire 306, end tool center 1160 coupled to pulley 1121 rotate together as a unit in a clockwise direction about third rotation axis 1143, thereby eventually causing end tool 1100 to perform a pitching motion while rotating upward, wherein pulleys 1123 and 1124 are rotatable about third rotation axis 1143, which is the end tool pitching rotation axis. At this time, since the first jaw 1101 and the wire 301 and the wire 305 fixedly coupled thereto are wound under the pulleys 1113 and 1114 rotatable about the third rotation shaft 1143, the wire 302 and the wire 306 are moved in opposite directions of the wires 301 and 305, respectively.

In one aspect, the tip tool center 1160 of the tip tool 1100 of the electrocautery surgical instrument 10 of the present invention further has a first and second elevation pulley portions 1163a and 1163b serving as tip tool elevation pulleys, the operation portion 200 further has pulleys 231 and 232 serving as operation 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 1160 including the first and second elevation sheave portions 1163a and 1163b may be formed to be rotatable about a third rotation axis 1143 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 1163a and 1163b of the end tool 1100 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 end tool center 1160 of the end tool 1100 through the wires 303 and 304, so that the end tool center 1160 is also rotated together, thereby making the end tool 1100 perform a pitching motion while finally rotating.

That is, the electrocautery surgical instrument 10 according to the fourth embodiment of the present invention has the first and second tilt pulley portions 1163a and 1163b of the tip tool 1100, 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 the tilt motion, so that the driving force of the tilt motion of the operation portion 200 is more perfectly transmitted to the tip tool 1100, whereby the reliability of the motion can be improved.

(Blade lead and guide tube)

Hereinafter, the blade wire 307 and the guide tube 1170 of the present invention will be described in more detail.

The guide tube 1170 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 1170. In other words, the blade wire 307 is movable with respect to the guide tube 1170 in a state where the blade wire 307 is inserted into the guide tube 1170.

Here, when the blade wire 307 is pushed or pulled, the guide tube 1170 prevents the blade wire 307 from being bent in an unexpected direction, thereby serving to guide the path of the blade wire 307. The guide tube 1170 described above allows smooth cutting operation.

In one aspect, one end of the guide tube 1170 may be fixedly coupled to an actuation center 1190 described later. Here, the actuation center 1190 may serve as a first joint. In addition, the other end portion of the guide tube 1170 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 1170 are fixedly coupled to predetermined points (the first coupling portion and the second coupling portion), respectively, the entire length of the guide tube 1170 can be maintained constant. Thus, the length of the blade wire 307 inserted inside the guide tube 1170 can also be kept constant.

In one aspect, the guide tube 1170 according to the present invention may be formed of a flexible material so as to be capable of being formed in a curved manner. Thus, when the end tool 1100 is performing yaw motions about the first rotational axis 1141 or pitch motions about the third rotational axis 1143, the shape of the guide tube 1170 may flex while deforming in response to these motions. In addition, when the guide tube 1170 is bent, the blade wire 307 inside it is also bent together.

Here, the length of the guide tube 1170 is constant, but the relative position and relative distance of the first joint (i.e., the actuation center 1190) and the second joint (not shown) may change with the pitch rotation or yaw rotation of the end tool 1100, and thus, a space for the guide tube 1170 to move in accordance with the change in the corresponding distance is required. To this end, a pitch Slit (PITCH SLIT) 1164 and a Yaw Slit (Yaw Slit) 1165 may be provided on the end tool center 1160 to form a space in which the guide tube 1170 is movable. The configuration of the end tool center 1160 as described above will be described in detail later.

In one aspect, as described above, the blade wire 307 is inserted through the interior of the guide tube 1170, and the blade wire 307 is movable within the guide tube 1170 relative to the guide tube 1170. That is, when the blade wire 307 is pulled in a state where the guide tube 1170 is fixed, the blade 1175 connected to the blade wire 307 moves toward the proximal end portion 1105, and when the blade wire 307 is pushed, the blade 1175 connected to the blade wire 307 moves toward the distal end portion 1104.

A more detailed description of this is as follows.

In order to perform the cutting action using blade 1175, the most reliable way is to push and pull blade 1175 with blade wire 307. In addition, in order for the blade wire 307 to push and pull the blade 1175, a guide tube 1170 that can guide the path of the blade wire 307 is required. If the guide tube 1170 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 a cutting operation using the blade 1175, the blade wire 307 and the guide tube 1170 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, it is necessary to use a wire that is relatively rigid (i.e., not easily bendable) 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 if a force of a certain degree or more is applied thereto, permanent deformation may occur.

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 when passing over the respective pulleys, a space having a gentle bending of the blade wire 307 is required between the jaw 1103 (i.e., the actuation rotation shaft 1145) and the tip tool center 1160 (i.e., the first rotation shaft 1141 as a yaw axis).

For this, one feature of the present invention is that the first rotation shaft 1141 and the actuation rotation shaft 1145, which are yaw rotation shafts, are separately provided, and the first rotation shaft 1141 and the actuation rotation shaft 1145 are spaced apart from each other to some extent, thereby forming a space in which the blade wire 307 and the guide tube 1170 can be gently bent.

In addition, the blade wire 307 and the guide tube 1170 need to pass through the end tool center 1160 to be connected to the blade 1175, and a space having the blade wire 307 and the guide tube 1170 bendable is required inside the end tool center 1160, so the following condition needs to be formed: 1) Inside the end tool center 1160 there is room for the blade wires 307/guide tubes 1170 to pass through while being flexible, i.e. forming pitch slits 1164 and yaw slits 1165; 2) Each rotation shaft is formed by dividing into two parts; 3) Pitch and yaw arcs 1166 and 1167 are additionally formed to guide bending of the blade wires 307 and guide tube 1170.

This is described from another point of view, that is, when one end portion of the guide tube 1170 is fixed inside the connection portion 400 and the other end portion thereof moves while performing pitch motion and yaw motion, the guide tube 1170 is bent in a direction that can achieve the most gentle curvature (hereinafter referred to as "the most gentle curvature") according to the distance change 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.

Thus, to ensure maximum gentle curvature, pitch slits 1164 and yaw slits 1165 are formed on the path of the guide tube 1170, and further pitch arcs 1166 and yaw arcs 1167 are additionally formed on the end tool center 1160. As a result, the guide tube 1170 can be formed into a shape closest to the maximum gentle curvature (even if the maximum gentle curvature is not reached).

Hereinafter, the end tool center 1160 as described above will be described in more detail.

(End tool center)

Fig. 147 is a perspective view showing the end tool center of the electrocautery instrument of fig. 140. Fig. 148 and 149 are cut-away perspective views of the end tool center of fig. 147. Fig. 150 and 151 are perspective views illustrating the end tool center of fig. 147. Fig. 152 is a side view showing the end tool center and guide tube of fig. 147. Fig. 153 is a plan view showing the end tool center and guide tube of fig. 147.

Referring to fig. 147-153, tip tool center 1160 includes a main body portion 1161, a first jaw pulley coupling portion 1162a, a second jaw pulley coupling portion 1162b, a first pitch pulley portion 1163a, a second pitch pulley portion 1163b, a pitch slit 1164, a yaw slit 1165, a pitch arc portion 1166, a yaw arc portion 1167, and a wire guide portion 1168. In addition, wire guide 1168 includes a first wire guide 1168a and a second wire guide 1168b.

The distal side of the tip tool center 1160 may be formed with a first jaw pulley coupling 1162a and a second jaw pulley coupling 1162b. Here, the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162b are formed to face each other, and the pulleys 1111 and 1121 are accommodated therein. Here, the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162b may be formed substantially parallel to a plane perpendicular to the first rotation axis 1141 as a yaw rotation axis.

The first jaw pulley coupling 1162a and the second jaw pulley coupling 1162b are connected by a body portion 1161. That is, the first jaw pulley coupling portion 1162a and the second jaw pulley coupling portion 1162b, which are parallel to each other, are coupled by the body portion 1161 formed in a direction substantially perpendicular thereto, and therefore, the first jaw pulley coupling portion 1162a, the second jaw pulley coupling portion 1162b, and the body portion 1161 are substantially formed in a "U" shape, and the pulleys 1111 and 1121 are accommodated therein.

This is described from another point of view, and can be described as the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162b extending from the main body 1161 in the X-axis direction.

Here, the pulley 1111 as the first jaw pulley is disposed adjacent to the first jaw pulley coupling 1162a of the tip tool center 1160, and the pulley 1121 as the second jaw pulley is disposed adjacent to the second jaw pulley coupling 1162b of the tip tool center 1160, and thus, a yaw slit 1165 may be formed between the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162 b. In addition, at least a portion of a blade assembly described later may be disposed inside the yaw slit 1165. Describing this from another perspective, at least a portion of the guide tube 1170, which can be described as a blade assembly, is disposed between the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162 b. As described above, one feature of the present invention is that since the blade assembly including the guide tube 1170 is disposed between the pulley 1111 as the first jaw pulley and the pulley 1121 as the second jaw pulley, the end tool 1100 can perform a cutting action using the blade 1175 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 1162a such that the first rotary shaft 1141 passes through the first jaw pulley coupling 1162a and the pulley 1111 to couple them. Further, a through hole is formed on the second jaw pulley coupling 1162b such that the first rotary shaft 1141 passes through the second jaw pulley coupling 1162b and the pulley 1121 to shaft-couple them.

At this time, as described above, the first rotary shaft 1141, which is a yaw rotary shaft, may be formed in two, i.e., formed as the first auxiliary shaft 1141a and the second auxiliary shaft 1141b, and the guide tube 1170 may pass between the first auxiliary shaft 1141a and the second auxiliary shaft 1141b of the first rotary shaft 1141.

In addition, a yaw slit 1165 may be formed between the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162 b. Because yaw slit 1165 is formed inside end tool center 1160 in this manner, guide tube 1170 may pass through the inside of end tool center 1160.

This is described from another perspective, i.e., the first rotational axis 1141 is separated up and down and does not pass through the end tool center 1160, and the yaw slit 1165 may be formed on a plane perpendicular to the first rotational axis 1141 near the first rotational axis 1141. Thus, the guide tube 1170 can move (i.e., move left and right) inside the yaw slit 1165 while passing near the first rotational axis 1141.

In one aspect, a yaw arc 1167 may be further formed on the body 1161. The yaw arc 1167 may be formed in a circular arc shape to have a predetermined curvature. In detail, the yaw arc 1167 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the first rotation axis 1141 as a yaw rotation axis. For example, the yaw arc 1167 may be formed in a fan shape, and may be formed along a path along which the guide tube 1170 is bent in the XY plane. When the end tool 1100 is performing yaw rotation, the yaw arc 1167 as described above may be used to guide the path of the guide tube 1170.

A wire guide 1168 for guiding a path of a wire passing through the inside of the end tool center 1160 is formed at one side of the body portion 1161. Here, the wire guide 1168 includes a first wire guide 1168a and a second wire guide 1168b. Here, the first wire guide 1168a may be formed on an inner surface of the first jaw pulley coupling 1162 a. In addition, a second wire guide 1168b may be formed on an inner surface of the second jaw pulley coupling 1162 b.

Here, the wire guide 1168 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 pulleys 1111 and 1121. Describing this from another perspective, it can be described that the wire guide portion 1168 protrudes into the space formed by the first jaw pulley coupling 1162a, the second jaw pulley coupling 1162b, and the main body portion 1161. This is described from another perspective, namely, a region adjacent to the first jaw pulley coupling 1162a and the second jaw pulley coupling 1162b in the wire guide 1168, a cross section of which is curved to have a predetermined curvature.

Or describing this from another point of view, it can be described that the outer circumferential surface of the wire guide 1168 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 1168 is not a member rotated about a predetermined axis, but is fixedly formed as a part of the end tool center 1160, 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.

Here, the wire guide 1168 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 1168 on the XY plane is shown to have a predetermined circular arc shape. However, the spirit of the present invention is not limited thereto, and the guide portion 1168 may be formed in various shapes and sizes to fit the path of the guide wire 305, the guide wire 302, for example, elliptical, parabolic, etc. in section to have a predetermined curvature, or the corners of a polygonal body are formed to have a circular arc shape to some extent, etc.

Here, guide grooves may be further formed on portions of the wire guide 1168 in contact with the wires 305 and 302 for better guiding paths of the wires 305 and 302. The guide groove may be formed in a groove (groove) shape recessed from the protruding surface of the wire guide 1168 to some extent.

Here, although the drawings show that the guide groove is formed on the entire arc surface of the wire guide 1168, 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 1168 as needed.

As described above, since the guide groove is further formed on the wire guide 1168, unnecessary friction with each wire can be reduced to improve the durability of the wire.

A first tilt sheave portion 1163a and a second tilt sheave portion 1163b may be formed on the proximal end side of the tip tool center 1160 to function as a tip tool tilt sheave. Here, the first and second elevation sheave portions 1163a and 1163b may be formed to face each other. Here, the first and second tilt sheave portions 1163a and 1163b may be formed substantially parallel to a plane perpendicular to the third rotation axis 1143 as a tilt rotation axis.

In detail, one end of the tip tool center 1160 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 1163a and a second elevation pulley portion 1163b can be formed. The wire 303 and the wire 304 described above are coupled to the first and second elevation sheave portions 1163a and 1163b serving as elevation sheaves of the end tool, and the end tool center 1160 performs an elevation motion while rotating about the third rotation axis 1143.

In one aspect, although not shown in the figures, the pitch pulleys may also be formed as separate components from the end tool center 1160 to be coupled with the end tool center 1160.

The first and second pitch sheave portions 1163a and 1163b are connected by a main body portion 1161. That is, since the first and second pitch sheave portions 1163a and 1163b parallel to each other are coupled by the main body portion 1161 formed in a direction substantially perpendicular thereto, the first and second pitch sheave portions 1163a and 1163b and the main body portion 1161 substantially form a "U" shape.

This is described from another angle, that is, it can be described that the first and second tilt sheave portions 1163a and 1163b are formed extending from the main body portion 1161 in the-X axis direction.

On the one hand, a through hole is formed on the first elevation sheave portion 1163a so that the third rotation shaft 1143 can pass through the first elevation sheave portion 1163a. Further, a through hole is formed on the second elevation sheave portion 1163b so that the third rotation shaft 1143 can pass through the second elevation sheave portion 1163b.

At this time, as described above, the third rotary shaft 1143, which is a pitch rotary shaft, may be formed in two, that is, formed as the first auxiliary shaft 1143a and the second auxiliary shaft 1143b, and the guide tube 1170 may pass between the first auxiliary shaft 1143a and the second auxiliary shaft 1143b of the third rotary shaft 1143.

A pitch slit 1164 may be formed between the first pitch sheave portion 1163a and the second pitch sheave portion 1163 b. Since the pitch slit 1164 is formed inside the end tool center 1160 in this way, the guide tube 1170 can pass through the inside of the end tool center 1160.

This is described from another perspective, i.e., the third rotational axis 1143 is split left and right and does not pass through the end tool center 1160, and the pitch slit 1164 may be formed on a plane perpendicular to the third rotational axis 1143 near the third rotational axis 1143. Thus, the guide tube 1170 can move (i.e., up and down) inside the pitch slit 1164 while passing near the third rotational axis 1143.

In one aspect, pitch arc 1166 may be further formed on body 1161. The pitch arc part 1166 may be formed in a circular arc shape to have a predetermined curvature. In detail, the pitch arc part 1166 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the third rotation axis 1143 as a pitch rotation axis. For example, the pitch arc 1166 is formed in a fan shape, and may be formed along a path along which the guide tube 1170 is curved in the XZ plane. As the end tool 1100 is pitched, the pitch arc 1166 as described above may be used to guide the path of the guide tube 1170.

Here, the pitch slit 1164 and the yaw slit 1165 may be formed to be connected to each other. Thus, the guide tube 1170 and the blade wire 307 inside it can be disposed completely through the inside of the end tool center 1160. In addition, the blade 1175 thus coupled to an end of the blade wire 307 can reciprocate linearly inside the first jaw 1101 and the second jaw 1102.

As described above, the present invention is characterized in that the blade wire 307 and the guide tube 1170 need to pass through the end tool center 1160 to be connected to the blade 1175, and a space in which the blade wire 307 and the guide tube 1170 can be bent is required inside the end tool center 1160, so that the following conditions need to be formed: 1) Inside the end tool center 1160 there is room for the blade wires 307/guide tubes 1170 to pass through while being flexible, i.e. forming pitch slits 1164 and yaw slits 1165; 2) Each rotation shaft is formed by dividing into two parts; 3) Pitch and yaw arcs 1166, 1167 are additionally formed to guide bending of the blade wires 307/guide tubes 1170.

Hereinafter, the function and function of the wire guide 1168 will be described in more detail.

The wire guide 1168 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 1101 and the second jaw 1102.

That is, when the auxiliary pulley is not provided, the pulley 1111 as the first jaw pulley and the pulley 1211 as the second jaw pulley can be rotated only to right angles, respectively, but in the fourth embodiment of the present invention, by additionally having the wire guide 1168 on the end tool center 1160, 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 1100 are yaw-rotated by 90 °. In other words, the present invention is characterized in that the arrangement of the wire guide 1168 in the end tool center 1160 can expand the range of yaw rotation in which the actuation operation is possible. In other words, the present invention is characterized in that the arrangement of the wire guide 1168 in the end tool center 1160 can expand the range of yaw rotation in which the actuation operation is possible.

Further, the present invention is characterized in that since the wire guide 1168 is formed on the existing end tool center 1160 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 when performing the pitching motion is shortened, and thus the effect of easier performing the surgical motion in a narrow space can be obtained.

A more detailed description of this is as follows.

The distal tool 1100 of the surgical instrument according to the fourth embodiment of the present invention is characterized in that since the wire guide 1168 that changes the path of the wire is formed on the inner side wall of the distal tool center 1160, the setting path of the wire can be changed even without a separate structure. As described above, the wire guide 1168 is formed on the end tool center 1160 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 pulley.

That is, the fastener 326 joining the wire 302 and the pulley 1121 may be rotated until it is located on the inner common tangent of the pulley 1121 and the wire guide 1168. Similarly, the fastener (see 323 in fig. 6) that combines the wire 305 and the pulley 1111 can be rotated until it is located on the inner common tangent line of the pulley 1111 and the wire guide 1168, 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 around the pulley 1111 by the wire guide 1168. 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 1121 through the wire guide 1168.

In other words, pulleys 1113 and 1114 are disposed on one side with respect to a plane perpendicular to the Y axis and passing through the X axis, and pulleys 1123 and 1124 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 1111 and the wire guide 1168, and the rotation angle of the pulley 1111 is enlarged by the wire guide 1168. In addition, the wire 302 is positioned on an inscribed line of the pulley 1121 and the wire guide 1168, and the rotation angle of the pulley 1121 is enlarged by the wire guide 1168.

The length of the end tool of the surgical instrument of the present embodiment, which is formed without the auxiliary pulley and the wire guide 1168, which can change the path of the wire, is formed on the inner side wall of the end tool center 1160, can be shortened as compared with the surgical instrument of the first embodiment, which forms a 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 operator easily 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 1111 as the first jaw pulley and the pulley 1121 as the second jaw pulley is widened, an effect of widening the range of yaw motion which can perform a normal opening and closing actuation motion and a cutting motion can be obtained.

(Actuation center)

Fig. 154 is a perspective view and cut-away perspective view showing the center of actuation of the electrocautery surgical instrument of fig. 140 of fig. 147. Fig. 155 is a diagram showing a state in which a guide tube, a blade wire, and a blade are attached in a cut-away perspective view of the actuation center of fig. 154. Fig. 156 is an exploded perspective view showing an end tool of the electrocautery instrument of fig. 140.

Referring to fig. 154 to 156, the actuation center 1190 may be formed in the shape of a box having a hollow interior. Further, an actuation center 1190 is coupled to the first jaw 1101 and the second jaw 1102, respectively. In detail, the actuation center 1190 is coupled to the first jaw 1101 shaft via a first actuation rotational shaft 1145 a. In addition, the actuation center 1190 is pivotally coupled to the second jaw 1102 by a second actuation rotational shaft 1145 b. At this time, the first actuation rotation shaft 1145a and the second actuation rotation shaft 1145b may be disposed on the same line in the Z-axis direction.

Further, a tube seating portion 1190a may be formed inside the actuation center 1190, and an end portion of the guide tube 1170 may be fixedly coupled to the tube seating portion 1190a.

In one aspect, the blade receiving portion 1190b may be formed inside the actuation center 1190, and the blade 1175 may be received inside the blade receiving portion 1190 b.

Further, a wire through hole 1190c may be formed between the tube seating portion 1190a and the blade receiving portion 1190b inside the actuation center 1190.

That is, the tube seating portion 1190a, the wire through hole 1190c, and the blade receiving portion 1190b are sequentially formed inside the actuation center 1190, and the blade wire 307 may be connected to the blade 1175 through the inside of the actuation center 1190.

As described above, by providing an actuation center 1190 between the first jaw 1101 and the second jaw 1102, the guide tube 1170 can be unbent or the angle of bend of the guide tube 1170 can be reduced even if the first jaw 1101 or the second jaw 1102 is rotated about the first rotational axis 1141 or the actuation rotational axis 1145, wherein the actuation center 1190 incorporates the guide tube 1170 thereon.

In detail, in the case where the guide tube 1170 is directly coupled to the first jaw 1101 or the second jaw 1102, when the first jaw 1101 or the second jaw 1102 is rotated, one end portion of the guide tube 1170 is also rotated together with the first jaw 1101 or the second jaw 1102, and at the same time, the guide tube 1170 is bent.

In contrast, as described in this embodiment, when the guide tube 1170 is coupled to the actuation center 1190, the guide tube 1170 does not bend or even slightly bends, even if the first jaw 1101 or the second jaw 1102 is rotated, thereby reducing the angle of bending, wherein the actuation center 1190 is not affected by the rotation of the jaws 1103.

That is, by changing the direct connection formed between the guide tube 1170 and the jaw 1103 to an indirect connection by actuating the center 1190, the degree of bending of the guide tube 1170 due to rotation of the jaw 1103 can be reduced.

(First jaw, second jaw, and actuation action)

Hereinafter, the combined structure of the first jaw 1101 and the second jaw 1102 of the end tool 1100 of the surgical instrument 10 of fig. 140 will be described in more detail.

Referring to fig. 157 to 162, etc., the first jaw 1101 includes a movable coupling hole 1101c, a jaw pulley coupling hole 1101d, and a shaft through portion 1101e.

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

On the other hand, a movable coupling hole 1101c, a jaw pulley coupling hole 1101d, and a shaft penetrating portion 1101e may be formed on the side of the first jaw 1101 coupled to the pulley 1111, that is, on the proximal end (proximal end) side.

Here, the movable coupling hole 1101c is formed to have a predetermined curvature, and may be formed substantially in an elliptical shape. The shaft coupling portion 1111a of the pulley 1111, which will be described later, may be inserted into the movable coupling hole 1101 c. Here, the short radius of the movable coupling hole 1101c may be formed to be substantially equal to or slightly larger than the radius of the shaft coupling portion 1111 a. In addition, the long radius of the swing coupling hole 1101c may be formed to be larger than the radius of the shaft coupling portion 1111 a. Accordingly, in a state in which the shaft coupling portion 1111a of the pulley 1111 is inserted into the movable coupling hole 1101c of the first jaw 1101, the shaft coupling portion 1111a is formed to be movable inside the movable coupling hole 1101c to some extent. As will be described in more detail later.

On the one hand, the jaw pulley coupling hole 1101d is formed in a cylindrical hole shape, and a jaw coupling portion 1111b of a pulley 1111, which will be described later, may be inserted into the jaw pulley coupling hole 1101d. Here, the radius of the jaw pulley coupling hole 1101d may be formed to be substantially equal to or slightly larger than the radius of the jaw coupling 1111 b. Accordingly, the jaw coupling 1111b of the pulley 1111 may be formed to be rotatably coupled to the jaw pulley coupling hole 1101d of the first jaw 1101. As will be described in more detail later.

The shaft penetration portion 1101e may be relatively formed at the distal end portion side of the first jaw 1101 as compared to the movable coupling hole 1101c and the jaw pulley coupling hole 1101 d. The shaft penetration portion 1101e is formed in a hole shape, and the actuation rotation shaft 1145 may be inserted through the shaft penetration portion 1101e.

The second jaw 1102 includes a movable coupling hole 1102c, a jaw pulley coupling hole 1102d, and a shaft penetration 1102e.

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

On the other hand, a movable coupling hole 1102c, a jaw pulley coupling hole 1102d, and a shaft penetrating portion 1102e may be formed on the side of the second jaw 1102 coupled to the pulley 1111, that is, on the proximal end (proximal end) side.

Here, the movable coupling hole 1102c is formed to have a predetermined curvature, and may be formed substantially in an elliptical shape. The shaft coupling portion 1121a of the pulley 1121 described later may be inserted into the movable coupling hole 1102 c. Here, the short radius of the movable coupling hole 1102c may be formed to be substantially equal to or slightly larger than the radius of the shaft coupling portion 1121 a. In addition, the long radius of the movable coupling hole 1102c may be formed to be larger than the radius of the shaft coupling portion 1121 a. Accordingly, in a state where the shaft coupling portion 1121a of the pulley 1121 is inserted into the movable coupling hole 1102c of the second jaw 1102, the shaft coupling portion 1121a is formed to be movable to some extent inside the movable coupling hole 1102 c. As will be described in more detail later.

On the one hand, the jaw pulley engaging hole 1102d is formed in a cylindrical hole shape, and a jaw engaging portion 1121b of a pulley 1121 described later can be inserted into the jaw pulley engaging hole 1102d. Here, the radius of the jaw pulley coupling hole 1102d may be formed to be substantially equal to or slightly larger than the radius of the jaw coupling 1121 b. Accordingly, the jaw coupling 1121b of the pulley 1121 may be formed to be rotatably coupled to the jaw pulley coupling hole 1102d of the second jaw 1102. As will be described in more detail later.

In one aspect, the shaft through portion 1102e can be formed opposite the distal end side of the second jaw 1102 as compared to the movable coupling hole 1102c and the jaw pulley coupling hole 1102 d. The shaft penetration portion 1102e is formed in a hole shape, and the actuation rotation shaft 1145 can be inserted through the shaft penetration portion 1102e.

The pulley 1111 as the first jaw pulley may include a shaft coupling 1111a and a jaw coupling 1111b. The pulley 1111 is integrally formed in a rotatable disc shape, and the shaft coupling portion 1111a and the jaw coupling portion 1111b may be formed to protrude to some extent on one surface of the pulley 1111. As described above, the shaft coupling portion 1111a of the pulley 1111 can be inserted into the movable coupling hole 1101c of the first jaw 1101, and the jaw coupling portion 1111b of the pulley 1111 can be inserted into the jaw pulley coupling hole 1101d of the first jaw 1101. The pulley 1111 may be formed to be rotatable about a first rotation shaft 1141 as a rotation shaft of the end tool jaw pulley.

In one aspect, the pulley 1121 as the second jaw pulley may also include a shaft coupling 1121a and a jaw coupling 1121b. The pulley 1121 is formed in a rotatable disc shape as a whole, and the shaft coupling portion 1121a and the jaw coupling portion 1121b may be formed protruding to some extent on one surface of the pulley 1121. As described above, the shaft coupling portion 1112a of the pulley 1112 can be inserted into the movable coupling hole 1102c of the second jaw 1102, and the jaw coupling portion 1112b of the pulley 1112 can be inserted into the jaw pulley coupling hole 1102d of the second jaw 1102. The pulley 1121 may be formed rotatable about a first rotational axis 1141 as the end tool jaw pulley rotational axis.

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

The first actuation rotary shaft 1145a is inserted through the shaft penetration 1101e and the actuation center 1190 of the first jaw 1101 in sequence. The second actuation rotary shaft 1145b is sequentially inserted through the shaft penetration 1102e of the second jaw 1102 and the actuation center 1190.

The shaft coupling 1111a of the pulley 1111 is inserted into the movable coupling hole 1101c of the first jaw 1101, and the jaw coupling 1111b of the pulley 1111 is inserted into the jaw pulley coupling hole 1101d of the first jaw 1101.

At this time, the jaw pulley coupling hole 1101d of the first jaw 1101 is rotatably coupled with the jaw coupling portion 1111b of the pulley 1111, and the movable coupling hole 1101c of the first jaw 1101 is movably coupled with the shaft coupling portion 1111a of the pulley 1111. (here, movably coupled means that the shaft coupling portion 1111a of the pulley 1111 is coupled to be movable to a certain extent inside the movable coupling hole 1101c of the first jaw 1101.)

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

At this time, the jaw pulley engaging hole 1102d of the second jaw 1101 is rotatably and axially engaged with the jaw engaging portion 1121b of the pulley 1121, and the movable engaging hole 1102c of the second jaw 1102 is movably engaged with the shaft engaging portion 1121a of the pulley 1121.

Here, the pulley 1111 and the pulley 1121 rotate about a first rotation shaft 1141 as the end tool jaw pulley rotation shaft. At the same time, the first jaw 1101 and the second jaw 1102 rotate about an actuation rotational axis 1145. That is, the rotational axis of pulley 1111 and the rotational axis of first jaw 1101 are different from each other. Similarly, the rotation axis of the pulley 1121 and the rotation axis of the second jaw 1102 are different from each other.

That is, although the rotation angle of the first jaw 1101 is limited to some extent by the movable coupling hole 1101c, it is rotated substantially about the actuation rotation shaft 1145 as the jaw rotation shaft. Similarly, although the rotation angle of the second jaw 1102 is limited to some extent by the movable engagement hole 1102c, it basically rotates about the actuation rotation shaft 1145 as the jaw rotation shaft.

The increase in the clamping force (grip force) due to the bonding relationship between the above-described constituent elements will be described.

One feature of the surgical instrument 110 according to an embodiment of the present invention is that the combined structure of the first jaw 1101 and the second jaw 1102 is formed in an X-shaped structure such that when the first jaw 1101 and the second jaw 1102 are rotated in a direction approaching each other (i.e., when the first jaw 1101 and the second jaw 1102 are closed (close), a clamping force (grip force) in a direction in which the first jaw 1101 and the second jaw 1102 are closed (close) further increases. A more detailed description of this is as follows.

As described above, in the operation of opening and closing the first jaw 1101 and the second jaw 1102, there are two shafts as the rotation centers thereof. That is, the first jaw 1101 and the second jaw 1102 are opened and closed about two axes, that is, the first rotation axis 1141 and the actuation rotation axis 1145. At this time, the rotation centers of the first jaw 1101 and the second jaw 1102 become the actuation rotation shaft 1145, and the rotation centers of the pulley 1111 and the pulley 1121 become the first rotation shaft 1141. At this time, the first rotary shaft 1141 is a shaft whose position is relatively fixed, and the actuation rotary shaft 1145 is a shaft whose position is relatively linearly moved. In other words, in a state where the position of the first rotation shaft 1141 is fixed, when the pulley 1111 and the pulley 1121 are rotated, the actuation rotation shaft 1145, which is the rotation shaft of the first jaw 1101 and the second jaw 1102, is moved forward and backward while opening (open)/closing (close) the first jaw 1101 and the second jaw 1102. A more detailed description of this is as follows.

R1 in fig. 161 is a distance from the jaw joint 1121b of the pulley 1121 to the shaft joint 1121a, and the length thereof is constant. Therefore, the distance from the first rotary shaft 1141 inserted into the shaft joint 1121a to the jaw joint 1121b is also constant at r1.

On the other hand, r2 in fig. 161 is a distance from the jaw pulley coupling hole 1102d of the second jaw 1102 to the shaft penetration portion 1102e, and the length thereof is constant. Therefore, the distance from the jaw coupling portion 1121b of the pulley 1121 inserted into the jaw pulley coupling hole 1102d to the rotary shaft 1145 inserted into the shaft penetration portion 1102e is also constant at r2.

That is, the lengths of r1 and r2 remain constant. Accordingly, when the pulley 1111 and the pulley 1121 rotate around the first rotation shaft 1141 in the direction of the arrow B1 in fig. 160 and the arrow B2 in fig. 161, respectively, to perform a closing (close) action, while the angle between r1 and r2 is changed in a state where the lengths of r1 and r2 remain constant, the first jaw 1101 and the second jaw 1102 rotate around the actuation rotation shaft 1145, and at this time, the actuation rotation shaft 1145 itself also performs a linear movement (i.e., a forward movement/a backward movement) in the arrow C1 in fig. 160 and the arrow C2 in fig. 161.

That is, assuming that the position of the first rotation shaft 1141, which is the rotation shaft of the end tool jaw pulley, is fixed, at this time, if the first jaw 1101 and the second jaw 1102 are closed (close), the actuation rotation shaft 1145, which is the jaw rotation shaft, is forced in the forward moving direction (i.e., distal end direction), and thus, the holding force (clip force) in the direction in which the first jaw 1101 and the second jaw 1102 are closed (close) is further increased.

This is described from another perspective, i.e., as the second jaw 1102 rotates about the actuation rotational axis 1145, the angle between r1 and r2 changes as the lengths of r1 and r2 remain constant as the pulley 1121 rotates about the first rotational axis 1141. That is, the angle θ2 between r1 and r2 in the closed (close) state of the second jaw 1102 as shown in fig. 161 (b) is further increased compared to the angle θ1 between r1 and r2 in the open (open) state of the second jaw 1102 as shown in fig. 161 (a).

Thus, as the second jaw 1102 is rotated from the open to the closed state, the angle between r1 and r2 changes, and at the same time, the actuation rotational shaft 1145 is forced in a forward direction of movement.

At this time, since the rotation shaft 1141 is a shaft whose position is relatively fixed, the actuation rotation shaft 1145 moves forward in the direction of arrow C1 in fig. 160 and arrow C2 in fig. 161, and the gripping force (grip force) in the direction in which the second jaw 1102 is closed (close) further increases.

This is described from another angle, that is, when the pulley 1111 and the pulley 1121 rotate around the first rotation shaft 1141 as axes of which relative positions are fixed, the angle θ between r1 and r2 changes in a state where the distances of r1 and r2 are constant. In addition, when the angle θ changes as described above, the first jaw 1101 and the second jaw 1102 push or pull the actuation rotational shaft 1145, thereby actuating the rotational shaft 1145 to move forward or backward. At this time, when the first jaw 1101 and the second jaw 1102 are rotated in the closing (close) direction, the actuation rotation shaft 1145 is moved forward in the arrow C1 in fig. 160 and the arrow C2 in fig. 161, and thus, the clamping force (grip force) is further increased. Conversely, when the first jaw 1101 and the second jaw 1102 are rotated in the opening (open) direction, the actuation rotary shaft 1145 is moved rearward in the opposite direction of arrow C1 in fig. 160 and arrow C2 in fig. 161.

According to the configuration described above, when the first jaw 1101 and the second jaw 1102 are closed (close), the clamping force (grip force) becomes stronger, so that the effect that the operator can perform the actuation action strongly even with a small force can be obtained.

(Constituent elements related to cautery and cutting)

With continued reference to fig. 140-162, etc., an end tool 1100 of a fourth embodiment of the present invention can include a first jaw 1101, a second jaw 1102, a first electrode 1151, a second electrode 1152, a guide tube 1170, and a blade 1175 to perform cauterizing (cautery) and cutting (cutting) actions.

Here, the constituent elements related to blade driving, such as the guide tube 1170 and the blade 1175, may be collectively referred to as a blade assembly. One feature of an embodiment of the present invention is that since the blade assembly including the guide tube 1170 and blade 1175 is disposed between the pulley 1111 as the first jaw pulley and the pulley 1121 as the second jaw pulley, the cutting action using the blade 1175 can be performed while the tip tool 1100 performs the pitching action and the yawing action. As will be described in more detail.

As described above, the first jaw 1101 is connected to the first jaw pulley 1111, and when the first jaw pulley 1111 rotates around the first rotation axis 1141, the first jaw 1101 rotates around the first rotation axis 1141 together with the first jaw pulley 1111.

In one aspect, the first electrode 1151 can be formed on a surface of the first jaw 1101 facing the second jaw 1102. In addition, a second electrode 1152 can be formed on a surface of the second jaw 1102 facing the first jaw 1101.

At this time, a slit 1151a may be formed on the first electrode 1151, and the blade 1175 may be moved through the slit 1151 a. Further, a slit 1152a may be formed on the second electrode 1152, and the blade 1175 may be moved through the slit 1152 a.

Meanwhile, although not shown in the drawings, a spacer (not shown) may be formed between the first jaw 1101 and the first electrode 1151, and a spacer (not shown) may be formed between the second jaw 1102 and the second electrode 1152. The spacer (not shown) may comprise an insulating material such as ceramic. Or the first jaw 1101 and the second jaw 1102 themselves may be comprised of insulators such that the first electrode 1151 and the second electrode 1152 may remain insulated from each other until they contact each other without a separate insulator.

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 1101 or the second jaw 1102. The placement of tissue between the first jaw 1101 and the second jaw 1102, and the flow of current through the first electrode 1151 and the second electrode 1152, creates a current, voltage, resistance, impedance (Impedance), temperature, and the sensor (not shown) may be configured to measure at least a portion thereof.

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

In one region of blade 1175, a sharp and cut tissue edge may be formed. As at least a portion of the blade 1175 moves between the distal end 1104 and the proximal end 1105 of the end tool 1100, tissue disposed between the first jaw 1101 and the second jaw 1102 can be cut.

Here, one feature of the end tool 1100 of the electrocautery surgical instrument 10 according to an embodiment of the present invention is to have a guide tube 1170 and a blade 1175 disposed between the pulley 1111 and the pulley 1121. Another feature is that by having guide tube 1170 and blade 1175 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. A more detailed description of this is as follows.

Heretofore, various types of electrocautery surgical instruments have been developed. Among them, a vessel cutter called ADVANCED ENERGY DEVICE or "vessel occluder (VESSEL SEALER)" has an increased sensing function compared to the existing bipolar cautery method, and therefore, it supplies power of different polarities to both electrodes, denatures blood vessels by the heat generated thereby to stop bleeding, 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 motion in most cases, since it is necessary to have a blade for cutting tissue after cauterization and a structural member for linear reciprocation of such a blade must be additionally provided 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 1100 of the electrocautery instrument 10 according to an embodiment of the present invention is to have a guide tube 1170 and a blade 1175, wherein the guide tube 1170 is disposed between the pulleys 1111 and 1121, and wherein the blade 1175 moves between a first position and a second position as the blade wire 307 disposed inside the guide tube 1170 moves. Another feature is that by having guide tube 1170 and blade 1175 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. 163 is a view showing a closed state of the end tool of the electrocautery instrument of fig. 140,

Fig. 164 is a view showing an open state of an end tool of the electrocautery instrument of fig. 140. Fig. 165 is a diagram showing a state in which the blade lead 307 and the blade 1175 are located at the first position, fig. 166 is a diagram showing a state in which the blade lead 307 and the blade 1175 are located at the second position, and fig. 167 is a diagram showing a state in which the blade lead 307 and the blade 1175 are located at the third position.

Referring to fig. 163 to 167, it can be described that the cutting actions of fig. 165 to 167 are performed in a state where the first jaw 1101 and the second jaw 1102 are closed (close) as shown in fig. 163, so that the tissue between the first jaw 1101 and the second jaw 1102 is cut.

Here, the first position shown in fig. 165 may be defined as a state in which the blade 1175 is maximally introduced to the proximal portion 1105 side of the tip tool 1100. Or may be defined as a state in which the blade 1175 is located on the side adjacent to the pulley 1111/1121.

In one aspect, the third position shown in fig. 167 may be defined as a state in which the blade 1175 is maximally extracted toward the distal end 1104 side of the end tool 1100. Or may be defined as a state in which the blade 1175 is located at a position maximally spaced apart from the pulley 1111/1121.

First, as shown in fig. 164, in a state where the first jaw 1101 and the second jaw 1102 are opened (open), a tissue to be cut is placed between the first jaw 1101 and the second jaw 1102, and then an actuation action is performed to close (close) the first jaw 1101 and the second jaw 1102 (as shown in fig. 163).

Then, as shown in fig. 165, in a state where the blade wire 307 and the blade 1175 are located at the first position, by applying electric currents of different polarities to the first electrode 1151 and the second electrode 1152, tissue located between the first jaw 1101 and the second jaw 1102 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 moved in the arrow A1 direction in fig. 155 and the arrow A2 direction in fig. 167 in sequence, the blade 1175 combined with the blade wire 307 is moved from the first position of the proximal end 1105 of the end tool 1100 to the third position of the distal end 1104 of the end tool 1100, while sequentially reaching the positions of fig. 166 and 167.

As described above, the blade 1175 cuts tissue located between the first jaw 1101 and the second jaw 1102 while moving in the X-axis direction.

However, the linear movement of the blade 1175 herein does not mean a complete straight line, but may be understood as a movement to the extent that the cutting of the tissue is performed while the linear movement is performed, 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 in a certain section, or the like.

On the one hand, when the blade wire 307 is pulled in the opposite direction in this state, the blade 1175 combined with the blade wire 307 will also return to the first position.

(Operation section)

Fig. 216 and 217 are perspective views of the operative portion of the surgical instrument of fig. 140. Fig. 218 is a schematic diagram simply showing the configuration of pulleys and wires that make up the joint of the electrocautery instrument shown in fig. 140.

Referring to fig. 140 to 162, 216 to 218, according to the electrocautery surgical instrument 10 of the fourth embodiment of the present invention, the operating portion 200 includes: a first handle 204 for grasping by a user; an actuation operation portion 203 for controlling an actuation movement of the end tool 1100; a deflection operation section 202 for controlling a deflection movement of the end tool 1100; and a pitch operation section 201 for controlling the pitch movement of the end tool 1100. Wherein it is to be appreciated that fig. 216 and 217 illustrate only the constituent elements associated with the pitch/yaw/actuation motion of the electrocautery surgical instrument 10.

In addition, the operation portion 200 of the electrocautery surgical instrument 10 further includes: a blade operating part 260 for controlling the movement of the blade of the end tool 1100 to perform cutting; and a cautery operation portion 270 for controlling supply of electric power to the first electrode 1151 and the second electrode 1152 of the tip tool 1100 to perform cautery.

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) 1101. And may include pulley 220, pulley 221, pulley 222, pulley 223, pulley 224, pulley 225, pulley 226, pulley 227, and pulley 228 associated with the rotational movement of the second jaw (jaw) 1102. In addition, the operation portion 200 may include a pulley 231, a pulley 232, a pulley 233, and a pulley 234 related to the pitching motion. In addition, a pulley 235 may be included as an intermediate pulley, which extends over the middle of the curved portion 402 of the connecting portion 400.

In which, although the pulleys facing each other are shown to be formed in parallel with each other in the drawings, the idea of the present invention is not limited thereto, and each pulley may be formed in various positions and sizes suitable for the arrangement of the operating portion.

In addition, the operation portion 200 of the fourth 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. Wherein the rotation shaft 241 may be used as an operation portion first jaw actuation rotation shaft, and the rotation shaft 242 may be used as an operation portion second jaw actuation rotation shaft. The rotation shaft 243 may be used as an operation unit deflection main rotation shaft, and the rotation shaft 244 may be used as an operation unit deflection sub rotation shaft. Further, the rotation shaft 245 may serve 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 portion (DISTAL END) 205 to the proximal end portion (proximal end) 206 of the operation portion 200.

One or more pulleys may be inserted into these respective 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, these constituent elements may also 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 also 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 also be collectively referred to as operation portion deflection sub-pulleys.

Pulleys 215 and 216 serve as the operating portion first jaw pitch sub-pulleys, and pulleys 225 and 226 serve as the operating portion second jaw pitch sub-pulleys, which may also 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 also 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 constituent elements are classified from the angle of the operation portion of each motion (yaw/pitch/actuation) as follows.

The pitch operation part 201 is used to control pitch motion of the tip tool 1100, and may include a pulley 215, a pulley 216, a pulley 217, a pulley 218, a pulley 225, a pulley 226, a pulley 227, a pulley 228, a pulley 231, a pulley 232, and a pulley 234. In addition, 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 yaw manipulation portion 202 is used to control yaw movement of the tip tool 1100, and 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. In addition, the deflection operation portion 202 may include a rotation shaft 243 and a rotation shaft 244. Further, the deflection operation section 202 may further include a deflection frame 207.

The actuation operation part 203 is for controlling an actuation motion of the end tool 1100, and may include a pulley 210, a pulley 220, a rotation shaft 241, and a rotation shaft 242. In addition, the actuation operation portion 203 may further include a first actuation operation portion 251 and a second actuation operation portion 256.

Each constituent element of the operation section 200 will be described in more detail below.

The first handle 204 is intended to be grasped by a user's hand, and in particular, the user may grip the first handle 204 around his or her palm. Further, 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. Wherein the ends of the first and second actuation extensions 252, 257 may be formed in a finger ring shape and act as a second handle.

Here, the rotation shafts 241 and 242, which are actuation rotation shafts, may form 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 idea of the present invention is not limited thereto, and the rotation shafts 241 and 242 may be formed in various directions to accommodate the hand structure of the user who grips the actuation operation portion 203 by an ergonomic (ergonomic) design.

On the other hand, the pulley 210, the first actuating extension 252, and the first actuating gear 253 may be fixedly coupled to each other and rotated together about the rotation shaft 241. The pulley 210 may be composed of one pulley or may be composed of two pulleys fixedly coupled to each other.

Likewise, the pulley 220, the second actuation extension 257, and the second actuation gear 258 may be fixedly coupled to one another and rotate together about the rotational axis 242. The pulley 220 may be composed of one pulley or may be composed of two pulleys fixedly coupled to each other.

Wherein the first actuating gear 253 and the second actuating gear 258 may be intermeshed, and when either side rotates, they rotate together in opposite directions to each other.

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. The deflection operation portion 202 may further include a pulley 213 and a pulley 214 as operation portion first jaw deflection sub-pulleys formed on one sides of the pulleys 211 and 212, and a pulley 223 and a pulley 224 as operation portion second jaw deflection sub-pulleys formed on one sides of the pulleys 221 and 222. Among them, the pulleys 213 and 214 and the pulleys 223 and 224 may be coupled to a pitch frame 208 to be described later.

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

In detail, a rotation shaft 243 is formed on one side of the actuation operation portion 203 on the first handle 204, and deflects the main rotation shaft as an operation portion. At this time, the first handle 204 may be rotated about the rotation axis 243.

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

On the other hand, the pulleys 211 and 212 and the pulleys 221 and 222 are combined with the rotation shaft 243 so that they can rotate around the rotation shaft 243. Also, the wire 301 or the wire 305 as the first jaw wire may be wound around the pulleys 211 and 212, and the wire 302 or the wire 306 as the second jaw wire may be wound around the pulleys 221 and 222. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be respectively composed of two pulleys facing each other and rotatable independently. Thus, the wound-in wire and the wound-out wire can be respectively wound on different pulleys so as not to interfere with each other during the action.

The deflecting frame 207 is rigidly connected to the first handle 204, the rotary shaft 241, the rotary shaft 242, and the rotary shaft 243, so that the first handle 204, the deflecting operation portion 202, and the actuating operation portion 203 can integrally perform deflecting rotation about the rotary shaft 243.

The pitch operation part 201 may include a rotation shaft 246, pulleys 217 and 218 as operation part first jaw pitch main pulleys, pulleys 227 and 228 as operation part second jaw pitch main pulleys, and a pitch frame (PITCH FRAME) 208. In addition, the pitch operation section 201 may further include a rotation shaft 245, pulleys 215 and 216 as operation section first jaw pitch sub-pulleys formed on one sides of the pulleys 217 and 218, and pulleys 225 and 226 as operation section second jaw pitch sub-pulleys formed on one sides of the pulleys 227 and 228. The pitch operation part 201 may be connected to the bending part 402 of the connection part 400 through the rotation shaft 246.

In detail, the pitch frame 208 is a base frame of the pitch operation part 201, one end of which is rotatably coupled to the rotation shaft 243. That is, the yaw frame 207 is 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 pitching rotated 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 pitching rotated 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 other words, when the user pitch-rotates 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 pulleys 227 and 228 are coupled to rotation axis 246 so as to be rotatable about rotation axis 246 of pitch frame 208.

Wherein the pulley 217 and the pulley 218 may be formed to face each other and to be independently rotatable. Thus, the wound-in wire and the wound-out wire can be respectively wound on different pulleys so as not to interfere with each other during the action. Likewise, the pulley 227 and the pulley 228 may be formed to face each other and be rotatable independently. Thus, the wound-in wire and the wound-out wire can be respectively wound on different pulleys so as not to interfere with each other during the action.

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

In the tip tool 1100, the pulley 1131 as a tip tool pitch pulley is fixedly coupled to the tip tool center 1180, and in the operation section 200, the pulleys 231 and 232 as operation section pitch pulleys are fixedly coupled to the pitch frame 208. In addition, these pulleys may be connected to each other by a wire 303 and a wire 304 as pitch wires, so that the pitch action of the end tool 1100 is more easily performed according to the pitch operation of the operation portion 200. Wherein wire 303 is fixedly coupled to pitch frame 208 via pulleys 231 and 233, and wire 304 is fixedly coupled to pitch frame 208 via pulleys 232 and 234. That is, by the pitching rotation of the operation portion 200, the pitching frame 208 is rotated together with the pulleys 231 and 232 about the rotation axis 246, and as a result, the wires 303 and 304 are also moved, so that in addition to the pitching action of the end tool by the wires 301, 302, 305 and 306 as jaw wires, additional pitching rotation power can be transmitted.

The connection relation between the first handle 204 and each of the pitch operation section 201, yaw operation section 202, and actuation operation section 203 is summarized as follows. The first handle 204 may be formed with 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. 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 can be directly connected. On the other 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. On the other hand, since the pitch operation section 201 is 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, and the pitch operation section 201 and the first handle 204 can be indirectly connected through the yaw operation section 202.

With continued reference to the drawings, in the electrocautery surgical instrument 10 according to the first embodiment of the present invention, the pitch operation part 201 and the end tool 1100 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 1100 is formed at the other end of the connection part 400.

In addition, one or more intermediate pulleys 235 for altering or guiding the wire path may be distributed throughout the middle of the connection 400, particularly at the bend 402. At least some of the wires are wound around such intermediate pulleys 235 to guide the path of the wires so that the wires can be arranged along the curved shape of the curved portion 402.

In which, although the connection part 400 is shown in the drawings as having the bent part 402 and being bent to have a predetermined curvature, the idea of the present invention is not limited thereto, and the connection part 400 may be formed in a straight line as needed or may be formed by at least one bending, in which case, it can be said that the pitch operation part 201 and the end tool 1100 are formed on substantially the same or parallel axes. Further, although it is shown in fig. 3 that the pitch operation part 201 and the end tool (end tool) 1100 are formed on axes parallel to the X axis, respectively, the idea of the present invention is not limited thereto, and the pitch operation part 201 and the end tool (end tool) 1100 may be formed on different axes.

(Actuation action, yaw action, pitch action)

The actuation, yaw and pitch actions in this embodiment are as follows.

First, the actuation action is as follows.

When the actuation extension 252, 257 is rotated using either one or both fingers in a state in which the user inserts the index finger into the finger ring formed in the first actuation extension 252 and inserts the thumb into the finger ring formed in the second actuation extension 257, the pulley 210 and the first actuation gear 253 fixedly coupled with the first actuation extension 252 are rotated about the rotation axis 241, and the pulley 220 and the second actuation gear 258 fixedly coupled with the second actuation extension 257 are rotated about the rotation axis 242. At this time, since the pulley 210 and the pulley 220 are rotated in opposite directions, the wire 301 and the wire 305, one end of which is fixedly coupled to be wound around the pulley 210, and the wire 302 and the wire 306, one end of which is fixedly coupled to be wound around the pulley 220, are also moved in opposite directions. Further, such a rotational force is transmitted to the end tool 1100 through the power transmission portion 300, thereby causing the two jaws (jaw) 1103 of the end tool 1100 to perform an actuation action.

Wherein the actuation action refers to an action of expanding or closing the jaws (jaw) 1101 and 1102 while the two jaws (jaw) 1101 and 1102 are rotated in opposite directions to each other as described above. That is, when the actuation extensions 252 and 257 of the actuation handle 203 are rotated in directions approaching each other, the first jaw (jaw) 1101 is rotated counterclockwise and the second jaw (jaw) 1102 is rotated clockwise, thereby closing the end tool 1100. Conversely, when the actuation extensions 252 and 257 of the actuation handle 203 are rotated in directions away from each other, the first jaw (jaw) 1101 is rotated clockwise and the second jaw (jaw) 1102 is rotated counterclockwise, thereby opening the end tool 1100.

In the present embodiment, in order to perform the above-described actuation operation, the first actuation extension 252 and the second actuation extension 257 are provided to form a second handle, and can be operated by grasping with two fingers. However, other modifications of the arrangement of the actuation operation portion 203 for the actuation operation of opening and closing the two jaws of the end tool 1100 are possible, for example, the two actuation pulleys (the pulley 210, the pulley 220) are operated opposite to each other by one actuation rotation portion, and the like, unlike the above.

Next, the deflection 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 deflection operation portion 202 are deflected and rotated about the rotation axis 243. That is, when the pulley 210 of the first actuation operation portion 251 fixedly coupled with the wire 301 and the wire 305 rotates about the rotation shaft 243, the wire 301 and the wire 305 wound around the pulley 211 and the pulley 212 are moved. Likewise, 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 are moved. At this time, the wires 301 and 305 connected to the first jaw 1101 and the wires 302 and 306 connected to the second jaw 1102 are wound around the pulleys 211 and 212 and the pulleys 221 and 222 so that the first jaw 1101 and the second jaw 1102 rotate in the same direction when performing the yaw rotation. Further, such a rotational force is transmitted to the end tool 1100 through the power transmission portion 300, so that the two jaws (jaw) 1103 of the end tool 1100 perform a deflecting action of 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 can rotate together about the rotation shaft 243.

Next, the pitching action is as follows.

When the user rotates the first handle 204 about the rotation axis 246 while holding the first handle 204, the actuation operation portion 203, the yaw operation portion 202, and the pitch operation portion 201 perform pitch rotation about the rotation axis 246. That is, when the pulley 210 of the first actuation operation portion 251 fixedly coupled with the wire 301 and the wire 305 rotates about the rotation shaft 246, the wire 301 and the wire 305 wound around the pulley 217 and the pulley 218 are moved. Likewise, 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 are moved. At this time, as described with reference to fig. 5, the wire 301 and the wire 305 as the first jaw wire move in the same direction, the wire 302 and the wire 306 as the second jaw wire move in the same direction, and 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 tilting main pulley, respectively, so that the first jaw 1101 and the second jaw 1102 can perform tilting rotation. Further, this rotational force is transmitted to the end tool 1100 through the power transmission portion 300, thereby causing the two jaws (jaw) 1103 of the end tool 1100 to perform a pitching motion.

At this time, since the pitch frame 208 is connected to the yaw frame 207, the yaw frame 207 is connected to the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243, and therefore, when the pitch frame 208 rotates around the rotation shaft 246, the yaw frame 207, the first handle 204, the rotation shaft 241, the rotation shaft 242, and the rotation shaft 243 connected to the pitch frame 208 rotate together. 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 surgical instrument 10 according to an embodiment of the present invention is characterized in that a pulley around which a wire (the first jaw wire or the second jaw wire) is wound is formed at each articulation point (actuation joint, yaw joint, pitch joint), and a rotational operation (actuation rotation, yaw rotation, pitch rotation) of the operation portion causes movement of each wire, as a result, causes a desired motion of the end tool 1100. Further, auxiliary pulleys may be formed at one side of each pulley, by which the wire is not wound around one pulley a plurality of times.

Fig. 218 is a schematic diagram simply illustrating the configuration of pulleys and wires that make up the joint of the electrocautery surgical instrument 10 according to an embodiment of the present invention as shown in fig. 140. In fig. 218, intermediate pulleys for changing the wire path are omitted, regardless of the joint motion.

Referring to fig. 218, 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) 1101.

Also, the operating part 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) 1102.

(Since the arrangement and configuration of each pulley in the operation portion 200 is basically the same as that of each pulley in the end tool 1100, some specific reference numerals in the drawings are omitted.)

The pulleys 211 and 212 and the pulleys 221 and 222 are rotatable independently of each other about the rotation shaft 243 as the same axis. At this time, the pulleys 211 and 212 and the pulleys 221 and 222 may be respectively composed of two pulleys facing each other and rotatable independently.

The pulleys 213 and 214, and the pulleys 223 and 224 are rotatable independently of each other about the rotation axis 244 as the same axis. At this time, the pulley 213 and the pulley 214 may be composed of two pulleys facing each other and rotatable independently, wherein the two pulleys may have different diameters. Likewise, the pulley 223 and the pulley 224 may be composed of two pulleys facing each other and rotatable independently, wherein the two pulleys may have different diameters.

The pulleys 215 and 216 and the pulleys 225 and 226 can be rotated independently of each other about the rotation shaft 245 as the same axis. At this time, the pulley 215 and the pulley 216 may have different diameters. Also, the pulley 225 and the pulley 226 may have different diameters.

Pulley 217 and pulley 218, and pulley 227 and pulley 228 are rotatable independently of each other about a rotation axis 246 as the same axis.

The wire 301 is wound around the pulley 210 after passing through the pulley 217, the pulley 215, the pulley 213, and the pulley 211 of the operation part 200 in order, and then coupled to the pulley 210 by the fastener 324. On the other hand, the wire 305 passes through the pulley 218, the pulley 216, the pulley 214, and the pulley 212 of the operation portion 200 in this order, and is coupled to the pulley 210 by the fastener 324. Thus, as the pulley 210 rotates, the wire 301 and the wire 305 are wrapped around or released from the pulley 210, respectively, causing the first jaw 1101 to rotate.

The wire 306 is wound around the pulley 220 after passing through the pulleys 227, 225, 223 and 221 of the operation part 200 in order, and then coupled with the pulley 220 by the fastener 327. On the other hand, the wire 302 is coupled to the pulley 220 by the fastener 327 after passing through the pulleys 228, 226, 224, and 222 of the operation unit 200 in this order. Thus, as the pulley 220 rotates, the wire 302 and the wire 306 are wrapped or released over the pulley 220, respectively, causing the second jaw 1102 to rotate.

(Conceptual diagram of pulleys and wires)

Fig. 220 and 221 are diagrams showing, in an exploded manner, the configuration of pulleys and wires associated with the actuation and yaw motions of the electrocautery surgical instrument 10 illustrated in fig. 140, respectively, according to a first and second jaw, according to an embodiment of the present invention. Fig. 220 is a diagram showing only the pulley and wire associated with the second jaw, and fig. 221 is a diagram showing only the pulley and wire associated with the first jaw. Further, fig. 219 is a perspective view showing a yaw motion of the surgical instrument of fig. 140. Here, constituent elements related to the cutting action are omitted in fig. 219.

First, the action of the wire that actuates the action will be described.

Referring to fig. 221, when the first actuating extension 252 rotates in the arrow OPA1 direction about the rotation shaft 241, the pulley 210 connected to the first actuating extension 252 rotates, and the wire 301 and the wire 305 wound around the pulley 210 move in the W1a and W1b directions, respectively, as a result, the first jaw 1101 of the end tool 1100 rotates in the arrow EPA1 direction.

Referring to fig. 220, 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 1102 of the end tool 1100 rotates in the direction of arrow EPA 2. Thus, when the user manipulates the first and second actuation extensions 252, 257 toward one another, the first and second jaws 1101, 1102 of the end tool perform a movement toward one another.

Next, the operation of the wire for yaw operation will be described.

First, since the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 are connected through the yaw frame (see 207 in fig. 216), the rotation shaft 243, the rotation shaft 241, and the rotation shaft 242 are rotated together as a whole.

Referring to fig. 221, when the first handle 204 is rotated in the arrow OPY1 direction about the rotation axis 243, the pulley 210, the pulley 211, the pulley 212, and the wire 301 and the wire 305 wound thereon are rotated as a unit about the rotation axis 243, as a result of which the wire 301 and the wire 305 wound on the pulley 211 and the pulley 212 are moved in the W1a, W1b directions, respectively, to thereby finally rotate the first jaw 1101 of the end tool 1100 in the arrow EPY1 direction.

Referring to fig. 220, 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 1101 of the end tool 1100 in the arrow EPY2 direction.

Fig. 223 and 224 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. 140, according to one embodiment of the present invention. Fig. 223 is a diagram showing only the pulley and wire associated with the second jaw, and fig. 224 is a diagram showing only the pulley and wire associated with the first jaw. Since there are two pulleys for the pitching operation as shown in fig. 140, two branches of each wire are wound along the same path, and thus, in fig. 223, they are shown as one line. Further, fig. 222 is a perspective view showing a pitching motion of the surgical instrument of fig. 140. Here, constituent elements related to the cutting action are omitted in fig. 222.

Referring to fig. 223, when the first handle 204 is rotated about the rotation axis 246 in the arrow OPP1 direction, the pulley 210, the pulley 215, the pulley 217, and the like, and the wire 301 wound thereon, and the like are rotated as a whole about the rotation axis 246. At this time, 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 1101 of the end tool 1100 rotates in the direction of arrow EPP 1.

Referring to fig. 224, 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, 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 1102 of the end tool 1100 rotates in the direction of arrow EPP 2.

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

As described with reference to fig. 140, 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 configurations are the same as the joint configurations of the end tools, 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 joint, yaw joint, pitch joint) around which wires (first jaw wire or second jaw wire) are wound, and a rotational operation (actuation rotation, yaw rotation, pitch rotation) of the operation section moves each wire to finally guide the end tool 1100 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 paths of the wires wound into and unwound from the pulleys are safely formed, thereby improving safety, efficiency, etc. of the wire transmission power.

On the one hand, as described above, the yaw manipulation section 202 and the actuation manipulation section 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 yaw manipulation section 202 and the actuation manipulation section 203 are not fixed, but relatively change as the first handle 204 rotates. That is, in fig. 140 and the like, the yaw operation portion 202 and the actuation operation portion 203 are shown to be parallel to the Z axis. However, when the first handle 204 is rotated, the yaw manipulation section 202 and the actuation manipulation section 203 are not parallel to the Z-axis. That is, the coordinate systems of the yaw manipulation section 202 and the actuation manipulation section 203 are changed according to the rotation of the first handle 204. In this specification, however, unless otherwise specified, the coordinate systems of the yaw operating portion 202 and the actuation operating portion 203 are described based on the state in which the first handle 204 is positioned vertically with respect to the connecting portion 400 as shown in fig. 2 for convenience of description.

(Pitch, yaw, cutting action of end tool)

Fig. 168 and 169 are views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is rotated by +90° in yaw. Fig. 170 and 171 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 140 in a state rotated by-90 ° in yaw.

As shown in fig. 168 to 171, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed so that even in a state where the jaws (jaw) are rotated by +90° to-90 ° in yaw, the opening and closing operations, that is, the actuation operations, can be performed normally.

Fig. 172 and 173 are views showing a procedure of performing a cutting operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is yaw-rotated by +90°.

As shown in fig. 172 and 173, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed to perform a cutting operation normally even in a state where the jaw (jaw) is rotated by +90° in yaw.

Fig. 174 and 175 are views showing the process of opening and closing operations in a state where the distal end tool of the electrocautery instrument of fig. 140 is rotated up to +90°. Fig. 176 and 177 are views showing the procedure of opening and closing operations in a state in which the distal end tool of the electrocautery instrument of fig. 140 is rotated up to-90 °. Further, fig. 178 is a cut-away perspective view of the end tool of the electrocautery instrument of fig. 176. Fig. 179 and 180 are views showing a procedure of performing a cutting operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is rotated up to-90 °.

As shown in fig. 174 to 180, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed to normally perform a cutting action even in a state where the jaws (jaw) are rotated at-90 ° pitch.

On the other hand, fig. 181 is a diagram showing a state in which the jaw (jaw) is rotated in pitch by-90 ° while being rotated in yaw by +90°, and fig. 182, 183 and 184 are perspective views showing a state in which the cutting operation is performed in a state in which the jaw (jaw) is rotated in pitch by-90 ° while being rotated in yaw by +90° as the cutting operation of the end tool of the electrocautery surgical instrument of fig. 140.

As shown in fig. 181 to 184, the end tool of the electrocautery surgical instrument according to the fourth embodiment of the present invention is formed to normally perform a cutting action even in a state in which the jaws (jaw) are rotated in pitch by-90 ° while being rotated in yaw by +90°.

(First modification of the fourth embodiment)

Hereinafter, an end tool 1200 of a surgical instrument according to a first modification of the fourth embodiment of the present invention will be described. Here, the configuration of the actuation center 1290 is characteristically different from the tip tool 1200 of the surgical instrument according to the first modification of the fourth embodiment of the present invention, as compared with the tip tool (see 1100 in fig. 140 and the like) of the surgical instrument according to the fourth embodiment of the present invention described above. As described above, a configuration different from the fourth embodiment will be described in detail later.

Fig. 185 and 186 are perspective views showing an end tool of an electrocautery instrument according to a first modification of the fourth embodiment of the present invention. Fig. 187 and 188 are plan views showing an end tool of an electrocautery surgical instrument according to a first modification of the fourth embodiment of the present invention. Fig. 189 and 190 are diagrams showing an actuation center of an electrocautery surgical instrument according to a first modification of the fourth embodiment of the present invention.

Referring to fig. 185 to 190, an end tool (end tool) 1200 of a first modification of the fourth 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 tip tool 1200 includes a plurality of pulleys including pulley 1211, pulley 1213, and pulley 1214 associated with the rotational movement of the first jaw (jaw) 1201. In another aspect, the tip tool 1200 includes a plurality of pulleys including pulley 1221 associated with rotational movement of the second jaw (jaw) 1202.

Further, the end tool 1200 of the first modification of the fourth 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 shaft 1241, the rotation shaft 1243, and the rotation shaft 1244 may be sequentially provided from the distal end (DISTAL END) 1204 toward the proximal end (proximal end) 1205 of the tip tool 1200.

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

The rotation shaft 1241 is inserted through the end tool center 1260, and the pulleys 1211 and 1221 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.

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. 146) and the wire (see 304 in fig. 146) are coupled to the first and second tilt pulley portions 1263a and 1263b serving as the tip tool tilt pulleys, and the tip tool center 1260 performs a tilt action while rotating about the rotation axis 1243.

Rotation axis 1243 and rotation axis 1244 are inserted through pitch center 1250, and pitch center 1250 can be axially coupled with end tool center 1260 by rotation axis 1243. Thus, the end tool center 1260 may be formed to be pitching rotatable relative to the pitch center 1250 about the rotational axis 1243.

In one aspect, the end tool 1200 of the first variation of the fourth embodiment of the present invention may further include components such as a first electrode 1251, a second electrode 1252, a catheter 1271, and a blade 1275 for performing cauterizing (cautery) and cutting (cutting) actions. Here, the constituent elements of the guide tube 1271, the blade 1275, etc. related to blade driving may be collectively referred to as a blade assembly. Since the constituent elements for performing the cauterizing (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the fourth embodiment, a detailed description thereof will be omitted herein.

As in the fourth embodiment of the present invention shown in fig. 140 and the like, the electrocautery surgical instrument according to the first modification of the fourth 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.

Hereinafter, the actuation center 1290 of the first modification of the fourth embodiment of the present invention will be described in more detail.

Referring to fig. 185 to 190, the actuation center 1290 may be formed in the shape of a box having a hollow interior. Here, on any one surface of the actuation center 1290, in detail, a first coupling hole 1290a is formed on a surface in contact with the first jaw 1201, and on the other surface of the actuation center 1290, in detail, a second coupling hole 1290b is formed on a surface in contact with the second jaw 1202.

At this time, the first coupling hole 1290a may be formed to be offset (offset) to some extent from the X-axis direction center line to any one direction. Further, the second coupling hole 1290b may be formed to be offset (offset) to some extent from the X-axis direction center line to the other direction.

In other words, it may be described that the first and second coupling holes 1290a and 1290b are not formed on the same line in the Z-axis direction but are offset (offset) from each other to some extent.

Further, an actuation center 1290 is associated with the first and second jaws 1201, 1202, respectively. In detail, the first actuating rotation shaft 1291 is inserted through the first combining hole 1290a of the first jaw 1201 and the actuating center 1290, thereby combining the actuating center 1290 with the first jaw 1201 shaft. Further, a second actuation rotational shaft 1292 is inserted through the second jaw 1202 and the second engagement aperture 1290b of the actuation center 1290, thereby axially engaging the actuation center 1290 with the second jaw 1202.

On the one hand, as shown in fig. 154 and the like, a tube seating portion, a wire through hole, and a blade receiving portion are formed in this order inside the actuation center 1290, and the blade wire 307 passes through the inside of the actuation center 1290 to be connected to the blade 1275.

As described above, by providing the actuation center 1290 between the first jaw 1201 and the second jaw 1202, the guide tube 1270 may not be bent or the bending angle of the guide tube 1270 may be reduced even if the first jaw 1201 or the second jaw 1202 rotates about the first rotation axis 1241 or the actuation rotation axis 1245, wherein the actuation center 1290 incorporates the guide tube 1270.

In detail, in the case where the guide tube 1270 is directly coupled to the first jaw 1201 or the second jaw 1202, when the first jaw 1201 or the second jaw 1202 is rotated, one end portion of the guide tube 1270 is also rotated together with the first jaw 1201 or the second jaw 1202, and at the same time, the guide tube 1270 is bent.

In contrast, as described in the present embodiment, when the guide tube 1270 is combined with the actuation center 1290, even if the first jaw 1201 or the second jaw 1202 is rotated, the guide tube 1270 is not bent or even slightly bent, and the angle of bending can be reduced, wherein the actuation center 1290 is not affected by the rotation of the jaw 1203.

That is, by changing the direct connection formed between the guide tube 1270 and the jaws 1203 to an indirect connection by actuating the center 1290, the degree of bending of the guide tube 1270 due to the rotation of the jaws 1203 can be reduced.

In particular, in the tip tool 1200 of the first modification of the fourth embodiment of the present invention, when the actuation center 1290 is coupled to the first jaw 1201 and the second jaw 1202, the first actuation rotation shaft 1291 and the second actuation rotation shaft 1292 are not formed on the same line in the Z-axis direction but are offset (offset) from each other to some extent. Therefore, when the first jaw 1201 and the second jaw 1202 perform the actuation motion, the first actuation rotation shaft 1291 and the second actuation rotation shaft 1292 are formed as one kind of two-point support, so that the effect of performing the actuation motion more stably can be obtained.

(Second modification of the fourth embodiment)

Hereinafter, an end tool 1300 of a surgical instrument according to a second modification of the fourth embodiment of the present invention will be described. Here, the configuration of the actuation center 1390 is characteristically different from that of the end tool 1300 of the surgical instrument according to the second modification of the fourth embodiment of the present invention described above (see 1100 in fig. 140 and the like). As described above, a configuration different from the fourth embodiment will be described in detail later.

Fig. 191 to 196 are diagrams showing an end tool of an electrocautery surgical instrument according to a second modification of the fourth embodiment of the present invention. Fig. 197 and 198 are diagrams illustrating an actuation center of an end tool of the electrocautery surgical instrument of fig. 191. Fig. 199 is a perspective view of a second jaw pulley showing an end tool of the electrocautery instrument of fig. 191. Fig. 200 and 201 are diagrams showing an end tool of the electrocautery instrument of fig. 191.

Referring to fig. 191 to 201, an end tool (end tool) 1300 of a second modification of the fourth embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping (grip) action, i.e., a first jaw 1301 and a second jaw 1302, and herein, the first jaw 1301 and the second jaw 1302 or constituent elements that encapsulate the first jaw 1301 and the second jaw 1302 are referred to as jaws (jaw) 1303, respectively.

In one aspect, the end tool 1300 includes a plurality of pulleys including pulley 1311, pulley 1313, and pulley 1314 associated with the rotational movement of the first jaw (jaw) 1301. In another aspect, the end tool 1300 includes a plurality of pulleys including pulley 1321 associated with the rotational movement of the second jaw (jaw) 1302.

Further, the end tool 1300 of the second modification of the fourth embodiment of the present invention may include a rotation shaft 1341, a rotation shaft 1343, and a rotation shaft 1344. Here, the rotation shaft 1341 may be inserted through the end tool center 1360, while the rotation shaft 1343 and the rotation shaft 1344 may be inserted through the pitch center 1350.

Further, the end tool 1300 of the second modification of the fourth embodiment of the present invention may include an end tool center 1360 and a pitch center 1350.

In one aspect, the end tool 1300 according to the second modification of the fourth embodiment of the present invention may further include constituent elements such as a first electrode 1351, a second electrode 1352, a guide tube 1371, and a blade 1375 for performing the cauterizing (cautery) and cutting (cutting) actions.

As in the fourth embodiment of the present invention shown in fig. 140 and the like, the electrocautery surgical instrument according to the second modification of the fourth 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.

Since the constituent elements of the present modification described above are substantially the same as those described in the fourth embodiment, a detailed description thereof will be omitted here.

Hereinafter, the actuation center 1390 of the second modification of the fourth embodiment of the present invention will be described in more detail.

Referring to fig. 191 to 201, the actuation center 1390 may be formed in the shape of a box having a hollow interior.

Here, on any one surface of the actuation center 1390, in detail, a first coupling hole 1390a is formed on a surface in contact with the first jaw 1301, and on the other surface of the actuation center 1390, in detail, a second coupling hole 1390b is formed on a surface in contact with the second jaw 1302.

At this time, the first coupling hole 1390a may be formed to be offset (offset) to some extent from the X-axis direction center line to any one direction. Further, the second coupling hole 1390b may be formed to be offset (offset) to some extent from the X-axis direction center line to the other direction.

In other words, it can be described that the first coupling hole 1390a and the second coupling hole 1390b are not formed on the same line in the Z-axis direction, but are offset (offset) from each other to some extent.

Further, an actuation center 1390 is coupled to the first and second jaws 1301, 1302, respectively. In detail, the first actuation rotation shaft 1391 is inserted through the first jaw 1301 and the first coupling hole 1390a of the actuation center 1390, thereby coupling the actuation center 1390 to the first jaw 1301 shaft. Further, a second actuation rotation shaft 1392 is inserted through the second coupling hole 1390b of the second jaw 1302 and actuation center 1390, thereby coupling the actuation center 1390 to the second jaw 1302 shaft.

On the one hand, as shown in fig. 154 and the like, a tube placement portion, a wire through hole, and a blade housing portion are formed in this order inside the actuation center 1390, and the blade wire 307 is connected to the blade 1375 through the inside of the actuation center 1390.

Further, a guide slit 1390c is formed on either one surface or both surfaces of the actuation center 1390 along the longitudinal direction thereof (i.e., X-axis direction). Further, since the slit coupling portion 1321c formed on the pulley 1321 is inserted into the guide slit 1390c, the linear movement of the pulley 1321 in the X-axis direction can be guided by the guide slit 1390c.

In detail, a shaft coupling portion 1321a, a jaw coupling portion 1321b, and a slit coupling portion 1321c may be formed on the pulley 1321. Here, the formation of the shaft coupling portion 1321a and the jaw coupling portion 1321b may be the same as described in the fourth embodiment and the like. The slit coupling portion 1321c may be formed to protrude further from the shaft coupling portion 1321a to some extent.

The slit coupling portion 1321c as described above is inserted into the guide slit 1390c of the actuation center 1390.

On the other hand, although not shown in the drawings, a slit coupling portion (not shown) may be formed on the pulley 1311 in the same manner.

As described above, by providing the actuation center 1390 between the first jaw 1301 and the second jaw 1302, even if the first jaw 1301 or the second jaw 1302 rotates about the first rotation axis 1341 or the actuation rotation axis 1345, the guide tube 1370 may not bend or the bending angle of the guide tube 1370 may be reduced, wherein the actuation center 1390 incorporates the guide tube 1370 thereon.

In detail, in the case where the guide tube 1370 is directly coupled to the first jaw 1301 or the second jaw 1302, when the first jaw 1301 or the second jaw 1302 rotates, one end portion of the guide tube 1370 also rotates together with the first jaw 1301 or the second jaw 1302, and at the same time, the guide tube 1370 bends.

In contrast, as described in this embodiment, when the guide tube 1370 is combined with the actuation center 1390, even if the first jaw 1301 or the second jaw 1302 is rotated, the guide tube 1370 is not bent or even slightly bent, and the angle of bending can be reduced, wherein the actuation center 1390 is not affected by the rotation of the jaw 1303.

That is, by changing the direct connection formed between the guide tube 1370 and the jaws 1303 to an indirect connection by actuating the center 1390, the degree of bending of the guide tube 1370 due to the rotation of the jaws 1303 can be reduced.

In particular, in the end tool 1300 of the second modification of the fourth embodiment of the present invention, when the actuation center 1390 is coupled to the first jaw 1301 and the second jaw 1302, the first actuation rotation shaft 1391 and the second actuation rotation shaft 1392 are not formed on the same line in the Z-axis direction, but are offset (offset) from each other to some extent. Therefore, when the first jaw 1301 and the second jaw 1302 perform the actuation motion, the first actuation rotation shaft 1391 and the second actuation rotation shaft 1392 are formed as one kind of two-point support, so that an effect of performing the actuation motion more stably can be obtained.

In addition, in the end tool 1300 according to the second modification of the fourth embodiment of the present invention, a pulley is formed

The slit coupling portion 1321c on 1321 is inserted into the guide slit 1390c of the actuation center 1390, so that the linear movement of the pulley 1321 in the X-axis direction can be guided by the guide slit 1390 c. That is, when the first and second jaws 1301 and 1302 perform the actuation motion, the first and second jaws 1301 and 1302 move along the guide slit 1390c of the actuation center 1390, and therefore, an effect of performing the actuation motion more stably can be obtained.

(Third modification of the fourth embodiment)

Hereinafter, an end tool 1400 of a surgical instrument according to a third modification of the fourth embodiment of the present invention will be described. Here, the configuration of the actuation center 1490 is characteristically different from the end tool 1400 of the surgical instrument according to the third modification of the fourth embodiment of the present invention described above (see 1100 in fig. 140 and the like). As described above, a configuration different from the fourth embodiment will be described in detail later.

Fig. 202 to 205 are diagrams showing an end tool of an electrocautery surgical instrument according to a third modification of the fourth embodiment of the present invention. Fig. 206 and 207 are diagrams illustrating an actuation center of an end tool of the electrocautery surgical instrument of fig. 202. Fig. 208 is a perspective view showing a second jaw pulley of the end tool of the electrocautery instrument of fig. 202.

Referring to fig. 202 to 208, an end tool (end tool) 1400 of a third modification of the fourth embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping action, i.e., a first jaw 1401 and a second jaw 1402, and herein, the first jaw 1401 and the second jaw 1402 or constituent elements that enclose the first jaw 1401 and the second jaw 1402 are referred to as jaws (jaw) 1403, respectively.

In one aspect, the end tool 1400 includes a plurality of pulleys including pulley 1411, pulley 1413, and pulley 1414 associated with the rotational movement of the first jaw (jaw) 1401. In another aspect, the end tool 1400 includes a plurality of pulleys including pulley 1421 associated with the rotational movement of the second jaw (jaw) 1402.

Further, the end tool 1400 of the third modification of the fourth embodiment of the present invention may include a rotation axis 1441, a rotation axis 1443, and a rotation axis 1444. Here, the rotational axis 1441 may be inserted through the end tool center 1460, while the rotational axis 1443 and the rotational axis 1444 may be inserted through the pitch center 1450.

Further, the end tool 1400 of the third modification of the fourth embodiment of the present invention may include an end tool center 1460 and a pitch center 1450.

In one aspect, the end tool 1400 of the third modification of the fourth embodiment of the present invention may further include constituent elements such as a first electrode 1451, a second electrode 1452, a guide tube 1471, and a blade 1475 for performing cauterizing (cautery) and cutting (cutting) actions.

As in the fourth embodiment of the present invention shown in fig. 140 and the like, the electrocautery surgical instrument according to the third variation of the fourth 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.

Hereinafter, the actuation center 1490 of the third modification of the fourth embodiment of the present invention will be described in more detail.

Referring to fig. 202 to 208, the actuation center 1490 may be formed in the shape of a box that is hollow inside.

Here, on any one surface of the actuation center 1490, in detail, a first engaging hole 1490a is formed on a surface in contact with the first jaw 1401, and on the other surface of the actuation center 1490, in detail, a second engaging hole 1490b is formed on a surface in contact with the second jaw 1402.

At this time, the first and second coupling holes 1490a and 1490b may be located on the same line in the Z-axis direction.

Further, an actuation center 1490 is coupled to the first jaw 1401 and the second jaw 1402, respectively. In detail, the first actuation rotation shaft 1491 is inserted through the first combining hole 1490a of the first jaw 1401 and the actuation center 1490, thereby combining the actuation center 1490 with the first jaw 1401 shaft. In addition, second actuation rotational axis 1492 is inserted through second engagement aperture 1490b of second jaw 1402 and actuation center 1490, thereby axially engaging actuation center 1490 with second jaw 1402.

On the one hand, as shown in fig. 154 and the like, a tube placement portion, a wire through hole, and a blade housing portion are formed in this order inside the actuation center 1490, and the blade wire 307 is connected to the blade 1475 through the inside of the actuation center 1490.

Further, a guide slit 1490c is formed on either one surface or both surfaces of the actuation center 1490 along the longitudinal direction thereof (i.e., the X-axis direction). Further, since the slit coupling portion 1421c formed on the pulley 1421 is inserted into the guide slit 1490c, the linear movement of the pulley 1421 in the X-axis direction can be guided by the guide slit 1490c.

In detail, a shaft coupling portion 1421a, a jaw coupling portion 1421b, and a slit coupling portion 1421c may be formed on the pulley 1421. Here, the formation of the shaft coupling portion 1421a and the jaw coupling portion 1421b may be the same as that described in the fourth embodiment and the like. The slit coupling portion 1421c may be formed to protrude further from the shaft coupling portion 1421a to some extent.

The slit coupling portion 1421c as described above is inserted into the guide slit 1490c of the actuation center 1490.

On the other hand, although not shown in the drawings, a slit coupling portion (not shown) may be formed on the pulley 1411 in the same manner.

As described above, by providing the actuation center 1490 between the first jaw 1401 and the second jaw 1402, even if the first jaw 1401 or the second jaw 1402 rotates about the first rotation axis 1441 or the actuation rotation axis 1445, the guide tube 1470 can be not bent or the bending angle of the guide tube 1470 can be reduced, wherein the guide tube 1470 is incorporated on the actuation center 1490.

In detail, in the case where the guide tube 1470 is directly coupled to the first jaw 1401 or the second jaw 1402, when the first jaw 1401 or the second jaw 1402 is rotated, one end portion of the guide tube 1470 is also rotated together with the first jaw 1401 or the second jaw 1402, and at the same time, the guide tube 1470 is bent.

In contrast, as described in this embodiment, when guide tube 1470 is combined with actuation center 1490, even if first jaw 1401 or second jaw 1402 is rotated, guide tube 1470 is not bent or even slightly bent, the angle of bending can be reduced, wherein actuation center 1490 is not affected by the rotation of jaws 1403.

That is, by changing the direct connection formed between the guide tube 1470 and the jaw 1403 to the indirect connection through the actuation center 1490, the degree of bending of the guide tube 1470 due to the rotation of the jaw 1403 can be reduced.

In particular, in the end tool 1400 of the third modification of the fourth embodiment of the present invention, the slit coupling portion 1421c formed on the pulley 1421 is inserted into the guide slit 1490c of the actuation center 1490, so that the linear movement of the pulley 1421 in the X-axis direction can be guided by the guide slit 1490 c. That is, when the first jaw 1401 and the second jaw 1402 perform the actuation motion, the first jaw 1401 and the second jaw 1402 move along the guide slit 1490c of the actuation center 1490, and therefore, an effect of performing the actuation motion more stably can be obtained.

(Fourth modification of the fourth embodiment)

Hereinafter, an end tool 1500 of a surgical instrument according to a fourth modification of the fourth embodiment of the present invention will be described. Here, the configuration of the actuation center 1590 is characteristically different from the tip tool 1500 of the surgical instrument according to the fourth modification of the fourth embodiment of the present invention described above (see 1100 in fig. 140 and the like). As described above, a configuration different from the fourth embodiment will be described in detail later.

Fig. 209 to 213 are diagrams showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention. Fig. 214 and 215 are diagrams showing the center of actuation of the end tool of the electrocautery surgical instrument of fig. 209.

Referring to fig. 209 to 215, an end tool (end tool) 1500 of a fourth modification of the fourth embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping (grip) operation, i.e., a first jaw 1501 and a second jaw 1502, and herein, the first jaw 1501 and the second jaw 1502 or constituent elements that enclose the first jaw 1501 and the second jaw 1502 are referred to as jaws (jaw) 1503, respectively.

In one aspect, the end tool 1500 includes a plurality of pulleys including pulley 1511, pulley 1513, and pulley 1514 associated with the rotational movement of the first jaw (jaw) 1501. In another aspect, the end tool 1500 includes a plurality of pulleys including pulley 1521 associated with the rotational movement of the second jaw (jaw) 1502.

Further, the end tool 1500 of the fourth modification of the fourth embodiment of the present invention may include a rotation shaft 1541, a rotation shaft 1543, and a rotation shaft 1544. Here, the rotation shaft 1541 may be inserted through the end tool center 1560, and the rotation shaft 1543 and the rotation shaft 1544 may be inserted through the pitch center 1550. The rotation shaft 1541, the rotation shaft 1543, and the rotation shaft 1544 may be provided in order from the distal end portion (DISTAL END) 1504 to the proximal end portion (proximal end) 1505 of the end tool 1500.

Further, the end tool 1500 of the fourth modification of the fourth embodiment of the present invention may include an end tool center 1560 and a pitch center 1550.

The rotation shaft 1541 is inserted through the end tool center 1560, and the pulleys 1511 and 1521 shaft-coupled to the rotation shaft 1541 and at least a portion of the first and second jaws 1501 and 1502 coupled thereto may be housed inside the end tool center 1560.

In one aspect, a first pitch block portion 1563a and a second pitch block portion 1563b may be formed at an end of the end tool center 1560 to function as an end tool pitch block. The wire (see 303 in fig. 146) and the wire (see 304 in fig. 146) are coupled to the first and second elevation sheave portions 1563a and 1563b serving as end tool elevation sheaves, and the end tool center 1560 performs an elevation motion while rotating about the rotation axis 1543.

Rotation axis 1543 and rotation axis 1544 are inserted through pitch center 1550, and pitch center 1550 may be coupled axially with end tool center 1560 through rotation axis 1543. Thus, the end tool center 1560 may be formed to be pitching rotatable about the rotational axis 1543 relative to the pitch center 1550.

In one aspect, the end tool 1500 of the fourth modification of the fourth embodiment of the present invention may further include constituent elements such as a first electrode 1551, a second electrode 1552, a guide tube 1571, and a blade 1575 for performing cauterizing (cautery) and cutting (cutting) actions. The constituent elements of the boot tube 1571, blade 1575, etc. that are related to blade drive may be collectively referred to herein as a blade assembly. Since the constituent elements for performing the cauterizing (cautery) and cutting (cutting) actions in the present embodiment are substantially the same as those described in the fourth embodiment, a detailed description thereof will be omitted herein.

As in the fourth embodiment of the present invention shown in fig. 140 and the like, the electrocautery surgical instrument according to a fourth modification of the fourth 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.

Hereinafter, the actuation center 1590 of the fourth modification of the fourth embodiment of the present invention will be described in more detail.

Referring to fig. 209 to 215, the actuation center 1590 may be formed in the shape of a box having a hollow interior. Here, on any one surface of the actuation center 1590, in detail, a first coupling hole 1590a is formed on a surface in contact with the first jaw 1501, and on the other surface of the actuation center 1590, in detail, a second coupling hole 1590b is formed on a surface in contact with the second jaw 1502. At this time, the first coupling hole 1590a and the second coupling hole 1590b may be disposed on the same line in the Z-axis direction.

Further, an actuation center 1590 is coupled to the first and second jaws 1501, 1502, respectively. In detail, the first actuation rotation shaft 1591 is inserted through the first jaw 1501 and the first coupling hole 1590a of the actuation center 1590, thereby coupling the actuation center 1590 with the first jaw 1501 shaft. In addition, a second actuation rotation shaft 1592 is inserted through the second jaw 1502 and a second coupling aperture 1590b of the actuation center 1590 to couple the actuation center 1590 to the second jaw 1502 shaft.

In one aspect, as illustrated in fig. 154 and the like, a tube seating portion, a wire through-hole, and a blade receiving portion are sequentially formed inside the actuation center 1590, and the blade wire 307 is connected to the blade 1575 through the inside of the actuation center 1590.

As described above, by providing the actuation center 1590 between the first and second jaws 1501, 1502, the guide tube 1570 may not bend or the bending angle of the guide tube 1570 may be reduced even if the first or second jaws 1501, 1502 are rotated about the first or actuation rotational axes 1541, 1545, wherein the actuation center 1590 incorporates the guide tube 1570 thereon.

In detail, in the case where the guide tube 1570 is directly coupled to the first jaw 1501 or the second jaw 1502, when the first jaw 1501 or the second jaw 1502 is rotated, one end portion of the guide tube 1570 is also rotated together with the first jaw 1501 or the second jaw 1502, and at the same time, the guide tube 1570 is bent.

In contrast, as described in this embodiment, when the guide tube 1570 is coupled to the actuation center 1590, the guide tube 1570 does not bend or even slightly bend, even if the first or second jaws 1501, 1502 are rotated, which actuation center 1590 is not affected by the rotation of the jaws 1503.

That is, by actuating the center 1590, changing the direct connection formed between the guide tube 1570 and the jaws 1503 to an indirect connection, the extent of bending of the guide tube 1570 due to rotation of the jaws 1503 may be reduced.

As described above, the present invention has been described with reference to an embodiment shown in the drawings, but this is merely exemplary, and it will be understood by those skilled in the art 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.

Advantageous effects

According to the present invention as described above, since the direction in which the operation portion is operated by the operator and the operation direction of the end tool are intuitively identical, the convenience of the operator and the accuracy, reliability and rapidity of the operation can be 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 pitching operation of another conventional surgical instrument, and fig. 1d is a conceptual diagram of a yawing operation.

Fig. 1e is a conceptual diagram of a pitching operation of the surgical instrument according to the present invention, and fig. 1f is a conceptual diagram of a yawing operation.

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

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

Fig. 7 and 8 are plan views showing an end tool of the electrocautery instrument of fig. 2.

Fig. 9 is a perspective view showing the center of an end tool of the electrocautery instrument of fig. 2.

Fig. 10 and 11 are cut-away perspective views of the tip tool center of fig. 9.

Fig. 12 and 13 are perspective views illustrating the center of the end tool of fig. 9.

Fig. 14 is a side view showing the end tool center and guide tube of fig. 9.

Fig. 15 is a plan view showing the end tool center and guide tube of fig. 9.

Fig. 16 and 17 are plan views showing opening and closing actions of the distal end tool of the electrocautery surgical instrument of fig. 2.

Fig. 18-20 are partial cross-sectional views illustrating the action of the blades of the end tool of the electrocautery surgical instrument of fig. 2.

Fig. 21 and 22 are bottom views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated by-90 ° in yaw.

Fig. 23 and 24 are bottom views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated by +90° in yaw.

Fig. 25 and 26 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in the state in which the tip tool of the electrocautery surgical instrument of fig. 2 is rotated by +90° in yaw.

Fig. 27 and 28 are views showing the 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-90 ° in pitch.

Fig. 29 and 30 are views showing the 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 up to +90°.

Fig. 31 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 2 is rotated-90 ° in pitch.

Fig. 32 and 33 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the tip tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in pitch.

Fig. 34 is a perspective view showing a state in which the electrocautery instrument of fig. 2 performs pitch rotation and yaw rotation.

Fig. 35 to 37 are views showing a state in which cutting operation is performed in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated 90 ° in pitch while being rotated 90 ° in yaw.

Fig. 38 to 40 are diagrams showing an end tool of an electrocautery surgical instrument according to a modification of the first embodiment of the present invention.

Fig. 41 is a perspective view showing an electrocautery instrument according to a second embodiment of the present invention.

Fig. 42 to 47 are views showing an end tool of the electrocautery surgical instrument of fig. 41.

Fig. 48 is a perspective view showing the end tool center of the electrocautery instrument of fig. 41.

Fig. 49 and 50 are cut-away perspective views of the tip tool center of fig. 48.

Fig. 51 and 52 are perspective views illustrating the center of the end tool of fig. 48.

Fig. 53 is a side view showing the end tool center and guide tube of fig. 48.

Fig. 54 is a plan view showing the end tool center and guide tube of fig. 48.

Fig. 55 is a perspective view showing a first jaw of an end tool of the electrocautery instrument of fig. 41.

Fig. 56 is a perspective view showing a second jaw of an end tool of the electrocautery instrument of fig. 41.

Fig. 57 is a perspective view showing a first jaw pulley of an end tool of the electrocautery instrument of fig. 41.

Fig. 58 is a plan view illustrating an opening and closing operation of a first jaw of the end tool of the electrocautery instrument of fig. 41.

Fig. 59 is a plan view showing an opening and closing operation of a second jaw of the end tool of the electrocautery instrument of fig. 41.

Fig. 60 is a plan view showing opening and closing operations of the first jaw and the second jaw of the distal end tool of the electrocautery instrument of fig. 41.

Fig. 61 and 62 are plan views showing opening and closing operations of the first jaw and the second jaw according to an actuation operation of the end tool of the electrocautery surgical instrument of fig. 41.

Fig. 63-65 are partial cross-sectional views illustrating the action of the blades of the end tool of the electrocautery surgical instrument of fig. 41.

Fig. 66 and 67 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 41 in a state of yaw rotation by +90°.

Fig. 68 and 69 are views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 41 is rotated by-90 ° in yaw.

Fig. 70 and 71 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in the state in which the distal end tool of the electrocautery surgical instrument of fig. 41 is rotated by +90° in yaw.

Fig. 72 and 73 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 41 in a state of being rotated-90 ° in pitch.

Fig. 74 and 75 are views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 41 in a state of being rotated up to +90°.

Fig. 76 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 41 is rotated-90 ° in pitch.

Fig. 77 and 78 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the tip tool of the electrocautery surgical instrument of fig. 41 is rotated-90 ° in pitch.

Fig. 79 is a perspective view showing a state in which the electrocautery instrument of fig. 41 performs pitch rotation and yaw rotation.

Fig. 80 to 82 are views showing a state in which a cutting operation is performed in a state in which the distal end tool of the electrocautery surgical instrument of fig. 41 is rotated by-90 ° in pitch while being rotated by +90° in yaw.

Fig. 86 is a perspective view showing an electrocautery instrument according to a third embodiment of the present invention.

Fig. 87 to 92 are diagrams showing an end tool of the electrocautery surgical instrument of fig. 86.

Fig. 93 is a perspective view showing a yaw center of an end tool of the electrocautery instrument of fig. 86.

Fig. 94 is a cut-away perspective view showing the yaw center of the end tool of the electrocautery instrument of fig. 86.

Fig. 95 and 96 are perspective views showing a yaw center of an end tool of the electrocautery surgical instrument of fig. 86.

Fig. 97 and 98 are perspective views showing an actuation pulley and guide wire of an end tool of the electrocautery instrument of fig. 86.

Fig. 99 and 100 are perspective views showing an actuation pulley of an end tool of the electrocautery instrument of fig. 86.

Fig. 101 is a perspective view showing an actuation link of an end tool of the electrocautery instrument of fig. 86.

Fig. 102 to 104 are views showing opening and closing operations of the first jaw and the second jaw of the distal end tool of the electrocautery surgical instrument of fig. 86.

Fig. 105-108 are perspective views illustrating actuation of an end tool of the electrocautery instrument of fig. 86.

Fig. 109-111 are partial cross-sectional views illustrating the action of the blades of the end tool of the electrocautery surgical instrument of fig. 86.

Fig. 114 and 115 are bottom views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 86 in a state of yaw rotation by +90°.

Fig. 116 to 119 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in the state in which the tip tool of the electrocautery surgical instrument of fig. 86 is rotated by +90° in yaw.

Fig. 120 to 123 are diagrams showing the actuating links and the guide tube in a state in which the end tool of the electrocautery instrument of fig. 86 is yaw rotated +90°.

Fig. 124 and 125 are diagrams showing the actuating links and guide tubes in a state in which the end tool of the electrocautery instrument of fig. 86 is yaw rotated +90°.

Fig. 126 and 127 are views showing the procedure of opening and closing operations in a state in which the distal end tool of the electrocautery surgical instrument of fig. 86 is rotated up to-90 °.

Fig. 128 and 129 are views showing the procedure of opening and closing operations in a state in which the distal end tool of the electrocautery instrument of fig. 86 is rotated up to +90°.

Fig. 130 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 86 is rotated-90 ° in pitch.

Fig. 131 and 132 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in the state in which the distal end tool of the electrocautery surgical instrument of fig. 86 is rotated up to +90°.

Fig. 133 is a perspective view showing a state in which the electrocautery instrument of fig. 86 performs pitch rotation and yaw rotation.

Fig. 134 to 136 are views showing a state in which the cutting operation is performed in a state in which the distal end tool of the electrocautery surgical instrument of fig. 86 is rotated 90 ° in pitch while being rotated 90 ° in yaw.

Fig. 140 is a perspective view showing an electrocautery instrument according to a fourth embodiment of the present invention.

Fig. 141 to 146 are views showing an end tool of the electrocautery surgical instrument of fig. 140.

Fig. 147 is a perspective view showing the end tool center of the electrocautery instrument of fig. 140.

Fig. 148 and 149 are cut-away perspective views of the end tool center of fig. 147.

Fig. 150 and 151 are perspective views illustrating the end tool center of fig. 147.

Fig. 152 is a side view showing the end tool center and guide tube of fig. 147.

Fig. 153 is a plan view showing the end tool center and guide tube of fig. 147.

Fig. 154 is a perspective view and cut-away perspective view showing the center of actuation of the electrocautery surgical instrument of fig. 140 of fig. 147.

Fig. 155 is a diagram showing a state in which a guide tube, a blade wire, and a blade are attached in a cut-away perspective view of the actuation center of fig. 154.

Fig. 156 is an exploded perspective view showing an end tool of the electrocautery instrument of fig. 140.

Fig. 157 is a perspective view illustrating a first jaw of an end tool of the electrocautery instrument of fig. 140.

Fig. 158 is a perspective view showing a second jaw of an end tool of the electrocautery instrument of fig. 140.

Fig. 159 is a perspective view showing a first jaw pulley of the electrocautery instrument of fig. 140.

Fig. 160 is a plan view illustrating an opening and closing operation of a first jaw of the end tool of the electrocautery instrument of fig. 140.

Fig. 161 is a plan view illustrating an opening and closing operation of a second jaw of the end tool of the electrocautery instrument of fig. 140.

Fig. 162 is a plan view illustrating opening and closing operations of the first jaw and the second jaw of the end tool of the electrocautery instrument of fig. 140.

Fig. 163 and 164 are plan views showing opening and closing actions of the end tool of the electrocautery surgical instrument of fig. 140.

Fig. 165-167 are partial cross-sectional views illustrating the action of the blades of the end tool of the electrocautery surgical instrument of fig. 140.

Fig. 168 and 169 are views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is rotated by-90 ° in yaw.

Fig. 170 and 171 are bottom views showing the process of opening and closing the distal tool of the electrocautery surgical instrument of fig. 140 in a yaw rotated +90°.

Fig. 172 and 173 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the distal tool of the electrocautery surgical instrument of fig. 140 is yaw-rotated.

Fig. 174 and 175 are views showing the process of opening and closing operations in a state where the distal end tool of the electrocautery instrument of fig. 140 is rotated up to +90°.

Fig. 176 and 177 are views showing the procedure of opening and closing operations in a state in which the distal end tool of the electrocautery instrument of fig. 140 is rotated up to-90 °.

Fig. 178 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 140 is rotated-90 ° in pitch.

Fig. 179 and 180 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is rotated-90 ° in pitch.

Fig. 181 is a perspective view showing a state in which the electrocautery instrument of fig. 140 performs pitch rotation and yaw rotation.

Fig. 182 to 184 are views showing a state in which the cutting operation is performed in a state in which the distal end tool of the electrocautery surgical instrument of fig. 140 is rotated 90 ° in pitch while being rotated 90 ° in yaw.

Fig. 185 and 186 are perspective views showing an end tool of an electrocautery instrument according to a first modification of the fourth embodiment of the present invention.

Fig. 187 and 188 are plan views showing an end tool of an electrocautery surgical instrument according to a first modification of the fourth embodiment of the present invention.

Fig. 189 and 190 are diagrams showing an actuation center of an electrocautery surgical instrument according to a first modification of the fourth embodiment of the present invention.

Fig. 191 to 196 are diagrams showing an end tool of an electrocautery surgical instrument according to a second modification of the fourth embodiment of the present invention.

Fig. 197 and 198 are diagrams illustrating an actuation center of an end tool of the electrocautery surgical instrument of fig. 191.

Fig. 199 is a perspective view of a second jaw pulley showing an end tool of the electrocautery instrument of fig. 191.

Fig. 200 and 201 are diagrams showing an end tool of the electrocautery instrument of fig. 191.

Fig. 202 to 205 are diagrams showing an end tool of an electrocautery surgical instrument according to a third modification of the fourth embodiment of the present invention.

Fig. 206 and 207 are diagrams illustrating an actuation center of an end tool of the electrocautery surgical instrument of fig. 202.

Fig. 208 is a perspective view showing a second jaw pulley of the end tool of the electrocautery instrument of fig. 202.

Fig. 209 to 213 are diagrams showing an end tool of an electrocautery surgical instrument according to a fourth modification of the fourth embodiment of the present invention.

Fig. 214 and 215 are diagrams showing the center of actuation of the end tool of the electrocautery surgical instrument of fig. 209.

Fig. 216 and 217 are perspective views showing an operation portion of the electrocautery surgical instrument of fig. 140.

Fig. 218 is a diagram schematically showing only the arrangement of pulleys and wires constituting the joint of the electrocautery instrument shown in fig. 140.

Fig. 219 is a perspective view illustrating a yaw motion of the electrocautery instrument of fig. 140.

Fig. 220 and 221 are diagrams showing the arrangement of pulleys and wires associated with the actuation and yaw motions of the electrocautery instrument shown in fig. 140, respectively, in an exploded view according to the first and second jaws.

Fig. 222 is a perspective view illustrating a pitching motion of the electrocautery instrument of fig. 140.

Fig. 223 and 224 are diagrams showing the arrangement of pulleys and wires associated with the pitching action of the electrocautery instrument shown in fig. 140, respectively, in an exploded manner according to the first and second jaws.

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 application. Singular expressions include plural expressions unless the context clearly indicates otherwise. In the present disclosure, 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.

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.

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.

< First embodiment of electrocautery surgical instrument >

Fig. 2 is a perspective view showing an electrocautery instrument according to a first embodiment of the present invention. Fig. 3, 4,5 and 6 are perspective views showing an end tool of the electrocautery instrument of fig. 2. Fig. 7 and 8 are plan views showing an end tool of the electrocautery instrument of fig. 2. Fig. 9 is a perspective view showing the center of an end tool of the electrocautery instrument of fig. 2. Fig. 10 and 11 are cut-away perspective views of the tip tool center of fig. 9. Fig. 12 and 13 are perspective views illustrating the center of the end tool of fig. 9. Fig. 14 is a side view showing the end tool center and guide tube of fig. 9. Fig. 15 is a plan view showing the end tool center and guide tube of fig. 9. Fig. 16 and 17 are plan views showing opening and closing actions of the distal 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 600, 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 operation part 200 is coupled to one end of the connection part 400, and the end tool 600 is coupled to the other end of the connection part 400, and the connection part 400 may be used to connect the operation part 200 and the end tool 600. 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 end tool 600, 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 600. 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 600 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 603 through wires (ELECTRIC WIRE) 411 and 412 to transfer electric power supplied from the external power source (not shown) to the jaws 603. 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 interfaces, such as a pincer shape, a bar shape, a lever shape, etc., which can be directly manipulated by a doctor, and when manipulated by the doctor, is connected to the corresponding interfaces to perform a predetermined operation of the end tool 600 inserted into the body of the surgical patient, thereby performing the 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 600 to operate the end tool 600.

An end tool 600 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 600, as shown in fig. 2, a pair of jaws (jaw) 603 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 600. For example, a configuration such as a single-arm cautery may also be used as the end tool. Such an end tool 600 is connected through the operation part 200 and the power transmission part 300, and receives the driving force of the operation part 200 through the power transmission part 300, thereby performing actions required for surgery, such as grasping (grip), cutting (cutting), suturing (suturing), and the like.

Wherein the end tool 600 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 600 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 600 rotates in the up-down direction with respect to the extending direction of the connection part 400 (X-axis direction in fig. 2), that is, a motion in which it rotates around the Y-axis in fig. 2. In other words, it means a movement in which the end tool 600 rotates up and down about the Y axis with respect to the joint 400, wherein the end tool 600 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 600 rotates in the left-right direction with respect to the extending direction (X-axis direction in fig. 2) of the connecting portion 400, 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 600 rotates left and right about the Z axis with respect to the joint 400, wherein the end tool 600 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) 603 formed in two end tools 600 rotate in the same direction about the Z axis.

On the other hand, the actuation (actuation) action refers to an action in which the tip tool 600 rotates about the same rotation axis as the deflection (yaw) action, but the two jaws (jaw) 603 rotate in opposite directions to each other to contract or expand the jaws (jaw). That is, it means a movement in which jaws (jaw) 603 formed in two end tools 600 rotate about the Z axis in directions opposite to each other.

The power transmission part 300 serves to transmit the driving force of the operation part 200 to the tip tool 600 by connecting the operation part 200 and the tip tool 600, and may include a plurality of wires, pulleys, connectors, joints, gears, and the like.

Hereinafter, the end tool 600, 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 the hand, the user can rotate the first handle 204 about the Y axis to perform a pitching motion, and rotate the first handle 204 about the Z axis 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 and/or the second actuation extension of the finger 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 600 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 600 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 600 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 leftward, the distal end portion of the end tool 600 also moves leftward, and when the user's finger moves downward, the distal end portion of the end tool 600 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 600 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 600 also extends in the +x axis direction. In other words, the forming direction of the end tool 600 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 respect 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 600 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 600 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 600 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 600.

(Power transmitting section)

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

Referring to fig. 2-4, 6, 7, 19, 20, 26, 33, 36, and 37, 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.

In addition, the power transmission part 300 of the electrocautery surgical instrument 10 according to an embodiment of the present invention may include a fastener 321, a fastener 322, a fastener 323, and a fastener 324 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 600 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 324 can act as a second jaw wire-end tool fastener.

Further, although not shown in the drawings, the operating portion 200 side may further include a fastener that fastens the first jaw wire-operating portion and a fastener that fastens the second jaw wire-operating portion.

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.

Further, since the fastener 323 is coupled to the pulley 611, the wire 301 and the wire 305 can be fixedly coupled to the pulley 611. Thus, the pulley 611 can rotate as the wires 301 and 305 are pulled and released.

In one aspect, a first jaw wire-operator fastener (not shown) can be incorporated at an end of wire 301 and wire 305 opposite where fastener 323 is fastened.

As a result, when the pulley of the operation part 200 is rotated by a motor or a human power, the wire 301 and the wire 305 are pulled and released, so that the pulley 611 of the end tool 600 can be rotated.

Similarly, the lead 302 and the lead 306, which are second jaw lead, are coupled with the fastener 324 and a second jaw lead-operator fastener (not shown), respectively, which are second jaw lead-end tool fasteners.

In addition, fastener 324 is coupled to pulley 621 and a second jaw wire-operator fastener is coupled to the pulley. As a result, when the pulley is rotated by a motor or a human force, the wire 302 and the wire 306 are pulled and released, so that the pulley 621 of the end tool can be rotated.

In addition, the fastener 321 is coupled with the first elevation sheave portion 663a of the end tool center 660, the fastener 322 is coupled with the second elevation sheave portion 663b of the end tool center 660, and the elevation wire-operating portion fastener (not shown) is coupled with a sheave provided at the operating portion 200. As a result, when the pulley provided in the operation part 200 is rotated by a motor or a human power, the wire 303 and the wire 304 are pulled and released, so that the end tool center 660 of the end tool 600 can be rotated.

On the one hand, one end portion of the blade wire 307 is coupled to a blade 675 described later, and the other end portion thereof is coupled to a blade operation portion (not shown in the figure) of the operation portion 200. By the operation of the blade operation portion, the blade wire 307 performs a cutting action while moving from the proximal end portion 605 to the distal end portion 604 of the tip tool, or the blade wire 307 may be returned from the distal end portion 604 to the proximal end portion 605 of the tip tool.

At this time, at least a portion of the blade wire 307 may be accommodated inside a guide tube 670 described later. Accordingly, when the guide tube 670 is bent according to the pitching or yawing motion of the end tool 600, the blade wire 307 accommodated therein may also be bent together with the guide tube 670. The guide tube 670 as described above will be described in more detail later.

Further, the blade wire 307 is formed to be linearly movable 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 675, when the blade wire 307 moves linearly along the longitudinal direction of the connection part 400, the blade 675 connected thereto also moves linearly.

That is, when the blade wire 307 moves linearly along the longitudinal direction of the connecting portion 400, the blade 675 connected thereto moves toward the distal end portion 604 side or the proximal end portion 605 side of the tip tool 600 and performs the cutting operation. As will be described in more detail later.

(End tool)

Hereinafter, the end tool 600 of the electrocautery instrument 10 of fig. 2 will be described in more detail.

Fig. 2 is a perspective view showing an electrocautery instrument according to a first embodiment of the present invention. Fig. 3, 4, 5 and 6 are perspective views showing an end tool of the electrocautery instrument of fig. 2. Fig. 7 and 8 are plan views showing an end tool of the electrocautery instrument of fig. 2. Fig. 9 is a perspective view showing the center of an end tool of the electrocautery instrument of fig. 2. Fig. 10 and 11 are cut-away perspective views of the tip tool center of fig. 9. Fig. 12 and 13 are perspective views illustrating the center of the end tool of fig. 9. Fig. 14 is a side view showing the end tool center and guide tube of fig. 9.

Fig. 15 is a plan view showing the end tool center and guide tube of fig. 9. Fig. 16 and 17 are plan views showing opening and closing actions of the distal end tool of the electrocautery surgical instrument of fig. 2.

Here, fig. 3 shows a state in which the end tool center 660 is combined with the pitch center 650, and fig. 4 shows a state in which the end tool center 660 and the pitch center 650 are removed. Fig. 5 shows a state in which the first jaw 601 and the second jaw 602 are removed, and fig. 6 shows a state in which the first jaw 601, the second jaw 602, the first electrode 651, the second electrode 652, 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 17, etc., an end tool 600 according to a first embodiment of the present invention may have a pair of jaws (jaw) 603 for performing a clamping (grip) action, i.e., a first jaw 601 and a second jaw 602. The first jaw 601 and the second jaw 602, or the constituent elements that comprise the first jaw 601 and the second jaw 602, respectively, may be referred to herein as jaws (jaw) 603.

In addition, the end tool may include pulleys 611, 613, 614, 615, and 616 associated with the rotational movement of the first jaw (jaw) 601. Further, pulleys 621, 623, 624, 625, and 626 associated with the rotational movement of the second jaw (jaw) 602 may be included.

In addition, an end tool (end tool) 600 of the first embodiment of the present invention may include an end tool center 660 and a pitch center 650.

Referring to fig. 12, a first rotation shaft 641 described later and a second rotation shaft 642 of a variation of the first embodiment described later are inserted through the end tool center 660, and the inside of the end tool center 660 may accommodate at least a portion of the pulley 611 and the pulley 621 shaft-coupled to the first rotation shaft 641. The end tool center 660 as described above will be described in more detail later.

Referring to fig. 3, a third rotation shaft 643 and a fourth rotation shaft 644, which will be described later, are inserted through the pitch center 650, and the pitch center 650 may be shaft-coupled with the first pitch sheave portion 663a and the second pitch sheave portion 663b of the end tool center 660 through the third rotation shaft 643. Thus, the end tool center 660 may be formed rotatable about the third rotational axis 643 relative to the pitch center 650.

Further, at least a portion of the pulley 613, the pulley 614, the pulley 623, and the pulley 624, which are shaft-coupled to the third rotation shaft 643, may be accommodated inside the pitch center 650. In addition, at least a portion of the pulleys 615, 616, 625, and 626 that are shaft-coupled to the fourth rotational shaft 644 may be housed inside the pitch center 650.

One end of pitch center 650 is connected to end tool center 660 and the other end of pitch center 650 is connected to connection 400.

Here, the end tool 600 of the first embodiment of the present invention may include a first rotation shaft 641, a third rotation shaft 643, and a fourth rotation shaft 644. As described above, the first rotation shaft 641 is inserted through the end tool center 660, and the third rotation shaft 643 and the fourth rotation shaft 644 may be inserted through the pitch center 650.

Referring to fig. 3, the first rotation shaft 641, the third rotation shaft 643, and the fourth rotation shaft 644 may be sequentially disposed from the distal end portion (DISTAL END) 604 of the end tool toward the proximal end portion (proximal end) 605. Thus, the first rotation shaft 641 may be referred to as a first pin, the third rotation shaft 643 as a third pin, and the fourth rotation shaft 644 as a fourth pin in this order from the distal end portion 604.

The second rotation shaft 642 of the end tool 600 of the electrocautery instrument 10 according to a modification of the first embodiment described later may be inserted through the end tool center 660 and referred to as a second pin.

Here, the first rotation shaft 641 serves as an end tool jaw pulley rotation shaft, the third rotation shaft 643 serves as an end tool pitch rotation shaft, and the fourth rotation shaft 644 can serve as an end tool pitch auxiliary rotation shaft of the end tool.

For example, the first rotation shaft 641 may include two shafts: a first auxiliary shaft and a second auxiliary shaft which are arranged to face each other and are spaced apart from each other by a certain distance. Further, the third rotation shaft 643 may include two shafts: a first auxiliary shaft and a second auxiliary shaft which are arranged to face each other and are spaced apart from each other by a certain distance. Further, the fourth rotation shaft 644 may include two shafts: a first auxiliary shaft and a second auxiliary shaft which are arranged to face each other and are spaced apart from each other by a certain distance.

Each rotation shaft is formed in such a way as to be divided into two in order to pass a guide pipe 670 described later through the end tool center 660 and the pitch center 650. That is, the guide pipe 670 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 axis as the central axis in the longitudinal direction, or may be provided with a certain degree of offset (offset).

On the one hand, although each rotation shaft is shown as being formed in two in the drawing, the spirit of the present invention is not limited thereto. That is, each rotation shaft is formed to be curved at the center, so that a retreat path of the guide tube 670 can be formed.

One or more pulleys may be inserted into the rotation shafts 641, 642, 644 as described above, which will be described in detail below.

In one aspect, the first rotation axis 641 provided on the end tool 600 may be an actuation rotation axis. Specifically, the joint of the first jaw 601 and the second jaw 602 may have a first rotation shaft 641 thereon, and the first rotation shaft may serve as a yaw rotation shaft and an actuation rotation shaft.

That is, in the end tool 600 of the electrocautery surgical instrument 10 according to the first embodiment of the present invention, both the yaw axis of rotation and the actuation axis of rotation may be formed by the first axis of rotation 641.

Specifically, the first rotation shaft 641 serving as both the yaw rotation shaft and the actuation rotation shaft may be provided at the joint portion of the first jaw 601 and the second jaw 602, and the first rotation shaft 641 may be used as the actuation rotation shaft for the actuation operation while the first jaw 601 and the second jaw 602 are rotated.

Referring to fig. 4-7, pulley 611 serves as an end tool first jaw pulley and pulley 621 serves as an end tool second jaw pulley. Pulley 611 may be referred to as a first jaw pulley, pulley 621 may be referred to as a second jaw pulley, and these two components may also be collectively referred to as an "end tool jaw pulley" or simply as a "jaw pulley".

The pulley 611 and the pulley 621 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 641 as the end tool jaw pulley rotation shaft.

Referring to fig. 14, at this time, the pulley 611 and the pulley 621 may be formed to be spaced apart to some extent, and a blade assembly receiving portion (reference numeral is not set) may be formed therebetween. In addition, at least a part of a blade assembly (reference numeral not set) described later may be provided in the blade assembly accommodating portion. In other words, a blade assembly including a guide tube 670 is disposed between the pulley 611 and the pulley 621.

In addition, the yaw and actuation actions of the end tool (end tool) are performed according to the rotation of the pulleys 611 and 621.

That is, when the pulley 611 and the pulley 621 rotate in the same direction about the first rotation axis 641, the first jaw 601 and the second jaw 602 perform a yaw motion while using the first rotation axis 641 as a rotation center axis.

On the other hand, when the pulley 611 and the pulley 621 rotate in opposite directions about the first rotation axis 641, the first jaw 601 and the second jaw 602 perform an actuation action while rotating about the first rotation axis 641, wherein the first rotation axis 641 is an actuation rotation axis sharing a rotation center axis with a yaw rotation axis.

Referring to fig. 4, 6 and 8, pulleys 613 and 614 serve as the end tool first jaw pitch master pulley, pulleys 623 and 624 serve as the end tool second jaw pitch master pulley, which may be collectively referred to as the end tool jaw pitch master pulley.

Pulleys 615 and 616 serve as end tool first jaw pitch sub-pulleys, pulleys 625 and 626 serve as end tool second jaw pitch sub-pulleys, which may be collectively referred to as end tool jaw pitch sub-pulleys.

Hereinafter, description is made regarding constituent elements related to rotation of the pulley 611.

Pulleys 613 and 614 serve as the end tool first jaw pitch master pulley. I.e., it acts as the primary rotary pulley for the pitching action of the first jaw 601. Here, the wire 301 as the first jaw wire is wound on the pulley 613, and the wire 305 as the first jaw wire is wound on the pulley 614.

Pulleys 615 and 616 function as the end tool first jaw pitch sub-pulleys. I.e., it acts as a secondary rotating pulley for the pitching action of the first jaw 601. Here, the wire 301 as the first jaw wire is wound on the pulley 615, and the wire 305 as the first jaw wire is wound on the pulley 616.

Here, the pulley 613 and the pulley 614 are disposed at one side of the pulley 611 and the pulley 612 in a manner facing each other. Here, the pulley 613 and the pulley 614 are formed to be rotatable independently of each other about a third rotation axis 643 which is a pitch rotation axis of the tip tool.

In addition, a pulley 615 and a pulley 616 are provided on one side of the pulley 613 and the pulley 614, respectively, in a manner facing each other. Here, the pulley 615 and the pulley 616 are formed to be rotatable independently of each other about a fourth rotation axis 644 as an end tool pitch assist rotation axis.

Here, although the pulleys 613, 615, 614, and 616 are shown in the drawings as being formed to be rotatable around the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions suitable for the arrangement thereof.

Referring to fig. 6, the wire 301 as the first jaw wire is wound thereon in order to be at least partially in contact with the pulley 615, the pulley 613, and the pulley 611. In addition, the wire 305 connected to the wire 301 by the fastener 323 is sequentially wound thereon in order to be at least partially in contact with the pulley 611, the first wire guide 668a of the end tool center 680, the pulley 614, and the pulley 616.

This is described from another point of view, i.e., to at least partially contact the pulley 615, the pulley 613, the pulley 611, the first wire guide 668a of the end tool center 680, the pulley 614, and the pulley 616, the wire 301 and the wire 305 as the first jaw wires are wound thereon in sequence, and the wire 301 and the wire 305 are formed to be movable with the each pulley while rotating the each pulley.

Thus, referring to fig. 7, when the wire 301 is pulled from the distal end 604 of the end tool 600 toward the proximal end 605 (bottom-to-top direction, as viewed in fig. 7), the fastener 323 coupled to the wire 301 and the pulley 611 coupled thereto and disposed opposite to the pulley 621 rotate in a first direction (counterclockwise direction, as viewed in fig. 7).

Conversely, when the wire 305 is pulled from the distal end 604 of the end tool 600 toward the proximal end 605 (bottom-to-top direction, as viewed in fig. 7), the fastener 323 coupled to the wire 305 and the pulley 611 coupled thereto rotate in a second direction (clockwise, as viewed in fig. 7) opposite the first direction.

Hereinafter, description is made regarding constituent elements related to rotation of the pulley 621.

Pulleys 623 and 624 serve as the end tool second jaw pitch master pulleys. I.e. it acts as the main rotary pulley for the pitching action of the second jaw 602. Here, the wire 306 as the second jaw wire is wound on the pulley 623, and the wire 302 as the second jaw wire is wound on the pulley 624.

Referring to fig. 7, pulleys 625 and 626 serve as an end tool second jaw pitch sub-pulley. I.e. it acts as a secondary rotating pulley for the pitching action of the second jaw 602. Here, wire 306, which is the second jaw wire, is wound around pulley 625, and wire 302, which is the second jaw wire, is wound around pulley 626.

Here, on one side of the pulley 621, the pulley 623 and the pulley 624 are disposed to face each other. Here, the pulley 623 and the pulley 624 are formed to be rotatable independently of each other about a third rotation axis 643 which is a pitch rotation axis of the end tool. In addition, the pulley 625 and the pulley 626 are provided on one side of the pulley 623 and the pulley 624, respectively, in a manner facing each other.

Here, the pulley 625 and the pulley 626 are formed to be rotatable independently of each other about a fourth rotation axis 644 as an end tool pitch assist rotation axis. Here, although the pulleys 623, 625, 624, and 626 are shown in the drawings as being formed to be rotatable around the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axis of each pulley may be formed in various directions suitable for the arrangement thereof.

The wire 306, which is the second jaw wire, is wound thereon in sequence for at least a portion to contact the pulley 625, the pulley 623, and the pulley 621. In addition, the wire 302 connected to the wire 306 by the fastener 324 is sequentially wound thereon for at least a portion to contact the pulley 621, the second wire guide 668b of the end tool center 680, the pulley 624, and the pulley 626.

This is described from another point of view, i.e., to at least partially contact the pulley 625, the pulley 623, the pulley 621, the second wire guide 668b of the end tool center 680, the pulley 624, and the pulley 626, the wire 306 and the wire 302 as the second jaw wires are wound thereon in sequence, and the wire 306 and the wire 302 are formed to be movable with the each pulley while rotating the each pulley.

Thus, referring to fig. 7, as the lead 306 is pulled from the distal end 604 of the end tool 600 in the proximal end 605 direction (bottom-to-top direction, as viewed in fig. 7), the fastener 324 coupled to the lead 306 and the pulley 621 coupled thereto and disposed opposite the pulley 611 rotate in a first direction (clockwise direction, as viewed in fig. 7).

Conversely, when the wire 302 is pulled from the distal end 604 of the end tool 600 in the proximal end 605 direction (bottom-to-top direction, as viewed in fig. 7), the fastener 324 coupled to the wire 302 and the pulley 621 coupled thereto rotate in a second direction (counter-clockwise direction, as viewed in fig. 7) opposite the first direction.

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 613 and 614, the pulley 611 fixedly combined with the wire 301 and the wire 305, the end tool center 660 combined with the pulley 611 are rotated together in the counterclockwise direction as a unit about the third rotation axis 643, thereby eventually causing the end tool to be rotated downward while performing the pitching motion, wherein the pulleys 613 and 614 can be rotated about the third rotation axis 643 as the end tool rotation axis.

At this time, since the second jaw 602 and the wire 302 and the wire 306 fixedly coupled thereto are wound over the pulleys 623 and 624 rotatable about the third rotation shaft 643, 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 623 and 624, the pulley 621 fixedly coupled to the wire 302 and the wire 306, the end tool center 660 coupled to the pulley 621 as a whole rotates together in the clockwise direction about the third rotation axis 643, thereby eventually causing the end tool to rotate upward while performing the pitching motion, wherein the pulleys 623 and 624 are rotatable about the third rotation axis 643 as the end tool pitching rotation axis.

At this time, since the first jaw 601 and the wire 301 and the wire 305 fixedly coupled thereto are wound under the pulleys 613 and 614 rotatable about the third rotation shaft 643, the wire 302 and the wire 306 are moved in opposite directions of the wires 301 and 305, respectively.

In one aspect, the tip tool center 660 of the tip tool 600 of the electrocautery surgical instrument 10 of the present invention further has a first and a second elevation pulley portion 663a, 663b serving as tip tool elevation pulleys, the operation portion 200 further has an operation portion elevation pulley (not shown in the drawings), 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 660 including the first and second elevation sheave portions 663a and 663b may be formed to be rotatable about a third rotation axis 643 as an end tool elevation rotation axis. In addition, the wires 303 and 304 may be used to connect the first and second elevation sheave portions 663a and 663b of the end tool with the operation portion elevation sheave of the operation portion 200.

Accordingly, when the operation section elevation pulley of the operation section 200 rotates, the rotation of the operation section elevation pulley is transmitted to the end tool center 660 of the end tool 600 through the wire 303 and the wire 304, thereby rotating the end tool center 660 together, thereby performing an elevation motion while finally rotating the end tool 600.

That is, the electrocautery surgical instrument 10 according to the first embodiment of the present invention has the first and second elevation sheave portions 663a and 663b of the tip tool 600, the operation portion elevation sheave of the operation portion 200, the wire 303 and the wire 304 of the power transmission portion 300 for transmitting power for performing elevation motion, so that the driving force of the elevation motion of the operation portion 200 is more perfectly transmitted to the tip tool, whereby the reliability of the motion can be improved.

(Blade lead and guide tube)

Hereinafter, the blade assembly of the present invention will be described in more detail, and in particular, the blade wire 307 and the guide tube 670 will be described in more detail.

Referring to fig. 3, 4 and 6, the guide tube 670 according to the present invention is formed to wrap the blade wire 307 in a predetermined interval, at which time the blade wire 307 can move inside the guide tube 670.

In other words, the blade lead 307 may move with respect to the guide tube 670 in a state where the blade lead 307 is inserted inside the guide tube 670.

Here, the guide tube 670 has a certain degree of rigidity, which can prevent the blade wire 307 from being bent in an unexpected direction when the blade wire 307 is pushed or pulled, thereby serving to guide the path of the blade wire 307. By the guide tube 670 as described above, a cutting operation of the tissue (tissue) can be smoothly performed.

In one aspect, one end of the guide tube 670 may be fixedly coupled to a preset area (first coupling portion) of the end tool center 660 or the first jaw 601 or the second jaw 602, which will be described later. In addition, the other end portion of the guide tube 670 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 670 are fixedly coupled to predetermined points (first coupling portion and second coupling portion), respectively, the entire length of the guide tube 670 can be maintained constant. Therefore, the length of the blade wire 307 inserted into the guide tube 670 can also be kept constant.

In addition, since the blade wire 307 can move inside the guide tube 670, the blade wire 307 can be prevented from moving and coming off in an unexpected direction inside the end tool 600.

In one aspect, the guide tube 670 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 performs a yaw motion about the first rotation axis 641 or a pitch motion about the third rotation axis 643, the shape of the guide tube 670 may be curved while being deformed corresponding to these motions. In addition, when the guide tube 670 is bent, the blade lead 307 inside the guide tube is also bent.

Here, the length of the guide pipe 670 is constant, but the relative position and the relative 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 600, and thus, a space for the guide pipe 670 to move is required according to the change of the corresponding distance.

To this end, a pitch Slit (PITCH SLIT) 664 and a Yaw Slit 665 (Yaw Slit) may be provided as a space on the end tool center 660 to form a space in which the guide pipe 670 can move. The configuration of the end tool center 660 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 670, and the blade wire 307 is movable relative to the guide tube 670 inside the guide tube 670. That is, when the blade lead 307 is pulled in a first direction (left to right direction with reference to fig. 6) in a state where the guide tube 670 is fixed, the blade 675 connected to the blade lead 307 moves toward the proximal end portion 605, and when the blade lead 307 is pushed in a second direction (right to left direction with reference to fig. 6), the blade 675 connected to the blade lead 307 moves toward the distal end portion 604.

A more detailed description of this is as follows.

In order to perform the cutting operation using the blade 675, it is most reliable to push and pull the blade 675 with the blade wire 307. In addition, in order for the blade wire 307 to push and pull the blade 675, a guide tube 670 that can guide the path of the blade wire 307 is required.

If the guide pipe 670 does not guide the path of the blade wire 307 (i.e., if the blade wire 307 is not caught), 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 675, the blade lead 307 and the guide tube 670 must be included.

Therefore, in order to prevent the blade wire 307 from being bent suddenly while passing over the pulley, a space is required inside the end tool center 660 described later, so that the guide tube 670 may not interfere with the end tool center 660 also in the case of bending deformation, wherein the guide tube 670 accommodates the blade wire 307.

For this reason, since in the present invention, the blade wire 307 and the guide tube 670 must pass through the end tool center 660 to be connected to the blade 675, and a space in which the blade wire 307 and the guide tube 670 can be bent must be provided inside the end tool center 660, the following condition needs to be formed: 1) A space which is bendable while the blade wire 307 and the guide tube 670 accommodating the blade wire 307 are formed inside the end tool center 660, that is, a pitch slit 664 and a yaw slit 665 are formed; 2) Each rotation shaft is uniformly divided into two, specifically, a first rotation shaft 641 which is both a yaw rotation shaft and an actuation rotation shaft, a third rotation shaft 643 which is a pitch rotation shaft, and a fourth rotation shaft 644 which is an end tool pitch auxiliary rotation shaft of the end tool 600 are uniformly divided into two, and each of the two divided rotation shafts is formed to face each other and to be spaced apart from each other by a certain distance; 3) Pitch arc 666 and yaw arc 667 are additionally formed to guide bending of blade lead 307 and guide tube 670.

This will be described from another point of view, that is, when one end portion of the guide tube 670 is fixed inside the connection portion 400 and the other end portion thereof moves while performing a pitch motion and a yaw motion, the guide tube 670 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 664 and a yaw slit 665 are formed on the path of the guide pipe 670, and further, a pitch arc portion 666 and a yaw arc portion 667, each surface of which faces the guide pipe 670, is formed as a curved surface having a curvature to some extent, are additionally formed on the end tool center 660. As a result, the guide tube 670 can be formed into a shape closest to the maximum gentle curvature (even if the maximum gentle curvature is not reached).

Hereinafter, the end tool center 660 as described above will be described.

(End tool center)

Referring to fig. 9 to 15, tip tool center 660 includes a main body portion 661, a first jaw pulley coupling portion 662a, a second jaw pulley coupling portion 662b, a first pitch pulley portion 663a, a second pitch pulley portion 663b, a pitch slit 664, a yaw slit 665, a pitch arc portion 666, a yaw arc portion 667, a first wire guide portion 668a, and a second wire guide portion 668b.

Referring to fig. 9, a distal end 604 side of the tip tool center may be formed with a first jaw pulley coupling 662a and a second jaw pulley coupling 662b. The first and second jaw pulley couplings 662a and 662b are formed to face each other, and they can internally receive the end tool first and second jaw pulleys 611 and 612, respectively.

Here, the first and second jaw pulley coupling portions 662a and 662b may be formed to be substantially parallel to a plane perpendicular to the first rotation axis 641 as a yaw rotation axis. However, not limited thereto, the first jaw pulley coupling portion 662a and the second jaw pulley coupling portion 662b are provided to face each other, and may be formed to have an angle with a plane perpendicular to the first rotation axis 641 as a yaw rotation axis in a technical idea that the pulleys 611 and 612 can be accommodated.

Referring to fig. 9 and 10, a first jaw pulley coupling 662a and a second jaw pulley coupling 662b may be connected by a main body portion 661. That is, the first jaw pulley coupling portion 662a and the second jaw pulley coupling portion 662b, which are parallel to each other, are coupled by the main body portion 661 formed in a direction substantially perpendicular thereto, and thus the first jaw pulley coupling portion 662a, the second jaw pulley coupling portion 662b, and the main body are substantially formed in a "U" shape, and the end tool first jaw pulley 611 and the end tool second jaw pulley 612 can be accommodated therein, respectively.

This is described from another angle, that is, it can be described that the first jaw pulley coupling portion 662a and the second jaw pulley coupling portion 662b are formed extending from the main body portion 661 in the X-axis direction.

Referring to fig. 9 and 12, a through hole (reference numeral is not set) may be formed in the first jaw pulley coupling portion 662a such that the first rotation shaft 641 passes through the first jaw pulley coupling portion 662a and the pulley 611 as an end tool first jaw pulley to shaft-couple them.

In addition, as in the first jaw pulley coupling portion 662a, a through hole (reference numeral is not set) may be formed in the second jaw pulley coupling portion 662b such that the first rotation shaft 641 passes through the second jaw pulley coupling portion 662b and the pulley 621, which is the end tool second jaw pulley, to shaft-couple them.

Referring to fig. 12, the first rotation shaft 641 as a yaw rotation shaft may be formed in two, and a plurality of first rotation shafts 641 formed in two are connected to through holes formed on the first and second jaw pulley coupling portions 662a and 662b, respectively, and they may be disposed at a distance from each other.

As a result, a space is formed between the pair of first rotation shafts 641 connected to the first and second jaw pulley coupling portions 662a and 662b facing each other, respectively, and a space through which the guide tube 670 can pass may be formed between the pair of first rotation shafts 641.

That is, since the blade assembly including the guide pipe 670 and the blade 675 is provided between the pulley 611 as the first jaw pulley and the pulley 621 as the second jaw pulley, there is an effect that the tip tool 600 can perform a cutting action using the blade 675 while performing a pitching action and a yawing action.

Referring to fig. 9 to 11, a first wire guide 668a may be formed on an inner surface of the first jaw pulley coupling 662a, and a second wire guide 668b may be formed on an inner surface of the second jaw pulley coupling 662 b.

The first and second wire guides 668a and 668b may serve as auxiliary pulleys, and it may expand the rotation angle of the end tool 600.

The wire guides, specifically, the first and second wire guides 668a and 668b, are in contact with the wire 305 and the wire 302, respectively, to change the setting paths of the wire 305 and the wire 302 to some extent, thereby expanding the respective rotation radii of the first jaw 601 and the second jaw 602.

That is, when the auxiliary pulleys are not provided, the first jaw pulley 611 and the second jaw pulley 621 can only yaw-rotate to right angles, respectively, but by forming the first wire guide portion 668a and the second wire guide portion 668b on the end tool center 660, an effect of expanding the maximum rotation angle of each pulley can be obtained.

Thus, in a state where the two jaws of the end tool 600, i.e., the first jaw 601 and the second jaw 602 are yaw-rotated by 90 °, an action can be achieved that requires opening the two jaws, i.e., the first jaw 601 and the second jaw 602, for the actuation action.

In other words, the present invention is characterized in that the range of yaw rotation in which the actuation action is possible can be enlarged by the arrangement of the wire guides of the end tool center 660, i.e., the first wire guide 668a and the second wire guide 668 b. In other words, the present invention is characterized in that the range of yaw rotation in which the actuation action is possible can be enlarged by the arrangement of the wire guides of the end tool center 660, i.e., the first wire guide 668a and the second wire guide 668 b.

Further, since the wire guide portions, i.e., the first wire guide portion 668a and the second wire guide portion 668b, are formed on the existing end tool center 660 without additionally providing a separate structure such as an auxiliary pulley, the rotation range can be enlarged even without adding components and processes.

According to the present invention as described above, since the rotation radius of the pulley 611 as the first jaw pulley and the pulley 621 as the second jaw pulley is widened, an effect of widening the range of the yaw motion which can perform the normal opening and closing actuation motion and the cutting motion can be obtained.

The first and second wire guides 668a and 668b may be formed parallel to a plane perpendicular to the first rotation axis 641 as a yaw rotation axis. However, not limited thereto, in the technical idea that the first lead guide 668a and the second lead guide 668b are formed to face each other, may have a certain angle with a plane perpendicular to the first rotation axis 641 as a yaw rotation axis.

A yaw slit 665 may be formed between the first jaw pulley coupling 662a and the second jaw pulley coupling 662b, which may also be formed between the first wire guide 668a and the second wire guide 668 b. Since the yaw slit 665 is formed inside the end tool center 660 in this way, the guide pipe 670 may pass through the inside of the end tool center 660.

This is described from another point of view, that is, the first rotation shaft 641 divided into two is separated up and down without passing through the end tool center 660, and the yaw slit 665 is formed on a plane perpendicular to the first rotation shaft 641 near the first rotation shaft 641, and thus, there is an effect that the guide pipe 670 can move within the yaw slit 665 while passing near the first rotation shaft 641.

Referring to fig. 9 and 10, a yaw arc portion 667 may be formed on the main body portion 661. The yaw arc portion 667 may be formed in a circular arc shape to have a curvature to some extent. In detail, the yaw arc portion may be formed to have a predetermined curvature when viewed on a plane perpendicular to the first rotation axis 641 as a yaw rotation axis. When the end tool 600 performs yaw rotation, the yaw arc 667 as described above may be used to guide the path of the guide tube 670.

For example, the yaw arc portion 667 may be formed in a fan shape, and may be formed along a path along which the guide tube 670 is curved on the XY plane. When the end tool 600 performs yaw rotation, the yaw arc 667 as described above may be used to guide the path of the guide tube 670.

The first and second elevation sheave portions 663a, 663b may be formed on the proximal end 605 side of the tip tool center 660.

In detail, the proximal end 605 of the tip tool center 660 is formed like a pulley in a disc shape, and grooves around which wires can be wound are formed on the outer circumferential surface thereof, so that a first elevation pulley portion 663a and a second elevation pulley portion 663b can be formed.

The above-described wire 303 and wire 304 are coupled to the first and second elevation sheave portions 663a and 663b serving as elevation sheaves of the end tool while the end tool center 660 rotates about the third rotation axis 643 to perform an elevation motion.

In one aspect, although not shown in the drawings, the pitch pulleys may be formed as separate members from the end tool center 660, thereby enabling various modifications, such as may be combined with the end tool center 660, and the like.

The first and second elevation sheave portions 663a and 663b may be formed to face each other. Here, the first and second elevation sheave portions 663a and 663b may be formed substantially parallel to a plane perpendicular to the third rotation axis 643 as an elevation rotation axis.

The first and second elevation sheave portions 663a and 663b may be connected by a main body portion 661. That is, since the first and second elevation sheave portions 663a and 663b parallel to each other are coupled by the main body portion 661 formed in a direction substantially perpendicular to them, the first elevation sheave portion 663a, the second elevation sheave portion 663b, and the main body portion 661 can be formed substantially in a "U" shape.

This point is described from another angle, that is, it may be described that the first and second elevation sheave portions 663a and 663b are formed to face each other and extend side by side from the main body portion 661 in the-X axis direction.

On the other hand, a through hole (reference numeral is not set) is formed in the first elevation sheave portion 663a, so that the third rotation shaft 643 can be passed through and connected to the first elevation sheave portion 663a. As with the first elevation sheave portion 663a, a through hole may be formed on the second elevation sheave portion 663b, and the third rotation shaft 643 may pass through the second elevation sheave portion 663b.

At this time, the third rotation shafts 643 as pitch rotation shafts are divided into two and may be disposed at intervals from each other, and the guide pipe 670 may pass through a space formed between the pair of third rotation shafts 643 and move.

Referring to fig. 13, a pitch slit 664 may be formed between the first and second pitch sheave portions 663a and 663 b. Since the pitch slit 664 is formed inside the end tool center 660 in this way, the guide pipe 670 can pass through the inside of the end tool center 660.

In one aspect, the pitch arc portion 666 may be further formed on the main body portion 661. The pitch arc portion 666 may be formed with a curved surface portion of a circular arc shape to have a predetermined curvature. In detail, the pitch arc portion 666 may be formed in a circular arc shape to have a predetermined curvature when viewed in a plane perpendicular to the third rotation axis 643 as a pitch rotation axis.

For example, the pitch arc portion 666 may be formed in a fan shape, and may be formed along a path along which the guide pipe 670 is curved in the XZ plane. When the end tool 600 is performing a pitch rotation, the pitch arc 666 as described above may be used to guide the path of the guide tube 670.

Thereby, when the end tool 600 performs a pitch rotation, it can guide the path of the guide pipe 670 and form a pitch arc portion 666 on the inner surface of the end tool center 660 contactable with the guide pipe 670, thereby preventing the path of the guide pipe 670 from being suddenly changed, and stably move the guide pipe 670 and the blade wire 307 moving inside the guide pipe 670 while having a slow curved path, wherein the pitch arc portion 666 has a predetermined curvature and is formed in a circular arc shape.

That is, when the end tool 600 performs a pitch rotation, the pitch arc 666 as described above may be used to guide the path of the guide tube 670.

Referring to fig. 9, pitch slit 664 and yaw slit 665 may be formed to be connected to each other. That is, the pitch slits 664 and the yaw slits 665 may be alternately formed outside in the circumferential direction with respect to the central axis in the longitudinal direction of the guide pipe 670 located inside the end tool center 660.

Thus, the guide tube 670 and the blade wire 307 inside thereof may be disposed through the inside of the end tool center 660. Further, a blade 675 at one end of the blade wire 307 can reciprocate linearly inside the first jaw 601 and the second jaw 602.

Therefore, the present invention is characterized in that the blade wire 307 and the guide tube 670 must pass through the end tool center 660 to be connected to the blade 675, and a space in which the blade wire 307 and the guide tube 670 can be bent is required inside the end tool center 660, so that the following conditions need to be formed: 1) Forming a space that is bendable while the blade wire 307/guide tube 670 does not interfere with the end tool center 660 and passes through the end tool center 660, i.e., pitch slit 664 and yaw slit 665, inside the end tool center 660; 2) The rotation shafts, specifically, the first rotation shaft 641 and the third rotation shaft 643 are uniformly divided into two; 3) Pitch arc 666 and yaw arc 667 are additionally formed to guide bending of blade wire 307/guide tube 670.

(Constituent elements related to cautery and cutting)

With continued reference to fig. 3-5, 18-20, 25, 26, 31-33, and 35-37, an end tool 600 of a first embodiment of the present invention may include a first jaw 601, a second jaw 602, a first electrode 651, a second electrode 652, a guide tube 670, and a blade 675 to perform cauterizing (cautery) and cutting (cutting) actions.

Here, the constituent elements of the guide pipe 670, the blade 675, and the like related to the driving of the blade 675 may be collectively referred to as a blade assembly. One feature of an embodiment of the present invention is that since the blade assembly including the guide tube 670 and the blade 675 is disposed on the yaw slit 665 formed between the pulley 611 as the first jaw pulley and the pulley 621 as the second jaw pulley, the cutting action using the blade 675 can be performed while the tip tool 600 performs the pitching action and the yawing action. As will be described in more detail.

As described above, the first jaw 601 is connected to the first jaw pulley 611, and when the first jaw pulley 611 rotates about the first rotation axis 641, the first jaw 601 and the first jaw pulley 611 rotate as a unit about the first rotation axis 641.

In one aspect, the first electrode 651 can be formed on a surface of the first jaw 601 facing the second jaw 602. In addition, a second electrode 652 can be formed on a surface of the second jaw 602 that faces the first jaw 601.

Referring to fig. 5, at this time, a slit 651a may be formed on the first electrode 651, and the blade 675 may be moved through the slit 651 a. Further, a slit 652a may be formed on the second electrode 652, and the blade 675 may be moved in a preset direction through the slit 652 a.

As an alternative embodiment, a spacer (not shown in the drawings) may be formed between the first jaw 601 and the first electrode 651, and a spacer may also be formed between the second jaw 602 and the second electrode 652. The spacer may comprise an insulating material such as ceramic. Or the first jaw 601 and the second jaw 602 themselves may be composed of insulators such that the first electrode 651 and the second electrode 652 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 601 or the second jaw 602. The placement of tissue between the first jaw 601 and the second jaw 602, and the flow of current through the first electrode 651 and the second electrode 652, creates a current, voltage, resistance, impedance (Impedance), temperature, and the sensor (not shown) may be formed to measure at least a portion thereof.

In one region of the blade 675, a sharp and cut tissue edge may be formed. As at least a portion of the blade 675 moves between the distal end 604 and the proximal end 605 of the end tool, tissue (tissue) disposed between the first jaw 601 and the second jaw 602 may be cut.

Here, one feature of the end tool 600 of the electrocautery surgical instrument 10 according to an embodiment of the present invention is to have a guide tube 670 and a blade 675 disposed between the pulley 611 and the pulley 621.

Yet another feature is that by having guide tube 670 and blade 675 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. A more detailed description of this is as follows.

Heretofore, various types of electrocautery surgical instruments have been developed. Among them, a vessel cutter called ADVANCED ENERGY DEVICE or "vessel occluder (VESSEL SEALER)" has an increased sensing function compared to the existing bipolar cautery method, and therefore, it supplies power of different polarities to both electrodes, denatures blood vessels by the heat generated thereby to stop bleeding, and then cuts out the hemostatic portion using a blade (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.

To address the above, one feature of the end tool 600 of the electrocautery instrument 10 according to an embodiment of the present invention is to have a guide tube 670 and a blade 675, wherein the guide tube 670 is disposed between the pulley 611 and the pulley 621, and the blade 675 moves between a first position and a second position with movement of the blade wire 307 disposed inside the guide tube 670. Yet another feature is that by having guide tube 670 and blade 675 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. 16 is a view showing an open state of the end tool 600 of the electrocautery instrument 10 of fig. 2, and fig. 17 is a view showing a closed state. Fig. 18 is a diagram showing a state in which the blade lead 307 and the blade 675 connected to the blade lead 307 are located at the first position, fig. 19 is a diagram showing a state in which the blade lead 307 and the blade 675 are located at the second position, and fig. 20 is a diagram showing a state in which the blade lead 307 and the blade 675 are located at the third position.

Referring to fig. 16 to 20, it can be described that the cutting action of fig. 18 to 20 is performed in a state where the first jaw 601 and the second jaw 602 are closed (close) as shown in fig. 16, so that the tissue between the first jaw 601 and the second jaw 602 is cut.

Here, the first position shown in fig. 18 may be defined as a state in which the blade 675 is maximally introduced to the proximal end 605 side of the end tool. Or may be defined as a state in which the blade 675 is located at a side position adjacent to the pulley 611/612.

In one aspect, the third position shown in fig. 20 may be defined as a state in which the blade 675 is maximally drawn toward the distal end 604 side of the end tool 600. Or may be defined as a condition in which the blade 675 is located at a position furthest spaced from the pulley 611/612.

First, as shown in fig. 17, in a state where the first jaw 601 and the second jaw 602 are opened (open), a tissue to be cut is placed between the first jaw 601 and the second jaw 602, and then an actuation action is performed to close (close) the first jaw 601 and the second jaw 602 (as shown in fig. 16).

Then, as shown in fig. 18, in a state where the blade lead 307 and the blade 675 are located at the first position, by applying electric currents of different polarities to the first electrode 651 and the second electrode 652, the tissue located between the first jaw 601 and the second jaw 602 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. 19 and the arrow A2 direction in fig. 20, the blade 675 coupled to the blade wire 307 is sequentially moved from the first position of the proximal end portion 605 of the end tool to the third position of the distal end portion 604 of the end tool, and simultaneously reaches the positions of fig. 19 and 20.

As described above, the blade 675 cuts tissue located between the first jaw 601 and the second jaw 602 while moving in the X-axis direction.

However, the linear movement of the blade 675 herein does not mean a complete straight line, but may be understood as a movement to the extent that the cutting of the tissue is performed while the linear movement is performed, even if not a complete straight line, for example, the middle portion of the straight line is bent at a predetermined angle, or a section having a gentle curvature exists in a certain section, or the like.

On the one hand, when the blade wire 307 is pulled in the opposite direction in this state, the blade 675 combined with the blade wire 307 will also return to the first position.

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

Fig. 16 and 17 are plan views showing opening and closing actions of the distal end tool of the electrocautery surgical instrument of fig. 2. The first jaw 601 may be coupled with the pulley 611 and the second jaw 602 may be coupled with the pulley 621.

Pulley 611 serves as an end tool first jaw pulley and pulley 621 serves as an end tool second jaw pulley. Pulley 611 may be referred to as a first jaw pulley, pulley 621 may be referred to as a second jaw pulley, and these two components may also be collectively referred to as an end tool jaw pulley or simply a jaw pulley.

The pulley 611 and the pulley 621 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 641 as the end tool jaw pulley rotation shaft. At this time, the pulley 611 and the pulley 621 are formed to be spaced apart to some extent, and a blade assembly, specifically, a guide tube 670, which accommodates the blade wire 307 therein, may be disposed between the pulley 611 and the pulley 621.

That is, at least a portion of the blade assembly may be disposed between the pulley 611 and the pulley 621, and a blade assembly (not shown) including a guide tube 670 may be disposed between the pulley 611 and the pulley 621.

Referring to fig. 16 and 17, when the pulley 621 rotates about the first rotational axis 641, the second jaw 602 can also rotate together about the first rotational axis 641.

On the one hand, since the pulley 611 is connected with the first jaw 601, when the pulley 611 rotates about the first rotation axis 641, the first jaw 601 connected therewith can rotate about the first rotation axis 641.

In the end tool 600 of the electrocautery instrument 10 according to an embodiment of the present invention, the first rotation axis 641, which is a yaw rotation axis, may be used as an actuation rotation axis.

That is, when the pulleys 611 and 621 respectively connected to the first jaw 601 and the second jaw 602 are rotated in the same direction about the first rotation shaft 641 which is both a yaw rotation shaft and an actuation rotation shaft, a yaw motion can be performed, and when rotated in different directions, an actuation motion can be performed.

Referring to fig. 17, since the pulley 611 and the pulley 621 rotate the first rotation shaft 641 as a rotation center axis in opposite directions, the first jaw 601 and the second jaw 602 respectively connected to the pulley 611 and the pulley 621 are separated from each other while rotating in opposite directions, and the end tool 600 may have an opened state.

Referring to fig. 21 and 22, a bottom view illustrating a process of performing an opening and closing operation in a state in which the end tool 600 of the electrocautery surgical instrument 10 of fig. 2 is rotated by-90 ° in yaw.

As shown in fig. 21, the pulley 611 and the pulley 621 facing the pulley 611 can be rotated about the first rotation shaft 641 by the wire power transmission portion 300 in the operation portion 200. When the pulley 611 and the pulley 621 rotate in opposite directions as shown in fig. 21, the first jaw 601 and the second jaw 602 coupled with the pulley 611 and the pulley 621, respectively, perform an actuation action while rotating relatively in directions approaching each other, and as shown in fig. 22, the first jaw 601 and the second jaw 602 may become a closed state.

Fig. 23 and 24 are bottom views showing a process of performing an opening and closing operation in a state in which the distal end tool of the electrocautery surgical instrument of fig. 2 is rotated by +90° in yaw. Referring to fig. 23 and 24, the first rotation shaft 641 may be yaw-rotated by +90° as a rotation center axis, and when the pulley 611 and the pulley 621 rotate in mutually different directions, the first jaw 601 and the second jaw 602 respectively connected to the pulley 611 and the pulley 621 may perform an actuating action in directions approaching or separating from each other.

Referring to fig. 21 to 24, the blade assembly, in particular, the guide tube 670, whose other end opposite to the one end to which the connection part 400 is connected to the end tool 600, and whose length may be kept constant.

When the tip tool 600, specifically, the first jaw 601 and the second jaw 602 rotate the first rotation shaft 641 as a rotation center shaft, the guide tube 670 also has a predetermined radius of curvature and can be gently curved, and can provide a stable moving path for the blade wire 307 movable between the distal end portion 604 and the proximal end portion 605 of the tip tool 600.

Fig. 25 and 26 are diagrams showing the path of the guide tube 670 and the movement path of the blade 675 during the cutting operation in the state in which the end tool 600 of the electrocautery surgical instrument of fig. 2 is rotated by +90° in yaw.

Referring to fig. 25 and 26, the end tool 600 of the electrocautery surgical instrument 10 according to the first embodiment of the present invention is formed to normally perform a cutting action even in a state where the jaws (jaw), i.e., the first jaw 601 and the second jaw 602, are yaw-rotated +90°.

Specifically, the blade wire 307 comes out of the inside of the guide tube 670, and the blade 675 connected to the blade wire 307 can perform a cutting action while moving in the a direction from the proximal end 605 to the distal end 604 side of the end tool 600.

Fig. 27 and 28 are views showing the 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-90 ° in pitch. Fig. 29 and 30 are views showing the 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 up to +90°. Fig. 31 is a view showing a path of the guide tube in a state in which the tip tool of the electrocautery instrument of fig. 2 is rotated-90 ° in pitch. Fig. 32 and 33 are diagrams showing the path of the guide tube and the movement path of the blade during the cutting operation in a state in which the tip tool of the electrocautery surgical instrument of fig. 2 is rotated-90 ° in pitch.

Referring to fig. 27 to 33, the end tool 600 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 where the jaws (jaw), i.e., the first jaw 601 and the second jaw 602 are rotated in pitch by-90 °, +90°.

On the other hand, fig. 34 is a view showing a state in which the jaw (jaw) is rotated in pitch by-90 ° while being rotated in yaw by +90°, and fig. 35 to 37 are views showing a state in which the cutting operation is performed in a state in which the tip tool of the electrocautery instrument of fig. 2 is rotated in pitch by-90 ° while being rotated in yaw by +90°.

Referring to fig. 34 to 37, the end tool 600 of the electrocautery surgical instrument 10 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), i.e., the first jaw 601 and the second jaw 602 are rotated in pitch by-90 ° while being rotated in yaw by +90°.

(Modification of the first embodiment-providing an auxiliary sheave at the tip tool center)

Hereinafter, an end tool 600 of a surgical instrument according to a modification of the first embodiment of the present invention will be described. Here, the arrangement of the end tool center 660', the arrangement of the auxiliary pulley 612, and the auxiliary pulley 622 of the surgical instrument 600 according to the modification of the first embodiment of the present invention are characteristically different from those 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.

Referring to fig. 38 to 40, an end tool (end tool) 600 of a modification of the first embodiment of the present invention includes a pair of jaws (jaw) for performing a clamping action, specifically a first jaw 601 and a second jaw 602, and herein, the first jaw 601 and the second jaw 602 or constituent elements that include the first jaw 601 and the second jaw 602 may be referred to as a jaw (jaw) 603, respectively.

The end tool 600 according to a variation of the first embodiment may include pulleys 611, 612, 613, 614, 615 and 616 associated with the rotational movement of the first jaw 601. Further, pulleys 621, 622, 623, 624, 625, and 626 associated with the rotational movement of the second jaw 602 may be included.

Compared to the end tool 600 according to the first embodiment of the present invention shown in fig. 6, the end tool 600 according to the modification of the first embodiment of the present invention may further include a pulley 612 and a pulley 622.

Referring to fig. 39 and 40, pulley 612 serves as an end tool first jaw auxiliary pulley and pulley 622 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 pulley 612 and the pulley 622 as the end tool jaw auxiliary pulley may be additionally provided at one side of the pulley 611 and the pulley 621, in other words, the pulley 612 as the auxiliary pulley may be provided between the pulley 611 and the pulley 613/the pulley 614. In addition, a pulley 622 as an auxiliary pulley may be provided between the pulley 621 and the pulley 623/624.

The pulley 612 and the pulley 622 may be formed to be rotatable independently of each other about the second rotation shaft 642.

The pulleys 612 and 622 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, to change the setting paths of the wire 305 and the wire 302 to some extent, thereby serving to enlarge the respective rotation angles of the first jaw 601 and the second jaw 602.

That is, when the auxiliary pulleys are not provided, the first jaw 601 and the second jaw 602 can be rotated only to right angles, but in the modification of the first embodiment of the present invention, by additionally having the pulleys 612 and 622 as the auxiliary pulleys, an effect of expanding the maximum rotation angle by a certain angle can be obtained.

This allows the two jaws of the end tool 600 to perform an action that requires opening the two jaws for actuation action in a state of being rotated 90 ° together in a clockwise or counter-clockwise direction.

In other words, the following features are provided: the range of yaw rotation that can be actuated can be expanded by pulley 612 and pulley 622. A more detailed description of this is as follows.

When the auxiliary pulley is not provided, since the first jaw wire 305 is fixedly coupled to the end tool first jaw pulley 611 and the second jaw wire 302 is fixedly coupled to the end tool second jaw pulley 621, the end tool first jaw pulley 611 and the end tool second jaw pulley 621 can be rotated only up to 90 °, respectively.

In this case, when the first jaw 601 and the second jaw 602 are actuated in a state of being located at a line of 90 °, the first jaw 601 may be opened, but the second jaw 602 cannot be rotated more than 90 °. Therefore, in a state in which the first jaw 601 and the second jaw 602 perform a yaw operation at a certain angle or more, there is a problem in that the actuation operation cannot be smoothly performed.

In order to solve the above-described problems, the electrocautery instrument 10 of the present invention is additionally provided with a pulley 612 and a pulley 622 as auxiliary pulleys on one side of the pulleys 611 and 621. As described above, by providing the pulley 612 and the pulley 622, the setting path of the wire 305 as the first jaw wire and the wire 302 as the second jaw wire is changed to some extent, thereby changing the tangential directions of the wire 305 and the wire 302, so that the fastener 324 joining the wire 302 and the pulley 621 can be additionally rotated by a certain angle.

That is, the fastener 326, which is the junction of the wire 302 and the pulley 621, can be rotated until it is located on the inner common tangent of the pulley 621 and the pulley 622. Similarly, the fastener 323, which is the joint of the wire 305 and the pulley 611, can be rotated until it is located on the inner common tangent line of the pulley 611 and the pulley 612, so that the rotation range can be enlarged.

In other words, the wire 301 and the wire 305 are disposed on either side by a pulley 612 as an auxiliary pulley, 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 two branches of the first jaw wire wound around the pulley 612. Meanwhile, the wire 302 and the wire 306 are disposed on the other side by a pulley 622, 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 two branches of the second jaw wire wound around a pulley 621.

In other words, the pulley 613 and the pulley 614 are disposed on either side with respect to a plane perpendicular to the Y axis and passing through the X axis, and the pulley 623 and the pulley 624 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 located on an inscribed line of the pulley 611 and the pulley 612, and the rotation angle of the pulley 611 is enlarged by the pulley 612. Further, the wire 302 is located on an inscribed line of the pulley 621 and the pulley 622, and the rotation angle of the pulley 621 is enlarged by the pulley 622.

According to the present invention as described above, as the rotation radius of the first jaw 601 and the second jaw 602 is widened, an effect of widening the range of the yaw motion that can perform the normal opening and closing actuation motion can be obtained.

Referring to fig. 38, a first rotation shaft 641 and a second rotation shaft 642 may be inserted through an end tool center 660' according to a modification of the first embodiment of the present invention. Unlike the end tool center 660 according to the first embodiment of the present invention, the first and second wire guide portions are not formed on the respective surfaces of the first and second jaw pulley coupling portions 662a and 662b facing each other, and a pulley 612 and a pulley 622 may be additionally provided to serve as auxiliary pulleys, wherein the pulley 612 and the pulley 622 are separately configured as separate members from the end tool center 660 'and may be shaft-coupled with the second rotation shaft 642 inserted through the end tool center 660'.

The second rotation shaft 642 inserted into the end tool center 660' may include two shafts: a first auxiliary shaft and a second auxiliary shaft which are arranged to face each other and are spaced apart from each other by a certain distance. Since the second rotation axis is divided into two and disposed at a distance from each other, the guide pipe 670 can pass through the end tool center 660' and the pitch center 650 therebetween.

Referring to fig. 38, the first rotation shaft 641, the second rotation shaft 642, the third rotation shaft 643, and the fourth rotation shaft 644 are sequentially provided from the distal end portion (DISTAL END) 604 toward the proximal end portion (proximal end) 605 of the end tool 600. Accordingly, the first rotation axis 641 may be referred to as a first pin, the second rotation axis 642 as a second pin, the third rotation axis 643 as a third pin, and the fourth rotation axis 644 as a fourth pin, in that order from the distal end portion 604.

The modification of the first embodiment of the present invention is identical to the end tool 600 according to the first embodiment except that the pulley 621 and the pulley 622 are used as auxiliary pulleys, in comparison with the first embodiment, in which the pulley 621 and the pulley 622 are not formed as one piece with the main body portion 661 at the end tool center 660 'but are provided as separate members and are shaft-coupled to the end tool center 660' by the second rotation shaft 642, and therefore, the contents within the repetition range will not be described in detail.

(Third embodiment of instrument for electrocautery)

(End tool according to the third embodiment)

(Jaw-chain-pulley connecting Structure)

< Fourth embodiment of instrument for electrocautery surgery >

(Power transmitting section)

(End tool)

(Blade lead and guide tube)

A more detailed description of this is as follows.

(End tool center)

A more detailed description of this is as follows.

(Actuation center)

(First jaw, second jaw, and actuation action)

(Constituent elements related to cautery and cutting)

(Operation section)

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

(Actuation action, yaw action, pitch action)

The actuation, yaw and pitch actions in this embodiment are as follows.

First, the actuation action is as follows.

Next, the deflection operation is as follows.

Next, the pitching action is as follows.

(Conceptual diagram of pulleys and wires)

First, the action of the wire that actuates the action will be described.

Next, the operation of the wire for yaw operation will be described.

(Pitch, yaw, cutting action of end tool)

(First modification of the fourth embodiment)

(Second modification of the fourth embodiment)

(Third modification of the fourth embodiment)

(Fourth modification of the fourth embodiment)

Industrial applicability

The present invention relates to surgical instruments, and more particularly, to surgical instruments that are used in laparoscopic surgery or various kinds of surgery, and that are manually or automatically activated, and that are usable at least in surgical instruments including surgical instruments that can lock and/or unlock a locking device.

Claims

1. An end tool for 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 the first rotation axis, spaced apart from the first jaw pulley by a distance; and a blade assembly including a blade that moves between a proximal end portion and a distal end portion of the first jaw upon receiving a driving force, and at least a portion of which is formed between the first jaw pulley and the second jaw pulley, wherein the end tool of the surgical instrument performs a yaw motion while the first jaw pulley and the second jaw pulley rotate about the first rotation axis, and performs an actuation motion while the first jaw and the second jaw rotate about an actuation rotation axis spaced apart from the first rotation axis by a certain degree.

2. The end tool of a surgical instrument of claim 1, further comprising: a blade wire, at least a portion of which is in contact with the blade assembly, thereby transmitting a driving force to make the blade movable.

3. The surgical instrument end tool of claim 2, 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.

4. A surgical instrument end tool according to claim 3, wherein the blade wire is connected to the blade through the interior of the guide tube.

5. A surgical instrument end tool according to claim 3, wherein when the guide tube is bent to a certain extent, the blade wire inside the guide tube is also bent together with the guide tube.

6. A surgical instrument end tool according to claim 3, wherein the blade wire is movable along the guide tube inside the guide tube.

7. A surgical instrument end tool according to claim 3, wherein the guide tube is formed to extend toward the blade side through between rotation center axes of the first and second jaw pulleys.

8. A surgical instrument end tool according to claim 3, 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, the second jaw pulley being disposed adjacent to the second jaw coupling of the end tool center, and a guide connecting the first and second jaw pulley couplings, and at least a portion of the blade assembly being formed between the first and second jaw pulleys.

9. The surgical instrument of claim 8, wherein the guide tube extends through the center of the end tool to the first jaw or the second jaw.

10. The distal end tool of claim 9, wherein an arc portion having a predetermined curvature and facing outward is formed on an inner peripheral surface of the distal end tool center, wherein the distal end tool center faces the guide tube passing through the distal end tool center.

11. The surgical instrument end tool of claim 1, wherein a yaw motion is performed in which the first jaw and the second jaw rotate in the same direction when the first jaw pulley and the second jaw pulley rotate in the same direction about the first rotational axis.

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

13. 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.

14. A surgical instrument end tool according to claim 13, wherein the end tool is formed to be yaw rotatable about the first axis of rotation while being pitch rotatable about the third axis of rotation.

15. The surgical instrument end tool of claim 13, 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.

16. The surgical instrument tip tool of claim 2, wherein the blade is movable between a proximal end and a distal end of the tip tool by the blade guide wire.

17. An end tool for 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 the first rotation axis, spaced apart from the first jaw pulley by a distance; and a blade assembly including a blade that moves between a proximal end portion and a distal end portion of the first jaw upon receiving a driving force, and at least a portion of which is formed between the first jaw pulley and the second jaw pulley, the tip tool of the surgical instrument being characterized in that the first jaw and the second jaw are disposed to intersect each other with a first point as a rotation center, and the rotation centers of the first jaw pulley and the second jaw pulley are formed on a second point disposed at a distance from the first point.

18. The end tool of a surgical instrument of claim 17, wherein the first point is located distally on the first jaw and the second jaw compared to the second point.

19. The end of surgical instrument tool of claim 17, wherein the first rotary shaft comprises a first auxiliary shaft and a second auxiliary shaft, the first auxiliary shaft and the second auxiliary shaft being disposed at a distance and receiving a portion of the blade assembly therebetween.

20. An end tool for 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 having at least a portion of the first and second jaw pulleys accommodated 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.

21. The end tool of a surgical instrument of claim 20, wherein the end tool center comprises: a main body portion connected to the first jaw pulley and the second jaw pulley; 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; and a first and a second pitch sheave portion extending from the main body portion in opposite directions to the one direction and formed to face each other.

22. The surgical instrument of claim 21, wherein the first jaw pulley is disposed adjacent the first jaw pulley interface of the tip tool center and the second jaw pulley is disposed adjacent the second jaw pulley interface of the tip tool center, and wherein at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

23. The surgical instrument of claim 21, wherein a yaw slit through which the guide tube may pass is formed between the first jaw pulley coupling and the second jaw pulley coupling.

24. The surgical instrument tip tool according to claim 23, wherein one side of the yaw slit is formed with a yaw arc having a predetermined curvature to guide a curved path of the guide tube in a yaw direction.

25. The tip tool of a surgical instrument according to claim 23, wherein the first rotation 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 first counter shaft and the second counter shaft of the first rotation shaft are disposed at a distance apart, and the yaw slit is formed between the first counter shaft and the second counter shaft.

26. The surgical instrument end tool of claim 21, wherein a pitch slit through which the guide tube can pass is formed between the first and second pitch pulley portions.

27. The end tool of a surgical instrument according to claim 26, wherein one side of the pitch slit is formed with a pitch arc portion having a predetermined curvature to guide a curved path in a pitch direction of the guide tube.

28. The end tool of a surgical instrument according to claim 26, wherein the third rotation shaft includes a first auxiliary shaft formed on the first pitch sheave portion side and a second auxiliary shaft formed on the second pitch sheave portion side, and the pitch slit is formed between the first auxiliary shaft and the second auxiliary shaft of the third rotation shaft.

29. The surgical instrument tip tool according to claim 21, wherein a yaw slit through which the guide tube passes is formed between the first jaw pulley coupling portion and the second jaw pulley coupling portion, and a pitch slit through which the guide tube passes is formed between the first pitch pulley portion and the second pitch pulley portion, the yaw slit and the pitch slit being formed to be connected to each other.

30. The surgical instrument end tool of claim 21, 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.

31. The end tool of the surgical instrument of claim 30, 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.

32. The surgical instrument of claim 31, wherein the first jaw wire is located on an internal tangent of the first jaw pulley and the first jaw auxiliary pulley, and wherein the angle of rotation of the first jaw pulley is enlarged by the first jaw auxiliary pulley.

33. The surgical instrument of claim 30, wherein first and second wire guides are formed on the body portion in regions adjacent to the first and second jaw pulleys, the wire guides being curved in cross-section to have a predetermined curvature.

34. The surgical instrument end tool of claim 33, 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.

35. The end tool of a surgical instrument of claim 20, 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.

36. The surgical instrument of claim 35, wherein tissue is cauterized when current flows through the first and second electrodes.

37. The surgical instrument of claim 36, wherein the blade 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.

38. The end tool of a surgical instrument of claim 20, wherein at least a portion of the guide tube is disposed between the first jaw pulley and the second jaw pulley.

39. The surgical instrument of claim 20, wherein the guide tube houses at least a portion of the blade guide wire therein and is formed to be bendable to some extent.

40. 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 to extend 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 the first jaw, the second jaw, the first jaw pulley, and the second jaw pulley share a central axis of rotation.

41. The electrocautery surgical instrument as set forth in claim 40, wherein at least a portion of the operating portion is formed extending in the distal tool direction.

42. The electrocautery instrument as defined in claim 41, wherein when the operating portion is rotated in the two or more directions, respectively, the end tool rotates in substantially the same direction as an operating direction of the operating portion.

43. An electrocautery instrument as defined in claim 41, wherein the operating portion is formed to extend away from a user grasping the electrocautery instrument.

44. An end tool for 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 the first rotation axis, spaced apart from the first jaw pulley by a distance; a blade, at least a portion of which is formed between the first jaw pulley and the second jaw pulley and moves between a proximal end and a distal end of the tip tool; a blade wire coupled with the blade to transmit a driving force required for movement of the blade to the blade; a guide tube which accommodates at least a portion of the blade wire therein and is formed so as to be bendable to some extent; an actuation center which is disposed between the first jaw and the second jaw, and which is combined with the first jaw and the second jaw, and an inside of which is formed to be hollow to be combined with an end portion of the guide tube.

45. The surgical instrument end tool of claim 44, wherein the guide tube and the blade wire received within the guide tube are formed through the hollow formed within the actuation center.

46. The surgical instrument of claim 44, wherein the guide tube is not directly coupled to the first jaw or the second jaw.