KR102695949B1 - Cartridge for surgical instrument - Google Patents

Abstract

The present invention relates to an end tool of a surgical instrument and a surgical instrument having the same, and more particularly, to an end tool of a surgical instrument having an end tool that is rotatable in two or more directions and operates so as to intuitively match the operation of an operating unit, and a surgical instrument having the same, in a surgical instrument that is mounted on a robot arm or can be manually operated for use in laparoscopic surgery or various other surgeries.

Description

Cartridge for surgical instrument{Cartridge for surgical instrument}

The present invention relates to an end tool of a surgical instrument and a surgical instrument having the same, and more particularly, to an end tool of a surgical instrument having an end tool that is rotatable in two or more directions and operates so as to intuitively match the operation of an operating unit, and a surgical instrument having the same, in a surgical instrument that is mounted on a robot arm or can be manually operated for use in laparoscopic surgery or various other surgeries.

Recently, laparoscopic surgery, which can reduce postoperative recovery time and complications through small incisions, has been actively utilized. Laparoscopic surgery is a method of performing surgery by making a number of small holes in the patient's abdomen and observing the inside of the abdominal cavity through these holes, and is widely used in general surgery, etc.

In performing such laparoscopic surgery, a suture device inserted into the body is used to suture the surgical site within the abdominal cavity. A surgical stapler that sutures the surgical site using medical staples is used as the suture device.

In general, a surgical stapler is a medical instrument that is widely used for cutting and anastomosis of organs in abdominal and thoracic organ surgeries. These surgical staplers include open staplers used in open thoracoscopy or laparotomy, and endo staplers used in thoracoscopy and laparoscope.

Surgical staplers have the advantage of not only shortening the operation time but also achieving precise suturing of the surgical site because they can perform the cutting of the surgical site and the anastomosis of the organ at the same time. In addition, surgical staplers are widely used in modern surgical operations because they have the advantage of faster recovery and less scarring than surgical sutures used for tissue cutting and suturing. In particular, surgical staplers are widely used in cancer surgery to cut cancer tissue and suture the cut site.

The background technology described above is technical information that the inventor possessed for deriving the present invention or acquired in the process of deriving the present invention, and cannot necessarily be considered as publicly known technology disclosed to the general public prior to the application for the present invention.

Patent registration number 1364967 (registered on February 11, 2014)

The present invention aims to provide a surgical instrument which is mounted on a robotic arm or which is manually operable for use in laparoscopic surgery or various other surgeries, and which has an end tool which can rotate in two or more directions and operates in intuitive accordance with the operation of an operating part.

One embodiment of the present invention provides a surgical instrument including an end tool including a cartridge, a first member; a second member formed to face the first member; a first member pulley coupled with the first member and formed to be rotatable around a first axis; a second member pulley coupled with the second member and formed to be rotatable around an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first member pulley to a certain extent; and at least one staple pulley, at least a portion of which is formed between the first member pulley and the second member pulley; and a reciprocating movement assembly connected to the staple drive assembly and moving linearly by the staple pulley when it rotates; and a working member that contacts the reciprocating movement assembly and moves in one direction by the reciprocating movement assembly when the reciprocating movement assembly moves in one direction.

Other aspects, features and advantages other than those described above will become apparent from the following drawings, claims and detailed description of the invention.

According to the present invention, since the direction of operation of the operating part by the surgeon and the direction of operation of the end tool are intuitively the same, the convenience of the surgeon is improved, and the accuracy, reliability, and speed of the surgery are improved.

Figure 1a is a conceptual diagram of the pitch motion of a conventional surgical instrument, and Figure 1b is a conceptual diagram of the yaw motion.
Figure 1c is a conceptual diagram of the pitch motion of another conventional surgical instrument, and Figure 1d is a conceptual diagram of the yaw motion.
Figure 1e is a conceptual diagram of a pitch operation of a surgical instrument according to the present invention, and Figure 1f is a conceptual diagram of a yaw operation.
FIG. 2 is a perspective view showing a surgical instrument according to the first embodiment of the present invention.
Figure 3 is a side view of the surgical instrument of Figure 2.
Figures 4 and 5 are perspective views showing the end tool of the surgical instrument of Figure 2.
FIG. 6 is a perspective view showing an end tool hub of the end tool of the surgical instrument of FIG. 2.
Figures 7 and 8 are plan views showing the end tool of the surgical instrument of Figure 2.
Figure 9 is a side view showing the end tool of the surgical instrument of Figure 2.
Figures 10 and 11 are exploded perspective views of the end tool of the surgical instrument of Figure 2.
Figure 12 is a perspective view showing the first pulley of the surgical instrument of Figure 2.
Figure 13 is an exploded perspective view showing the staple pulley and staple link of the surgical instrument of Figure 2.
Figure 14 is a plan view showing the first section of the surgical instrument of Figure 2.
Figure 15 is a plan view showing the second section of the surgical instrument of Figure 2.
Fig. 16 is a plan view showing the opening and closing operation of the first section of the surgical instrument of Fig. 2.
Fig. 17 is a plan view showing the opening and closing operation of the second section of the surgical instrument of Fig. 2.
Figure 18 is a plan view showing the opening and closing operations of the first and second sections of the surgical instrument of Figure 2.
Figure 19 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of Figure 2.
Fig. 20 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of Fig. 2.
Figure 21 is a perspective view showing the first section and cartridge of the surgical instrument of Figure 2.
Figure 22 is an exploded perspective view showing the cartridge of Figure 21.
Figure 23 is a perspective view showing the combined cartridge of Figure 21.
Figure 24 is a side view showing the cartridge of Figure 21.
Figure 25 is a cross-sectional view showing the cartridge of Figure 21.
Figure 26 is a side cross-sectional view showing the cartridge of Figure 21.
Figures 27 and 28 are perspective views showing the working member of the cartridge of Figure 21.
FIG. 29 is a side cross-sectional view showing the stapling-related structure of the end tool of the surgical instrument of FIG. 2.
Figures 30 and 31 are cross-sectional views showing the stapling structure of the end tool of the surgical instrument of Figure 2.
Figures 32 to 35 are perspective views showing the ratchet driving operation of the end tool of Figure 30.
Figures 36 and 37 are plan views showing the ratchet driving operation of the end tool of Figure 30.
Fig. 38 is a perspective view showing the overall ratchet driving operation of the end tool of Fig. 30.
Figures 39 and 40 are perspective views showing the overall stapling operation of the end tool of Figure 30.
Figures 41 and 42 are perspective views showing the operating section of the surgical instrument of Figure 2.
Figure 43 is a drawing that simply shows only the configuration of the pulleys and wires that constitute the joint of the surgical instrument illustrated in Figure 2.
Figure 44 is a perspective view showing the operation of the surgical instrument of Figure 2.
Figures 45 and 46 are drawings illustrating the configuration of pulleys and wires related to the actuation operation and the yaw operation of the surgical instrument illustrated in Figure 2, respectively, for the first and second sections.
FIGS. 47, 48 and 49 are drawings illustrating the configuration of pulleys and wires related to the stapling and cutting operations of the surgical instrument illustrated in FIG. 2, respectively, for sections 1 and 2.
Fig. 50 is a perspective view showing the pitch motion of the surgical instrument of Fig. 2.
Figures 51, 52 and 53 are drawings illustrating the configuration of pulleys and wires related to the pitch motion of the surgical instrument illustrated in Figure 2, respectively, for the first and second sections.
FIG. 54, FIG. 55, FIG. 56, and FIG. 57 are plan views showing the actuation operation of the end tool of the surgical instrument of FIG. 2, and are drawings showing the process of performing the actuation operation in a state where the jaws are rotated by -90°.
FIGS. 58, 59, 60, and 61 are plan views showing the actuation operation of the end tool of the surgical instrument of FIG. 2, and are drawings showing the process of performing the actuation operation while the jaws are rotated by +90°.
Figure 62 is a plan view showing the staple operation of the end tool of the surgical instrument of Figure 2, and is a drawing showing the process of performing the staple operation in a state where the jaws are rotated by +90°.
FIG. 63 is a plan view showing the staple operation of the end tool of the surgical instrument of FIG. 2, and is a drawing showing the process of performing the staple operation in a state where the jaws are rotated by -90°.
Figures 64, 65, 66, and 67 are perspective views showing the pitch motion of the surgical instrument of Figure 2.
Figures 68, 69, 70, and 71 are perspective views showing the operation of the surgical instrument of Figure 2.
Figures 72, 73, 74, and 75 are plan views showing the end tool of the surgical instrument of Figure 2 in a pitch rotation and yaw rotation state.
FIGS. 76 and 77 are drawings showing a cartridge of a surgical instrument according to a first modified example of the first embodiment of the present invention.
FIGS. 78 and 79 are drawings showing a cartridge of a surgical instrument according to a second modified example of the first embodiment of the present invention.
FIGS. 80 and 81 are drawings showing a cartridge of a surgical instrument according to a third modified example of the first embodiment of the present invention.
FIGS. 82 and 83 are drawings showing a cartridge of a surgical instrument according to a fourth modified example of the first embodiment of the present invention.
FIGS. 84 and 85 are drawings showing a cartridge of a surgical instrument according to a fifth modified example of the first embodiment of the present invention.
Fig. 86 is a drawing showing the operating state of the cartridge of Fig. 84.
Fig. 87 is a perspective view showing an end tool of a surgical instrument according to a second embodiment of the present invention.
Figures 88 and 89 are enlarged views of the end tool of the surgical instrument of Figure 87.
FIGS. 90 and 91 are enlarged views showing the end tool of the surgical instrument of FIG. 87 from different angles.
Figures 92 and 93 are drawings showing a state in which the jaws of the end tool of the surgical instrument of Figure 87 are rotated 90° counterclockwise.
Fig. 94 is an enlarged perspective view showing the end tool hub of the surgical instrument of Fig. 87.
FIGS. 95 and 96 are perspective views showing an end tool of a surgical instrument according to a third embodiment of the present invention.
Fig. 97 is a perspective view showing the end tool of the surgical instrument of Fig. 96 in an open state.
Fig. 98 is a perspective view showing the end tool of the surgical instrument of Fig. 96 in a closed state.
Fig. 99 is a side view showing the end tool of the surgical instrument of Fig. 95.
Figures 100 and 101 are exploded perspective views of the end tool of the surgical instrument of Figure 96.
Figure 102 is a plan view showing the first end tool of the surgical instrument of Figure 96 in a fully open state.
Figures 103 and 104 are plan views showing the opening and closing operation of the end tool of the surgical instrument of Figure 96.
Figures 105 and 106 are perspective views showing an end tool of a surgical instrument according to a fourth embodiment of the present invention.
Figures 107 and 108 are perspective views of the end tool of the surgical instrument of Figures 105 and 106 from different angles.
Fig. 109 is a side view showing the end tool of the surgical instrument of Fig. 105.
Figures 110 and 111 are exploded perspective views of the end tool of the surgical instrument of Figure 105.
Figure 112 is an exploded perspective view of the staple link assembly of the surgical instrument of Figure 105.
Figures 113 and 114 are side and plan views showing the respective operating states of the staple link assembly of Figure 112.
Fig. 115 is a perspective view showing the internal structure of the end tool of the surgical instrument of Fig. 105.
Figures 116 and 117 are perspective views showing each operating state of the end tool of Figure 115.
Figures 118 and 119 are perspective views showing each operating state of the end tool of Figure 115.
Figures 120 and 121 are perspective views showing each operating state of the end tool of Figure 115.
Fig. 122 is a perspective view showing an end tool of a surgical instrument according to the fifth embodiment of the present invention.
Figure 123 is an enlarged view of the end tool of the surgical instrument of Figure 122.
Fig. 124 is a side view showing the end tool of the surgical instrument of Fig. 122.
Figures 125 and 126 are exploded perspective views of the end tool of the surgical instrument of Figure 122.
Figure 127 is an exploded perspective view of the staple pulley assembly of the surgical instrument of Figure 122.
Fig. 128 is a plan view showing the operating state of the staple pulley in the end tool of Fig. 122.
Fig. 129 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of Fig. 122, and Fig. 130 is a plan view of Fig. 129.
Figures 131 and 132 are plan views showing the opening and closing operation of the end tool of the surgical instrument of Figure 122.
Figures 133 and 134 are drawings showing the process of the end tool of the surgical instrument of Figure 122 changing from a deactivated state to an activated state.
FIGS. 135 to 139 are drawings explaining a process in which the end tool of the surgical instrument of FIG. 122 is activated from an inactive state to perform a stapling and cutting operation.
Fig. 140 is a perspective view showing an end tool of a surgical instrument according to the sixth embodiment of the present invention.
Figure 141 is an enlarged view of the end tool of the surgical instrument of Figure 140.
Fig. 142 is a side view showing the end tool of the surgical instrument of Fig. 140.
Figures 143 and 144 are exploded perspective views of the end tool of the surgical instrument of Figure 140.
Figure 145 is an exploded perspective view of the staple pulley assembly of the surgical instrument of Figure 140.
Fig. 146 is a side view showing the operating state of the staple pulley in the end tool of Fig. 140.
Figures 147 and 148 are plan views showing the opening and closing operation of the end tool of the surgical instrument of Figure 140.
Figure 149 is a perspective view showing the process of the end tool of the surgical instrument of Figure 140 changing from an inactive state to an active state.
Figures 150 to 153 are perspective views showing an end tool of a surgical instrument according to the seventh embodiment of the present invention.
Figures 154 and 155 are side views showing the end tool of the surgical instrument of Figure 150.
Figures 156 and 157 are plan views showing the end tool of the surgical instrument of Figure 150.
Figures 158 to 160 are plan views showing the staple operation of the end tool of the surgical instrument of Figure 150, and are drawings showing the process of performing the staple operation while the jaws are rotated by +90°.
Figures 161 to 163 are plan views showing the staple operation of the end tool of the surgical instrument of Figure 150, and are drawings showing the process of performing the staple operation while the jaws are rotated by -90°.
Figures 164 to 166 are perspective views showing an end tool of a surgical instrument according to the eighth embodiment of the present invention.
Figures 167 and 168 are perspective views showing a cartridge of the surgical instrument of Figure 164.
Fig. 169 is a bottom view of the cartridge of Fig. 167.
Figures 170 and 171 are perspective views showing each operating state of the end tool of Figure 164.
Fig. 172 is a perspective view showing an end tool of a surgical instrument according to the ninth embodiment of the present invention.
Fig. 173 is a perspective view showing the working member of the cartridge of the surgical instrument of Fig. 172.
Fig. 174 is a cross-sectional view showing a cartridge of the surgical instrument of Fig. 172.
Fig. 175 is an enlarged perspective view showing a cartridge of the surgical instrument of Fig. 172.
Figures 176 to 179 are drawings showing the process of moving a work member.
Figures 180, 181 and 182 are drawings showing the process of attaching the work member to the second section.
Figures 183, 184 and 185 are drawings showing the process of separating the working member from the second section.

One embodiment of the present invention provides a surgical instrument including an end tool including a cartridge, a first member; a second member formed to face the first member; a first member pulley coupled with the first member and formed to be rotatable around a first axis; a second member pulley coupled with the second member and formed to be rotatable around an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first member pulley to a certain extent; and at least one staple pulley, at least a portion of which is formed between the first member pulley and the second member pulley; and a reciprocating movement assembly connected to the staple drive assembly and moving linearly by the staple pulley when it rotates; and a working member that contacts the reciprocating movement assembly and moves in one direction by the reciprocating movement assembly when the reciprocating movement assembly moves in one direction.

In the present invention, when the staple pulley rotates, the reciprocating movement assembly connected to the staple drive assembly can move toward the distal side or the proximal side of the cartridge.

In the present invention, when the staple pulley alternately rotates clockwise and counterclockwise, the reciprocating movement assembly connected to the staple drive assembly can alternately move toward the distal side and the proximal side of the cartridge.

In the present invention, when the reciprocating movement assembly moves toward the distal end of the cartridge, the working member can be moved toward the distal end of the cartridge by the reciprocating movement assembly.

In the present invention, by the staple drive assembly, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the reciprocating movement assembly connected to the staple drive assembly.

In the present invention, as the working member moves in the one direction, the Ÿ‡ branch of the working member sequentially pushes up a plurality of staples in the cartridge to perform a stapling operation, and at the same time, a cutting operation can be performed as the blade formed on one side of the Ÿ‡ branch of the working member moves in the one direction.

In the present invention, the staple drive assembly may include a link member connecting the staple pulley and the reciprocating movement assembly.

In the present invention, the working member includes a ratchet member having a ratchet formed on at least one surface, and the ratchet of the ratchet member can be formed to be in contact with the reciprocating movement assembly.

In the present invention, the working member can move toward the distal end of the cartridge together with the reciprocating movement assembly only when the reciprocating movement assembly moves toward the distal end of the cartridge.

In the present invention, when the staple pulley rotates in a first direction among the clockwise and counterclockwise directions, the link member connected to the staple pulley, the reciprocating movement assembly connected to the link member, and the working member in contact with the reciprocating movement assembly can move in the distal direction of the cartridge.

In the present invention, when the staple pulley rotates in a direction opposite to the first direction among clockwise and counterclockwise directions, the link member connected to the staple pulley and the reciprocating assembly connected to the link member move in a proximal direction of the end tool, and the working member can be stopped in the one direction.

In the present invention, the staple drive assembly may include a first link member connected to one area of the staple pulley and a second link member connected to another area of the staple pulley, and the reciprocating movement assembly may include a first reciprocating movement member connected to the first link member and a second reciprocating movement member connected to the second link member.

In the present invention, the working member may include a ratchet member having a first ratchet and a second ratchet formed therein, wherein the first ratchet may be formed to be in contact with the first reciprocating moving member, and the second ratchet may be formed to be in contact with the second reciprocating moving member.

In the present invention, when the staple pulley rotates in one direction, the first ratchet and the first reciprocating member may come into contact, and when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member may come into contact.

In the present invention, when the staple pulley rotates in a first direction among the clockwise and counterclockwise directions, the first link member connected to the staple pulley, the first reciprocating moving member connected to the first link member, and the working member in contact with the first reciprocating moving member can move in the distal direction of the cartridge.

In the present invention, when the staple pulley rotates in a direction opposite to the first direction among clockwise and counterclockwise directions, the second link member connected to the staple pulley, the second reciprocating moving member connected to the second link member, and the working member in contact with the second reciprocating moving member can move in the distal direction of the cartridge.

In the present invention, a staple wire may be further included that is coupled with the staple pulley and rotates the staple pulley.

In the present invention, there may be an inactive state in which the staple drive assembly and the reciprocating movement assembly are separated, and an active state in which the staple drive assembly and the reciprocating movement assembly are connected.

In the present invention, only in the activated state, when the staple pulley rotates, the reciprocating movement assembly can move linearly.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis may be further included.

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

In the present invention, the first group pulley, the staple pulley, and the second group pulley can be sequentially formed in a laminated manner.

Another embodiment of the present invention provides an end tool of a surgical instrument, comprising: a first member that can accommodate a cartridge; a second member formed to face the first member; a first member pulley coupled with the first member and formed to be rotatable about a first axis; a second member pulley coupled with the second member and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first member pulley to a certain extent; a staple drive assembly including at least one staple pulley, at least a portion of which is formed between the first member pulley and the second member pulley; and a staple wire that at least a portion of which is in contact with the staple pulley and transmits a driving force required for the rotation of the staple pulley to the staple pulley; wherein the staple drive assembly is connected to the reciprocating movement assembly of the cartridge, and a rotational motion of the staple pulley is converted into a linear motion of the reciprocating movement assembly.

In the present invention, an end tool hub is further provided, which includes a first pulley coupling portion and a second pulley coupling portion formed to face each other, and a guide portion connecting the first pulley coupling portion and the second pulley coupling portion, wherein the first pulley is arranged adjacent to the first pulley coupling portion of the end tool hub, and the second pulley is arranged adjacent to the second pulley coupling portion of the end tool hub, such that at least a portion of the staple drive assembly can be formed between the first pulley and the second pulley.

In the present invention, the first shaft can be sequentially inserted through the first group pulley coupling portion, the first group pulley, the staple pulley, the second group pulley, and the second group pulley coupling portion.

In the present invention, the first group pulley, the staple pulley, and the second group pulley can be sequentially formed in the end tool hub.

In the present invention, the first group pulley, the staple pulley, and the second group pulley can be formed to be rotatable independently of each other.

In the present invention, a staple auxiliary pulley may be further included that is arranged between the staple pulley and the guide portion.

In the present invention, the staple wire is positioned on a common inner tangent line of the staple pulley and the staple auxiliary pulley, and the rotation angle of the staple pulley can be expanded by the staple auxiliary pulley.

In the present invention, the area adjacent to the first pulley, the staple pulley, and the second pulley in the guide section can be formed to be curved so that its cross section has a predetermined curvature.

In the present invention, the staple wire is positioned on a common inner tangent line of the staple pulley and the guide portion, and the rotation angle of the staple pulley can be expanded by the guide portion.

In the present invention, the staple drive assembly may include a staple link assembly connecting the staple pulley and the reciprocating movement assembly.

In the present invention, the staple link assembly may include a first link coupled with the staple pulley and a second link coupled with the first link and the reciprocating movement assembly, respectively.

In the present invention, when the staple pulley alternately rotates clockwise and counterclockwise, the staple link assembly connected to the staple pulley can alternately move toward the distal side and the proximal side of the end tool.

In the present invention, by the staple link assembly, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the reciprocating movement assembly connected to the staple link assembly.

In the present invention, the first member has a guide groove formed along its longitudinal direction, and the staple link assembly can move along the guide groove.

In the present invention, a jaw rotation axis is further included that is inserted through the first group and the second group and becomes a rotation center of the first group and the second group, and the first axis is a jaw pulley rotation axis that is inserted through the first group pulley and the second group pulley and becomes a rotation center of the first group pulley and the second group pulley, and when the first group pulley and the second group pulley rotate around the jaw pulley rotation axis, the jaw rotation axis can move relatively to the jaw pulley rotation axis.

In the present invention, when the first group and the second group are closed, the jaw rotation axis can move in the distal direction of the end tool, and when the first group and the second group are opened, the jaw rotation axis can move in the proximal direction of the end tool.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis may be further included.

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

In the present invention, the first wire may further be wound at least partially around the first pulley and the pair of end tool first pitch main pulleys; and the second wire may further be wound at least partially around the second pulley and the pair of end tool second pitch main pulleys.

Another embodiment of the present invention provides an end tool of a surgical instrument, including: a first jaw and a second jaw which are independently rotatable; a first jaw pulley coupled with the first jaw and formed to be rotatable about a first axis; a second jaw pulley coupled with the second jaw and formed to be rotatable about an axis substantially the same as or parallel to the first axis; a staple pulley formed to be rotatable about an axis substantially the same as or parallel to the first axis and disposed adjacent to the first jaw pulley or the second jaw pulley; and a staple link assembly connected to the staple pulley and reciprocating according to the bidirectional rotation of the staple pulley.

In the present invention, the staple link assembly can be combined with the reciprocating movement assembly of the cartridge accommodated in the first clause to reciprocate the reciprocating movement assembly.

In the present invention, the staple link assembly can move toward the distal side or the proximal side of the end tool depending on the rotational direction of the staple pulley.

In the present invention, a protrusion is formed on one side of the staple pulley and the staple link assembly, and a hole is formed on the other side, so that the protrusion can be axially coupled to the hole.

In the present invention, a protruding member is formed in the staple pulley, and a slot is formed in the staple link assembly, so that when the staple pulley rotates, the protruding member can move within the slot while contacting the slot.

In the present invention, the staple link assembly may include a single link.

In the present invention, the staple link assembly may include a link member.

In the present invention, the link member may include a first link coupled with the staple pulley and a second link coupled with the first link.

In the present invention, the staple link assembly may include a first link member and a second link member.

In the present invention, the cartridge accommodated in the first clause includes a first reciprocating moving member and a second reciprocating moving member, and the first link member can be connected to the first reciprocating moving member, and the second link member can be connected to the second reciprocating moving member.

In the present invention, the first member has a guide groove formed along its longitudinal direction, and the staple link assembly can move along the guide groove.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis.

In the present invention, when the first group pulley and the second group pulley rotate in the same direction about the second axis, the staple pulley can rotate together with the first group pulley and the second group pulley.

In the present invention, when the first group pulley and the second group pulley rotate in the same direction about the first axis, the staple pulley can rotate together with the first group pulley and the second group pulley.

In the present invention, when the first group pulley and the second group pulley rotate in different directions about the first axis, the staple pulley can rotate together with either the first group pulley or the second group pulley.

In the present invention, while the staple pulley rotates around the first axis by the staple wire, the first group pulley and the second group pulley may not rotate.

In the present invention, a cartridge receiving portion capable of receiving a cartridge may be formed in the first group, and an anvil capable of contacting a staple of the cartridge may be formed in the second group.

In the present invention, the wire may further include: a first wire, at least a portion of which is wound around the first pulley; a second wire, at least a portion of which is wound around the second pulley; and a staple wire, at least a portion of which is wound around the staple pulley.

Another embodiment of the present invention comprises: a first jaw and a second jaw which are independently rotatable; a first jaw pulley coupled with the first jaw and formed to be rotatable about a first axis; a first jaw wire at least partially wound around the first jaw pulley; a second jaw pulley coupled with the second jaw and formed to be rotatable about the first axis; a second jaw wire at least partially wound around the second jaw pulley; a pair of end tool first jaw pitch main pulleys formed on one side of the first jaw pulley and formed to be rotatable about a second axis forming a predetermined angle with the first axis; a pair of end tool second jaw pitch main pulleys formed on one side of the second jaw pulley and formed to be rotatable about an axis substantially the same as or parallel to the second axis; a staple pulley formed to be rotatable about the first axis and disposed between the first jaw pulley and the second jaw pulley; a staple link assembly connected to the staple pulley and reciprocating according to the bidirectional rotation of the staple pulley; It may include a staple wire that is in at least partial contact with the staple pulley and transmits a driving force necessary for rotation of the staple pulley to the staple pulley.

In the present invention, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the staple link assembly.

In the present invention, the staple link assembly is coupled with the reciprocating movement assembly of the cartridge accommodated in the first group, and the rotational motion of the staple pulley can be transmitted to the working member of the cartridge through the staple link assembly and the reciprocating movement assembly.

In the present invention, by the staple link assembly, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the reciprocating movement assembly connected to the staple link assembly.

In the present invention, a jaw rotation axis is further included that is inserted through the first group and the second group and becomes a rotation center of the first group and the second group, and the first axis is a jaw pulley rotation axis that is inserted through the first group pulley and the second group pulley and becomes a rotation center of the first group pulley and the second group pulley, and when the first group pulley and the second group pulley rotate around the jaw pulley rotation axis, the jaw rotation axis can move relatively to the jaw pulley rotation axis.

In the present invention, when the first group and the second group are closed, the jaw rotation axis can move in the distal direction of the end tool, and when the first group and the second group are opened, the jaw rotation axis can move in the proximal direction of the end tool.

In the present invention, a fluid coupling hole is formed in the first group or the second group, and an axial coupling part is formed in the first group pulley or the second group pulley, so that when the axial coupling part is fitted into the fluid coupling hole, the axial coupling part can be formed to move to a certain extent within the fluid coupling hole.

In the present invention, when the staple pulley alternately rotates clockwise and counterclockwise, the staple link assembly connected to the staple pulley can alternately move toward the distal side and the proximal side of the end tool.

In the present invention, the first member has a guide groove formed along its longitudinal direction, and the staple link assembly can move along the guide groove.

In the present invention, the end tool further includes an end tool hub including a first pulley coupling portion and a second pulley coupling portion formed to face each other, and a guide portion connecting the first pulley coupling portion and the second pulley coupling portion, and an area of the guide portion adjacent to the first pulley, the staple pulley, and the second pulley may be formed to be curved so that its cross section has a predetermined curvature.

In the present invention, the staple wire is positioned on a common inner tangent line of the staple pulley and the guide portion, and the rotation angle of the staple pulley can be expanded by the guide portion.

In the present invention, the first group, the first group pulley, the second group, and the second group pulley can be formed to rotate around the same rotation axis.

In the present invention, the first group pulley, the staple pulley, and the second group pulley can be sequentially formed in a laminated manner.

In the present invention, a guide groove may be formed along the longitudinal direction of the anvil of the second group so that the clamp of the cartridge accommodated in the first group can move along the guide groove.

In the present invention, a coupling groove may be formed at both ends of the guide groove of the anvil, through which the clamp can be introduced or withdrawn with respect to the anvil.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis may be further included.

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

In the present invention, the first wire may further be wound at least partially around the first pulley and the pair of end tool first pitch main pulleys; and the second wire may further be wound at least partially around the second pulley and the pair of end tool second pitch main pulleys.

In the present invention, a staple second auxiliary pulley may be further included, which is arranged between the first group pulley and the end tool first group pitch main pulley, or between the second group pulley and the end tool second group pitch main pulley, and is formed to be rotatable around an axis substantially identical to or parallel to the second axis, to guide the path of the first group wire or the second group wire.

Another embodiment of the present invention provides a surgical instrument, comprising: a first member capable of receiving a cartridge; a second member formed to face the first member; a first member pulley coupled with the first member and formed to be rotatable about a first axis; a second member pulley coupled with the second member and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first member pulley by a predetermined amount; at least one staple pulley, at least a portion of which is formed between the first member pulley and the second member pulley; a staple link assembly including a first link member coupled to one area of the staple pulley and a second link member coupled to another area of the staple pulley; and a staple wire, at least a portion of which is wound around the staple pulley.

In the present invention, the first link member can be coupled with the first reciprocating moving member of the cartridge accommodated in the first group, and the second link member can be coupled with the second reciprocating moving member of the cartridge accommodated in the first group.

In the present invention, the staple pulley may be formed with a first link coupling portion and a second link coupling portion, the first link member may be coupled to the first link coupling portion, and the second link member may be coupled to the second link coupling portion.

In the present invention, the first link coupling portion and the second link coupling portion can be arranged on opposite sides with respect to the central axis of the staple pulley.

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

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

In the present invention, the cartridge accommodated in the first clause may include a reciprocating movement assembly including a first reciprocating movement member and a second reciprocating movement member formed to face each other, and a ratchet member formed to be movable along the reciprocating movement assembly and having a first ratchet and a second ratchet formed therein.

In the present invention, the first ratchet may be formed to be in contact with the first reciprocating moving member, and the second ratchet may be formed to be in contact with the second reciprocating moving member.

In the present invention, when the staple pulley rotates in one direction, the first ratchet and the first reciprocating member may come into contact, and when the staple pulley rotates in the other direction, the second ratchet and the second reciprocating member may come into contact.

In the present invention, when the staple pulley rotates in one direction, the first reciprocating member comes into close contact with the first ratchet and pushes the first ratchet, thereby causing the ratchet member to move in the distal direction of the cartridge, and when the staple pulley rotates in the other direction, the second reciprocating member comes into close contact with the second ratchet and pushes the second ratchet, thereby causing the ratchet member to move in the distal direction of the cartridge.

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

In the present invention, the first link member may include a first link and a second link, and the second link member may include a third link and a fourth link.

In the present invention, it may be characterized in that the heights of the fastening portion formed on the first link member and coupled with the first reciprocating moving member and the fastening portion formed on the second link member and coupled with the second reciprocating moving member in the first axis are substantially the same.

In the present invention, the fourth link may be formed in a bar shape that is bent at least once.

In the present invention, the first ratchet may be formed on one side of the ratchet member, and the second ratchet may be formed on the other side of the ratchet member.

In the present invention, it may be characterized in that when the first reciprocating moving member moves in the proximal direction of the end tool, the first reciprocating moving member pushes the first ratchet toward the second reciprocating moving member, and when the second reciprocating moving member moves in the proximal direction of the end tool, the second reciprocating moving member pushes the second ratchet toward the first reciprocating moving member.

In the present invention, the ratchet member may include a first ratchet member having the first ratchet formed on one surface, and a second ratchet member having the second ratchet formed on one surface.

In the present invention, it may be characterized in that when the first reciprocating moving member moves in the proximal direction of the end tool, the first reciprocating moving member pushes the first ratchet toward the second reciprocating moving member, and when the second reciprocating moving member moves in the proximal direction of the end tool, the second reciprocating moving member pushes the second ratchet toward the first reciprocating moving member.

In the present invention, a first elastic member interposed between the first ratchet member and the first reciprocating member and applying an elastic force in a direction in which the first ratchet member comes into close contact with the first reciprocating member may be included, and a second elastic member interposed between the first ratchet member and the second reciprocating member and applying an elastic force in a direction in which the second ratchet member comes into close contact with the second reciprocating member may be included.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis may be further included.

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

In the present invention, the first wire may further be wound at least partially around the first pulley and the pair of end tool first pitch main pulleys; and the second wire may further be wound at least partially around the second pulley and the pair of end tool second pitch main pulleys.

Another embodiment of the present invention provides an end tool of a surgical instrument, comprising: a first member capable of receiving a cartridge; a second member formed to face the first member; a first member pulley coupled with the first member and formed to be rotatable about a first axis; a second member pulley coupled with the second member and formed to be rotatable about an axis substantially the same as or parallel to the first axis and formed to be spaced apart from the first member pulley to a certain extent; a staple pulley disposed between the first member pulley and the second member pulley and having a protruding member formed in one region; a link having a slot formed in one region into which the protruding member of the staple pulley is inserted; and a staple wire at least partially wound around the staple pulley.

In the present invention, it may be characterized in that when the staple pulley rotates, the protruding member moves within the slot while contacting the slot to move the link.

In the present invention, the link may be formed as a single member.

In the present invention, when the staple pulley rotates, the link moves in one direction, and the link can move according to the width of the slot in the one direction.

In the present invention, the protruding member is formed in a pin shape, and the link can move by pressing the slot of the link while the protruding member rotates.

In the present invention, the slot is formed obliquely and not concentrically with the staple pulley, and the pin can move along the slot.

In the present invention, the protruding member is formed in a cam shape, and as the protruding member rotates, the slot of the link is pressed, allowing the link to move.

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

In the present invention, the cartridge accommodated in the first clause includes a reciprocating movement assembly and a working member, and may have an inactive state in which the link and the reciprocating movement assembly are separated, and an activated state in which the link and the reciprocating movement assembly are connected.

In the present invention, only in the activated state, when the staple pulley rotates, the reciprocating movement assembly can move linearly.

In the present invention, when the first and second groups are opened, the reciprocating movement assembly can move in the proximal direction of the end tool.

In the present invention, when the first and second sections are closed, the reciprocating movement assembly and the link can come into contact.

In the present invention, when the staple pulley rotates while the first and second groups are closed, the link and the reciprocating movement assembly can be in an activated state in which they are connected.

In the present invention, by the link, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the reciprocating moving assembly connected to the link.

In the present invention, the bidirectional rotational motion of the staple pulley can be converted into a reciprocating linear motion of the link.

In the present invention, the first group pulley, the staple pulley, and the second group pulley can be sequentially formed in a laminated manner.

In the present invention, a pair of end tool first pitch main pulleys formed on one side of the first pulley and formed to be rotatable around a second axis forming a predetermined angle with the first axis; and a pair of end tool second pitch main pulleys formed on one side of the second pulley and formed to be rotatable around an axis substantially identical to or parallel to the second axis may be further included.

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

In the present invention, the first wire may further be wound at least partially around the first pulley and the pair of end tool first pitch main pulleys; and the second wire may further be wound at least partially around the second pulley and the pair of end tool second pitch main pulleys.

Another embodiment of the present invention provides a cartridge of a surgical instrument having an end tool rotatable in at least one direction, the cartridge comprising: a housing; a cover covering one surface of the housing and having a slit formed along a first direction, which is a longitudinal direction of the housing; a plurality of staples arranged inside the housing; a reciprocating movement assembly arranged inside the housing and formed to be movable along the first direction with respect to the housing, the reciprocating movement assembly having a plurality of protrusions formed on at least one surface; and a working member formed on one side of the reciprocating movement assembly and formed to be in contact with the reciprocating movement assembly, the working member being formed to be movable along the first direction by the reciprocating movement assembly.

In the present invention, the reciprocating movement assembly may be connected to a staple driving assembly formed in the end tool, and when the staple pulley of the staple driving assembly rotates, the reciprocating movement assembly may move along the first direction.

In the present invention, it may be characterized in that when the staple pulley alternately rotates clockwise and counterclockwise, the reciprocating movement assembly connected to the staple drive assembly alternately moves toward the distal side and the proximal side of the cartridge.

In the present invention, it may be characterized in that the reciprocating movement assembly moves toward the distal end of the cartridge, thereby moving the working member in contact with the reciprocating movement assembly in the first direction.

In the present invention, the working member may include: a main body; one or more slanted surfaces formed on one side of the main body and formed so that the height of the proximal side of the cartridge is higher than that of the distal side; a blade formed on one side of the slanted surfaces and having a sharply formed edge; and a ratchet member formed on one side of the main body and having one or more ratchets formed that can come into contact with the uneven portion of the reciprocating movement assembly.

In the present invention, an elastic member may be further included that is formed between the main body or the Ÿ‡ and the ratchet member to provide an elastic force that urges the ratchet toward the reciprocating movement assembly.

In the present invention, it may be characterized in that when the reciprocating movement assembly moves toward the distal portion of the cartridge, the reciprocating movement assembly comes into close contact with the ratchet and pushes the ratchet, thereby causing the working member to move toward the distal portion of the cartridge.

In the present invention, it may be characterized in that when the reciprocating movement assembly moves toward the proximal portion of the cartridge, the working member remains stationary in the one direction.

In the present invention, when the reciprocating movement assembly moves toward the proximal portion of the cartridge, the inclined surface of the reciprocating movement assembly can press the inclined surface of the ratchet in a direction in which the ratchet member moves away from the reciprocating movement assembly.

In the present invention, the reciprocating movement assembly may include a first reciprocating movement member and a second reciprocating movement member formed to face each other, and the ratchet member may include a first ratchet formed to be in contact with the first reciprocating movement member and a second ratchet formed to be in contact with the second reciprocating movement member.

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

In the present invention, the first reciprocating moving member and the second reciprocating moving member can alternately move toward the distal portion of the cartridge.

In the present invention, the first reciprocating moving member is connected to a first link member connected to one area of the staple pulley of the end tool, and the second reciprocating moving member is connected to a second link member connected to the other area of the staple pulley, so that when the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating moving member connected to the first link member, and the ratchet member in contact with the first reciprocating moving member move in the distal direction of the cartridge, and when the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating moving member connected to the second link member, and the ratchet member in contact with the second reciprocating moving member can move in the distal direction of the cartridge.

In the present invention, the first ratchet may be formed on one side of the ratchet member, and the second ratchet may be formed on the other side of the ratchet member.

In the present invention, when the first reciprocating moving member moves in the proximal direction of the cartridge, the first reciprocating moving member can push the first ratchet toward the second reciprocating moving member, and when the second reciprocating moving member moves in the proximal direction of the cartridge, the second reciprocating moving member can push the second ratchet toward the first reciprocating moving member.

In the present invention, the ratchet member may include a first ratchet member having the first ratchet formed on one surface, and a second ratchet member having the second ratchet formed on one surface.

In the present invention, when the first reciprocating moving member moves in the proximal direction of the cartridge, the first reciprocating moving member can push the first ratchet toward the second reciprocating moving member, and when the second reciprocating moving member moves in the proximal direction of the cartridge, the second reciprocating moving member can push the second ratchet toward the first reciprocating moving member.

In the present invention, the device may further include a first elastic member interposed between the first ratchet member and the first reciprocating member and applying an elastic force in a direction in which the first ratchet member comes into close contact with the first reciprocating member, and a second elastic member interposed between the first ratchet member and the second reciprocating member and applying an elastic force in a direction in which the second ratchet member comes into close contact with the second reciprocating member.

In the present invention, one or more protrusions may be formed in an area on the inner surface of the housing that can contact the working member, and a snap that can contact the protrusions may be formed on the working member.

In the present invention, when the reciprocating movement assembly moves toward the proximal portion of the cartridge, the snap and the protrusion come into contact, so that the working member can be prevented from moving toward the proximal portion of the cartridge.

In the present invention, one end of the snap is coupled with the working member and can be formed to enable a certain degree of elastic deformation.

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

In the present invention, a clamp extending along the first direction may be formed on one side of the blade of the working member.

In the present invention, a guide groove is formed in the anvil of the second set of the end tool along the first direction, so that the clamp can move along the guide groove.

In the present invention, a coupling groove may be formed at both ends of the anvil through which the clamp can be introduced into or withdrawn from the anvil.

Another embodiment of the present invention comprises the steps of: (a) when a staple pulley of a staple drive assembly rotates in a first direction about a first axis, a staple link assembly connected to the staple pulley and a reciprocating assembly of a cartridge connected to the staple link assembly move in a distal direction of the cartridge along a second axis; (b) when the reciprocating assembly moves in the distal direction of the cartridge, a working member in contact with the reciprocating assembly moves in the distal direction of the cartridge together with the reciprocating assembly; (c) when the working member moves in the distal direction of the cartridge, the working member ejects staples within the cartridge to the outside of the cartridge, while a blade of the working member moves in the distal direction of the cartridge; (d) a step of causing the staple link assembly connected to the staple pulley and the reciprocating movement assembly of the cartridge connected to the staple link assembly to move in the proximal direction of the cartridge when the staple pulley rotates in a second direction opposite to the first direction about the first axis; a method for driving a surgical instrument is provided.

In the present invention, when the staple pulley rotates in the first direction or the second direction, the reciprocating movement assembly can move in the distal direction of the cartridge or in the proximal direction of the cartridge.

In the present invention, the bidirectional rotational motion of the staple pulley about the first axis can be converted into a reciprocating linear motion of the reciprocating movement assembly connected to the staple pulley along the second axis.

In the present invention, by the reciprocating linear motion of the reciprocating movement assembly, the working member can move in the distal direction of the cartridge.

In the present invention, a rack is formed on one side of the reciprocating movement assembly, and the working member includes a ratchet member having a ratchet formed thereon, so that the ratchet member can move in the distal direction of the cartridge by pushing the ratchet member while the rack is in close contact with the ratchet member.

In the present invention, in the step (d), the working member can be stationary in the second axis direction.

In the present invention, the working member can move toward the distal end of the cartridge together with the reciprocating movement assembly only when the reciprocating movement assembly moves toward the distal end of the cartridge.

In the present invention, the staple drive assembly may include a first link member connected to one area of the staple pulley, and a second link member connected to another area of the staple pulley, the reciprocating movement assembly may include a first reciprocating movement member connected to the first link member, and a second reciprocating movement member connected to the second link member, and the working member may include a ratchet member having a first ratchet and a second ratchet formed therein.

In the present invention, in step (a), the first ratchet and the first reciprocating moving member may come into contact, and in step (b), the second ratchet and the second reciprocating moving member may come into contact.

In the present invention, in the step (a), the first link member connected to the staple pulley, the first reciprocating moving member connected to the first link member, and the working member in contact with the first reciprocating moving member can move in the distal direction of the cartridge, and the second link member connected to the staple pulley, and the second reciprocating moving member connected to the second link member can move in the proximal direction of the cartridge.

In the present invention, in the step (d), the first link member connected to the staple pulley, the first reciprocating moving member connected to the first link member, and the working member in contact with the second link member and the second reciprocating moving member can move in the distal direction of the cartridge.

In the present invention, in the step (d), the working member can move in the distal direction of the cartridge.

In the present invention, a staple wire is further included that is coupled with the staple pulley to rotate the staple pulley, and the bidirectional rotation of the staple pulley by the staple wire can be converted into a reciprocating linear motion of the reciprocating movement assembly.

In the present invention, as the working member moves toward the distal end of the cartridge, the Ÿ‡ branch of the working member sequentially pushes up a plurality of staples within the cartridge to perform a stapling operation, and at the same time, a cutting operation can be performed as the blade formed on one side of the Ÿ‡ branch of the working member moves toward the distal end of the cartridge.

In the present invention, steps (a) to (d) can be performed repeatedly.

The present invention can be modified in various ways and has various embodiments, and specific embodiments are illustrated in the drawings and described in detail. However, this is not intended to limit the present invention to specific embodiments, and it should be understood that all modifications, equivalents, and substitutes included in the spirit and technical scope of the present invention are included. In describing the present invention, if it is determined that a specific description of a related known technology may obscure the gist of the present invention, the detailed description thereof will be omitted.

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

The terminology used in this application is only used to describe specific embodiments and is not intended to limit the present invention. The singular expression includes the plural expression unless the context clearly indicates otherwise. In this application, it should be understood that the terms "comprises" or "has" and the like are intended to specify the presence of a feature, number, step, operation, component, part or combination thereof described in the specification, but do not exclude in advance the possibility of the presence or addition of one or more other features, numbers, steps, operations, components, parts or combinations thereof.

Hereinafter, embodiments of the present invention will be described in detail with reference to the attached drawings. When describing with reference to the attached drawings, identical or corresponding components are assigned the same drawing numbers and redundant descriptions thereof are omitted.

In addition, in describing various embodiments of the present invention, it should be understood that each embodiment should not be interpreted or implemented independently, and that the technical ideas described in each embodiment can be interpreted or implemented in combination with other embodiments that are individually described.

A surgical instrument according to the present invention is characterized in that, when the operating unit is rotated in one direction for at least one of pitch, yaw, and actuation movements, the end tool rotates in the same direction as the operating direction of the operating unit intuitively.

Figure 1a is a conceptual diagram of the pitch motion of a conventional surgical instrument, and Figure 1b is a conceptual diagram of the yaw motion.

Referring to FIG. 1a, when performing a pitch motion of a conventional surgical instrument, the end tool (120a) is formed in front of the rotation center (121a) of the end tool, and the operating unit (110a) is formed in a state in which the rotation center (111a) of the operating unit is formed in the back, so that when the operating unit (110a) is rotated clockwise, the end tool (120a) also rotates clockwise, and when the operating unit (110a) is rotated counterclockwise, the end tool (120a) also rotates counterclockwise. Meanwhile, referring to FIG. 1B, when performing the operation of a conventional surgical instrument, the end tool (120a) is formed in front of the rotation center (121a) of the end tool, and the operating unit (110a) is formed in the rear of the rotation center (111a) of the operating unit, so that when the operating unit (110a) is rotated clockwise, the end tool (120a) also rotates clockwise, and when the operating unit (110a) is rotated counterclockwise, the end tool (120a) also rotates counterclockwise. In this case, when viewed from the perspective of the user's left-right direction, when the user moves the operating unit (110a) to the left, the end tool (120a) moves to the right, and when the user moves the operating unit (110a) to the right, the end tool (120a) moves to the left. As a result, since the user's operating direction and the operating direction of the end tool are opposite, there is a problem that it may cause a mistake by the user, and the user's operation is not easy.

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

Referring to FIG. 1c, some of the conventional surgical instruments are formed in a mirror-symmetrical shape, so that when performing a pitch motion, the end tool (120b) is formed in front of the rotation center (121b) of the end tool, and the operating unit (110b) is formed in the back of the rotation center (111b) of the operating unit, so that when the operating unit (110b) is rotated clockwise, the end tool (120b) rotates counterclockwise, and when the operating unit (110b) is rotated counterclockwise, the end tool (120b) rotates clockwise. In this case, from the perspective of the rotational direction of the operating unit and the end tool, the rotational direction in which the user rotates the operating unit (110b) and the rotational direction of the end tool (120b) accordingly are opposite to each other. As a result, there exists a problem in that it can cause confusion in the direction of operation for the user, the motion of the joint is not intuitive, and it can cause mistakes. In addition, referring to FIG. 1d, when performing this movement, the end tool (120b) is formed in front of the rotation center (121b) of the end tool, and the operating unit (110b) is formed in the rear of the rotation center (111b) of the operating unit, so that when the operating unit (110b) is rotated clockwise, the end tool (120b) rotates counterclockwise, and when the operating unit (110b) is rotated counterclockwise, the end tool (120b) rotates clockwise. In this case, when viewed from the perspective of the rotational direction of the operating unit and the end tool, the rotational direction in which the user rotates the operating unit (110b) and the rotational direction of the end tool (120b) accordingly are opposite to each other. As a result, there was a problem that this could cause confusion in the direction of operation for the user, the joint movement was not intuitive, and could cause mistakes. In this way, in the pitch or yaw manipulation of a conventional surgical instrument by a user, the direction of the user's manipulation and the direction of movement of the end tool do not coincide with each other in either the rotational direction or the left-right direction. This is because the configurations of the end tool and the operating portion in the joint configuration of the conventional surgical instrument are different. That is, the end tool is formed in front of the rotational center of the end tool, whereas the operating portion is formed behind the rotational center of the operating portion. In order to solve this problem, the surgical instrument according to one embodiment of the present invention illustrated in FIGS. 1E and 1F is characterized in that the end tool (120c) is formed in front of the rotational center (121c) of the end tool, and the operating portion (110c) is also formed in front of the rotational center (111c) of the operating portion, so that the operations of the operating portion (110c) and the end tool (120c) are intuitively consistent. To put this characteristic differently, unlike conventional examples of configurations in which the operating portion moves closer to the user with respect to its own joints (i.e., moves away from the end tool), as shown in FIGS. 1a, 1b, 1c, and 1d, a surgical instrument according to one embodiment of the present invention as shown in FIGS. 1e and 1f is formed such that at least a portion of the operating portion can move closer to the end tool (than its own joints) with respect to its own joints at one or more moments during the operating process.

To explain this differently, in the case of conventional surgical instruments such as those shown in FIGS. 1a, 1b, 1c, and 1d, the end tool is positioned in front of its own center of rotation, whereas the operating unit is formed behind its own center of rotation, so that the end tool, which moves forward while the rear is fixed, moves forward while the rear is fixed through the operation of the operating unit, which moves backward while the front is fixed, and thus the structure is not intuitively consistent. Due to this, there is a problem that there is a discrepancy in the left-right perspective or the rotational direction perspective between the operation of the operating unit and the operation of the end tool, which can cause confusion to the user, and it is difficult to intuitively and quickly perform the operation of the operating unit, which can cause mistakes. In contrast, in the surgical instrument according to one embodiment of the present invention, since both the end tool and the operating unit move based on the center of rotation formed in the rear, it can be said that the operations are intuitively consistent with each other in terms of structure. In other words, since the moving part of the end tool moves based on the rotation center formed at the rear, and the moving part of the operating part also moves based on the corresponding rotation center formed at the rear, it can be said that the movements are intuitively consistent with each other in terms of structure. This allows the user to intuitively and quickly perform control of the direction of the end tool, and has the advantage of significantly reducing the possibility of making a mistake. Below, a specific mechanism that enables this function will be described.

<First embodiment of surgical instrument>

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

First, referring to FIGS. 2 and 3, a surgical instrument (10) according to the first embodiment of the present invention includes an end tool (100), a manipulation unit (200), a power transmission unit (300), and a connection unit (400).

Here, the connecting portion (400) is formed in a hollow shaft shape, and one or more wires and electric wires can be accommodated therein. An operating portion (200) is coupled to one end of the connecting portion (400), and an end tool (100) is coupled to the other end, so that the connecting portion (400) can play a role of connecting the operating portion (200) and the end tool (100). Here, the connecting portion (400) of the surgical instrument (10) according to the first embodiment of the present invention has a straight portion (401) and a bent portion (402), and is characterized in that the straight portion (401) is formed on the side coupled with the end tool (100), and the bent portion (402) is formed on the side coupled with the operating portion (200). In this way, by forming the end of the operating portion (200) of the connecting portion (400) by bending, the pitch operating portion (201), the yaw operating portion (202), and the actuation operating portion (203) are formed on an extension of the end tool (100) or adjacent to the extension. Expressing this in another aspect, it can be described that at least a portion of the pitch operating portion (201) and the yaw operating portion (202) are accommodated within the concave portion formed by the bending portion (402). The shape and operation of the operating portion (200) and the end tool (100) can be more intuitively matched by the shape of the bending portion (402).

Meanwhile, the plane on which the bending 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 bending portion (402) is formed on substantially the same plane as the XZ plane, interference between the operating parts may be reduced. Of course, for intuitive operation of the end tool and the operating part, other types of configurations may be possible as well as the XZ plane.

Meanwhile, a connector (410) may be formed in the bending portion (402). The connector (410) may be connected to an external power source (not shown), and further, the connector (410) may be connected to an end tool (100) via an electric wire, so as to transmit electric energy supplied from an external power source (not shown) to the end tool (100). In addition, the electric energy transmitted to the end tool (100) in this way may provide a driving force for rotating a staple pulley (see 161 of FIG. 5) described below in a clockwise or counterclockwise direction.

The operating unit (200) is formed at one end of the connecting unit (400) and is provided with an interface that can be directly controlled by the doctor, for example, in the shape of forceps, stick, lever, etc. When the doctor controls this, the end tool (100) connected to the corresponding interface and inserted into the body of the surgical patient performs a predetermined operation, thereby performing the surgery. Here, in FIG. 2, the operating unit (200) is illustrated as being formed in the shape of a handle that can be rotated while inserting a finger, but the idea of the present invention is not limited thereto, and various forms of operating units that are connected to the end tool (100) and can operate the end tool (100) are possible.

The end tool (100) is formed at the other end of the connecting portion (400) and is inserted into the surgical site to perform movements necessary for the surgery. As an example of such an end tool (100), a pair of jaws (103) for performing a grip movement, as illustrated in FIG. 2, may be used. However, the idea of the present invention is not limited thereto, and various devices for surgery may be used as the end tool (100). For example, a configuration such as a one-armed cauterizer may also be used as the end tool. Such an end tool (100) is connected by the operating portion (200) and the power transmission portion (300), and receives the driving force of the operating portion (200) through the power transmission portion (300), thereby performing movements necessary for the surgery, such as gripping, cutting, and suturing movements.

Here, the end tool (100) of the surgical instrument (10) according to the first embodiment of the present invention is formed to be rotatable in at least one direction, and for example, the end tool (100) may be formed to perform a pitch motion centered on the Y-axis of FIG. 2, and a yaw motion and an actuation motion centered on the Z-axis of FIG. 2.

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

First, the pitch motion means a motion in which the end tool (100) rotates up and down with respect to the extension direction of the connecting portion (400) (the X-axis direction in FIG. 2), that is, a motion in which the end tool (100) rotates around the Y-axis in FIG. 2. In other words, it means a motion in which the end tool (100) that is formed to extend from the connecting portion (400) in the extension direction of the connecting portion (400) (the X-axis direction in FIG. 2) rotates up and down with respect to the connecting portion (400) around the Y-axis.

Next, the yaw motion means a motion in which the end tool (100) rotates left and right with respect to the extension direction of the connecting portion (400) (the X-axis direction in FIG. 2), that is, a motion in which it rotates around the Z-axis in FIG. 2. In other words, it means a motion in which the end tool (100), which is formed to extend from the connecting portion (400) in the extension direction of the connecting portion (400) (the X-axis direction in FIG. 2), rotates left and right with respect to the connecting portion (400) around the Z-axis. That is, it means a motion in which two jaws (103) formed on the end tool (100) rotate around the Z-axis in the same direction.

Meanwhile, the actuation motion means a motion in which the end tool (100) rotates around the same rotational axis as the yaw motion, but the two jaws (103) rotate in opposite directions while the jaws close or open. In other words, it means a motion in which the two jaws (103) formed on the end tool (100) rotate in opposite directions around the Z-axis.

The power transmission unit (300) connects the operating unit (200) and the end tool (100) and transmits the driving force of the operating unit (200) to the end tool (100), and may include a number of wires, pulleys, links, joints, gears, etc.

The end tool (100), operating unit (200), power transmission unit (300), etc. of the surgical instrument (10) of Fig. 2 will be described in detail later.

(Intuitive Drive)

Below, the intuitive operation of the surgical instrument (10) of the present invention will be described.

First, the user can perform a pitch motion by rotating the first handle (204) around the Y-axis (i.e., the rotation axis (246) of FIG. 41) while holding the first handle (204) with the palm, and can perform a yaw motion by rotating the first handle (204) around the Z-axis (i.e., the rotation axis (243) of FIG. 43). In addition, the user can perform an actuation motion by operating the actuation operating unit (203) while inserting the thumb and index finger into the first actuation extension (252) and/or the second actuation extension (257) in the form of a hand loop formed at one end of the actuation operating unit (203).

Here, the surgical instrument (10) according to the first embodiment of the present invention is characterized in that when the operating unit (200) is rotated in a certain direction with respect to the connecting unit (400), the end tool (100) rotates in a direction intuitively identical to the operating direction of the operating unit (200). In other words, when the first handle (204) of the operating unit (200) is rotated in a certain direction, the end tool (100) also rotates in a direction intuitively identical to the said direction to perform a pitch or yaw motion. Here, the intuitively identical direction can be further explained as meaning that the movement direction of the user's finger holding the operating unit (200) and the movement direction of the distal end of the end tool (100) are substantially in the same direction. Of course, the same direction here may not be a perfectly matching direction on the three-dimensional coordinate system, and for example, it may be understood as an identity such that when the user's finger moves to the left, the distal end of the end tool (100) also moves to the left, and when the user's finger moves down, the distal end of the end tool (100) also moves down.

And, for this purpose, the surgical instrument (10) according to the first embodiment of the present invention is characterized in that the operating part (200) and the end tool (100) are formed in the same direction with respect to a plane perpendicular to the extension axis (X-axis) of the connecting part (400). That is, when viewed based on the YZ plane of FIG. 2, the operating part (200) is formed to extend in the +X-axis direction, and at the same time, the end tool (100) is also formed to extend in the +X-axis direction. In other words, it may be said that the formation direction of the end tool (100) at one end of the connecting part (400) and the formation direction of the operating part (200) at the other end of the connecting part (400) are in the same direction with respect to the YZ plane. Or, in other words, it may be said that the operating part (200) is formed in a direction away from the torso of the user holding it, that is, in the direction in which the end tool (100) is formed. That is, the first handle (204), the first actuation operating unit (251), and the second actuation operating unit (256), which the user grasps and moves for the actuation motion, the yaw motion, and the pitch motion, are formed so that the moving parts for performing each motion are formed to extend in the +X-axis direction more than the rotation center of each joint for the corresponding motion. Through this, the operating unit (200) can be configured in the same way as the moving parts of the end tool (100) are formed to extend in the +X-axis direction more than the rotation center of each joint for the corresponding motion, and as explained through FIG. 1, the user's operating direction and the operating direction of the end tool are aligned from both the perspective of the rotation direction and the left-right direction, so that intuitively identical operations can be possible as a result.

Specifically, in the case of conventional surgical instruments, the direction in which the user operates the operating unit and the actual operating direction of the end tool are different from each other and do not intuitively match, so there is a problem that intuitive operation is not easy from the surgeon's perspective, it takes a long time to become skilled in moving the end tool in the desired direction, and in some cases, malfunction may occur, causing harm to the patient.

In order to solve such a problem, the surgical instrument (10) according to the first embodiment of the present invention is characterized in that the operating direction of the operating unit (200) and the operating direction of the end tool (100) are intuitively in the same direction, and to this end, the operating unit (200), like the end tool (100), is characterized in that the part that actually moves for the actuation motion, the yaw motion, and the pitch motion is formed to extend in the +X-axis direction more than the center of rotation of the corresponding joint of each motion.

Below, the end tool (100), operating unit (200), power transmission unit (300), etc. of the surgical instrument (10) of Fig. 2 will be described in more detail.

(power transmission)

Below, the power transmission unit (300) of the surgical instrument (10) of Fig. 2 will be described in more detail.

Referring to FIGS. 2 to 20, FIG. 43, etc., a power transmission unit (300) of a surgical instrument (10) according to one 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), a wire (307), and a wire (308).

Here, wire (301) and wire (305) can form a pair and serve as a first-piece wire. Wire (302) and wire (306) can form a pair and serve as a second-piece wire. Here, a component including wire (301) and wire (305), which are first-piece wires, and wire (302) and wire (306), which are second-piece wires, can be referred to as a jaw wire. In addition, wire (303) and wire (304) can form a pair and serve as a pitch wire. In addition, wire (307) and wire (308) can form a pair and serve as a staple wire.

In addition, the power transmission unit (300) of the surgical instrument (10) according to one embodiment of the present invention may include a fastening member (see 321 of FIG. 7), a fastening member (323), a fastening member (324), a fastening member (326), a fastening member (327), and a fastening member (see 329 of FIG. 62) that are fastened to each end of each wire to fasten the wire and the pulley. Here, each of the fastening members may have various shapes, such as a ball shape and a tube shape, as needed.

Here, on the end tool (100) side, the fastening member (see 321 of FIG. 7) may perform the role of a pitch wire-end tool fastening member, the fastening member (323) may perform the role of a first-stage wire-end tool fastening member, the fastening member (326) may perform the role of a second-stage wire-end tool fastening member, and the fastening member (see 329 of FIG. 62) may perform the role of a staple wire-end tool fastening member.

In addition, on the side of the operating unit (200), the fastening member (324) can perform the role of a first-order wire-operating unit fastening member, and the fastening member (327) can perform the role of a second-order wire-operating unit fastening member. In addition, although not shown in the drawing, a pitch wire-operating unit fastening member and a staple wire-operating unit fastening member can be further formed on the side of the operating unit (200).

The detailed description of the connection between the wires, fastening members, and each pulley is as follows.

First, the wire (301) and wire (305), which are the first wires, may be a single wire. The fastening member (323), which is the first wire-end tool fastening member, is inserted into the middle point of the first wire, which is a single wire, and after the fastening member (323) is pressed (crimped) to fix it, the two strands of the first wire may be referred to as wire (301) and wire (305), respectively, with the fastening member (323) as the center.

Alternatively, the wire (301) and the wire (305) of Article 1 may be formed as separate wires, and the wire (301) and the wire (305) may be connected by a fastening member (323).

And, by the fastening member (323) being coupled to the pulley (111), the wire (301) and the wire (305) can be fixedly coupled to the pulley (111). As a result, the pulley (111) can rotate as the wire (301) and the wire (305) are pulled and released.

Meanwhile, the opposite end of the wire (301) and the wire (305) to which the fastening member (323) is fastened can be joined with the first wire-manipulation member fastening member (see 324 of FIG. 43).

And, as the first wire-manipulating member fastening member (see 324 of FIG. 43) is connected to the pulley (210) in this way, the wire (301) and the wire (305) can be fixedly connected to the pulley (210). As a result, when the pulley (210) is rotated by a motor or manpower, the wire (301) and the wire (305) are pulled and released, allowing the pulley (111) of the end tool (100) to rotate.

In the same manner, the wire (302) and the wire (306), which are the second wires, are respectively connected to the connecting member (see 326 of FIG. 43) which is the second wire-end tool connecting member, and the second wire-manipulating member connecting member (see 327 of FIG. 43). Then, the connecting member (see 326 of FIG. 43) is connected to the pulley (121), and the second wire-manipulating member connecting member (see 327 of FIG. 43) is connected to the pulley (220). As a result, when the pulley (220) is rotated by a motor or manpower, the wire (302) and the wire (306) are pulled and released, thereby allowing the pulley (121) of the end tool (100) to rotate.

In the same manner, the wire (303) and the wire (304), which are pitch wires, are respectively connected to a connecting member (see 321 of FIG. 7) which is a pitch wire-end tool connecting member and a pitch wire-manipulating member connecting member (not shown). Then, the connecting member (see 321 of FIG. 7) is connected to a pulley (131), and the pitch wire-manipulating member connecting member (not shown) is connected to a pulley (231). As a result, when the pulley (231) is rotated by a motor or manpower, the wire (303) and the wire (304) are pulled and released, thereby allowing the pulley (131) of the end tool (100) to rotate.

In the same manner, the wire (307) and the wire (308), which are staple wires, are respectively connected to a fastening member (see 329 of FIG. 62) which is a staple wire-end tool fastening member and a staple wire-manipulating member fastening member (not shown). Then, the fastening member (see 329 of FIG. 62) is connected to the staple pulley (161), and the staple wire-manipulating member fastening member (not shown) is connected to the pulley (see 269 of FIG. 47). As a result, when the pulley (269) is rotated by a motor or manpower, the wire (307) and the wire (308) are pulled and released, thereby allowing the staple pulley (161) of the end tool (100) to rotate.

(end tool)

Below, the end tool (100) of the surgical instrument (10) of Fig. 2 will be described in more detail.

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

Here, Fig. 4 illustrates a state in which the end tool hub (180) and the pitch hub (107) are combined, and Fig. 5 illustrates a state in which the end tool hub (180) is removed. Meanwhile, Fig. 7 is a drawing mainly illustrating wires, and Fig. 8 is a drawing mainly illustrating pulleys.

Referring to FIGS. 4 to 8, etc., the end tool (100) of the first embodiment of the present invention has a pair of jaws for performing a grip operation, that is, a first jaw (101) and a second jaw (102). Here, each of the first jaw (101) and the second jaw (102), or a component encompassing the first jaw (101) and the second jaw (102) may be referred to as a jaw (103).

In addition, the end tool (100) may include pulleys (111), pulleys (112), pulleys (113), pulleys (114), pulleys (115), and pulleys (116) associated with the rotational motion of the first jaw (101). In addition, the end tool may include pulleys (121), pulleys (122), pulleys (123), pulleys (124), pulleys (125), and pulleys (126) associated with the rotational motion of the second jaw (102).

Here, the drawing shows that the facing pulleys are formed parallel to each other, but the idea of the present invention is not limited thereto, and each pulley may be formed in various positions and sizes suitable for the configuration of the end tool.

Additionally, the end tool (100) of the first embodiment of the present invention may include an end tool hub (180) and a pitch hub (107).

The end tool hub (180) has a rotation shaft (141) and a rotation shaft (142) penetratingly inserted therein, and can also accommodate at least a portion of a pulley (111) and a pulley (121) that are axially coupled to the rotation shaft (141) inside. In addition, the end tool hub (180) can accommodate at least a portion of a pulley (112) and a pulley (122) that are axially coupled to the rotation shaft (142) inside.

In detail, referring to FIG. 6, the end tool hub (180) includes a first pulley coupling portion (181), a second pulley coupling portion (182), a guide portion (183), and a pitch pulley coupling portion (185).

In detail, the first pulley coupling part (181) and the second pulley coupling part (182) are formed to face each other, and the pulley (111), the pulley (121), and the staple pulley (161) are accommodated therein. In addition, the first pulley coupling part (181) and the second pulley coupling part (182) are each formed with a through hole, so that the rotation shaft (141) passes through the first pulley coupling part (181), the pulley (111), the staple pulley (161), the pulley (121), and the second pulley coupling part (182) to axially couple them.

The first pulley coupling part (181) and the second pulley coupling part (182) are connected by the guide part (183). That is, the first pulley coupling part (181) and the second pulley coupling part (182), which are parallel to each other, are connected by the guide part (183) formed in a direction approximately perpendicular thereto, so that the first pulley coupling part (181), the second pulley coupling part (182), and the guide part (183) form an approximately “ㄷ” shape, and the pulley (111), the pulley (121), and the staple pulley (161) are accommodated inside.

Here, the first pulley (111) is positioned adjacent to the first pulley coupling portion (181) of the end tool hub (180), and the second pulley (121) is positioned adjacent to the second pulley coupling portion (182) of the end tool hub (180), so that a staple assembly receiving portion may be formed between the first pulley coupling portion (181) and the second pulley coupling portion (182). In addition, at least a portion of a staple pulley assembly (see 160 of FIG. 13) and a staple link assembly (see 170 of FIG. 13), which will be described later, may be formed within the staple assembly receiving portion. In other words, it may be expressed that at least a portion of a staple pulley (161) and a link member (171) are positioned between the first pulley coupling portion (181) and the second pulley coupling portion (182). In this way, by arranging at least a part of the staple pulley assembly (see 160 of FIG. 13) and the staple link assembly (see 170 of FIG. 13) between the first group pulley (111) and the second group pulley (121), it is possible to perform a stapling operation and a cutting operation using the staple pulley (161) together with the pitch operation and the yaw operation of the end tool (100), which is one feature of the present invention. This will be described in more detail later.

Meanwhile, a pulley (131) that performs the role of an end tool pitch pulley may be formed at one end of the end tool hub (180). As illustrated in FIG. 6, the pulley (131) may be formed as one body with the end tool hub (180). That is, a disk-shaped pulley may be formed at one end of the end tool hub (180), and a groove may be formed on an outer circumferential surface thereof, into which a wire may be wound. Alternatively, the pulley (131) may be formed as a separate member from the end tool hub (180) and coupled with the end tool hub (180). The above-described wire (303) and wire (304) are coupled to the pulley (131) that performs the role of an end tool pitch pulley, and the pulley (131) performs a pitch motion while rotating around the rotation axis (143).

The pitch hub (107) is penetrated by a rotation shaft (143) and a rotation shaft (144) to be described later, and the pitch hub (107) and the end tool hub (180) (and pulley (131)) can be axially coupled by the rotation shaft (143). Accordingly, the end tool hub (180) and the pulley (131) can be formed to be rotatable relative to the pitch hub (107) with the rotation shaft (143) as the center.

In addition, the pitch hub (107) can accommodate at least a portion of the pulley (113), the pulley (114), the pulley (123), and the pulley (124) that are axially coupled to the rotation shaft (143) inside. In addition, the pitch hub (107) can accommodate at least a portion of the pulley (115), the pulley (116), the pulley (125), and the pulley (126) that are axially coupled to the rotation shaft (144) inside.

In addition, the end tool (100) of the first embodiment of the present invention may include a rotational axis (141), a rotational axis (142), a rotational axis (143), and a rotational axis (144). As described above, the rotational axis (141) and the rotational axis (142) may be inserted through the end tool hub (180), and the rotational axis (143) and the rotational axis (144) may be inserted through the pitch hub (107).

The rotation axis (141), rotation axis (142), rotation axis (143), and rotation axis (144) may be arranged sequentially from the distal end (104) to the proximal end (105) of the end tool (100). Accordingly, starting from the distal end (104), the rotation axis (141) may be referred to as the 1st pin, the rotation axis (142) may be referred to as the 2nd pin, the rotation axis (143) may be referred to as the 3rd pin, and the rotation axis (144) may be referred to as the 4th pin.

Here, the rotation axis (141) functions as an end tool jaw pulley rotation axis, the rotation axis (142) functions as an end tool jaw auxiliary pulley rotation axis, the rotation axis (143) functions as an end tool pitch rotation axis, and the rotation axis (144) can function as an end tool pitch auxiliary rotation axis of the end tool (100).

Each of these rotation axes (141)(142)(143)(144) can have one or more pulleys fitted to it, which will be described in detail below.

Meanwhile, a rotational axis (145) may be further formed on one side of the rotational axis (141), specifically, on the distal end (104) of the rotational axis (141). The rotational axis (145) may be inserted through the first section (101) and the second section (102) to function as a rotational axis. This will be described in detail below.

Pulley (111) functions as an end tool jaw 1 pulley, and pulley (121) functions as an end tool jaw 2 pulley. Pulley (111) may be referred to as a jaw 1 pulley, and pulley (121) may be referred to as a jaw 2 pulley, or these two components may be collectively referred to as an end tool jaw pulley or simply a jaw pulley.

The end tool jaw pulley pulley (111) and the pulley (121) are formed to face each other and are formed to be able to rotate independently of each other around the rotation axis (141), which is the end tool jaw pulley rotation axis. At this time, the pulley (111) and the pulley (121) are formed to be spaced apart from each other to a certain extent, so that a staple assembly receiving portion can be formed therebetween. In addition, at least a part of the staple pulley assembly (160) and the staple link assembly (170) described later can be placed in the staple assembly receiving portion.

Here, the drawing shows that the pulley (111) and the pulley (121) are formed to rotate around a single axis of rotation (141), but it is of course possible for each end tool jaw pulley to be formed to rotate around a separate axis. Here, the first jaw (101) is fixedly coupled to the pulley (111) and rotates together with the pulley (111), and the second jaw (102) is fixedly coupled to the pulley (121) and rotates together with the pulley (121). The yaw motion and actuation motion of the end tool (100) are performed according to the rotation of the pulley (111) and the pulley (121). That is, when the pulley (111) and the pulley (121) rotate in the same direction around the rotation axis (141), the yaw motion is performed, and when the pulley (111) and the pulley (121) rotate in opposite directions around the rotation axis (141), the actuation motion is performed.

Here, the first jaw (101) and the pulley (111) may be formed as separate members and coupled to each other, or the first jaw (101) and the pulley (111) may be formed as one body. Similarly, the second jaw (102) and the pulley (121) may be formed as separate members and coupled to each other, or the second jaw (102) and the pulley (121) may be formed as one body.

Pulley (112) functions as an end tool 1st auxiliary pulley, and pulley (122) functions as an end tool 2nd auxiliary pulley. These two components may be collectively referred to as an end tool 2nd auxiliary pulley or simply an auxiliary pulley.

In detail, the end tool auxiliary pulleys, pulley (112) and pulley (122), may be additionally provided on one side of the pulley (111) and pulley (121). In other words, the auxiliary pulley, pulley (112), may be arranged between the pulley (111) and pulley (113)/pulley (114). In addition, the auxiliary pulley, pulley (122), may be arranged between the pulley (121) and pulley (123)/pulley (124). The pulley (112) and pulley (122) may be formed to be independently rotatable around a rotational axis (142). Although the drawing shows that the pulley (112) and pulley (122) rotate around one rotational axis (142), it is to be understood that the pulley (112) and pulley (122) may each be formed to be rotatable around a separate axis. Such auxiliary pulleys will be described in more detail later.

Pulleys (113) and (114) function as end tool 1st pitch main pulleys, and pulleys (123) and (124) function as end tool 2nd pitch main pulleys, and these two components may be collectively referred to as end tool 2nd pitch main pulleys.

Pulleys (115) and (116) function as end tool 1st pitch sub-pulleys, and pulleys (125) and (126) function as end tool 2nd pitch sub-pulleys, and these two components may be collectively referred to as end tool 2nd pitch sub-pulleys.

Below, the components related to the rotation of the pulley (111) are described.

Pulley (113) and pulley (114) function as the end tool 1st pitch main pulley. That is, they function as the main rotation pulley of the pitch operation of 1st (101). Here, wire (301), which is a 1st wire, is wound around pulley (113), and wire (305), which is a 1st wire, is wound around pulley (114).

Pulleys (115) and (116) function as end tool 1st pitch sub-pulleys. That is, they function as sub-rotation pulleys of the pitch motion of 1st (101). Here, wire (301), which is a 1st wire, is wound around pulley (115), and wire (305), which is a 1st wire, is wound around pulley (116).

Here, on one side of the pulley (111) and the pulley (112), a pulley (113) and a pulley (114) are arranged to face each other. Here, the pulley (113) and the pulley (114) are formed to be able to rotate independently of each other around a rotation axis (143) which is an end tool pitch rotation axis. In addition, on one side of each of the pulleys (113) and (114), a pulley (115) and a pulley (116) are arranged to face each other. Here, the pulley (115) and the pulley (116) are formed to be able to rotate independently of each other around a rotation axis (144) which is an end tool pitch auxiliary rotation axis. Here, the drawing illustrates that the pulley (113), the pulley (115), the pulley (114) and the pulley (116) are all formed to be able to rotate around the Y-axis direction, but the spirit of the present invention is not limited thereto, and the rotation axes of each pulley may be formed in various directions as appropriate for the configuration.

Article 1 Wire (301) is wound sequentially so that at least a portion of the wire is in contact with pulley (115), pulley (113), and pulley (111). Then, wire (305) connected to wire (301) by fastening member (323) is wound sequentially so that at least a portion of the wire is in contact with pulley (111), pulley (112), pulley (114), and pulley (116).

To explain this from another perspective, the wire (301) and the wire (305), which are the first wires, are wound sequentially so that at least a portion of them contact the pulley (115), the pulley (113), the pulley (111), the pulley (112), the pulley (114), and the pulley (116), and the wire (301) and the wire (305) are formed so that they can move along the pulleys while rotating the pulleys.

Accordingly, when the wire (301) is pulled toward the arrow 301 of FIG. 7, the fastening member (323) to which the wire (301) is coupled and the pulley (111) coupled therewith rotate in the direction of arrow L of FIG. 8. Conversely, when the wire (305) is pulled toward the arrow 305 of FIG. 7, the fastening member (323) to which the wire (305) is coupled and the pulley (111) coupled therewith rotate in the direction of arrow R of FIG. 8.

Below, the pulley (112) and pulley (122) that perform the role of auxiliary pulley will be described in more detail.

Pulley (112) and pulley (122) can play a role in expanding the rotation angle of each of the first group (101) and the second group (102) by contacting the first group wire (305) and the second group wire (302) to a certain extent by changing the arrangement path of the wire (305) and the wire (302).

That is, when the auxiliary pulley is not arranged, each of the first and second groups could only rotate to a right angle, but in one embodiment of the present invention, by additionally providing auxiliary pulleys, pulley (112) and pulley (122), the effect of increasing the maximum rotation angle by θ as seen in FIG. 8 can be obtained. This enables an operation in which the two groups of the end tool (100) must be separated for the actuation operation in a state in which they yaw together by 90° in the L direction. This is because the second group (102) can rotate by an additional angle (θ) as shown in FIG. 8. Similarly, the actuation operation is possible even in a state in which the two groups yaw in the L direction. In other words, it has the characteristic of being able to expand the range of yaw rotation in which the actuation operation is possible through the pulley (112) and the pulley (122).

To elaborate further,

If the auxiliary pulley is not arranged, the first group wire is fixedly connected to the end tool first group pulley, and the second group wire is fixedly connected to the end tool second group pulley, so that the end tool first group pulley and the end tool second group pulley can only rotate up to 90°. In this case, if the actuation operation is performed while the first and second groups are positioned on the 90° line, the first group can open, but the second group cannot rotate more than 90°. Therefore, there was a problem that the actuation operation was not performed smoothly when the first and second groups were performing the yaw operation more than a certain angle.

In order to solve such a problem, in the case of the surgical instrument (10) of the present invention, auxiliary pulleys, pulley (112) and pulley (122), are additionally arranged on one side of pulley (111) and pulley (121). By arranging pulley (112) and pulley (122) in this way, the arrangement paths of wire (305), which is the first wire, and wire (302), which is the second wire, are changed to a certain extent, thereby changing the tangent direction of wire (305) and wire (302), and thus, the fastening member (323) that connects wire (301) and pulley (111) can rotate up to line N of FIG. 8. That is, the fastening member (323), which is the connecting portion of wire (301) and pulley (111), can rotate until it is positioned on the common inner tangent line of pulley (111) and pulley (112). Likewise, the fastening member (326), which is a joint between the wire (302) and the pulley (121), can be rotated until it is positioned on the common inner tangent line of the pulley (121) and the pulley (122), so that the rotation range in the L direction can be expanded.

In other words, by the pulley (112), the two strands of the first wire wound around the pulley (111), which are wires (301) and (305), are arranged on one side based on a plane that is perpendicular to the Y-axis and passes through the X-axis. At the same time, by the pulley (122), the two strands of the second wire wound around the pulley (121), which are wires (302) and (306), are arranged on the other side based on a plane that is perpendicular to the Y-axis and passes through the X-axis.

In other words, pulleys (113) and (114) are positioned on one side relative to a plane that is perpendicular to the Y-axis and passes through the X-axis, and pulleys (123) and (124) are positioned on the other side relative to a plane that is perpendicular to the Y-axis and passes through the X-axis.

In other words, the wire (305) is positioned on the inner tangent of the pulley (111) and the pulley (112), and the rotation angle of the pulley (111) is expanded by the pulley (112). In addition, the wire (302) is positioned on the inner tangent of the pulley (121) and the pulley (122), and the rotation angle of the pulley (121) is expanded by the pulley (122).

According to the present invention, the rotation radius of the joint (101) and joint (102) is widened, thereby obtaining the effect of widening the range of motion in which normal opening and closing actuation can be performed.

Next, components related to the rotation of the pulley (121) are described.

Pulley (123) and pulley (124) function as the end tool 2nd pitch main pulley. That is, they function as the main rotation pulley of the pitch operation of 2nd (102). Here, wire (306), which is a 2nd wire, is wound around pulley (123), and wire (302), which is a 2nd wire, is wound around pulley (124).

Pulley (125) and pulley (126) function as end tool 2nd pitch sub-pulleys. That is, they function as sub-rotation pulleys of the pitch motion of 2nd (102). Here, wire (306), which is a 2nd wire, is wound around pulley (125), and wire (302), which is a 2nd wire, is wound around pulley (126).

On one side of the pulley (121), a pulley (123) and a pulley (124) are arranged to face each other. Here, the pulley (123) and the pulley (124) are formed to be able to rotate independently of each other around a rotation axis (143), which is an end tool pitch rotation axis. In addition, on one side of each of the pulleys (123) and (124), a pulley (125) and a pulley (126) are arranged to face each other. Here, the pulley (125) and the pulley (126) are formed to be able to rotate independently of each other around a rotation axis (144), which is an end tool pitch auxiliary rotation axis. Here, the drawing illustrates that the pulley (123), the pulley (125), the pulley (124) and the pulley (126) are all formed to be able to rotate around the Y-axis direction, but the spirit of the present invention is not limited thereto, and the rotation axes of each pulley may be formed in various directions as appropriate for the configuration.

Article 2 Wire (306) is wound sequentially so that at least a portion of the wire is in contact with pulley (125), pulley (123), and pulley (121). Then, wire (302) connected to wire (306) by fastening member (326) is wound sequentially so that at least a portion of the wire is in contact with pulley (121), pulley (122), pulley (124), and pulley (126).

To explain this from another perspective, the wire (306) and the wire (302), which are the second wires, are wound sequentially so that at least a portion of them contact the pulley (125), the pulley (123), the pulley (121), the pulley (122), the pulley (124), and the pulley (126), and the wire (306) and the wire (302) are formed so that they can move along the pulleys while rotating the pulleys.

Accordingly, when the wire (306) is pulled toward the arrow 306 of FIG. 7, the fastening member (326) to which the wire (306) is coupled and the pulley (121) coupled therewith rotate in the direction of arrow R of FIG. 8. Conversely, when the wire (302) is pulled toward the arrow 302 of FIG. 7, the fastening member (326) to which the wire (302) is coupled and the pulley (121) coupled therewith rotate in the direction of arrow L of FIG. 8.

Below, the pitch motion of the present invention is described in more detail.

Meanwhile, when the wire (301) is pulled toward the arrow 301 of FIG. 7 and at the same time, the wire (305) is pulled toward the arrow 305 of FIG. 7 (i.e., when both strands of the first wire are pulled), as shown in FIGS. 43 and 51, the wire (301) and the wire (305) are wound downward around the pulley (113) and the pulley (114) that can rotate around the rotation axis (143), which is the end tool pitch rotation axis, so that the pulley (111) to which the wire (301) and the wire (305) are fixedly coupled and the end tool hub (180) to which the pulley (111) is coupled rotate together in the counterclockwise direction around the rotation axis (143), resulting in the end tool (100) performing a pitch motion while rotating downward. At this time, since the second article (102) and the wire (302) and wire (306) fixedly connected thereto are wound above the pulley (123) and pulley (124) that can rotate around the rotation axis (143), the wire (302) and wire (306) are released in the opposite direction of 301 and 305, respectively.

Conversely, when the wire (302) is pulled toward the arrow 302 of FIG. 7 and at the same time the wire (306) is pulled toward the arrow 306 of FIG. 7, as shown in FIGS. 43 and 51, the wire (302) and the wire (306) are wound upwards around the pulley (123) and the pulley (124) that can rotate around the rotation axis (143), which is the end tool pitch rotation axis, so that the pulley (121) to which the wire (302) and the wire (306) are fixedly coupled and the end tool hub (180) to which the pulley (121) is coupled rotate together clockwise around the rotation axis (143), resulting in the end tool (100) performing a pitch motion while rotating upward. At this time, since the first article (101) and the wire (301) and the wire (305) fixedly connected thereto are wound underneath the pulley (113) and the pulley (114) that can rotate around the rotation axis (143), the wire (301) and the wire (305) move in the opposite directions of 302 and 306, respectively.

Meanwhile, the end tool (100) of the surgical instrument (10) of the present invention may further include a pulley (131) which is an end tool pitch pulley, the operating unit (200) may further include a pulley (231) and a pulley (232) which are operating unit pitch pulleys, and the power transmission unit (300) may further include a wire (303) and a wire (304) which are pitch wires. In detail, the pulley (131) of the end tool (100) may rotate around a rotation axis (143) which is an end tool pitch rotation axis, and may be formed integrally with the end tool hub (180) (or fixedly coupled to the end tool hub (180)). In addition, the wire (303) and the wire (304) may play a role in connecting the pulley (131) of the end tool (100) and the pulley (231) and the pulley (232) of the operating unit (200).

Therefore, when the pulley (231) and pulley (232) of the operating unit (200) rotate, the rotation of the pulley (231) and pulley (232) is transmitted to the pulley (131) of the end tool (100) through the wire (303) and the wire (304), so that the pulley (131) also rotates, and as a result, the end tool (100) performs a pitch motion while rotating.

That is, the surgical instrument (10) according to the first embodiment of the present invention is provided with a pulley (131) of the end tool (100), a pulley (231) and a pulley (232) of the operating unit (200), and a wire (303) and a wire (304) of the power transmission unit (300) for power transmission for pitch motion, thereby enabling the driving force of the pitch motion of the operating unit (200) to be transmitted more perfectly to the end tool (100), thereby improving operational reliability.

Here, the diameters of the end tool jaw pitch main pulleys, pulley (113), pulley (114), pulley (123) and pulley (124), and the diameters of the end tool pitch pulleys, pulley (131), may be the same as or different from each other. At this time, the ratio of the diameter of the end tool jaw pitch main pulley to the diameter of the end tool pitch pulley may be the same as the ratio of the diameter of the operation part pitch pulley of the operation part (200) to the diameter of the operation part pitch main pulley, which will be described later. This will be described in detail later.

(Staple pulley related components)

Below, the staple pulley (161) of the end tool (100) of the surgical instrument (10) of Fig. 2 will be described in more detail.

FIG. 9 is a side view showing an end tool of the surgical instrument of FIG. 2, and FIGS. 10 and 11 are perspective views showing the first section of the surgical instrument of FIG. 2. FIG. 12 is a perspective view showing the first section pulley of the surgical instrument of FIG. 2, and FIG. 13 is an exploded perspective view showing the staple pulley and staple link of the surgical instrument of FIG. 2.

Referring to FIGS. 4 to 13, etc., the end tool (100) of the first embodiment of the present invention may include a staple pulley (161), a staple auxiliary pulley (162), a pulley (163), a pulley (164), a pulley (165), and a pulley (166) related to the linear/rotary motion of each pulley and link for stapling and cutting.

The staple pulley (161) is formed to face the end tool jaw pulleys, pulley (111) and pulley (121), and is formed to be able to rotate independently of each other around the rotation axis (141), which is the end tool jaw pulley rotation axis. Here, the drawing shows that the staple pulley (161) is arranged between the pulley (111) and the pulley (121), but the spirit of the present invention is not limited thereto, and the staple pulley (161) may be arranged at various positions adjacent to the pulley (111) or the pulley (121).

Here, the present invention is characterized in that the staple pulley (161), pulley (111), and pulley (121) are formed to rotate substantially around the same axis. By forming the staple pulley (161), pulley (111), and pulley (121) to rotate around the same axis in this way, it is possible to perform pitch motion/yaw motion/actuation motion while also performing stapling and cutting motions. This will be described in more detail later. However, in the drawing here, the staple pulley (161), pulley (111), and pulley (121) are formed to rotate around one rotational axis (141), but it goes without saying that each jaw pulley can be formed to rotate around a separate axis that is concentric with each other.

From another perspective, this can be expressed as a structure in which a first group pulley-in pulley (111), a staple pulley (161), and a second group pulley-in pulley (121) are sequentially formed in layers along a rotation axis (141). Or, it can be expressed as a structure in which a staple pulley (161) is placed between pulleys (111) and (121) facing each other. Here, the first group pulley-in pulley (111), the staple pulley (161), and the second group pulley-in pulley (121) can be formed to be able to rotate independently of each other.

The staple auxiliary pulley (162) may be additionally provided on one side of the staple pulley (161), in other words, the staple auxiliary pulley (162) may be arranged between the staple pulley (161) and the pulley (163)/pulley (164). The staple auxiliary pulley (162) may be formed to be rotatable independently of the pulley (112) and the pulley (122) around the rotation axis (142). In this drawing, the staple auxiliary pulley (162), the pulley (112), and the pulley (122) are formed to rotate around one rotation axis (142), but it goes without saying that the staple auxiliary pulley (162), the pulley (112), and the pulley (122) may be formed to be rotatable around separate axes, respectively. Such a staple auxiliary pulley will be described in more detail later.

Pulley (163) and pulley (164) can function as staple pitch main pulleys, and pulley (165) and pulley (166) can function as staple pitch sub pulleys.

Below, the components related to the rotation of the staple pulley (161) are described.

Pulley (163) and pulley (164) function as staple pitch main pulleys. Here, wire (307), which is a staple wire, is wound around pulley (163), and wire (308), which is a staple wire, is wound around pulley (164).

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

Here, on one side of the staple pulley (161) and the staple auxiliary pulley (162), a pulley (163) and a pulley (164) are arranged to face each other. Here, the pulley (163) and the pulley (164) are formed to be able to rotate independently of each other around the rotation axis (143), which is the end tool pitch rotation axis. In addition, on one side of each of the pulleys (163) and (164), a pulley (165) and a pulley (166) are arranged to face each other. Here, the pulley (165) and the pulley (166) are formed to be able to rotate independently of each other around the rotation axis (144), which is the end tool pitch auxiliary rotation axis. Here, although the drawing illustrates that the pulley (163), the pulley (165), the pulley (164) and the pulley (166) are all formed to be able to rotate around the Y-axis direction, the spirit of the present invention is not limited thereto, and the rotation axes of each pulley may be formed in various directions as appropriate for the configuration.

As described above, the rotation axis (141), the rotation axis (142), the rotation axis (143), and the rotation axis (144) can be arranged sequentially from the distal end (104) to the proximal end (105) of the end tool (100). Accordingly, the staple pulley (161), the staple auxiliary pulley (162), the pulley (163)/pulley (164), and the pulley (165)/pulley (166) can be arranged sequentially from the distal end (104) to the proximal end (105) of the end tool (100).

The wire (307), which is a staple wire, is wound sequentially so that at least a portion thereof is in contact with the pulley (165), the pulley (163), the staple auxiliary pulley (162), and the staple pulley (161). Then, the wire (308), which is connected to the wire (307) by the fastening member (see 329 of FIG. 62), is wound sequentially so that at least a portion thereof is in contact with the staple pulley (161), the staple auxiliary pulley (162), the pulley (164), and the pulley (166).

To explain this from another perspective, wire (307) and wire (308), which are staple wires, are wound sequentially so that at least a portion of them contact pulley (165), pulley (163), staple auxiliary pulley (162), staple pulley (161), staple auxiliary pulley (162), pulley (164), and pulley (166), and wire (307) and wire (308) are formed so that they can move along the pulleys while rotating the pulleys.

Accordingly, when the wire (307) is pulled, the fastening member (see 329 of FIG. 62) to which the wire (307) is coupled and the staple pulley (161) coupled thereto rotate in one direction. Conversely, when the wire (308) is pulled, the fastening member (see 329 of FIG. 62) to which the wire (308) is coupled and the staple pulley (161) coupled thereto rotate in the opposite direction.

Below, the staple auxiliary pulley (162) will be described in more detail.

The staple auxiliary pulley (162) can play a role in expanding the rotation angle of the staple pulley (161) by contacting the staple wires, i.e., wires (307) and wires (308), and changing the arrangement path of the wires (307) and wires (308) to a certain extent.

That is, when the staple auxiliary pulley is not arranged, the staple pulley can only rotate up to a right angle, but in one embodiment of the present invention, by additionally providing the staple auxiliary pulley (162), which is an auxiliary pulley, the effect of increasing the maximum rotation angle by θ in both directions can be obtained. This enables the staple pulley (161) to rotate for the stapling and cutting operation while the two sets of the end tool (100) are rotated together by 90°, thereby making it possible to move the work member (540), which will be described later, in a linear manner. In other words, through the staple auxiliary pulley (162), it has the characteristic of being able to expand the range of yaw rotation in which the stapling and cutting operation is possible.

To elaborate further, here is the explanation:

In the case of the surgical instrument (10) of the present invention, a staple auxiliary pulley (162) is additionally arranged on one side of the staple pulley (161). By arranging the staple auxiliary pulley (162) in this way, the arrangement path of the wire (307) and the wire (308), which are staple wires, is changed to a certain extent, thereby changing the tangential direction of the wire (307) and the wire (308), and thus increasing the rotational angle of the fastening member (see 329 of FIG. 62) that connects the wire (307) and the wire (308) and the staple pulley (161). That is, the fastening member (see 329 of FIG. 62), which is the connecting portion of the wire (307) and the wire (308) and the staple pulley (161), is rotatable until it is positioned on the common inner tangent line of the staple pulley (161) and the staple auxiliary pulley (122).

In other words, the wire (307) and the wire (308) are positioned on the inner tangent line of the staple pulley (161) and the staple auxiliary pulley (162), and the rotation angle of the staple pulley (161) is expanded by the staple auxiliary pulley (162).

*By the present invention, the rotation radius of the staple pulley (161) is widened, thereby obtaining the effect of widening the range of motion in which normal stapling and cutting operations can be performed.

(staple drive assembly)

Below, the staple drive assembly (150) will be described in more detail.

Referring to FIG. 13, etc., the staple drive assembly (150) may include a staple pulley assembly (160) and a staple link assembly (170). Here, the staple drive assembly (150) is characterized by being connected to a reciprocating movement assembly (550) of a cartridge (500) to be described later, and converting a rotational motion of the staple pulley (161) into a linear motion of the reciprocating movement assembly (550). In other embodiments of the present invention to be described later, the staple drive assembly may also be understood as a concept including a staple pulley assembly and a staple link assembly.

The staple pulley assembly (160) may include one or more staple pulleys (161). The staple pulley assembly (160) may be formed between the pulley (111) and the pulley (121), adjacent to the pulley (111) and the pulley (121). In this embodiment, it is assumed that the staple pulley assembly (160) includes one staple pulley (161).

A shaft penetration portion (161a) may be formed in the staple pulley (161). The shaft penetration portion (161a) is formed in a hole shape, and a rotational shaft (141), which is an end tool jaw pulley rotational axis, may be inserted through the shaft penetration portion (161a). In addition, a link coupling portion (161b) may be formed in the staple pulley (161). A staple link assembly (170), which will be described later, may be coupled to the link coupling portion (161b). This will be described in more detail later.

Meanwhile, the end tool (100) of the first embodiment of the present invention may further include a staple link assembly (170) connected to the staple pulley assembly (160). The staple link assembly (170) may include one or more link members (171). The staple link assembly (170) may play a role of connecting the staple pulley assembly (160) and the reciprocating movement assembly (550) of the cartridge (500) to be described later. In this embodiment, it is assumed that the staple link assembly (170) includes one link member (171), and the link member (171) includes a first link (172) and a second link (173).

The first link (172) is formed in an elongated bar shape, and through holes may be formed at both ends. A link connecting portion (161b) of a staple pulley (161) may be inserted through the through hole at one end of the first link (172). A second link (173) may be inserted through the through hole at the other end of the first link (172).

The second link (173) is formed in an elongated bar shape and can be combined with the first link (172). The second link (173) can include a first protrusion (173a), a second protrusion (173b), and a fastening portion (173c).

In detail, a first protrusion (173a) may be formed at one end of the second link (173). When this first protrusion (173a) is fitted into the through hole of the first link (172) and axially coupled, the second link (173) may be coupled with the first link (172). In addition, the first protrusion (173a) may be fitted into the guide groove (101b) of the first clause (101) described below.

Meanwhile, a second protrusion (173b) may be formed in a central region of the second link (173). The second protrusion (173b) may be fitted into the guide groove (101b) of the first article (101) described later.

In this way, when the first protrusion (173a) and the second protrusion (173b) of the second link (173) formed in a protrusion shape are fitted into the groove-shaped guide groove (101b), the first protrusion (173a) and the second protrusion (173b) move along the guide groove (101b), thereby causing the staple link assembly (170) to move relative to the first member (101) (and the cartridge (500) therein). This will be described in more detail later.

Meanwhile, a fastening part (173c) may be formed at the other end of the second link (173). This fastening part (173c) may be combined with a fastening part (551a) of a reciprocating movement assembly (550) of a cartridge (500) to be described later.

In a state as shown in FIG. 13, when the staple pulley (161) rotates clockwise, the link member (171) connected to the staple pulley (161) can move as a whole toward the distal portion (see 101f of FIG. 14) of the first article (101). Conversely, when the staple pulley (161) rotates counterclockwise, the link member (171) connected to the staple pulley (161) can move as a whole toward the proximal portion (see 101g of FIG. 14) of the first article (101).

Therefore, the bidirectional rotational motion of the staple pulley assembly (160) can cause the reciprocating linear motion of the reciprocating movement assembly (550) of the cartridge (500) through the staple link assembly (170). This will be described in more detail later.

(Article 1, Article 2 and Actuation Action)

Below, the joint structure of the first section (101) and the second section (102) of the end tool (100) of the surgical instrument (10) of Fig. 2 will be described in more detail.

FIG. 14 is a plan view showing the first group of the surgical instrument of FIG. 2, and FIG. 15 is a plan view showing the second group of the surgical instrument of FIG. 2. FIG. 16 is a plan view showing the opening and closing operation of the first group of the surgical instrument of FIG. 2, and FIG. 17 is a plan view showing the opening and closing operation of the second group of the surgical instrument of FIG. 2, and FIG. 18 is a plan view showing the opening and closing operations of the first and second groups of the surgical instrument of FIG. 2. FIG. 19 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 2, and FIG. 20 is a plan view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 2.

Referring to FIGS. 9 to 20, etc., the first member (101) includes a cartridge receiving portion (101a), a guide groove (101b), a fluid coupling hole (101c), a pulley coupling hole (101d), and an axial penetration portion (101e).

The first article (101) is formed in an overall elongated rod shape, and a cartridge (500) is accommodated on the distal portion (101f) side, and a pulley (111) is coupled to the proximal portion (101g) so as to be rotatable around a rotation axis (141). In other words, the first article (101) is formed in a shape in which one side (the upper surface) of a hollow box is removed, so that a cartridge accommodation portion (101a) capable of accommodating a cartridge (500) can be formed inside the first article (101). That is, the first article (101) can be formed in a cross section that is approximately in a 'U' shape.

In the first article (101), a guide groove (101b) may be formed on one side of the cartridge receiving portion (101a), for example, on the proximal portion (101g) side, to guide the movement of the staple link assembly (170) to be described later. The guide groove (101b) may be formed in a groove shape along the movement path of the staple link assembly (170). Then, when the first protrusion (173a) and the second protrusion (173b) of the second link (173) formed in a protrusion shape are fitted into the groove-shaped guide groove (101b), the first protrusion (173a) and the second protrusion (173b) move along the guide groove (101b), thereby causing the staple link assembly (170) to move relative to the first article (101) (and the cartridge (500) therein). That is, the staple link assembly (170) can move along the guide groove (101b) of Article 1 (101).

Meanwhile, a fluid coupling hole (101c), a pulley coupling hole (101d), and an axial penetration portion (101e) can be formed on the proximal end side of Article 1 (101).

Here, the fluid coupling hole (101c) is formed to have a predetermined curvature and may be formed in an approximately elliptical shape. The shaft coupling portion (111a) of the pulley (111), which will be described later, may be fitted into the fluid coupling hole (101c). Here, the short radius of the fluid coupling hole (101c) may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion (111a). Meanwhile, the major radius of the fluid coupling hole (101c) may be formed to be larger than the radius of the shaft coupling portion (111a). Accordingly, when the shaft coupling portion (111a) of the pulley (111) is fitted into the fluid coupling hole (101c) of the first member (101), the shaft coupling portion (111a) is formed to be able to move to a certain extent within the fluid coupling hole (101c). This will be described in more detail later.

Meanwhile, the pulley coupling hole (101d) is formed in a cylindrical hole shape, and a pulley coupling part (111b) of a pulley (111) to be described later can be fitted into the pulley coupling hole (101d). Here, the radius of the pulley coupling hole (101d) can be formed to be substantially the same as or slightly larger than the radius of the pulley coupling part (111b). Accordingly, the pulley coupling part (111b) of the pulley (111) can be formed to be rotatably coupled to the pulley coupling hole (101d) of the first pulley (101). This will be described in more detail later.

The shaft penetration portion (101e) can be formed relatively on the distal side (101f) of the first joint (101) compared to the fluid coupling hole (101c) and the pulley coupling hole (101d). The shaft penetration portion (101e) is formed in the shape of a hole, and the rotational axis (145), which is the rotational axis of the joint, can be inserted through the shaft penetration portion (101e).

*Article 2 (102) includes an anvil (102a), a fluid coupling hole (102c), a pulley coupling hole (102d), and an axial penetration portion (102e).

Article 2 (102) is formed in an overall elongated rod shape, and an anvil (102a) is formed on the distal side (102f), and a pulley (112) is coupled to the proximal side (102g) so as to be rotatable around a rotation axis (141).

In detail, the anvil (102a) is formed in a flat plane shape, and on one side thereof, shapes corresponding to the shape of the staple (530) to be described later can be formed. Such an anvil (102a) can serve as a support to support the opposite side of the working member (540) when the working member (540) pushes up the staple (530) in the stapling operation, thereby allowing the staple (530) to be bent.

Meanwhile, a fluid coupling hole (102c), a pulley coupling hole (102d), and an axial penetration portion (102e) can be formed on the proximal end side of the second article (102).

Here, the fluid coupling hole (102c) is formed to have a predetermined curvature and may be formed in an approximately elliptical shape. The shaft coupling portion (121a) of the pulley (121), which will be described later, may be fitted into the fluid coupling hole (102c). Here, the short radius of the fluid coupling hole (102c) may be formed to be substantially the same as or slightly larger than the radius of the shaft coupling portion (121a). Meanwhile, the major radius of the fluid coupling hole (102c) may be formed to be larger than the radius of the shaft coupling portion (121a). Accordingly, when the shaft coupling portion (121a) of the pulley (121) is fitted into the fluid coupling hole (102c) of the second member (102), the shaft coupling portion (121a) is formed to be able to move to a certain extent within the fluid coupling hole (102c). This will be described in more detail later.

Meanwhile, the pulley coupling hole (102d) is formed in a cylindrical hole shape, and a pulley coupling part (121b) of a pulley (121) to be described later can be fitted into the pulley coupling hole (102d). Here, the radius of the pulley coupling hole (102d) can be formed to be substantially the same as or slightly larger than the radius of the pulley coupling part (121b). Accordingly, the pulley coupling part (121b) of the pulley (121) can be formed to be rotatably coupled to the pulley coupling hole (102d) of the second member (102). This will be described in more detail later.

Meanwhile, the shaft penetration portion (102e) may be formed relatively farther away (102f) from the second joint (102) than the fluid coupling hole (102c) and the pulley coupling hole (102d). The shaft penetration portion (102e) is formed in a hole shape, and the rotational axis (145), which is the rotational axis of the joint, may be inserted through the shaft penetration portion (102e).

The first pulley, a pulley (111), may include a shaft coupling portion (111a) and a jaw coupling portion (111b). The pulley (111) is formed in an overall rotatable disk shape, and the shaft coupling portion (111a) and the jaw coupling portion (111b) may be formed to protrude to a certain degree on one surface thereof. As described above, the shaft coupling portion (111a) of the pulley (111) may be fitted into the fluid coupling hole (101c) of the first pulley (101), and the jaw coupling portion (111b) of the pulley (111) may be fitted into the jaw pulley coupling hole (101d) of the first pulley (101). The pulley (111) may be formed to be rotatable about a rotation axis (141), which is an end tool jaw pulley rotation axis.

Meanwhile, the second pulley (121) may also include a shaft coupling portion (121a) and a jaw coupling portion (121b). The pulley (121) is formed in an overall rotatable disk shape, and the shaft coupling portion (121a) and the jaw coupling portion (121b) may be formed to protrude to a certain degree on one side thereof. As described above, the shaft coupling portion (121a) of the pulley (121) may be fitted into the fluid coupling hole (102c) of the second pulley (102), and the jaw coupling portion (121b) of the pulley (121) may be fitted into the jaw pulley coupling hole (102d) of the second pulley (102). The pulley (121) may be formed to be rotatable about a rotation axis (141), which is an end tool jaw pulley rotation axis.

The relationship between each component described above is as follows.

The rotational axis (141), which is the end tool jaw pulley rotational axis, is sequentially inserted through the shaft coupling portion (111a) of the pulley (111), the fluid coupling hole (101c) of the first member (101), the shaft penetration portion (161a) of the staple pulley (161), the fluid coupling hole (102c) of the second member (102), and the shaft coupling portion (121a) of the pulley (121).

The rotation axis (145), which is the rotation axis of the first article, is sequentially inserted through the shaft penetration portion (101e) of the first article (101) and the shaft penetration portion (102e) of the second article (102).

The shaft coupling part (111a) of the pulley (111) is fitted into the fluid coupling hole (101c) of the first group (101), and the joint coupling part (111b) of the pulley (111) is fitted into the joint pulley coupling hole (101d) of the first group (101).

At this time, the pulley coupling hole (101d) of Article 1 (101) and the joint coupling portion (111b) of the pulley (111) are rotatably coupled, and the fluid coupling hole (101c) of Article 1 (101) and the shaft coupling portion (111a) of the pulley (111) are fluidly coupled.

The shaft coupling part (121a) of the pulley (121) is fitted into the fluid coupling hole (102c) of the second member (102), and the joint coupling part (121b) of the pulley (121) is fitted into the joint pulley coupling hole (102d) of the second member (102).

At this time, the pulley coupling hole (102d) of Article 2 (101) and the joint coupling portion (121b) of the pulley (121) are rotatably coupled, and the fluid coupling hole (102c) of Article 2 (102) and the shaft coupling portion (121a) of the pulley (121) are fluidly coupled.

Here, pulley (111) and pulley (121) rotate around the rotation axis (141), which is the end tool jaw pulley rotation axis. The first jaw (101) and the second jaw (102) rotate around the rotation axis (145), which is the jaw rotation axis. That is, the rotation axes of pulley (111) and first jaw (101) are different from each other. Similarly, the rotation axes of pulley (121) and second jaw (102) are different from each other.

That is, the first group (101) basically rotates around the rotation axis (145), which is the rotation axis of the joint, although its rotation angle is limited to a certain extent by the fluid coupling hole (101c). Similarly, the second group (102) basically rotates around the rotation axis (145), which is the rotation axis of the joint, although its rotation angle is limited to a certain extent by the fluid coupling hole (102c).

The amplification of grip force due to the bonding relationship between each component described above is explained.

A surgical instrument (10) according to one embodiment of the present invention is characterized in that the joint structure of the first jaw (101) and the second jaw (102) forms an X-shaped structure, and when the first jaw (101) and the second jaw (102) rotate in a direction in which they come closer to each other (i.e., when the first jaw (101) and the second jaw (102) close), the grip force in the direction in which the first jaw (101) and the second jaw (102) close becomes greater. This will be described in more detail as follows.

As described above, in the opening and closing operations of the first article (101) and the second article (102), there are two axes that serve as the centers of rotation. That is, the first article (101) and the second article (102) perform the opening and closing operations centered on the two axes of the rotation axis (141) and the rotation axis (145). At this time, the centers of rotation of the first article (101) and the second article (102) become the rotation axis (145), and the centers of rotation of the pulley (111) and the pulley (121) become the rotation axis (141). At this time, the rotation axis (141) becomes an axis whose position is relatively fixed, and the rotation axis (145) becomes an axis whose position moves in a straight line relatively. In other words, when the position of the rotation axis (141) is fixed and the pulley (111) and pulley (121) rotate, the rotation axis (145), which is the rotation axis of the first group (101) and the second group (102), moves back and forth, causing the first group (101) and the second group (102) to open/close. This will be explained in more detail as follows.

In Fig. 17, r1 is the distance from the joint coupling part (121b) of the pulley (121) to the shaft coupling part (121a), and its length is constant. Accordingly, the distance from the rotation shaft (141) inserted into the shaft coupling part (121a) to the joint coupling part (121b) is also constant as r1.

Meanwhile, r2 of Fig. 17 is the distance from the pulley coupling hole (102d) of the second article (102) to the shaft penetration portion (102e), and its length is constant. Accordingly, the distance from the joint coupling portion (121b) of the pulley (121) inserted into the pulley coupling hole (102d) to the rotation shaft (145) inserted into the shaft penetration portion (102e) is also constant as r2.

That is, the lengths of r1 and r2 are maintained constant. Accordingly, when the pulley (111) and the pulley (121) perform a closing operation by rotating in the direction of arrow A1 of Fig. 16 and arrow A2 of Fig. 17, respectively, around the rotation axis (141), the first group (101) and the second group (102) rotate around the rotation axis (145) while the angle between r1 and r2 changes while the lengths of r1 and r2 are maintained constant, and at this time, the rotation axis (145) itself moves in a straight line (i.e., moves forward/backward) by the amount of arrow B1 of Fig. 16 and arrow B2 of Fig. 17.

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

To express this from another perspective, since the lengths of r1 and r2 are maintained constant when the second member (102) rotates around the rotation axis (145), when the pulley (121) rotates around the rotation axis (141), the angle between r1 and r2 changes while the lengths of r1 and r2 are maintained constant. That is, compared to the angle θ1 between r1 and r2 when the second member (102) is open as shown in Fig. 17 (a), the angle θ2 between r1 and r2 when the second member (102) is closed as shown in Fig. 17 (b) becomes larger.

Accordingly, when the second clause (102) rotates from an open state to a closed state, the angle between r1 and r2 changes and the rotation axis (145) receives a force in the forward direction.

At this time, since the rotation axis (141) is an axis whose position is relatively fixed, the joint rotation axis (145) moves forward in the direction of arrow B1 of Fig. 16 and arrow B2 of Fig. 17, and also, the grip force becomes greater in the direction in which the second joint (102) closes.

To express this from another perspective, when the pulley (111) and the pulley (121) rotate around the rotation axis (141), which is an axis whose relative positions are fixed, the angle (θ) between r1 and r2 changes while the distance between r1 and r2 is constant. And when the angle (θ) changes in this way, the first group (101) and the second group (102) push or pull the rotation axis (145), and thus the rotation axis (145) moves forward or backward. At this time, when the first group (101) and the second group (102) rotate in the closing direction, the rotation axis (145) moves forward in the direction of arrow B1 of FIG. 16 and arrow B2 of FIG. 17, and the grip force becomes even greater. Conversely, when the first clause (101) and the second clause (102) rotate in the direction of opening, the rotation axis (145) moves backward in the opposite direction of arrow B1 of Fig. 16 and arrow B2 of Fig. 17.

With this configuration, when the first article (101) and the second article (102) are closed, the grip force becomes stronger, so that the operator can perform the actuation movement strongly with less force.

(cartridge)

Below, the cartridge (500) of the surgical instrument (10) of Fig. 2 will be described in more detail.

FIG. 21 is a perspective view showing the first article of the surgical instrument and the cartridge of FIG. 2. FIG. 22 is an exploded perspective view showing the cartridge of FIG. 21, FIG. 23 is a combined perspective view showing the cartridge of FIG. 21, FIG. 24 is a side view showing the cartridge of FIG. 21, FIG. 25 is a perspective sectional view showing the cartridge of FIG. 21, and FIG. 26 is a side sectional view showing the cartridge of FIG. 21. FIGS. 27 and 28 are perspective views showing the working member of the cartridge of FIG. 21. FIG. 29 is a side sectional view showing the stapling-related structure of the end tool of the surgical instrument of FIG. 2, and FIGS. 30 and 31 are perspective sectional views showing the stapling structure of the end tool of the surgical instrument of FIG. 2. FIGS. 32 to 35 are perspective views illustrating the ratchet driving operation of the end tool of FIG. 30, and FIGS. 36 and 37 are plan views illustrating the ratchet driving operation of the end tool of FIG. 30. FIG. 38 is a perspective view illustrating the ratchet driving operation of the end tool of FIG. 30 as a whole. FIGS. 39 and 40 are perspective views illustrating the staple operation of the end tool of FIG. 30 as a whole.

Referring to FIGS. 21 to 40, etc., the cartridge (500) is formed to be mountable and detachable to the first article (101), and includes a plurality of staples (530) and blades (542) inside to perform tissue suturing and cutting. Here, the cartridge (500) may include a cover (510), a housing (520), a staple (530), a pull-out member (535), a working member (540), and a reciprocating movement assembly (550).

The housing (520) forms the outer shape of the cartridge (500), and is formed in a form in which one side (top surface) of an entirely hollow box is removed, and can be formed to accommodate a reciprocating movement assembly (550), a working member (540), and a staple (530) inside. Here, the housing (520) can be formed in a cross section that is approximately in a 'U' shape.

The cover (510) is formed to cover the upper part of the housing (520). The cover (510) may be formed with staple holes (511) through which a plurality of staples (530) can be discharged to the outside. Before the stapling operation, the staples (530) accommodated inside the housing (520) are pushed upward by the work member (540) during the stapling operation, pass through the staple holes (511) of the cover (510), and are pulled out to the outside of the cartridge (500), thereby performing stapling.

Meanwhile, a slit (512) may be formed along the length direction of the cover (510). The blade (542) of the working member (540) may protrude through the slit (512) to the outside of the cartridge (500). As the blade (542) of the working member (540) passes along the slit (512), the tissue on which stapled stapling has been completed may be cut.

A plurality of staples (530) may be arranged inside the housing (520). As the work member (540) described later moves linearly in one direction, the plurality of staples (530) may be sequentially pushed up from the inside to the outside of the housing (520) to perform sealing, i.e., stapling. Here, the material of the staples (530) may include titanium, stainless steel, and the like.

Meanwhile, a pull-out member (535) may be further arranged between the housing (520) and the staple (530). In other words, it may be expressed that the staple (530) is arranged on top of the pull-out member (535). In this case, the work member (540) may push up the pull-out member (535) while moving linearly in one direction, and the pull-out member (535) may push up the staples (530).

In this way, it can be described that the working member (540) pushes up the staples (530) including both the case where the working member (540) directly pushes up the staples (530) and the case where the working member (540) pushes up the take-out member (535) so that the take-out member (535) pushes up the staples (530) (i.e., the working member (540) indirectly pushes up the staples (530).

A reciprocating movement assembly (550) may be arranged at the lower part inside the housing (520). The reciprocating movement assembly (550) may include one or more reciprocating movement members (551). In the present embodiment, one reciprocating movement member (551) is illustrated as being provided, but in embodiments described below, a plurality of reciprocating movement members (551) may be provided.

In this embodiment, the reciprocating member (551) may be a rack. The reciprocating member (551) may include a recessed portion (551b) and a fastening portion (551a). In detail, the reciprocating member (551) may be formed in a long bar shape, and a plurality of recessed portions (551b) in a sawtooth shape may be formed on one surface. The recessed portions (551b) may be formed to be in contact with a working member (540) to be described later, particularly, a ratchet member (543) of the working member (540). In other words, the reciprocating member (551) may include a plurality of recessed portions (551b) having a shape that engages with the ratchets (543a) of the ratchet member (543).

Meanwhile, although not shown in the drawing, the reciprocating member (551) may be provided with various shapes of members, other than a rack shape, that are directly or indirectly connected to the staple pulley (161) and can perform linear reciprocating motion according to the rotational motion of the staple pulley (161). For example, the reciprocating member (551) may be in the form of a clutch without a protruding portion.

Here, the reciprocating member (551) is not fixedly connected to other components of the cartridge (500) and may be formed to be relatively movable with respect to other components of the cartridge (500). That is, the reciprocating member (551) can perform a reciprocating linear motion with respect to the housing (520) and the cover (510) connected to the housing (520).

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

A working member (540) may be placed inside the housing (520). The working member (540) may be formed to be in contact with the reciprocating member (551), and may be formed to move linearly in one direction according to the reciprocating linear motion of the reciprocating member (551). In other words, the working member (540) interacts with the reciprocating member (551) to perform stapling and cutting while moving along the extension direction of the connecting portion (400).

The working member (540) may include a wedge (541), a blade (542), a ratchet member (543), an elastic member (544), and a body (545).

The main body (545) can be formed in a long rectangular column shape and forms the base of the working member (540).

The Ÿ‡-ji (541) is formed on at least one side of the main body (545), and may be formed to have a predetermined slope. That is, the Ÿ‡-ji (541) may be formed to have a predetermined slope in the extension direction of the connection part (400). In other words, the Ÿ‡-ji may be formed to have a higher height on the proximal side (501) than on the distal side (502) of the cartridge (500). Although the drawing illustrates that the Ÿ‡-ji (541) is formed two on each side of the main body (545), the spirit of the present invention is not limited thereto, and may be formed in various numbers and shapes depending on the shape of the staple (530) or the extraction member (535) that comes into contact with the Ÿ‡-ji (541).

Such a Ÿ‡-ji (541) is formed so as to be able to sequentially come into contact with a withdrawal member (535) or a plurality of staples (530), and can perform a role of sequentially pushing up the staples (530). As illustrated in FIG. 40, which will be described later, when the working member (540) moves toward the distal portion (502), it can perform a role of sequentially pushing up the staples (530) and pulling them out to the outside of the cartridge (500).

A blade (542) may be formed on one side of the Ÿ‡ji (541), more specifically, on the proximal portion (501) side of the Ÿ‡ji (541). An edge portion (542a) that is sharply formed to cut tissue is formed on one area of the blade (542). When at least a part of this edge portion (542a) is pulled out of the first section (101) and the cartridge (500), tissue positioned between the first section (101) and the second section (102) may be cut. The edge portion (542a) of the blade (542) may always be pulled out of the first section (101). Alternatively, the edge portion (542a) of the blade (542) may be normally accommodated inside the first article (101) or inside the cartridge (500), and may be pulled out of the first article (101) only when the working member (540) moves along the longitudinal direction.

The ratchet member (543) is formed on one side of the Ÿ‡ member (541), more specifically, on the lower side of the Ÿ‡ member (541), and may be formed to face the reciprocating member (551) to be described later. The ratchet member (543) may be formed in a bar shape and may include a plurality of ratchets (543a) on one side. The ratchet member (543) causes the working member (540) to move only in one direction (i.e., in the distal direction) with respect to the reciprocating member (551). The ratchet (543a) of the ratchet member (543) may be formed to be in contact with the uneven portion (551b) of the reciprocating member (551) described above.

The elastic member (544) is formed on one side of the main body (545) or the ratchet member (541) and serves to apply a predetermined elastic force to the ratchet member (543). For example, one area of the elastic member (544) is connected to the ratchet member (541) or the main body (545), and another area of the elastic member (544) is connected to the ratchet member (543), so that the elastic member (544) may connect the ratchet member (543) or the main body (545). Here, the elastic member (544) may apply an elastic force in the direction in which the ratchet member (543) comes into close contact with the reciprocating member (551). To this end, the elastic member (544) may be formed in the form of a plate spring, and in addition, may be provided in various forms such as a coil spring and a disc spring that may provide a predetermined elastic force to the ratchet member (543).

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

And, in order to be able to engage with the ratchet (543a) of the ratchet member (543), the first surface (551b1) (specifically, the surface on the proximal portion (501) side) of the reciprocating member (551) is formed to have a predetermined angle and a gentle slope, and the second surface (551b2) (specifically, the surface on the distal portion (502) side) can be formed to be vertical or close to vertical.

In a state where the reciprocating moving member (551) and the ratchet member (543) are fastened to each other (or meshed or in close contact), the inclined first surface (543a1) of the ratchet (543a) and the inclined first surface (551b1) of the uneven portion (551b) may be arranged to face each other (i.e., to contact each other). In addition, the vertical second surface (543a2) of the ratchet (543a) and the vertical second surface (551b2) of the uneven portion (551b) may be arranged to face each other (i.e., to contact each other).

By this configuration, when the ratchet (543a) and the recessed portion (551b) are connected (or engaged) with each other, they function as a kind of ratchet, so that movement in only one direction is possible.

For example, assuming that the reciprocating member (551) is fixed, the work member (540) can move in a direction in which the second surface (543a2) and the second surface (551b2) formed vertically move away from each other, but cannot move in a direction in which the second surface (543a2) and the second surface (551b2) come closer to each other while in contact.

To put it another way, when the reciprocating member (551) and the ratchet member (543) are connected to each other (or are engaged or in close contact) and the reciprocating member (551) moves toward the distal portion (502), the ratchet member (543) moves together toward the distal portion (502) by the reciprocating member (551). That is, the vertical second surface (551b2) of the reciprocating member (551) pushes the vertical second surface (543a2) of the working member (540), so that the ratchet member (543) moves together toward the distal portion (502) by the reciprocating member (551).

Conversely, when the reciprocating member (551) and the ratchet member (543) are fastened to each other (or meshed or in close contact) and the reciprocating member (551) moves toward the proximal portion (501), the ratchet member (543) remains fixed and only the reciprocating member (551) moves toward the proximal portion (501). That is, when the working member (540) is fixed, the inclined first surface (551b1) of the reciprocating member (551) moves along the inclined first surface (543a1) of the working member (540), so that only the reciprocating member (551) moves toward the proximal portion (501).

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

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

As a result, the cartridge (500) is accommodated in the cartridge receiving portion (101a) of Article 1 (101), and at this time, the reciprocating member (551) of the cartridge (500) and the staple link assembly (170) of the end tool (100) are coupled. Accordingly, the rotational motion of the staple pulley (161) of the end tool (100) is converted into the linear motion of the reciprocating member (551) through the staple link assembly (170).

At this time, since the fastening portion (551a) of the reciprocating member (551) is connected to the staple pulley (161) through the staple link assembly (170), when the staple pulley (161) alternately rotates clockwise/counterclockwise, the reciprocating member (551) can repeat forward and backward movements. In addition, when the reciprocating member (551) moves forward, the working member (540) moves forward together with the reciprocating member (551), and when the reciprocating member (551) moves backward, only the reciprocating member (551) moves backward and the working member (540) can stop in place. By repeating this process, as the working member (540) moves forward, the staple (530) is stapled by the blade (541) at the same time, and the blade (542) can cut the stapled tissue.

To elaborate further, here it is:

(stapling and cutting action)

Referring to FIG. 38, a method of driving a surgical instrument according to one embodiment of the present invention is as follows.

First, when the staple pulley (161) rotates in either the clockwise or counterclockwise direction, the staple link assembly (170) connected to the staple pulley (161) and the reciprocating movement assembly (550) of the cartridge (500) connected to the staple link assembly (170) move toward the distal portion (502) of the cartridge (500).

And, when the reciprocating movement assembly (550) moves toward the distal portion (502) of the cartridge (500), the working member (540) in contact with the reciprocating movement assembly (550) moves toward the distal portion (502) of the cartridge (500) together with the reciprocating movement assembly (550).

And, as the working member (540) moves toward the distal part (502) of the cartridge (500), the working member (540) ejects the staple (530) to the outside of the cartridge (500) and at the same time, the blade (542) of the working member (540) moves toward the distal part (502) of the cartridge (500).

Meanwhile, when the staple pulley (161) rotates in one direction other than the clockwise or counterclockwise direction, the staple link assembly (170) connected to the staple pulley (161) and the reciprocating assembly (550) of the cartridge (500) connected to the staple link assembly (170) move toward the proximal portion (501) of the cartridge (500), and at this time, the working member (540) is stopped.

And, as these steps are performed repeatedly, the stapling action by the Ÿ‡ji (541) and the cutting action by the blade (542) are performed simultaneously.

To elaborate further, here it is:

First, in a state such as Fig. 38 (a), when the staple pulley (161) rotates in the direction of arrow A1 (i.e., clockwise) as shown in Fig. 38 (b), the staple link assembly (170) connected thereto and the reciprocating member (551) connected to the staple link assembly (170) move in the direction of arrow B1 (i.e., distal direction). In this state, since the reciprocating member (551) and the working member (540) are in close contact by the elastic member (see 544 of Fig. 37), when the reciprocating member (551) moves in the direction of arrow B1, the working member (540) also moves in the direction of arrow B1 together with the reciprocating member (551).

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

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

In this state, when the staple pulley (161) starts to rotate in the direction of arrow A3 (i.e., counterclockwise) as shown in FIG. 38 (e), the staple link assembly (170) connected thereto and the reciprocating member (551) connected to the staple link assembly (170) move in the direction of arrow B3 (i.e., proximal direction). In this state, due to the connection structure of the ratchet member (543) and the reciprocating member (551), even if the reciprocating member (551) moves in the direction of B3, the overall position of the working member (540) is maintained the same, and while the elastic member (544) repeats elastic deformation and restoration, only the ratchet member (543) repeats a certain degree of separation and contact with the reciprocating member (551). (See FIG. 35 and FIG. 37) That is, even if the reciprocating member (551) moves in the direction of arrow B3, the working member (540) remains stationary when viewed in the X-axis direction.

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

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

By repeating this process, when the staple pulley (161) rotates clockwise/counterclockwise alternately, the reciprocating moving member (551) repeats moving forward and backward, and the working member (540) repeats moving forward and stopping, so that as a result, the working member (540) moves toward the distal part (502). Then, as the working member (540) moves toward the distal part (502), the stapling action by the Ÿ‡paper (541) and the cutting action by the blade (542) are performed simultaneously.

Below, a stapling operation of a surgical instrument according to one embodiment of the present invention is described.

Fig. 39 is a perspective view showing the staple operation of the end tool of Fig. 30 section by section, and Fig. 40 is a perspective view showing the staple operation of the end tool of Fig. 30 as a whole.

Referring to FIGS. 39 and 40, in a state such as FIG. 39 (a), when the working member (540) moves in the direction of arrow A1 of FIG. 39 (b), the Ÿ‡ (541) of the working member (540) pushes up the extraction member (535), and the extraction member (535) pushes up the lower side of the staple (530). As a result, the staple (530) is discharged to the outside of the first group (101) and the cartridge (500).

In this state, when the work member (540) moves further in the direction of arrow A2 of arrow Fig. 39 (c), the discharged staple (530) is continuously pushed up by the work member (540) while in contact with the anvil (102a) of the second member (102), so that stapling is performed while both ends of the staple (530) are bent.

As this operation is performed continuously, stapling is performed sequentially from the staple (530) on the proximal side (501) to the staple (530) on the distal side (502) among the plurality of staples (530), as shown in FIG. 40.

(Control panel)

*Figures 41 and 42 are perspective views showing the operating section of the surgical instrument of Figure 2. Figure 43 is a drawing that simply shows only the configuration of the pulley and wire constituting the joint of the surgical instrument shown in Figure 2.

Referring to FIGS. 2 to 42, the operating unit (200) of the surgical instrument (10) according to the first embodiment of the present invention includes a first handle (204) that can be held by a user, an actuation operating unit (203) that controls the actuation movement of the end tool (100), a yaw operating unit (202) that controls the yaw movement of the end tool (100), and a pitch operating unit (201) that controls the pitch movement of the end tool (100). Here, it can be understood that only components related to the pitch/yaw/actuation movement of the surgical instrument (10) are illustrated in FIGS. 41 and 42.

In addition, the operating unit (200) of the surgical instrument (10) may further include a staple operating unit (260) that controls the movement of the staple pulley assembly (160) of the end tool (100) to perform stapling and cutting.

The operating unit (200) may include pulleys (210), pulleys (211), pulleys (212), pulleys (213), pulleys (214), pulleys (215), pulleys (216), pulleys (217), and pulleys (218) related to the rotational motion of the first jaw (101). In addition, the operating unit (200) may include pulleys (220), pulleys (221), pulleys (222), pulleys (223), pulleys (224), pulleys (225), pulleys (226), pulleys (227), and pulleys (228) related to the rotational motion of the second jaw (102). In addition, the operating unit (200) may include pulleys (231), pulleys (232), pulleys (233), and pulleys (234) related to the pitch motion. In addition, it may include a pulley (235), which is an intermediate pulley, placed in the middle of the bending portion (402) of the connecting portion (400).

Here, the drawing shows that the facing pulleys are formed parallel to each other, but the idea of the present invention is not limited thereto, and each pulley may be formed in various positions and sizes suitable for the configuration of the operating unit.

In addition, the operating unit (200) of the first embodiment of the present invention may include a rotation shaft (241), a rotation shaft (242), a rotation shaft (243), a rotation shaft (244), a rotation shaft (245), and a rotation shaft (246). Here, the rotation shaft (241) may function as a first actuation rotation axis of the operating unit, and the rotation shaft (242) may function as a second actuation rotation axis of the operating unit. In addition, the rotation shaft (243) may function as a main rotation axis of the operating unit, and the rotation shaft (244) may function as a sub-rotation axis of the operating unit. In addition, the rotation shaft (245) may function as a pitch sub-rotation axis of the operating unit, and the rotation shaft (246) may function as a pitch main rotation axis of the operating unit.

The rotation axis (241)/rotation axis (242), rotation axis (243), rotation axis (244), rotation axis (245), and rotation axis (246) can be arranged sequentially from the distal end (205) to the proximal end (206) of the operating unit (200).

Each of these rotation axes (241)(242)(243)(244)(245)(246) can have one or more pulleys fitted on it, which will be described in detail later.

Pulley (210) functions as a first stage actuation pulley of the operating unit, and pulley (220) functions as a second stage actuation pulley of the operating unit. These components may be collectively referred to as an operating unit actuation pulley.

Pulleys (211) and (212) function as the main pulleys of the first section of the operating unit, and pulleys (221) and (222) function as the main pulleys of the second section of the operating unit. These components may be collectively referred to as the main pulleys of the operating unit.

Pulleys (213) and (214) function as the first sub-pulleys of the operating section, and pulleys (223) and (224) function as the second sub-pulleys of the operating section. These components may be collectively referred to as the sub-pulleys of the operating section.

Pulleys (215) and (216) function as operation section 1 pitch sub-pulleys, and pulleys (225) and (226) function as operation section 2 pitch sub-pulleys. These components may be collectively referred to as operation section pitch sub-pulleys.

Pulleys (217) and (218) function as the first pitch main pulley of the operating section, and pulleys (227) and (228) function as the second pitch main pulley of the operating section. These components may be collectively referred to as the pitch main pulley of the operating section.

Pulleys (231) and (232) function as operating unit pitch wire main pulleys, and pulleys (233) and (234) function as operating unit pitch wire sub pulleys.

The above components are classified from the perspective of the operating part for each movement (pitch/yaw/actuation) as follows.

The pitch manipulation unit (201) for controlling the pitch movement of the end tool (100) may include a pulley (215), a pulley (216), a pulley (217), a pulley (218), a pulley (225), a pulley (226), a pulley (227), a pulley (228), a pulley (231), a pulley (232), and a pulley (234). In addition, the pitch manipulation unit (201) may include a rotation axis (245), a rotation axis (246). In addition, the pitch manipulation unit (201) may further include a pitch frame (208).

The yaw control unit (202) for controlling the yaw movement of the end tool (100) may include a pulley (211), a pulley (212), a pulley (213), a pulley (214), a pulley (221), a pulley (222), a pulley (223), and a pulley (224). In addition, the yaw control unit (202) may include a rotation shaft (243), a rotation shaft (244). In addition, the yaw control unit (202) may further include a yaw frame (207).

The actuation operating unit (203) for controlling the actuation movement of the end tool (100) may include a pulley (210), a pulley (220), a rotation shaft (241), and a rotation shaft (242). In addition, the actuation operating unit (203) may further include a first actuation operating unit (251) and a second actuation operating unit (256).

Below, each component of the operating unit (200) will be described in more detail.

The first handle (204) is formed so that a user can hold it with his or her hand, and in particular, it can be formed so that a user can hold it by wrapping his or her palm around the first handle (204). Then, an actuation operating part (203) and a yaw operating part (202) are formed on the first handle (204), and a pitch operating part (201) is formed on one side of the yaw operating part (202). Then, the other end of the pitch operating part (201) is connected to a bending part (402) of a connecting part (400).

The actuation operating unit (203) includes a first actuation operating unit (251) and a second actuation operating unit (256). The first actuation operating unit (251) includes a rotation shaft (241), a pulley (210), a first actuation extension (252), and a first actuation gear (253). The second actuation operating unit (256) includes a rotation shaft (242), a pulley (220), a second actuation extension (257), and a second actuation gear (258). Here, ends of the first actuation extension (252) and the second actuation extension (257) are formed in a hand ring shape and can be operated as a second handle.

Here, the rotation axis (241) and the rotation axis (242), which are the actuation rotation axes, can be formed to form a predetermined angle with the XY plane on which the connecting portion (400) is formed. For example, the rotation axis (241) and the rotation axis (242) can be formed in a direction parallel to the Z axis, and in this state, when the pitch control unit (201) or the yaw control unit (202) rotates, the coordinate system of the actuation control unit (203) can relatively change. Of course, the idea of the present invention is not limited thereto, and the rotation axis (241) and the rotation axis (242) can be formed in various directions to suit the hand structure of the user who holds the actuation control unit (203) by ergonomic design.

Meanwhile, the pulley (210), the first actuation extension (252), and the first actuation gear (253) may be fixedly coupled to each other and formed to be rotatable together around the rotation axis (241). Here, the pulley (210) may be composed of one pulley or may be composed of two pulleys that are 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 each other and formed to be rotatable together around the rotation axis (242). Here, the pulley (220) may be composed of one pulley or may be composed of two pulleys that are fixedly coupled to each other.

Here, the first actuation gear (253) and the second actuation gear (258) are formed to mesh with each other, so that when one side rotates, they can be formed to rotate together in the opposite direction.

*The yaw operating unit (202) may include a rotation shaft (243), a first yaw main pulley of the operating unit, a pulley (211) and a pulley (212), a second yaw main pulley of the operating unit, a pulley (221) and a pulley (222), and a yaw frame (207). In addition, the yaw operating unit (202) may further include a first yaw sub-pulley of the operating unit, a pulley (213) and a pulley (214), formed on one side of the pulley (211) and the pulley (212), and a second yaw sub-pulley of the operating unit, a pulley (223) and a pulley (224), formed on one side of the pulley (221) and the pulley (222). Here, the pulley (213) and the pulley (214) and the pulley (223) and the pulley (224) may be coupled to a pitch frame (208) to be described later.

Here, the drawing shows that the yaw control unit (202) includes a pulley (211) and a pulley (212) and a pulley (221) and a pulley (222), and that the pulley (211) and the pulley (212) and the pulley (221) and the pulley (222) are formed to face each other and have two pulleys that can rotate independently, but the idea of the present invention is not limited thereto. That is, one or more pulleys having the same or different diameters may be provided depending on the configuration of the yaw control unit (202).

In detail, a rotation axis (243), which is the main rotation axis of the operation unit, is formed on one side of the actuation operation unit (203) on the first handle (204). At this time, the first handle (204) is formed so as to be rotatable around the rotation axis (243).

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

Meanwhile, the pulley (211) and the pulley (212) and the pulley (221) and the pulley (222) are coupled to the rotation axis (243) so as to be rotatable about the rotation axis (243). In addition, the first wire, wire (301) or wire (305), can be wound around the pulley (211) and the pulley (212), and the second wire, wire (302) or wire (306), can be wound around the pulley (221) and the pulley (222). At this time, the pulley (211) and the pulley (212) and the pulley (221) and the pulley (222) can be formed to face each other and can be configured as two pulleys that can rotate independently. Therefore, the wire that is wound in and the wire that is wound out can be wound on separate pulleys, respectively, so that they can operate without interfering with each other.

This frame (207) rigidly connects the first handle (204), the rotation shaft (241), the rotation shaft (242), and the rotation shaft (243), so that the first handle (204), the yaw operating unit (202), and the actuation operating unit (203) can integrally rotate around the rotation shaft (243).

The pitch manipulation unit (201) may include a rotation shaft (246), a first pitch main pulley of the manipulation unit, a pulley (217) and a pulley (218), a second pitch main pulley of the manipulation unit, a pulley (227) and a pulley (228), and a pitch frame (208). In addition, the pitch manipulation unit (201) may further include a rotation shaft (245), a first pitch sub-pulley of the manipulation unit, a pulley (215) and a pulley (216), formed on one side of the pulley (217) and the pulley (218), and a second pitch sub-pulley of the manipulation unit, a pulley (225) and a pulley (226), formed on one side of the pulley (227) and the pulley (228). The pitch manipulation unit (201) may be connected to a bending portion (402) of a connecting portion (400) via the rotation shaft (246).

In detail, the pitch frame (208) becomes the base frame of the pitch operating unit (201), and a rotation axis (243) is rotatably connected to one end thereof. That is, the yaw frame (207) is formed to be rotatable about the rotation axis (243) with respect to the pitch frame (208).

As described above, the yaw frame (207) connects the first handle (204), the rotation shaft (243), the rotation shaft (241), and the rotation shaft (242), and furthermore, since the yaw frame (207) is axially coupled with the pitch frame (208), when the pitch frame (208) pitch-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) pitch-rotate together. That is, when the pitch operating unit (201) rotates around the rotation shaft (246), the actuation operating unit (203) and the yaw operating unit (202) rotate together with the pitch operating unit (201). In other words, when the user rotates the first handle (204) about the rotation axis (246), the actuation operating unit (203), the yaw operating unit (202), and the pitch operating unit (201) move together.

The pulley (217) and pulley (218) and the pulley (227) and pulley (228) are coupled to the rotation axis (246) so as to be rotatable around the rotation axis (246) of the pitch frame (208).

Here, the pulley (217) and the pulley (218) can be formed to face each other and can be formed to be independently rotatable. Accordingly, the wire to be wound in and the wire to be wound out can be wound on separate pulleys, respectively, so that they can operate without interfering with each other. Similarly, the pulley (227) and the pulley (228) can also be formed to face each other and can be formed to be independently rotatable. Accordingly, the wire to be wound in and the wire to be wound out can be wound on separate pulleys, respectively, so that they can operate without interfering with each other.

Next, the operation of the wire (303) and wire (304), which are pitch wires, is as follows.

The end tool (100) is formed by having an end tool pitch pulley, a pulley (131), fixedly connected to an end tool hub (180), and the operating unit (200) is formed by having an operating unit pitch pulley, a pulley (231) and a pulley (232), fixedly connected to a pitch frame (208). In addition, these pulleys are connected to each other by wires (303) and (304), which are pitch wires, so that the pitch operation of the end tool (100) can be more easily performed according to the pitch operation of the operating unit (200). Here, the wire (303) is fixedly connected to the pitch frame (208) via the pulley (231) and the pulley (233), and the wire (304) is fixedly connected to the pitch frame (208) via the pulley (232) and the pulley (234). That is, the pitch frame (208) and the pulley (231) and the pulley (232) rotate together about the rotation axis (246) by the pitch rotation of the operating unit (200), and as a result, the wire (303) and the wire (304) also move, so that, separately from the pitch motion of the end tool by the wire (301), the wire (302), the wire (305) and the wire (306), which are the joint wires, additional pitch rotation power can be transmitted.

The connection relationship between the first handle (204) and the pitch control unit (201), the yaw control unit (202), and the actuation control unit (203) is as follows. A rotation axis (241), a rotation axis (242), a rotation axis (243), a rotation axis (244), a rotation axis (245), and a rotation axis (246) may be formed on the first handle (204). At this time, since the rotation axis (241) and the rotation axis (242) are formed directly on the first handle (204), the first handle (204) and the actuation control unit (203) may be directly connected. Meanwhile, since the rotation axis (243) is formed directly on the first handle (204), the first handle (204) and the yaw control unit (202) may be directly connected. On the other hand, since the pitch manipulation unit (201) is formed to be connected to the yaw manipulation unit (202) on one side of the yaw manipulation unit (202), the pitch manipulation unit (201) is not directly connected to the first handle (204), and the pitch manipulation unit (201) and the first handle (204) can be formed to be indirectly connected through the yaw manipulation unit (202).

Continuing to refer to the drawings, in the surgical instrument (10) according to the first embodiment of the present invention, the pitch manipulation unit (201) and the end tool (100) may be formed on the same or parallel axis (X-axis). That is, the rotation axis (246) of the pitch manipulation unit (201) is formed at one end of the bending portion (402) of the connecting portion (400), and the end tool (100) is formed at the other end of the connecting portion (400).

In addition, one or more intermediate pulleys (235) may be arranged in the middle of the connecting portion (400), particularly in the bent portion (402), to change or guide the path of the wires. At least a portion of the wires are formed to be wound around these intermediate pulleys (235) to guide the path of the wires, thereby allowing the wires to be arranged along the bent shape of the bent portion (402).

Here, the drawing illustrates that the connecting portion (400) is formed by being curved so as to have a predetermined curvature by including a bending portion (402), but the idea of the present invention is not limited thereto, and the connecting portion (400) may be formed as a straight line as necessary, or may be formed by being bent more than once, and even in such a case, it can be said that the pitch manipulation portion (201) and the end tool (100) are formed on substantially the same or parallel axes. In addition, FIG. 3 illustrates that the pitch manipulation portion (201) and the end tool (100) are each formed on an axis parallel to the X-axis, but the idea of the present invention is not limited thereto, and the pitch manipulation portion (201) and the end tool (100) may be formed on different axes.

The staple operating unit (260) is connected to the staple pulley (161) of the end tool (100) by staple wires (307) and (308), and can perform the function of rotating the staple pulley (161) alternately in a clockwise or counterclockwise direction.

To this end, although not shown in the drawing, the staple operating unit (260) may include a motor (not shown). That is, while the user presses the staple operating unit (260) formed in the form of a button, the motor (not shown) is driven to alternately rotate the operating unit staple pulley (see 269 of FIG. 47) clockwise or counterclockwise. In addition, the staple pulley (161) of the end tool (100) may alternately rotate clockwise or counterclockwise.

(actuation motion, yaw motion, pitch motion)

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

First, the actuation motion is as follows:

When a user rotates the actuation extension (252)(257) by using one or both fingers while inserting the index finger into the hand loop formed on the first actuation extension (252) and the thumb into the hand loop formed on the second actuation extension (257), the pulley (210) and the first actuation gear (253) fixedly coupled to the first actuation extension (252) rotate around the rotation axis (241), and the pulley (220) and the second actuation gear (258) fixedly coupled to the second actuation extension (257) rotate around the rotation axis (242). At this time, the pulley (210) and the pulley (220) rotate in opposite directions, and therefore, the wire (301) and the wire (305) wound with one end fixedly connected to the pulley (210), and the wire (302) and the wire (306) wound with one end fixedly connected to the pulley (220) also move in opposite directions. Then, this rotational force is transmitted to the end tool (100) through the power transmission unit (300), and the two jaws (103) of the end tool (100) perform an actuation operation.

Here, the actuation motion means an motion to open or close the two jaws (101)(102) while the two jaws (101)(102) rotate in opposite directions as described above. That is, when the actuation extensions (252)(257) of the actuation operating unit (203) are rotated in a direction toward each other, the first jaw (101) rotates counterclockwise and the second jaw (102) rotates clockwise, thereby closing the end tool (100). Conversely, when the actuation extensions (252)(257) of the actuation operating unit (203) are rotated in a direction away from each other, the first jaw (101) rotates clockwise and the second jaw (102) rotates counterclockwise, thereby opening the end tool (100).

In this embodiment, a second handle is configured by providing a first actuation extension (252) and a second actuation extension (257) for the actuation operation described above, and can be operated by gripping two fingers. However, the configuration of the actuation operation unit (203) for the actuation operation of opening and closing the two jaws of the end tool (100) with respect to the above-described actuation operation may be sufficiently modified to include other examples, such as a configuration in which two actuation pulleys (pulley (210), pulley (220)) operate in opposite directions with one actuation rotation unit.

Next, the movement is as follows:

When the user rotates the first handle (204) around the rotation axis (243) while holding the first handle (204), the actuation operating unit (203) and the yaw operating unit (202) yaw around the rotation axis (243). That is, when the pulley (210) of the first actuation operating unit (251) to which the wire (301) and the wire (305) are fixedly connected rotate around the rotation axis (243), the wire (301) and the wire (305) wound around the pulley (211) and the pulley (212) move. Similarly, when the pulley (220) of the second actuation operating part (256) to which the wire (302) and the wire (306) are fixedly connected rotates around the rotation axis (243), the wire (302) and the wire (306) wound around the pulley (221) and the pulley (222) move. At this time, the wire (301) and the wire (305) connected to the first group (101) and the wire (302) and the wire (306) connected to the second group (102) are wound around the pulley (211) and the pulley (212) and the pulley (221) and the pulley (222) so that the first group (101) and the second group (102) rotate in the same direction when the pulley rotates. And, this rotational power is transmitted to the end tool (100) through the power transmission unit (300), so that the two jaws (103) of the end tool (100) perform a rotational motion in the same direction.

At this time, since the yoke 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 yoke operating unit (202), and the actuation operating unit (203) rotate together around the rotation shaft (243).

Next, the pitch motion is as follows:

When the user rotates the first handle (204) around the rotation axis (246) while holding the first handle (204), the actuation operating unit (203), the yaw operating unit (202), and the pitch operating unit (201) perform pitch rotation around the rotation axis (246). That is, when the pulley (210) of the first actuation operating unit (251) to which the wire (301) and the wire (305) are fixedly connected rotates around the rotation axis (246), the wire (301) and the wire (305) wound around the pulley (217) and the pulley (218) move. Similarly, when the pulley (220) of the second actuation operating unit (256) to which the wire (302) and the wire (306) are fixedly coupled rotates around the rotation axis (246), the wire (302) and the wire (306) wound around the pulley (227) and the pulley (228) move. At this time, as described with reference to FIGS. 41 to 43, the first wires, the wire (301) and the wire (305), move in the same direction, and the second wires, the wire (302) and the wire (306), move in the same direction, so that the first wire (101) and the second wire (102) can perform pitch rotation, the first wires, the wire (301), the wire (305), the wire (302), and the wire (306) are wound around the operating unit pitch main pulleys, the pulley (217), the pulley (218), the pulley (227), and the pulley (228), respectively. And, this rotational power is transmitted to the end tool (100) through the power transmission unit (300), so that the two jaws (103) of the end tool (100) perform a pitch motion.

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

In summary, a surgical instrument (10) according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), a wire (first group wire or second group wire) is wound around the pulley, and a rotational operation (actuation rotation, yaw rotation, pitch rotation) of an operating unit causes movement of each wire, thereby inducing a desired motion of an end tool (100). Furthermore, auxiliary pulleys may be formed on one side of each of the pulleys, and these auxiliary pulleys prevent the wire from being wound around a single pulley multiple times.

Fig. 43 is a drawing that simply illustrates only the configuration of pulleys and wires that constitute the joint of the surgical instrument (10) according to one embodiment of the present invention illustrated in Fig. 2. In Fig. 43, intermediary pulleys for changing the path of the wire regardless of the joint movement are omitted.

Referring to FIG. 43, the operating unit (200) may include pulleys (210), (211), (212), (213), (214), (215), (216), (217), and (218) related to the rotational motion of the first jaw (101).

In addition, the operating unit (200) may include pulleys (220), pulleys (221), pulleys (222), pulleys (223), pulleys (224), pulleys (225), pulleys (226), pulleys (227), and pulleys (228) related to the rotational motion of the second jaw (102). (Since the arrangement and configuration of each pulley in the operating unit (200) is in principle the same as the arrangement and configuration of each pulley in the end tool (100), some specific notations of drawing symbols in the drawing are omitted.)

The pulley (211) and pulley (212) and the pulley (221) and pulley (222) can be formed to be able to rotate independently of each other around the same axis, which is the rotation axis (243). At this time, the pulley (211) and pulley (212) and the pulley (221) and pulley (222) can be formed as two pulleys that are formed to face each other and are able to rotate independently.

The pulley (213) and the pulley (214) and the pulley (223) and the pulley (224) can be formed to be independently rotatable about the same axis, which is the rotation axis (244). At this time, the pulley (213) and the pulley (214) can be formed as two pulleys that are formed to face each other and are formed to be independently rotatable, and at this time, the two pulleys can be formed to have different diameters. Similarly, the pulley (223) and the pulley (224) can be formed as two pulleys that are formed to face each other and are formed to be independently rotatable, and at this time, the two pulleys can be formed to have different diameters.

The pulley (215) and the pulley (216) and the pulley (225) and the pulley (226) can be formed to be able to rotate independently of each other around the same axis, that is, the rotation axis (245). At this time, the pulley (215) and the pulley (216) can be formed to have different diameters. In addition, the pulley (225) and the pulley (226) can be formed to have different diameters.

The pulley (217) and pulley (218) and the pulley (227) and pulley (228) can be formed to be able to rotate independently of each other around the same axis, that is, the rotation axis (246).

The wire (301) passes through the pulley (217), pulley (215), pulley (213), and pulley (211) of the operating unit (200) in sequence, is wound around the pulley (210), and is then connected to the pulley (210) by the fastening member (324). Meanwhile, the wire (305) passes through the pulley (218), pulley (216), pulley (214), and pulley (212) of the operating unit (200) in sequence, and is then connected to the pulley (210) by the fastening member (324). Accordingly, when the pulley (210) rotates, the wire (301) and the wire (305) are wound around or unwound from the pulley (210), and the first member (101) rotates accordingly.

The wire (306) passes through the pulley (227), pulley (225), pulley (223), and pulley (221) of the operating unit (200) in sequence, is wound around the pulley (220), and is then connected to the pulley (220) by the fastening member (327). Meanwhile, the wire (302) passes through the pulley (228), pulley (226), pulley (224), and pulley (222) of the operating unit (200) in sequence, and is then connected to the pulley (220) by the fastening member (327). Accordingly, when the pulley (220) rotates, the wire (302) and the wire (306) are wound around or unwound from the pulley (220), and the second member (102) rotates.

(Pulley and wire concept)

FIGS. 45 and 46 are drawings illustrating the configuration of pulleys and wires related to the actuation operation and the yaw operation of the surgical instrument (10) according to one embodiment of the present invention illustrated in FIG. 2, respectively, for groups 1 and 2. FIG. 45 is a drawing illustrating only the pulley and wire related to group 2, and FIG. 46 is a drawing illustrating only the pulley and wire related to group 1. In addition, FIG. 44 is a perspective view illustrating the yaw operation of the surgical instrument of FIG. 2. Here, components related to the stapling and cutting operations are omitted in FIG. 44.

First, we will explain the wire operation of the actuation operation.

Referring to FIG. 46, when the first actuation extension (252) rotates in the direction of arrow OPA1 around the rotation axis (241), the pulley (210) connected to the first actuation extension (252) rotates, and the wire (301) and wire (305) wound around the pulley (210) move in the directions W1a and W1b, respectively, so that the first jaw (101) of the end tool (100) rotates in the direction of arrow EPA1.

Referring to FIG. 45, when the second actuation extension (257) rotates in the direction of arrow OPA2 about the rotation axis (242), the pulley (220) connected to the second actuation extension (257) rotates, and the two strands of wire (302) and wire (306) wound around the pulley (220) move in the W2a and W2b directions, respectively, so that the second jaw (102) of the end tool (100) rotates in the direction of arrow EPA2. Accordingly, when the user manipulates the first actuation extension (252) and the second actuation extension (257) in a direction approaching each other, an operation is performed in which the first jaw (101) and the second jaw (102) of the end tool approach each other.

Next, we will explain the wire operation of this movement.

First, since the rotation axis (243), the rotation axis (241), and the rotation axis (242) are connected by the frame (see 207 in FIG. 41), the rotation axis (243), the rotation axis (241), and the rotation axis (242) rotate together as one unit.

Referring to FIG. 46, when the first handle (204) is rotated in the direction of arrow OPY1 around the rotation axis (243), the pulley (210), the pulley (211), the pulley (212), and the wire (301) and the wire (305) wound therearound rotate as a whole around the rotation axis (243), and as a result, the wire (301) and the wire (305) wound around the pulley (211) and the pulley (212) move in the W1a and W1b directions, respectively, and as a result, the first set (101) of the end tool (100) rotates in the direction of arrow EPY1.

Referring to FIG. 45, when the first handle (204) is rotated in the direction of arrow OPY2 around the rotation axis (243), the pulley (220), the pulley (221), the pulley (222), and the wire (302) and the wire (306) wound therearound rotate as a whole around the rotation axis (243), and as a result, the wire (302) and the wire (306) wound around the pulley (221) and the pulley (222) move in the W2a and W2b directions, respectively, and as a result, the first set (101) of the end tool (100) rotates in the direction of arrow EPY2.

FIGS. 47, 48 and 49 are drawings illustrating the configuration of pulleys and wires related to the stapling and cutting operations of the surgical instrument (10) according to one embodiment of the present invention illustrated in FIG. 2, respectively, for the first and second groups. Here, FIGS. 47 to 49 are drawings mainly showing pulleys and wires related to the second group.

Here, FIGS. 47 to 48 illustrate an actuation operation process for closing two joints, and FIGS. 48 to 49 illustrate an operation process for stapling and cutting a tissue interposed between two joints.

First, we will explain the wire operation of the actuation operation.

Referring to FIGS. 47 and 48, when the first actuation extension (252) of the first actuation operating unit (251) rotates in the direction of arrow OPA1 about the rotation axis (241), the pulley (210) connected to the first actuation extension (252) rotates, and the wire (see 301 of FIG. 43) and the wire (see 305 of FIG. 43) wound around the pulley (210) move respectively, resulting in the first jaw (101) of the end tool (100) rotating in the direction of arrow EPA1.

At this time, the staple pulley (269) of the staple operating unit (260) is formed to be rotatable around the rotation axis (241) together with the first actuation operating unit (251). Therefore, when the first actuation extension unit (252) rotates around the rotation axis (241), the staple operating unit (260) also rotates around the rotation axis (241) together with the first actuation operating unit (251).

As a result, when the pulley (111) of the end tool (100) rotates during the actuation operation, the staple pulley (161) also rotates together with the pulley (111).

Next, the wire motions of stapling and cutting operations are described.

Referring to FIGS. 48 and 49, when the staple operating unit (260) is rotated in the direction of arrow OPC1 around the rotation axis (247), which is the operating unit cutting rotation axis, the operating unit staple pulley (269) and the staple wires (wire (307) and wire (308)) wound therearound rotate around the rotation axis (247), and as a result, the wire (307) and wire (308) wound around the operating unit staple pulley (269) move respectively, and as a result, the staple pulley (161) of the end tool (100) rotates in the direction of arrow EPC1.

Meanwhile, when the staple operating unit (260) rotates, the operating unit staple pulley (269) rotates around the rotation axis (247), and at this time, the rotation of the staple operating unit (260) does not affect the first actuation operating unit (251).

As a result, when the operating unit staple pulley (269) rotates, the staple pulley (161) of the end tool (100) rotates independently of the first step (101). Then, when the staple pulley (161) rotates alternately in the clockwise/counterclockwise direction, the staple link assembly (170) connected to the staple pulley (161) and the reciprocating movement assembly (550) of the cartridge (500) connected thereto perform a reciprocating linear motion, whereby the working member (540) of the cartridge (500) moves toward the distal portion (502), thereby performing a stapling and cutting operation.

Here, the drawing illustrates that the staple operating unit (260) is formed in a bar shape, and that the user manually rotates the staple operating unit (260), but the spirit of the present invention is not limited thereto. That is, as described above, the staple operating unit (260) may include a motor (not shown), and while the user presses the staple operating unit (260) formed in a button shape, the motor (not shown) may be driven to alternately rotate the operating unit staple pulley (269) in a clockwise or counterclockwise direction. In addition, the staple pulley (161) of the end tool (100) may alternately rotate in a clockwise or counterclockwise direction.

FIGS. 51, 52, and 53 are drawings illustrating the configuration of pulleys and wires related to the pitch operation of the surgical instrument (10) according to one embodiment of the present invention illustrated in FIG. 2, for each of Group 1 and Group 2. FIG. 51 is a drawing illustrating only the pulley and wire related to Group 2, and FIG. 52 is a drawing illustrating only the pulley and wire related to Group 1. FIG. 53 is a drawing illustrating only the pulley and wire related to the staple pulley. As illustrated in FIG. 43 and the like, there are two pulleys each related to the pitch operation, and since both strands of each wire are wound along the same path, this is expressed as one line in FIGS. 51 and 53. In addition, FIG. 50 is a perspective view illustrating the pitch operation of the surgical instrument of FIG. 2. Here, components related to the stapling and cutting operations are omitted in FIG. 50.

Referring to FIG. 51, when the first handle (204) is rotated in the direction of arrow OPP1 around the rotation axis (246), the pulley (210), the pulley (215), the pulley (217), and the wire (301) wound around them all rotate around the rotation axis (246). At this time, as shown in FIG. 51, the first wires, wire (301) and wire (305), are wound above the pulley (217) and pulley (218), so they move toward arrow W1. As a result, as described with reference to FIG. 5, the first set (101) of the end tool (100) rotates in the direction of arrow EPP1.

Referring to FIG. 52, when the first handle (204) is rotated in the direction of arrow OPP2 around the rotation axis (246), the pulley (220), the pulley (225), the pulley (227), and the wire (302) wound around them all rotate around the rotation axis (246). At this time, as shown in FIG. 52, the second group wires, wire (302) and wire (306), are wound around the lower side of the pulley (227) and pulley (228), so they move toward arrow W2. As a result, as described with reference to FIG. 5, the second group (102) of the end tool (100) rotates in the direction of arrow EPP2.

Referring to FIG. 53, when the first handle (204) is rotated in the direction of arrow OPC1 around the rotation axis (246), the operating unit staple pulley (269), pulley (265), pulley (267), etc., and the wire (307) and wire (308) wound therearound, etc., collectively rotate around the rotation axis (246). At this time, the staple wires, wire (307) and wire (308), are wound below the pulley (267) and pulley (268), so they move toward arrow W3. As a result, as described with reference to FIG. 5, the staple pulley (161) of the end tool (100) rotates in the direction of arrow EPC1.

As a result, when the pulley (111) of the end tool (100) rotates around the rotation axis (143) during the pitch motion, the staple pulley (161) also rotates around the rotation axis (143) together with the pulley (111).

Therefore, actuation manipulation, yaw manipulation, and pitch manipulation can be operated independently of each other.

As described through Fig. 1, the actuation operating unit (203), the yaw operating unit (202), and the pitch operating unit (201) have their rotation axes positioned at the rear of each operating unit, so that they are configured identically to the joint configuration of the end tool, allowing the user to perform intuitively matching operations.

In particular, a surgical instrument (10) according to one embodiment of the present invention is characterized in that a pulley is formed at each joint point (actuation joint, yaw joint, pitch joint), a wire (first group wire or second group wire) is formed to be wound around the pulley, and a rotational operation (actuation rotation, yaw rotation, pitch rotation) of an operating unit causes movement of each wire, which induces a desired motion of the end tool (100). Furthermore, auxiliary pulleys may be formed on one side of each of the pulleys, and by these auxiliary pulleys, the wire can be prevented from being wound around one pulley multiple times, so that the wires wound around the pulleys do not come into contact with each other, and the paths of the wires wound into and out of the pulleys are also safely formed, so that the safety and efficiency of the power transmission of the wires can be improved.

Meanwhile, as described above, the yaw operation unit (202) and the actuation operation unit (203) are formed directly on the first handle (204). Therefore, when the first handle (204) rotates around the rotation axis (246), the yaw operation unit (202) and the actuation operation unit (203) also rotate together with the first handle (204). Therefore, the coordinate systems of the yaw operation unit (202) and the actuation operation unit (203) are not fixed, but rather change relatively continuously according to the rotation of the first handle (204). That is, in FIG. 2 and the like, the yaw operation unit (202) and the actuation operation unit (203) are illustrated as being parallel to the Z-axis. However, when the first handle (204) rotates, the yaw operation unit (202) and the actuation operation unit (203) become not parallel to the Z-axis. That is, the coordinate system of the yaw operating unit (202) and the actuation operating unit (203) changes according to the rotation of the first handle (204). However, in this specification, for the convenience of explanation, unless otherwise described, the coordinate system of the yaw operating unit (202) and the actuation operating unit (203) is explained based on the state in which the first handle (204) is positioned vertically with respect to the connecting unit (400) as shown in FIG. 2.

(Correlation between stapling and cutting actions and other actions)

Below we describe the correlation between stapling and cutting actions and other actions (pitch, yaw, and actuation actions).

First, when the end tool (100) performs a pitch motion, the staple pulley (161) also performs a pitch motion. That is, when the pulley (111) and the pulley (121) perform a pitch motion in which they rotate in the same direction about the rotation axis (143), the staple pulley (161) must also rotate in the same direction together with the pulleys (111) and (121). If the staple pulley (161) does not rotate together with the pulleys (111) and (121) when they rotate about the rotation axis (143), there is a risk that the cartridge (500) connected to the staple pulley (161) moves relative to the first group (101) and becomes separated from the first group (101). In addition, the rotation of the staple pulley (161) that is not synchronized with the pulley (111) may cause unintended forward movement of the reciprocating member (551), which may result in unintended stapling motion.

Next, when the end tool (100) yaws, the staple pulley (161) also yaws. That is, when the pulley (111) and the pulley (121) perform a yaw motion in which they rotate in the same direction around the rotation axis (141), the staple pulley (161) must also rotate in the same direction together with the pulleys (111) and (121). If the staple pulley (161) does not rotate together with the pulleys (111) and (121) when they rotate around the rotation axis (141), there is a risk that the cartridge (500) connected to the staple pulley (161) moves relative to the first member (101) and becomes separated from the first member (101). In addition, the rotation of the staple pulley (161) that is not synchronized with the pulley (111) may cause unintended forward movement of the reciprocating member (551), which may result in unintended stapling motion.

Next, during the actuation operation of the end tool (100), the staple pulley (161) rotates together with the pulley (111). That is, when the pulley (111) and the pulley (121) perform an actuation movement in which they rotate in opposite directions around the rotation axis (141), the staple pulley (161) must rotate in the same direction as the pulley (111). If the staple pulley (161) does not rotate together with the pulley (111) when it rotates around the rotation axis (143), there is a risk that the cartridge (500) connected to the staple pulley (161) moves relative to the first group (101) and is separated from the first group (101). In addition, the rotation of the staple pulley (161) that is not synchronized with the pulley (111) may cause unintended forward movement of the reciprocating member (551), which may result in unintended stapling operation.

Meanwhile, when the end tool (100) performs stapling and cutting operations, the pulley (111) and the pulley (121) do not rotate. That is, when the staple pulley (161) rotates around the rotation axis (141) and the reciprocating member (551) of the link member (171) and the cartridge (500) connected thereto performs a linear reciprocating movement, the pulley (111) and the pulley (121) must not rotate. Otherwise, the first group (101) or the second group (102) will rotate during the stapling and cutting operations, and the stapling and cutting operations cannot be performed normally.

As a result, when the first pulley (111) rotates, the staple pulley (161) accommodated inside the first pulley (101) must also rotate together with the pulley (111). On the other hand, when the staple pulley (161) rotates for stapling and cutting, the pulley (111) and the pulley (121) must be formed so as not to rotate and maintain their positions. The correlation between such stapling and cutting operations and other operations (yaw operations and actuation operations) is as described above.

To express this from another perspective, the pulley (111) and the pulley (121) can be expressed as being independent of the rotation of the staple pulley (161). That is, even if the staple pulley (161) rotates due to the staple wire, the pulley (111) and the pulley (121) may not rotate. On the contrary, the staple pulley (161) can be expressed as being dependent on the rotation of the pulley (111). That is, when the pulley (111) rotates due to the staple wire, the staple pulley (161) can also be formed to rotate together with the pulley (111).

FIGS. 54 and 56 are drawings showing a state in which the jaws are yawed by -90°, and FIGS. 55 and 57 are drawings showing a process in which the actuation operation is performed in a state in which the jaws are yawed by -90°. Here, FIGS. 54 and 55 are drawings showing a pulley (111), and FIGS. 56 and 57 are drawings in which the pulley (111) is omitted.

FIGS. 58 and 60 are drawings illustrating a state in which the jaws are yawed by +90°, and FIGS. 59 and 61 are drawings illustrating a process in which the actuation operation is performed in a state in which the jaws are yawed by +90°. Here, FIGS. 58 and 59 are drawings illustrating a pulley (111), and FIGS. 60 and 61 are drawings in which the pulley (111) is omitted.

As illustrated in FIGS. 54 to 61, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so that the jaws can perform the actuation operation normally even when rotated by +90° or -90°.

FIG. 62 is a plan view showing the stapling and cutting operation of the end tool of the surgical instrument of FIG. 2, and is a drawing showing the process of performing the stapling and cutting operation in a state where the jaws are yawed by +90°. As shown in FIG. 62, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform the stapling and cutting operation normally even in a state where the jaws are yawed by +90°.

In detail, when the pulley (111), the pulley (121), and the staple pulley (161) are rotated +90 degrees around the rotation axis (141), and the staple pulley (161) alternately rotates clockwise/counterclockwise, the link member (171) and the reciprocating member (551) connected thereto repeat forward and backward. Then, when the reciprocating member (551) moves forward, the work member (540) moves forward together with the reciprocating member (551), and when the reciprocating member (551) moves backward, only the reciprocating member (551) moves backward and the work member (540) stops in place. By repeating this process, the work member (540) moves toward the distal portion (502), and the stapling and cutting operations are performed.

FIG. 63 is a plan view showing the stapling and cutting operation of the end tool of the surgical instrument of FIG. 2, and is a drawing showing the process of performing the stapling and cutting operation in a state where the jaws are yawed by -90°. As shown in FIG. 63, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform the stapling and cutting operation normally even in a state where the jaws are yawed by -90°.

In detail, when the pulley (111), the pulley (121), and the staple pulley (161) are rotated -90 degrees around the rotation axis (141), and the staple pulley (161) alternately rotates clockwise/counterclockwise, the link member (171) and the reciprocating member (551) connected thereto repeat forward and backward. Then, when the reciprocating member (551) moves forward, the work member (540) moves forward together with the reciprocating member (551), and when the reciprocating member (551) moves backward, only the reciprocating member (551) moves backward and the work member (540) stops in place. By repeating this process, the work member (540) moves toward the distal portion (502), and the stapling and cutting operations are performed.

FIG. 64 is a drawing illustrating a state in which the jaws are pitch rotated by -90°, and FIG. 65 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws are pitch rotated by -90°. FIG. 66 is a drawing illustrating a state in which the jaws are pitch rotated by +90°, and FIG. 67 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws are pitch rotated by +90°.

Referring to FIGS. 64 to 67, it can be seen that the operations of the operating unit (200) and the end tool (100) are intuitively consistent when performing a pitch motion. That is, when the operating unit (200) rotates in the + direction with respect to the pitch rotation axis (Y-axis), the end tool (100) also rotates in the + direction with respect to the pitch rotation axis (Y-axis). In addition, when the operating unit (200) rotates in the - direction with respect to the pitch rotation axis (Y-axis), the end tool (100) also rotates in the - direction with respect to the pitch rotation axis (Y-axis). Here, the rotation angle of the operating unit (200) and the rotation angle of the end tool (100) can be variously set depending on the ratio of the pulleys.

FIG. 68 is a drawing illustrating a state in which the jaws are yawed by +90°, and FIG. 69 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws are yawed by +90°. FIG. 70 is a drawing illustrating a state in which the jaws are yawed by -90°, and FIG. 71 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws are yawed by -90°.

Referring to FIGS. 68 to 71, it can be seen that the operations of the operating unit (200) and the end tool (100) are intuitively consistent when performing this operation. That is, when the operating unit (200) rotates in the + direction with respect to the yaw rotation axis (Z-axis), the end tool (100) also rotates in the + direction with respect to the yaw rotation axis (Z-axis). In addition, when the operating unit (200) rotates in the - direction with respect to the yaw rotation axis (Z-axis), the end tool (100) also rotates in the - direction with respect to the yaw rotation axis (Z-axis). Here, the rotation angle of the operating unit (200) and the rotation angle of the end tool (100) can be variously set depending on the ratio of the pulleys.

FIG. 72 is a drawing illustrating a state in which the jaws pitch rotate by -90° and yaw rotate by +90° at the same time, and FIG. 73 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws pitch rotate by -90° and yaw rotate by +90° at the same time, and FIG. 74 is a drawing illustrating a state in which the jaws pitch rotate by +90° and yaw rotate by -90° at the same time, and FIG. 75 is a drawing illustrating a process in which an actuation operation is performed in a state in which the jaws pitch rotate by +90° and yaw rotate by -90° at the same time.

Referring to FIGS. 72 to 75, it can be seen that the operations of the operating unit (200) and the end tool (100) are intuitively consistent even when performing the pitch and yaw movements simultaneously.

<Example 2 - Engraving>

Hereinafter, an end tool (700) of a surgical instrument according to a second embodiment of the present invention will be described. Here, the end tool (700) of the surgical instrument according to the second embodiment of the present invention is characterized by a different configuration of an end tool hub (780) that performs the role of an auxiliary pulley compared to the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.). This different configuration compared to the first embodiment will be described in detail later.

FIG. 87 is a perspective view showing an end tool of a surgical instrument according to a second embodiment of the present invention, and FIGS. 88 and 89 are enlarged views of the end tool of the surgical instrument of FIG. 87. FIGS. 90 and 91 are enlarged views showing the end tool of the surgical instrument of FIG. 87 from different angles. FIGS. 92 and 93 are drawings showing a state in which the jaws of the end tool of the surgical instrument of FIG. 87 are rotated 90° counterclockwise. FIG. 94 is an enlarged perspective view showing the end tool hub of the surgical instrument of FIG. 87.

Here, FIGS. 89 and 91 illustrate a state in which the wires have been removed, and FIG. 93 illustrates a state in which the jaw pulley coupling parts of the end tool hub and the jaw pulley have been removed.

Referring to FIGS. 87 to 94, an end tool (700) of a second embodiment of the present invention includes a pair of jaws for performing a gripping operation, that is, a first jaw (701) and a second jaw (702), wherein each of the first jaw (701) and the second jaw (702), or a component encompassing the first jaw (701) and the second jaw (702) may be referred to as a jaw (703).

Meanwhile, the end tool (700) includes a plurality of pulleys including a pulley (711), a pulley (713), and a pulley (714) related to the rotational motion of the first jaw (701). In the present embodiment, the pulleys related to the rotational motion of the first jaw (701) are substantially the same as the pulley (113), the pulley (114), the pulley (115), and the pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (700) includes a plurality of pulleys including a pulley (721) related to the rotational motion of the second jaw (702). In the present embodiment, the pulleys related to the rotational motion of the second jaw (702) are substantially the same as the pulleys (123), (124), (125), and (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (700) of the second embodiment of the present invention may include a rotational axis (741), a rotational axis (743), and a rotational axis (744). Here, the rotational axis (741) may be inserted through the end tool hub (780), and the rotational axis (743) and the rotational axis (744) may be inserted through the pitch hub (707). The rotational axis (741), the rotational axis (743), and the rotational axis (744) may be arranged sequentially from the distal end (704) of the end tool (700) to the proximal end (705).

*In addition, the end tool (700) of the second embodiment of the present invention may include an end tool hub (780) and a pitch hub (707).

The end tool hub (780) has a rotation shaft (741) to be described later inserted therethrough, and at least a portion of a pulley (711) and a pulley (721) coupled to the rotation shaft (741), and a first member (701) and a second member (702) coupled thereto, can be accommodated inside the end tool hub (780). Here, one embodiment of the present invention is characterized in that a guide member (783) that functions as an auxiliary pulley is formed in the end tool hub (780). That is, a guide member (783) that guides the paths of the wire (305) and the wire (302) can be formed in the end tool hub (780). The guide part (783) of the end tool hub (780) of this type can change the path of the wire by performing the role of the auxiliary pulley (see 112, 122, 162 of FIG. 9) in the first embodiment, and the guide part (783) of the end tool hub (780) performing the role of the auxiliary pulley in this way will be described in more detail later.

Meanwhile, a pulley (731) that performs the role of an end tool pitch pulley may be formed at one end of the end tool hub (780). The pulley (731) may be formed as a separate member from the end tool hub (780) and may be combined with the end tool hub (780). Alternatively, the pulley (731) may be formed as one body with the end tool hub (780). Then, a wire (see 303 of FIG. 5) and a wire (see 304 of FIG. 5) are combined with the pulley (731) that performs the role of an end tool pitch pulley, and the pulley (731) performs a pitch motion while rotating around a rotation axis (743).

A rotation shaft (743) and a rotation shaft (744) are inserted through the pitch hub (707), and the pitch hub (707) can be axially coupled with the end tool hub (780) and the pulley (731) by the rotation shaft (743). Accordingly, the end tool hub (780) and the pulley (731) can be formed to be capable of pitch rotation with respect to the pitch hub (707) with the rotation shaft (743) as the center.

Meanwhile, the end tool (700) of the second embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (see 160 of FIG. 13) and a staple link assembly (see 170 of FIG. 13) to perform stapling and cutting operations.

The staple pulley assembly (see 160 of FIG. 13) can be formed between the pulley (711) and the pulley (721), adjacent to the pulley (711) and the pulley (721). In this embodiment, it is assumed that the staple pulley assembly (see 160 of FIG. 13) includes one staple pulley (761).

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

Meanwhile, the second embodiment of the present invention is characterized in that a staple pulley assembly (see 160 of FIG. 13) and a staple link assembly (see 170 of FIG. 13) are arranged between a first pulley (711) and a second pulley (721), thereby enabling stapling and cutting operations using a cartridge (see 500 of FIG. 22) to be performed together with a pitch operation and a yaw operation of the end tool (700). Since the components for performing the stapling and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, a detailed description thereof will be omitted here.

A surgical instrument according to the second embodiment of the present invention may include wire (301), wire (302), wire (303), wire (304), wire (305), wire (306), wire (307), and wire (308), similarly to the first embodiment of the present invention illustrated in FIG. 7, etc.

In addition, the surgical instrument according to the second embodiment of the present invention may include a fastening member (321), a fastening member (323), a fastening member (324), a fastening member (326), a fastening member (327), and a fastening member (329) that are fastened to each end of each wire to fasten the wire and the pulley, similarly to the first embodiment of the present invention illustrated in FIG. 7, etc.

Hereinafter, the end tool hub (780) of the second embodiment of the present invention will be described in more detail, with particular focus on the guide portion (783) of the end tool hub (780) that performs the role of an auxiliary pulley.

The end tool hub (780) includes a first pulley coupling portion (781), a second pulley coupling portion (782), a guide portion (783), a guide groove (784), and a pitch pulley coupling portion (785).

In detail, the first pulley coupling portion (781) and the second pulley coupling portion (782) are formed to face each other, and the pulley (711), the pulley (721), and the staple pulley (761) are accommodated therein. In addition, a through hole is formed in each of the pulley coupling portions (781)(782), so that the rotation shaft (741) passes through the pulley coupling portions (781)(782) and the pulley (711), the pulley (721), and the staple pulley (761) to axially couple them.

The first pulley coupling part (781) and the second pulley coupling part (782) are connected by the guide part (783). That is, the first pulley coupling part (781) and the second pulley coupling part (782), which are parallel to each other, are connected by the guide part (783) formed in a direction approximately perpendicular thereto, so that the first pulley coupling part (781), the second pulley coupling part (782), and the guide part (783) form an approximately “ㄷ” shape, and the pulley (711), the pulley (721), and the staple pulley (761) are accommodated inside.

From another perspective, it can be seen that the first pulley coupling portion (781) and the second pulley coupling portion (782) are formed by extending in the X-axis direction from both ends of the guide portion (783) that is formed long in the Z-axis direction.

Here, the guide portion (783) may be formed in a cylindrical shape with a cross-section that is approximately a semicircle. And this semicircle may be arranged to protrude toward the pulley (711), the pulley (721), and the staple pulley (761). From another perspective, it may be expressed that the guide portion (783) is formed to protrude toward the space formed by the first pulley coupling portion (781), the second pulley coupling portion (782), and the guide portion (783). From another perspective, it may be expressed that the area adjacent to the first pulley coupling portions (781)(782) in the guide portion (783) is formed to be curved so that its cross-section has a predetermined curvature.

Or, to express it from another perspective, it can be said that the guide portion (783) functions as a kind of pulley member, with the wire (305), the wire (302), the wire (307), and the wire (308) wound around its outer surface, thereby guiding the path of the wire (305), the wire (302), the wire (307), and the wire (308). However, the guide portion (783) here is not a member that rotates around a predetermined axis like a pulley in the original sense, but is formed to be fixed as a part of the end tool hub (780), and it can be said that it partially performs the function of a pulley by having the wire wound around it.

Here, the drawing illustrates that the guide portion (783) is formed in a cylindrical shape with a cross-section that is approximately a semicircle. That is, at least a portion of the cross-section of the guide portion (783) on the XY plane is illustrated as having a predetermined arc shape. However, the idea of the present invention is not limited thereto, and the cross-section may be formed to have a predetermined curvature, such as an ellipse or a parabola, or the corners of a polygonal column may be formed to be rounded to a certain degree, and may be formed in various shapes and sizes suitable for guiding the paths of the wires (305), the wires (302), the wires (307), and the wires (308).

Here, in the portion of the guide portion (783) that comes into contact with the wire (305), the wire (302), the wire (307), and the wire (308), a guide groove (784) may be further formed to better guide the path of the wire (305), the wire (302), the wire (307), and the wire (308). The guide groove (784) may be formed in the shape of a groove that is sunken to a certain degree from the protruding surface of the guide portion (783).

Here, the drawing shows that the guide groove (784) is formed on the entire arc surface of the guide portion (783), but the idea of the present invention is not limited thereto, and it is also possible for the guide groove (784) to be formed on only a part of the arc surface of the guide portion (783) as needed.

By forming a guide groove (784) in the guide portion (783) in this way, the durability of the wire can be improved.

In the guide portion (783), a pitch pulley coupling portion (785) may be further formed in the direction opposite to the formation direction of the pulley coupling portions (781)(782). The pitch pulley coupling portion (785) may be formed in a direction parallel to the pitch pulley, that is, on the XZ plane, the pulley (731). A through hole into which a rotational axis (743) may be inserted may be formed in the pitch pulley coupling portion (785), and the rotational axis (743) may penetrate the pitch pulley coupling portion (785) and the pulley (731), so that these two members may be coupled. Here, the pitch pulley coupling portion (785) may be formed to be somewhat biased toward one side relative to the center when viewed in the XY plane, so that the pulley (731) may be formed to be balanced overall when coupled.

Below, the role and function of the guide section (783) will be described in more detail.

The guide part (783) can perform the function of expanding the rotation radius of each of the first group (701) and the second group (702) by making contact with the wire (305) and the wire (302) and changing the arrangement path of the wire (305) and the wire (302) to a certain extent.

In addition, the guide part (783) can play a role in expanding the rotation radius of the staple pulley (761) by contacting the blade wires, wire (307) and wire (308), and changing the arrangement path of the wires (307) and wire (308) to a certain extent.

That is, when the auxiliary pulley is not arranged, each of the first group pulley (711), the second group pulley (721), and the staple pulley (761) can only rotate up to a right angle, but in the second embodiment of the present invention, by additionally providing a guide part (783) to the end tool hub (780), the effect of increasing the maximum rotation angle of each pulley can be obtained.

This enables an operation in which the two groups of the end tool (700) must be separated for actuation operation while the two groups are rotated 90°. In other words, the configuration of the guide part (783) of the end tool hub (780) has the characteristic of expanding the range of yaw rotation in which actuation operation is possible.

In addition, the staple pulley (761) can be additionally rotated for the cutting operation while the two groups are rotated 90° by the guide part (783) of the end tool hub (780) that functions as an auxiliary pulley. In other words, the configuration of the guide part (783) of the end tool hub (780) has the feature of expanding the range of rotation in which the cutting operation is possible.

Furthermore, by forming a guide part (783) on an existing end tool hub (780) without adding a separate structure such as an auxiliary pulley, it has the characteristic of being able to implement an expansion of the rotation range without adding parts and manufacturing processes.

In this way, since a separate structure for expanding the rotation angle is not additionally placed, the number of parts is reduced and the manufacturing process is simplified, and the length of the end tool is shortened by the size of the auxiliary pulley, so that the length of the end tool is shortened when performing a pitch motion, and thus the effect of making it easier to perform a surgical motion in a narrow space can be obtained.

To elaborate further,

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

That is, the fastening member (326) that connects the wire (302) and the pulley (721) is rotatable until it is positioned on the common inner tangent line of the pulley (721) and the guide portion (783). Similarly, the fastening member (see 323 of FIG. 8) that connects the wire (305) and the pulley (711) is rotatable until it is positioned on the common inner tangent line of the pulley (711) and the guide portion (783), so that the rotation angle of the fastening member (see 323 of FIG. 8) can be expanded. Similarly, the fastening member (329) that connects the wires (307) and (308) and the pulley (761) is rotatable until it is positioned on two common inner tangent lines of the pulley (761) and the guide portion (783), so that the rotation angle of the fastening member (329) can be expanded.

To explain this from another perspective, the wire (301) and wire (305) wound around the pulley (711) by the guide part (783) are arranged on one side based on a plane that is perpendicular to the Y-axis and passes through the X-axis. At the same time, the wire (302) and wire (306) wound around the pulley (721) by the guide part (783) are arranged on the other side based on a plane that is perpendicular to the Y-axis and passes through the X-axis.

In other words, pulleys (713) and (714) are arranged on one side relative to a plane that is perpendicular to the Y-axis and passes through the X-axis, and pulleys (723) and (724) are arranged on the other side relative to a plane that is perpendicular to the Y-axis and passes through the X-axis.

In other words, the wire (305) is positioned on the inner tangent line of the pulley (711) and the guide part (783), and the rotation angle of the pulley (711) is expanded by the guide part (783). In addition, the wire (302) is positioned on the inner tangent line of the pulley (721) and the guide part (783), and the rotation angle of the pulley (721) is expanded by the guide part (783).

Compared to the surgical instrument of the first embodiment in which a separate auxiliary pulley is formed, the length of the end tool of the surgical instrument of the present modified example in which the auxiliary pulley is not formed and a guide portion (783) capable of changing the path of the wire is formed on the inner wall of the end tool hub (780) can be shortened. As the length of the end tool is shortened in this way, the operator's manipulation becomes easier when performing a surgery in a narrow surgical space within the human body, and the side effects of the surgery can be reduced.

According to the present invention, the rotational radius of the first pulley (711), the second pulley (721), and the staple pulley (761) is widened, thereby obtaining the effect of widening the range of motion in which normal opening/closing actuation and cutting motion can be performed.

<Example 3 - Direct type>

Hereinafter, an end tool (800) of a surgical instrument according to a third embodiment of the present invention will be described. Here, the end tool (800) of the surgical instrument according to the third embodiment of the present invention is characterized by differences in the configuration and joint relationship of the first member (801) and the second member (802) compared to the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.). Hereinafter, the configuration that is different from that of the first embodiment will be described in detail.

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

Referring to FIG. 95 and FIG. 104, an end tool (800) of a third embodiment of the present invention includes a pair of jaws (803) for performing a gripping operation, that is, a first jaw (801) and a second jaw (802). Here, each of the first jaw (801) and the second jaw (802), or a component encompassing the first jaw (801) and the second jaw (802) may be referred to as jaws (803).

Meanwhile, the end tool (800) includes a plurality of pulleys including a pulley (811) and a pulley (812) related to the rotational motion of the first jaw (801). In the present embodiment, the pulleys related to the rotational motion of the first jaw (801) are substantially the same as the pulleys (111), (112), (113), (114), (115), and (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (800) includes a plurality of pulleys including a pulley (821) and a pulley (822) related to the rotational motion of the second jaw (802). In the present embodiment, the pulleys related to the rotational motion of the second jaw (802) are substantially the same as the pulley (121), pulley (122), pulley (123), pulley (124), pulley (125), and pulley (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (800) of the third embodiment of the present invention may include a rotational axis (841), a rotational axis (842), a rotational axis (843), and a rotational axis (844). Here, the rotational axis (841) and the rotational axis (842) may be inserted through the end tool hub (880), and the rotational axis (843) and the rotational axis (844) may be inserted through the pitch hub (807). The rotational axis (841), the rotational axis (842), the rotational axis (843), and the rotational axis (844) may be arranged sequentially from the distal end (804) of the end tool (800) to the proximal end (805).

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

The end tool hub (880) has a rotation shaft (841) and a rotation shaft (842) penetratingly inserted therein, and also, a pulley (811) and a pulley (821) coupled to the rotation shaft (841), and at least a portion of the first member (801) and the second member (802) coupled thereto can be accommodated inside the end tool hub (880).

A rotation shaft (843) and a rotation shaft (844) are inserted through the pitch hub (807), and the pitch hub (807) can be axially coupled with the end tool hub (880) by the rotation shaft (843). Accordingly, the end tool hub (880) can be formed to be capable of pitch rotation with respect to the pitch hub (807) with the rotation shaft (843) as the center.

Meanwhile, the end tool (800) of the third embodiment of the present invention may further include components such as a staple pulley assembly (see 160 of FIG. 13) to perform stapling and cutting operations.

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

Meanwhile, the third embodiment of the present invention is characterized in that a staple pulley assembly (see 160 of FIG. 13) is arranged between the first pulley (811) and the second pulley (821), thereby enabling the stapling and cutting operations using a cartridge (see 500 of FIG. 22) to be performed together with the pitch and yaw operations of the end tool (800). Since the components for performing the stapling and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, a detailed description thereof will be omitted here.

Below, the first section (801) and the second section (802) of the end tool (800) of the surgical instrument according to the third embodiment of the present invention will be described in more detail.

The end tool (800) of the surgical instrument according to the third embodiment of the present invention is characterized in that it does not have a jaw pulley rotation axis and a jaw rotation axis separately, but rather a single rotation axis (841) simultaneously performs the roles of the jaw pulley rotation axis and the jaw rotation axis. In other words, in this embodiment, a direct connection structure is adopted instead of the X-shaped structure of the first embodiment when connecting the first jaw (801) and the second jaw (802).

That is, in the first embodiment of the present invention, the rotation axis (see 141 of FIG. 17) which is the jaw pulley rotation axis and the rotation axis (see 145 of FIG. 17) which is the jaw rotation axis are placed separately, thereby strengthening the grip force when the jaw is closed. In contrast, the third embodiment of the present invention is characterized in that the rotation axis (841) performs the roles of the jaw rotation axis and the jaw pulley rotation axis together, and each jaw and the jaw pulley rotate together as one unit.

In detail, the first article (801) includes a cartridge receiving portion (see 101a of FIG. 14) and a guide groove (801b). The first article (801) is formed as an elongated rod shape overall, and a cartridge (500) is received at the distal portion (801f) side, and a pulley (811) is coupled to the proximal portion (801g) so as to be rotatable around a rotation axis (841).

Here, the drawing depicts the first article (801) and the pulley (811) as being formed integrally, but it is also possible to have a configuration in which the first article (801) and the pulley (811) are formed as separate parts and then combined.

Article 2 (802) includes an anvil (802a). Article 2 (802) is formed in an overall elongated rod shape, with an anvil (802a) formed on the distal side (802f) and a pulley (812) coupled to the proximal side (802g) so as to be rotatable around a rotation axis (841).

Here, the drawing shows that the second member (802) and the pulley (821) are formed as one piece, but it is also possible to have a configuration in which the second member (802) and the pulley (821) are formed as separate parts and then combined.

The end tool jaw pulley rotation axis (841) is sequentially inserted through the pulley (811) combined with (or formed integrally with) the first jaw (801), the staple pulley (861), and the pulley (821) combined with (or formed integrally with) the second jaw (802).

Accordingly, the pulley (811) combined with (or formed integrally with) the first article (801), the staple pulley (861), and the pulley (821) combined with (or formed integrally with) the second article (802) all rotate around the rotation axis (841).

In addition, the third embodiment of the present invention includes an auxiliary pulley (812). The auxiliary pulley (812) may be in contact with the wire (305) and the wire (302) to change the arrangement path of the wire (305) and the wire (302) to a certain extent, thereby expanding the rotation radius of each of the first group (801) and the second group (802).

As a result, unlike the first embodiment, in this embodiment, since there is no separate rotation axis that restrains the first article (801) and the second article (802), the rotation angle between the first article (801) and the second article (802) is expanded to approximately 120 degrees. In addition, since the first article (801) and the second article (802) are connected by a single axis without a separate connection structure for the X-shaped structure connection between the first article (801) and the second article (802), the number of parts can be reduced and manufacturing can be facilitated.

<Example 4 - Dual Rack>

Hereinafter, an end tool (900) of a surgical instrument according to a fourth embodiment of the present invention will be described. Here, the end tool (900) of the surgical instrument according to the fourth embodiment of the present invention is characterized by a staple link assembly (970) and a reciprocating movement assembly (950) of a cartridge (910) that are different from the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.). Hereinafter, the configurations that are different from the first embodiment will be described in detail.

FIGS. 105 and 106 are perspective views showing an end tool of a surgical instrument according to a fourth embodiment of the present invention. Here, FIG. 106 shows a state in which an end tool hub is removed. FIGS. 107 and 108 are perspective views of the end tool of the surgical instrument of FIGS. 105 and 106 viewed from different angles. Here, FIG. 108 shows a state in which an end tool hub is removed. FIG. 109 is a side view showing the end tool of the surgical instrument of FIG. 105. FIGS. 110 and 111 are exploded perspective views of the end tool of the surgical instrument of FIG. 105. FIG. 112 is an exploded perspective view of the staple link assembly of the surgical instrument of FIG. 105. FIGS. 113 and 114 are side views and plan views showing respective operating states of the staple link assembly of FIG. 112. Fig. 115 is a perspective view showing the internal structure of the end tool of the surgical instrument of Fig. 105. Figs. 116 and 117 are perspective views showing each operating state of the end tool of Fig. 115. Figs. 118 and 119 are perspective views showing each operating state of the end tool of Fig. 115. Here, Figs. 118 and 119 mainly express the operations of the reciprocating movement assembly and the staple link assembly. Figs. 120 and 121 are perspective views showing each operating state of the end tool of Fig. 115. Here, Figs. 120 and 121 mainly express the operations of the reciprocating movement assembly and the working member.

Referring to FIG. 105 and FIG. 121, an end tool (900) of a fourth embodiment of the present invention includes a pair of jaws (903), i.e., a first jaw (901) and a second jaw (902), for performing a gripping operation. Here, each of the first jaw (901) and the second jaw (902), or a component encompassing the first jaw (901) and the second jaw (902) may be referred to as jaws (903).

Meanwhile, the end tool (900) includes a plurality of pulleys including a pulley (911) and a pulley (912) related to the rotational motion of the first jaw (901). In the present embodiment, the pulleys related to the rotational motion of the first jaw (901) are substantially the same as the pulley (111), pulley (112), pulley (113), pulley (114), pulley (115), and pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (900) includes a plurality of pulleys including a pulley (921) and a pulley (922) related to the rotational motion of the second jaw (902). In the present embodiment, the pulleys related to the rotational motion of the second jaw (902) are substantially the same as the pulley (121), pulley (122), pulley (123), pulley (124), pulley (125), and pulley (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (900) of the fourth embodiment of the present invention may include a rotational axis (941), a rotational axis (942), a rotational axis (933), and a rotational axis (944). Here, the rotational axis (941) and the rotational axis (942) may be inserted through the end tool hub (980), and the rotational axis (933) and the rotational axis (944) may be inserted through the pitch hub (907). The rotational axis (941), the rotational axis (942), the rotational axis (933), and the rotational axis (944) may be arranged sequentially from the distal end (904) of the end tool (900) to the proximal end (905).

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

The end tool hub (980) has a rotation shaft (941) and a rotation shaft (942) inserted therethrough, and also, a pulley (911) and a pulley (921) coupled to the rotation shaft (941), and at least a portion of the first member (901) and the second member (902) coupled thereto can be accommodated inside the end tool hub (980).

A rotation shaft (933) and a rotation shaft (944) are inserted through the pitch hub (907), and the pitch hub (907) can be axially coupled with the end tool hub (980) by the rotation shaft (933). Accordingly, the end tool hub (980) can be formed to be capable of pitch rotation with respect to the pitch hub (907) with the rotation shaft (933) as the center.

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

The staple pulley assembly (960) can be formed between the pulley (911) and the pulley (921), adjacent to the pulley (911) and the pulley (921). In this embodiment, it is assumed that the staple pulley assembly (960) includes one staple pulley (961).

The fourth embodiment of the present invention is characterized in that a staple pulley assembly (960) is arranged between a first pulley (911) and a second pulley (921), thereby enabling stapling and cutting operations using a cartridge (910) to be performed together with pitch and yaw operations of an end tool (900).

Hereinafter, the staple pulley assembly (960), the staple link assembly (970) and the reciprocating movement assembly (950) of the end tool (900) of the surgical instrument according to the fourth embodiment of the present invention will be described in more detail.

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

Referring to FIGS. 105 to 121, etc., the staple pulley assembly (960) may include one or more staple pulleys (961).

A staple pulley (961) may be formed with an axial penetration portion (961a). The axial penetration portion (961a) is formed in a hole shape, and a rotational axis (941), which is an end tool jaw pulley rotational axis, may be inserted through the axial penetration portion (961a).

In addition, a first link coupling portion (961b) and a second link coupling portion (961c) may be formed on the staple pulley (961). A first link member (971) of a staple link assembly (970) may be coupled to the first link coupling portion (961b), and a second link member (976) of a staple link assembly (970) may be coupled to the second link coupling portion (961c). Here, the first link coupling portion (961b) and the second link coupling portion (961c) may be arranged on opposite sides with respect to the central axis of the staple pulley (961).

Meanwhile, the end tool (900) of the fourth embodiment of the present invention may further include a staple link assembly (970) connected to the staple pulley assembly (960). Here, the staple link assembly (970) may perform a role of connecting the staple pulley assembly (960) and the reciprocating movement assembly (950) of the cartridge (910) to be described later. The end tool (900) of the fourth embodiment of the present invention is characterized in that the staple link assembly (970) includes two pairs of link members, a first link member (971) and a second link member (976).

The first link member (971) may include a first link (972) and a second link (973).

The first link (972) is formed in an elongated bar shape, and through holes may be formed at both ends. A first link coupling portion (961b) of a staple pulley (961) may be inserted through the through hole at one end of the first link (972). A second link (973) may be inserted through the through hole at the other end of the first link (972).

The second link (973) is formed in an elongated bar shape and can be combined with the first link (972). The second link (973) can include a first protrusion (973a), a second protrusion (973b), and a fastening portion (973c).

In detail, a first protrusion (973a) may be formed at one end of the second link (973). When the first protrusion (973a) is fitted into the through hole of the first link (972) and axially coupled, the second link (973) may be coupled with the first link (972). In addition, the first protrusion (973a) may be fitted into the first guide groove (901b) of the first clause (901) described below.

Meanwhile, a second protrusion (973b) may be formed in a central region of the second link (973). The second protrusion (973b) may be fitted into the first guide groove (901b) of the first article (901) described later.

In this way, when the first protrusion (973a) and the second protrusion (973b) of the second link (973) formed in a protrusion shape are fitted into the first guide groove (901b) having a groove shape, the first protrusion (973a) and the second protrusion (973b) move along the first guide groove (901b), thereby causing the first link member (971) to move relative to the first member (901) (and the cartridge (910) therein). This will be described in more detail later.

Meanwhile, a fastening part (973c) may be formed at the other end of the second link (973). This fastening part (973c) may be combined with a fastening part (951a) of a first reciprocating moving member (951) of a cartridge (910) to be described later.

In a state as shown in FIG. 113, when the staple pulley (961) rotates in the direction of arrow A1 of FIG. 114 (i.e., clockwise), the first link member (971) connected to the staple pulley (961) can move in the direction of arrow B1 of FIG. 114, that is, in the direction of the distal portion (901f) of the first set (901). Conversely, when the staple pulley (961) rotates counterclockwise, the first link member (971) connected to the staple pulley (961) can move in the direction of arrow C1 of FIG. 114, that is, in the direction of the proximal portion (901g) of the first set (901).

Accordingly, the bidirectional rotational motion of the staple pulley assembly (960) can cause a reciprocating linear motion of the first reciprocating moving member (951) of the cartridge (910) through the first link member (971) of the staple link assembly (970). This will be described in more detail later.

The second link member (976) may include a third link (977) and a fourth link (978).

The third link (977) is formed in an elongated bar shape, and may have through holes formed at both ends. A second link coupling portion (961c) of a staple pulley (961) may be inserted through the through hole at one end of the third link (977). A fourth link (978) may be inserted through the through hole at the other end of the third link (977).

The fourth link (978) is formed in a bar shape that is bent at least once and can be combined with the third link (977). The fourth link (978) can include a first protrusion (978a), a second protrusion (978b), and a fastening portion (978c).

In detail, a first protrusion (978a) may be formed at one end of the fourth link (978). When this first protrusion (978a) is fitted into the through hole of the third link (977) and axially coupled, the fourth link (978) may be coupled with the third link (977). In addition, the first protrusion (978a) may be fitted into the second guide groove (901c) of the first clause (901) described below.

Meanwhile, a second protrusion (978b) may be formed in a central region of the fourth link (978). The second protrusion (978b) may be fitted into the second guide groove (901c) of the first article (901) described later.

In this way, when the first protrusion (978a) and the second protrusion (978b) of the fourth link (978) formed in a protrusion shape are fitted into the second guide groove (901c) having a groove shape, the first protrusion (978a) and the second protrusion (978b) move along the second guide groove (901c), thereby causing the second link member (976) to move relative to the first member (901) (and the cartridge (910) therein). This will be described in more detail later.

Meanwhile, a fastening part (978c) may be formed at the other end of the fourth link (978). This fastening part (978c) may be combined with a fastening part (952a) of a second reciprocating moving member (952) of a cartridge (910) to be described later.

Here, the fourth link (978) may include two horizontal regions and one vertical region connecting them.

In detail, since the first link coupling portion (961b) and the second link coupling portion (961c) are positioned on opposite sides with respect to the central axis of the staple pulley (961), a height difference (based on the Z-axis direction) exists between the first link (972) coupled with the first link coupling portion (961b) and the third link (977) coupled with the second link coupling portion (961c).

In contrast, it is structurally easy for the first reciprocating movement member (951) and the second reciprocating movement member (952) of the reciprocating movement assembly (950) to be described later to be positioned at the same height (based on the Z-axis direction).

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

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

In a state such as Fig. 113, when the staple pulley (961) rotates in the direction of arrow A1 of Fig. 114 (i.e., clockwise), the second link member (976) connected to the staple pulley (961) can move in the direction of arrow C1 of Fig. 114, that is, in the direction of the proximal portion (901g) of the first set (901). Conversely, when the staple pulley (961) rotates counterclockwise, the second link member (976) connected to the staple pulley (961) can move in the direction of arrow B1 of Fig. 114, that is, in the direction of the distal portion (901f) of the first set (901).

Accordingly, the bidirectional rotational motion of the staple pulley assembly (960) can cause a reciprocating linear motion of the second reciprocating moving member (952) of the cartridge (910) through the second link member (976) of the staple link assembly (970). This will be described in more detail later.

As described above, the first link coupling portion (961b) and the second link coupling portion (961c) can be positioned on opposite sides with respect to the central axis of the staple pulley (961). In addition, the first link member (971) is coupled to the first link coupling portion (961b), and the second link member (976) is coupled to the second link coupling portion (961c).

Accordingly, when the staple pulley (961) rotates in one direction (e.g., clockwise), the first link member (971) moves forward and the second link member (976) moves backward. On the other hand, when the staple pulley (961) rotates in another direction (e.g., counterclockwise), the first link member (971) moves backward and the second link member (976) moves forward.

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

(cartridge)

Below, the cartridge (910) of the end tool (900) of the surgical instrument according to the fourth embodiment of the present invention will be described in more detail.

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

In detail, referring to FIGS. 115 to 117, etc., the cartridge (910) is formed to be mountable and detachable to the first article (901), and includes a plurality of staples (see 530 of FIG. 22) and a working member (940) inside, thereby performing suturing and cutting of tissue.

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

The housing (920) forms the outer shape of the cartridge (910), and may be formed in a form in which one side (the upper side) of an entirely hollow box is removed, and may be formed to accommodate a reciprocating movement assembly (950), a working member (940), and a staple (see 530 of FIG. 22) therein. Here, the housing (920) may be formed in a cross section having an approximately 'U' shape.

A plurality of staples (see 530 of FIG. 22) may be arranged inside the housing (920). As the work member (940) described later moves linearly in one direction, the plurality of staples (see 530 of FIG. 22) may be sequentially pushed up from the inside to the outside of the housing (920) to perform sealing, i.e. stapling.

A reciprocating movement assembly (950) may be placed at the bottom inside the housing (920). In this embodiment, the reciprocating movement assembly (950) includes a first reciprocating movement member (951) and a second reciprocating movement member (952).

In this embodiment, the first reciprocating moving member (951) and the second reciprocating moving member (952) may be racks. The first reciprocating moving member (951) may include a protruding portion (951b) and a fastening portion (951a).

In detail, the first reciprocating moving member (951) may be formed in a long bar shape, and a plurality of protruding portions (951b) in a sawtooth shape may be formed on one surface. The protruding portions (951b) may be formed so as to be in contact with a working member (940) to be described later, particularly, a ratchet member (943) of the working member (940). In other words, the first reciprocating moving member (951) may include a plurality of protruding portions (951b) having a shape that engages with the first ratchets (943a) of the ratchet member (943).

Likewise, the second reciprocating moving member (952) may include a protruding portion (952b) and a fastening portion (952a). That is, the second reciprocating moving member (952) may include a plurality of protruding portions (952b) shaped to engage with the second ratchets (943b) of the ratchet member (943).

Here, the first reciprocating moving member (951) and the second reciprocating moving member (952) are not fixedly connected to other components of the cartridge (910) and can be formed to be relatively movable with respect to other components of the cartridge (910). That is, the first reciprocating moving member (951) and the second reciprocating moving member (952) can perform a reciprocating linear motion with respect to the housing (920) and the cover (510) connected to the housing (920).

Meanwhile, a fastening portion (951a) may be formed on a proximal end side adjacent to the pulley (911) of the first reciprocating moving member (951), and this fastening portion (951a) may be fastened and combined with the first link member (971) of the staple link assembly (970) of the end tool (900). Accordingly, when the first link member (971) performs a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction), the first reciprocating moving member (951) fastened thereto may also perform a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction).

Likewise, a fastening member (952a) may be formed on a proximal end side adjacent to the pulley (911) of the second reciprocating moving member (952), and this fastening member (952a) may be fastened and combined with the second link member (976) of the staple link assembly (970) of the end tool (900). Accordingly, when the second link member (976) performs a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction), the second reciprocating moving member (952) fastened thereto may also perform a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction).

A working member (940) may be placed inside the housing (920). The working member (940) may be formed to be in contact with the first reciprocating moving member (951) and the second reciprocating moving member (952), and may be formed to move linearly in one direction according to the reciprocating linear motion of the first reciprocating moving member (951) and the second reciprocating moving member (952). In other words, the working member (940) interacts with the first reciprocating moving member (951) and the second reciprocating moving member (952) to perform stapling and cutting while moving along the extension direction of the connecting portion (400).

The working member (940) may include a wedge (see 541 of FIG. 22), a blade (see 542 of FIG. 22), a ratchet member (943), an elastic member (see 544 of FIG. 22), etc. Here, in the drawing, the remaining components of the working member (940) except for the ratchet member (943), i.e., the wedge, blade, etc., are omitted, but it is obvious that such components may be included in the working member (940).

The ratchet member (943) may include a first ratchet (943a) and a second ratchet (943b). Here, the first ratchet (943a) may be formed to be engageable with the first reciprocating member (951), and the second ratchet (943b) may be formed to be engageable with the second reciprocating member (952). That is, an operation in which the first ratchet (943a) engages (or comes into close contact with) the first reciprocating member (951) and the working member (940) advances by the first reciprocating member (951), and an operation in which the second ratchet (943b) engages (or comes into close contact with) the second reciprocating member (952) and the working member (940) advances by the second reciprocating member (952) are alternately performed.

Here, due to the structural shape of the ratchet member (943) itself, even if a separate elastic member is not provided, the ratchet member (943) can be alternately brought into close contact with the first reciprocating moving member (951) and the second reciprocating moving member (952). This will be described in more detail below.

(Operation of reciprocating moving assembly and work member)

Below, the operation of the reciprocating movement assembly (950) and the work member (940) is described in more detail.

FIG. 120 and FIG. 121 are drawings showing the respective operating states of the reciprocating movement assembly (950) and the working member (940). Here, FIG. 120 (a) is a drawing showing a state in which the first ratchet (943a) of the ratchet member (943) and the first reciprocating movement member (951) are in close contact, FIG. 120 (e) is a drawing showing a state in which the second ratchet (943b) of the ratchet member (943) and the second reciprocating movement member (952) are in close contact, and FIG. 120 (i) is a drawing showing a state in which the first ratchet (943a) of the ratchet member (943) and the first reciprocating movement member (951) are in close contact again.

And, from FIG. 120 (a) to FIG. 120 (e) show an operating state in which the staple pulley (961) rotates counterclockwise (in the opposite direction of arrow A1 in FIG. 114) and the second reciprocating moving member (952) advances, and here, from FIG. 120 (e) to FIG. 120 (i) show an operating state in which the staple pulley (961) rotates clockwise (in the direction of arrow A1 in FIG. 114) and the first reciprocating moving member (951) advances.

First, the operation from Fig. 120 (a) to Fig. 120 (e) is explained.

Fig. 120 (a) shows a state where the first ratchet (943a) of the ratchet member (943) and the first reciprocating member (951) are in close contact.

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

In this state, if the staple pulley (961) is further rotated counterclockwise (in the opposite direction of arrow A1 in FIG. 114), the first reciprocating moving member (951) moves further in the direction of arrow c1 (i.e., moves backward), as shown in FIG. 120 (c), and the second reciprocating moving member (952) moves further in the direction of arrow c2 (i.e., moves forward). Then, the uneven portion (951b) of the first reciprocating moving member (951) further pushes the first ratchet (943a) of the ratchet member (943) toward the second reciprocating moving member (952), and thereby the ratchet member (943) as a whole further rotates in the direction of arrow c3. And, when the ratchet member (943) rotates in the direction of arrow c3, the first ratchet (943a) of the ratchet member (943) is further separated from the uneven portion (951b) of the first reciprocating member (951), and the second ratchet (943b) of the ratchet member (943) comes into further contact with the uneven portion (952b) of the second reciprocating member (952).

In this state, if the staple pulley (961) is further rotated counterclockwise (in the opposite direction of arrow A1 in FIG. 114), the first reciprocating moving member (951) moves further in the direction of arrow d1 (i.e., moves backward), as shown in FIG. 120 (d), and the second reciprocating moving member (952) moves further in the direction of arrow d2 (i.e., moves forward). Then, the uneven portion (951b) of the first reciprocating moving member (951) further pushes the first ratchet (943a) of the ratchet member (943) toward the second reciprocating moving member (952), and thereby the ratchet member (943) as a whole further rotates in the direction of arrow d3. And, when the ratchet member (943) rotates in the direction of arrow d3, the first ratchet (943a) of the ratchet member (943) is completely separated from the uneven portion (951b) of the first reciprocating member (951), and the second ratchet (943b) of the ratchet member (943) comes into close contact with the uneven portion (952b) of the second reciprocating member (952).

In this state, if the staple pulley (961) is further rotated counterclockwise (in the opposite direction of arrow A1 in FIG. 114), the first reciprocating moving member (951) moves further in the direction of arrow e1 (i.e., moves backward), as shown in FIG. 120 (e), and the second reciprocating moving member (952) moves further in the direction of arrow e2 (i.e., moves forward). Then, since the second ratchet (943b) of the ratchet member (943) is in close contact with the uneven portion (952b) of the second reciprocating moving member (952), the ratchet member (943) is moved linearly in the direction of arrow e4 by the second reciprocating moving member (952).

Next, the operation from Fig. 120 (e) to Fig. 120 (i) is described.

Fig. 120 (e) shows a state where the second ratchet (943b) of the ratchet member (943) and the second reciprocating member (952) are in close contact.

In this state, when the staple pulley (961) rotates clockwise (in the direction of arrow A1 in Fig. 114), the first reciprocating moving member (951) moves in the direction of arrow f1 (i.e., moves forward) as shown in Fig. 120 (f), and the second reciprocating moving member (952) moves in the direction of arrow f2 (i.e., moves backward). Then, the uneven portion (952b) of the second reciprocating moving member (952) pushes the second ratchet (943b) of the ratchet member (943) toward the first reciprocating moving member (951), and thereby the ratchet member (943) rotates as a whole in the direction of arrow f3. And, when the ratchet member (943) rotates in the direction of arrow f3, the second ratchet (943b) of the ratchet member (943) begins to separate from the uneven portion (952b) of the second reciprocating member (952), and the first ratchet (943a) of the ratchet member (943) begins to contact the uneven portion (951b) of the first reciprocating member (951).

In this state, if the staple pulley (961) is further rotated clockwise (in the direction of arrow A1 in Fig. 114), the first reciprocating moving member (951) moves further in the direction of arrow g1 (i.e., moves forward) as shown in Fig. 120 (g), and the second reciprocating moving member (952) moves further in the direction of arrow g2 (i.e., moves backward). Then, the uneven portion (952b) of the second reciprocating moving member (952) further pushes the second ratchet (943b) of the ratchet member (943) toward the first reciprocating moving member (951), whereby the ratchet member (943) as a whole further rotates in the direction of arrow g3. And, when the ratchet member (943) rotates in the direction of arrow g3, the second ratchet (943b) of the ratchet member (943) is further separated from the uneven portion (952b) of the second reciprocating member (952), and the first ratchet (943a) of the ratchet member (943) comes into further contact with the uneven portion (951b) of the first reciprocating member (951).

In this state, if the staple pulley (961) is further rotated clockwise (in the direction of arrow A1 in Fig. 114), the first reciprocating moving member (951) moves further in the direction of arrow h1 (i.e., moves forward) as shown in Fig. 120 (h), and the second reciprocating moving member (952) moves further in the direction of arrow h2 (i.e., moves backward). Then, the uneven portion (952b) of the second reciprocating moving member (952) further pushes the second ratchet (943b) of the ratchet member (943) toward the first reciprocating moving member (951), and thereby the ratchet member (943) as a whole further rotates in the direction of arrow h3. And, when the ratchet member (943) rotates in the direction of arrow h3, the second ratchet (943b) of the ratchet member (943) is completely separated from the uneven portion (952b) of the second reciprocating member (952), and the first ratchet (943a) of the ratchet member (943) comes into close contact with the uneven portion (951b) of the first reciprocating member (951).

In this state, if the staple pulley (961) is further rotated clockwise (in the direction of arrow A1 in Fig. 114), the first reciprocating moving member (951) moves further in the direction of arrow i1 (i.e., moves forward), and the second reciprocating moving member (952) moves further in the direction of arrow i2 (i.e., moves backward), as shown in Fig. 120 (i). Then, since the first ratchet (943a) of the ratchet member (943) is in close contact with the uneven portion (951b) of the first reciprocating moving member (951), the ratchet member (943) is moved in a straight line in the direction of arrow i4 by the first reciprocating moving member (951).

Figure 121 is a drawing that extracts some of the movements of Figure 120, and is a drawing that mainly explains the forward movement of the work member (940).

FIG. 121 (a) is a drawing showing a state in which a first ratchet (943a) of a ratchet member (943) and a first reciprocating member (951) are in close contact, FIG. 121 (e) is a drawing showing a state in which a second ratchet (943b) of a ratchet member (943) and a second reciprocating member (952) are in close contact, and FIG. 121 (i) is a drawing showing a state in which a first ratchet (943a) of a ratchet member (943) and a first reciprocating member (951) are in close contact again.

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

Then, the uneven portion (951b) of the first reciprocating member (951) pushes the first ratchet (943a) of the ratchet member (943) toward the second reciprocating member (952), whereby the ratchet member (943) rotates as a whole in the direction of arrow e3, so that the first ratchet (943a) of the ratchet member (943) is separated from the uneven portion (951b) of the first reciprocating member (951), and the second ratchet (943b) of the ratchet member (943) comes into close contact with the uneven portion (952b) of the second reciprocating member (952).

In this state, when the staple pulley (961) is further rotated counterclockwise (in the opposite direction of arrow A1 in Fig. 114), the second ratchet (943b) of the ratchet member (943) is in close contact with the uneven portion (952b) of the second reciprocating member (952), so that the ratchet member (943) is moved in a straight line in the direction of arrow e4 by the second reciprocating member (952).

Meanwhile, in the state of Fig. 121 (e), when the staple pulley (961) rotates clockwise (in the direction of arrow A1 of Fig. 114), the first reciprocating moving member (951) moves in the direction of arrow i1 (i.e., moves forward), and the second reciprocating moving member (952) moves in the direction of arrow i2 (i.e., moves backward), as shown in Fig. 121 (i).

Then, the uneven portion (952b) of the second reciprocating member (952) pushes the second ratchet (943b) of the ratchet member (943) toward the first reciprocating member (951), whereby the ratchet member (943) rotates as a whole in the direction of arrow i3, so that the second ratchet (943b) of the ratchet member (943) is separated from the uneven portion (952b) of the second reciprocating member (952), and the first ratchet (943a) of the ratchet member (943) comes into close contact with the uneven portion (951b) of the first reciprocating member (951).

In this state, when the staple pulley (961) is further rotated clockwise (in the direction of arrow A1 in Fig. 114), the first ratchet (943a) of the ratchet member (943) is in close contact with the uneven portion (951b) of the first reciprocating member (951), so that the ratchet member (943) is moved in a straight line in the direction of arrow i4 by the first reciprocating member (951).

Below, the overall operation of this embodiment is described.

Figures 118 and 119 are perspective views showing each operating state of the end tool of Figure 115. Here, Figure 118 is a drawing showing when the staple pulley rotates clockwise, and Figure 119 is a drawing showing when the staple pulley rotates counterclockwise.

Fig. 118 (a) shows a state in which the first ratchet (943a) of the ratchet member (943) and the first reciprocating member (951) are in close contact. In this state, when the staple pulley (961) is continuously rotated in the b1 direction of Fig. 118 (b) and the c1 direction of Fig. 118 (c), the first reciprocating member (951) moves in the b2 direction of Fig. 118 (b) and the c2 direction of Fig. 118 (c) by the first link member (971) connected to the staple pulley (961). At the same time, the second reciprocating member (952) moves in the b3 direction of Fig. 118 (b) and the c3 direction of Fig. 118 (c) by the second link member (976) connected to the staple pulley (961). And, since the first ratchet (943a) of the ratchet member (943) is in close contact with the uneven portion (951b) of the first reciprocating member (951), the ratchet member (943) is moved linearly in the direction of b4 of Fig. 118 (b) and c4 of Fig. 118 (c) by the first reciprocating member (951).

Fig. 119 (a) shows a state in which the second ratchet (943b) of the ratchet member (943) and the second reciprocating member (952) are in close contact. In this state, when the staple pulley (961) is continuously rotated in the b1 direction of Fig. 119 (b) and the c1 direction of Fig. 119 (c), the first reciprocating member (951) moves in the b2 direction of Fig. 119 (b) and the c2 direction of Fig. 119 (c) by the first link member (971) connected to the staple pulley (961). At the same time, the second reciprocating member (952) moves in the b3 direction of Fig. 119 (b) and the c3 direction of Fig. 119 (c) by the second link member (976) connected to the staple pulley (961). And, since the second ratchet (943b) of the ratchet member (943) is in close contact with the uneven portion (952b) of the second reciprocating member (952), the ratchet member (943) is moved linearly in the direction of b4 of Fig. 119 (b) and c4 of Fig. 119 (c) by the second reciprocating member (952).

In conclusion, when the staple pulley (961) rotates in one direction, the first reciprocating moving member (951) moves forward and the second reciprocating moving member (952) moves backward. At this time, the second reciprocating moving member (952) that moves backward pushes the work member (940) toward the first reciprocating moving member (951) to bring the work member (940) into close contact with the first reciprocating moving member (951), and the first reciprocating moving member (951) that moves forward moves the brought into close contact with the work member (940) forward.

Meanwhile, when the staple pulley (961) rotates in the other direction, the second reciprocating moving member (952) moves forward and the first reciprocating moving member (951) moves backward. At this time, the first reciprocating moving member (951) moving backward pushes the work member (940) toward the second reciprocating moving member (952) to bring the work member (940) into close contact with the second reciprocating moving member (952), and the second reciprocating moving member (952) moving forward moves the brought into close contact with the work member (940) forward.

As a result, when the staple pulley (961) rotates in one direction, the first reciprocating moving member (951) advances the working member (940), and when the staple pulley (961) rotates in the opposite direction, the second reciprocating moving member (952) advances the working member (940), so that the forward speed of the working member (940) is approximately doubled compared to the first embodiment, thereby obtaining the effect of shortening the stapling and cutting time.

<Example 5 - Pin/Slot Type>

Hereinafter, an end tool (1000) of a surgical instrument according to a fifth embodiment of the present invention will be described. Here, the end tool (1000) of the surgical instrument according to the fifth embodiment of the present invention is characterized by a different configuration of a staple pulley assembly (1060) and a staple link assembly (1070) compared to the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.). Hereinafter, the different configuration compared to the first embodiment will be described in detail.

FIG. 122 is a perspective view showing an end tool of a surgical instrument according to a fifth embodiment of the present invention, and FIG. 123 is an enlarged view of the end tool of the surgical instrument of FIG. 122. FIG. 124 is a side view showing the end tool of the surgical instrument of FIG. 122. FIG. 125 and FIG. 126 are exploded perspective views of the end tool of the surgical instrument of FIG. 122. FIG. 127 is an exploded perspective view of the staple pulley assembly of the surgical instrument of FIG. 122. FIG. 128 is a plan view showing the operating state of the staple pulley in the end tool of FIG. 122. FIG. 129 is a perspective view showing the opening and closing operation of the end tool of the surgical instrument of FIG. 122, and FIG. 130 is a plan view of FIG. 129. FIGS. 131 and 132 are plan views showing the opening and closing operation of the end tool of the surgical instrument of FIG. 122. FIGS. 133 and 134 are drawings showing the process of changing the end tool of the surgical instrument of FIG. 122 from a deactivated state to an activated state. FIGS. 135 to 139 are drawings explaining the process of changing the end tool of the surgical instrument of FIG. 122 from a deactivated state to an activated state to perform stapling and cutting operations.

Here, Fig. 123 illustrates a state in which the end tool hub is removed. Figs. 128 and 129 illustrate a state in which the end tool hub and the jaw pulley, etc. are removed. Figs. 131 to 134 primarily illustrate the operation of the staple pulley assembly, the staple link assembly, and the reciprocating assembly. Figs. 135 to 139 primarily illustrate the coupling relationship between the reciprocating member and the working member.

Referring to FIGS. 122 to 139, an end tool (1000) of a fifth embodiment of the present invention includes a pair of jaws (1003) for performing a grip operation, that is, a first jaw (1001) and a second jaw (1002). Here, each of the first jaw (1001) and the second jaw (1002), or a component encompassing the first jaw (1001) and the second jaw (1002) may be referred to as a jaw.

Meanwhile, the end tool (1000) includes a plurality of pulleys including a pulley (1011) and a pulley (1012) related to the rotational motion of the first jaw (1001). In the present embodiment, the pulleys related to the rotational motion of the first jaw (1001) are substantially the same as the pulley (111), pulley (112), pulley (113), pulley (114), pulley (115), and pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1000) includes a plurality of pulleys including a pulley (1021) and a pulley (1022) related to the rotational motion of the second jaw (1002). In the present embodiment, the pulleys related to the rotational motion of the second jaw (1002) are substantially the same as the pulley (121), pulley (122), pulley (123), pulley (124), pulley (125), and pulley (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (1000) of the fifth embodiment of the present invention may include a rotational axis (1041), a rotational axis (1042), a rotational axis (1043), and a rotational axis (1044). Here, the rotational axis (1041) and the rotational axis (1042) may be inserted through an end tool hub (1080), and the rotational axis (1043) and the rotational axis (1044) may be inserted through a pitch hub (1007). The rotational axis (1041), the rotational axis (1042), the rotational axis (1043), and the rotational axis (1044) may be arranged sequentially from a distal end (1004) to a proximal end (1005) of the end tool (1000).

Additionally, the end tool (1000) of the fifth embodiment of the present invention may include an end tool hub (1080) and a pitch hub (1007).

An end tool hub (1080) has a rotation shaft (1041) and a rotation shaft (1042) inserted therethrough, and also a pulley (1011) and a pulley (1021) coupled to the rotation shaft (1041), and at least a portion of the first member (1001) and the second member (1002) coupled thereto can be accommodated inside the end tool hub (1080).

A rotation shaft (1043) and a rotation shaft (1044) are inserted through the pitch hub (1007), and the pitch hub (1007) can be axially coupled with the end tool hub (1080) by the rotation shaft (1043). Accordingly, the end tool hub (1080) can be formed to be capable of pitch rotation with respect to the pitch hub (1007) with the rotation shaft (1043) as the center.

Meanwhile, the end tool (1000) of the fifth embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (1060) and a staple link assembly (1070) to perform stapling and cutting operations.

The staple pulley assembly (1060) can be formed between the pulley (1011) and the pulley (1021), adjacent to the pulley (1011) and the pulley (1021). In this embodiment, it is assumed that the staple pulley assembly (1060) includes one staple pulley (1061).

In the fifth embodiment of the present invention, a staple pulley assembly (1060) is arranged between the first pulley (1011) and the second pulley (1021), thereby enabling stapling and cutting operations using a cartridge (500) to be performed together with the pitch and yaw operations of the end tool (1000).

Hereinafter, the staple pulley assembly (1060), the staple link assembly (1070), and the reciprocating movement assembly (550) of the end tool (1000) of the surgical instrument according to the fifth embodiment of the present invention will be described in more detail.

The end tool (1000) of the surgical instrument according to the fifth embodiment of the present invention is characterized in that the staple pulley assembly (1060) and the staple link assembly (1070) form a pin/slot structure. In addition, the effect of amplifying the force for advancing the reciprocating movement assembly (550) can be obtained by this structure. Furthermore, it can be possible to switch from an inactive state in which the staple link assembly (1070) and the reciprocating movement assembly (550) are separated from each other to an active state in which the staple link assembly (1070) and the reciprocating movement assembly (550) are coupled to each other.

Referring to FIGS. 122 to 139, etc., the staple pulley assembly (1060) may include one or more staple pulleys (1061).

A staple pulley (1061) may be formed with an axial penetration portion (1061a). The axial penetration portion (1061a) is formed in a hole shape, and a rotational axis (1041), which is an end tool jaw pulley rotational axis, may be inserted through the axial penetration portion (1061a).

In addition, a protruding member (1061b) may be formed on the staple pulley (1061). A link member (1071) of a staple link assembly (1070) may be coupled to the protruding member (1061b). Here, the protruding member (1061b) is formed in a pin shape and may be fitted into a slot (1072d) of the link member (1071) to be described later.

Meanwhile, the end tool (1000) of the fifth embodiment of the present invention may further include a staple link assembly (1070) connected to a staple pulley assembly (1060), and the staple link assembly (1070) may include a link member (1071). Here, the staple link assembly (1070) may play a role of connecting the staple pulley assembly (1060) and a reciprocating movement assembly (550) of a cartridge (500) to be described later.

The present embodiment is characterized in that the staple link assembly (1070) includes only one link. That is, since the staple pulley assembly (1060) and the staple link assembly (1070) are coupled by a pin/slot structure, it becomes possible for the rotational motion of the staple pulley assembly (1060) to be converted into the linear motion of the staple link assembly (1070) even though the staple link assembly (1070) includes only one link.

In detail, the link member (1071) may be formed as a single link of the first link (1072). In other words, the first link (1072) may be formed as a single member.

The first link (1072) is formed in an elongated bar shape and may include a first protrusion (1072a), a second protrusion (1072b), a fastening portion (1072c), and a slot (1072d).

A first protrusion (1072a) and a second protrusion (1072b) may be formed in a central region of the first link (1072). The first protrusion (1072a) and the second protrusion (1072b) may be fitted into the guide groove (1001b) of the first member (1001).

In this way, when the first protrusion (1072a) and the second protrusion (1072b) of the first link (1072) formed in a protrusion shape are fitted into the guide groove (1001b) of the groove shape, the first protrusion (1072a) and the second protrusion (1072b) move along the guide groove (1001b), thereby causing the link member (1071) to move relative to the first article (1001) (and the cartridge (500) therein). This will be described in more detail later.

Meanwhile, a fastening portion (1072c) may be formed at one end of the first link (1072). This fastening portion (1072c) may be combined with a fastening portion (551a) of a reciprocating moving member (551) of the cartridge (500).

Meanwhile, a slot (1072d) may be formed at one end of the first link (1072). Here, the slot (1072d) is formed in the shape of an elongated hole, into which a pin-shaped protruding member (1061b) may be fitted. In detail, the slot (1072d) is formed to have a predetermined curvature and may be formed in an approximately oval shape. Here, the short radius of the slot (1072d) may be formed to be substantially the same as or slightly larger than the radius of the protruding member (1061b). Meanwhile, the major radius of the slot (1072d) may be formed to be larger than the radius of the protruding member (1061b). Therefore, when the protruding member (1061b) of the staple pulley (1061) is fitted into the slot (1072d) of the first link (1072), the protruding member (1061b) is formed to be able to move to a certain extent within the slot (1072d).

Here, the slot (1072d) may be formed obliquely rather than concentrically. Accordingly, when the staple pulley (1061) rotates, the protruding member (1061b) may push the slot (1072d) while in contact with the slot (1072d) to move the first link (1072). That is, when the staple pulley (1061) rotates, the protruding member (1061b) moves while in contact with the slot (1072d) within the slot (1072d), thereby allowing the first link (1072) to move in a straight line along the guide groove (1001b) of the first article (1001).

(Displacement of staple link assembly due to rotation of staple pulley)

Below, the displacement of the staple link assembly (1070) according to the rotation of the staple pulley (1061) is described.

Referring to FIG. 128, in the fifth embodiment of the present invention, the staple pulley (1061) and the staple link assembly (1070) are coupled in a pin/slot form. That is, a pin-shaped protruding member (1061b) formed on the staple pulley (1061) is coupled to a slot (1072d) formed on the staple link assembly (1070). Therefore, when the staple pulley (1061) rotates in the direction of arrow R, the displacement of the protruding member (1061b) of the staple pulley (1061) in the X-axis direction becomes D1. And, the displacement of the staple link assembly (1070) in the X-axis direction becomes D2.

Meanwhile, referring to FIG. 38, etc., in the first embodiment of the present invention, the staple pulley (161) and the staple link assembly (170) are axially coupled, and therefore, the displacement of the protruding member (1061b) of the staple pulley (1061) in the X-axis direction becomes much longer than in the fifth embodiment.

In other words, compared to when the staple pulley and the staple link assembly are axially coupled as in the first embodiment of the present invention, when the staple pulley and the staple link assembly are pin/slot coupled as in this embodiment, even if the staple pulley rotates the same amount, the displacement of the staple link assembly in the X-axis direction is reduced.

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

As a result, in the fifth embodiment of the present invention, the staple pulley (1061) and the staple link assembly (1070) are coupled in a pin/slot form, and since the displacement of the staple link assembly (1070) in the X-axis direction due to the rotation of the staple pulley (1061) is relatively reduced compared to other embodiments, the force received by the staple link assembly (1070) in the X-axis direction is relatively increased compared to other embodiments.

By the fifth embodiment of the present invention, the force for advancing the staple link assembly (1070) and the reciprocating movement assembly (550) connected thereto is amplified, and thus, the effect of performing the stapling operation more robustly can be obtained.

(Active and Deactivated)

Below, the activation state and deactivation state in this embodiment are described.

In the first embodiment of the present invention described above, since the staple link assembly and the reciprocating movement assembly are always connected, when the staple pulley rotates, the reciprocating movement assembly also moves in a straight line. In addition, since the staple pulley is dependent on the jaw pulley, when the jaw pulley rotates, that is, during the yaw motion or the actuation motion, the staple pulley also rotates. As a result, the reciprocating movement assembly also moves forward/backward during the yaw motion or the actuation motion, and the work member may move during this process. Therefore, if the yaw motion or the actuation motion is repeated, an undesired stapling motion may be performed.

In order to solve such a problem, the fifth embodiment of the present invention is characterized in that there exists an inactive state in which the reciprocating movement assembly (550) and the working member (540) are not coupled but separated, and an activated state in which the reciprocating movement assembly (550) and the working member (540) are coupled. In addition, the inactive state can be maintained in the jaw open state, and the inactive state can be switched to the activated state in the jaw close state. In addition, after becoming the activated state, the reciprocating movement assembly repeats forward and backward according to the alternate rotational motion of the staple pulley, and the working member moves forward.

Such distinction between active and inactive states can be made possible by the pin/slot structure described above. This will be described in more detail below.

Referring to FIG. 130, FIG. 131, and FIG. 132, etc., when the first jaw (1001) rotates in the direction of arrow R of FIG. 132 while the second jaw (1002) rotates in the opposite direction of arrow R while the jaw (1003) is in a closed state as shown in FIG. 131, the jaw (1003) becomes open. Here, it is assumed that the X-axis direction position of the jaw rotation axis (1045) is fixed while other components move.

When the jaw (1003) is in the open state, the first jaw pulley (1011) and the staple pulley (1061) rotate in the same direction.

When the first pulley (1011) rotates in the direction of arrow R of Fig. 132, the pulley (1011), the staple pulley (1061), the staple link assembly (1070), and the reciprocating assembly (550) move together toward the distal portion (1001f) while the jaw rotation axis (1045) is fixed (i.e., moves forward). Therefore, A1 of Fig. 131, which is the distance between the rotation axis (1041) and the jaw rotation axis (1045) when the jaw (1003) is closed, is larger than A2 of Fig. 132, which is the distance between the rotation axis (1041) and the jaw rotation axis (1045) when the jaw (1003) is open. (i.e., A1 > A2)

At the same time, when the staple pulley (1061) rotates in the direction of arrow R of Fig. 132, the staple link assembly (1070) connected to the staple pulley (1061) and the reciprocating assembly (550) connected thereto move (i.e., move backward) as a whole in the proximal direction (1001g). Therefore, B1 of Fig. 131, which is the distance between the rotational axis (1041) and the staple link assembly (1070) (the second protrusion (1072b) thereof) when the jaw (1003) is closed, is greater than B2 of Fig. 132, which is the distance between the rotational axis (1041) and the staple link assembly (1070) (the second protrusion (1072b) thereof) when the jaw (1003) is open. (i.e., B1 > B2)

However, at this time, due to the pin/slot structure as described above, the displacement of the staple link assembly (1070) in the X-axis direction when the staple pulley (1061) rotates is relatively small (compared to other embodiments).

That is, in the fifth embodiment of the present invention, the relationship (A1-A2) > (B1-B2) is established.

In other words, when the jaw (1003) is opened, the distal movement amount (A1-A2) of the pulley (1011), the staple pulley (1061), the staple link assembly (1070), and the reciprocating assembly (550) becomes greater than the proximal movement amount (B1-B2) of the staple link assembly (1070) and the reciprocating assembly (550) connected thereto.

As a result, by synthesizing the two moving components of the above-described reciprocating movement assembly (550), when the jaw (1003) is opened, the reciprocating movement assembly (550) moves in the distal direction (1001f). That is, the reciprocating movement assembly (550) moves forward.

That is, in the first embodiment, etc., the amount of backward movement of the reciprocating movement assembly due to the rotation of the staple pulley is greater than the amount of forward movement of the reciprocating movement assembly due to the rotation of the jaw pulley, so that the reciprocating movement member moves backward when the jaw is opened, whereas in the present embodiment, the amount of forward movement of the reciprocating movement assembly due to the rotation of the jaw pulley is greater than the amount of backward movement of the reciprocating movement assembly due to the rotation of the staple pulley, so that the reciprocating movement member moves forward when the jaw is opened.

And, as the reciprocating movement assembly (550) moves forward in this way, the reciprocating movement assembly (550) and the work member (540) become further separated, and therefore, when the jaw is opened, the reciprocating movement assembly (550) and the work member (540) are not connected and can be maintained in an inactive state in which they are separated.

Conversely, when the first jaw (1001) rotates in the opposite direction of arrow R in Fig. 132 and the second jaw (1002) rotates in the direction of arrow R while the jaw (1003) is in the open state as in Fig. 132, the jaw (1003) becomes the closed state of Fig. 131.

In this way, when the jaw (1003) is closed, the reciprocating movement assembly (550) moves toward the proximal portion (1001g). That is, the reciprocating movement assembly (550) moves backward.

When in a closed state as in Fig. 131, the recessed portion (550b) of the reciprocating movement assembly (550) and the ratchet (543a) of the ratchet member (543) of the working member (540) are in contact but are not coupled to each other.

Accordingly, between the state of Fig. 132, which is the maximum open state of the jaw (1003), and the state of Fig. 131, which is the closed state of the jaw (1003), the reciprocating movement assembly (550) and the work member (540) can be maintained in an inactive state in which they are not connected but separated. That is, in this state, even if the staple pulley (1061) rotates, the work member (540) does not move, and therefore, the stapling and cutting operations are not performed.

Next, referring to FIGS. 133 and 134, etc., for stapling and cutting operations, the staple pulley (1061) is rotated in the direction of arrow R of FIG. 134 while the jaw (1003) is closed as shown in FIG. 133.

When the staple pulley (1061) rotates in the direction of arrow R, the staple link assembly (1070) connected to the staple pulley (1061) and the reciprocating assembly (550) connected thereto move as a whole toward the proximal portion (1001g) (i.e., move backward). Then, as shown in FIG. 134, the reciprocating assembly (550) moves toward the proximal portion (1001g) so that the ratchet member (543) of the working member (540) and the reciprocating assembly (550) are engaged, thereby performing a transition from the deactivated state to the activated state.

After being switched to an activated state in this manner, the staple pulley (1061) performs an alternating rotational motion, causing the reciprocating movement assembly (550) to move forward and backward repeatedly, thereby causing the work member (540) to move forward.

Figures 135 to 139 are drawings explaining a process in which the end tool of the surgical instrument of Figure 122 is activated from an inactive state to perform a stapling and cutting operation. Here, (a) of each drawing shows a state in which the jaw (1003) is open, (b) of each drawing shows a state in which the jaw (1003) is closed, and (c) of each drawing shows a state in which the staple pulley (1061) is rotated in a state in which the jaw (1003) is closed.

Figure 135 is a drawing illustrating the entire process of the end tool of the surgical instrument of Figure 122 being activated from an inactive state to an active state to perform a stapling and cutting operation.

As shown in Fig. 135 (a), when the jaw (1003) is in an open state, the reciprocating movement assembly (550) and the working member (540) are not fastened and are in an inactive state where they are separated. That is, compared to Fig. 135 (b) where the jaw (1003) is in a closed state, in Fig. 135 (a) where the jaw (1003) is in an open state, the reciprocating movement assembly (550) moves forward in the distal direction (1001f). Therefore, the reciprocating movement assembly (550) and the working member (540) are in a state where they are maximally separated from each other.

Meanwhile, when in the closed state as in Fig. 135 (b), the uneven portion (550b) of the reciprocating movement assembly (550) and the ratchet (543a) of the ratchet member (543) of the working member (540) are in contact but are not coupled to each other. That is, even in this state, the reciprocating movement assembly (550) and the working member (540) are not coupled but are separated, which is an inactive state.

Meanwhile, when the staple pulley (1061) rotates in the direction of arrow R as shown in Fig. 135 (c) while the jaw (1003) is closed as shown in Fig. 135 (b), the reciprocating movement assembly (550) moves toward the proximal portion (1001g) so that the ratchet member (543) of the working member (540) and the reciprocating movement assembly (550) are engaged, thereby performing a transition from the deactivated state to the activated state.

After being switched to an activated state in this manner, the staple pulley (1061) performs an alternating rotational motion, causing the reciprocating movement assembly (550) to move forward and backward repeatedly, thereby causing the work member (540) to move forward.

Fig. 136 is a drawing explaining the open/closed state of the jaw (1003) in the end tool of the surgical instrument of Fig. 122.

As shown in Fig. 136 (a), when the jaw (1003) is in an open state, the reciprocating movement assembly (550) and the working member (540) are not fastened but are in an inactive state where they are separated. That is, compared to Fig. 136 (b) where the jaw (1003) is in a closed state, in Fig. 136 (a) where the jaw (1003) is in an open state, the reciprocating movement assembly (550) moves forward in the distal direction (1001f). Therefore, the reciprocating movement assembly (550) and the working member (540) are in a state where they are maximally separated from each other.

Meanwhile, when in the closed state as in Fig. 136 (b), the uneven portion (550b) of the reciprocating movement assembly (550) and the ratchet (543a) of the ratchet member (543) of the working member (540) are in contact but are not coupled to each other. That is, even in this state, the reciprocating movement assembly (550) and the working member (540) are not coupled but are separated, which is an inactive state.

FIG. 137 is a drawing explaining a state in which, in the end tool of the surgical instrument of FIG. 122, the staple pulley rotates and the reciprocating movement assembly (550) and the working member (540) are connected when the jaw (1003) is closed.

As shown in Fig. 137 (b), when the staple pulley (1061) is rotated in the direction of arrow R as shown in Fig. 137 (c), the reciprocating assembly (550) moves toward the proximal portion (1001g) so that the ratchet member (543) of the working member (540) and the reciprocating assembly (550) are engaged, thereby performing a transition from the deactivated state to the activated state.

FIG. 138 is a drawing explaining a motion in which a working member (540) initially advances after being switched to an activated state in the end tool of the surgical instrument of FIG. 122, and FIG. 139 is a drawing explaining a motion in which a working member (540) gradually advances while a staple pulley (161) performs an alternating rotational motion in the end tool of the surgical instrument of FIG. 122.

After being switched to an activated state in this manner, the staple pulley (1061) performs an alternating rotational motion, causing the reciprocating movement assembly (550) to move forward and backward repeatedly, thereby causing the work member (540) to move forward and perform stapling and cutting operations.

<Example 6 - Cam/Slot Type>

Hereinafter, an end tool (1100) of a surgical instrument according to a sixth embodiment of the present invention will be described. Here, the end tool (1100) of the surgical instrument according to the sixth embodiment of the present invention is characterized by a different configuration of a staple pulley assembly (1160) and a staple link assembly (1170) compared to the end tool of the surgical instrument according to the fifth embodiment of the present invention described above (see 1000 of FIG. 122, etc.). Hereinafter, the different configuration compared to the fifth embodiment will be described in detail.

FIG. 140 is a perspective view showing an end tool of a surgical instrument according to the sixth embodiment of the present invention, and FIG. 141 is an enlarged view of the end tool of the surgical instrument of FIG. 140. FIG. 142 is a side view showing the end tool of the surgical instrument of FIG. 140. FIGS. 143 and 144 are exploded perspective views of the end tool of the surgical instrument of FIG. 140. FIG. 145 is an exploded perspective view of the staple pulley assembly of the surgical instrument of FIG. 140. FIG. 146 is a side view showing the operating state of the staple pulley in the end tool of FIG. 140. FIGS. 147 and 148 are plan views showing the opening and closing operation of the end tool of the surgical instrument of FIG. 140. FIG. 149 is a perspective view showing a process in which the end tool of the surgical instrument of FIG. 140 changes from a deactivated state to an activated state.

Here, Fig. 141 illustrates a state where the end tool hub is removed. Figs. 146 to 148 mainly express the operation of the staple pulley assembly, staple link assembly, and reciprocating assembly. Fig. 149 mainly expresses the coupling relationship between the reciprocating member and the working member.

Referring to FIGS. 140 to 149, an end tool (1100) of the sixth embodiment of the present invention includes a pair of jaws (1103) for performing a grip operation, that is, a first jaw (1101) and a second jaw (1102). Here, each of the first jaw (1101) and the second jaw (1102), or a component encompassing the first jaw (1101) and the second jaw (1102) may be referred to as a jaw.

Meanwhile, the end tool (1100) includes a plurality of pulleys including a pulley (1111) and a pulley (1112) related to the rotational motion of the first jaw (1101). In the present embodiment, the pulleys related to the rotational motion of the first jaw (1101) are substantially the same as the pulley (111), pulley (112), pulley (113), pulley (114), pulley (115), and pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1100) includes a plurality of pulleys including a pulley (1121) and a pulley (1122) related to the rotational motion of the second jaw (1102). In the present embodiment, the pulleys related to the rotational motion of the second jaw (1102) are substantially the same as the pulley (121), pulley (122), pulley (123), pulley (124), pulley (125), and pulley (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (1100) of the sixth embodiment of the present invention may include a rotational axis (1141), a rotational axis (1142), a rotational axis (1143), and a rotational axis (1144). Here, the rotational axis (1141) and the rotational axis (1142) may be inserted through an end tool hub (1180), and the rotational axis (1143) and the rotational axis (1144) may be inserted through a pitch hub (1107). The rotational axis (1141), the rotational axis (1142), the rotational axis (1143), and the rotational axis (1144) may be arranged sequentially from a distal end (1104) to a proximal end (1105) of the end tool (1100).

Additionally, the end tool (1100) of the sixth embodiment of the present invention may include an end tool hub (1180) and a pitch hub (1107).

An end tool hub (1180) has a rotation shaft (1141) and a rotation shaft (1142) inserted therethrough, and also a pulley (1111) and a pulley (1121) coupled to the rotation shaft (1141), and at least a portion of the first member (1101) and the second member (1102) coupled thereto can be accommodated inside the end tool hub (1180).

A rotation shaft (1143) and a rotation shaft (1144) are inserted through the pitch hub (1107), and the pitch hub (1107) can be axially coupled with the end tool hub (1180) by the rotation shaft (1143). Accordingly, the end tool hub (1180) can be formed to be capable of pitch rotation with respect to the pitch hub (1107) with the rotation shaft (1143) as the center.

Meanwhile, the end tool (1100) of the sixth embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (1160) and a staple link assembly (1170) to perform stapling and cutting operations.

The staple pulley assembly (1160) can be formed between the pulley (1111) and the pulley (1121), adjacent to the pulley (1111) and the pulley (1121). In this embodiment, it is assumed that the staple pulley assembly (1160) includes one staple pulley (1161).

In the sixth embodiment of the present invention, a staple pulley assembly (1160) is arranged between a first pulley (1111) and a second pulley (1121), thereby enabling stapling and cutting operations using a cartridge (500) to be performed together with pitch and yaw operations of an end tool (1100).

Hereinafter, the staple pulley assembly (1160), the staple link assembly (1170), and the reciprocating movement assembly (see 550 of FIG. 22, etc.) of the end tool (1100) of the surgical instrument according to the sixth embodiment of the present invention will be described in more detail.

The end tool (1100) of the surgical instrument according to the sixth embodiment of the present invention is characterized in that the staple pulley assembly (1160) and the staple link assembly (1170) form a cam/slot structure. In addition, the effect of amplifying the force for advancing the reciprocating assembly (550) can be obtained by this structure. Furthermore, it can be possible to switch from a deactivated state in which the staple link assembly (1170) and the reciprocating assembly are separated from each other to an activated state in which the staple link assembly (1170) and the reciprocating assembly are coupled to each other.

Referring to FIGS. 122 to 139, etc., the staple pulley assembly (1160) may include one or more staple pulleys (1161).

A staple pulley (1161) may be formed with an axial penetration portion (1161a). The axial penetration portion (1161a) is formed in a hole shape, and a rotational axis (1141), which is an end tool jaw pulley rotational axis, may be inserted through the axial penetration portion (1161a).

In addition, a protruding member (1161b) may be formed on the staple pulley (1161). The protruding member (1161b) may be coupled with the link member (1171) of the staple link assembly (1170). Here, the center of the protruding member (1161b) does not coincide with the center of the staple pulley (1161), and the protruding member (1161b) may be formed to be eccentric to a certain degree with respect to the staple pulley (1161). The protruding member (1161b) may be fitted into a slot (1172d) of the link member (1171) to be described later.

Meanwhile, the end tool (1100) of the sixth embodiment of the present invention may further include a staple link assembly (1170) connected to a staple pulley assembly (1160), and the staple link assembly (1170) may include a link member (1171). Here, the staple link assembly (1170) may play a role of connecting the staple pulley assembly (1160) and a reciprocating movement assembly of a cartridge (500) to be described later.

The present embodiment is characterized in that the staple link assembly (1170) includes only one link. That is, since the staple pulley assembly (1160) and the staple link assembly (1170) are coupled by a cam/slot structure, even if the staple link assembly (1170) includes only one link, it becomes possible for the rotational motion of the staple pulley assembly (1160) to be converted into the linear motion of the staple link assembly (1170).

In detail, the link member (1171) may be formed as a single link of the first link (1172). In other words, the first link (1172) may be formed as a single member.

The first link (1172) is formed in an elongated bar shape and may include a first protrusion (1172a), a second protrusion (1172b), a fastening portion (1172c), and a slot (1172d).

A first protrusion (1172a) and a second protrusion (1172b) may be formed in a central region of the first link (1172). The first protrusion (1172a) and the second protrusion (1172b) may be fitted into the guide groove (1101b) of the first member (1101).

In this way, when the first protrusion (1172a) and the second protrusion (1172b) of the first link (1172) formed in a protrusion shape are fitted into the guide groove (1101b) of the groove shape, the first protrusion (1172a) and the second protrusion (1172b) move along the guide groove (1101b), thereby causing the link member (1171) to move relative to the first member (1101) (and the cartridge (500) therein). This will be described in more detail later.

Meanwhile, a fastening portion (1172c) may be formed at one end of the first link (1172). This fastening portion (1172c) may be combined with a fastening portion (551a) of a reciprocating moving member (551) of a cartridge (500).

Meanwhile, a slot (1172d) may be formed at one end of the first link (1172). Here, the slot (1172d) is formed in the shape of an elongated hole, into which a protruding member (1161b) may be fitted. In detail, the slot (1172d) is formed to have a predetermined curvature and may be formed in an approximately oval shape. Here, the slot (1172d) may be formed to be somewhat larger than the protruding member (1161b). Accordingly, when the protruding member (1161b) of the staple pulley (1161) is fitted into the slot (1172d) of the first link (1172), the protruding member (1161b) is formed to be able to move to a certain extent within the slot (1172d).

As described above, the protruding member (1161b) may be formed to be eccentric to a certain degree with respect to the staple pulley (1161). Therefore, when the staple pulley (1161) rotates, the protruding member (1161b) may push the slot (1172d) while in contact with the slot (1172d) to move the first link (1172). That is, when the staple pulley (1161) rotates, the protruding member (1161b) moves while in contact with the slot (1172d) within the slot (1172d), thereby allowing the first link (1172) to move in a straight line along the guide groove (1101b) of the first member (1101).

(Displacement of staple link assembly due to rotation of staple pulley)

Below, the displacement of the staple link assembly (1170) according to the rotation of the staple pulley (1161) is described.

Referring to FIG. 146, in the sixth embodiment of the present invention, a staple pulley (1161) and a staple link assembly (1170) are coupled in a cam/slot form. That is, a protruding member (1161b) formed in the staple pulley (1161) is coupled to a slot (1172d) formed in a slot form in the staple link assembly (1170). Therefore, when the staple pulley (1161) rotates in the direction of arrow R, the displacement of the protruding member (1161b) of the staple pulley (1161) in the X-axis direction becomes D1. And, the displacement of the staple link assembly (1170) in the X-axis direction becomes D2.

Meanwhile, referring to FIG. 38, etc., in the first embodiment of the present invention, the staple pulley (161) and the staple link assembly (170) are axially coupled, and therefore, the displacement of the protruding member (1161b) of the staple pulley (1161) in the X-axis direction becomes much longer than in the sixth embodiment.

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

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

As a result, in the sixth embodiment of the present invention, the staple pulley (1161) and the staple link assembly (1170) are coupled in a cam/slot form, and since the displacement of the staple link assembly (1170) in the X-axis direction due to the rotation of the staple pulley (1161) is relatively reduced compared to other embodiments, the force received by the staple link assembly (1170) in the X-axis direction is relatively increased compared to other embodiments.

By the sixth embodiment of the present invention, the force for advancing the staple link assembly (1170) and the reciprocating movement assembly (550) connected thereto is amplified, and thus, the effect of performing the stapling operation more robustly can be obtained.

(Active and Deactivated)

Below, the activation state and deactivation state in this embodiment are described.

The sixth embodiment of the present invention is characterized in that there exists a deactivated state in which the reciprocating movement assembly (550) and the working member (540) are not coupled and separated, and an activated state in which the reciprocating movement assembly (550) and the working member (540) are coupled. In addition, the deactivated state can be maintained in the jaw open state, and the deactivated state can be switched to the activated state in the jaw close state. In addition, after becoming the activated state, the reciprocating movement assembly repeats forward and backward movement according to the alternate rotational movement of the staple pulley, and the working member moves forward.

Such distinction between active and inactive states can be made possible by the cam/slot structure described above. This will be described in more detail below.

Referring to FIGS. 147, 148, and 149, etc., when the first jaw (1101) is rotated in the direction of arrow R of FIG. 148 while the second jaw (1102) is rotated in the opposite direction of arrow R when the jaw (1103) is closed as shown in FIG. 147, the jaw (1103) becomes open. Here, it is assumed that the X-axis direction position of the jaw rotation axis (1145) is fixed and other components move.

When the jaw (1103) is in the open state, the first jaw pulley (1111) and the staple pulley (1161) rotate in the same direction.

When the first pulley (1111) rotates in the direction of arrow R of Fig. 148, the pulley (1111), the staple pulley (1161), the staple link assembly (1170), and the reciprocating assembly move together toward the distal portion (1101f) while the jaw rotation axis (1145) is fixed (i.e., moves forward). Therefore, A1 of Fig. 147, which is the distance between the rotation axis (1141) and the jaw rotation axis (1145) when the jaw (1103) is closed, is larger than A2 of Fig. 148, which is the distance between the rotation axis (1141) and the jaw rotation axis (1145) when the jaw (1103) is open. (i.e., A1 > A2)

At the same time, when the staple pulley (1161) rotates in the direction of arrow R of Fig. 148, the staple link assembly (1170) connected to the staple pulley (1161) and the reciprocating assembly connected thereto move (i.e., move backward) as a whole in the direction of the proximal portion (1101g). Therefore, B1 of Fig. 147, which is the distance between the rotational axis (1141) and the staple link assembly (1170) (the second protrusion (1172b) thereof) when the jaw (1103) is closed, is larger than B2 of Fig. 148, which is the distance between the rotational axis (1141) and the staple link assembly (1170) (the second protrusion (1172b) thereof) when the jaw (1103) is open. (i.e., B1 > B2)

However, at this time, due to the cam/slot structure as described above, the displacement of the staple link assembly (1170) in the X-axis direction when the staple pulley (1161) rotates is relatively small (compared to other embodiments).

That is, in the sixth embodiment of the present invention, the relationship (A1-A2) > (B1-B2) is established.

In other words, when the jaw (1103) is opened, the distal movement amount (A1-A2) of the pulley (1111), the staple pulley (1161), the staple link assembly (1170), and the reciprocating assembly becomes greater than the proximal movement amount (B1-B2) of the staple link assembly (1170) and the reciprocating assembly connected thereto.

As a result, by synthesizing the two moving components of the above-described reciprocating movement assembly, when the jaw (1103) is opened, the reciprocating movement assembly moves in the distal direction (1101f). That is, the reciprocating movement assembly moves forward.

That is, in the first embodiment, etc., the amount of backward movement of the reciprocating movement assembly due to the rotation of the staple pulley is greater than the amount of forward movement of the reciprocating movement assembly due to the rotation of the jaw pulley, so that the reciprocating movement member moves backward when the jaw is opened, whereas in the present embodiment, the amount of forward movement of the reciprocating movement assembly due to the rotation of the jaw pulley is greater than the amount of backward movement of the reciprocating movement assembly due to the rotation of the staple pulley, so that the reciprocating movement member moves forward when the jaw is opened.

And, as the reciprocating movement assembly moves forward in this way, the reciprocating movement assembly and the work member (540) become further separated, and therefore, when the jaw is opened, the reciprocating movement assembly and the work member (540) are not connected and can be maintained in an inactive state in which they are separated.

Conversely, when the first jaw (1101) rotates in the opposite direction of arrow R of Fig. 148 and the second jaw (1102) rotates in the direction of arrow R while the jaw (1103) is in the open state as shown in Fig. 148, the jaw (1103) becomes the closed state of Fig. 147.

In this way, when the jaw (1103) is closed, the reciprocating movement assembly (550) moves toward the proximal portion (1101g). That is, the reciprocating movement assembly moves backward.

When in a closed state as in Fig. 147, the reciprocating movement assembly's uneven portion (see 551b of Fig. 22, etc.) and the ratchet (543a) of the ratchet member (543) of the working member (540) are in contact but are not coupled to each other.

Accordingly, between the state of Fig. 148, which is the maximum open state of the jaw (1103), and the state of Fig. 147, which is the closed state of the jaw (1103), the reciprocating movement assembly (550) and the work member (540) can be maintained in an inactive state in which they are not connected but separated. That is, in this state, even if the staple pulley (1161) rotates, the work member (540) does not move, and therefore, the stapling and cutting operations are not performed.

Next, for the stapling and cutting operation, the staple pulley (1161) is rotated in the direction of arrow R of Fig. 148 with the jaw (1103) closed as shown in Fig. 149 (a).

When the staple pulley (1161) rotates in the direction of arrow R, the staple link assembly (1170) connected to the staple pulley (1161) and the reciprocating assembly (550) connected thereto move as a whole toward the proximal portion (1101g) (i.e., move backward). Then, as shown in FIG. 149 (b), the reciprocating assembly (550) moves toward the proximal portion (1101g) so that the ratchet member (543) of the working member (540) and the reciprocating assembly (550) are engaged, thereby performing a transition from the deactivated state to the activated state.

After being switched to an activated state in this manner, the staple pulley (1161) performs an alternating rotational motion, causing the reciprocating movement assembly (550) to move forward and backward repeatedly, thereby causing the work member (540) to move forward and perform stapling and cutting operations.

<Example 7 - Addition of a second auxiliary pulley for staple wire>

Hereinafter, an end tool (1200) of a surgical instrument according to the seventh embodiment of the present invention will be described. Here, the end tool (1200) of the surgical instrument according to the seventh embodiment of the present invention is significantly different from the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.) in that a staple second auxiliary pulley (1267), which is an auxiliary pulley for a staple wire, is additionally provided. Hereinafter, the configuration that is different from the first embodiment will be described in detail.

FIGS. 150 to 153 are perspective views showing an end tool of a surgical instrument according to the seventh embodiment of the present invention. Here, FIGS. 150 and 152 show a closed state of the end tool, and FIGS. 151 and 153 show an open state of the end tool. Meanwhile, FIGS. 152 and 153 show a state in which an end tool hub is removed. FIGS. 154 and 155 are side views showing an end tool of the surgical instrument of FIG. 150. FIGS. 156 and 157 are plan views showing an end tool of the surgical instrument of FIG. 150. FIGS. 158 to 160 are plan views showing a staple operation of the end tool of the surgical instrument of FIG. 150, and are drawings showing a process in which the staple operation is performed in a state in which the jaws are rotated by +90°. Figures 161 to 163 are plan views showing the staple operation of the end tool of the surgical instrument of Figure 150, and are drawings showing the process of performing the staple operation while the jaws are rotated by -90°.

Referring to FIGS. 150 to 163, an end tool (1200) of the seventh embodiment of the present invention includes a pair of jaws (1203) for performing a grip operation, that is, a first jaw (1201) and a second jaw (1202). Here, each of the first jaw (1201) and the second jaw (1202), or a component encompassing the first jaw (1201) and the second jaw (1202) may be referred to as a jaw.

Meanwhile, the end tool (1200) includes a plurality of pulleys including a pulley (1211) and a pulley (1212) related to the rotational motion of the first jaw (1201). In the present embodiment, the pulleys related to the rotational motion of the first jaw (1201) are substantially the same as the pulley (111), pulley (112), pulley (113), pulley (114), pulley (115), and pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1200) includes a plurality of pulleys including a pulley (1221) and a pulley (1222) related to the rotational motion of the second jaw (1202). In the present embodiment, the pulleys related to the rotational motion of the second jaw (1202) are substantially the same as the pulley (121), pulley (122), pulley (123), pulley (124), pulley (125), and pulley (126) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (1200) of the seventh embodiment of the present invention may include a rotational axis (1241), a rotational axis (1242), a rotational axis (1243), and a rotational axis (1244). Here, the rotational axis (1241) and the rotational axis (1242) may be inserted through an end tool hub (1280), and the rotational axis (1243) and the rotational axis (1244) may be inserted through a pitch hub (1207). The rotational axis (1241), the rotational axis (1242), the rotational axis (1243), and the rotational axis (1244) may be arranged sequentially from a distal end (1204) to a proximal end (1205) of the end tool (1200).

Additionally, the end tool (1200) of the seventh embodiment of the present invention may include an end tool hub (1280) and a pitch hub (1207).

An end tool hub (1280) has a rotation shaft (1241) and a rotation shaft (1242) inserted therethrough, and at least a portion of a pulley (1211) and a pulley (1221) coupled to the rotation shaft (1241) and a first member (1201) and a second member (1202) coupled thereto can be accommodated inside the end tool hub (1280).

A rotation shaft (1243) and a rotation shaft (1244) are inserted through the pitch hub (1207), and the pitch hub (1207) can be axially coupled with the end tool hub (1280) by the rotation shaft (1243). Accordingly, the end tool hub (1280) can be formed to be capable of pitch rotation with respect to the pitch hub (1207) with the rotation shaft (1243) as the center.

Meanwhile, the end tool (1200) of the seventh embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (1260) and a staple link assembly (1270) to perform stapling and cutting operations.

The staple pulley assembly (1260) can be formed between the pulley (1211) and the pulley (1221), adjacent to the pulley (1211) and the pulley (1221). In this embodiment, it is assumed that the staple pulley assembly (1260) includes one staple pulley (1261).

In the seventh embodiment of the present invention, a staple pulley assembly (1260) is arranged between a first pulley (1211) and a second pulley (1221), thereby enabling stapling and cutting operations using a cartridge (1210) to be performed together with pitch and yaw operations of an end tool (1200).

Below, the pulley configuration of the end tool (1200) of the surgical instrument according to the seventh embodiment of the present invention is described in more detail.

The end tool (1200) of the seventh embodiment of the present invention may include a staple pulley (1261), a staple auxiliary pulley (1262), a pulley (1263), a pulley (1264), a pulley (1265), and a pulley (1266) related to linear/rotary movement of staples. In addition, the end tool (1200) of the seventh embodiment of the present invention may further include a staple second auxiliary pulley, a pulley (1267) and a pulley (1268).

The staple pulley (1261) is formed to face the end tool jaw pulley, i.e., the pulley (see 111 of FIG. 5) and the pulley (see 121 of FIG. 5), and is formed to be able to rotate independently of each other around the rotation axis (1241), which is the end tool jaw pulley rotation axis.

Here, the present invention is characterized in that the staple pulley (1261), the pulley (see 111 of FIG. 5), and the pulley (see 121 of FIG. 5) are formed to rotate around the same axis. In this way, by the staple pulley (1261), the pulley (see 111 of FIG. 5), and the pulley (see 121 of FIG. 5) being formed to rotate around the same axis, it is possible to perform pitch motion/yaw motion/actuation motion while also enabling cutting motion using staples.

A staple auxiliary pulley (1262) may be additionally provided on one side of the staple pulley (1261), in other words, the staple auxiliary pulley (1262) may be arranged between the pulley (1261) and the pulley (1263)/pulley (1264). The staple auxiliary pulley (1262) may be formed to be independently rotatable about the pulley (see 112 of FIG. 6) and the pulley (see 122 of FIG. 6) around the rotation axis (1242).

Pulleys (1263) and (1264) function as staple pitch main pulleys, and pulleys (1265) and (1266) function as staple pitch sub pulleys.

Staple secondary auxiliary pulleys, pulley (1267) and pulley (1268), may be arranged between the staple auxiliary pulley (1262) and the pulley (1263)/pulley (1264). The staple auxiliary pulley (1262) may be formed to be rotatable around a predetermined axis that is parallel to the rotation axis (1243), which is the central axis of the pulley (1263) and the pulley (1264).

Below, the components related to the rotation of the staple pulley (1261) are described.

Pulley (1263) and pulley (1264) function as staple pitch main pulleys. Here, wire (307), which is a staple wire, is wound around pulley (1263), and wire (308), which is a staple wire, is wound around pulley (1264).

Pulley (1265) and pulley (1266) function as staple pitch sub-pulleys. Here, wire (307), which is a staple wire, is wound around pulley (1265), and wire (308), which is a staple wire, is wound around pulley (1266).

Here, on one side of the staple pulley (1261) and the staple auxiliary pulley (1262), a pulley (1263) and a pulley (1264) are arranged to face each other. Here, the pulley (1263) and the pulley (1264) are formed to be able to rotate independently of each other around a rotation axis (1243), which is an end tool pitch rotation axis. In addition, on one side of each of the pulleys (1263) and (1264), a pulley (1265) and a pulley (1266) are arranged to face each other. Here, the pulley (1265) and the pulley (1266) are formed to be able to rotate independently of each other around a rotation axis (1244), which is an end tool pitch auxiliary rotation axis. Here, the drawing shows that pulley (1263), pulley (1265), pulley (1264), and pulley (1266) are all formed to be rotatable around the Y-axis direction, but the spirit of the present invention is not limited thereto, and the rotation axes of each pulley may be formed in various directions as appropriate to the configuration.

The wire (307), which is a staple wire, is wound sequentially so that at least a portion thereof is in contact with the pulley (1265), the pulley (1263), the pulley (1267), the staple auxiliary pulley (1262), and the staple pulley (1261). Then, the wire (308), which is connected to the wire (307) by the fastening member (329), is wound sequentially so that at least a portion thereof is in contact with the staple pulley (1261), the staple auxiliary pulley (1262), the pulley (1268), the pulley (1264), and the pulley (1266).

To explain this from another perspective, wire (307) and wire (308), which are staple wires, are wound sequentially so that at least a portion of them contact pulley (1265), pulley (1263), pulley (1267), staple auxiliary pulley (1262), staple pulley (1261), staple auxiliary pulley (1262), pulley (1268), pulley (1264), and pulley (1266), and wire (307) and wire (308) are formed so that they can move along the pulleys while rotating the pulleys.

Accordingly, when the wire (307) is pulled, the fastening member (329) to which the wire (307) is coupled and the staple pulley (1261) coupled thereto rotate in one direction. Conversely, when the wire (308) is pulled, the fastening member (329) to which the wire (308) is coupled and the staple pulley (1261) coupled thereto rotate in the opposite direction.

Here, the end tool (1200) of the surgical instrument according to the seventh embodiment of the present invention may additionally be provided with staple second auxiliary pulleys, namely pulley (1267) and pulley (1268), to prevent detachment of staple wires, namely wire (307) and wire (308).

That is, by arranging the staple second auxiliary pulley (1267) between the staple auxiliary pulley (1262) and the pulley (1263), the path of the wire (307) entering the end tool hub (1280) is changed to a certain degree. In addition, by arranging the staple second auxiliary pulley (1268) between the staple auxiliary pulley (1262) and the pulley (1264), the path of the wire (308) entering the end tool hub (1280) is changed to a certain degree.

In detail, the height in the Z-axis direction of the wire (307) coming out of the staple auxiliary pulley (1262) and the height in the Z-axis direction of the wire (307) entering the pulley (1263) are different from each other. At this time, if the staple second auxiliary pulley (1267) does not exist, the path of the wire (307) becomes diagonal, and therefore there is a risk that the wire (307) will be detached from the pulley. Similarly, the height in the Z-axis direction of the wire (308) coming out of the staple auxiliary pulley (1262) and the height in the Z-axis direction of the wire (308) entering the pulley (1264) are different from each other. At this time, if the staple second auxiliary pulley (1268) does not exist, the path of the wire (308) becomes diagonal, and therefore there is a risk that the wire (308) will be detached from the pulley.

Therefore, in the present embodiment, the staple second auxiliary pulley (1267) is arranged between the staple auxiliary pulley (1262) and the pulley (1263) to change the path of the wire (307) to a certain degree so that the wire (307) coming out of the staple auxiliary pulley (1262) is parallel. Similarly, the staple second auxiliary pulley (1268) is arranged between the staple auxiliary pulley (1262) and the pulley (1264) to change the path of the wire (308) to a certain degree so that the wire (308) coming out of the staple auxiliary pulley (1262) is parallel.

By preventing the staple wires (307) and (308) from coming off the pulley according to the present invention, the cutting operation can be made to operate more smoothly.

FIGS. 158 to 160 are plan views showing the stapling and cutting operations of the end tool of the surgical instrument of FIG. 150, illustrating the process of performing the stapling and cutting operations in a state where the jaws are yawed by +90°. As illustrated in FIGS. 158 to 160, the end tool of the surgical instrument according to the seventh embodiment of the present invention is formed so as to be able to perform the stapling and cutting operations normally even in a state where the jaws are yawed by +90°.

In detail, when the pulley (1211), the pulley (1221), and the staple pulley (1261) are rotated +90 degrees around the rotation axis (1241), and the staple pulley (1261) alternately rotates clockwise/counterclockwise, the link member (1271) and the reciprocating member (551) connected thereto repeat forward and backward. Then, when the reciprocating member (551) moves forward, the work member (540) moves forward together with the reciprocating member (551), and when the reciprocating member (551) moves backward, only the reciprocating member (551) moves backward and the work member (540) stops in place. By repeating this process, the work member (540) moves toward the distal portion (502), and the stapling and cutting operations are performed.

FIGS. 161 to 163 are plan views showing the stapling and cutting operations of the end tool of the surgical instrument of FIG. 150, illustrating the process of performing the stapling and cutting operations in a state where the jaws are yawed by -90°. As illustrated in FIG. 63, the end tool of the surgical instrument according to the first embodiment of the present invention is formed so as to be able to perform the stapling and cutting operations normally even in a state where the jaws are yawed by -90°.

In detail, when the pulley (1211), the pulley (1221), and the staple pulley (1261) are rotated -90 degrees around the rotation axis (1241), and the staple pulley (1261) alternately rotates clockwise/counterclockwise, the link member (1271) and the reciprocating member (551) connected thereto repeat forward and backward. Then, when the reciprocating member (551) moves forward, the work member (540) moves forward together with the reciprocating member (551), and when the reciprocating member (551) moves backward, only the reciprocating member (551) moves backward and the work member (540) stops in place. By repeating this process, the work member (540) moves toward the distal portion (502), and the stapling and cutting operations are performed.

<Example 8 - Dual Rack & Spring>

Hereinafter, an end tool (1300) of a surgical instrument according to the eighth embodiment of the present invention will be described. Here, the end tool (1300) of the surgical instrument according to the eighth embodiment of the present invention is characterized by differences in the staple link assembly (1370) and the reciprocating movement assembly (1350) of the cartridge compared to the end tool of the surgical instrument according to the fourth embodiment of the present invention described above (see 900 of FIG. 105, etc.). Hereinafter, the configurations that are different from the fourth embodiment will be described in detail.

FIGS. 164 to 166 are perspective views showing an end tool of a surgical instrument according to the eighth embodiment of the present invention. Here, FIGS. 164 to 166 show a state in which the first group, the second group, the end tool hub, etc. are removed. FIGS. 167 and 168 are perspective views showing a cartridge of the surgical instrument of FIG. 164. FIG. 169 is a bottom view of the cartridge of FIG. 167. FIGS. 170 and 171 are perspective views showing each operating state of the end tool of FIG. 164. Here, FIGS. 170 and 171 mainly express the operation of the reciprocating movement assembly and the working member.

Referring to FIG. 164 and FIG. 171, an end tool (1300) of the eighth embodiment of the present invention includes a pair of jaws for performing a gripping operation, namely, a first jaw (see 901 of FIG. 105) and a second jaw (see 902 of FIG. 105).

Meanwhile, the end tool (1300) includes a plurality of pulleys including a pulley (1311) and a pulley (1312) related to the rotational motion of the first jaw (see 901 of FIG. 105). In the present embodiment, the pulleys related to the rotational motion of the first jaw (see 901 of FIG. 105) are substantially the same as the pulleys (111), (112), (113), (114), (115), and (116) described in FIG. 105 of the fourth embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1300) includes a plurality of pulleys including a pulley (1321) and a pulley (1322) related to the rotational motion of the second jaw (see 902 of FIG. 105). In the present embodiment, the pulleys related to the rotational motion of the second jaw (see 902 of FIG. 105) are substantially the same as the pulleys (121), (122), (123), (124), (125), and (126) described in FIG. 105 of the fourth embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1300) of the eighth embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (1360) and a staple link assembly (1370) to perform stapling and cutting operations.

The staple pulley assembly (1360) can be formed between the pulley (1311) and the pulley (1321), adjacent to the pulley (1311) and the pulley (1321). In this embodiment, it is assumed that the staple pulley assembly (1360) includes one staple pulley (1361).

The eighth embodiment of the present invention is characterized in that a staple pulley assembly (1360) is arranged between a first pulley (1311) and a second pulley (1321), thereby enabling stapling and cutting operations using a cartridge (1310) to be performed together with pitch and yaw operations of an end tool (1300).

Hereinafter, the staple pulley assembly (1360), the staple link assembly (1370) and the reciprocating movement assembly (1350) of the end tool (1300) of the surgical instrument according to the eighth embodiment of the present invention will be described in more detail.

An end tool (1300) of a surgical instrument according to an eighth embodiment of the present invention is characterized in that a staple link assembly (1370) includes a first link member (1371) and a second link member (1376), and a reciprocating movement assembly (1350) of a cartridge (1310) includes a first reciprocating movement member (1351) and a second reciprocating movement member (1352), thereby forming a kind of dual rack structure.

Referring to FIGS. 164 to 171, the staple pulley assembly (1360) may include one or more staple pulleys (1361).

A staple pulley (1361) may have an axial penetration portion formed therein. The axial penetration portion is formed in a hole shape, and a rotary shaft (1341), which is an end tool jaw pulley rotation axis, may be inserted through the axial penetration portion.

In addition, the staple pulley (1361) may be formed with a first link coupling portion and a second link coupling portion. A first link member (1371) of the staple link assembly (1370) may be coupled to the first link coupling portion, and a second link member (1376) of the staple link assembly (1370) may be coupled to the second link coupling portion. Here, the first link coupling portion and the second link coupling portion may be arranged on opposite sides with respect to the central axis of the staple pulley (1361).

Meanwhile, the end tool (1300) of the eighth embodiment of the present invention may further include a staple link assembly (1370) connected to the staple pulley assembly (1360). Here, the staple link assembly (1370) may perform a role of connecting the staple pulley assembly (1360) and the reciprocating movement assembly (1350) of the cartridge (1310) to be described later. The end tool (1300) of the eighth embodiment of the present invention is characterized in that the staple link assembly (1370) includes two pairs of link members, a first link member (1371) and a second link member (1376).

The first link member (1371) may include a first link (1372) and a second link (1373).

The second link member (1376) may include a third link (1377) and a fourth link (1378).

The configuration of the first link member (1371) and the second link member (1376) is substantially the same as the configuration of the first link member (see 971 of FIG. 110) and the second link member (see 976 of FIG. 110) of the fourth embodiment illustrated in FIG. 105, etc., so a detailed description thereof is omitted in this embodiment.

In a state as shown in FIG. 164, when the staple pulley (1361) rotates in the direction of arrow A1 of FIG. 164 (i.e., clockwise), the first link member (1371) connected to the staple pulley (1361) can move in the direction of arrow B1 of FIG. 164, that is, in the distal direction of the cartridge (1310). Conversely, when the staple pulley (1361) rotates counterclockwise, the first link member (1371) connected to the staple pulley (1361) can move in the direction of arrow C1 of FIG. 164, that is, in the proximal direction of the cartridge (1310).

Meanwhile, when the staple pulley (1361) rotates in the direction of arrow A1 of Fig. 164 (i.e., clockwise), the second link member (1376) connected to the staple pulley (1361) can move in the direction of arrow C1 of Fig. 164, that is, in the proximal direction of the cartridge (1310). Conversely, when the staple pulley (1361) rotates counterclockwise, the second link member (1376) connected to the staple pulley (1361) can move in the direction of arrow B1 of Fig. 164, that is, in the distal direction of the cartridge (1310).

That is, when the staple pulley (1361) rotates in one direction (e.g., clockwise), the first link member (1371) moves forward and the second link member (1376) moves backward. On the other hand, when the staple pulley (1361) rotates in another direction (e.g., counterclockwise), the first link member (1371) moves backward and the second link member (1376) moves forward.

With this structure, when the staple pulley (1361) rotates clockwise and counterclockwise alternately, the first link member (1371) and the second link member (1376) perform a linear reciprocating motion, and at this time, the first link member (1371) and the second link member (1376) move in opposite directions. That is, when the first link member (1371) moves forward (i.e., moves toward the distal side), the second link member (1376) moves backward (i.e., moves toward the proximal side). Conversely, when the first link member (1371) moves backward (i.e., moves toward the proximal side), the second link member (1376) moves forward (i.e., moves toward the distal side).

As a result, the bidirectional rotational motion of the staple pulley assembly (1360) can cause a reciprocating linear motion of the first reciprocating moving member (1351) and the second reciprocating moving member (1352) of the cartridge (1310) through the first link member (1371) and the second link member (1376) of the staple link assembly (1370).

(cartridge)

Below, the cartridge (1310) of the end tool (1300) of the surgical instrument according to the eighth embodiment of the present invention will be described in more detail.

The cartridge (1310) of the end tool (1300) of the surgical instrument according to the eighth embodiment of the present invention is characterized in that the reciprocating movement assembly (1350) includes a first reciprocating movement member (1351) and a second reciprocating movement member (1352).

In detail, referring to FIGS. 164 to 169, etc., the cartridge (1310) is formed to be mountable and detachable to the first article (1301), and includes a plurality of staples (see 530 of FIG. 22) and a working member (1340) inside, thereby performing suturing and cutting of tissue.

Here, the cartridge (1310) may include a cover (see 510 of FIG. 22), a housing (see 520 of FIG. 22), a staple (see 530 of FIG. 22), a working member (1340), and a reciprocating movement assembly (1350).

The housing (see 520 of FIG. 22) forms the outer shape of the cartridge (1310), and may be formed in a form in which one side (the upper side) of an entirely hollow box is removed, and may be formed to accommodate a reciprocating movement assembly (1350), a working member (1340), and a staple (see 530 of FIG. 22) therein. Here, the housing (see 520 of FIG. 22) may be formed in a cross section having an approximately 'U' shape.

A plurality of staples (see 530 of FIG. 22) may be arranged inside the housing (see 520 of FIG. 22). As the work member (1340) described later moves linearly in one direction, the plurality of staples (see 530 of FIG. 22) may be sequentially pushed up from the inside to the outside of the housing (see 520 of FIG. 22), thereby performing sealing, i.e. stapling.

A reciprocating movement assembly (1350) may be arranged at the lower part of the housing (see 520 of FIG. 22). In this embodiment, the reciprocating movement assembly (1350) includes a first reciprocating movement member (1351) and a second reciprocating movement member (1352).

In this embodiment, the first reciprocating moving member (1351) and the second reciprocating moving member (1352) may be racks. The first reciprocating moving member (1351) may include a protruding portion (1351b) and a fastening portion (1351a).

In detail, the first reciprocating moving member (1351) may be formed in a long bar shape, and a plurality of protruding portions (1351b) in a sawtooth shape may be formed on one surface. The protruding portions (1351b) may be formed so as to be in contact with a working member (1340) to be described later, particularly, a first ratchet member (1343) of the working member (1340). In other words, the first reciprocating moving member (1351) may include a plurality of protruding portions (1351b) having a shape that engages with the first ratchets (1343a) of the first ratchet member (1343).

Similarly, the second reciprocating moving member (1352) may include a recessed portion (1352b) and a fastening portion (1352a). That is, the second reciprocating moving member (1352) may include a plurality of recessed portions (1352b) shaped to engage with the recessed portions (1347a) of the second ratchet member (1347).

Here, the first reciprocating moving member (1351) and the second reciprocating moving member (1352) are not fixedly connected to other components of the cartridge (1310) and can be formed to be relatively movable with respect to other components of the cartridge (1310). That is, the first reciprocating moving member (1351) and the second reciprocating moving member (1352) can perform a reciprocating linear motion with respect to the housing (see 520 of FIG. 22) and the cover (see 510 of FIG. 22).

Meanwhile, a fastening portion (1351a) may be formed on a proximal end side adjacent to the pulley (1311) of the first reciprocating moving member (1351), and this fastening portion (1351a) may be fastened and combined with the first link member (1371) of the staple link assembly (1370) of the end tool (1300). Accordingly, when the first link member (1371) performs a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction), the first reciprocating moving member (1351) fastened thereto can also perform a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction).

Similarly, a fastening portion (1352a) may be formed on a proximal end side adjacent to the pulley (1311) of the second reciprocating moving member (1352), and this fastening portion (1352a) may be fastened and combined with the second link member (1376) of the staple link assembly (1370) of the end tool (1300). Accordingly, when the second link member (1376) performs a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction), the second reciprocating moving member (1352) fastened thereto may also perform a reciprocating linear motion along the extension direction of the connecting member (400) (i.e., the Y-axis direction).

A working member (1340) may be arranged inside the housing (see 520 of FIG. 22). The working member (1340) may be formed to be in contact with the first reciprocating moving member (1351) and the second reciprocating moving member (1352), and may be formed to move linearly in one direction according to the reciprocating linear motion of the first reciprocating moving member (1351) and the second reciprocating moving member (1352). In other words, the working member (1340) interacts with the first reciprocating moving member (1351) and the second reciprocating moving member (1352) to perform stapling and cutting while moving along the extension direction of the connecting portion (400).

The working member (1340) may include a wedge (see 541 of FIG. 27), a blade (see 542 of FIG. 27), a first ratchet member (1343), a first elastic member (1344), a second ratchet member (1347), a second elastic member (1348), etc. Here, in the drawing, the remaining components of the working member (1340) except for the ratchet member and the elastic member, i.e., the wedge, the blade, etc., are omitted, but it is to be understood that such components may be included in the working member (1340). Here, the first ratchet member (1343) and the second ratchet member (1347) may be collectively referred to as a ratchet member.

The first ratchet member (1343) may include a first ratchet (1343a), and the second ratchet member (1347) may include a second ratchet (1347a). Here, the first ratchet (1343a) of the first ratchet member (1343) may be formed to be engageable with the first reciprocating member (1351), and the second ratchet (1347a) of the second ratchet member (1347) may be formed to be engageable with the second reciprocating member (1352). That is, an operation in which the first ratchet (1343a) of the first ratchet member (1343) engages (or comes into close contact with) the first reciprocating member (1351) and the work member (1340) advances by the first reciprocating member (1351), and an operation in which the second ratchet (1347a) of the second ratchet member (1347) engages (or comes into close contact with) the second reciprocating member (1352) and the work member (1340) advances by the second reciprocating member (1352) are alternately performed.

The first ratchet member (1343) may be formed to be rotatable about a rotation axis (1345a). For example, a rotation axis (1345a) may be formed to protrude from the lower portion of the main body (1345), and the first ratchet member (1343) may be fitted to the rotation axis (1345a). Accordingly, when the first ratchet member (1343) is pressed by the first reciprocating member (1351) or receives an elastic force by the first elastic member (1344), the first ratchet member (1343) may be rotated about the rotation axis (1345a).

The first elastic member (1344) is formed on one side of the first ratchet member (1343) and serves to apply a predetermined elastic force to the first ratchet member (1343). For example, one area of the elastic member (1344) may contact a support portion (1345c) that protrudes from the lower portion of the main body (1345), and another area of the elastic member (1344) may contact the first ratchet member (1343). Here, the first elastic member (1344) may apply an elastic force in a direction in which the first ratchet member (1343) comes into close contact with the first reciprocating member (1351). To this end, the first elastic member (1344) may be formed in the form of a plate spring, and in addition thereto, may be provided in various forms such as a coil spring and a plate spring that may provide a predetermined elastic force to the first ratchet member (1343).

The second ratchet member (1347) may be formed to be rotatable about a rotation axis (1345b). For example, a rotation axis (1345b) may be formed to protrude from the lower portion of the main body (1345), and the second ratchet member (1347) may be fitted to the rotation axis (1345b). Accordingly, when the second ratchet member (1347) is pressed by the second reciprocating member (1352) or receives an elastic force by the second elastic member (1348), the second ratchet member (1347) may be rotated about the rotation axis (1345b).

The second elastic member (1348) is formed on one side of the second ratchet member (1347) and serves to apply a predetermined elastic force to the second ratchet member (1347). For example, one area of the elastic member (1344) may contact a support portion (1345d) that protrudes from the lower portion of the main body (1345), and another area of the elastic member (1344) may contact the second ratchet member (1347). Here, the second elastic member (1348) may apply an elastic force in the direction in which the second ratchet member (1347) comes into close contact with the second reciprocating member (1352). To this end, the second elastic member (1348) may be formed in the form of a plate spring, and in addition thereto, may be provided in various forms such as a coil spring and a plate spring that may provide a predetermined elastic force to the second ratchet member (1347).

(Operation of reciprocating moving assembly and work member)

Below, the operation of the reciprocating movement assembly (1350) and the work member (1340) is described in more detail.

Figures 170 and 171 are drawings showing the respective operating states of the reciprocating movement assembly (1350) and the working member (1340). Here, Figure 170 is a drawing showing when the first reciprocating movement member (1351) moves forward and the second reciprocating movement member (1352) moves backward, and Figure 171 is a drawing showing when the first reciprocating movement member (1351) moves backward and the second reciprocating movement member (1352) moves forward.

Here, FIG. 170 is a drawing showing when the staple pulley (1361) rotates clockwise (in the direction of arrow A1 of FIG. 164) so that the first reciprocating moving member (1351) moves forward and the second reciprocating moving member (1352) moves backward.

And, Fig. 171 is a drawing showing when the staple pulley (1361) rotates counterclockwise (in the opposite direction of arrow A1 of Fig. 164) so that the first reciprocating moving member (1351) moves backward and the second reciprocating moving member (1352) moves forward.

First, the operation from Fig. 170 (a) to Fig. 170 (e) is explained.

Fig. 170 (a) shows a state in which the first ratchet (1343a) of the first ratchet member (1343) and the first reciprocating member (1351) are in close contact, and the second ratchet (1347a) of the second ratchet member (1347) and the second reciprocating member (1352) are in close contact.

In this state, when the staple pulley (1361) rotates clockwise (in the direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves in the direction of arrow b1 (i.e., moves forward) as shown in Fig. 170 (b), and the second reciprocating moving member (1352) moves in the direction of arrow b2 (i.e., moves backward). Then, the uneven portion (1352b) of the second reciprocating moving member (1352) pushes the second ratchet (1347a) of the second ratchet member (1347) toward the first reciprocating moving member (1351), and thereby the second ratchet member (1347) rotates overall in the direction of arrow b3 about the rotation axis (1345b). And as the second ratchet member (1347) rotates, the second ratchet (1347a) of the second ratchet member (1347) begins to separate from the protruding portion (1352b) of the second reciprocating member (1352).

In this state, if the staple pulley (1361) is further rotated clockwise (in the direction of arrow A1 of Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow c1 (i.e., moves forward), as shown in Fig. 170 (c), and the second reciprocating moving member (1352) moves further in the direction of arrow c2 (i.e., moves backward). Then, the uneven portion (1352b) of the second reciprocating moving member (1352) further pushes the second ratchet (1347a) of the second ratchet member (1347) toward the first reciprocating moving member (1351), and thereby the second ratchet member (1347) as a whole further rotates in the direction of arrow c3. And as the second ratchet member (1347) rotates, the second ratchet (1347a) of the second ratchet member (1347) is further separated from the protruding portion (1352b) of the second reciprocating member (1352).

In this state, if the staple pulley (1361) is further rotated clockwise (in the direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow d1 (i.e., moves forward), and the second reciprocating moving member (1352) moves further in the direction of arrow d2 (i.e., moves backward), as shown in Fig. 170 (d). Then, the uneven portion (1352b) of the second reciprocating moving member (1352) pushes the second ratchet (1347a) of the second ratchet member (1347) further toward the first reciprocating moving member (1351), and when the inclined first surface (see 551b1 of FIG. 36) of the second reciprocating moving member (1352) passes the end of the inclined first surface (see 543a1 of FIG. 36) of the second ratchet member (1347), the uneven portion (1352b) of the second reciprocating moving member (1352) meets the next second ratchet (1347a) of the second ratchet member (1347). At this time, the second elastic member (1348) applies an elastic force in the direction in which the second ratchet member (1347) comes into close contact with the second reciprocating member (1352), so that the second reciprocating member (1352) and the second ratchet member (1347) are in a state in which their front surfaces are in close contact again.

In this state, if the staple pulley (1361) is further rotated clockwise (in the direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow e1 (i.e., moves forward), as shown in Fig. 170 (e), and the second reciprocating moving member (1352) moves further in the direction of arrow e2 (i.e., moves backward). Then, while repeating the operations described above, the first ratchet member (1343) is moved linearly in the direction of arrow e4 by the first reciprocating moving member (1351).

Next, the operation from Fig. 171 (a) to Fig. 171 (e) is described.

Fig. 171 (a) shows a state in which the first ratchet (1343a) of the first ratchet member (1343) and the first reciprocating member (1351) are in close contact, and the second ratchet (1347a) of the second ratchet member (1347) and the second reciprocating member (1352) are in close contact.

In this state, when the staple pulley (1361) rotates counterclockwise (in the opposite direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves in the direction of arrow b1 (i.e., moves backward) as shown in Fig. 171 (b), and the second reciprocating moving member (1352) moves in the direction of arrow b2 (i.e., moves forward). Then, the uneven portion (1351b) of the first reciprocating moving member (1351) pushes the first ratchet (1343a) of the first ratchet member (1343) toward the second reciprocating moving member (1352), and thereby the first ratchet member (1343) rotates overall in the direction of arrow b3 about the rotation axis (1345a). And as the first ratchet member (1343) rotates, the first ratchet (1343a) of the first ratchet member (1343) begins to separate from the protruding portion (1351b) of the first reciprocating member (1351).

In this state, if the staple pulley (1361) is further rotated counterclockwise (in the opposite direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow c1 (i.e., moves backward), as shown in Fig. 171 (c), and the second reciprocating moving member (1352) moves further in the direction of arrow c2 (i.e., moves forward). Then, the uneven portion (1351b) of the first reciprocating moving member (1351) further pushes the first ratchet (1343a) of the first ratchet member (1343) toward the second reciprocating moving member (1352), and thereby the first ratchet member (1343) as a whole further rotates in the direction of arrow c3. And as the first ratchet member (1343) rotates, the first ratchet (1343a) of the first ratchet member (1343) is further separated from the protruding portion (1351b) of the first reciprocating member (1351).

In this state, if the staple pulley (1361) is further rotated counterclockwise (in the opposite direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow d1 (i.e., moves backward), and the second reciprocating moving member (1352) moves further in the direction of arrow d2 (i.e., moves forward), as shown in Fig. 171 (d). Then, the uneven portion (1351b) of the first reciprocating moving member (1351) further pushes the first ratchet (1343a) of the first ratchet member (1343) toward the second reciprocating moving member (1352), and when the inclined first surface (see 551b1 of FIG. 36) of the first reciprocating moving member (1351) passes the end of the inclined first surface (see 543a1 of FIG. 36) of the first ratchet member (1343), the uneven portion (1351b) of the first reciprocating moving member (1351) meets the next first ratchet (1343a) of the first ratchet member (1343). At this time, the first elastic member (1344) applies an elastic force in the direction in which the first ratchet member (1343) comes into close contact with the first reciprocating member (1351), so that the first reciprocating member (1351) and the first ratchet member (1343) are in a state in which their front surfaces are in close contact again.

In this state, if the staple pulley (1361) is further rotated counterclockwise (in the opposite direction of arrow A1 in Fig. 164), the first reciprocating moving member (1351) moves further in the direction of arrow e1 (i.e., moves backward), as shown in Fig. 171 (e), and the second reciprocating moving member (1352) moves further in the direction of arrow e2 (i.e., moves forward). Then, while repeating the operations described above, the second ratchet member (1347) is moved linearly in the direction of arrow e4 by the second reciprocating moving member (1352).

In conclusion, when the staple pulley (1361) rotates in one direction, the first reciprocating moving member (1351) moves forward and the second reciprocating moving member (1352) moves backward. At this time, the second reciprocating moving member (1352) that moves backward pushes the work member (1340) toward the first reciprocating moving member (1351) to bring the work member (1340) into close contact with the first reciprocating moving member (1351), and the first reciprocating moving member (1351) that moves forward moves the brought into close contact with the work member (1340) forward.

Meanwhile, when the staple pulley (1361) rotates in the other direction, the second reciprocating moving member (1352) moves forward and the first reciprocating moving member (1351) moves backward. At this time, the first reciprocating moving member (1351) moving backward pushes the work member (1340) toward the second reciprocating moving member (1352) to bring the work member (1340) into close contact with the second reciprocating moving member (1352), and the second reciprocating moving member (1352) moving forward moves the brought into close contact with the work member (1340) forward.

As a result, when the staple pulley (1361) rotates in one direction, the first reciprocating moving member (1351) advances the working member (1340), and when the staple pulley (1361) rotates in the opposite direction, the second reciprocating moving member (1352) advances the working member (1340), so that the forward speed of the working member (1340) is approximately doubled compared to the first embodiment, thereby obtaining the effect of shortening the stapling and cutting time.

<Example 9 - Anvil Clamp Structure>

Hereinafter, an end tool (1500) of a surgical instrument according to the ninth embodiment of the present invention will be described. Here, the end tool (1500) of the surgical instrument according to the ninth embodiment of the present invention is significantly different from the end tool of the surgical instrument according to the first embodiment of the present invention (see 100 of FIG. 2, etc.) in that a clamp (1546) is additionally formed on the working member (1540) of the cartridge (1510). Hereinafter, the configuration that is different from the first embodiment will be described in detail.

Fig. 172 is a perspective view showing an end tool of a surgical instrument according to the ninth embodiment of the present invention. Fig. 173 is a side cross-sectional view showing a working member of a cartridge of the surgical instrument of Fig. 172. Fig. 174 is a perspective cross-sectional view showing a cartridge of the surgical instrument of Fig. 172. Fig. 175 is an enlarged perspective view showing a cartridge of the surgical instrument of Fig. 172. Figs. 176 to 179 are drawings showing a process of moving a working member. Figs. 180, 181, and 182 are drawings showing a process of attaching a working member to a second member. Figs. 183, 184, and 185 are drawings showing a process of separating a working member from a second member.

Referring to FIGS. 172 to 185, an end tool (1500) of the ninth embodiment of the present invention includes a pair of jaws (1503), namely, a first jaw (1501) and a second jaw (1502), for performing a grip operation. Here, each of the first jaw (1501) and the second jaw (1502), or a component encompassing the first jaw (1501) and the second jaw (1502) may be referred to as jaws (1503). This will be described in more detail later.

Meanwhile, the end tool (1500) includes a plurality of pulleys including a first jaw pulley (see 111 of FIG. 8) and a first auxiliary pulley (see 121 of FIG. 8) related to the rotational motion of the first jaw (1501). In the present embodiment, the pulleys related to the rotational motion of the first jaw (1501) are substantially the same as the pulley (111), pulley (112), pulley (113), pulley (114), pulley (115), and pulley (116) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

Meanwhile, the end tool (1500) includes a plurality of pulleys including a pulley (1521) and a pulley (1522) related to the rotational motion of the second jaw (1502). In the present embodiment, the pulleys related to the rotational motion of the second jaw (1502) are substantially the same as the pulley (151), pulley (152), pulley (153), pulley (154), pulley (155), and pulley (156) described in FIG. 8 of the first embodiment, and therefore, a detailed description thereof will be omitted here.

In addition, the end tool (1500) of the ninth embodiment of the present invention may include a rotational axis (1541), a rotational axis (1542), a rotational axis (1543), and a rotational axis (1544). Here, the rotational axis (1541) and the rotational axis (1542) may be inserted through an end tool hub (1580), and the rotational axis (1543) and the rotational axis (1544) may be inserted through a pitch hub (1507). The rotational axis (1541), the rotational axis (1542), the rotational axis (1543), and the rotational axis (1544) may be arranged sequentially from a distal end (1504) to a proximal end (1505) of the end tool (1500).

Additionally, the end tool (1500) of the ninth embodiment of the present invention may include an end tool hub (1580) and a pitch hub (1507).

An end tool hub (1580) has a rotation shaft (1541) and a rotation shaft (1542) inserted therethrough, and at least a portion of a pulley (1511) and a pulley (1521) coupled to the rotation shaft (1541) and a first member (1501) and a second member (1502) coupled thereto can be accommodated inside the end tool hub (1580).

A rotation shaft (1543) and a rotation shaft (1544) are inserted through the pitch hub (1507), and the pitch hub (1507) can be axially coupled with the end tool hub (1580) by the rotation shaft (1543). Accordingly, the end tool hub (1580) can be formed to be capable of pitch rotation with respect to the pitch hub (1507) with the rotation shaft (1543) as the center.

Meanwhile, the end tool (1500) of the ninth embodiment of the present invention may further include components such as a staple drive assembly (see 150 of FIG. 13) including a staple pulley assembly (see 160 of FIG. 13) and a staple link assembly (see 170 of FIG. 13) to perform stapling and cutting operations.

The staple pulley assembly (see 160 of FIG. 13) can be formed between the pulley (1511) and the pulley (1521), adjacent to the pulley (1511) and the pulley (1521). In this embodiment, it is assumed that the staple pulley assembly (see 160 of FIG. 13) includes one staple pulley (1561).

The staple link assembly (see 170 of FIG. 13) may include one or more link members (1571). The staple link assembly (see 170 of FIG. 13) may serve to connect the staple pulley assembly (1560) and the reciprocating movement assembly (1550) of the cartridge (1510). In this embodiment, it is assumed that the staple link assembly (see 170 of FIG. 13) includes one link member (1571), and the link member (1571) includes two links.

In this way, the ninth embodiment of the present invention is characterized in that a staple pulley assembly (see 160 of FIG. 13) and a staple link assembly (see 170 of FIG. 13) are arranged between a first pulley (1511) and a second pulley (1521), thereby enabling the stapling and cutting operations using a cartridge (1510) to be performed together with the pitch and yaw operations of the end tool (1500). Since the components for performing the stapling and cutting operations in this embodiment are substantially the same as the components described in the first embodiment, a detailed description thereof will be omitted here.

Hereinafter, the second embodiment (1502) and the cartridge (1510) of the ninth embodiment of the present invention will be described in more detail, with particular focus on the clamp (1546) formed on the working member (1540) of the cartridge (1510).

Article 2 (1502) includes an anvil, a guide groove (1502b), a first coupling groove (1502h), and a second coupling groove (1502i).

Article 2 (1502) is formed in an overall elongated rod shape, with an anvil formed on the distal side (1502f) and a pulley (1512) coupled to the proximal side (1502g) so as to be rotatable around a rotation axis (1541).

In detail, the anvil is formed in a flat plane shape, and on one side thereof, shapes corresponding to the shape of the staple (1530) to be described later can be formed. Such an anvil can serve as a support to support the opposite side of the working member (1540) when the working member (1540) pushes up the staple (1530) in the stapling operation, thereby allowing the staple (1530) to be bent.

A guide groove (1502b) that guides the movement of the working member (1540) of the cartridge (1510) may be formed on the inner side of the second article (1502). The guide groove (1502b) may be formed in a groove shape along the movement path of the working member (1540). Then, when the clamp (1546) of the working member (1540) formed in a protrusion shape is fitted into the groove-shaped guide groove (1502b), the clamp (1546) moves along the guide groove (1502b), thereby causing the working member (1540) to move relative to the second article (1502). That is, the working member (1540) can move along the guide groove (1502b) of the second article (1502).

A first coupling groove (1502h) may be formed in the proximal portion (1502g) of the second article (1502), and a second coupling groove (1502i) may be formed in the distal portion (1502f). Here, the first coupling groove (1502h) and the second coupling groove (1502i) may be formed at both ends of the guide groove (1502b). The first coupling groove (1502h) and the second coupling groove (1502i) are formed to be slightly larger than the clamp (1546) of the working member (1540), so that the clamp (1546) can be introduced into the second article (1502) or withdrawn from the second article (1502). That is, the clamp (1546) can be introduced into the second member (1502) through the first coupling groove (1502h), moved along the guide groove (1502b), and then withdrawn out of the second member (1502) through the second coupling groove (1502i). This will be described in more detail later.

The cartridge (1510) may include a cover (see 510 of FIG. 22), a housing (see 520 of FIG. 22), a staple (1530), a working member (1540), and a reciprocating movement assembly (1550). Here, other components of the cartridge (1510) except for the working member (!540) are substantially the same as the cartridge described in the first embodiment (see 500 of FIG. 22), and therefore, a detailed description thereof will be omitted.

The working member (1540) may include a base (1541), a blade (1542), a ratchet member (1543), an elastic member (1544), and a body (1545). Furthermore, the working member (1540) of the ninth embodiment of the present invention further includes a clamp (1546).

The clamp (1546) may be formed on one side of the blade (1542) and may be formed in a shape approximately parallel to the main body (1545) or the Ÿ‡ji (1541). In addition, a protrusion (1546a) may be formed on one end thereof, and this protrusion (1546a) may move along the guide groove (1502b).

Here, the working member (1540) of the ninth embodiment of the present invention is characterized in that it additionally has a clamp (1546) parallel to the Ÿ‡ paper (1541), so that the working member (1540) forms a ‘ㄷ’ shape overall, thereby better withstanding the strong pressure applied to the Ÿ‡ paper (1541) during the stapling operation.

Figures 176 to 179 are drawings showing the process of moving a work member.

As described above, when the first clause (1501) and the second clause (1502) are closed, the clamp (1546) can pass through the first coupling groove (1502h) and be positioned within the guide groove (1502b), as illustrated in FIG. 176.

In this state, as shown in Fig. 177, when the working member (1540) moves in the direction of arrow A, the clamp (1546) can also move along the guide groove (1502b).

In this state, as illustrated in FIG. 178, when the working member (1540) continues to move along the direction of arrow B and reaches the distal portion (1502f) of the second member (1502), the clamp (1546) can be pulled out through the second engaging groove (1502i) and out of the guide groove (1502b).

Figures 180, 181 and 182 are drawings showing the process of attaching the work member to the second section.

In a state like Fig. 180, the second member (1502) is rotated in the direction of arrow A of Fig. 181 and arrow B of Fig. 182 so that the first member (1501) and the second member (1502) are closed. Then, the clamp (1546) passes through the first coupling groove (1502h) and is positioned within the guide groove (1502b).

Figures 183, 184 and 185 are drawings showing the process of separating the working member from the second section.

In a state similar to that of Fig. 183, the second member (1502) rotates in the direction of arrow A of Fig. 184 and arrow B of Fig. 185 to open the first member (1501) and the second member (1502). Then, the clamp (1546) passes through the second coupling groove (1502i) and comes out of the guide groove (1502b).

In this way, the working member (1540) of the ninth embodiment of the present invention additionally has a clamp (1546) parallel to the Ÿ‡ paper (1541), so as to obtain an effect of better withstanding the strong pressure applied to the Ÿ‡ paper (1541) during the stapling operation.

(First modification of the first embodiment - ratchet modification: hinge type 1)

Hereinafter, a surgical instrument according to a first modified example of the first embodiment of the present invention will be described. Here, the surgical instrument according to the first modified example of the first embodiment of the present invention is characterized by a different shape of the elastic member (564) of the cartridge compared to the surgical instrument according to the first embodiment of the present invention described above (see 10 of FIG. 2, etc.).

FIGS. 76 and 77 are drawings showing a cartridge of a surgical instrument according to a first modified example of the first embodiment of the present invention.

Referring to FIGS. 76 and 77, a support member (566) may be formed to protrude from one side of the main body (see 545 of FIG. 27), for example, from the lower surface of the main body (see 545 of FIG. 27). In addition, one end of the elastic member (564) may be formed to be coupled with the support member (566) of the main body (see 545 of FIG. 27), and the other end of the elastic member (564) may be formed to be in contact with the ratchet member (563).

At this time, the elastic member (564) can apply elastic force in the direction in which the ratchet member (563) comes into close contact with the reciprocating member (see 551 of FIG. 22). To this end, the elastic member (564) can be formed in the form of a plate spring, and in addition, it can be provided in various forms such as a coil spring and a plate spring that can provide a predetermined elastic force to the ratchet member (563).

Here, the first modified example of the first embodiment of the present invention is characterized in that the elastic member (564) is not formed integrally with the working member (560), but is formed as a separate member, so that the elastic member (564) is arranged between the support member (566) of the main body (see 545 of FIG. 27) and the ratchet member (563).

In detail, in the first embodiment of the present invention, the elastic member (see 544 of FIG. 28) is formed integrally with the working member (see 540 of FIG. 28), whereas in this modified example, the elastic member (564) is formed as a separate member from the working member (560) and is interposed between the support member (566) of the main body (see 545 of FIG. 27) of the working member (560) and the ratchet member (563).

(Second modification of the first embodiment - ratchet modification: hinge type 2)

Hereinafter, a surgical instrument according to a second modified example of the first embodiment of the present invention will be described. Here, the surgical instrument according to the second modified example of the first embodiment of the present invention is characterized by a different shape of the elastic member (574) of the cartridge compared to the surgical instrument according to the first embodiment of the present invention described above (see 10 of FIG. 2, etc.).

FIGS. 78 and 79 are drawings showing a cartridge of a surgical instrument according to a second modified example of the first embodiment of the present invention.

Referring to FIGS. 78 and 79, a support member (576) may be formed to protrude from one side of the main body (see 545 of FIG. 27), for example, from the lower surface of the main body (see 545 of FIG. 27). Then, one end of the elastic member (574) may be formed to contact the support member (576) of the main body (see 545 of FIG. 27), and the other end of the elastic member (574) may be formed to be coupled with the ratchet member (573).

At this time, the elastic member (574) can apply elastic force in the direction in which the ratchet member (573) comes into close contact with the reciprocating member (see 551 of FIG. 22). To this end, the elastic member (574) can be formed in the form of a plate spring, and in addition, it can be provided in various forms such as a coil spring and a plate spring that can provide a predetermined elastic force to the ratchet member (573).

Here, the second modified example of the first embodiment of the present invention is characterized in that the elastic member (574) is not formed integrally with the working member (570), but is formed as a separate member, so that the elastic member (574) is arranged between the support member (576) of the main body (see 545 of FIG. 27) and the ratchet member (573).

In detail, in the first embodiment of the present invention, the elastic member (see 544 of FIG. 28) is formed integrally with the working member (see 540 of FIG. 28), whereas in this modified example, the elastic member (574) is formed as a separate member from the working member (570) and is interposed between the support member (576) of the main body (see 545 of FIG. 27) of the working member (570) and the ratchet member (573).

(Third modification of the first embodiment - ratchet modification: hinge type 3)

Hereinafter, a surgical instrument according to a third modified example of the first embodiment of the present invention will be described. Here, the surgical instrument according to the third modified example of the first embodiment of the present invention is characterized by a different shape of the elastic member (584) of the cartridge compared to the surgical instrument according to the first embodiment of the present invention described above (see 10 of FIG. 2, etc.).

FIGS. 80 and 81 are drawings showing a cartridge of a surgical instrument according to a third modified example of the first embodiment of the present invention.

Referring to FIGS. 80 and 81, one end of the elastic member (584) may be formed to contact the inner wall of the housing (520), and the other end of the elastic member (584) may be formed to engage with the ratchet member (583).

At this time, the elastic member (584) can apply elastic force in the direction in which the ratchet member (583) comes into close contact with the reciprocating member (551). To this end, the elastic member (584) can be formed in the form of a plate spring, and in addition, can be provided in various forms such as a coil spring and a plate spring that can provide a predetermined elastic force to the ratchet member (583).

Here, the third modified example of the first embodiment of the present invention is characterized in that the elastic member (584) is not formed integrally with the working member (580), but is formed as a separate member, so that the elastic member (584) is placed between the housing (520) and the ratchet member (583).

In detail, in the first embodiment of the present invention, the elastic member (see 544 of FIG. 28) is formed integrally with the working member (see 540 of FIG. 28), whereas in this modified example, the elastic member (584) is formed as a separate member from the working member (580) and is interposed between the housing (520) and the ratchet member (583).

(4th modification of the first embodiment - ratchet modification: vertical type)

Hereinafter, a surgical instrument according to a fourth modified example of the first embodiment of the present invention will be described. Here, the surgical instrument according to the fourth modified example of the first embodiment of the present invention is characterized by a different shape of the elastic member (594) of the cartridge compared to the surgical instrument according to the first embodiment of the present invention described above (see 10 of FIG. 2, etc.).

FIGS. 82 and 83 are drawings showing a cartridge of a surgical instrument according to a fourth modified example of the first embodiment of the present invention.

Referring to FIGS. 82 and 83, a support member (596) may be formed to protrude from one side of the main body (see 545 of FIG. 27), for example, from the lower surface of the main body (see 545 of FIG. 27). Here, the support member (596) is formed in an overall shape of approximately a 'ㄷ', and an elastic member (594) may be accommodated therein. Accordingly, both ends of the elastic member (594) may be formed to contact the support member (596), and the central portion of the elastic member (594) may be formed to contact the ratchet member (593).

At this time, the elastic member (594) can apply elastic force in the direction in which the ratchet member (593) comes into close contact with the reciprocating member (see 551 of FIG. 22). To this end, the elastic member (594) can be formed in the form of a plate spring, and in addition, can be provided in various forms such as a coil spring and a plate spring that can provide a predetermined elastic force to the ratchet member (593).

Here, the fourth modified example of the first embodiment of the present invention is characterized in that the elastic member (594) is not formed integrally with the working member (590), but is formed as a separate member, so that the elastic member (594) is arranged between the support member (596) of the main body (see 545 of FIG. 27) and the ratchet member (593).

In detail, in the first embodiment of the present invention, the elastic member (see 544 of FIG. 28) is formed integrally with the working member (see 540 of FIG. 28), whereas in this modified example, the elastic member (594) is formed as a separate member from the working member (590) and is interposed between the support member (596) of the main body (see 545 of FIG. 27) of the working member (590) and the ratchet member (593).

(Fifth modification of the first embodiment - snap for preventing backward movement)

Hereinafter, a surgical instrument according to a fifth modified example of the first embodiment of the present invention will be described. Here, the surgical instrument according to the fifth modified example of the first embodiment of the present invention is characterized by a difference from the surgical instrument according to the first embodiment of the present invention described above (see 10 of FIG. 2, etc.) in that a snap (646) for preventing backward movement is further formed on the cartridge (600).

FIGS. 84 and 85 are drawings showing a cartridge of a surgical instrument according to a fifth modified example of the first embodiment of the present invention. FIG. 86 is a drawing showing the operating state of the cartridge of FIG. 84.

Referring to FIGS. 84 to 86, a cartridge (600) is formed to be mountable and detachable to the first article (see 101 of FIG. 2), and includes a plurality of staples (see 530 of FIG. 25) and blades (see 642 of FIG. 27) therein to perform suturing and cutting of tissue. Here, the cartridge (600) may include a cover (610), a housing (620), a staple (see 530 of FIG. 25), a take-out member (see 535 of FIG. 25), a working member (640), and a reciprocating movement assembly (650).

The housing (620) forms the outer shape of the cartridge (600), and is formed in a form in which one side (the upper side) of an entirely hollow box is removed, and can be formed to accommodate a reciprocating movement assembly (650), a working member (640), and a staple (see 530 of FIG. 25) therein. Here, the housing (620) can be formed in a cross section that is approximately in a 'U' shape.

One or more protrusions (621) may be formed on the inner surface of the housing (620), more specifically, on the inner surface of the housing (620) facing the recessed portion (see 551b of FIG. 22) of the reciprocating movement assembly (650). In other words, it may be said that one or more protrusions (621) are formed in an area of the inner surface of the housing (620) that can come into contact with the working member (640). The one or more protrusions (621) may be formed in a wedge shape. In other words, it may be described that the one or more protrusions (621) include an inclined surface formed so that the height of the distal side is higher than the proximal side of the cartridge (600). Such protrusions (621) are formed so as to be in contact with the snap (646) of the working member (640), thereby preventing the working member (640) from moving backward (i.e., moving toward the proximal side). This will be explained in more detail later.

The cover (610) is formed to cover the upper part of the housing (620). The cover (610) may be formed with staple holes (see 511 of FIG. 23) through which a plurality of staples (630) can be discharged to the outside. Before the stapling operation, the staples (see 530 of FIG. 25) accommodated inside the housing (620) are pushed upward by the work member (640) during the stapling operation, and are pulled out to the outside of the cartridge (600) through the staple holes (see 511 of FIG. 23) of the cover (610), thereby performing stapling.

A reciprocating movement assembly (650) may be placed at the lower portion inside the housing (620). The reciprocating movement assembly (650) may include one or more reciprocating movement members (651). In the present embodiment, the reciprocating movement members (651) may be a rack.

The working member (640) may include a wedge (641), a blade (642), a ratchet member (643), an elastic member (644), a body (645), and a snap (646).

The snap (646) may be formed to protrude from either the main body (645) or the side of the Ÿ‡ji (641). The snap (646) is formed in a wedge shape and is formed to come into contact with the inner surface of the housing (620). At this time, the snap (646) may be formed to engage with the protrusion (621) of the housing (620). When the snap (646) and the protrusion (621) are engaged, the work member (640) may be prevented from moving backward (i.e., toward the proximal portion) by the snap (646) and the protrusion (621).

Here, the snap (646) can be formed to be elastically deformable to a certain degree. That is, it can act as a kind of plate spring. Accordingly, when the snap (646) moves along the inclined surface of the protrusion (621), the snap (646) can be elastically deformed to a certain degree toward the main body (645). Then, when the snap (646) goes over the inclined surface of the protrusion (621) and comes into contact with the next protrusion (621), the snap (646) can be elastically restored toward the housing (620).

In summary, the cartridge (600) is accommodated in the cartridge receiving portion (see 101a of FIG. 2) of the first article (see 101 of FIG. 2), and at this time, the reciprocating member (651) of the cartridge (600) and the staple link assembly (see 170 of FIG. 13) of the end tool (see 100 of FIG. 2) are coupled. Accordingly, the rotational motion of the staple pulley (see 161 of FIG. 13) of the end tool (see 100 of FIG. 2) is converted into the linear motion of the reciprocating member (651) through the staple link assembly (see 170 of FIG. 13).

At this time, since the fastening portion (651a) of the reciprocating member (651) is connected to the staple pulley (161) through the staple link assembly (170), when the staple pulley (161) alternately rotates clockwise/counterclockwise, the reciprocating member (651) can repeat forward and backward movements. In addition, when the reciprocating member (651) moves forward, the working member (640) moves forward together with the reciprocating member (651), and when the reciprocating member (651) moves backward, only the reciprocating member (651) moves backward and the working member (640) can stop in place. By repeating this process, as the working member (640) moves forward, the staple (630) is stapled by the blade (641) at the same time, and the blade (642) can cut the stapled tissue.

Here, when the reciprocating moving member (651) moves backward, only the reciprocating moving member (651) moves backward and the working member (640) can be more reliably stopped in place. That is, the working member (640) can be more reliably prevented from moving toward the proximal part (see 501 in FIG. 23) of the cartridge (600) by the snap (646) and the protrusion (621).

To elaborate further, here it is:

First, in a state such as Fig. 86 (a), when the staple pulley (see 161 of Fig. 13) rotates in a certain direction as in Fig. 86 (b), the staple link assembly (see 170 of Fig. 13) connected thereto and the reciprocating member (651) connected to the staple link assembly (see 170 of Fig. 13) move in the direction of arrow b1 (i.e., toward the distal end of the cartridge). In this state, since the reciprocating member (551) and the working member (640) are in close contact by the elastic member (644), when the reciprocating member (651) moves in the direction of arrow b1, the working member (640) also moves in the direction of arrow b1 together with the reciprocating member (651). At this time, the snap (646) can be elastically deformed to a certain extent in the direction of arrow b2 (i.e., toward the main body (645)) while moving along the inclined surface of the protrusion (621).

Next, when the staple pulley (see 161 of FIG. 13) is further rotated in one direction as shown in FIG. 86 (c), the staple link assembly (see 170 of FIG. 13), the reciprocating member (651), and the working member (640) connected thereto are further moved in the direction of arrow c1. Then, when the snap (646) goes over the inclined surface of the protrusion (621) and comes into contact with the next protrusion (621), the snap (646) can be elastically restored toward the housing (620).

Next, in a state such as Fig. 86 (c), when the staple pulley (see 161 of Fig. 13) rotates in the opposite direction as in Fig. 86 (d), the staple link assembly (see 170 of Fig. 13) connected thereto and the reciprocating member (651) fastened with the staple link assembly (see 170 of Fig. 13) move in the direction of arrow d1 (i.e., in the proximal direction of the cartridge). In this state, due to the fastening structure of the ratchet member (643) and the reciprocating member (651), even if the reciprocating member (651) moves in the d1 direction, the overall position (i.e., the X-axis direction position) of the working member (640) is maintained the same, and while the elastic member (644) repeats elastic deformation in the direction of arrow d2, the ratchet member (643) is separated from the reciprocating member (651) to a certain extent. That is, even if the reciprocating moving member (651) moves in the direction of arrow d1, the working member (640) remains stationary when viewed from the X-axis direction.

At this time, the snap (646) engages with the protrusion (621) of the housing (620), thereby more reliably preventing movement of the workpiece in the X-axis direction.

Next, as shown in Fig. 86 (e), when the staple pulley (see 161 of Fig. 13) is further rotated in the opposite direction, only the staple link assembly (see 170 of Fig. 13) connected thereto and the reciprocating member (651) moves further in the direction of arrow e1, and the working member (640) remains stationary in place when viewed from the X-axis direction.

By repeating this process, when the staple pulley (see 161 of FIG. 13) rotates clockwise/counterclockwise alternately, the reciprocating member (651) repeats moving forward and backward, and the working member (640) repeats moving forward and stopping, so that as a result, the working member (640) moves toward the distal portion (see 502 of FIG. 23). Then, as the working member (640) moves toward the distal portion (see 502 of FIG. 23), the stapling action by the Ÿ‡paper (641) and the cutting action by the blade (642) are performed simultaneously.

Although the present invention has been described with reference to one embodiment shown in the drawings, this is merely exemplary, and those skilled in the art will understand that various modifications and variations of embodiments are possible from this. Accordingly, the true technical protection scope of the present invention should be determined by the technical idea of the appended patent claims.

10: Surgical instruments
100: End tool
200: Control Panel
300: Power Transmission
400: Connection

Claims (25)

In a cartridge of a surgical instrument having an end tool rotatable in at least one direction,
housing;
A cover covering one side of the housing and having a slit formed along a first direction, which is the longitudinal direction of the housing;
A plurality of staples arranged inside the housing;
A reciprocating movement assembly disposed inside the housing, formed to be movable along the first direction with respect to the housing, and having a plurality of protruding portions formed on at least one surface;
A working member formed on one side of the reciprocating movement assembly and formed so as to be in contact with the reciprocating movement assembly, and formed so as to be movable along the first direction by the reciprocating movement assembly;
A cartridge of a surgical instrument, wherein the reciprocating movement assembly is connected to a staple drive assembly formed in the end tool, such that when the staple pulley of the staple drive assembly rotates, the reciprocating movement assembly moves along the first direction. delete In paragraph 1,
When the above staple pulley rotates alternately clockwise and counterclockwise,
A cartridge of a surgical instrument, characterized in that the reciprocating movement assembly connected to the staple drive assembly alternately moves toward the distal side and the proximal side of the cartridge. In the third paragraph,
A cartridge of a surgical instrument, characterized in that the reciprocating movement assembly moves the working member in contact with the reciprocating movement assembly in the first direction as the reciprocating movement assembly moves toward the distal end of the cartridge. In paragraph 1,
The above absence of work,
entity;
One or more Ÿ‡-shaped surfaces formed on one side of the main body and including an inclined surface formed so that the height of the proximal side of the cartridge is higher than that of the distal side;
A blade formed on one side of the above Ÿ‡, and including a sharply formed edge portion;
A cartridge of a surgical instrument, comprising: a ratchet member formed on one side of the main body and having at least one ratchet formed thereon, the ratchet being capable of coming into contact with the protruding portion of the reciprocating movement assembly; In paragraph 5,
A cartridge of a surgical instrument further comprising an elastic member formed between the main body or the Ÿ‡ and the ratchet member to provide an elastic force for urging the ratchet toward the reciprocating movement assembly. In paragraph 5,
A cartridge of a surgical instrument, characterized in that when the reciprocating movement assembly moves toward the distal end of the cartridge, the reciprocating movement assembly comes into close contact with the ratchet and pushes the ratchet, thereby moving the working member toward the distal end of the cartridge. In paragraph 7,
A cartridge of a surgical instrument, characterized in that when the reciprocating movement assembly moves toward the proximal portion of the cartridge, the working member remains stationary in the one direction. In Article 8,
When the above reciprocating movement assembly moves toward the proximal side of the cartridge,
A cartridge for a surgical instrument, characterized in that the inclined surface of the reciprocating movement assembly presses the inclined surface of the ratchet in a direction in which the ratchet member moves away from the reciprocating movement assembly. In paragraph 7,
The above reciprocating movement assembly includes a first reciprocating movement member and a second reciprocating movement member formed to face each other,
A cartridge of a surgical instrument, wherein the ratchet member includes a first ratchet formed to be in contact with the first reciprocating moving member and a second ratchet formed to be in contact with the second reciprocating moving member. In Article 10,
When the first reciprocating moving member moves toward the distal end of the cartridge, the first reciprocating moving member comes into close contact with the first ratchet and pushes the first ratchet, thereby causing the working member to move toward the distal end of the cartridge.
A cartridge of a surgical instrument, characterized in that when the second reciprocating moving member moves toward the distal end of the cartridge, the second reciprocating moving member comes into close contact with the second ratchet and pushes the second ratchet, thereby causing the working member to move toward the distal end of the cartridge. In Article 10,
A cartridge of a surgical instrument, characterized in that the first reciprocating moving member and the second reciprocating moving member alternately move toward the distal portion of the cartridge. In Article 10,
The first reciprocating moving member is connected to a first link member connected to one area of the staple pulley of the end tool, and the second reciprocating moving member is connected to a second link member connected to another area of the staple pulley.
When the staple pulley rotates in one direction, the first link member connected to the staple pulley, the first reciprocating member connected to the first link member, and the ratchet member in contact with the first reciprocating member move in the distal direction of the cartridge,
A cartridge of a surgical instrument, characterized in that when the staple pulley rotates in the other direction, the second link member connected to the staple pulley, the second reciprocating member connected to the second link member, and the ratchet member in contact with the second reciprocating member move in the distal direction of the cartridge. In Article 10,
The first ratchet is formed on one side of the ratchet member,
A cartridge of a surgical instrument, characterized in that the second ratchet is formed on the other side of the ratchet member. In Article 14,
When the first reciprocating moving member moves in the proximal direction of the cartridge, the first reciprocating moving member pushes the first ratchet toward the second reciprocating moving member,
A cartridge of a surgical instrument, characterized in that when the second reciprocating moving member moves in the proximal direction of the cartridge, the second reciprocating moving member pushes the second ratchet toward the first reciprocating moving member. In Article 10,
The ratchet member is a cartridge of a surgical instrument including a first ratchet member having the first ratchet formed on one surface and a second ratchet member having the second ratchet formed on one surface. In Article 16,
When the first reciprocating moving member moves in the proximal direction of the cartridge, the first reciprocating moving member pushes the first ratchet toward the second reciprocating moving member,
A cartridge of a surgical instrument, characterized in that when the second reciprocating moving member moves in the proximal direction of the cartridge, the second reciprocating moving member pushes the second ratchet toward the first reciprocating moving member. In Article 16,
A first elastic member interposed between the first ratchet member and the first reciprocating member, the first elastic member applying an elastic force in a direction in which the first ratchet member comes into close contact with the first reciprocating member;
A cartridge of a surgical instrument further comprising a second elastic member interposed between the first ratchet member and the second reciprocating member, the second elastic member applying an elastic force in a direction in which the second ratchet member comes into close contact with the second reciprocating member. In a cartridge of a surgical instrument having an end tool rotatable in at least one direction,
housing;
A cover covering one side of the housing and having a slit formed along a first direction, which is the longitudinal direction of the housing;
A plurality of staples arranged inside the housing;
A reciprocating movement assembly disposed inside the housing, formed to be movable along the first direction with respect to the housing, and having a plurality of protruding portions formed on at least one surface;
A working member formed on one side of the reciprocating movement assembly and formed so as to be in contact with the reciprocating movement assembly, and formed so as to be movable along the first direction by the reciprocating movement assembly;
At least one protrusion is formed in an area on the inner side of the housing that can come into contact with the work member,
A cartridge of a surgical instrument, characterized in that the working member has a snap formed that can contact the protrusion. In Article 19,
A cartridge of a surgical instrument, characterized in that when the reciprocating movement assembly moves toward the proximal portion of the cartridge, the snap and the protrusion come into contact, thereby preventing the working member from moving toward the proximal portion of the cartridge. In Article 19,
A cartridge of a surgical instrument, characterized in that one end of the snap is formed to be coupled with the working member and to enable a certain degree of elastic deformation. In Article 19,
A cartridge for a surgical instrument, characterized in that the one or more protrusions include an inclined surface formed so that the height of the distal side of the cartridge is higher than that of the proximal side. In paragraph 5,
A cartridge of a surgical instrument, wherein a clamp is formed on one side of the blade of the above working member and extends along the first direction. In paragraph 23,
A cartridge of a surgical instrument, characterized in that a guide groove is formed in the anvil of the second set of the end tool along the first direction, and the clamp moves along the guide groove. In Article 24,
A cartridge of a surgical instrument, characterized in that a coupling groove is formed at both ends of the anvil, through which the clamp can be introduced or withdrawn with respect to the anvil.