WO2015163546A1 - 수술용 인스트루먼트 - Google Patents
수술용 인스트루먼트 Download PDFInfo
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- WO2015163546A1 WO2015163546A1 PCT/KR2014/009599 KR2014009599W WO2015163546A1 WO 2015163546 A1 WO2015163546 A1 WO 2015163546A1 KR 2014009599 W KR2014009599 W KR 2014009599W WO 2015163546 A1 WO2015163546 A1 WO 2015163546A1
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- pulley
- jaw
- gear
- end tool
- axis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/71—Manipulators operated by drive cable mechanisms
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- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
- F16H—GEARING
- F16H21/00—Gearings comprising primarily only links or levers, with or without slides
- F16H21/46—Gearings comprising primarily only links or levers, with or without slides with movements in three dimensions
- F16H21/52—Gearings comprising primarily only links or levers, with or without slides with movements in three dimensions for interconverting rotary motion and oscillating motion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00318—Steering mechanisms
- A61B2017/00323—Cables or rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2911—Handles rings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2925—Pistol grips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
Definitions
- the present invention relates to surgical instruments, and more particularly, to surgical instruments that are manually operable for use in laparoscopic surgery or various other surgeries.
- surgery means repairing a disease by cutting, slitting, or manipulating skin, mucous membranes, or other tissues with medical devices.
- open surgery to incise and open the skin of the surgical site to treat, shape, or remove the organs therein causes problems such as bleeding, side effects, patient pain, and scars. Therefore, in recent years, surgery or using a robot (robot), which is performed by inserting only a medical device, for example, a laparoscope, a surgical instrument, a microsurgical microscope, etc. by forming a predetermined hole in the skin, has been spotlighted as an alternative.
- a robot which is performed by inserting only a medical device, for example, a laparoscope, a surgical instrument, a microsurgical microscope, etc. by forming a predetermined hole in the skin
- a surgical instrument is a tool for operating a surgical site by manipulating an end tool provided at one end of a shaft passing through a hole drilled in the skin by a doctor using a predetermined driving unit by hand or by using a robot arm. .
- the end tool provided in the surgical instrument performs a rotating operation, a gripping, a cutting operation, and the like through a predetermined structure.
- the existing surgical instrument has a problem that the end tool portion is not bent, so it is not easy to access the surgical site and perform various surgical operations.
- surgical instruments have been developed that can bend the end tool, but the operation of the control unit to bend the end tool or perform the surgical operation is intuitively consistent with the operation of the actual end tool to bend or perform the surgical operation. Not so, the intuitive operation is not easy from the operator's point of view, there was a problem that takes a long time to be skilled in the method of use.
- the background art described above is technical information possessed by the inventors for the derivation of the present invention or acquired during the derivation process of the present invention, and is not necessarily a publicly known technique disclosed to the general public before the application of the present invention.
- An object of the present invention is to solve the above-mentioned problems, and to provide a surgical instrument for intuitively matching the operation of the actual end tool bending or performing the surgical operation, and the operation of the corresponding operation unit. do. More specifically, to this end, an end tool having various degrees of freedom, an operation unit having a structure for intuitively operating the operation of the end tool, and transmitting a driving force of the operation unit to the end tool to enable the operation of the end tool according to the operation of the operation unit. Provide a power transmission.
- One embodiment of the present invention includes an end tool comprising a first jaw and a second jaw, each rotatably formed; A pitch operator controlling the pitch movement of the end tool, a yaw operator controlling the yaw movement of the end tool, and an actuation movement of the end tool.
- An operation unit including an actuation operator controlling an operation; A first set wire connected to the first set to transfer the operation of the manipulation section to the first set, a second set wire connected to the second set to transfer the operation of the manipulation section to the second set, the yaw control section or the actuator
- a power transmission unit including one or more differential members for transmitting rotation of the operation control unit to the first or second pair of wires through the first pair of wires or the second pair of wires; And a connection part extending in a first direction (X axis), the end tool being coupled to one end thereof, and the operation part being coupled to the other end thereof, the connecting part connecting the operation part to the end tool.
- a surgical instrument characterized in that it is formed to.
- Another embodiment of the present invention includes a first jaw and a second jaw rotatable independently of each other; A J11 pulley coupled to the first jaw and rotatably formed about a first axis formed in the end tool hub; A J16 pulley formed on one side of the J11 pulley and formed to be rotatable about a second axis formed on one side of the first shaft; A J12 pulley and a J14 pulley formed on one side of the J16 pulley and formed to have a predetermined angle with the first axis and rotatably around a third axis formed on one side of the end tool hub; A J21 pulley coupled to the second jaw and formed to be rotatable about an axis that is substantially the same or parallel to the first axis, and formed on one side of the J21 pulley and substantially the same or parallel to the second axis.
- the operation direction of the operation unit by the operator and the operation direction of the end tool are intuitively the same direction, the convenience of the operator can be improved and the accuracy, reliability, and quickness of the operation can be obtained. .
- Figure 1a is a conceptual diagram of the pitch operation of a conventional surgical instrument
- Figure 1b is a conceptual diagram of yaw operation.
- Figure 1c is a pitch operation conceptual diagram of another conventional surgical instrument
- Figure 1d is a yaw operation conceptual diagram.
- Figure 1e is a conceptual diagram of the pitch operation of the surgical instrument according to the present invention
- Figure 1f is a yaw operation conceptual diagram.
- FIG. 2 is a perspective view showing a surgical instrument according to a first embodiment of the present invention.
- FIG. 3 is an internal perspective view of the surgical instrument of FIG.
- FIG. 4 is a side view of the surgical instrument of FIG.
- FIG. 5 is a perspective view illustrating an upper portion of an operation unit of the surgical instrument of FIG. 3.
- FIG. 6 is a perspective view illustrating a lower portion of an operation unit of the surgical instrument of FIG. 3.
- FIG. 7 and 8 are perspective views showing the end tool of the surgical instrument of FIG.
- 9A is a plan view illustrating an end tool of the surgical instrument of FIG. 3.
- 9B is a plan view illustrating an end tool of a conventional surgical instrument.
- FIG. 10 is a conceptual diagram illustrating a pitch operation of the surgical instrument of FIG.
- FIG. 11 is a perspective view illustrating a pitch operation of the surgical instrument of FIG. 3.
- FIG. 11 is a perspective view illustrating a pitch operation of the surgical instrument of FIG. 3.
- FIG. 12 and 13 are views showing yaw operation of the surgical instrument of FIG.
- FIG. 14 and 15 are views showing the actuation operation of the surgical instrument of FIG.
- FIG. 16 is a perspective view showing a surgical instrument according to a second embodiment of the present invention.
- FIG. 17 is a plan view of the surgical instrument of FIG.
- FIG. 18 is a perspective view illustrating an operation unit of the surgical instrument of FIG. 16.
- FIG. 19 is a view showing the yaw operation of the surgical instrument of FIG.
- 20 and 21 are views showing the actuation operation of the surgical instrument of FIG.
- first and second may be used to describe various components, but the components should not be limited by the terms. The terms are used only for the purpose of distinguishing one component from another.
- each embodiment should not be interpreted or implemented independently, and the technical spirit described in each embodiment may be interpreted or implemented in combination with other embodiments separately described. It should be understood that there is.
- the end tool rotates in the same direction intuitively as the operation direction of the operation unit. It features.
- Figure 1a is a conceptual diagram of the pitch operation of a conventional surgical instrument
- Figure 1b is a conceptual diagram of yaw operation.
- the end tool 120a in performing a pitch 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 operation unit 110a is the rotation center 111a of the operation unit. In the state formed at the rear side, the end tool 120a is also rotated clockwise when the operation unit 110a is rotated clockwise, and the end tool 120a is also counterclockwise when the operation unit 120a is rotated counterclockwise. It is formed to rotate. Meanwhile, referring to FIG. 1B, in performing the yaw 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 operation unit 110a is the rotation center of the operation unit.
- Figure 1c is a pitch operation conceptual diagram of another conventional surgical instrument
- Figure 1d is a yaw operation conceptual diagram.
- the end tool 120b is formed in front of the center of rotation (121b) of the end tool, 110b is formed behind the rotation center 111b of the operation unit.
- the operation unit 110b is rotated clockwise, the end tool 120b rotates counterclockwise, and the operation unit 110b rotates counterclockwise.
- the end tool 120b is then formed to rotate clockwise.
- the rotational direction in which the user rotates the operation unit 110b and the rotational direction of the end tool 120b corresponding thereto are opposite to each other.
- the end tool 120b in performing the yaw operation, is formed in front of the rotation center 121b of the end tool, and the operation unit 110b is located behind the rotation center 111b of the operation unit.
- the end tool 120b rotates in the counterclockwise direction
- the end tool 120b is formed to rotate in the clockwise direction. do.
- the surgical instrument in order to solve such a problem, the surgical instrument according to an embodiment of the present invention shown in Figures 1e and 1f forms the end tool 120c in front of the center of rotation (121c) of the end tool, 110c) is also formed in front of the rotation center 111c of the operation unit, it characterized in that the operation of the operation unit 110c and the end tool 120c intuitively coincide.
- FIGS. 1A, 1B, 1C and 1D, FIGS. 1E and 1F Surgical instrument according to an embodiment of the present invention is shown in at least one moment of the operation process is formed so that at least a portion of the control unit closer to the end tool (than their joints) relative to their joints will be.
- the surgical instrument according to an embodiment of the present invention can be said to intuitively coincide with each other because the end tool and the operation unit move with respect to the rotation center formed at the rear.
- This allows the user to intuitively and quickly perform end tool direction manipulations, which significantly reduces the possibility of mistakes.
- a detailed mechanism for enabling such a function will be described.
- FIG. 2 is a perspective view showing a surgical instrument according to a first embodiment of the present invention
- Figure 3 is an internal perspective view of the surgical instrument of Figure 2
- Figure 4 is a side view of the surgical instrument of FIG.
- the surgical instrument 100 is the operation unit 110, end tool (end tool 120), power transmission unit 130 and It includes a connector 140.
- the connection portion 140 is formed in a hollow shaft (shaft) shape, one or more wires (to be described later) can be accommodated therein, one end of the operation unit 110 is coupled, the other end end The tool 120 may be coupled to serve to connect the operation unit 110 and the end tool 120.
- the operation unit 110 is formed at one end of the connection unit 140, and provided with an interface that can be directly manipulated by a doctor, for example, a tong shape, a stick shape, a lever shape, and the like,
- the end tool 120 connected to the corresponding interface and inserted into the body of the surgical patient performs a predetermined operation to perform the surgery.
- the operation unit 110 is shown as being formed in the shape of a handle that can be rotated in the state of inserting the finger in FIG. 2, the spirit of the present invention is not limited thereto, and the end tool 120 is connected to the end tool 120. It will be possible to operate a variety of forms of operation 120).
- the end tool 120 is formed at the other end of the connecting portion 140, and is inserted into the surgical site to perform the operation required for surgery.
- a pair of jaws 121, 122 may be used to perform a grip operation as shown in FIG. 2.
- the spirit of the present invention is not limited thereto, and various devices for surgery may be used as the end tool 120.
- a configuration such as a one-armed cauterizer could be used as the end tool.
- the end tool 120 is connected by the operation unit 110 and the power transmission unit 130, by receiving the driving force of the operation unit 110 through the power transmission unit 130, the grip (grip), cutting ( Perform operations necessary for surgery such as cutting and suturing.
- the end tool 120 of the surgical instrument 100 is formed to be rotatable in at least two directions, for example, the end tool 120 is the Y axis of FIG. It may be configured to perform a pitch movement around the center and to perform a yaw movement and an actuation movement around the Z axis of FIG. 2. This will be described later in detail.
- the power transmission unit 130 connects the operation unit 110 and the end tool 120 to transmit the driving force of the operation unit 110 to the end tool 120, and includes a plurality of wires, pulleys, links, and nodes. , Gears, and the like.
- FIG. 5 is a perspective view illustrating an upper portion of an operation unit of the surgical instrument of FIG. 3
- FIG. 6 is a perspective view illustrating a lower portion of an operation unit of the surgical instrument of FIG. 3.
- the operation unit 110 of the surgical instrument 100 is a pitch operation unit for controlling the pitch (pitch) movement of the end tool (end tool 120) Actuation of the pitch operator 111, the yaw operator 112 for controlling the yaw motion of the end tool 120, and the end tool 120 (actuation) It includes an actuation operator (113) for controlling the movement.
- the user rotates the pitch driving knob 1112 in a state of holding the pitch driving knob 1112 of the pitch manipulation unit 111 with the palm of the pitch.
- the actuation movement can be performed.
- the pitch operation refers to an operation in which the end tool 120 rotates in the up and down direction with respect to the connecting portion 140, that is, the operation about the Y axis of FIG. 2.
- the end tool 120 extending from the connecting portion 140 in the extending direction of the connecting portion 140 may be rotated up and down about the Y axis with respect to the connecting portion 140.
- the yaw motion refers to an operation in which the end tool 120 rotates in the left and right directions with respect to the connecting portion 140, that is, the rotation about the Z axis of FIG. 2.
- the end tool 120 extending from the connecting portion 140 in the extending direction of the connecting portion 140 rotates from side to side about the Z axis with respect to the connecting portion 140. it means.
- the actuation (actuation) operation is to rotate about the same axis of rotation as the yaw (yaw) motion, the jaw (jaw) is retracted or opened while the two jaws (121, 122) rotate in opposite directions Means. That is, the movement of the two jaws (121, 122) formed in the end tool 120 to rotate in the opposite direction with respect to the Z axis.
- the end tool 120 controls the operation unit with respect to the connection unit 140. It is characterized in that the rotation in the same direction intuitively to the operation direction of 110).
- the end tool 120 when the pitch manipulation unit 111 of the manipulation unit 110 is rotated in one direction, the end tool 120 also intuitively rotates in the same direction as the one direction to perform the pitch movement, and the yaw control unit of the manipulation unit 110 is performed.
- the end tool 120 When the 112 is rotated in one direction, the end tool 120 also rotates in the same direction intuitively as the one direction to perform yaw motion.
- the same direction may be explained by the fact that the moving direction of the index finger of the user holding the operation unit 110 and the moving direction of the distal end of the end tool 120 form substantially the same direction.
- the same direction may not be a perfectly matched direction on the three-dimensional coordinates, for example, when the user's index finger moves to the left end of the end tool 120 also moves to the left, the user's index It will be understood that if the finger moves to the right, the degree of intuition may be maintained such that the distal end of the end tool 120 also moves to the right.
- the surgical instrument 100 is based on a plane perpendicular to the extension axis (X axis) of the connecting portion 140 Characterized in that formed in the same direction. That is, when viewed from the YZ plane of FIG. 2, the operation unit 110 extends in the + X axis direction, and at the same time, the end tool 120 also extends in the + X axis direction.
- the direction in which the end tool 120 is formed at one end of the connection part 140 and the direction in which the operation part 110 is formed at the other end of the connection part 140 are the same direction with respect to the YZ plane. It might be said.
- the operation unit 110 is formed in a direction away from the body of the user holding the tooth, that is, the direction in which the end tool 120 is formed.
- the surgical instrument 100 is such that the operation direction of the operation unit 110 and the operation direction of the end tool 120 is intuitively the same direction, this
- it is characterized in that it is formed extending in the same direction. This will be described in more detail as follows.
- the pitch operation unit 111 includes a pitch operating axis 1111 and a pitch drive knob 1112.
- the pitch driving shaft 1111 may be formed in a direction parallel to the Y axis, and the pitch driving knob 1112 is connected to the pitch driving shaft 1111 and is formed to rotate about the pitch driving shaft 1111.
- the pitch drive knob 1112 rotates about the pitch drive shaft 1111, and thus the rotational force. It is transmitted to the end tool 120 through this power transmission part 130, the operation part control member 115, and the end tool control member 123, and the end tool 120 rotates the pitch operation part 111.
- the end tool 120 when the pitch manipulation unit 111 rotates clockwise around the pitch drive shaft 1111, the end tool 120 also rotates clockwise around an axis parallel to the pitch drive shaft 1111 and vice versa.
- the operation unit 111 rotates counterclockwise around the pitch drive shaft 1111
- the end tool 120 also rotates counterclockwise around an axis parallel to the pitch drive shaft 1111.
- the yaw control part 112 and the actuation operation part 113 are formed on one end of the pitch drive knob 1112 of the pitch operation part 111. Therefore, when the pitch manipulation unit 111 rotates about the pitch drive shaft 1111, the yaw manipulation unit 112 and the actuation manipulation unit 113 also rotate together with the pitch manipulation unit 111. That is, while the pitch driving knob 1112 of the pitch manipulation unit 111 is vertically positioned with respect to the connecting portion 140 in FIG. 2, etc., the pitch driving knob of the pitch manipulation unit 111 is illustrated in FIG. 11 to be described later. The state in which 1112 rotates about the pitch drive shaft 1111 by a certain degree so that the pitch drive knob 1112 is at a predetermined angle with respect to the connecting portion 140 is illustrated.
- the coordinate system of the yaw control part 112 and the actuation operation part 113 is not fixed but it changes continuously with the rotation of the pitch operation part 111.
- FIG. That is, in FIG. 2, the yaw drive shaft 1121 of the yaw manipulator 112 is parallel to the Z axis, and the actuation drive shaft 1131 of the actuation manipulator 113 is shown to be parallel to the Y axis.
- the pitch operation part 111 rotates, the yaw drive shaft 1121 of the yaw operation part 112 will not be parallel to a Z axis. That is, the coordinate system of the yaw control part 112 and the actuation operation part 113 changed with rotation of the pitch operation part 111.
- the coordinate system of the yaw control unit 112 and the actuation operation unit 113 is the pitch drive knob 1112 with respect to the connection unit 140 as shown in FIG. 2. The description will be based on the vertical position.
- the yaw operating portion 112 includes a yaw operating axis 1121 and a yaw operating member 1122.
- the yaw drive shaft 1121 may be formed to have a predetermined angle with the XY plane in which the connecting portion 140 is formed.
- the yaw drive shaft 1121 may be formed in a direction parallel to the Z axis as shown in FIG. 3, and in this state, when the pitch manipulation unit 111 rotates, the yaw manipulation unit 112 as described above.
- the coordinate system of) can be changed relatively.
- the spirit of the present invention is not limited thereto, and by the ergonomic design, the yaw drive shaft 1121 may be formed in various directions so as to be suitable for the structure of the user's hand holding the yaw control unit 112.
- the yaw driver 1122 is formed to be rotatable about the yaw drive shaft 1121.
- the yaw driver 1122 rotates about the yaw drive shaft 1121, and the rotational force transmits power. It is transmitted to the end tool 120 through the part 130, so that the two jaws 121, 122 of the end tool 120 are in the same direction as the rotation direction of the yaw driver 1122. Rotate left and right.
- a pulley 1121a may be formed in the yaw rotating axis 1121.
- the yaw wire 130Y may be connected to the pulley 1121a, and the rotational force is transmitted to the end tool 120 through the power transmission unit 130 including the yaw wire 130Y to the end tool 120.
- Two jaws 121, 122 perform the yaw operation.
- the actuation operating unit 113 includes an actuation rotating axis 1131 and an actuation rotating member 1132.
- the actuation drive shaft 1131 may be formed to form a predetermined angle with the XZ plane on which the connecting portion 140 is formed.
- the actuation drive shaft 1131 may be formed in a direction parallel to the Y axis as shown in FIG. 2, and in this state, when the pitch operation unit 111 rotates, the actuation operation unit as described above.
- the coordinate system of 113 may vary relatively.
- the spirit of the present invention is not limited thereto, and by the ergonomic design, the actuation driving shaft 1131 may be formed in various directions so as to be suitable for the structure of the user's hand holding the actuation operating unit 113. will be.
- the actuation drive unit 1132 is formed to be rotatable about the actuation drive shaft 1131.
- the actuation drive unit 1132 rotates about the actuation drive shaft 1131, and thus The rotational force is transmitted to the end tool 120 through the power transmission unit 130, so that two jaws 121 and 122 of the end tool 120 perform an actuation operation.
- the actuation operation means an operation of opening or closing the jaws 121 and 122 while the two jaws 121 and 122 rotate in opposite directions.
- a pulley 1131a may be formed at one end of the actuation operating axis 1131.
- an actuation wire 130A may be connected to the pulley 1131a.
- the pitch drive shaft 1111 and the end tool 120 of the pitch manipulation unit 111 have the same axis ( X axis) or parallel axis. That is, the pitch driving shaft 1111 of the pitch manipulation unit 111 is formed at one end of the connection unit 140, and an end tool 120 is formed at the other end of the connection unit 140.
- the connection portion 140 is illustrated as being formed in a straight line, the spirit of the present invention is not limited thereto, and the connection portion 140 is bent to have a predetermined curvature or bent one or more times as necessary. In this case, it may be said that the pitch manipulation part 111 and the end tool 120 are formed on substantially the same or parallel axes.
- the pitch manipulation unit 111 and the end tool 120 are formed on the same axis (X-axis), the inventive concept is not limited thereto, and the pitch manipulation unit 111 may be used. And the end tool 120 may be formed on different axes from each other.
- the surgical instrument 100 in order for the surgical instrument 100 according to the first embodiment of the present invention to intuitively match joint motions (pitch motion, yaw motion) of the end tool 120 and the operation part 110,
- the end tool 120 and the operation unit 110 are formed to extend in the same direction.
- the operation unit 110c is also formed in front of the rotation center 111c of the operation unit. It was.
- the yaw control part 112 is formed in one end of the pitch operation part 111, and when the pitch operation part 111 rotates about the pitch drive shaft 1111, the yaw operation part 112 also pitch-shaft drive 1111 together.
- the center of gravity is moved around the center, but at the same time, the end tool 120 is also pitch rotated, so that the same intuition of the yaw control part 112 and the direction of the end tool 120 are the same.
- one operation part may change the "shape in which the operation part is extended toward the end tool" according to the operation of the other operation part, but this should be understood from the viewpoint of the above description, and such "operation part is extended toward the end tool". Shape "may be satisfied in at least one of various operation situations of the operation unit.
- a part of the operation unit 110 ends (rather than his joints) at any one or more moments of operation based on his joints. It may be expressed as being closer to the tool 120.
- the operation unit 110 of the surgical instrument 100 further includes an operation unit control member 115 to interlock with the pitch drive shaft 1111 of the pitch operation unit 111. Since the configuration of the operation unit control member 115 is substantially the same as the configuration of the end tool control member 123 which will be described later, other configurations of the operation unit control member 115, the end tool control member 123, and the operation unit 110 are described. The relationship with the elements will be described later.
- the power transmission unit 130 of the surgical instrument 100 includes a yaw wire 130Y, an actuation wire 130A, and a pitch wire ( 130P), Article 1 wire 130J1, Article 2 wire 130J2, and power transmission assembly 135.
- the power transmission assembly 135 may be received in the pitch drive knob 1112.
- the yaw manipulation section 112 and the actuation manipulation section 113 are formed on one end of the pitch drive knob 1112 of the pitch manipulation section 111. Therefore, when the pitch manipulation unit 111 rotates about the pitch drive shaft 1111, the yaw manipulation unit 112 and the actuation manipulation unit 113 also rotate together with the pitch manipulation unit 111.
- the yaw control unit 112 is also connected to the first jaw 121 and the second jaw 122 to connect the first jaw 121 and the second jaw 122.
- the actuation operation unit 113 is also connected to the first jaw 121 and the second jaw 122 to connect the first jaw 121 and the second jaw 122.
- the surgical instrument 100 receives the driving force from the yaw control unit 112 and the actuation operation unit 113, and the first article 121 and the second article 122 It characterized in that it comprises a power transmission assembly 135 for transmitting to each).
- the power transmission assembly 135 is connected via the yaw control unit 112 and the yaw wire 130Y, and includes a yaw pulley 135YP, a yaw drive bar 135B, and a first gear that rotate together with the yaw control unit 112. 135G1 and a fourth gear 135G4, and the yaw pulley 135YP, the yaw drive bar 135B, the first gear 135G1, and the fourth gear 135G4 rotate together.
- first jaw driver 135J1 which transmits a driving force to rotate the first jaw 121 in accordance with the rotation of the yaw manipulator 112 and the actuation manipulator 113, and the yaw manipulator 112 and the actuation manipulator.
- a second jaw driver 135J2 transmitting a driving force to rotate the second jaw 122 in accordance with the rotation of the 113.
- the actuation gear 135AG which rotates together with the actuation operation part 113, the 2nd gear 135G2 interposed between the 1st gear 135G1 and the actuation gear 135AG, and the actuation gear 135AG
- a third gear 135G3 interposed between the fourth gear 135G4.
- the first gear 135G1, the second gear 135G2, the third gear 135G3, and the fourth gear 135G4 are sequentially stacked in the Z-axis direction, and rotate about the pitch control unit central axis 1113. It can be formed to.
- the actuation gear 135AG rotates about the actuation gear central axis 135AG1 fixed in a direction perpendicular to the Z axis.
- the actuation gear 135AG is connected to the actuation wire 130A and is formed to rotate together with the pulley 1131a of the actuation operation unit 113. This will be described in more detail as follows.
- the first jaw driver 135J1 includes a first jaw drive gear 135J11, a first jaw connecting member 135J12, a first jaw drive pulley 135J13, and a first jaw drive gear central axis 135J14.
- the first set driving gear 135J11 is interposed between the third gear 135G3 and the fourth gear 135G4 in the form of a bevel gear, and according to the relative movement of the third gear 135G3 or the fourth gear 135G4. It is formed so as to rotate about the 1 set drive gear center axis 135J14, or to revolve around the pitch control part center axis 1113.
- the first set connecting member 135J12 is formed to connect the first set driving gear central shaft 135J14 and the first set driving pulley 135J13, and the first set driving gear 135J11 and the first set driving gear central shaft A 135J14, a first jaw connecting member 135J12 and a first jaw driving pulley 135J13 may be rotated together about the pitch manipulation center axis 1113.
- the first set pulley 135J13 is connected to the first set wire 130J1 and transmits the rotation of the yaw control unit 112 and the actuation operating unit 113 to the first set 121.
- the second jaw driver 135J2 includes a second jaw drive gear 135J21, a second jaw connecting member 135J22, a second jaw drive pulley 135J23, and a second jaw drive gear central axis 135J24.
- the second set driving gear 135J21 is interposed between the first gear 135G1 and the second gear 135G2 in the form of a bevel gear, and according to the relative movement of the first gear 135G1 or the second gear 135G2. It is formed so as to rotate about the 2nd drive gear center axis
- the second set connecting member 135J22 is formed to connect the second set driving gear central shaft 135J24 and the second set driving pulley 135J23, and the set second driving gear 135J21 and the set second driving gear central shaft
- the 135J24, the second jaw connecting member 135J22 and the second jaw driving pulley 135J23 together rotate about the pitch manipulation center axis 1113.
- the Article 2 drive pulley (135J23) is connected to the Article 2 wire (130J2), and transmits the rotation of the yaw control unit 112 and the actuation operation unit 113 to the second tank (122).
- This power transmission assembly 135 may be described in more detail as follows.
- the first jaw 121 and the second jaw 122 should rotate, respectively, the yaw control unit 112 and the actuation operating unit 113, respectively.
- Article 121 and Article 122 should operate differently for the operation of. That is, when the yaw control unit 112 is rotated, the first jaw 121 and the second jaw 122 should rotate in the same direction, whereas when the actuation operating unit 113 is rotated, the first jaw 121 and the first jaw 121 must be rotated.
- the two tanks 122 should rotate in opposite directions.
- first differential member a structure for determining the operation of Article 1 121 with respect to the two rotational inputs of the yaw control unit 112 and the actuation operation unit 113 is required, which is the Article 1 drive gear 135J11. ), The fourth gear 135G4 and the third gear 135G3. (Hereinafter referred to as first differential member)
- the structure that determines the operation of the second tank 122 with respect to the two rotational inputs of the yaw control unit 112 and the actuation operation unit 113 is the Article 2 drive gear (135J21), the first gear (135G1) and It consists of two gears 135G2. (Hereinafter referred to as second differential member)
- first differential member and second differential member each consist of two input gears and one output gear.
- the first differential member receives the rotation of the fourth gear 135G4 and the third gear 135G3 as an input and outputs the rotation of the first set driving gear 135J11, and the second differential member has the first gear.
- the rotation of the 135G1 and the second gear 135G2 is input, and the rotation of the second set driving gear 135J21 is the output.
- Each drive system rotates the output gear according to the rotational input of the two input gears, and when the output gear rotates, as a result, the entire jaw driver including the output gear (first jaw driver 135J1 or second jaw driver 135J2) is included. Rotates about the pitch operating portion central axis 1113 in the same direction as the one-way rotation of the input gear. Therefore, each drive system receives two inputs and can rotate the output gear without affecting the other inputs.
- the first differential member may rotate the first jaw 121 according to the rotational input of the yaw control unit 112 or the actuation operating unit 113
- the second differential member may rotate the yaw control unit 112 or the actuation operating unit.
- the second tank 122 may be rotated.
- the rotation operation of the yaw control unit 112 is configured to rotate the one input gear of the first differential member and the second differential member in the same direction, and the rotation operation of the actuation operation unit 113 is performed by the first differential member and the first differential member.
- the other input gears of the two differential members were configured to rotate in opposite directions.
- the rotation operation of the yaw control unit 112 causes the yaw drive bar 135B to be connected to the first gear 135G1 and the fourth gear 135G4, so that the rotation operation of the yaw control unit 112 is performed by the first gear 135G1.
- the fourth gear 135G4 are rotated in the same direction, and accordingly, the first jaw drive gear 135J11 and the second jaw drive gear 135J21 rotate in the same direction, and as a result, the first jaw ( 121 and the second tank 122 is configured to rotate in the same direction to perform the yaw operation.
- the rotation operation of the actuation operation unit 113 rotates the second gear 135G2 and the third gear 135G3, which are the respective input gears of the two drive systems, by the actuation gear 135AG in the opposite direction, and accordingly As the first jaw drive gear 135J11 and the second jaw drive gear 135J21 rotate in opposite directions, as a result, the first jaw 121 and the second jaw 122 rotate in opposite directions, thereby actuating operation.
- the gear is illustrated as a drive system that extracts one output from two inputs.
- the spirit of the present invention is not limited thereto, and one output can be extracted from two inputs. It will be appreciated that a variety of drive systems are applicable.
- first gear 135G1, the second gear 135G2, the third gear 135G3, and the fourth gear 135G4 are sequentially stacked along the pitch control unit central axis 1113
- the spirit of the present invention is not limited in any way, and the gears may be formed along the central axis 1113 which is separate from the pitch control unit central axis 1113.
- FIG. 7 and 8 are perspective views showing the end tool of the surgical instrument of Figure 3
- Figure 9a is a plan view showing the end tool of the surgical instrument of FIG.
- the end tool 120 of the first embodiment of the present invention includes an end tool control member 123, and the end tool control member 123 is a first set.
- Article 1 121, J11 pulley (123J11), J12 pulley (123J12), J14 pulley (123J14), Article 2 122, J21 pulley (123J21), J22 pulley (123J22), J24 pulley (123J24) ) May all be formed to rotate about the end tool pitch drive shaft 123PA.
- connection hub 141 is formed at one end of the connection unit 140 that is coupled to the end tool 120.
- J12 pulley (123J12), J13 pulley (123J13), J14 pulley (123J14), J15 pulley (123J15), J22 pulley (123J22), J23 pulley (123J23), J24 pulley (123J24), J25 pulley ( 123J25 is coupled to the connection hub 141.
- each pulley may be formed in various positions and sizes suitable for the configuration of the end tool. will be.
- the J11 pulley 123J11 and the J21 pulley 123J21 are formed to face each other, and are formed to be rotatable independently of each other about the jaw rotation shaft 123JA.
- the first jaw 121 is coupled to the J11 pulley 123J11 to rotate together with the J11 pulley 123J11
- the second jaw 122 is coupled to the J21 pulley 123J21 to J21 pulley. Can rotate with 123J21.
- yaw motion and actuation motion of the end tool 120 are performed.
- one side of the J11 pulley (123J11) and J21 pulley (123J21) may be further provided with a secondary pulley J16 pulley (123J16) and J26 pulley (123J26), such auxiliary pulleys have a secondary exit pulley (123S) It may be formed to be rotatable about the center.
- the J16 pulley 123J16 and the J26 pulley 123J26 are formed to rotate about one auxiliary exiting shaft 123S, each auxiliary pulley may be formed to be rotatable about a separate axis.
- each auxiliary pulley may be formed to be rotatable about a separate axis.
- the auxiliary pulley J16 pulley 123J16 may be disposed between the J11 pulley 123J11 and the J12 pulley 123J12 / J14 pulley 123J14.
- the auxiliary pulley J26 pulley 123J26 may be disposed between the J21 pulley 123J21 and the J22 pulley 123J22 / J24 pulley 123J24. This auxiliary pulley will be described in more detail later.
- a J12 pulley 123J12 and a J14 pulley 123J14 are disposed to face each other.
- the J12 pulley 123J12 and the J14 pulley 123J14 are formed to be rotatable independently of each other about the Y-axis direction.
- the J13 pulley 123J13 and the J15 pulley 123J15 are disposed to face each other.
- J13 pulley 123J13 and the J15 pulley 123J15 are formed to be rotatable independently of each other about the Y-axis direction.
- J12 pulley (123J12), J13 pulley (123J13), J14 pulley (123J14) and J15 pulley (123J15) are all shown to be formed to rotate around the Y-axis direction, the spirit of the present invention is Without being limited to this, the rotational axes of each pulley may be formed in various directions to suit the configuration.
- Article 1 jaw drive wire 130J1 is J13 pulley (123J13), J12 pulley (123J12), J11 pulley (123J11), J16 pulley (123J16), J14 pulley (123J14), J15 pulley (123J15) and at least part Is wound so that the first jaw driving wire 130J1 can move along the pulleys while rotating the pulleys.
- the first jaw drive wire 130J1 is pulled toward the arrow J1L in FIG. 9A
- the first jaw drive wire 130J1 is pulled by the J13 pulley 123J13, J12 pulley 123J12, and J11 pulley ( 123J11), J16 pulley (123J16), J14 pulley (123J14), J15 pulley (123J15) is rotated, where J11 pulley (123J11) is rotated in the direction of the arrow L of Figure 9a (jaw) (121) Rotate together.
- auxiliary pulleys 123J16 and 123J26 will be described in more detail.
- the auxiliary pulleys 123J16 and 123J26 contact the first wire 130J1 and the second wire 130J2 and change the arrangement paths of the first wire 130J1 and the second wire 130J2 to some extent, It may serve to enlarge the radius of rotation of each of the first tank 121 and second tank 122. That is, when the auxiliary pulley is not disposed as shown in FIG. 9B, each of the first tank 121 ′ and the second tank 122 ′ may rotate up to a right angle, but in one embodiment of the present invention, the auxiliary pulley 123J16, By further including 123J26, it is possible to obtain the effect of increasing the maximum rotation angle by ⁇ as seen in FIG. 9A. This will be described in more detail as follows.
- each of the J11 pulley 123J11 ′ and the J21 pulley may rotate only to the M line of FIG. 9B.
- the coupling portion of the Article 1 wire 130J1 'and the J11 pulley 123J11' becomes rotatable only to the tangential direction of the Article 1 wire 130J1 '.
- J11 pulley (123J11) and J26 pulley (123J16) and J26 pulley (one side of the J11 pulley (123J11) and J21 pulley (123J21) 123J26) is further arranged.
- the coupling portion of the article 1 wire 130J1 and the J11 pulley 123J11 is rotatable until it is positioned on a common internal line between the J11 pulley 123J11 and the J16 pulley 123J16.
- the engaging portion of the Article 2 wire (130J2) and J21 pulley (123J21) is rotatable until it is located on the common internal line of the J21 pulley (123J21) and J26 pulley (123J26). .
- the present invention by increasing the rotation radius of the first tank 121 and the second tank 122, it is possible to obtain the effect of widening the working range in which the normal opening and closing actuation operation can be performed.
- a J22 pulley 123J22 and a J24 pulley 123J24 are disposed to face each other.
- the J22 pulley 123J22 and the J24 pulley 123J24 are formed to be rotatable independently of each other about the Y-axis direction.
- the J23 pulley 123J23 and the J25 pulley 123J25 are disposed to face each other.
- the J23 pulley 123J23 and the J15 pulley 123J25 are formed to be rotatable independently of each other about the Y-axis direction.
- the J22 pulley 123J22, J23 pulley 123J23, J24 pulley 123J24 and J25 pulley 123J25 are all shown to be rotatable about the Y-axis direction, the spirit of the present invention is Without being limited to this, the rotational axes of each pulley may be formed in various directions to suit the configuration.
- Article 2 jaw driving wire 130J2 is J23 pulley (123J23), J22 pulley (123J22), J21 pulley (123J21), J26 pulley (123J26), J24 pulley (123J24), J25 pulley (123J25) and at least part Is wound so that a second jaw drive wire 130J2 can move along the pulleys while rotating the pulleys.
- the end tool hub 123a and the first jaw 121 and the second jaw 122 coupled thereto are end tool pitch drive shafts. It rotates counterclockwise about 123PA, and as a result, the end tool 120 rotates downward to perform the pitch movement.
- one end of the second jaw drive wire 130J2 is pulled toward the arrow J2R in FIG. 9A, while the other end of the second jaw drive wire 130J2 is pulled toward the arrow J2L in FIG. 9A.
- the end tool hub 123a and the first jaw 121 and the second jaw 122 coupled thereto rotate in a clockwise direction about the end tool pitch drive shaft 123PA, resulting in an end tool. 120 rotates upward to perform the pitch movement.
- the end tool 120 of the surgical instrument 100b of the present invention further includes a pitch pulley 123P
- the operation unit (see 110 in FIG. 11) further includes a pitch pulley (see 115P in FIG. 11).
- the power transmission unit 130 further includes a pitch wire 130P.
- the pitch pulley 123P of the end tool 120 may be fixedly coupled to the end tool hub 123a to be rotatable with the end tool hub 123a about the end tool pitch drive shaft 123PA.
- the pitch pulley 115P of the operation unit 110 may be fixedly connected to the operation unit hub 115a, and may be rotatable with the operation unit hub 115a about the pitch drive shaft 1111.
- the pitch wire 130P may serve to connect the pitch pulley 123P of the end tool 120 and the pitch pulley 115P of the operation unit 110.
- the pitch drive knob 1112 when the user rotates the pitch drive knob 1112 about the pitch drive shaft 1111 while holding the pitch drive knob 1112 of the pitch control unit 111 of the control unit 110 by hand, the pitch drive knob ( The operation unit hub 115a coupled to 1112 and the pitch pulley 115P coupled thereto rotate about the pitch drive shaft 1111, and the rotation of the pitch pulley 115P is performed by the end tool 120 through the pitch wire 130P.
- the pitch pulley 123P is transmitted to rotate the pitch pulley 123P together. As a result, the end tool 120 rotates to perform the pitch movement.
- the surgical instrument 100 is a pitch pulley 123P of the end tool 120, the pitch pulley 115P of the operation unit 110 and the pitch wire of the power transmission unit 130. 130P, the driving force of the pitch operation of the pitch operation part 111 is transmitted to the end tool 120 more completely, and operation
- FIG. 10 is a conceptual view illustrating a pitch operation of the surgical instrument of FIG. 3
- FIG. 11 is a perspective view illustrating a pitch operation of the surgical instrument of FIG. 3.
- the operation unit 110 of the surgical instrument 100 further includes an operation unit control member 115 connected to the pitch drive shaft 1111 of the pitch operation unit 111.
- the operation part control member 115 is substantially the same as the configuration of the end tool control member 123 described above, and the end tool control member 123 and the operation part control member 115 are mutually centered around the YZ plane of FIG. 3. It is arranged symmetrically. In other words, the end tool control member 123 and the operation unit control member 115 may be expressed as being mirrored about the YZ plane of FIG. 3.
- control panel control member 115 includes a J11 pulley 135J13, J12 pulley 115J12, J13 pulley 115J13, J14 pulley 115J14, and J15 pulley associated with the rotational motion of the first jaw 121.
- the first jaw driving wire 130J1 is formed at least with the J13 pulley 115J13, J12 pulley 115J12, J11 pulley 135J13, J14 pulley 115J14, J15 pulley 115J15 of the control part control member 115. A portion is wound to be in contact, and a first jaw drive wire 130J1 is formed to move along the pulleys while rotating the pulleys.
- Article 2 jaw drive wire (130J2) is at least a J23 pulley (115J23), J22 pulley (115J22), J21 pulley (135J23), J24 pulley (115J24), J25 pulley (115J25) of the control panel control member 115 A portion is wound to be in contact, and a second jaw drive wire 130J2 is formed to move along the pulleys while rotating the pulleys.
- the rotation axis of the J12 pulley 115J12, J14 pulley 115J14, J22 pulley 115J22, J24 pulley 115J24 is the pitch operating axis 1111 of the pitch operating section 111.
- the part extended from the rotation shaft of J11 pulley 135J13 and J21 pulley 135J23 becomes the pitch drive knob 1112 of the pitch operation part 111 directly.
- the pitch operation is specifically performed as follows.
- FIG. 2 shows the pitch knob (see 1112 of FIG. 2) centering on the pitch drive shaft 1111 while the user grips the pitch drive knob (see 1112 of FIG. 2) of the pitch manipulation unit 111 of the operation unit 110 by hand.
- the first jaw driving wire 130J1 is pulled toward the operation unit 110 as a whole, and is moved in the direction of arrow PJ1 of FIG.
- the second jaw driving wire 130J2 is unwound from the operation unit 110 and moved toward the end tool 120, and moves in the direction of arrow PJ2 of FIG. 10.
- the J12 pulley 123J12 and the J14 pulley 123J14 are rotated counterclockwise about the end tool pitch drive shaft 123PA as much as the first jaw driving wire 130J1 is pulled toward the operation unit 110.
- the J22 pulley 123J22 and the J24 pulley 123J24 are counterclockwise around the end tool pitch drive shaft 123PA as the second jaw drive wire 130J2 is loosened toward the end tool 120.
- the end tool hub 123a and the first jaw 121 and the second jaw 122 coupled thereto perform the pitch movement while rotating downward.
- the end tool control member 123 and the operation unit control member 115 form a mirroring structure in which symmetrically arranged with respect to the YZ plane of FIG. have.
- the pitch operation can be performed independently of the yaw operation and the actuation operation.
- the yaw motion is that the J11 pulley (135J13) and J21 pulley (135J23) of the control panel control member 115 rotates about the pitch control section central axis (1113), thereby J11 pulley (123J11) of the end tool control member 123.
- the J21 pulley 123J21 rotate about the jaw rotational axis 123JA, so that two jaws 121 and 122 rotate.
- an operation input of the operation unit 110 may be separated into a pitch, yaw and actuation action.
- the power transmission unit 130 is required.
- the rotation operation of the pitch operation unit 111 is performed by the yaw operation unit 112 and the actuation operation unit 113.
- the pitch operation of the end tool 120 is enabled regardless of the manipulation.
- the power transmission assembly 135 is provided so that the operation of the yaw operating portion 112 and the actuation operating portion 113 is converted into the operation of the two jaws of the end tool 120, so that the yaw operating portion 112 And the operation of the actuation operation unit 113 are connected to the yaw operation and the actuation operation of the end tool 120. That is, by the power transmission assembly 135, the rotation of the yaw control unit 112 causes the two jaws to rotate in the same direction, and the rotation of the actuation operating unit 113 causes the two jaws to rotate each other. Rotate in the other direction.
- the pitch operation is as follows.
- the pitch drive knob 1112 is rotated around the pitch drive shaft 1111 in a state in which the user grips the pitch drive knob 1112 of the pitch control unit 111 of the operation unit 110 by hand.
- the operation part control member 115 also rotates about the pitch drive shaft 1111.
- the first jaw driving wire 130J1 wound around the operation unit control member 115 is pulled toward the operation unit 110 as a whole and moved in the direction of arrow PJ1 in FIG. 10.
- the second jaw drive wire 130J2 wound around the operation part control member 115 is unwound from the operation part control member 115 as a whole and moves in the direction of arrow PJ2 in FIG. 10.
- the end tool control member 123 connected to the first jaw drive wire 130J1 and the second jaw drive wire 135J23 is formed in FIG. 10 about the end tool pitch drive shaft 1231.
- the pitch motion is performed while rotating in the EP direction.
- 12 and 13 are views showing yaw operation of the surgical instrument of FIG.
- the first gear 135G1 and the fourth gear 135G4 are rotated about the pitch control unit central axis 1113
- the first gear 135G1 is first moved in the direction of arrow Y with respect to the second gear 135G2.
- Rotates, and the second jaw drive gear 135J21 formed in the second jaw drive part 135J2 rotates in the C direction with respect to the second jaw drive gear central axis 135J24, and the entire second jaw drive part 135J2 is rotated. It rotates in the arrow Y direction about the pitch control part center axis 1113.
- the fourth gear 135G4 is integrally connected to the first gear 135G1, the fourth gear 135G4 also rotates in the Y direction.
- the first set driving gear 135J11 formed in the first set driving unit 135J1 is the first set.
- the entire first set driving unit 135J1 rotates in the Y direction about the pitch operating unit central axis 1113 while rotating in the B direction with respect to the drive gear central axis 135J14.
- first jaw driver 135J1 and the second jaw driver 135J2 rotate in the same direction, and the first jaw 121 connected with the first jaw driver 135J1 and the first jaw wire 130J1.
- the second jaw driver 135J2 and the second jaw 122 connected through the second jaw wire 130J2 are rotated in the same direction, so that yaw motion is performed.
- 14 and 15 are views showing the actuation operation of the surgical instrument of FIG.
- the second gear 135G2 meshed with the upper side of the actuation gear 135AG rotates in the direction J2 of FIG. 15.
- the second gear drive gear 135J21 meshed between the first gear 135G1 and the second gear 135G2 rotates in the E direction with respect to the second gear drive gear central axis 135J24 and simultaneously
- the whole 2nd drive part 135J2 rotates about arrow pitch J2 centering on the pitch control part center axis 1113.
- the third gear 135G3 meshed with the lower side of the actuation gear 135AG is rotated in the direction J1 of FIG.
- the first gear drive gear 135J11 meshed between the third gear 135G3 and the fourth gear 135G4 rotates in the F direction with respect to the first gear drive gear central axis 135J14, and the first gear
- the entire jaw driving unit 135J1 rotates in the direction of an arrow J1 about the pitch operating unit central axis 1113.
- first jaw 121 connected through the first jaw driver 135J1 and the first jaw wire 130J1 and the second jaw 122 connected through the second jaw driver 135J2 and the second jaw wire 130J2.
- a purely mechanical configuration of a surgical instrument that performs an output operation of an end tool by independent inputs of a pitch drive unit, a yaw drive unit, and an actuation drive unit without using a motor, an electronic control, or software.
- the surgical instrument 200 according to the second embodiment of the present invention is the power of the surgical instrument 200 compared to the surgical instrument (see 100 of FIG. 2) according to the first embodiment of the present invention described above
- the configuration of the delivery assembly 235 is characteristically different.
- the configuration changed compared to the first embodiment will be described in detail later.
- FIG. 16 is a perspective view showing a surgical instrument according to a second embodiment of the present invention
- Figure 17 is a plan view of the surgical instrument of Figure 16
- Figure 18 is a perspective view showing the operation of the surgical instrument of Figure 16.
- the surgical instrument 200 is the operation unit 210, the end tool (end tool 220), the power transmission unit 230 and It includes a connector 240.
- the operation unit 210 performs a yaw movement of the end tool 220 and a pitch operator 211 for controlling a pitch movement of the end tool 220.
- the pitch operation unit 211 includes a pitch drive shaft 2111 and a pitch drive knob (not shown).
- the yaw manipulator 212 includes a yaw drive shaft 2121 and a yaw driver 2122.
- the actuation operating unit 213 includes an actuation driving shaft 2131 and an actuation driving unit 2132.
- the power transmission unit 230 connects the yaw wire 230Y, the actuation wire 230A, the pitch wire (not shown), the Article 1 wire 230J1, the Article 2 wire 230J2, and the power transmission assembly 235. Include. Here, power transmission assembly 235 may be received within pitch drive knob 2112.
- the power transmission assembly 235 receives the driving force from the yaw control unit 212 and the actuation operation unit 213, and transmits the driving force to the first tank 221 and the second tank 222, respectively.
- the power transmission assembly 235 is connected to the yaw control unit 212 and the yaw wire 230Y, the yaw pulley 235YP, the first gear 235G1, the fourth gear that rotates together with the yaw control unit 212. 235G4, and the yaw pulley 235YP, the first gear 235G1, and the fourth gear 235G4 are connected to each other by the yaw driving bar 235B and rotate together.
- the first jaw driver 235J1 which transmits a driving force to rotate the first jaw 221 according to the rotation of the yaw manipulator 212 and the actuation manipulator 213, and the yaw manipulator 212 and the actuation manipulator.
- a second jaw driver 235J2 which transmits a driving force to rotate the second jaw 222 according to the rotation of the 213.
- an actuating gear 235AG that rotates together with the actuation operating portion 213, a second gear 235G2 interposed between the first gear 235G1 and the actuation gear 235AG, and an actuation gear 235AG.
- a third gear 235G3 interposed between the fourth gear 235G4.
- the first gear 235G1, the second gear 235G2, the third gear 235G3, and the fourth gear 235G4 are sequentially formed in the pitch operation part central axis 2113, and are formed in the pitch operation part central axis 2113. It may be formed to rotate about.
- the actuation gear 235AG rotates about the actuation gear center axis 235AG1 fixed in a direction perpendicular to the Z axis.
- the actuation gear 235AG is connected to the actuation wire 230A and is formed to rotate together with the pulley 2131a of the actuation operation unit 213. This will be described in more detail as follows.
- the first jaw driver 235J1 includes a first jaw drive gear 235J11, a first jaw connecting member 235J12, a first jaw drive pulley 235J13, and a first jaw drive gear central shaft 235J14.
- the first set driving gear 235J11 is interposed between the first gear 235G1 and the second gear 235G2 in the form of a bevel gear, and according to the relative movement of the first gear 235G1 or the second gear 235G2. It is formed so as to rotate about the 1 set drive gear center axis
- the first set connecting member 235J12 is formed to connect the first set driving gear central shaft 235J14 and the first set driving pulley 235J13, and the first set driving gear 235J11 and the first set driving gear central shaft 235J14, the first jaw connecting member 235J12 and the first jaw driving pulley 235J13 together rotate about the pitch manipulation center axis 2113.
- FIG. The first set driving pulley 235J13 is connected to the first set wire 230J1 to transmit rotation of the yaw control unit 212 and the actuation operating unit 213 to the first set 221.
- the first set connecting member 235J12 is formed to fit in the pitch control unit central axis 2113, is formed in the form of a bar (bar) extending in two different directions from the pitch control unit central axis 2113, of which One bar may be connected to the first jaw driving gear 235J11 and the other bar may be formed to connect to the first jaw driving pulley 235J13.
- a bar connected to the first jaw driving pulley 235J13 may be formed farther from the pitch manipulation unit central axis 2113 than the second jaw connecting member 235J22. Accordingly, the first set connecting member 235J12 and the second set connecting member 235J22 do not collide with each other.
- a bar connected to the first jaw driving pulley 235J13 is formed far from the pitch control unit central axis 2113, so that the first jaw driver 235J1 and the second jaw driver 235J2 do not interfere with each other. It can rotate freely.
- the second jaw driver 235J2 includes a second jaw drive gear 235J21, a second jaw connecting member 235J22, a second jaw drive pulley 235J23, and a second jaw drive gear central shaft 235J24.
- the second set driving gear 235J21 is interposed between the first gear 235G1 and the second gear 235G2 in the form of a bevel gear, and according to the relative movement of the third gear 235G3 or the fourth gear 235G4. It is formed so as to rotate about the 2nd drive gear center axis
- the Article 2 connecting member 235J22 is formed to connect the Article 2 drive gear central shaft 235J24 and the Article 2 drive pulley 235J23, and the Article 2 drive gear 235J21 and Article 2 drive gear central shaft 235J24, the second jaw connecting member 235J22 and the second jaw driving pulley 235J23 together to rotate about the pitch control center axis 2113.
- the second set driving pulley 235J23 is connected to the second set wire 230J2 to transmit rotation of the yaw control unit 212 and the actuation operating unit 213 to the second set 222.
- the present invention is applicable to surgical instruments that are manually operable for use in laparoscopic surgery or various other surgeries.
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Abstract
Description
Claims (30)
- 각각 회전가능하도록 형성되는 제1 조(jaw) 및 제2 조(jaw)를 포함하는 엔드 툴(end tool);상기 엔드 툴의 피치(pitch) 운동을 제어하는 피치 조작부(pitch operator)와, 상기 엔드 툴의 요(yaw) 운동을 제어하는 요 조작부(yaw operator)와, 상기 엔드 툴의 액츄에이션(actuation) 운동을 제어하는 액츄에이션 조작부(actuation operator)를 포함하는 조작부;상기 제1 조와 연결되어 상기 조작부의 동작을 상기 제1 조에 전달하는 제1 조 와이어, 상기 제2 조와 연결되어 상기 조작부의 동작을 상기 제2 조에 전달하는 제2 조 와이어, 상기 요 조작부 또는 상기 액츄에이션 조작부의 회전을 상기 제1 조 와이어 또는 상기 제2 조 와이어를 통해 상기 제1 조 또는 상기 제2 조로 전달하는 하나 이상의 차동 부재를 포함하는 동력 전달부; 및제1 방향(X축)으로 연장 형성되며, 일 단부에는 상기 엔드 툴이 결합되고, 타 단부에는 상기 조작부가 결합되어, 상기 조작부와 상기 엔드 툴을 연결하는 연결부;를 포함하고,상기 피치 조작부는 상기 제1 방향에 대해 수직인 제2 방향(Y축)을 중심으로 회전 가능하도록 형성되고,적어도 상기 조작부의 어느 한 동작 상태에서 상기 조작부의 적어도 일부가, 자신의 회전축보다 상기 엔드 툴에 가깝도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 1 항에 있어서,상기 조작부가 피치 조작을 위해 상기 제2 방향(Y축)을 중심으로 소정 각도 회전된 하나 이상의 동작 상태에서, 상기 조작부의 적어도 일부가 자신의 회전축보다 상기 엔드 툴에 가깝도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 1 항에 있어서,상기 요 조작부 또는 상기 액츄에이션 조작부는 상기 피치 조작부의 일 단부에 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 3 항에 있어서,상기 피치 조작부의 회전에 따라 상기 요 조작부 또는 상기 액츄에이션 조작부는 상기 피치 조작부와 함께 회전하는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 1 항에 있어서,상기 차동 부재는,상기 요 조작부에 연결된 제1 입력부 및 상기 액츄에이션 조작부에 연결된 제2 입력부와, 상기 제1 입력부 및 제2 입력부에 연결된 하나의 출력부로 구성된 제1 차동 부재; 및상기 요 조작부에 연결된 제1 입력부 및 상기 액츄에이션 조작부에 연결된 제2 입력부와, 상기 제1 입력부 및 제2 입력부에 연결된 하나의 출력부로 구성된 제2 차동 부재;를 포함하고,상기 요 조작부는 상기 제1 차동 부재의 제1 입력부 및 상기 제2 차동 부재의 제1 입력부에 연결되며,상기 요 조작부의 동작은, 상기 제1 차동 부재의 제1 입력부 및 이와 연결된 상기 제1 차동 부재의 출력부와, 상기 제2 차동 부재의 제1 입력부 및 이와 연결된 상기 제2 차동 부재의 출력부를 동일한 방향으로 회전시키도록 형성되고,상기 액츄에이션 조작부는 상기 제1 차동 부재의 제2 입력부 및 상기 제2 차동 부재의 제2 입력부에 연결되며,상기 액츄에이션 조작부의 동작은, 상기 제1 차동 부재의 제2 입력부 및 이와 연결된 상기 제1 차동 부재의 출력부와, 상기 제2 차동 부재의 제2 입력부 및 이와 연결된 상기 제2 차동 부재의 출력부를 서로 반대 방향으로 회전시키도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 5 항에 있어서,상기 제1 차동 부재의 출력부는 상기 제1 조와 연결되고,상기 제2 차동 부재의 출력부는 상기 제2 조와 연결되어,상기 요 조작부 또는 상기 액츄에이션 조작부의 동작에 따라 상기 제1 조 또는 상기 제2 조가 움직이도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 5 항에 있어서,상기 동력 전달부는,차동 부재 중심축을 따라 차례로 형성되는 제1 기어, 제2 기어, 제3 기어 및 제4 기어와,상기 제2 기어와 상기 제3 기어와 각각 맞물리도록 형성되며, 상기 액츄에이션 조작부의 회전에 따라 액츄에이션 기어 중심축을 중심으로 회전 가능하도록 형성되는 액츄에이션 기어를 포함하는, 수술용 인스트루먼트.
- 제 7 항에 있어서,상기 제1 기어와 상기 제4 기어는 상기 요 조작부의 회전에 따라 동일한 방향으로 회전 가능하도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 7 항에 있어서,상기 액츄에이션 기어가 상기 액츄에이션 기어 중심축을 중심으로 회전하면, 상기 제2 기어와 상기 제3 기어는 서로 반대 방향으로 회전하는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 7 항에 있어서,제1 조 구동부는,상기 제3 기어 및 상기 제4 기어와 각각 맞물리도록 형성되며 제1 조 구동 기어 중심축을 중심으로 회전 가능하도록 형성되는 제1 조 구동 기어;상기 제1 와이어와 연결되어 상기 제1 와이어와 함께 회전하도록 형성되는 제1 조 구동 풀리; 및상기 제1 조 구동 기어와 상기 제1 조 구동 풀리를 연결하는 제1 조 연결부재;를 포함하고,제2 조 구동부는,상기 제1 기어 및 상기 제2 기어와 각각 맞물리도록 형성되며 제2 조 구동 기어 중심축을 중심으로 회전 가능하도록 형성되는 제2 조 구동 기어;상기 제2 와이어와 연결되어 상기 제2 와이어와 함께 회전하도록 형성되는 제2 조 구동 풀리; 및상기 제2 조 구동 기어와 상기 제2 조 구동 풀리를 연결하는 제2 조 연결부재;를 포함하는 수술용 인스트루먼트.
- 제 10 항에 있어서,상기 제1 조 구동 기어는 베벨 기어 형태로 상기 제3 기어와 상기 제4 기어 사이에 개재되어, 상기 제3 기어 또는 상기 제4 기어의 상대적인 움직임에 따라 상기 제1 조 구동 기어 중심축을 중심으로 자전하거나, 또는 상기 차동 부재 중심축을 중심으로 공전하도록 형성되고,상기 제2 조 구동 기어는 베벨 기어 형태로 상기 제1 기어와 상기 제2 기어 사이에 개재되어, 상기 제1 기어 또는 상기 제2 기어의 상대적인 움직임에 따라 상기 제2 조 구동 기어 중심축을 중심으로 자전하거나, 또는 상기 차동 부재 중심축을 중심으로 공전하도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 11 항에 있어서,상기 요 조작부가 회전하면 상기 제1 조 구동부와 상기 제2 조 구동부는 서로 동일한 방향으로 회전하고,상기 액츄에이션 조작부가 회전하면 상기 제1 조 구동부와 상기 제2 조 구동부는 서로 반대 방향으로 회전하는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 10 항에 있어서,상기 제1 조 연결부재는 상기 차동 부재 중심축에 끼워지도록 형성되며, 상기 차동 부재 중심축으로부터 서로 다른 두 방향으로 각각 연장되는 바(bar) 형태로 형성되고, 그 중 하나의 바(bar)는 상기 제1 조 구동 기어와 연결되고, 다른 측의 바(bar)는 상기 제1 조 구동 풀리와 연결되도록 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 제 13 항에 있어서,상기 제1 조 구동 풀리와 연결된 바(bar)는 상기 제2 조 연결부재 보다 상기 차동 부재 중심축으로부터 더 멀게 형성되는 것을 특징으로 하는 수술용 인스트루먼트.
- 서로 독립적으로 회전 가능한 제1 조(jaw) 및 제2 조(jaw);상기 제1 조와 결합하며, 엔드 툴 허브에 형성되는 제1 축을 중심으로 회전 가능하도록 형성되는 J11 풀리;상기 J11 풀리의 일 측에 형성되며, 상기 제1 축의 일 측에 형성되는 제2 축을 중심으로 회전 가능하도록 형성되는 J16 풀리;상기 J16 풀리의 일 측에 형성되고, 상기 제1 축과 소정의 각도를 이루도록 형성되며 상기 엔드 툴 허브의 일 측에 형성되는 제3 축을 중심으로 회전 가능하도록 형성되는 J12 풀리 및 J14 풀리;상기 제2 조와 결합하며, 상기 제1 축과 실질적으로 동일 또는 평행한 축을 중심으로 회전 가능하도록 형성되는 J21 풀리,상기 J21 풀리의 일 측에 형성되며, 상기 제2 축과 실질적으로 동일 또는 평행한 축을 중심으로 회전 가능하도록 형성되는 J26 풀리;상기 J26 풀리의 일 측에 형성되고, 상기 제3 축과 실질적으로 동일 또는 평행한 축을 중심으로 회전 가능하도록 형성되는 J22 풀리 및 J24 풀리;를 포함하고,제1 조 와이어는 상기 J12 풀리, J11 풀리, J16 풀리, J14 풀리와 적어도 일부가 접촉하도록 형성되고,제2 조 와이어는 상기 J22 풀리, J21 풀리, J26 풀리, J24 풀리와 적어도 일부가 접촉하도록 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 J11 풀리를 기준으로 상기 제1 조 및 제2 조의 반대쪽으로 상기 J16 풀리가 배치되고,상기 J21 풀리를 기준으로 상기 제1 조 및 제2 조의 반대쪽으로 상기 J26 풀리가 배치되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 제1 축과 상기 제2 축은 실질적으로 평행하게 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 제1 축과 상기 제3 축은 실질적으로 수직하게 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 제1 조 와이어는 상기 J11 풀리에 고정 결합되고,상기 제2 조 와이어는 상기 J21 풀리에 고정 결합되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 J16 풀리의 직경이 상기 J11 풀리의 직경보다 작고,상기 J26 풀리의 직경이 상기 J21 풀리의 직경보다 작도록 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 엔드 툴 허브의 일 측에는 상기 엔드 툴 허브에 대해 상기 제3 축을 중심으로 회전 가능한 연결부 허브가 형성되고,상기 엔드 툴 허브와 상기 연결부 허브의 공유축 상에 상기 J12 풀리, J14 풀리, J22 풀리 및 J24 풀리가 형성되는 것을 특징으로 하는 엔드 툴.
- 제 21 항에 있어서,상기 연결부 허브에는상기 제3 축과 실질적으로 평행한 축을 중심으로 회전 가능하도록 형성되는 J13 풀리 및 J15 풀리와,상기 제3 축과 실질적으로 평행한 축을 중심으로 회전 가능하도록 형성되는 J23 풀리 및 J25 풀리가 형성되는 것을 특징으로 하는 엔드 툴.
- 제 22 항에 있어서,상기 제1 조 와이어는 상기 J12 풀리와 상기 J13 풀리의 사이를 지나도록 형성되고,상기 제2 조 와이어는 상기 J22 풀리와 상기 J23 풀리의 사이를 지나도록 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 엔드 툴 허브에 결합되며, 상기 제3 축을 중심으로 회전하는 피치 풀리를 더 포함하는 엔드 툴.
- 제 15 항에 있어서,상기 엔드 툴의 요(yaw) 운동 및 액츄에이션(actuation) 운동은 상기 제1 조에 연결된 J11 풀리를 회전시키는 제1 조 와이어와, 상기 제2 조에 연결된 J21 풀리를 회전시키는 제2 조 와이어에 의해 수행되고,상기 엔드 툴의 피치(pitch) 운동은 상기 J11 풀리에 감긴 상기 제1 조 와이어의 양쪽을 당기거나 또는 상기 J21 풀리에 감긴 상기 제2 조 와이어의 양쪽을 당겨서 수행되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 제1 조 와이어 또는 상기 제2 조 와이어에 대하여, 상기 엔드 툴에 감겨 있는 와이어의 양쪽을 당기면 상기 엔드 툴의 피치(pitch) 운동이 수행되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 제1 조 와이어 또는 상기 제2 조 와이어에 대하여, 상기 엔드 툴에 감겨 있는 와이어의 일 측은 당기고 타 측은 밀면, 상기 엔드 툴의 요(yaw) 운동 또는 액츄에이션(actuation) 운동이 수행되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 J11 풀리에 감긴 상기 제1 조 와이어의 양쪽 가닥은 상기 제2 축에 대해 동일한 측에 배치되고,상기 J21 풀리에 감긴 상기 제2 조 와이어의 양쪽 가닥은 상기 제2 축에 대해 동일한 측에 배치되는 것을 특징으로 하는 엔드 툴.
- 제 15 항에 있어서,상기 J11 풀리에 감긴 상기 제1 조 와이어의 어느 한 쪽은 상기 J11 풀리와 상기 J16 풀리의 사이를 지나도록 형성되고,상기 J21 풀리에 감긴 상기 제2 조 와이어의 어느 한 쪽은 상기 J21 풀리와 상기 J26 풀리의 사이를 지나도록 형성되는 것을 특징으로 하는 엔드 툴.
- 제 15 항 내지 제 29 항 중 어느 한 항의 엔드 툴을 구비하는 수술용 인스트루먼트.
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US20070208375A1 (en) * | 2006-02-23 | 2007-09-06 | Kouji Nishizawa | Surgical device |
KR20100099818A (ko) * | 2009-03-04 | 2010-09-15 | 주식회사 아덴 | 수술기구 |
KR20110028613A (ko) * | 2011-03-03 | 2011-03-21 | 정창욱 | 최소 침습 수술 도구 |
KR20130057250A (ko) * | 2011-11-23 | 2013-05-31 | 주식회사 리브스메드 | 수술용 인스트루먼트 |
KR20130023311A (ko) * | 2013-01-28 | 2013-03-07 | 정창욱 | 굽은 샤프트를 갖는 최소 침습 수술 기구 |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
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GB2546399B (en) * | 2015-12-10 | 2021-05-26 | Cmr Surgical Ltd | Symmetrically arranged surgical instrument articulation |
GB2590881A (en) * | 2015-12-10 | 2021-07-07 | Cmr Surgical Ltd | Surgical instrument articulation |
GB2590881B (en) * | 2015-12-10 | 2022-02-16 | Cmr Surgical Ltd | Surgical instrument articulation |
CN114302682A (zh) * | 2020-08-07 | 2022-04-08 | 博洛尼亚大学阿尔玛母校研究室 | 腹腔镜手术器械 |
Also Published As
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JP7521839B2 (ja) | 2024-07-24 |
JP2021180857A (ja) | 2021-11-25 |
US20200121345A1 (en) | 2020-04-23 |
US11246615B2 (en) | 2022-02-15 |
US11712257B2 (en) | 2023-08-01 |
US20230320745A1 (en) | 2023-10-12 |
JP7254378B2 (ja) | 2023-04-10 |
JP2018149299A (ja) | 2018-09-27 |
US12082836B2 (en) | 2024-09-10 |
KR20150123056A (ko) | 2015-11-03 |
US20220104842A1 (en) | 2022-04-07 |
JP2017513678A (ja) | 2017-06-01 |
JP2019030703A (ja) | 2019-02-28 |
JP6622339B2 (ja) | 2019-12-18 |
JP2020044347A (ja) | 2020-03-26 |
JP6919917B2 (ja) | 2021-08-18 |
US20170042560A1 (en) | 2017-02-16 |
JP6621895B2 (ja) | 2019-12-18 |
JP2024124501A (ja) | 2024-09-12 |
KR101584766B1 (ko) | 2016-01-12 |
US10631886B2 (en) | 2020-04-28 |
JP2023076527A (ja) | 2023-06-01 |
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