WO2025178368A1 - Suturing device for endoscopic surgery - Google Patents

Abstract

A suturing device for endoscopic surgery is provided. A suturing device for endoscopic surgery, according to an aspect of the present invention, comprises: a needle to which a medical thread is attached; a first jaw including a first jaw extension part that extends in one direction and has a first space formed therein as an empty space, and a first jaw distal end in which is formed a first needle insertion hole into which the needle is inserted in a direction inclined at a predetermined angle with respect to the one direction; a first jaw connector having a first jaw coupling end coupled to the first jaw extension part at one end and including a first plate connected to the first jaw coupling end; a first locker including a first locker body reciprocally movable along the one direction within the first space, and a first blade extending from the first locker body along the one direction; a jaw base on which the first jaw connector is mounted; a first jaw fixing sheath that has one end fixed to the first jaw coupling end and is formed as a hollow structure; and a first jaw moving tendon penetrating the hollow inside of the first jaw fixing sheath and having one end protruding from the first jaw fixing sheath to be fixed to the first locker body, wherein the needle has a first needle groove in which part of the needle is recessed in a direction perpendicular to the extension direction of the needle, and as the first locker reciprocates within the first space, the first blade can intersect with the first needle groove in the first needle insertion hole.

Description

Endoscopic surgical suture device

The present invention relates to a suture device for endoscopic surgery, and more particularly, to an endoscopic suture device that can operate using a tendon sheath.

Endoscopic surgery or procedures are becoming increasingly popular with the advancement of minimally invasive medical technology, and accordingly, the demand for small endoscopic surgical suture devices that can be mounted and operated on the tip of an endoscope is increasing.

Typically, surgical suture devices repeatedly penetrate the incision site with a needle element combined with medical thread to apply pressure and close the wound. However, conventional devices required complex linkage structures or power transmission systems to reciprocate these needle elements. This made the devices heavy and bulky, making them difficult to use in confined spaces such as endoscopic insertion paths.

Meanwhile, the development of cable-driven systems, which secure actuators externally and transmit power via flexible cables, suggests the potential for miniaturization and weight reduction in endoscopic surgical devices. Among these, the tendon-sheath system encases a thin, long tendon within a sheath, transmitting power through the tensile force exerted by the tendon.

This tendon-sheath design allows for power transmission in confined spaces. However, if the tendon is very thin and long, buckling can easily occur when compressive forces other than tensile forces are applied. Furthermore, relying on a single tendon can limit the durability and stability of the tendon, and there are concerns that its performance may deteriorate under load or repeated motion.

Therefore, a new technology has been required to overcome these limitations of the tendon-sheath method and to stably reciprocate the needle member at the tip of the endoscope.

The present invention is intended to solve the above problems, and an object of the present invention is to provide an endoscopic surgical suture device using a tendon sheath.

Another object of the present invention is to provide an endoscopic surgical suture device that can be equipped on the tip of an endoscope to suture a target point inside the body.

Another object of the present invention is to provide a tendon-sheath-based endoscopic surgical suture device capable of preventing tendon buckling and transmitting stable power.

The tasks of the present invention are not limited to the tasks mentioned above, and other tasks not mentioned will be clearly understood by those skilled in the art to which the present invention pertains from the description below.

According to one aspect of the present invention, there is provided a needle to which a medical thread is coupled; a first jaw including a first jaw extension portion extending in one direction and having a first space formed as an empty space inside, and a first jaw distal portion having a first needle insertion hole formed in a direction inclined at a predetermined angle with respect to the one direction; a first jaw connector including a first jaw coupling end provided at one end thereof to be coupled with the first jaw extension portion and a first plate connected to the first jaw coupling end; a first locker including a first locker body reciprocally movable in the one direction within the first space, and a first blade extending from the first locker body in the one direction; a jaw base on which the first jaw connector is mounted; a first jaw fixing sheath formed in a hollow shape and having one end fixed to the first jaw coupling end; And a first jaw moving tendon penetrating the hollow interior of the first jaw fixing sheath and having one end protruding from the first jaw fixing sheath and fixed to the first locker body; wherein the needle has a first needle groove in which a portion of the needle is sunken in a direction inclined at a predetermined angle with respect to the extension direction of the needle, and an endoscopic surgical suture device is provided, wherein the first blade can pass through the first needle groove within the first needle insertion hole as the first locker reciprocates within the first space.

At this time, an endoscopic surgical suture device may be provided, further comprising: a first jaw moving sheath formed in a hollow shape, one end of which is fixed to the first locker body; a first jaw fixing tendon penetrating the hollow interior of the first jaw moving sheath and having one end protruded from the first jaw moving sheath and fixed to the first jaw;

At this time, an endoscopic surgical suture device may be provided, further comprising: a first sheath holder for fixing the other end of the first jaw fixing sheath; a first tendon driver connected to the other end of the first jaw moving tendon; a first tendon holder for fixing the other end of the first jaw fixing tendon; and a first sheath driver connected to the other end of the first jaw moving sheath, wherein the first tendon driver moves the first jaw moving tendon relative to the first jaw fixing sheath, and the first sheath driver moves the first jaw moving sheath relative to the first jaw fixing tendon.

At this time, an endoscopic surgical suture device may be provided in which the first jaw includes a first locking hole penetrating the first jaw along the extension direction of the first blade, and the first blade reciprocates within the first locking hole according to the reciprocating movement of the first locker, wherein the first locking hole intersects the first needle insertion hole.

At this time, an endoscopic surgical suture device may be provided in which the first locking hole is formed to intersect with the lower portion of the first needle insertion hole, and the intersection of the first locking hole and the first needle insertion hole is formed in a shape corresponding to the shape of the first needle groove at a position corresponding to the position of the first needle groove.

At this time, a second jaw including a second jaw extension portion having a second space formed as an empty space inside and extending in one direction, and a second jaw end portion having a second needle insertion hole formed in a direction inclined at a predetermined angle with respect to the one direction; a second jaw connector having a second jaw coupling end provided at one end thereof to be coupled to the second jaw extension portion, and including a second plate connected to the second jaw coupling end, and mounted on the jaw base; a second locker including a second locker body reciprocally movable in the one direction within the second space, and a second blade extending from the second locker body along the one direction; a second jaw fixing sheath having one end fixed to the second jaw coupling end and formed in a hollow shape; And a second jaw moving tendon penetrating the hollow interior of the second jaw fixing sheath and having one end protruding from the second jaw fixing sheath and fixed to the second locker body; wherein the needle is provided with a second needle groove in which a portion of the needle is sunken in a direction inclined at a predetermined angle with respect to the extension direction of the needle, and as the second locker reciprocates within the second space, an endoscopic surgical suture device can be provided in which the second blade is capable of inserting the second needle groove within the second needle insertion hole.

At this time, an endoscopic surgical suture device may be provided, further comprising a first shaft formed in a bar shape; wherein the first jaw connector includes a first rotation hole penetrating the first plate in a direction perpendicular to the first plate, the second jaw connector includes a second rotation hole penetrating the second plate in a direction perpendicular to the second plate, and the first rotation hole and the second rotation hole are passed through the first shaft together, so that the first jaw connector and the second jaw connector are capable of rotating in directions opposite to each other at a predetermined angle with respect to the first shaft as the center.

At this time, an endoscopic surgical suture device may be provided, further comprising: a second jaw moving sheath formed in a hollow shape, one end of which is fixed to the second locker body; a second jaw fixing tendon penetrating the hollow interior of the second jaw moving sheath and having one end protruded from the second jaw moving sheath and fixed to the second jaw;

At this time, an endoscopic surgical suture device may be provided, further comprising: a second sheath holder for fixing the other end of the second jaw fixing sheath; a second tendon driver connected to the other end of the second jaw moving tendon; a second tendon holder for fixing the other end of the second jaw fixing tendon; and a second sheath driver connected to the other end of the second jaw moving sheath, wherein the second tendon driver moves the second jaw moving tendon relative to the second jaw fixing sheath, and the second sheath driver moves the second jaw moving sheath relative to the second jaw fixing tendon.

At this time, an endoscopic surgical suture device may be provided in which the second jaw includes a second locking hole penetrating the second jaw along the extension direction of the second blade, and the second blade reciprocates within the second locking hole according to the reciprocating movement of the second locker, and the second locking hole intersects the second needle insertion hole.

At this time, an endoscopic surgical suture device may be provided in which the second locking hole is formed to intersect with the lower portion of the second needle insertion hole, and the intersection of the second locking hole and the second needle insertion hole is formed in a shape corresponding to the shape of the second needle groove at a position corresponding to the position of the second needle groove.

At this time, an endoscopic surgical suture device may be provided, including: a roll connector having a cylindrical inner surface, on which the jaw base is mounted on one side; a center cylinder having a cylindrical outer surface, wherein the outer surface is in contact with the inner surface of the roll connector; a first rolling sheath having one end fixed to the roll connector and formed in a hollow shape; and a second rolling sheath; a first rolling tendon penetrating the first rolling sheath and the hollow interior, and having one end penetrating the interior of the roll connector and in contact with the center cylinder; and a second rolling tendon penetrating the second rolling sheath and the hollow interior, and having one end penetrating the interior of the roll connector and in contact with the center cylinder.

At this time, an endoscopic surgical suture device may be provided, wherein the center cylinder includes a first fixing portion to which one end of the first rolling tendon is fixed, and a second fixing portion to which one end of the second rolling tendon is fixed.

At this time, an endoscopic surgical suture device may be provided in which the center cylinder further includes a stopper formed such that a longitudinal end of the center cylinder protrudes radially outward along the circumference of the center cylinder, and a radius of a circumference formed by an end of the stopper is formed to be larger than an inner circumference of the roll connector.

At this time, an endoscopic surgical suture device may be provided in which the first fixing part and the second fixing part are positioned on the stopper.

At this time, an endoscopic surgical suture device may be provided in which the first fixing part and the second fixing part are formed in a hole shape penetrating the stopper along the longitudinal direction of the center cylinder, and one end of the first rolling tendon is fixed to the hole formed by the first fixing part, and one end of the second rolling tendon is fixed to the hole formed by the second fixing part.

At this time, an endoscopic surgical suture device may be provided in which one end of the first rolling tendon passes through a hole formed by the first fixing portion, one end of the second rolling tendon passes through a hole formed by the second fixing portion, and one end of the first rolling tendon and one end of the second rolling tendon are connected to each other, so that the first rolling tendon and the second rolling tendon are formed as one tendon.

At this time, the center cylinder includes a rolling groove on the outer surface thereof along the circumferential direction of the rotational axis of the center cylinder, in which one end of the first rolling tendon and one end of the second rolling tendon are in contact, and one end of the first rolling sheath and one end of the second rolling sheath extend in a direction parallel to the rotational axis of the center cylinder, and the first rolling tendon extends into the rolling groove by penetrating one end of the first rolling sheath in a direction parallel to the rotational axis of the center cylinder, and the second rolling tendon extends into the rolling groove by penetrating one end of the second rolling sheath in the longitudinal direction of the center cylinder, and the roll connector has a first curved surface that guides the first rolling tendon along the bending direction of the first rolling tendon, and a second curved surface that guides the second rolling tendon along the bending direction of the first rolling tendon.

At this time, an endoscopic surgical suture device may be provided, further comprising: a first rolling holder for fixing the other end of the first rolling sheath; a second rolling holder for fixing the other end of the second rolling sheath; a first rolling driver connected to the other end of the first rolling tendon; and a second rolling driver connected to the other end of the second rolling tendon, wherein the first rolling driver moves the first rolling tendon relative to the first rolling sheath, and the second rolling driver moves the second rolling tendon relative to the second rolling sheath, wherein the first rolling driver and the second rolling driver move the other end of the first rolling tendon and the other end of the second rolling tendon in opposite directions.

According to another aspect of the present invention, there is provided a first jaw extending in one direction and into which a needle is inserted laterally; a second jaw extending in one direction and into which the needle is inserted laterally; a first plate having a first sliding portion in the shape of a groove or hole extending in a direction inclined with respect to an extending direction of the first jaw, the first jaw connector being coupled to one end of the first jaw on the extending side; a second plate having a second sliding portion in the shape of a groove or hole extending in a direction inclined with respect to an extending direction of the second jaw, the second jaw connector being coupled to one end of the second jaw on the extending side; a first shaft penetrating through the first jaw connector and the second jaw connector in a direction perpendicular to the extending directions of the first and second jaws; a jaw base on which the first shaft is disposed at one position; a bracket fixed to the jaw base; a slider on which a second shaft is formed in a protruding manner, one end and the other end of which are disposed in the first sliding portion and the second sliding portion, respectively; An endoscopic surgical suture device may be provided, comprising: a middle sheath formed in a hollow shape with one end fixed to the slider; and a middle tendon penetrating the hollow interior of the middle sheath and having one end protruding from the middle sheath and fixed to the bracket; wherein, as the middle sheath moves relative to the middle tendon, the slider moves along the extension direction of the middle tendon as one piece with the middle sheath, and the first shaft serves as a rotational center axis, and the first jaw connector and the second jaw connector rotate in opposite directions.

At this time, an endoscopic surgical suture device may be provided, further comprising: a first side sheath formed in a hollow shape, one end of which is fixed to the jaw base; a first side tendon penetrating the hollow interior of the first side sheath and having one end protruding from the first side sheath and fixed to the slider;

At this time, an endoscopic surgical suture device may be provided, further comprising: a middle tendon holder for fixing the other end of the middle tendon; a middle sheath actuator connected to the other end of the middle sheath; a first side sheath holder for fixing the other end of the first side sheath; and a first side tendon actuator connected to the other end of the first side tendon, wherein the first side tendon actuator moves the first side tendon relative to the first side sheath, and the middle sheath actuator moves the middle sheath relative to the middle tendon.

At this time, an endoscopic surgical suture device may be provided, further comprising: a second side sheath formed in a hollow shape, one end of which is fixed to the jaw base; a second side tendon penetrating the hollow interior of the second side sheath and having one end protruding from the second side sheath and fixed to the slider;

At this time, an endoscopic surgical suture device may be provided, further comprising: a middle tendon holder for fixing the other end of the middle tendon; a middle sheath driver connected to the other end of the middle sheath; a first side sheath holder for fixing the other end of the first side sheath; a first side tendon driver connected to the other end of the first side tendon; a second side sheath holder for fixing the other end of the second side sheath; and a second side tendon driver connected to the other end of the second side tendon, wherein the first side tendon driver moves the first side tendon relative to the first side sheath, the second side tendon driver moves the second side tendon relative to the second side sheath, and the middle sheath driver moves the middle sheath relative to the middle tendon.

At this time, an endoscopic surgical suture device may be provided in which the first side tendon and the second side tendon are fixed to the slider at positions symmetrical to each other with the middle sheath as the center.

At this time, the middle tendon is positioned at a position that bisects the jaw base on both sides of the extension direction, and the middle tendon is fixed to the bracket by penetrating the first shaft along the extension direction of the middle tendon, and an endoscopic surgical suture device can be provided.

At this time, an endoscopic surgical suture device may be provided, including: a roll connector having a cylindrical inner surface, on which the jaw base is mounted on one side; a center cylinder having a cylindrical outer surface, wherein the outer surface is in contact with the inner surface of the roll connector; a first rolling sheath having one end fixed to the roll connector and formed in a hollow shape; and a second rolling sheath; a first rolling tendon penetrating the first rolling sheath and the hollow interior, and having one end penetrating the interior of the roll connector and in contact with the center cylinder; and a second rolling tendon penetrating the second rolling sheath and the hollow interior, and having one end penetrating the interior of the roll connector and in contact with the center cylinder.

At this time, an endoscopic surgical suture device may be provided, wherein the center cylinder includes a first fixing portion to which one end of the first rolling tendon is fixed, and a second fixing portion to which one end of the second rolling tendon is fixed.

At this time, an endoscopic surgical suture device may be provided in which the center cylinder further includes a stopper formed such that a longitudinal end of the center cylinder protrudes radially outward along the circumference of the center cylinder, and a radius of a circumference formed by an end of the stopper is formed to be larger than an inner circumference of the roll connector.

At this time, an endoscopic surgical suture device may be provided in which the first fixing part and the second fixing part are positioned on the stopper.

At this time, an endoscopic surgical suture device may be provided in which the first fixing part and the second fixing part are formed in a hole shape penetrating the stopper along the longitudinal direction of the center cylinder, and one end of the first rolling tendon is fixed to the hole formed by the first fixing part, and one end of the second rolling tendon is fixed to the hole formed by the second fixing part.

At this time, an endoscopic surgical suture device may be provided in which one end of the first rolling tendon passes through a hole formed by the first fixing portion, one end of the second rolling tendon passes through a hole formed by the second fixing portion, and one end of the first rolling tendon and one end of the second rolling tendon are connected to each other, so that the first rolling tendon and the second rolling tendon are formed as one tendon.

At this time, the center cylinder includes a rolling groove on the outer surface thereof along the circumferential direction of the rotational axis of the center cylinder, in which one end of the first rolling tendon and one end of the second rolling tendon are in contact, and one end of the first rolling sheath and one end of the second rolling sheath extend in a direction parallel to the rotational axis of the center cylinder, and the first rolling tendon extends into the rolling groove by penetrating one end of the first rolling sheath in a direction parallel to the rotational axis of the center cylinder, and the second rolling tendon extends into the rolling groove by penetrating one end of the second rolling sheath in the longitudinal direction of the center cylinder, and the roll connector has a first curved surface that guides the first rolling tendon along the bending direction of the first rolling tendon, and a second curved surface that guides the second rolling tendon along the bending direction of the first rolling tendon.

At this time, an endoscopic surgical suture device may be provided, further comprising: a first rolling holder for fixing the other end of the first rolling sheath; a second rolling holder for fixing the other end of the second rolling sheath; a first rolling driver connected to the other end of the first rolling tendon; and a second rolling driver connected to the other end of the second rolling tendon, wherein the first rolling driver moves the first rolling tendon relative to the first rolling sheath, and the second rolling driver moves the second rolling tendon relative to the second rolling sheath, wherein the first rolling driver and the second rolling driver move the other end of the first rolling tendon and the other end of the second rolling tendon in opposite directions.

At this time, an endoscopic surgical suture device may be provided in which the jaw base includes a raised portion formed by partially raising outward, and a grasper that can move outward of the raised portion is accommodated in the raised portion.

At this time, an endoscopic surgical suture device may be provided, wherein the grasper has a spiral-shaped end extending toward the direction of movement of the grasper.

According to the above configuration, an endoscopic surgical suture device according to one aspect of the present invention can utilize a tendon sheath.

An endoscopic surgical suture device according to another aspect of the present invention may be provided at the tip of an endoscope to suture a target point inside the body.

According to another aspect of the present invention, a tendon-sheath-based endoscopic surgical suture device can prevent buckling of the tendon and transmit stable power.

The effects of the present invention are not limited to the effects described above, and should be understood to include all effects that can be inferred from the detailed description of the present invention or the composition of the invention described in the claims.

FIG. 1 is a perspective view illustrating an endoscopic suture device according to one embodiment of the present invention.

Figure 2 is an exploded perspective view illustrating an endoscopic suture device according to one embodiment of the present invention.

FIG. 3 is a diagram schematically illustrating the connection relationship of a tendon-sheath structure in an endoscopic suture device according to one embodiment of the present invention.

FIG. 4 is a diagram illustrating the operation of the tendon-sheath structure illustrated in FIG. 3 in an endoscopic suture device according to one embodiment of the present invention.

FIG. 5 is an exploded perspective view showing some components of an endoscopic suture device according to one embodiment of the present invention from different angles.

FIG. 6 is a perspective view illustrating a part of a configuration of an endoscopic suture device according to one embodiment of the present invention.

Fig. 7 is a cross-sectional view illustrating the B-B′ section shown in Fig. 6.

FIG. 8 is a cross-sectional view showing the connection relationship between the components of the endoscopic suture device and the tendon-sheath structure according to one embodiment of the present invention illustrated in FIG. 7.

FIG. 9 is a cross-sectional view showing the first locker of the endoscopic suture device according to one embodiment of the present invention advanced in the state of FIG. 7.

FIG. 10 is a cross-sectional view showing the connection relationship between the components of the endoscopic suture device and the tendon-sheath structure according to one embodiment of the present invention illustrated in FIG. 9.

FIG. 11 is a cross-sectional view showing a needle fixed by a first blade in a state where the first jaw and the second jaw of an endoscopic suturing device according to one embodiment of the present invention are spaced apart.

FIG. 12 is a cross-sectional view showing a needle fixed by a first blade in a state where the first jaw and the second jaw of an endoscopic suturing device according to one embodiment of the present invention are close to each other.

FIG. 13 is a cross-sectional view showing the needle of the endoscopic suture device according to one embodiment of the present invention in FIG. 12 being replaced.

FIG. 14 is a cross-sectional view showing the first and second jaws of the endoscopic suture device according to one embodiment of the present invention in FIG. 13 separated from each other.

FIG. 15 is a drawing showing the connection relationship between some components of an endoscopic suture device and a tendon-sheath structure according to one embodiment of the present invention.

FIG. 16 is an enlarged cross-sectional view of some components of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 15.

FIG. 17 is a drawing showing the slider of the endoscopic suture device according to one embodiment of the present invention advanced in the state of FIG. 15.

FIG. 18 is an enlarged cross-sectional view of some components of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 17.

Figure 19 is an exploded perspective view of a roll connector and a center cylinder of an endoscopic suture device according to one embodiment of the present invention.

FIG. 20 is a drawing illustrating some components including a roll connector and a center cylinder of an endoscopic suturing device according to one embodiment of the present invention.

FIG. 21 is a drawing showing a roll connector of an endoscopic suturing device according to one embodiment of the present invention rotated about a center cylinder.

Figure 22 is a side view of an endoscopic suturing device according to one embodiment of the present invention.

FIG. 23 is a side view illustrating a roll connector of an endoscopic suturing device according to one embodiment of the present invention rotated about a center cylinder.

FIG. 24 is a top view of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 22.

FIG. 25 is a top view of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 23.

FIG. 26 is a drawing illustrating a manipulator according to one embodiment of the present invention.

FIG. 27 is a drawing illustrating a manipulator according to another embodiment of the present invention.

Fig. 28 is a drawing showing the internal configuration of a manipulator according to one embodiment of the present invention.

FIG. 29 is a drawing illustrating a process of assisting suturing using an endoscopic suturing device and a grasper according to one embodiment of the present invention.

FIG. 30 is a drawing illustrating a needle positioned at a stitch point using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 31 is a drawing illustrating a first stitch performed using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 32 is a drawing illustrating an endoscopic suturing device according to one embodiment of the present invention, wherein a needle is exchanged and moved to a second stitch point.

FIG. 33 is a drawing illustrating positioning a needle to perform a second stitch using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 34 is a drawing illustrating a second stitch performed using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 35 is a drawing illustrating a third stitch performed using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 36 is a drawing illustrating a fourth stitch performed using an endoscopic suturing device according to one embodiment of the present invention.

FIG. 37 is a drawing illustrating an endoscopic suture device according to one embodiment of the present invention being retracted to perform approximation.

FIG. 38 is a drawing illustrating stitching one edge of a mucosal defect using an endoscopic suture device according to one embodiment of the present invention.

FIG. 39 is a drawing illustrating stitching the opposite edge of a mucosal defect using an endoscopic suture device according to one embodiment of the present invention.

FIG. 40 is a drawing illustrating an endoscopic suture device according to one embodiment of the present invention being retracted to perform approximation of a mucosal defect.

FIG. 41 is a drawing illustrating stitching of one edge of a mucosal defect larger than the mucosal defect illustrated in FIG. 38 using an endoscopic suture device according to one embodiment of the present invention.

FIG. 42 is a drawing illustrating stitching of the opposite edge of the mucosal defect illustrated in FIG. 41 using an endoscopic suture device according to one embodiment of the present invention.

FIG. 43 is a drawing illustrating an endoscopic suture device according to one embodiment of the present invention being retracted to perform approximation to the mucosal defect illustrated in FIG. 42.

FIG. 44 is a drawing illustrating a process of performing U-shaped stitching by rotating an endoscopic suture device according to one embodiment of the present invention.

FIG. 45 is a drawing illustrating a process of performing stitching in a path similar to the path illustrated in FIG. 44 without rotating the endoscopic suture device according to one embodiment of the present invention.

Hereinafter, with reference to the attached drawings, embodiments of the present invention will be described in detail so that those skilled in the art can easily practice the present invention. The present invention may be implemented in various different forms and is not limited to the embodiments described herein. In the drawings, parts irrelevant to the description have been omitted for clarity of description, and the same reference numerals designate identical or similar components throughout the specification.

The words and terms used in this specification and claims should not be construed as limited to their ordinary or dictionary meanings, but should be interpreted in a way that is consistent with the technical idea of the present invention, in accordance with the principles by which the inventor can define terms and concepts in order to best explain his or her invention.

In this specification, terms such as “include” or “have” are intended to describe the presence of a feature, number, step, operation, component, part or combination thereof described in the specification, but should be understood not to exclude in advance the possibility of the presence or addition of one or more other features, numbers, steps, operations, components, parts or combinations thereof.

In order to clearly express the characteristics of the composition in the drawing, the thickness and size are exaggerated, and the thickness and size of the composition shown in the drawing are not necessarily the same as in reality.

In the following description of the drawings, each direction is defined based on the coordinate axes illustrated in Fig. 1. More specifically, the positive direction of the z-axis is defined as upward, and the negative direction of the z-axis is defined as downward. The positive direction of the y-axis is defined as forward, and the negative direction of the y-axis is defined as backward. The positive direction of the x-axis is defined as left, and the negative direction of the x-axis is defined as right.

In the following description, descriptions of some components may be omitted to clarify the features of the present invention.

Fig. 1 is a perspective view illustrating an endoscopic suture device according to one embodiment of the present invention. Fig. 2 is an exploded perspective view illustrating an endoscopic suture device according to one embodiment of the present invention.

An endoscopic surgical suture device (1) according to one embodiment of the present invention is a device provided at the distal end of an endoscope, and used to suture a portion of the body to be sutured using a tendon sheath. In this case, the portion to be sutured may be, for example, a portion incised during a surgical procedure or a portion torn or penetrated due to trauma or the like.

In the present disclosure, a tendon refers to a thin linear member having flexibility and a predetermined tensile rigidity, and a sheath refers to a tubular member having flexibility and a predetermined compressive rigidity and having a hole through which a tendon can pass. In this case, the tendon may be formed in various structures, such as a plurality of wires twisted or combined to form a single tendon.

An endoscopic surgical suture device (1) according to one embodiment of the present invention may include a first jaw (110) and a second jaw (210) into which a needle (800) is inserted to suture a portion to be sutured using the needle (800).

At this time, the first jaw (110) can be connected to the first jaw connector (130), the second jaw (210) can be connected to the second jaw connector (230), and the first jaw connector (130) and the second jaw connector (230) can be coupled to the jaw base (300).

At this time, the first jaw (110) has a first locker (120) accommodated therein and can be connected to the first jaw connector (130), and the second jaw (210) has a second locker (220) accommodated therein and can be connected to the second jaw connector (230).

The first locker (120) and the second locker (220) are powered by a tendon-sheath structure to control whether the needle (800) is fixed to the first jaw (110) and the second jaw (210) within the first jaw (110) and the second jaw (210).

In addition, an endoscopic surgical suture device (1) according to one embodiment of the present invention may include a roll connector (610) on which a jaw base (300) is mounted, and a center cylinder (620) whose outer surface is in contact with the inner surface of the roll connector (610).

Accordingly, a roll function can be implemented in which the roll connector (610) and the jaw base (300) rotate as one unit around the center cylinder (620).

In addition, the jaw base (300) may include a raised portion (310) formed by the jaw base (300) being raised upward based on Fig. 1. An auxiliary device such as a grasper or forceps may be inserted into the raised portion (310) to assist the suturing operation of the endoscopic surgical suturing device (1).

FIG. 3 is a diagram illustrating the connection relationship of a tendon-sheath structure in an endoscopic suture device according to one embodiment of the present invention. FIG. 4 is a diagram illustrating the operation of the tendon-sheath structure illustrated in FIG. 3 in an endoscopic suture device according to one embodiment of the present invention.

As illustrated in FIGS. 3 and 4, an endoscopic surgical suture device (1) according to one embodiment of the present invention can be driven by a plurality of tendon-sheath structures.

The tendon-sheath structure of the endoscopic surgical suture device (1) according to one embodiment of the present invention can drive specific components by pairing two or three pairs of multiple tendon-sheath structures to prevent buckling and efficiently transmit power.

At this time, the multi-tendon-sheath structure of the endoscopic surgical suture device (1) according to one embodiment of the present invention may be configured such that a tendon-sheath structure in which the tendon moves while the sheath is fixed and a tendon-sheath structure in which the sheath moves while the tendon is fixed are paired.

Accordingly, the middle sheath (410), the first moving sheath (450), and the second moving sheath (470) illustrated in FIGS. 3 and 4 can have one end connected to the middle sheath drive unit (414), the first sheath drive unit (454), and the second sheath drive unit (474), respectively.

At this time, the middle tendon (510), the first fixed tendon (550) and the second fixed tendon (570), which are paired with the middle sheath (410), the first moving sheath (450) and the second moving sheath (470), respectively, can have one end fixed to the middle tendon holder (514), the first tendon holder (554) and the second tendon holder (574), respectively.

Additionally, the other ends of the middle tendon (510), the first fixed tendon (550) and the second fixed tendon (570) can be fixed to fixed positions of the bracket (730), the first jaw (110) and the second jaw (210), respectively.

Accordingly, the middle sheath (410), the first moving sheath (450), and the second moving sheath (470) of the endoscopic surgical suture device (1) according to one embodiment of the present invention can be guided to move along the extension direction of the middle tendon (510), the first fixed tendon (550), and the second fixed tendon (570) with both ends fixed.

At this time, the first side sheath (420) - first side tendon (520) structure and the second side sheath (430) - second side tendon (530) structure can be paired with the middle sheath (410) - middle tendon (510) structure.

Unlike the middle sheath (410), one end of the first side sheath (420) can be fixed to the first side sheath holder (424), and the remaining end of the first side sheath (420) can be fixed to the jaw base (300).

Accordingly, the first side sheath (420) can be a fixed sheath with both ends fixed.

Additionally, the first side tendon (520) paired with the first side sheath (420) may have one end connected to the first side tendon drive (524).

Accordingly, the first side tendon (520) can be guided to move along the extension direction of the first side sheath (420) to which both ends are fixed.

Likewise, unlike the middle sheath (410), one end of the second side sheath (430) may be fixed to the second side sheath holder (434), and the remaining end of the second side sheath (430) may be fixed to the jaw base (300).

Accordingly, the second side sheath (430) can be a fixed sheath with both ends fixed.

Additionally, a second side tendon (530) paired with a second side sheath (430) may have one end connected to a second side tendon drive unit (534).

Accordingly, the second side tendon (530) can be guided to move along the extension direction of the second side sheath (430) to which both ends are fixed.

In this way, the endoscopic surgical suture device (1) according to one embodiment of the present invention may be configured as a structure in which a middle sheath (410) - middle tendon (510) structure, a first side sheath (420) - first side tendon (520) structure, and a second side sheath (430) - second side tendon (530) structure, in which the fixation and movement of the sheath and tendon are different from each other, are paired.

Similarly, unlike the first movable sheath (450), one end of the first fixed sheath (440) may be fixed to the first sheath holder (444), and the other end of the first fixed sheath (440) may be fixed to the mating end (134) of the first jaw connector (130).

Accordingly, the first fixed sheath (440) can be a fixed sheath with both ends fixed.

*In addition, the first moving tendon (540) paired with the first fixed sheath (440) may have one end connected to the first tendon drive unit (544).

Accordingly, the first moving tendon (540) can be guided to move along the extension direction of the first fixed sheath (440) with both ends fixed.

Accordingly, the endoscopic surgical suture device (1) according to one embodiment of the present invention may be configured as a structure in which a first movable sheath (450) - first fixed tendon (550) structure and a first fixed sheath (440) - first movable tendon (540) structure, in which the fixation and movement of the sheath and tendon are different from each other, are paired.

Likewise, unlike the second movable sheath (470), one end of the second fixed sheath (460) may be fixed to the second sheath holder (464), and the other end of the second fixed sheath (460) may be fixed to the mating end (234) of the second jaw connector (230).

Accordingly, the second fixed sheath (460) can be a fixed sheath with both ends fixed.

Additionally, a second moving tendon (560) paired with a second fixed sheath (460) may have one end connected to a second tendon drive unit (564).

Accordingly, the second moving tendon (560) can be guided to move along the extension direction of the second fixed sheath (460) with both ends fixed.

Accordingly, the endoscopic surgical suture device (1) according to one embodiment of the present invention may be configured as a structure in which a second movable sheath (470) - second fixed tendon (570) structure and a second fixed sheath (460) - second movable tendon (560) structure, in which the fixation and movement of the sheath and tendon are different from each other, are paired.

By this structure, referring to FIGS. 3 and 4, it is possible to move the slider (710) by moving the first middle tendon (510), the first side tendon (520), and the second side tendon (530) together along the extension direction of the first middle tendon (510), the first side tendon (420), and the second side tendon (430).

Additionally, it is possible to move the first locker (120) by moving the first moving tendon (540) and the first moving sheath (450) together along the extension direction of the first fixed sheath (440) and the first fixed tendon (550).

Likewise, it is possible to move the second locker (220) by moving the second moving tendon (560) and the second moving sheath (470) together along the extension direction of the second fixed sheath (460) and the second fixed tendon (570).

The movement mechanism of other components according to the operation of the tendon-sheath structure of the structure shown in FIGS. 3 and 4 is described with different drawings.

FIG. 5 is an exploded perspective view illustrating some components of an endoscopic suture device according to an embodiment of the present invention from a different angle. FIG. 6 is a perspective view illustrating some components of an endoscopic suture device according to an embodiment of the present invention. FIG. 7 is a cross-sectional view taken along the line B-B′ illustrated in FIG. 6. FIG. 8 is a cross-sectional view illustrating the connection relationship between the components of the endoscopic suture device and the tendon-sheath structure according to an embodiment of the present invention illustrated in FIG. 7. FIG. 9 is a cross-sectional view illustrating a state in which the first locker of the endoscopic suture device according to an embodiment of the present invention is advanced in the state illustrated in FIG. 7. FIG. 10 is a cross-sectional view illustrating the connection relationship between the components of the endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 9.

Referring to FIGS. 2 and 5 to 7, the first jaw (110) of the endoscopic surgical suture device (1) according to one embodiment of the present invention can be coupled to the first jaw connector (130) while the first locker (120) is accommodated therein.

At this time, the first jaw (110), the first locker (120) and the first jaw connector (130) may be inserted into the first fixed sheath (440) and the first moving tendon (540) structures, and a part of the first moving sheath (450) and the first fixed tendon (550) structures.

More specifically, the first jaw (110) may include an extension portion (111) extending in the front-back direction and a bent portion (112) whose end is bent toward the insertion portion of the needle (800). At this time, a first fixed tendon hole (117) may be formed in the front portion of the first jaw (110) across the extension portion (111) in the front-back direction.

At this time, one end (552) of the first fixed tendon (550) can be fixed to the first fixed tendon hole (117).

Meanwhile, the first locker (120) can be formed in a shape including a first locker body (124) and a first blade (122) protruding forward from the first locker body (124).

At this time, a first moving tendon hole (123) to which one end (542) of a first moving tendon (540) is fixed can pass through the first locker body (124), and a first locker sheath hole (121) to which one end (442) of a first moving sheath (440) is fixed can pass through the first locker body (124).

At this time, in the first locker body (124) according to one embodiment of the present invention, one end (542) of the first moving tendon (540) may be fixed to the first moving tendon hole (123), but it is not necessarily limited thereto, and it is also not limited to the case where a first moving tendon groove is formed within the first locker body (124) and one end (542) of the first moving tendon is fixed to the first moving tendon groove.

Meanwhile, a first space (113) in which a first locker (120) can be accommodated can be formed inside the first jaw (110).

At this time, the inner surface of the first space (113) may be formed in a shape corresponding to the shape of the outer surface of the first locker (120). In addition, the first space (113) may be formed so that the front-to-back length of the first space (113) is longer than the front-to-back length of the first locker (120) so that the first locker (120) can move in the front-to-back direction inside the first space (113).

At this time, in the first jaw (110), a first locking hole (119) can be formed at a position corresponding to the position of the first blade (122) while the first locker (120) is accommodated in the first space (113).

The first blade (122) moves forward and backward as a unit with the first locker body (124) as the first locker (120) moves forward and backward in the first space (113), so that the first locking hole (119) can be formed to extend a predetermined distance in the forward and backward direction.

As an example, the first locking hole (119) can penetrate the first jaw (110) in the front-back direction and extend to the front end of the first jaw (110).

Meanwhile, a first needle insertion hole (115) into which a needle (800) can be inserted can be formed in the first jaw (110).

As an example, the first needle insertion hole (115) can penetrate the first jaw (110) along the insertion direction of the needle (800).

At this time, the first needle insertion hole (115) and the first locking hole (119) can be formed to intersect each other.

More specifically, referring to FIGS. 7 and 9, the first needle insertion hole (115) can penetrate the first jaw (110) in the left-right direction, and the first locking hole (119) can penetrate the first jaw (110) in the front-back direction.

At this time, the first needle insertion hole (115) is positioned relatively higher than the first locking hole (119), but a part of the lower portion of the first needle insertion hole (115) and a part of the upper portion of the first locking hole (119) may intersect each other.

Referring to FIG. 2, a needle (800) used in an endoscopic surgical suture device (1) according to one embodiment of the present invention may have a first needle groove (810) formed in which a portion is sunken in a direction perpendicular to the insertion direction.

At this time, the first needle groove (810) may be formed by, for example, a lower portion of the needle (800) being sunken upward.

At this time, the first needle groove (810) can be formed in a shape corresponding to the portion where the first locking hole (119) and the first needle insertion hole (115) intersect when the needle (800) is inserted into the first needle insertion hole (115).

Accordingly, when the first blade (122) is inserted into the intersection of the portion corresponding to the first needle groove (810), the first blade (122) can be engaged with the first needle groove (810).

At this time, in order for the needle (800) to be removed from the first needle insertion hole (115), the needle (800) must be removed to the right with respect to the first jaw (110), but the first blade (122) can restrict the left-right movement of the needle (800), thereby preventing the needle (800) from being removed from the first needle insertion hole (115).

Meanwhile, the first jaw connector (130) has a coupling end (134) formed at the front end that can be coupled to the rear end of the first jaw (110).

The coupling end (134) is coupled to the rear portion of the first jaw (110) to prevent the first locker (120) from being detached from the first space (113) to the rear.

At this time, a first fixed sheath hole (133) to which one end (442) of the first fixed sheath (440) is fixed can be formed at the coupling end (134), and a first moving sheath hole (135) penetrated by the first moving sheath (450) can be formed.

At this time, one end (442) of the first fixed sheath is fixed to the first fixed sheath hole (133), but one end (452) of the first moving sheath is not fixed to the first moving sheath hole (135).

The movement of the first jaw (110), the first locker (120), and the first jaw connector (130) having such a structure can be controlled by the tendon-sheath structure illustrated in FIGS. 8 and 10.

Referring to FIGS. 8 and 10, the other end (441) of the first fixed sheath (440) can be fixed to the first sheath holder (444). In addition, the other end (541) of the first moving tendon (540) penetrating the first fixed sheath (440) can be connected to the first tendon drive unit (544).

At this time, the first tendon drive unit (544) can apply tensile force and compressive force to the other end (541) of the first moving tendon to move the first moving tendon (540).

At this time, the first moving tendon (540) can move forward and backward along the extension direction of the first fixed sheath (440).

Meanwhile, the other end (451) of the first moving sheath (450) can be connected to the first sheath drive unit (454). In addition, the other end (551) of the first fixed tendon (550) penetrating the first moving sheath (450) can be connected to the first tendon holder (554).

At this time, the first sheath drive unit (454) can apply tensile and compressive force to the other end (451) of the first moving sheath to move the first moving sheath (450).

At this time, the first moving sheath (450) can move forward and backward along the extension direction of the first fixed tendon (550).

At this time, the first tendon drive unit (544) and the first sheath drive unit (454) can move the other end (541) of the first moving tendon and the other end (451) of the first moving sheath in the same direction.

For example, when the first tendon drive unit (544) applies a compressive force to the other end (541) of the first moving tendon, the first sheath drive unit (454) can also apply a compressive force to the other end (451) of the first moving sheath. Similarly, when the first tendon drive unit (544) applies a tensile force to the other end (541) of the first moving tendon, the first sheath drive unit (454) can also apply a tensile force to the other end (451) of the first moving sheath.

Accordingly, one end (542) of the first moving tendon and one end (452) of the first moving sheath can move forward and backward together with the first locker (120).

For example, when the first tendon drive unit (544) and the first sheath drive unit (454) apply a compressive force to the other end (541) of the first moving tendon and the other end (451) of the first moving sheath, one end (542) of the first moving tendon and one end (452) of the first moving sheath can move forward together with the first locker (120).

Accordingly, the first blade (122) can advance within the first locking hole (119), and the needle (800) inserted into the first needle insertion hole (115) can be fixed to the first jaw (110).

In contrast, for example, when the first tendon drive unit (544) and the first sheath drive unit (454) apply tensile force to the other end (541) of the first moving tendon and the other end (451) of the first moving sheath, one end (542) of the first moving tendon and one end (452) of the first moving sheath can move rearward together with the first locker (120).

Accordingly, the first blade (122) moves backward within the first locking hole (119), and the needle (800) inserted into the first needle insertion hole (115) can be released from the first jaw (110).

The structure and operation process of the first jaw (110), the first locker (120), the first jaw connector (130), the first fixed sheath (440), the first movable sheath (450), the first movable tendon (540), the first fixed tendon (550), the first sheath holder (444), the first sheath drive unit (454), the first tendon drive unit (544) and the first tendon holder (554) are symmetrical to the second jaw (210), the second locker (220), the second jaw connector (230), the second fixed sheath (460), the second movable sheath (470), the second movable tendon (560), the second fixed tendon (570), the second sheath holder (464), the second sheath drive unit (474), the second tendon drive unit (564) and the second tendon Since it can be applied in the same way as holder (574), it is omitted to avoid unnecessary redundant description.

Accordingly, the description of the second jaw (210), the second locker (220), the second jaw connector (230), the second fixed sheath (460), the second movable sheath (470), the second movable tendon (560), the second fixed tendon (570), the second sheath holder (464), the second sheath drive unit (474), the second tendon drive unit (564) and the second tendon holder (574) is as follows unless otherwise stated: the first jaw (110), the first locker (120), the first jaw connector (130), the first fixed sheath (440), the first movable sheath (450), the first movable tendon (540), the first fixed tendon (550), the first sheath holder (444), the first sheath drive unit (454), the first tendon drive unit (544) and the first tendon The description of the holder (554) applies.

Likewise, in the description process of the specification below, unless otherwise described, the description of the second jaw (210), the second locker (220), the second jaw connector (230), the second fixed sheath (460), the second movable sheath (470), the second movable tendon (560), the second fixed tendon (570), the second sheath holder (464), the second sheath drive unit (474), the second tendon drive unit (564) and the second tendon holder (574) is the same as the description of the first jaw (110), the first locker (120), the first jaw connector (130), the first fixed sheath (440), the first movable sheath (450), the first movable tendon (540), the first fixed tendon (550), the first sheath holder (444), the first sheath drive unit (454), the first tendon drive unit (544) and the first The description of the tendon holder (554) applies.

FIG. 11 is a cross-sectional view illustrating a state in which a needle is fixed by a first blade in a state in which the first jaw and the second jaw of an endoscopic suture device are separated from each other according to an embodiment of the present invention. FIG. 12 is a cross-sectional view illustrating a state in which a needle is fixed by a first blade in a state in which the first jaw and the second jaw of an endoscopic suture device are brought closer to each other according to an embodiment of the present invention. FIG. 13 is a cross-sectional view illustrating a state in which the needle of the endoscopic suture device according to an embodiment of the present invention is exchanged in FIG. 12. FIG. 14 is a cross-sectional view illustrating a state in which the first jaw and the second jaw of the endoscopic suture device according to an embodiment of the present invention are separated from each other according to FIG. 13.

Referring to FIGS. 11 to 14, with the first shaft (720) as the rotational center axis, the first jaw (110), the first rocker (120), and the first jaw connector (130) can rotate at a predetermined angle in opposite directions to the second jaw (210), the second rocker (220), and the second jaw connector (230).

Accordingly, the distance between the first jaw bending portion (112) and the second jaw bending portion (212) can be changed with rotation.

As shown in Fig. 11, when the first locker (120) is advanced, the first blade (122) is received in the front part of the first locking hole (119), so that the needle (800) can be fixed to the first jaw (110).

Thereafter, as illustrated in FIG. 12, the first jaw (110) and the second jaw (210) rotate with respect to the first shaft (720) so that both ends of the needle (800) can be accommodated in the first needle insertion hole (115) and the second needle insertion hole (215).

At this time, referring to FIGS. 12 and 13, the first locker (120) moves backward and the second locker (220) moves forward, so that the fixing target of the needle (800) can be changed.

More specifically, in FIG. 12, the first blade (122) is received in the front part of the first locking hole (119) so that the needle (800) is fixed to the first jaw (110), and the second blade (222) is received in the rear part of the second locking hole (219) so that the needle (800) is not fixed to the second jaw (210).

In contrast, in FIG. 13, the first blade (122) moves backward and is received in the rear portion of the first locking hole (119), and the needle (800) is not fixed to the first jaw (110), and the second blade (222) moves forward and is received in the front portion of the second locking hole (219), and the needle (800) is fixed to the second jaw (210).

Thereafter, as illustrated in FIG. 14, when the first jaw (110) and the second jaw (210) rotate with respect to the first shaft (720) so that the first jaw bending portion (112) and the second jaw bending portion (212) move apart, the needle (800) can be moved together with the second jaw (210) while being fixed to the second jaw (210).

At this time, as described above, the first locker (120) can move forward when the first tendon driving unit (544) and the first sheath driving unit (454) apply a compressive force to the other end (541) of the first moving tendon and the other end (451) of the first moving sheath. In addition, the first locker (120) can move backward when the first tendon driving unit (544) and the first sheath driving unit (454) apply a tensile force to the other end (541) of the first moving tendon and the other end (451) of the first moving sheath.

Likewise, the second locker (220) can move forward when the second tendon drive unit (564) and the second sheath drive unit (474) apply a compressive force to the other end (561) of the second moving tendon and the other end (471) of the second moving sheath. In addition, the second locker (220) can move backward when the second tendon drive unit (564) and the second sheath drive unit (474) apply a tensile force to the other end (561) of the second moving tendon and the other end (471) of the second moving sheath.

In this process, the exchange of needles (800) between the first jaw (110) and the second jaw (210) can be performed.

At this time, when fixing the needle (800) only with a tendon or sheath, stress may be concentrated on the tendon and sheath formed with a relatively thin thickness, which may cause the tendon and sheath to break, and there is a risk that the tendon and sheath may not be able to fix the needle (800) properly due to the repulsive force during the process in which the endoscopic surgical suture device (1) penetrates the suture target area with the needle (800).

In the case of an endoscopic surgical suture device (1) according to one embodiment of the present invention, by fixing the needle (800) using the first blade (122) and the second blade (222), it is possible to stably support and reciprocate the needle (800) with power transmitted through the tendon sheath.

FIG. 15 is a drawing showing some components of an endoscopic suture device according to one embodiment of the present invention and the connection relationship of a tendon-sheath structure. FIG. 16 is an enlarged cross-sectional view showing some components of an endoscopic suture device according to one embodiment of the present invention shown in FIG. 15. FIG. 17 is a drawing showing a slider of an endoscopic suture device according to one embodiment of the present invention advanced in the state of FIG. 15. FIG. 18 is an enlarged cross-sectional view showing some components of an endoscopic suture device according to one embodiment of the present invention shown in FIG. 17.

The first jaw connector (130) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may include a first plate (132) together with a joining end (134).

At this time, a first sliding portion (131) extending in a direction inclined at a predetermined angle with respect to the front-back direction can be formed on the first plate (132).

The first sliding portion (131) may be formed in a hole shape that penetrates the first plate (132) in the vertical direction, and is not limited to being formed in a groove shape in which the upper surface of the first plate (132) is sunken downward.

Meanwhile, the first jaw connector (130) may include a first rotation protrusion (136) formed by protruding upward from a portion of the first plate (132).

At this time, a first rotation hole (137) that penetrates the first rotation protrusion (136) in the vertical direction can be formed in the central portion of the first rotation protrusion (136).

At this time, a first shaft (720) that becomes the rotation center axis of the first jaw (110) and the first jaw connector (130) can be inserted into the first rotation hole (137).

Meanwhile, the second jaw connector (230) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may include a second plate (232) together with a joining end (234).

At this time, a second sliding portion (231) extending in a direction inclined at a predetermined angle with respect to the front-back direction may be formed on the second plate (232).

The second sliding part (231) may be formed in a hole shape that penetrates the second plate (232) in the vertical direction, and is not limited to being formed in a groove shape in which the lower surface of the second plate (232) is sunken upward.

Meanwhile, the second jaw connector (230) may include a second rotation protrusion (236) formed by protruding downwardly a portion of the second plate (232).

At this time, a second rotation hole (237) that penetrates the second rotation protrusion (236) in the vertical direction can be formed in the central portion of the second rotation protrusion (236).

At this time, a first shaft (720) that becomes the rotation center axis of the second jaw (210) and the second jaw connector (230) can be inserted into the second rotation hole (237).

Meanwhile, the first shaft (720) can be fixed to one position of the jaw base (300), and accordingly, the first jaw (110) and the second jaw (210) can rotate around the first shaft (720) as a central axis on the one position of the jaw base (300).

Meanwhile, the slider (710) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may include a second shaft (712) protruding in the vertical direction.

The second shaft (712) protruding in the vertical direction of the slider (710) can have both ends inserted into the first sliding part (131) and the second sliding part (231).

At this time, the slider (710) is accommodated at a predetermined position within the jaw base (300) and can slide forward and backward within the jaw base (300).

As the slider (710) slides, the second shaft (712) can also slide forward and backward.

At this time, the first jaw connector (130) and the second jaw connector (230) can rotate the first sliding part (131) and the second sliding part (231) according to the forward and backward movement of the second shaft (712) while the positions of the first rotation protrusion (136) and the second rotation protrusion (236) are fixed by the first shaft (720).

At this time, the first jaw connector (130) and the second jaw connector (230) can also rotate together with the rotation of the first sliding part (131) and the second sliding part (231).

*At this time, referring to FIGS. 15 to 18, one end (412) of the middle sheath (410), one end (522) of the first side tendon (520), and one end (532) of the second side tendon (530) can be fixed to the slider (710).

Additionally, one end (512) of the middle tendon (510) penetrating the middle sheath (410) and protruding from the middle sheath (410) can be fixed to a bracket (730) fixed to the jaw base (300).

In addition, one end (422) of the first side sheath (420) and one end (432) of the second side sheath (430) can be fixed to the jaw base (300).

Meanwhile, referring to FIGS. 15 and 17, the other ends (421, 431) of the first side sheath (420) and the second side sheath (430) can be fixed to the first side sheath holder (424) and the second side sheath holder (434). In addition, the other ends (521, 531) of the first side tendon (520) and the second side tendon (530) penetrating the first side tendon (420) and the second side tendon (430) can be connected to the first side tendon drive unit (524) and the second side tendon drive unit (534).

At this time, the first side tendon driving unit (524) and the second side tendon driving unit (534) can apply tensile force and compressive force to the other ends (521, 531) of the first side tendon (520) and the second side tendon (530) to move the first side tendon (520) and the second side tendon (530).

At this time, the first side tendon (520) and the second side tendon (530) can be moved forward and backward along the extension direction of the first side sheath (420) and the second side sheath (430).

Meanwhile, the other end (411) of the first middle sheath (410) can be connected to the first middle sheath drive unit (414). In addition, the other end (511) of the first middle tendon (510) penetrating the first middle sheath (410) can be connected to the first middle tendon holder (514).

At this time, the first middle sheath drive unit (414) can move the first middle sheath (410) by applying tensile force and compressive force to the other end (411) of the first middle sheath (410).

At this time, the first middle sheath (410) can be moved forward and backward along the extension direction of the first middle tendon (510).

At this time, the first side tendon drive unit (524), the second side tendon drive unit (534), and the first middle sheath drive unit (414) can move the other ends (521, 531) of the first side tendon (520) and the second side tendon (530) and the other end (411) of the first middle sheath (410) in the same direction.

For example, when the first side tendon drive unit (524) and the second side tendon drive unit (534) apply a compressive force to the other ends (521, 531) of the first side tendon (520) and the second side tendon (530), the first middle sheath drive unit (414) can also apply a compressive force to the other end (411) of the first middle sheath (410).

Accordingly, one end (522) of the first side tendon, one end (532) of the second side tendon, and one end (412) of the first middle sheath can be moved forward together with the slider (710).

Likewise, when the first side tendon drive unit (524) and the second side tendon drive unit (534) apply a tensile force to the other ends (521, 531) of the first side tendon (520) and the second side tendon (530), the first middle sheath drive unit (414) can also apply a tensile force to the other end (411) of the first middle sheath (410).

Accordingly, one end (522) of the first side tendon, one end (532) of the second side tendon, and one end (412) of the first middle sheath can be moved rearward together with the slider (710).

Meanwhile, according to the forward and backward movement of the slider (710), the first jaw connector (130) and the second jaw connector (230) rotate, and accordingly, the distance between the first jaw (110) and the second jaw (210) may change.

For example, when the slider (710) is positioned at the rear of the jaw base (300), the first jaw (110) and the second jaw (210) can be positioned at close positions.

In contrast, when the slider (710) is positioned at the front of the jaw base (300), the first jaw connector (130) and the second jaw connector (230) can be positioned apart from each other with respect to the first shaft (720). Accordingly, the first jaw (110) and the second jaw (210) can be positioned at positions far apart from each other.

In accordance with one embodiment of the present invention, the endoscopic surgical suture device (1) is not a double structure in which only the first side sheath (420) - first side tendon (520) is paired with the middle sheath (410) - middle tendon (510) structure, but is triple-paired with the second side sheath (430) - second side tendon (530) structure, so that the tendon-sheath or slider (710) can be prevented from being weighted or moved in one of the left and right directions during the forward and backward movement of the slider (710).

In addition, among the triple tendon-sheath structures, the first side tendon (520) and the second side tendon (530) which are relatively thin move the slider (710) together with the middle sheath (410) which is relatively thick, so that the deviation due to the difference in thickness between the tendon and the sheath can be alleviated.

In addition, since the triple tendon-sheath structure is formed with a thickness corresponding to the thickness that includes the entire triple tendon-sheath structure, for example, the thickness from the left end of the first side sheath (420) to the right end of the second side sheath (430) as seen in FIGS. 16 and 18, twisting can be minimized despite repeated operations of the endoscopic surgical suture device (1).

Hereinafter, the components of the present invention, including the roll connector (610) and the center cylinder (620) of the endoscopic surgical suture device (1) according to one embodiment of the present invention, will be described by changing the reference of the coordinate axis.

In the following description of the drawings, each direction is defined based on the coordinate axes illustrated in Fig. 19. More specifically, the positive direction of the z-axis is defined as upward, and the negative direction of the z-axis is defined as downward. The positive direction of the y-axis is defined as left, and the negative direction of the y-axis is defined as right. The positive direction of the x-axis is defined as forward, and the negative direction of the x-axis is defined as backward.

FIG. 19 is an exploded perspective view of a roll connector and a center cylinder of an endoscopic suture device according to an embodiment of the present invention. FIG. 20 is a drawing illustrating some components including a roll connector and a center cylinder of an endoscopic suture device according to an embodiment of the present invention. FIG. 21 is a drawing illustrating a state in which a roll connector of an endoscopic suture device according to an embodiment of the present invention is rotated relative to a center cylinder. FIG. 22 is a side view of an endoscopic suture device according to an embodiment of the present invention. FIG. 23 is a side view illustrating a state in which a roll connector of an endoscopic suture device according to an embodiment of the present invention is rotated relative to a center cylinder. FIG. 24 is a top view of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 22. FIG. 25 is a top view of an endoscopic suture device according to an embodiment of the present invention illustrated in FIG. 23.

An endoscopic surgical suture device (1) according to one embodiment of the present invention may include a roll connector (610) including a cylindrical center cylinder (620) and an inner surface (612) that contacts an outer surface (622) of the center cylinder (620).

At this time, the outer circumferential surface (622) of the center cylinder (620) can be formed in a cylindrical shape, and the inner circumferential surface (612) of the roll connector (610) can be formed in a corresponding cylindrical shape.

A coupling protrusion (626) protruding radially outward from the center cylinder (620) may be formed on the outer surface (622) of the center cylinder (620). At this time, a coupling groove (619) having a shape corresponding to the coupling protrusion (626) may be formed on the inner surface (612) of the roll connector (610).

More specifically, the coupling groove (619) may be formed in a shape in which the inner surface (612) of the roll connector (610) is radially recessed outward to correspond in shape to the coupling protrusion (626) when viewed from the top.

At this time, the joining groove (619) can be formed in a form extending upward and downward on the inner surface (612) of the roll connector (610).

Accordingly, when the roll connector (610) is mounted on the center cylinder (620), the coupling projection (626) of the center cylinder (620) can be mounted by sliding along the coupling groove (619) of the roll connector (610).

Meanwhile, a stopper (624) may be formed on the outer surface (622) of the center cylinder (620) such that the longitudinal end of the center cylinder (620) protrudes radially outward along the circumference of the center cylinder (620).

At this time, the radius of the circle formed by the end of the stopper (624), that is, the outer radial periphery of the stopper (624), may be formed to be larger than the radius of the circle formed by the inner peripheral surface (612) of the roll connector (610).

Meanwhile, a rolling groove (621) may be formed on the outer surface (622) of the center cylinder (620) by partially recessing the center cylinder (620) in the radial direction.

At this time, the rolling groove (621) may be formed in a form extending along the circumference of the outer surface (622) of the center cylinder (620). In addition, the upper end of the rolling groove (621) may be located at the lower end of the stopper (624).

Meanwhile, a mounting surface (618) on which a jaw base (300) is mounted can be formed on one side of the roll connector (610).

At this time, one end (482) of the first rolling sheath (480) and one end (492) of the second rolling sheath (490) can be fixed to one side of the roll connector (610) where the mounting surface (618) is formed.

As an example, a first rolling sheath hole (611) and a second rolling sheath hole (613) may be formed on one side of the roll connector (610) to which one end (482) of the first rolling sheath (480) and one end (492) of the second rolling sheath (490) are fixed.

At this time, one end (582) of the first rolling tendon (580) may protrude from one end (482) of the first rolling sheath, and one end (592) of the second rolling tendon (590) may protrude from one end (492) of the second rolling sheath.

Accordingly, a first rolling tendon hole (615) communicating with one end of the first rolling sheath hole (611) may be formed at one end of the first rolling sheath hole (611), and a second rolling tendon hole (617) communicating with one end of the second rolling sheath hole (613) may be formed at one end of the second rolling sheath hole (613).

The first rolling tendon hole (615) and the second rolling tendon hole (617) may be exposed to the inner surface (612) of the roll connector (610).

At this time, one end (582) of the first rolling tendon and one end (592) of the second rolling tendon can pass through the rolling groove (621) of the center cylinder (620).

Meanwhile, referring to FIGS. 20 and 21, one end (482) of the first rolling sheath and one end (492) of the second rolling sheath may be arranged to face upward. In contrast, one end (582) of the first rolling tendon and one end (592) of the second rolling tendon may pass upward through one end (482) of the first rolling sheath and one end (492) of the second rolling sheath, be bent in a horizontal direction, and then extend into the rolling groove (621).

Accordingly, in order to guide the bending of one end (482) of the first rolling sheath and one end (492) of the second rolling sheath, the inner surface (612) of the rolling connector (610) may include a first curved surface (614) and a second curved surface (616) extending from the first rolling tendon hole (615) and the second rolling tendon hole (617), respectively.

At this time, a first fixing part (623) to which one end (582) of the first rolling tendon is fixed, and a second fixing part (625) to which one end (592) of the second rolling tendon is fixed can be formed in the center cylinder (620).

As an example, the first fixed part (623) and the second fixed part (625) can be formed in the shape of holes that penetrate the stopper (624) in the vertical direction.

At this time, one end (582) of the first rolling tendon is fixed to a hole formed by the first fixing part (623), and one end (692) of the second rolling tendon is fixed to a hole formed by the second fixing part (625).

More specifically, one end (582) of the first rolling tendon can penetrate the first fixing portion (623) from the rolling groove (621) to the upper side of the first fixing portion (623), and one end (592) of the second rolling tendon can penetrate the second fixing portion (625) from the rolling groove (621) to the upper side of the second fixing portion (625).

At this time, one end (582) of the first rolling tendon and one end (592) of the second rolling tendon can be connected to each other on the upper side of the first stopper (624). Accordingly, the first rolling tendon (580) and the second rolling tendon (590) can be formed into one tendon.

Meanwhile, referring to FIG. 3, the other end of the first rolling sheath (480) can be fixed to the first rolling holder (484), and the other end of the second rolling sheath (490) can be fixed to the second rolling holder (494).

Additionally, the other end of the first rolling tendon (580) can be connected to the first rolling drive unit (584), and the other end of the second rolling tendon (590) can be connected to the second rolling drive unit (594).

At this time, the first rolling drive unit (584) can move the first rolling tendon (580) by applying tensile force and compressive force to the other end of the first rolling tendon (580).

At this time, the first rolling tendon (580) can move forward and backward along the extension direction of the first rolling sheath (480).

Similarly, the second rolling drive unit (594) can move the second rolling tendon (590) by applying tensile and compressive forces to the other end of the second rolling tendon (590).

At this time, the second rolling tendon (590) can move forward and backward along the extension direction of the second rolling sheath (490).

At this time, the first rolling drive unit (584) and the second rolling drive unit (594) can move the other end of the first rolling tendon (580) and the other end of the second rolling tendon (590) in different directions.

For example, when the first rolling drive unit (584) applies a compressive force to the other end of the first rolling tendon (580), the second rolling drive unit (594) can apply a tensile force to the other end of the second rolling tendon (590). Conversely, when the first rolling drive unit (584) applies a tensile force to the other end of the first rolling tendon (580), the second rolling drive unit (594) can apply a compressive force to the other end of the second rolling tendon (590).

*According to the movement of the first rolling tendon (580) and the second rolling tendon (590), the roll connector (610) can move relative to the first fixed part (623) and the second fixed part (625).

Accordingly, the roll connector (610) can rotate at a predetermined angle with the center cylinder (620) as the rotational center axis.

Accordingly, as illustrated in FIGS. 22 to 25, as the roll connector (610) moves clockwise with respect to the center cylinder (620), the jaw base (300) mounted on the mounting surface (618) of the roll connector (610) and the first jaw (110) and second jaw (210) mounted on the jaw base (300) can be moved clockwise with respect to the center cylinder (620) as a unit.

Likewise, as the roll connector (610) moves counterclockwise with respect to the center cylinder (620), the jaw base (300) mounted on the mounting surface (618) of the roll connector (610) and the first jaw (110) and second jaw (210) mounted on the jaw base (300) can be moved counterclockwise with respect to the center cylinder (620) as a unit.

The center cylinder (620) may be equipped with an endoscopic device including an endoscopic camera.

Accordingly, the endoscopic surgical suture device (1) according to one embodiment of the present invention is capable of rotating in the circumferential direction of the endoscopic camera with the endoscopic camera as the central axis.

Therefore, the endoscopic surgical suture device (1) can rotate around the endoscopic camera without the endoscopic camera rotating, while the endoscopic camera faces the same direction.

Accordingly, the entire endoscopic device including the endoscopic camera must be rotated to facilitate suturing during endoscopic surgery, compared to a conventional endoscopic surgical suture device that can be rotated.

Fig. 26 is a drawing illustrating a manipulator according to one embodiment of the present invention. Fig. 27 is a drawing illustrating a manipulator according to another embodiment of the present invention. Fig. 28 is a drawing illustrating the internal configuration of a manipulator according to one embodiment of the present invention.

A manipulator (900) for manipulating an endoscopic surgical suture device (1) according to one embodiment of the present invention may include an outer body (901), jaw levers (910, 920) protruding to both sides of the outer body (901), an inner body (902) accommodated inside the outer body (901), blade levers (930, 940) mounted on the inner body (902) and protruding to both sides of the outer body (901), and a roll knob (970) for controlling a first rolling drive unit (584) and a second rolling drive unit (594).

At this time, when the two jaw levers (910, 920) are rotated in a direction that brings them closer to each other, the slider (710) can move backward within the jaw base (300).

At this time, the first side tendon drive unit (524) can apply tensile force to the other end (521) of the first side tendon (520).

Additionally, the second side tendon drive unit (534) can apply tensile force to the other end (531) of the second side tendon (530).

In addition, the middle sheath drive unit (414) can apply tensile force to the other end (411) of the middle sheath (410).

Accordingly, the slider (710) moves backward within the jaw base (300), and the bending portion (112) of the first jaw (110) and the bending portion (212) of the second jaw (210) can come closer to each other.

Conversely, when the two jaw levers (910, 920) are rotated away from each other, the slider (710) can advance within the jaw base (300).

At this time, the first side tendon drive unit (524) can apply a compressive force to the other end (521) of the first side tendon (520).

Additionally, the second side tendon drive unit (534) can apply a compressive force to the other end (531) of the second side tendon (530).

In addition, the middle sheath drive unit (414) can apply compressive force to the other end (411) of the middle sheath (410).

Accordingly, the slider (710) moves forward within the jaw base (300), and the bending portion (112) of the first jaw (110) and the bending portion (212) of the second jaw (210) can move away from each other.

The method of controlling the driving unit through such a jaw lever (910, 920) may be controlled by turning a screw to push a tendon or sheath with an idler-shaped mechanism to transmit tension, but is not necessarily limited thereto.

For example, it is not limited to controlling the driving unit by transmitting a signal in another mechanical or electrical manner in conjunction with the rotation of the jaw lever (910, 920).

Meanwhile, the two blade levers (930, 940) can be rotated around a predetermined central axis.

For example, comparing FIG. 27 and FIG. 28, the blade levers (930, 940) are positioned in a neutral state in FIG. 27, but in FIG. 28, the left blade lever (930) can be positioned in a forward state and the right blade lever (940) can be positioned in a backward state.

At this time, referring to FIG. 28, the two blade levers (930, 940) can be rotated clockwise around the central axis.

At this time, the manipulator (900) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may include a left blade holder (932) linked to the position of the left blade lever (930) and a right blade holder (942) linked to the position of the right blade lever (940).

Accordingly, the left blade holder (932) and the right blade holder (942) can control the driving unit that drives the first rocker (120) and the second rocker (220) in conjunction with the rotation of the two blade levers (930, 940).

For example, when the left blade lever (930) is rotated and positioned forward relative to the right blade lever (940), the left blade holder (932) can control at least one of the first moving tendon drive (544) or the first moving sheath drive (454) to advance the first rocker (120).

At this time, the first moving tendon drive unit (544) can apply a compressive force to the other end (541) of the first moving tendon (540), or the first moving sheath drive unit (454) can apply a compressive force to the other end (451) of the first moving sheath (450).

Accordingly, the first locker (120) can move forward.

On the other hand, when the left blade lever (930) is rotated and positioned rearward relative to the right blade lever (940), the left blade holder (932) can control at least one of the first moving tendon drive unit (544) or the first moving sheath drive unit (454) in a manner that moves the first rocker (120) backward.

At this time, the first moving tendon drive unit (544) can apply a tensile force to the other end (541) of the first moving tendon (540), or the first moving sheath drive unit (454) can apply a tensile force to the other end (451) of the first moving sheath (450).

Accordingly, the first locker (120) can move backward.

Likewise, when the right blade lever (940) is rotated and positioned forward relative to the left blade lever (930), the right blade holder (942) can control at least one of the second moving tendon drive (564) or the second moving sheath drive (474) to advance the second rocker (220).

At this time, the second moving tendon drive unit (564) can apply a compressive force to the other end (561) of the second moving tendon (560), or the second moving sheath drive unit (474) can apply a compressive force to the other end (471) of the second moving sheath (470).

Accordingly, the second locker (220) can move forward.

On the other hand, when the right blade lever (940) is rotated and positioned rearward relative to the left blade lever (930), the right blade holder (942) can control at least one of the second moving tendon drive unit (564) or the second moving sheath drive unit (474) in a manner that moves the second rocker (220) backward.

At this time, the second moving tendon drive unit (564) can apply a tensile force to the other end (561) of the second moving tendon (560), or the second moving sheath drive unit (474) can apply a tensile force to the other end (471) of the second moving sheath (470).

Accordingly, the second locker (220) can move backward.

The method of controlling the driving unit through such a blade lever (930, 940) may be controlled by turning a screw to push a tendon or sheath with an idler-shaped mechanism to transmit tension, but is not necessarily limited thereto.

For example, it is not limited to controlling the driving unit by transmitting a signal in another mechanical or electrical manner in conjunction with the rotation of the blade lever (930, 940).

Meanwhile, the manipulator (900) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may be equipped with a roll knob (970) that can rotate clockwise or counterclockwise.

As the roll knob (970) rotates clockwise or counterclockwise, the first rolling drive unit (584) and the second rolling drive unit (594) can be controlled to apply a compressive force or a tensile force to the other end of the first rolling tendon (580) or the other end of the second rolling tendon (590).

For example, when the roll knob (970) rotates clockwise, the first rolling drive unit (584) can apply a tensile force to the other end of the first rolling tendon (580), and the second rolling drive unit (594) can apply a compressive force to the other end of the second rolling tendon (590).

Accordingly, the roll connector (610) can be rotated clockwise with respect to the center cylinder (620).

Conversely, when the roll knob (970) rotates counterclockwise, the first rolling drive unit (584) can apply a compressive force to the other end of the first rolling tendon (580), and the second rolling drive unit (594) can apply a tensile force to the other end of the second rolling tendon (590).

Accordingly, the roll connector (610) can be rotated counterclockwise with respect to the center cylinder (620).

The method of controlling the drive unit through a roll knob (970) like this can be controlled by turning a screw to push a tendon or sheath with an idler-shaped mechanism to transmit tension, but is not necessarily limited thereto.

For example, it is not limited to controlling the driving unit by transmitting a signal in another mechanical or electrical manner in conjunction with the rotation of the roll knob (970).

Meanwhile, the manipulator (900) of the endoscopic surgical suture device (1) according to one embodiment of the present invention may further include a channel connector (950) for controlling an auxiliary device such as a grasper (312) or forceps mounted on a raised portion (310) of a jaw base (300).

An auxiliary tool such as a grasper (312) or forceps may be mounted on the raised portion (310) of the jaw base (300), and may be connected to and controlled by a manipulator (900) through a line such as a grasper line (314).

At this time, the channel connector (950) may have a channel line (952) extending from one side to be connected to a line such as the gripper line (314), and a channel port (954) may be provided on the other side.

Accordingly, an auxiliary device such as a grasper (312) or forceps can be moved and operated to one side from the raised portion (310) by receiving a mechanical or electrical signal from the manipulator (900).

Meanwhile, one side of the manipulator (900) may be provided with a strain relief (960) to alleviate the bending between one or more tendon-sheath bundles and the manipulator (900).

Below, a process of performing suturing by an endoscopic surgical suturing device (1) and a manipulator (900) according to one embodiment of the present invention formed with the above structure is described.

FIG. 29 is a drawing illustrating a process of assisting suturing using an endoscopic suturing device and a grasper according to one embodiment of the present invention.

An auxiliary device such as a grasper (312) or forceps of an endoscopic surgical suture device (1) according to one embodiment of the present invention can perform a function of pulling tissue (20) near a suture target portion (30) by protruding to one side from a raised portion (310) of the endoscopic surgical suture device (1).

More specifically, referring to (a) of FIG. 29, an endoscopic surgical suture device (1) according to one embodiment of the present invention can be aligned near a suture target portion (30) to perform suturing.

Thereafter, an auxiliary tool such as a grasper (312) or forceps may be moved to grab a portion of an edge (21) of the tissue (20) or a part of the tissue (20).

At this time, the grasper (312) is formed in a spiral shape extending in one direction, so that it can dig into the target area to be pulled. Afterwards, when the grasper (312) is fixed to the target area, the grasper (312) is retracted toward the raised portion (310) or the endoscopic surgical suture device (1) is retracted, so that the target area dug by the grasper (312) can be pulled a predetermined distance.

At this time, forceps can be used to pick up and bring the target area.

At this time, before the needle (800) penetrates the tissue (20), an auxiliary device such as a grasper (312) or forceps can horizontally align the height of the pulled tissue and the height of the first jaw (110) and the second jaw (210).

Accordingly, when the edge (21) portion or target portion of the tissue (20) is located between the first jaw (110) and the second jaw (210), the needle (800) can penetrate the portion or portion as the bend portion (112) of the first jaw (110) and the bend portion (212) of the second jaw (210) come closer.

At this time, the fixed relationship between the needle (800) and the first jaw (110) and the second jaw (210) changes according to the movement of the first locker (120) and the second locker (220), and the needle (800) passes through the relevant part or area and then comes out, so that the thread (801) connected to the needle (800) can pass through the relevant part or area.

At this time, a separate tag may be attached to the end (802) of the thread (801).

In addition, the thread (801) used in the endoscopic surgical suture device (1) according to one embodiment of the present invention may be a barbed suture.

At this time, the thread (801) can be formed to have a wedge-shaped pattern facing the direction of entry. Accordingly, a hook having a wedge-shaped pattern is provided in the opposite direction to the direction of entry of the thread (801), so that the thread (801) can be formed to not come loose without a separate knot.

Accordingly, it is possible for the endoscopic surgical suture device (1) according to one embodiment of the present invention to suture the suture target portion (30) more easily by using an auxiliary device such as a grasper (312) or forceps.

FIG. 30 is a drawing illustrating a state in which a needle is positioned at a stitch point using an endoscopic suture device according to an embodiment of the present invention. FIG. 31 is a drawing illustrating a state in which a first stitch is performed using an endoscopic suture device according to an embodiment of the present invention. FIG. 32 is a drawing illustrating a state in which a needle is exchanged and moved to a second stitch point using an endoscopic suture device according to an embodiment of the present invention. FIG. 33 is a drawing illustrating a state in which a needle is positioned to perform a second stitch using an endoscopic suture device according to an embodiment of the present invention. FIG. 34 is a drawing illustrating a state in which a second stitch is performed using an endoscopic suture device according to an embodiment of the present invention. FIG. 35 is a drawing illustrating a state in which a third stitch is performed using an endoscopic suture device according to an embodiment of the present invention. FIG. 36 is a drawing illustrating a state in which a fourth stitch is performed using an endoscopic suture device according to an embodiment of the present invention. FIG. 37 is a drawing illustrating a state in which an endoscopic suture device is retracted and an approximation is performed according to an embodiment of the present invention.

In order to perform suturing of tissue (20) using an endoscopic surgical suturing device (1) according to one embodiment of the present invention, a needle (800) can first be positioned at a stitch point as shown in FIG. 30.

At this time, in order to perform suturing smoothly, the needle (800) can be placed in a direction perpendicular to the incision direction.

To this end, the roll connector (610) of the endoscopic surgical suture device (1) rotates relative to the endoscopic camera to easily align the needle (800) in the correct direction.

Afterwards, the first stitch can be performed as shown in FIG. 31.

The first stitch may be performed, as an example, on the left side of the suture target portion (30).

At this time, the needle (800) can penetrate one edge (21) located on the left side of the suture target portion (30).

During this process, a portion of the tissue (20) may be pulled using an auxiliary tool such as a grasper (312) or forceps as described above.

At this time, the first stitch point may be performed at a position corresponding to a distance corresponding to a predetermined ratio of the length (33) of the suture target portion (30) from one end (31) of the suture target portion (30), as an example.

For example, the first stitch point can be performed at a position corresponding to 1/4 of the length (33) from one end (31) of the suture target portion (30).

In this process, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change.

Accordingly, as shown in FIGS. 30 to 32, needle exchange can be performed in which the positions where the needle (800) is connected to the first jaw (110) and the second jaw (210) are changed before and after the first stitch.

More specifically, referring to FIG. 30, before penetrating the first stitch point, the needle (800) is engaged with the first jaw (110), and referring to FIG. 32, after penetrating the first stitch point, the needle (800) may be changed to be engaged with the second jaw (210).

Thereafter, as illustrated in FIG. 33, an endoscopic surgical suture device (1) according to one embodiment of the present invention can be aligned to the second stitch point.

At this time as well, the roll connector (610) of the endoscopic surgical suture device (1) rotates based on the endoscopic camera to easily align the needle (800) in the correct direction.

The second stitch may be performed, as an example, on the right side of the suture target portion (30).

At this time, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change during the process of aligning the endoscopic surgical suture device (1) at the second stitch point.

More specifically, as illustrated in FIG. 32, after penetrating the first stitch point, the needle (800) may be engaged with the second jaw (210), and as it is aligned to the second stitch point, as illustrated in FIG. 33, the needle (800) may be changed to be engaged with the first jaw (110).

Afterwards, the needle (800) can penetrate the other edge (22) located on the right side of the suture target portion (30).

During this process, a portion of the tissue (20) may be pulled using an auxiliary tool such as a grasper (312) or forceps as described above.

At this time, the second stitch point may be performed at a position corresponding to a distance corresponding to a predetermined ratio of the length (33) of the suture target portion (30) from one end (31) of the suture target portion (30), as an example.

For example, the second stitch point can be performed at a position corresponding to 1/4 of the length (33) from one end (31) of the suture target portion (30).

Even in the second stitch process, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change.

Accordingly, as shown in FIGS. 33 and 34, needle exchange can be performed in which the positions where the needle (800) is connected to the first jaw (110) and the second jaw (210) are changed before and after the second stitch.

More specifically, referring to FIG. 33, before penetrating the second stitch point, the needle (800) is engaged with the first jaw (110), and referring to FIG. 34, after penetrating the second stitch point, the needle (800) may be changed to be engaged with the second jaw (210).

Thereafter, as illustrated in FIG. 35, an endoscopic surgical suture device (1) according to one embodiment of the present invention can be aligned to the third stitch point.

At this time as well, the roll connector (610) of the endoscopic surgical suture device (1) rotates based on the endoscopic camera to easily align the needle (800) in the correct direction.

The third stitch may be performed, as an example, on the left side of the suture target portion (30).

At this time, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change during the process of aligning the endoscopic surgical suture device (1) at the third stitch point.

More specifically, as illustrated in FIG. 34, after penetrating the second stitch point, the needle (800) may be engaged with the second jaw (210), and as it is aligned to the third stitch point, as illustrated in FIG. 35, the needle (800) may be changed to be engaged with the first jaw (110).

Afterwards, a needle (800) can penetrate one edge (21) located on the left side of the suture target portion (30).

During this process, a portion of the tissue (20) may be pulled using an auxiliary tool such as a grasper (312) or forceps as described above.

At this time, the third stitch point may be performed at a position corresponding to a distance corresponding to a predetermined ratio of the length (33) of the suture target portion (30) from the other end (32) of the suture target portion (30), as an example.

For example, the second stitch point can be performed at a position corresponding to 1/4 of the length (33) from the other end (32) of the suture target portion (30).

Even in the third stitch process, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change.

Accordingly, as shown in FIGS. 35 and 36, needle exchange can be performed in which the positions where the needle (800) is connected to the first jaw (110) and the second jaw (210) are changed before and after the third stitch.

More specifically, referring to FIG. 35, before penetrating the third stitch point, the needle (800) is engaged with the first jaw (110), and referring to FIG. 36, after penetrating the third stitch point, the needle (800) may be changed to be engaged with the second jaw (210).

As with the first to third stitch processes described above, the endoscopic surgical suture device (1) according to one embodiment of the present invention can be aligned to the fourth stitch point.

At this time as well, the roll connector (610) of the endoscopic surgical suture device (1) rotates based on the endoscopic camera to easily align the needle (800) in the correct direction.

The fourth stitch may be performed, as an example, on the right side of the suture target portion (30).

At this time, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change during the process of aligning the endoscopic surgical suture device (1) at the fourth stitch point.

More specifically, after penetrating the third stitch point, the needle (800) may be engaged with the second jaw (210), and then, while being aligned to the fourth stitch point, the needle (800) may change to be engaged with the first jaw (110).

Afterwards, the needle (800) can penetrate the other edge (22) located on the right side of the suture target portion (30).

During this process, a portion of the tissue (20) may be pulled using an auxiliary tool such as a grasper (312) or forceps as described above.

At this time, the fourth stitch point may be performed at a position corresponding to a distance corresponding to a predetermined ratio of the length (33) of the suture target portion (30) from the other end (32) of the suture target portion (30), as an example.

For example, the second stitch point can be performed at a location corresponding to 1/4 of the length (33) from the other end (32) of the suture target portion (30) or the other end (32).

Even in the fourth stitch process, the fastening relationship between the first jaw (110), the second jaw (210) and the needle (800) may change.

Accordingly, a needle exchange can be performed in which the positions where the needle (800) is connected to the first jaw (110) and the second jaw (210) are changed before and after the fourth stitch.

More specifically, before penetrating the fourth stitch point, the needle (800) may be connected to the first jaw (110), and after penetrating the fourth stitch point, the needle (800) may be connected to the second jaw (210).

Referring to FIG. 36, after the last stitch is completed, the endoscopic surgical suture device (1) can be retracted while the bend portion (112) of the first jaw (110) and the bend portion (212) of the second jaw (210) are brought closer to each other, i.e., the first jaw (110) and the second jaw (210) are closed.

As the endoscopic surgical suture device (1) is retracted, an approximation operation can be performed in which the thread (801) connected to the needle (800) is pulled as shown in FIG. 37.

After confirming that the thread (801) is pulled and the tissue (20) around the suture target area (30) is gathered, a certain layer of the tissue (20) around the first stitch can be sutured to form a predetermined anchor.

The anchor can prevent the thread (801) from slipping out and the suture target part (30) from opening.

The suturing method using the endoscopic surgical suturing device (1) according to one embodiment of the present invention according to the above process is comprised of four stitch steps, which is exemplary and not necessarily limited thereto.

The number of stitches may increase or decrease depending on the size of the area to be sutured and the suture situation.

FIG. 38 is a drawing illustrating stitching one edge of a mucosal defect using an endoscopic suture device according to an embodiment of the present invention. FIG. 39 is a drawing illustrating stitching the opposite edge of a mucosal defect using an endoscopic suture device according to an embodiment of the present invention. FIG. 40 is a drawing illustrating approximation of a mucosal defect by retracting an endoscopic suture device according to an embodiment of the present invention.

At this time, referring to FIG. 38, an endoscopic surgical suture device (1) according to one embodiment of the present invention can stitch one edge (21) of a tissue (20) with a needle (800) to suture a suture target portion (30).

At this time, the suture target portion (30) may be a mucosal defect, and one edge (21) of the tissue (20) may be formed as a mucosal layer.

At this time, the endoscopic surgical suture device (1) according to one embodiment of the present invention can perform a needle (800) exchange operation between the first jaw (110) and the second jaw (210) as described above.

Accordingly, as illustrated in FIG. 39, the endoscopic surgical suture device (1) according to one embodiment of the present invention can connect both edges (21, 22) of the tissue (20) surrounding the suture target portion (30) with a thread (801) by stitching the other edge (22) of the tissue (20).

At this time, the endoscopic surgical suture device (1) according to one embodiment of the present invention can stitch the tissue (20) around the suture target portion (30) several times as shown in FIGS. 30 to 37.

At this time, stitching can be performed at regular intervals of 5 to 10 mm.

In addition, in each stitching process, the endoscopic surgical suture device (1) according to one embodiment of the present invention can align the needle (800) in a direction perpendicular to the edge (21, 22) of the tissue (20) surrounding the suture target portion (30). Thereafter, the needle (800) can penetrate the edge (21, 22) of the tissue (20) in the vertical direction in each stitching process.

After multiple stitchings are performed, the endoscopic surgical suture device (1) is retracted as shown in FIG. 40, and the thread connected to the needle (800) is pulled to perform an approximation operation.

FIG. 41 is a drawing illustrating stitching one edge of a mucosal defect larger than the mucosal defect illustrated in FIG. 38 using an endoscopic suture device according to an embodiment of the present invention. FIG. 42 is a drawing illustrating stitching the opposite edge of the mucosal defect illustrated in FIG. 41 using an endoscopic suture device according to an embodiment of the present invention. FIG. 43 is a drawing illustrating approximation of the mucosal defect illustrated in FIG. 42 by retracting the endoscopic suture device according to an embodiment of the present invention.

As shown in FIGS. 41 to 43, when the size of the suture target portion (30) is greater than a predetermined size, multiple stitchings can be performed while the endoscopic surgical suture device (1) is moved from one edge (21) of the tissue (20) to the other edge (22) of the tissue (20).

In this case, stitching can be performed not only on the edge (21, 22) of the tissue (20) forming the mucosal layer, but also on the submucosal layer (23) located between the edges (21, 22) of the tissue (20).

After the stitching operation is performed through this process, as shown in Fig. 43, the endoscopic surgical suture device (1) is retracted, and the thread connected to the needle (800) is pulled to perform the approximation operation.

FIG. 44 is a drawing illustrating a process of performing U-shaped stitching by rotating an endoscopic suture device according to one embodiment of the present invention. FIG. 45 is a drawing illustrating a process of performing stitching along a path similar to the path illustrated in FIG. 44 without rotating an endoscopic suture device according to one embodiment of the present invention.

When stitching is performed along various paths such as a U-shape as illustrated in FIGS. 44 and 45, the endoscopic surgical suture device (1) according to one embodiment of the present invention can gently adjust the direction of the stitch using a roll function.

Referring to FIG. 44, an endoscopic surgical suture device (1) according to one embodiment of the present invention can rotate the direction of the first jaw (110), the second jaw (210), and the needle (800) while rotating the roll connector (610) relative to the center cylinder (620) without rotating the endoscopic camera.

At this time, the part indicated in the shape of O in FIGS. 44 and 45 illustrates the path through which the needle (800) penetrates the tissue (20), and the part indicated in the shape of X illustrates the path through which the needle (800) penetrates the tissue (20).

In addition, the part indicated by the solid line in the stitching path is the case where the thread (801) is located on the outside of the tissue (20), that is, close to the endoscopic surgical suture device (1), and the part indicated by the dotted line is the case where the thread (801) is located on the inside of the tissue (20), that is, far from the endoscopic surgical suture device (1).

Comparing Fig. 44 and Fig. 45, when the roll connector (610) is not rotated, the path of the solid line portion and the path of the dotted line portion can be formed to form a steep slope.

However, when performing stitching work while rotating the roll connector (610), the slope formed by the path of the solid line portion and the path of the dotted line portion can be minimized.

Accordingly, when the rotation function of the roll connector (610) is used throughout the entire path, the stitching path can be formed more gently than when it is not used.

When the approximate operation is performed on the thread (801) after the stitching operation, a tensile force is applied to the end of the thread (801). At this time, when the stitching path is formed gently as shown in Fig. 44, the tensile force can be formed in a relatively constant direction.

Accordingly, it is possible to prevent the thread (801) from twisting and to seal the suture target portion (30) in a sturdy form after the approximation operation.

However, when the stitching path is formed with a steep slope as shown in Fig. 45, the tensile force is not formed in a constant direction, so the possibility of the thread (801) becoming twisted increases, and it is difficult to firmly approximate the suture target portion (30).

Accordingly, not only does the suturing work using the endoscopic surgical suturing device (1) become easier by utilizing the rotation function of the roll connector (610), but it is also possible to maintain a firm suturing state after suturing.

Although one embodiment of the present invention has been described above, the spirit of the present invention is not limited to the embodiment presented in this specification, and a person skilled in the art who understands the spirit of the present invention will be able to easily propose other embodiments by adding, changing, deleting, or adding components within the scope of the same spirit, but this will also be considered to fall within the spirit of the present invention.

Claims (37)

A needle with a medical thread attached; A first jaw including a first jaw extension portion having a first space formed as an empty space inside while extending in one direction, and a first jaw end portion having a first needle insertion hole formed in a direction inclined at a predetermined angle with respect to the one direction into which the needle is inserted; A first jaw connector having a first jaw coupling end coupled to the first jaw extension at one end and including a first plate connected to the first jaw coupling end; A first locker including a first locker body that can reciprocate along the one direction within the first space, and a first blade extending from the first locker body along the one direction; A jaw base on which the first jaw connector is mounted; A first jaw fixing sheath formed in a hollow shape and fixed to the first jaw joint end; and A first jaw moving tendon penetrating the hollow interior of the first jaw fixing sheath and having one end protruding from the first jaw fixing sheath and fixed to the first locker body; The above needle is provided with a first needle groove in which a portion of the needle is sunken in a direction inclined at a predetermined angle with respect to the extension direction of the needle, An endoscopic surgical suture device, wherein the first blade can pass through the first needle groove within the first needle insertion hole as the first locker reciprocates within the first space. In the first paragraph, A first jaw moving sheath formed in a hollow shape and fixed to the first rocker body; An endoscopic surgical suture device further comprising a first jaw fixing tendon penetrating the hollow interior of the first jaw moving sheath and having one end protruding from the first jaw moving sheath and fixed to the first jaw. In the second paragraph, A first sheath holder for fixing the other end of the first jaw fixing sheath; A first tendon actuator connected to the other end of the first jaw moving tendon; A first tendon holder for fixing the other end of the first jaw fixing tendon; and Further comprising a first sheath actuator connected to the other end of the first jaw moving sheath; An endoscopic surgical suture device, wherein the first tendon actuator moves the first jaw moving tendon relative to the first jaw fixing sheath, and the first sheath actuator moves the first jaw moving sheath relative to the first jaw fixing tendon. In the first paragraph, The first jaw includes a first locking hole penetrating the first jaw along the extension direction of the first blade, The first blade reciprocates within the first locking hole according to the reciprocating movement of the first locker. An endoscopic surgical suture device, wherein the first locking hole passes through the first needle insertion hole. In the fourth paragraph, The above first locking hole is formed to intersect with the above first needle insertion hole, An endoscopic surgical suture device, wherein the intersection of the first locking hole and the first needle insertion hole is formed in a shape corresponding to the shape of the first needle groove at a position corresponding to the position of the first needle groove. In the first paragraph, A second jaw including a second jaw extension portion having a second space formed as an empty space inside while extending in one direction, and a second jaw end portion having a second needle insertion hole formed in a direction inclined at a predetermined angle with respect to the one direction into which the needle is inserted; A second jaw connector having a second jaw coupling end coupled to the second jaw extension at one end and including a second plate connected to the second jaw coupling end, and mounted on the jaw base; A second locker including a second locker body that can reciprocate along the one direction within the second space, and a second blade extending from the second locker body along the one direction; A second jaw fixing sheath formed in a hollow shape and fixed to the second jaw joint end; and Further comprising a second jaw moving tendon penetrating the hollow interior of the second jaw fixing sheath and having one end protruding from the second jaw fixing sheath and fixed to the second rocker body; The above needle is provided with a second needle groove in which a portion of the needle is sunken in a direction inclined at a predetermined angle with respect to the extension direction of the needle. An endoscopic surgical suture device, wherein the second blade can pass through the second needle groove within the second needle insertion hole as the second locker reciprocates within the second space. In paragraph 6, further comprising a first shaft formed in a bar shape; The first jaw connector includes a first rotation hole penetrating the first plate in a direction perpendicular to the first plate, and the second jaw connector includes a second rotation hole penetrating the second plate in a direction perpendicular to the second plate. The first rotation hole and the second rotation hole are penetrated together through the first shaft, An endoscopic surgical suture device, wherein the first jaw connector and the second jaw connector are capable of rotating in opposite directions at a predetermined angle with respect to the first shaft as the center. In paragraph 6, A second jaw moving sheath formed in a hollow shape and fixed to the second rocker body; An endoscopic surgical suture device further comprising a second jaw fixing tendon penetrating the hollow interior of the second jaw moving sheath and having one end protruding from the second jaw moving sheath and fixed to the second jaw. In paragraph 8, A second sheath holder for fixing the other end of the second jaw fixing sheath; A second tendon actuator connected to the other end of the second jaw moving tendon; A second tendon holder for fixing the other end of the second jaw fixing tendon; and Further comprising a second sheath actuator connected to the other end of the second jaw moving sheath; An endoscopic surgical suture device, wherein the second tendon actuator moves the second jaw moving tendon relative to the second jaw fixing sheath, and the second sheath actuator moves the second jaw moving sheath relative to the second jaw fixing tendon. In paragraph 6, The second jaw includes a second locking hole penetrating the second jaw along the extension direction of the second blade, The second blade reciprocates within the second locking hole according to the reciprocating movement of the second locker. An endoscopic surgical suture device, wherein the second locking hole intersects the second needle insertion hole. In Article 10, The second locking hole is formed to intersect with the second needle insertion hole, An endoscopic surgical suture device, wherein the intersection of the second locking hole and the second needle insertion hole is formed in a shape corresponding to the shape of the second needle groove at a position corresponding to the position of the second needle groove. In the first paragraph, A roll connector having a cylindrical inner surface and having the above-mentioned jaw base mounted on one side; A center cylinder having an outer circumferential surface in a cylindrical shape, wherein the outer circumferential surface is in contact with the inner circumferential surface of the roll connector; A first rolling sheath formed in a hollow shape and fixed to the above roll connector; and a second rolling sheath; A first rolling tendon penetrating the hollow interior of the first rolling sheath and having one end penetrating the interior of the roll connector to contact the center cylinder; and An endoscopic surgical suture device, comprising a second rolling tendon penetrating the hollow interior of the second rolling sheath and having one end penetrating the interior of the roll connector to contact the center cylinder. In Article 12, An endoscopic surgical suture device, wherein the center cylinder includes a first fixing portion to which one end of the first rolling tendon is fixed, and a second fixing portion to which one end of the second rolling tendon is fixed. In the 13th paragraph, The center cylinder further includes a stopper formed such that a longitudinal end of the center cylinder protrudes radially outwardly along the circumference of the center cylinder, An endoscopic surgical suture device, wherein the radius of the circumference formed by the end of the stopper is formed to be larger than the inner circumference of the roll connector. In Article 14, An endoscopic surgical suture device, wherein the first fixing part and the second fixing part are located on the stopper. In Article 14, The first fixing part and the second fixing part are formed in the shape of a hole penetrating the stopper along the length direction of the center cylinder, An endoscopic surgical suture device, wherein one end of the first rolling tendon is fixed to a hole formed by the first fixing part, and one end of the second rolling tendon is fixed to a hole formed by the second fixing part. In Article 16, One end of the first rolling tendon penetrates the hole formed by the first fixing portion, and one end of the second rolling tendon penetrates the hole formed by the second fixing portion. An endoscopic surgical suture device, wherein one end of the first rolling tendon and one end of the second rolling tendon are connected to each other, so that the first rolling tendon and the second rolling tendon are formed into one tendon. In Article 12, The center cylinder includes a rolling groove on the outer surface thereof, in which one end of the first rolling tendon and the second rolling tendon contact each other along the circumferential direction of the rotational axis of the center cylinder, One end of the first rolling sheath and one end of the second rolling sheath extend in a direction parallel to the rotation axis of the center cylinder, The first rolling tendon extends into the rolling groove by penetrating one end of the first rolling sheath in a direction parallel to the rotational axis of the center cylinder, and the second rolling tendon extends into the rolling groove by penetrating one end of the second rolling sheath in the longitudinal direction of the center cylinder. An endoscopic surgical suture device, wherein the roll connector has a first curved surface that guides the first rolling tendon along the direction in which the first rolling tendon bends, and a second curved surface that guides the second rolling tendon along the direction in which the first rolling tendon bends. In Article 12, A first rolling holder for fixing the other end of the first rolling sheath; A second rolling holder for fixing the other end of the second rolling sheath; A first rolling actuator connected to the other end of the first rolling tendon; and Further comprising a second rolling actuator connected to the other end of the second rolling tendon; The first rolling actuator moves the first rolling tendon relative to the first rolling sheath, and the second rolling actuator moves the second rolling tendon relative to the second rolling sheath. An endoscopic surgical suture device, wherein the first rolling actuator and the second rolling actuator move the other end of the first rolling tendon and the other end of the second rolling tendon in opposite directions. A first jaw extending in one direction and into which a needle is inserted laterally; A second jaw extending in one direction and into which the needle is inserted laterally; A first plate having a first sliding portion in the shape of a groove or hole extending in an inclined direction with respect to the extension direction of the first jaw, and a first jaw connector coupled to one end of the extension direction side of the first jaw; A second plate having a second sliding portion in the shape of a groove or hole extending in an inclined direction with respect to the extension direction of the second jaw, and a second jaw connector coupled to one end of the extension direction side of the second jaw; A first shaft penetrating the first jaw connector and the second jaw connector in a direction perpendicular to the extension direction of the first jaw and the second jaw; A jaw base in which the first shaft is positioned at one position; A bracket fixed to the above jaw base; A slider having a second shaft formed protrudingly, the first and second ends of which are respectively arranged in the first sliding portion and the second sliding portion; A middle sheath formed in a hollow shape and fixed to the above slider; and A middle tendon penetrating the hollow interior of the middle sheath and having one end protruding from the middle sheath and fixed to the bracket; An endoscopic surgical suture device, wherein the slider moves along the extension direction of the middle tendon as a unit with the middle sheath as the middle sheath moves relative to the middle tendon, and the first shaft serves as a rotational center axis and the first jaw connector and the second jaw connector rotate in opposite directions. In Article 20, A first side sheath formed in a hollow shape and fixed to the above jaw base; An endoscopic surgical suture device further comprising a first side tendon penetrating the hollow interior of the first side sheath and having one end protruding from the first side sheath and fixed to the slider. In Article 21, A middle tendon holder for fixing the other end of the middle tendon; A middle sheath actuator connected to the other end of the middle sheath; A first side sheath holder for fixing the other end of the first side sheath; and Further comprising a first side tendon actuator connected to the other end of the first side tendon; An endoscopic surgical suture device, wherein the first side tendon actuator moves the first side tendon relative to the first side sheath, and the middle sheath actuator moves the middle sheath relative to the middle tendon. In Article 21, A second side sheath is formed in a hollow shape and is fixed to the above jaw base; An endoscopic surgical suture device further comprising a second side tendon penetrating the hollow interior of the second side sheath and having one end protruding from the second side sheath and fixed to the slider. In Article 23, A middle tendon holder for fixing the other end of the middle tendon; A middle sheath actuator connected to the other end of the middle sheath; A first side sheath holder for fixing the other end of the first side sheath; A first side tendon actuator connected to the other end of the first side tendon; A second side sheath holder for fixing the other end of the second side sheath; and Further comprising a second side tendon actuator connected to the other end of the second side tendon; An endoscopic surgical suture device, wherein the first side tendon actuator moves the first side tendon relative to the first side sheath, the second side tendon actuator moves the second side tendon relative to the second side sheath, and the middle sheath actuator moves the middle sheath relative to the middle tendon. In paragraph 24, An endoscopic surgical suture device, wherein the first side tendon and the second side tendon are fixed to the slider at positions symmetrical to each other with the middle sheath as the center. In paragraph 22, The above middle tendon is positioned at a position that bisects the jaw base on both sides in the extension direction, An endoscopic surgical suture device, wherein the middle tendon is fixed to the bracket by penetrating the first shaft along the extension direction of the middle tendon. In paragraph 22, A roll connector having a cylindrical inner surface and having the above-mentioned jaw base mounted on one side; A center cylinder having an outer circumferential surface in a cylindrical shape, wherein the outer circumferential surface is in contact with the inner circumferential surface of the roll connector; A first rolling sheath formed in a hollow shape and fixed to the above roll connector; and a second rolling sheath; A first rolling tendon penetrating the first rolling sheath and the hollow interior and having one end penetrating the interior of the roll connector and contacting the center cylinder; and An endoscopic surgical suture device, comprising: a second rolling tendon penetrating the second rolling sheath and the hollow interior, one end of which penetrates the interior of the roll connector and contacts the center cylinder; In Article 27, An endoscopic surgical suture device, wherein the center cylinder includes a first fixing portion to which one end of the first rolling tendon is fixed, and a second fixing portion to which one end of the second rolling tendon is fixed. In Article 28, The center cylinder further includes a stopper formed such that a longitudinal end of the center cylinder protrudes radially outwardly along the circumference of the center cylinder, An endoscopic surgical suture device, wherein the radius of the circumference formed by the end of the stopper is formed to be larger than the inner circumference of the roll connector. In paragraph 29, An endoscopic surgical suture device, wherein the first fixing part and the second fixing part are located on the stopper. In paragraph 29, The first fixing part and the second fixing part are formed in the shape of a hole penetrating the stopper along the length direction of the center cylinder, An endoscopic surgical suture device, wherein one end of the first rolling tendon is fixed to a hole formed by the first fixing part, and one end of the second rolling tendon is fixed to a hole formed by the second fixing part. In Article 31, One end of the first rolling tendon penetrates the hole formed by the first fixing portion, and one end of the second rolling tendon penetrates the hole formed by the second fixing portion. An endoscopic surgical suture device, wherein one end of the first rolling tendon and one end of the second rolling tendon are connected to each other, so that the first rolling tendon and the second rolling tendon are formed into one tendon. In Article 27, The center cylinder includes a rolling groove on the outer surface thereof, in which one end of the first rolling tendon and the second rolling tendon contact each other along the circumferential direction of the rotational axis of the center cylinder, One end of the first rolling sheath and one end of the second rolling sheath extend in a direction parallel to the rotation axis of the center cylinder, The first rolling tendon extends into the rolling groove by penetrating one end of the first rolling sheath in a direction parallel to the rotational axis of the center cylinder, and the second rolling tendon extends into the rolling groove by penetrating one end of the second rolling sheath in the longitudinal direction of the center cylinder. An endoscopic surgical suture device, wherein the roll connector has a first curved surface that guides the first rolling tendon along the direction in which the first rolling tendon bends, and a second curved surface that guides the second rolling tendon along the direction in which the first rolling tendon bends. In Article 27, A first rolling holder for fixing the other end of the first rolling sheath; A second rolling holder for fixing the other end of the second rolling sheath; A first rolling actuator connected to the other end of the first rolling tendon; and Further comprising a second rolling actuator connected to the other end of the second rolling tendon; The first rolling actuator moves the first rolling tendon relative to the first rolling sheath, and the second rolling actuator moves the second rolling tendon relative to the second rolling sheath. An endoscopic surgical suture device, wherein the first rolling actuator and the second rolling actuator move the other end of the first rolling tendon and the other end of the second rolling tendon in opposite directions. In claim 1 or claim 24, The above jaw base includes a raised portion formed by a portion protruding outward, An endoscopic surgical suture device, wherein a predetermined auxiliary member is accommodated in the above-mentioned raised portion. In Article 35, An endoscopic surgical suture device, wherein the auxiliary member is a grasper that can move outward from the raised portion. In Article 36, An endoscopic surgical suture device, wherein the grasper has a spiral-shaped end extending toward the direction of movement of the grasper.