MX2007016054A - Surgical instrument - Google Patents

Abstract

A surgical instrument including a sleeve through which a tool is inserted and having a rotatable housing to facilitate in situ tool exchange and a pair of handles rotatable among at least two lockable positions. One handle includes a latching mechanism and the other includes a locking part for one-handed locking/unlocking. The handles are coupled to drums connected by an inner shaft having winglets for locking the handles to each other or to the housing for rotating the handles about the instrument or relative to each another. Optionally, a knob is coupled to the housing via a bearing shaft having a groove for receiving a movable locking plate, which is movable between locked and unlocked positions such that when locked the tool received in the sleeve is retained within the instrument and when unlocked the sleeve is separable from the remainder of the instrument.

Description

SURGICAL INSTRUMENT FIELD OF THE INVENTION The present invention relates generally to surgical instruments and, more particularly, to a surgical instrument having a removable or detachable sleeve assembly.

BACKGROUND OF THE INVENTION Laparoscopic instruments are used during laparoscopic procedures, which are generally used to examine a patient and / or perform a small surgery on the patient. For example, a laparoscopic instrument can be used to examine the patient's abdominal cavity for signs of disease or abnormality. In addition, fully invasive surgery can be avoided by using the laparoscopic instrument to perform the relatively small surgery. Similarly, in arthroscopic procedures that are minimally invasive, such as over a knee joint, an arthroscopic instrument is used to access the joints or bones.

The laparoscopic (or arthroscopic) instrument generally includes a gripping end and a maneuvering end that are connected by a hollow flexible cylindrical shaft. The laparoscopic instrument is inserted into the patient through a cannula / trocar unit. After the laparoscopic instrument is inserted into the patient through a cannula that is anchored to the body via a small incision, the surgeon can insert one of a plurality of laparoscopic tools into the laparoscopic instrument to perform a particular surgical procedure. For example, if a grasping procedure is required, the surgeon will insert a grasping tool into the laparoscopic instrument. Similarly, if a cutting procedure is required, the surgeon will insert a cutting tool into the laparoscopic instrument. A problem associated with current laparoscopic instruments is that they can cause the surgeon to lose his "feeling" when laparoscopic tools are changed. During surgery, the surgeon develops a specific "feeling" associated with the location and positioning of the laparoscopic instrument relative to the patient's internal cavities. Because the surgeon may be required to perform different procedures during a single surgery, each procedure requiring a different laparoscopic tool, the surgeon may lose the "feel" when changing the laparoscopic tools.

In an exemplary setting, the surgeon uses an examination tool to find the best location to perform a cutting procedure. After finding the best location, the surgeon retrieves the laparoscopic instrument from within the patient, replaces the examination tool with a cutting tool, and reinsertes the laparoscopic instrument into the patient. It can consume time and frustrate the surgeon locating, for a second time, the best location to perform the cutting procedure. Another problem associated with current laparoscopic instruments is that they have a fixed grasping end and, therefore, limit the ability and / or comfort of the surgeon to reach desired positions within the patient's body. Depending on the surgical procedure, the surgeon must often change the position of the laparoscopic instrument or contract its position with the body to reach different parts of the internal cavity of a patient. For example, the surgeon will often attempt to achieve the best cutting position before performing a delicate cutting procedure by rotating and / or moving the grasping end of the laparoscopic tool in the different awkward and awkward positions. Because the grasping end of the laparoscopic instrument is fixed, the surgeon must perform the cutting procedure by grasping the laparoscopic tool in an awkward or awkward position that decreases the likelihood of a satisfactory surgical procedure, or must contract his or her body to gain access to the hard-to-reach area of the patient's internal cavity.

Yet another problem associated with current laparoscopic instruments is that the surgeon must fasten the maneuvering end together to maintain a grasping tool in a closed position. A prolonged buckling action results in fatigue for the hands and also undesirably holds one of the surgeon's hands to perform various tasks. If the surgeon removes or relaxes his hand from the grip end, then the grasping tool may lose its strength in the structure of the inner body that it grasped. Thus, there is a need to provide a laparoscopic tool that allows the surgeon to retain the "feeling" developed during a surgical procedure by changing the laparoscopic tools without having to remove the laparoscopic instrument from within the patient's body. There is also a need for an adjustable grip end for a laparoscopic or arthroscopic instrument to achieve desired and / or comfortable operating positions. There is still another need for a laparoscopic or arthroscopic instrument that can close a grasping tool in a fixed position without requiring manual fastening by the surgeon. The present invention satisfies these and different needs.

BRIEF DESCRIPTION OF THE INVENTION In one aspect of the present invention, a method for replacing a tool of a laparoscopic instrument without removing the laparoscopic instrument from a body is presented. The method includes rotating a housing portion of the laparoscopic instrument to expose one end of the tool to be removed, removing the tool from the laparoscopic instrument without removing the laparoscopic instrument from the body, and inserting a second tool into a sleeve of the laparoscopic instrument. The method may further include registering the exposed end of the tool in at least one of a slit receiving a ball and of a hole receiving a ball from the accommodation part when the portion of the housing assembly is in a blocking position. or pressing a locking lever to unlock the housing assembly from a locking position. The rotation may include rotating the housing part about an axis of the laparoscopic instrument selected from a group consisting of an "X" axis, a "Y" axis, and a "Z" axis. The "X" axis is any axis that lies in the 3-dimensional space occupied by the laparoscopic instrument. Alternatively, the rotation may include rotating the housing assembly over a laparoscopic instrument joint, the housing assembly being pivotally coupled to the joint via an articulation bolt. The method may further include gripping a pair of handles when rotating the housing assembly. The pair of handles is attached to the housing assembly. The method can further include moving the tool linearly when the housing assembly is in a locked position to manipulate a tool device located at an opposite end of the tool. In another aspect of the present invention, a laparoscopic instrument includes a housing assembly that includes a pair of handles and a joint portion. The hinge portion is pivotally connected to the housing part and includes an extension of the tool knob for insertion into an incision of a body. The extension of the knob includes an open end and an elongated hollow shaft (sleeve) for receiving a first tool for insertion into the sleeve through the open end. The articulation portion pivots between a closed position and an open position and is located in the open position with the extension of the knob remaining in the body when there is a change of the first tool with a second tool. The housing assembly may include a cylinder assembly that has at least two cylinders connected to the respective elements of the pair of handles. The cylinders rotate independently of one another to allow the movement of the handles in relation to one another. The cylinders also rotate together in a fixed ratio over a pitch of the shaft through the center of the cylinders to allow rotation of the handles in a fixed relation on the shaft. The articulation in the closed position can rotate around an axis perpendicular to an axis of the extension of the knob to achieve the open position. Alternatively, the articulation portion in the closed position can rotate about an axis parallel to an axis of the extension of the knob to achieve the open position. The hinge portion may further include a locking lever for locking the hinge portion in at least the lock position and the open position. The housing assembly may include a groove that receives a ball to receive a ball end of the first tool and the second tool when the articulation portion is in the closed position. In yet another aspect of the present invention, a method of replacing a tool of a laparoscopic instrument includes inserting a laparoscopic instrument into an incision of a body having a first tool and a pair of handles coupled to the first tool. The laparoscopic instrument housing assembly rotates from a locked position to an open position to expose one end of the first tool. The first tool is removed and a second tool is inserted without removing the laparoscopic instrument from the body. The housing assembly rotates from the open position to the locking position to attach the second tool to the handles of the laparoscopic instrument. The method may further press a locking lever to release the housing assembly from the locking position or press the locking lever to release the housing assembly from the open position. The method can also rotate one of the handles to cause a linear movement of a tool device of the first tool or of the second tool. The method may further include rotating the housing assembly around any axis of the laparoscopic instrument that lies in the 3-dimensional occupied space by the laparoscopic instrument. In still another aspect of the present invention, a method of exchanging the tools in a surgical instrument includes inserting a first tool through an elongated sleeve of the surgical instrument, by moving part of the surgical instrument to allow removal of the first elongate sleeve tool, remove the first tool from the elongated sleeve, and insert a second tool into the elongated sleeve. The surgical instrument may be a laparoscopic instrument or an arthroscopic instrument. The method may further include inserting the surgical instrument together with its elongated sleeve through a cannula in the body. The movement may include rotating a housing assembly of the surgical instrument to expose one end of the first tool to be removed. In another aspect of the present invention, a laparoscopic instrument includes a first rotatable pivot handle between at least two locking positions, or, in another aspect of the present invention, between at least three locking positions. The instrument may further include a cylinder attached to the first handle and a shaft passage through the cylinder. The cylinder is rotatable about the axis to cause the first handle to pivot between the at least two locking positions. The instrument includes a second handle that pivots in pivot between the at least two or three locking positions with the first handle. The instrument may further include a second cylinder attached to the second handle. The shaft also passes through the second cylinder, which is rotated about the axis to cause the second handle to rotate by pivoting between the at least two or three locking positions. The instrument may further include a cylinder attached to the first handle, a second handle attached to a second cylinder, a cylinder of the tool coupled to the cylinder and to the second cylinder, and an axle passing through all three cylinders to be rotatable between the at least two or three blocking positions. The shaft may further include the fins disposed along a length of the shaft and positioned to lock together any pair of the cylinder combination., of the second cylinder, and of the cylinder tool while the shaft is rotated between the at least two or three locking positions. The instrument may further include a housing, a cylinder attached to the handle, an axis passing through the cylinder to secure the cylinder along a central axis of the housing and a push button connected to the shaft to move the shaft between one of the at least two blocking positions and another position. The instrument may further include a cylinder of the tool connected to the handle and a tool having a ball end and one end of the tool. The ball end of the tool is removably connected to the tool cylinder in at least two or three locking positions. In yet another aspect of the present invention, a laparoscopic instrument has a transverse axis along which a tip is disposed. The laparoscopic instrument includes a pivoting trigger handle in pivot between at least two locking positions on an axis orthogonal to the transverse axis. The instrument may further include a trigger cylinder attached to the trigger handle, a cylinder of the tool is rotatably secured to the trigger cylinder in the at least two locking positions, and a clamping cylinder attached to a clamping handle. The locking cylinder is rotatably secured to the trigger cylinder when the trigger cylinder is in an unlocked position. The instrument also includes a finned shaft to axially secure the trigger cylinder, the tool cylinder, and the locking cylinder to each other. The finned shaft may include one or more finlets, slot portions of a wedge seal, keys, or bolts. The finned shaft is movable between a first position and a second position. The tool cylinder and the trigger cylinder are rotatably secured with respect to one another in the first position, and the trigger cylinder and the clamping cylinder are rotatably secured with respect to the other in the second position. The first position corresponds to one of the at least two blocking positions. In still another aspect of the present invention, a method of using a laparoscopic instrument has a trigger cylinder connected to an instrument handle. The method includes rotating the trigger cylinder from a first locking position of the cylinder to a second locking position of the cylinder. The method may further include unlocking the trigger cylinder from the first locking position of the cylinder before turning the cylinder to the second locking position of the cylinder. The rotation may include turning the trigger cylinder together with a clamping cylinder to a second position of the cylinder. The method may further include pressing a button to unlock the trigger cylinder of the first locking position of the cylinder and releasing the push button to lock the trigger cylinder and the locking cylinder in the second locking position of the cylinder. The method may further include disengaging the locking cylinder from at least one thrust pin when pressing the push button. The method may further include positioning an axis in a first position of the shaft in a rotary fashion to secure the trigger cylinder to the tool cylinder in the first locking position of the cylinder, pushing the axis of the first position of the shaft to a second position of the shaft to rotatably secure the trigger cylinder to the clamping cylinder in an unlocked position of the cylinder, the trigger cylinder is rotatably released from the tool cylinder in the unlocked position of the cylinder, by rotating the clamping cylinder together with the trigger cylinder to the second position of the cylinder, and pushing the axis of the second position of the shaft to the first position of the shaft to rotatably secure the trigger cylinder to the tool cylinder in the second position of blocking the cylinder. The method may also include the insertion of a tool into the laparoscopic instrument and, move the tool linearly to manipulate a tool device located at one end of the tool. The displacement can be done linearly by rotating a handle that engages the cylinder of the trigger. According to another aspect of the present invention, a laparoscopic instrument includes a first handle and a second handle. The first handle includes a latching mechanism. The second handle is rotatable coupled to the first handle and includes a locking piece. The first handle and the second handle are in a locked position when the latching mechanism engages with the locking piece, and the first handle and the second handle are in an open position when the latching mechanism is disengaged from the latching piece. blocking. The latching mechanism may include at least one locking tooth and the locking part includes at least one locking tooth, the locking tooth being coupled to the locking tooth in the locking position. The latch mechanism may further include a latching lever engaged by pivot to the first handle. The hook lever aligns with the first handle in the locked position. A free end of the latching lever can pivot in a direction away from the first handle to achieve the open position. The latch mechanism may include a limiter of the lever located along the rotational path of the latch lever to limit the rotation of the latch lever. The limiter of the lever can be coupled close to a free end of the hooking lever. The latch mechanism may include a part that engages the teeth locking attached to a free end of a latch lever and the latch includes a portion that engages the latch teeth. The latch lever is rotatably coupled to the first handle at a fixed end, and the latch lever aligns with the first handle in the locked position. The part that engages the locking teeth is aligned and engages the part that engages the locking teeth when the first handle is in the locked position. In another aspect of the present invention, a method is directed to lock and unlock a first handle of a laparoscopic instrument relative to a second handle. The method includes pushing the first handle toward the second handle to engage a latching mechanism of the first handle to a locking part of the second handle. The method may include tilting the latching mechanism against the locking piece to secure a plurality of teeth to each other. At least one of the plurality of teeth can be located in the engaging mechanism and corresponding to the plurality of teeth can be located in the locking part. The method may further include rotating the latching mechanism away from the first handle to unlock the first handle from the second handle. The method may further include mounting the latch mechanism on a pivoting latch lever coupled to the first handle and rotating a free end of the latch lever to disengage the latching mechanism from the latch piece. The method may further include limiting the pivoting movement of the latching lever using a lever limiter. The limited lever can be coupled to the first handle close to the free end of the latching lever. The method may also include rotating the free end of the latching lever in a direction that is perpendicular to the rotating direction of the first handle substantially toward the second handle. Still further, the method may include coupling the latching mechanism to a gripping end of the first handle. In yet another aspect of the present invention, a laparoscopic instrument includes a pair of pivoting handles between a locked position and an open position. The laparoscopic instrument also includes a hook lever, a limiter of the lever, a part that engages the teeth, and a blocking piece. The latching lever is rotatably coupled to a trigger handle of the pair of handles at a rotating point. The limiter of the lever is coupled to the trigger handle proximate a free end of the hooking lever and is directed to restrict the pivoting movement of the hooking lever. The part that engages the tooth is coupled to the trigger handle. The locking piece is coupled to the handle for fixing the pair of handles such that the locking piece is coupled to the engageable part of the tooth when the pair of handles is in the locked position, and such that the locking piece is unlatched from the handle. the part that engages the teeth when the pair of handles are in the open position. The locking piece can be pushed towards the part that engages the teeth by means of a frictional force exerted by at least one pair of locking teeth. In another aspect of the present invention, there is provided a method of replacing a tool with a sleeve of a surgical instrument without having to remove the sleeve from a body. The surgical instrument may be laparoscopic or arthroscopic. The method includes pushing a releasable locking mechanism of the surgical instrument from a locking position to an unlocking position, such that it causes the sleeve to be uncoupled from the surgical instrument, and to remove at least the surgical instrument part from the sleeve, such that the tool emerges from the sleeve together with at least the part of the surgical instrument. The method may further include rotating a housing assembly of the surgical instrument to expose one end of the tool, and separating the tool from the laparoscopic instrument. A second tool is inserted through the sleeve. The thrust may include pressing a locking structure that is immobilized so that it is released with a portion of the tool or moving a locking plate in a direction generally away from the tool. According to yet another aspect of the present invention, there is provided a surgical instrument that includes a releasable housing assembly coupled to an elongated hollow sleeve via a movable locking mechanism between at least one locking position and an unlocking position such that in the locking position, the sleeve is secured to the housing assembly and in the unlocked position the sleeve is separated from the housing assembly. The locking mechanism may include a movable locking plate and the housing assembly includes an elongated shaft having a groove formed along its length, the movable locking plate shaped to fit within at least part of the slot when the locking mechanism is in the blocking position. The surgical instrument may further include a rotary knob coupled to the locking plate and secured to the elongated hollow shaft, and a tool inserted through the elongated hollow shaft. The surgical instrument is laparoscopic or arthroscopic, for example. The sleeve may include an insulating layer. The housing assembly may include a pair of handles, and the surgical instrument may further include a rotating articulation portion connected to the housing assembly and include a sleeve for insertion into an incision of a body, the sleeve having an open end and an elongated hollow shaft for receiving a first tool for insertion into the hollow shaft through the open end, the hinge portion pivots between a closed position and an open position, the hinge portion is placed in the open position with the sleeve staying in the body when the first tool changes with a second tool. The articulation portion of the surgical instrument may further include a locking lever for locking the hinge portion in at least the locking position and the open position. The housing assembly may further include a slit that receives a ball to receive a ball end of a tool when the hinge portion is in the closed position. According to yet another aspect of the present invention, a surgical instrument includes a pair of handles, a cylinder assembly coupled to the pair of handles, a rotating knob assembly that includes a locking mechanism, an elongated hollow sleeve coupled to the knob, and a tool inserted through the at least the knob and the elongated hollow sleeve, wherein the locking mechanism is interconnected so that it is released to the knob assembly with the cylinder assembly such that in a locked position the knob assembly is secured to the cylinder assembly and in an unlocking position the knob assembly is separable from the cylinder assembly. The cylinder assembly can include at least two cylinders connected to the respective elements of the pair of handles, the cylinders rotate independently of each other to allow the movement of the handle relative to one another, the cylinders also rotate together in a fixed relation to each other. an axis that passes through the center of the cylinders to allow the rotation of the handle in a fixed relation on the axis. The rotating knob assembly may include a knob having an opening and a support shaft disposed in the opening and having a groove formed thereon to receive a portion of the locking mechanism in the locked position. The cylinder assembly may include a receiving groove for receiving one end of the tool when the locking mechanism is in the locked position. The surgical instrument may further include a rotatable hinge portion connected to the cylinder assembly, the hinge portion that rotates between a closed position and an open position, one end of the tool exposed when the hinge portion is in the open position.

The above summary of the present invention is not intended to represent each embodiment, or each aspect, of the present invention. The additional specific features and benefits of the present invention are apparent from the detailed description, the figures, and the claims set forth below.

BRIEF DESCRIPTION OF THE FIGURES Figure IA is a detailed perspective view showing a first portion of a laparoscopic instrument according to an embodiment of the present invention. Figure 1AI is a bottom view of the perspective of the tool cylinder shown in Figure IA according to one embodiment of the present invention. Figure IB is a detailed perspective view showing a second portion to the laparoscopic instrument shown in Figure IA. Figure 2 is a perspective view of the laparoscopic instrument assembly of Figures IA and IB.

Figure 3 is a front view of the laparoscopic instrument of Figures IA and IB. Figure 4 is a top view of the laparoscopic instrument of Figures IA and IB.

Figure 5 is a rear view of the laparoscopic instrument of Figures IA and IB. Figure 6 is a bottom view of the laparoscopic instrument of Figures IA and IB.

Figure 7 is a view of the left side of the laparoscopic instrument of Figures IA and IB, showing one end of the tool of the laparoscopic instrument. Figure 8 is a view of the right side of the laparoscopic instrument of Figures IA and IB, showing one end of the handle of the laparoscopic instrument. Figure 9 is a detailed perspective view showing a subset of the cylinder of the laparoscopic instrument of Figures IA and IB. Fig. 10 is a perspective view of the assembly showing the details of the interior space of the sub-assembly of the cylinder of Fig. 9. Fig. 11 is a cross-sectional plan view of the sub-assembly of the cylinder of Fig. 9. Figs. 12A-12C are perspective views of an assembly comprising a finned shaft and a handle cylinder according to three alternative embodiments of the present invention, respectively.

Figure 13 is a cross-sectional view showing the interaction between a finned shaft and a subset of the cylinder according to one embodiment of the present invention.

Figure 14 is a cross-sectional view of the perspective of the sub-assembly of the cylinder of Figure 9 showing a push-button in a fully depressed position and pair of handles in a first position.

Fig. 15 is a cross-sectional view of the perspective showing the pusher of Fig. 14 in the fully depressed position and the pair of handles in a second position. Figure 16 is a cross-sectional view of the perspective showing the pusher of Figure 14 in a non-depressed position and the pair of handles in the second position. Figure 17 is a partial perspective detailed view showing a sub-assembly of the laparoscopic instrument shotgun of Figures IA and IB in an open position of the cylinder head. Figure 18 is a perspective view of the sub-assembly of the shotgun of Figure 17 in an open position of the stock exposing an insertion end of a laparoscopic tool.

Figure 19 is a perspective view of the sub-assembly of the shotgun of Figure 17 showing an assembled subassembly of the shotgun in an open position of the stock. Figure 20A is a representative schematic front view showing an alternative embodiment of a subset of the shotgun rotating on an "X" axis of a laparoscopic instrument. Figure 20B is a side view representative of Figure 20A. Figure 21A is a representative top view showing another alternative embodiment of a subset of the shotgun rotating on a "Y" axis of a laparoscopic instrument. Figure 21B is a front view representative of Figure 22 A. Figure 22 A is a perspective view of pair of handles of the laparoscopic instrument of Figures IA and IB in an open aligned position. Figure 22B is a perspective view of the pair of handles of Figure 22A in a locked position. Figure 23A is a perspective view of the pair of handles of Figure 22A in a closed offset position.

Figure 23b is a perspective view of the pair of handles of Figure 22 A in an open offset position.

Figure 24 is a perspective view of a surgical instrument illustrating an arrangement for removing the surgical instrument from a sleeve that remains in place, according to another embodiment of the present invention. Figure 25 is a side view of a surgical instrument partially retracting from an insulated sleeve and a sectional view of the insulated sleeve that is inserted into a body through a cannula / trocar unit anchored through an incision . Although the invention is susceptible to different modifications and alternative forms, specific embodiments are shown by way of example in the drawings and are described in detail herein. It should be understood, however, that the invention is not intended to be limited to the particular forms disclosed. Rather, the invention is to cover all modifications, equivalents, and alternatives that fall within the spirit and scope of the invention as defined by the appended claims.

DETAILED DESCRIPTION OF ILLUSTRATED MODALITIES With reference to Figures IA and IB, a general description of the parts associated with a laparoscopic instrument 100 is provided according to one embodiment of the present invention. A more detailed description of the parts and their associated movements is provided in subsequent drawings. The laparoscopic instrument 100 includes a push button 102 having a generally cylindrical disk shape. The push button 102 is connected to a finned shaft 104 via a knob shaft 106, which is inserted through a central hole of the push button 102. The push button 102 is adjacent to a spring 108, which includes an end that is in contact with the push button 102 and another end that is in contact with a tool cover 110. The tool cover 110 is a generally cylindrical plate that includes a central hole and a plurality of countersunk holes in the periphery. The finned shaft 104 protrudes through the central hole of the tool cover 110 towards the push button 102. Two connecting screws 112 connect the tool cover 110 to a housing 114. The housing 114 includes a receiving part 116 of the cylinder for accommodating at least in part a cylinder 118 of the tool, a cylinder 120 of the trigger, and a clamping cylinder 122, which is located adjacent to the other as shown. The housing 114 further includes a slit 115 that receives a ball to allow pivotal movement of the housing 114, as described in more detail below with reference to Figures 17-19. With reference to Figure 1AI, the cylinder 118 of the tool is illustrated as being generally cylindrical, having a central through hole, which is cylindrical in shape, and which includes a plurality of slits through which the finned shaft 104 highlights. Although the plurality of slits is shown to have three slits, alternatively, any number of slots can be used. The height of the groove extends only with the part of the tool of the cylinder 118 (ie, the grooves are not through grooves). For example, the height of the slit is half the height of the cylinder 118 of the tool. In alternative embodiments, the height of the slot extends with the complete cylinder 118 of the tool. In still other alternative embodiments, the central hole may have any different three-dimensional shape, for example, a partial toroid, to receive the finned shaft 104 through. As explained in more detail below, the slits of the cylinder 118 of the tool engage the finned shaft 104 to secure the cylinder 118 of the tool to the clamping cylinder 122 in any one of a plurality of positions. A washer 124 of the cylinder and a plug 126 are located between the cylinder 118 of the tool and the housing 114. The cylinder 118 of the tool includes a hole 127 that receives a ball along its periphery as shown. The trigger cylinder 120 is generally cylindrical and is attached to a trigger handle 128 that includes a latching mechanism 130. The trigger cylinder 120 is attached to the trigger handle 128 directly or through a mechanical link. The trigger cylinder 120 includes a central slotted hole having substantially the same shapes and dimensions as the slotted hole in the tool cylinder 118 with which the finned shaft 104 protrudes. The clamping cylinder 122 is generally cylindrical and is attached to a clamping handle 132 which includes a locking part 134 for the latching mechanism 130. The clamping cylinder 122 is attached to the clamping handle 132 directly or through a mechanical joint . The clamping cylinder 122 includes a central slotted hole having substantially the same shapes and dimensions as the slotted holes of the tool cylinder 118 and the trigger cylinder 120 with which the finned shaft 104 protrudes. The clamping cylinder 122 further includes a plurality of the fixing holes 135 for securing the clamping cylinder 122 as described in more detail below. The finned shaft 104 generally includes a cylindrical shaft 136 and a plurality of fins 138, which are formed in two symmetrical pairs along the axis 136. The end of the fin of the finned shaft 104 is attached to a locking plate 140 by means of a locking screw 142. In alternative embodiments, the fins 138 They can be slots for a wedge gasket or parts of that, keys, or bolts. A clamping cover 144 is located along the finned shaft 104, between the locking plate 140 and the clamping cylinder 122. The clamping cover 144 includes a central slotted hole having substantially the same shape and dimensions as the holes grooves of the cylinder 118 of the tool, of the trigger cylinder 120, and of the clamping cylinder 122 through which the finned shaft 104 protrudes. Furthermore, the fastening cover 144 includes a plurality of bolt receiving holes through which the corresponding thrust bolts 146 are inserted. The thrust bolts 146 protrude through the locking plate 140, the fastening cover 144. , and the fixing holes 135 for securing the clamping cylinder 122 to the locking plate 140. The locking plate 140 includes a recessed slot 148 for receiving the finned shaft 104 and a plurality of bolt receiving holes therethrough. which insert the corresponding push pins 146. A lock washer 150 is inserted between the head of the locking screw 142 and the locking plate 140. Now back to figure IB, the housing 114 is pivotally connected to a joint 152 by means of a hinge pin 154, which is inserted with a plurality of the holes 156 of the pivot of the hinge. The housing 114 is attached to the link 152 in a rotating portion 157 of the housing, which is inserted into a slotted area of the joint of the link 152. The link 152 includes a locking lever 158, which is attached to the link 152. by means of a screw 160 of the lever. The locking lever 158 is inserted into a slot 159 of the lever, which is located at a lower end of the link 152. A spring 162 of the lever is located within the slot 159 of the lever to maintain the locking lever 158 in a closed position. The locking lever 158 includes an actuation end 163 and a locking end 165. The actuation end 163 is actuated by pushing the locking lever 158 towards the spring 162 of the lever to unlock the joint 152 from a closed position to a position open, as is described in more detail below with reference to figures 17-19. When the locking lever 158 is pressed, it rotates about the axis of the screw 160 of the lever such that the blocking end 165 causes the link 152 to rotate about the axis of the hinge bolt 154 (the "Z" axis). A long bearing 164 and a short bearing 166 are used to rotatably attach a knob 168 to the link 152. A plurality of set screws 170 are screwed into the knob 168 to retain the long bearing 165 and the short bearing 166 relative to to knob 168. An extension or sleeve 172 of the knob is attached to knob 168 using a threaded end of extension 172 of the knob. The extension 172 of the knob is a hollow shaft (or sleeve) that is used to accommodate a tool holder 174, which is inserted into the recess of the extension 172 of the knob. The tool holder 174 is a hollow shaft that accommodates a tool 176, which includes a ball 178 at one insertion end and a scissor device 180 at a maneuvering end. The tool 176 is inserted into the tool holder 174, as shown. According to the embodiment shown, the device 180 of the scissors is a device with three gripping members. The outer surface of the sleeve 172 can be composite or coated with an insulating material, such as teflon, to electrically isolate the operator of the instrument 100 from the sleeve 172 when using an electric tool such as a cauterization tool. For example, the sleeve 172 is wrapped with a Teflon shrink tube. Figures 2-8 show different views of the laparoscopic instrument 100 in an assembled form and represent the representative movements of the trigger handle 128. The cylinder 118 of the tool, the trigger cylinder 120, and the clamping cylinder 122 were assembled together with the housing 114. The trigger handle 128 and the fixing handle 132 are shown in a locking position, which is described in more detail below. The housing 114 and the link 152 are shown in a closed position, and the ball 178 is received by the hole 127 receiving a ball from the cylinder 118 of the tool. As represented by the dashed lines, the trigger handle 128 is rotated relative to the fixing handle 132 in a counterclockwise direction (from the locked position) to open the scissor device 180 at the end of the handle. maneuver of the tool 176. The rotation of the trigger handle 128 generally causes the rotation of the tool cylinder 118, which in turn causes the linear movement of the tool 176. The linear movement of the tool 176 causes an opening / closing movement for the tool 176. 180 device of the scissors. The relationship between the three cylinders 118, 120, 122 (also referred to as the interleaved cylinder assembly) is described in more detail below. Further, as best seen in Figure 3, the position of the shaft 136 (represented by the screw of the push-button 106) can be aligned with the hole 156 of the pivot of the hinge or it can be different from the position of the hole 156 of the hinge pin. the joint For example, the center of the spindle 136 may be the same distance in the direction of the "Y" axis from the "X" axis of the tool 176 as the bore 156 of the pivot of the hinge. Alternatively, the distance between the center of the shaft 136 and the "X" axis of the tool 176 may be smaller or larger than the distance between the hole 156 of the pivot of the hinge and the "X" axis of the tool 176.

An electrical probe 182 projects and attaches to the housing 114. The electrical probe 182 is electrically coupled to the tool 176 (such as a cauterization tool) to supply an electrical current with an external current supply. For example, the electrical current is supplied by means of the electric probe 182 to an electrocautery tool 176 for cauterizing the tissue of the organs during a surgical procedure. Alternatively, a hole or plug is formed in the housing 114 to receive an electrode therein. With reference to Figures 9-11, the cylinder 118 of the tool, the trigger cylinder 120, and the clamping cylinder 122 are sandwiched between the tool cover 110 (located at the top, adjacent to the cylinder 118 of the tool) and fixing cover 144 (located at the bottom, adjacent to the fixing cylinder 122). The push button 102 is located at the top of the interleaved cylinder assembly - proximate the tool cover 110 - and the locking plate 140 is located at the bottom of the interleaved cylinder assembly - close to the fastening cover 144. shaft 136 protrudes through each of the clamping cover 144, the clamping cylinder 122, the firing cylinder 120, the cylinder 118 of the tool, and the tool cover 110. The shaft 136 is joined by means of the screw of lock 142 to lock plate 140 and by means of screw 106 of button to push button 102. Shaft 136 also protrudes through spring 108. Finels 138 attached to shaft 136 are adapted to protrude only through the slits corresponding to the tool cylinder 118, the trigger cylinder 120, the clamping cylinder 122, and the clamping cover 144. Depending on whether the push button 102 is in a depressed position or not imida, the fins 138 highlight with only some of the cylinder of the tool 118, the trigger cylinder 120, the clamping cylinder 122, and the clamping cover 144. Depending on the position of the fins 138, the rotational movement of the cylinder, 120 of the trigger is locked with respect to the tool cylinder 118 or the clamping cylinder 122.

The fins 138 include pairs of the fins 138a of the top and pairs of the fins 138b of the bottom. According to the indications of Figs. 10-11, the push button 102 is in a non-depressed position in which the fins of the upper part 138a protrude through the cylinder 118 of the tool and the cylinder 120 of the trigger. In the non-depressed position, the rotational movement of the trigger cylinder 120 is fixed with respect to the cylinder 118 of the tool. If the push button 102 is in a depressed position, the fins 138a on the top rotate inside the trigger cylinder 120 (where the fins 138b of the bottom are located in the non-depressed position), and the fins 138b of the bottom rotate within the fixing cylinder 122. In the depressed position, the rotational movement of the trigger cylinder 120 is fixed with respect to the fixing cylinder 122. The new arrangement according to the present invention allows the handles 128, 132 to be rotated regardless of the position of the cylinder 120 of the trigger relative to the cylinder 118 of the tool. This aspect advantageously allows the surgeon to manipulate the handles 128, 132 in any position of the cylinder. According to the present invention, instead of having to twist or turn the surgeon's body in order to gain access to an area difficult to reach from the internal cavity of a patient, the surgeon simply rotates the cylinder to achieve a new position and can continue for manipulating the handles 128, 132, which control the tool 176 within the patient's body. It is advantageous for the handles 128, 132 to be manipulated even as if they rotated together about the axis 136.

With reference to Figures 12A-12C, the alternate embodiments of the finned shaft 136 of Figures 1-11 are shown representing three different combinations of the flap. For ease of understanding, FIG. 12B shows the finned shaft 104 of FIGS. 1-11, including shaft 136 and the two sets of fins 138. In an alternative embodiment, shown in FIG. 12A, a finned shaft 1204a includes an axis 1236a and a single set of fins 1238a. To accommodate the single assembly of the flaps 1238a, the holes through which the finned shaft 1204a (eg, slotted opening of a trigger cylinder 1220a) are modified to include a single slit 1239a stand out. Each flap on the set of flaps 1238a is spaced to block most of either cylinder when they are rotated. In another alternative embodiment, shown in Figure 12C, a finned shaft 1204c includes an axis 1236c and three sets of the fins 1238c approximately 120 degrees apart. To accommodate the three sets of the flaps 1238c, the holes through which the finned shaft 1204c (eg, slotted opening of a trigger cylinder 1220c) protrudes are modified to include three slits 1239c. With reference to Figure 13, a schematic cross-sectional representation illustrates the relationship between a finned shaft 1304 and a plurality of cylinders, a cylinder 1318 of the tool, a cylinder 1320 of the trigger, and a clamping cylinder 1322, and the different ones finned shaft positions 1304 relative to the cylinders 1318, 1320, 1322. The finned shaft 1304 includes an axle 1336 and a set of two fins 1338. From left to right, the cylinders include the cylinder 1318 of the tool, the cylinder 1320 of the trigger, and the clamping cylinder 1322. The cylinders 1318, 1320, 1322 are housed within a housing 1314 such that each cylinder can rotate freely unless it is locked in place by the fins 1338. The cylinders 1318, 1320 , 1322 are fixed from the rotational movement when the studs 1338 protrude through corresponding grooves of the cylinder. The movement of the finned shaft 1304 immobilizes one or more of the cylinders 1318, 1320, 1322 with respect to each other to achieve a desired rotational combination. For example, as described below, the movement of the finned shaft 1304 in any of a plurality of the AF positions achieves any desired rotational combination for the cylinders 1318, 1320, 1322. As indicated in FIG. 13, the insert and Cylinder combinations can be used to provide a type of "binary logic" for mechanical devices, such as gears and clutches. The versatility of using the flaps and cylinders according to the present invention allows any combination of cylinder movements to be made. The concepts of Figure 13 and related modalities can be implemented in any mechanical system, including laparoscopic instruments. The present invention expressly contemplates that the blocking and release modalities shown and described herein are not limited to laparoscopic instruments. In position A, the fingers 1338 are located to the right of the fixing cylinder 1322. In this position, each of the cylinders 1318, 1320, 1322 is free to rotate with respect to the other. In position B, the finned shaft 1304 moves towards the cylinders 1318, 1320, 1322 such that the fins 1338 are located within the fastening cylinder 1322 only. Accordingly, in this position the clamping cylinder 1322 is fixed from the rotational movement, while the cylinder 1318 of the tool and the cylinder of the trigger 1320 are free to rotate. In the position C, the finned shaft 1304 moves further towards the cylinders 1318, 1320, 1322 such that the flaps 1338 are located within the cylinder 1320 of the trigger and the clamping cylinder 1322. Accordingly, in this position the trigger cylinder 1320 and the clamping cylinder 1322 are fixed from the rotational movement, while the Cylinder 1318 of the tool is free to rotate. In the D position, the finned shaft 1304 moves further towards the cylinders 1318, 1320, 1322 such that the fins 1338 are located within the three cylinders. Therefore, in this position each of the cylinders 1318, 1320, 1322 is set of the rotational movement. In position E, finned shaft 1304 is further moved to cylinders 1318, 1320, 1322 such that fins 1338 are located within cylinder 1318 of the tool and cylinder 1320 of the trigger. Accordingly, in this position the cylinder 1318 of the tool and the trigger cylinder 1320 are fixed from the rotational movement, although the locking cylinder 1322 is free to rotate. In the F position, the finned shaft 1304 is further moved to the cylinders 1318, 1320, 1322 such that the fins 1338 are located within the tool cylinder 1318 only. Accordingly, in this position the cylinder 1318 of the tool is fixed from the rotational movement, although the trigger cylinder 1320 and the clamping cylinder 1322 are free to rotate.

With reference to Figures 14-16, a cut-away perspective view of the cylinders 118, 120, 122 is shown revealing the finned shaft 104 in different positions together with the fins 138. Referring to these figures, the movement of the finned shaft 104 and handle 128, 132 will now be described in more detail. In Figure 14, push button 102 is shown in a depressed position, and handles 128, 132 are shown in a first position. Pressing the push button 102 causes the finned shaft 104 to slide in a direction away from the movement of the push button 102 until the fins 138a on the top are located within the trigger cylinder 120 and the fins 138b of the bottom are located inside the locking cylinder 122. In this configuration, the trigger cylinder 120 and the clamping cylinder 122 are fixed or locked together, which in turn locks the handles 128, 132 together. In addition, the locking plate 140 and the thrust pins 146 are correspondingly pushed away from the clamping cylinder 122, which is now disengaged from the locking plate 140 and from the thrust pins 146. Accordingly, in the depressed position the trigger cylinder 120 and the clamping cylinder 122 are locked with respect to each other. In addition, because the clamping cylinder 122 now disengages from the locking plate 140 and from the thrust pins 146, the combination of the trigger cylinder 120 and the clamping cylinder 122 is free to rotate about the "Z" axis. (the axis of finned shaft 104). In Figure 15, the push button 102 remains in the depressed position. However, the handles 128, 132 have been rotated counter clockwise from the first position to a second position. Thus, the only two components that change their position from the first position to the second position are the trigger handle 128 and the attachment handle 132. For example, the position of the tool cylinder 118 remains unchanged. By turning the handles 128, 132 to a new position, while maintaining the position of the tool cylinder 118, a surgeon using the laparoscopic instrument 100 may be able to achieve a position that better grasps the handles 128, 132 without changing the the position of the interior part of the tool 176 within a patient and without turning or twisting the surgeon's body to maintain a comfortable and firm grip. As can be seen in Figures IA and 9, the fixing handle 132 is secured to the locking plate 140 by inserting the push pins 146 through the fixing holes 135. Three pairs of fixing holes 135 are shown, and each pair of the fixing hole represents a different position of the handle (up to three different positions in the mode shown in figure A). When the push button 102 is depressed, the push pins 146 disengage the fixing holes 135, allowing the clamping cylinder 122 to rotate freely. The force exerted by the spring 108 allows the surgeon to rotate the clamping cylinder 122 (and thereby the clamping handle 132) until the push pins 146"click" in alignment with a different set of the clamping holes 135. Although three pairs of fixing holes 135 are shown allowing the fixing handle 132 to be rotated between one of three different positions, smaller or additional fixing holes are contemplated in the different embodiments to allow the fixing handle 132 to rotate between a corresponding number of positions. For example, if four positions are desired, four pairs of fixing holes 135 are formed in the locking cylinder 122 and spaced according to each desired position. Although two thrust pins 146 are shown in Figure IA, in different embodiments, a different number of thrust bolts are used instead. In FIG. 16, the push button 102 is shown in the non-depressed position to couple the clamping cylinder 122 to the locking plate 140 and the trigger cylinder 120 to the cylinder 118 of the tool. The fins 138 are now located within the cylinder 118 of the tool and the trigger cylinder 120 to secure the cylinder 118 of the tool and the cylinder 120 of the trigger to each other. The push pins 146 engage the clamping cylinder 122, when fixing the handles 128, 132 in a second position. When the cylinder 118 of the tool and the trigger cylinder 120 are fixed in relation to one another, that is, in the non-depressed position, the trigger handle 128 can be partially rotated. The rotation of the trigger handle 128 causes the rotation of the tool cylinder 118, which in turn causes the linear movement of the tool 176. The linear movement of the tool 176 allows the surgeon to use the maneuvering end of the tool 176. For example , a movement against the clockwise direction of the trigger handle 128 causes the opening of the device 180, while a clockwise movement of the trigger handle 128 causes the closure of the device 180 of the scissors. With reference to Figures 17-19, a subset of the laparoscopic instrument 100's gun is shown in an open "cylinder head" position. The term "shotgun" subset refers to the similarity of the laparoscopic instrument 100 to the butt of a shotgun, which allows the surgeon to replace the laparoscopic tool without removing the instrument 100 from the patient's body. Although the instrument 100 is inserted into the patient's body, the sub-assembly of the shotgun can be opened and closed like a shotgun to expose one end of the tool for removal and reinsertion. The laparoscopic instrument 100 includes a hinge portion 1700 and a housing portion 1702, which together form the sub-assembly of the shotgun having a "yoke" that pivots on a hinge 152. The hinge portion 1700 generally includes hinge 152, the tool 176, and the device 180 of the scissors. The housing part 1702 generally includes the housing 114, the handles 128, 132, and the cylinders 118, 120, 122. The rotation of the joint 152 with respect to the housing 114 of the laparoscopic instrument 100 is described in more detail with respect to the figures. 18 and 19. In Figure 17, the link 152 is assembled to the rotating portion 157 of the housing using the hinge bolt 154. The housing 114 pivots on the hinge pin 154 on the "Z" axis to provide the opening and / or the closing movement of the housing portion 1702 with respect to the articulation portion 1700. In FIGS. 18 and 19, the articulation portion 1700 is shown in an open position, which has pivoted in a counter direction. clockwise about the "Z" axis from the closed position. While the articulation portion 1700 is pushed into the open position, the ball 178 - together with the tool 176 - retracts from the hole 127 that receives a ball from the cylinder 118 of the tool. To open the articulation portion 1700, the locking lever 158 is depressed in a direction toward the tool 176 (as previously described with reference to FIG. IB) such that the locking end 165 (shown in FIG. IB) releases the portion that rotates 157 of the housing. While the articulation portion 1700 is pushed into the open position, the ball 178 passes through the slit 115 receiving a ball formed in the housing 114 until the ball 178 leaves the slit 115 receiving a ball. After moving the articulation portion 1700 in the open position, the surgeon can remove the tool 176 from within the articulation portion 1700 and replace it with another laparoscopic tool without removing any other part of the instrument 100 from the patient's body. Thus, during the replacement of the tool, the extension or sleeve 172 of the knob remains within the patient in a fixed position. That is, in contrast to the laparoscopic instruments of the prior art, it is not required that the surgeon remove the instrument 100 from within the patient to replace the tool 176 with another tool. Holding the instrument 100 within the patient while exchanging the tools advantageously eliminates the need for the surgeon to search for and find a body part or a previously located position. The location of the hole 127 receiving a ball is found by drawing a circle on the hinge bolt 154, whose radius extends to the end of the ball 178 (when the tool 176 is fully inserted into the knob extension 172). Where the circle intersects cylinder 118 of the tool is where the manufacturer should form the hole 127 that receives a ball. In an alternative embodiment, instead of adapting the articulation portion 1700 to oscillate open, the articulation portion 1700 is adapted to slide open. For example, instead of having the housing 114 rotatable with respect to the link 152, the housing 114 slides open with respect to the link 152 in, for example, a "Z" axis direction, to allow removal and / or the insertion of the tool 176. With reference to Figures 20A and 20B, an alternative embodiment of the present invention shows a laparoscopic instrument 2000 that includes a housing 2014 and a hinge 2052. The hinge 2052 pivots about an "X" axis of the laparoscopic instrument 2000. Specifically, the hinge 2052 pivots about a hinge bolt 2052, which is inserted through a hinge of the pivot of the hinge 2056, with respect to the housing 2014. With reference to figures 21 A and 21B , an alternative embodiment of the present invention shows a laparoscopic instrument 2100 including a housing 2114 and a hinge 2152. The articulation 215 2 pivots about a "Y" axis of the laparoscopic instrument 2100. Specifically, the hinge 2152 pivots about a hinge pin 2152 with respect to the housing 2114. The slits in the housing 2014 and 2114, respectively, and the respective cylinders they will allow the exposed part of each respective axis and ball to travel within each respective cylinder.

With reference to Figures 22A-23B, the locking of the trigger handle 128 with respect to the fixing handle 132 will be described in more detail. In Figure 22A, the handles 128, 132 are in an open and aligned position relative to one another. In the open position there is no contact between the latching mechanism 130 of the trigger handle 128 and the locking handle lock piece 134. The latching mechanism 130 and the locking piece 134 include a plurality of corresponding teeth 2282 that are slanted. to lock the handles 128, 132 to each other, as described more fully below with reference to Fig. 22B. The trigger handle 128 further includes a latching lever 2284, which is rotatably connected to the trigger handle 128 at a pivoting point 2286, and a limiter 2288 of the lever. The limiter 2288 of the lever limits the rotational movement of the latch lever 2284 to a distance that is sufficient to disengage coupled the teeth 2282. One reason for limiting the rotational movement of the latching lever 2284 is to prevent the lever from engaging. latch 2284 interferes with the operation of the laparoscopic instrument 100. The latch mechanism 130 is mounted on the latch lever 2284 such that the latch mechanism 130 moves whenever the latch lever 2284 is moved. The aligned position shows the latch lever 2284. latch 2284 parallel to the fixing handle 132 in the XY plane. In Figure 22B, handles 128, 132 are shown in a locked position, and handles 128, 132 are correspondingly in a closed and aligned position. The latching mechanism 130 and the locking piece 134 are immobilized by means of the plurality of corresponding teeth 2282, which are included in each of the latching mechanism 130 and of the locking piece 134. To lock the handles 128, 132, at least one of the handles 128, 132 is rotated about the axis "Z" towards the other of the handles 128, 132. For example, the trigger handle 128 is rotated in a clockwise direction toward the clamping handle 132. The corresponding ones of the teeth 2282 are coupled by means of friction forces to prevent movement of the handles 128, 132 towards an open position. The teeth 2282 are urged to encourage movement of the handles 128, 132 toward one another but to resist movement of the handles 128, 132 away from each other. The ability to lock the handles 128, 132 during surgery advantageously releases the hand of the surgeon to perform the various tasks, while leaving the instrument 100 inside the patient's body. It also allows the surgeon to relax the grasped hand of the instrument 100 to minimize hand fatigue that is caused by prolonged holding and by manipulation of the handles 128, 132. Even more, without locking the handles, if the hand of the hand rests. The surgeon holding the handles 128, 132 will momentarily relax or lose its tightening, the tool 176 may slide or dislodge from a desired position within the patient's body cavity. When the handles 128, 132 are in the locked position, the tool 176 can reliably be maintained within the patient. With the handles blocked, the surgeon can also rotate them together according to the present invention to a better position without disturbing the position of the tool 176 within the body cavity. In Fig. 23A, the handles 128, 132 are shown in a closed and displaced position. The handles 128, 132 are fixed with respect to the "Z" axis while the latching lever 2284 is pushed in the direction of the "Z" axis to unlock the latching mechanism 130 of the locking piece 134. When the latching mechanism is engaged. 130 moves in the direction of the "Z" axis away from the locking piece 134, by means of the movement of the latch lever 2284, one of the engaged teeth 2282 disengages, causing the trigger handle 128 to unlock from the handle of fixation 132.

In Figure 23B, handles 128, 132 are shown in an open and offset position. After the trigger handle 128 moves in the direction of the "Z" axis (according to the indications of Figure 23A) away from the fixing handle 132, the trigger handle 128 is rotated in a leftward direction around the "Z" axis. " To position the latching lever 2284 in the initial open and aligned position of Fig. 22A, the latch lever 2284 must be pushed in the direction of the "Z" axis towards the trigger handle 128 in order to place the latching lever 2284 in the same XY plane as the fixing handle 132. Now, the trigger handle 128 is ready to be locked relative to the fixing handle 132.

Preferably, the latch lever 2284 is positioned to be manipulated by the surgeon with a single finger, for example with the pink finger of the hand holding the handles 128, 132. In this regard, the surgeon is not required to remove the hand of the hand. the handles 128, 132 to lock or unlock them. In operation, the surgeon simply moves the latching lever 2284 with the pink finger, which is not typically located within the handle 128 as are the fingers of the ring and the middle part. Now back to Figure 24, a partially detailed surgical instrument 2400 is shown configured to allow removal of the surgical instrument 2400 from a sleeve 172 that remains in place while the surgical installation 2400 is removed from the patient's body. The surgical instrument 2400 can be a laparoscopic instrument in some modalities or an arthroscopic instrument in different modalities. In the embodiment shown in Figure 24, the surgical instrument includes a knob 2468 attached to the extension of the knob (or sleeve) 172 through which the tool 176 is inserted and a locking plate 2490 that is shaped to fit inside a slot formed in a long bearing 2464 as shown. The embodiment shown in Figure 24 differs from the embodiment shown in Figures 18-19, for example, in that in Figure 24, the surgical instrument 2400 is removable from the sleeve 172 without rotating the surgical instrument 2400 in a position of the stock. as described with respect to Figures 18 and 19. In both embodiments, the sleeve remains in the body while the tool 176 is removed; in Figures 18 and 19, the tool 176 is removed by rotating the articulation portion 1700 as described in an open position and then grasping the tool 176 by the exposed ball 178, while in Figure 24, the complete surgical instrument 2400 (FIG. with the exception of the locking plate 2490, the sleeve 172, and the knob 2468) is removed by pushing the locking plate 2490 away from the groove formed in the long bearing 2464. The locking plate 2490 is secured to the knob 2468 by a pair of the screws 2492, which pass through elongated slots in the locking plate 2490, allowing movement of the locking plate 2490. When the locking plate 2490 is in a locked position, the sleeve 172 is coupled to the housing 114 with the cooperation of the short bearing 166 (shown in figure 24 partially broken away for ease of illustration), the long bearing 2464, and the locking plate 2490. When the plate of bl opener 2490 is pushed from the locking position to an open or unlocking position, the locking plate 2490 emerges from groove formed in the long bearing 2464 to allow separation or decoupling of the knob and sleeve assembly 2468, 172 from the debris of the surgical instrument 2400. The sleeve 172 remains in the patient's body, allowing the surgeon to quickly locate the internal part of the body on which, the surgeon is operating when a new tool is inserted through the sleeve 172. After a new tool is inserted into the sleeve 172 and the locking plate 2490 locks onto the groove in the long bearing 2464, the sleeve 172 is secured again to the remains of the surgical instrument 2400 and forms an integral part thereof. In other words, the separation of the sleeve 172 from the remains of the surgical instrument 2400 depends on the position of the blocking plate 2490. Note that in Figure 24, the surgical installation 2400 is also adapted to the tools of the exchange by means of the described technique of the "shotgun" with respect to figures 18 and 19, giving the surgeon two options to exchange the tools. For example, after the tool is removed by unlocking the locking plate 2490, the articulation portion 1700 can be rotated (after depressing the locking lever 158 for release of the articulation portion 1700) in an open position of the "cylinder head" for exposing the ball 178 of the tool 176, which can be held by the operator to remove the tool 176 and exchange it for another. In various embodiments, the surgical instrument 2400 does not have a linkage portion 1700, and allows tool exchange by releasing the locking plate 2490. Once removed from the patient's body, the tool 176 can be decoupled in addition to the surgical instrument 2400. 2490 lock plate can be configured in any number of ways to facilitate a quick release lock. For example, in some embodiments, the locking plate 2490 may have a spring mechanism that unlocks the locking plate 2490 by pushing down on the plate 2490 causing the plate 2490 to jump out of the groove formed in the long bearing 2464. A Specific modality is shown in Figure 24, however, the present invention contemplates the different mechanisms to block so that the sleeve 172 of the remains of the instrument is released. In all embodiments, sleeve 172 can remain within the patient's body while the surgical instrument is removed therefrom through the cannula / trocar unit anchored at the interface of the incision. The tool 176 can be removed through the sleeve 172 without removing any other part of the surgical instrument or the tool 176 can be removed together with the instrument while the sleeve 172 remains in place. As mentioned above, the sleeve 172 helps the surgeon to quickly locate the location of the operation site when a new tool is inserted through the sleeve 172. Keeping the sleeve operating as a "place holder" within the patient's body , the surgeon no longer needs to recover the "sensation" lost by the removal of the tool and relocate the site of the operation. Now back to FIG. 25, the surgical instrument 2400 is shown partially inserted into the body 185 of a patient by means of a unit 184 of the cannula / trocar. The locking plate 2490 has been moved to the unlocking position in the direction of the arrow A, releasing the surgical instrument 2400 from the sleeve 172, and the surgical instrument 2400 has partially retracted from the sleeve 172 in the direction of the arrow B. An insulating layer or liner 186 is disposed or formed within the hollow shaft of the sleeve 172 to prevent electrocution of the instrument operator 100 by applying an electric current to the tool 180 for use in, for example, in a cauterization procedure. As mentioned above, the electric probe 182 is used to electrically connect the tool 180 to a power source. The insulating layer 186 or the coating may include Teflon, for example. At least some of the parts described above with reference to Figures 1A-25 are injection molded parts, which are precision molded with hot oil or water molds when using high strength plastics, filled with graphite, glass, or carbon such as PEEK ™ (polyetheretherketone), Ultem® (polyetherimide), Grivory®, or RADEL® R (polyphenylsulfone). Injection molded parts include simple cavity molds and family molds. For example, some of the molded parts may be cold run molds. Although the above embodiments have been described with respect to a laparoscopic instrument 100, the present invention is equally applicable to an arthroscopic instrument.

Although the invention is susceptible to different modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and described in detail herein. It should be understood, however, that it is not intended to limit the invention to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives that fall within the spirit and scope of the invention as is defined by the appended claims.

Claims (104)

1. A method for replacing a tool of a cuff of a surgical instrument without having to remove the cuff from a body, characterized in that it comprises: pushing a releasable locking mechanism of the surgical instrument from a locking position to an unlocking position, such so as to cause the cuff to be uncoupled from the surgical instrument; and removing at least the part of the surgical instrument from the sleeve such that the tool emerges from the sleeve together with at least the part of the surgical instrument.

The method according to claim 1, characterized in that it further comprises: rotating a housing assembly of the surgical instrument to expose one end of the tool; and separate the tool from the laparoscopic instrument.

3. The method according to claim 2, characterized in that it further comprises inserting a second tool through the sleeve.

4. The method according to claim 1, characterized in that the surgical instrument is a laparoscopic instrument.

5. The method according to claim 1, characterized in that the surgical instrument is an arthroscopic instrument.

6. The method according to claim 1, characterized in that the thrust includes pressing a structure that blocks immobilized so that it can be released with a portion of the tool.

The method according to claim 1, characterized in that the thrust includes moving a locking plate in a direction generally away from the tool.

8. A surgical instrument comprising a housing assembly releasably attached to an elongated hollow sleeve by means of a movable locking mechanism between at least one locking position and an unlocking position such that in the position of blocking the sleeve is secured to the housing assembly and in the unlocked position the sleeve is detachable from the housing assembly.

9. The surgical instrument according to claim 8, characterized in that the locking mechanism includes a movable locking plate and the housing assembly includes an elongated shaft having a groove formed along its length, the movable locking plate is shaped to fit into at least part of the slot when the locking mechanism is in the locked position.

The surgical instrument according to claim 9, characterized in that it further comprises: a rotary knob coupled to the locking plate and secured to the elongated hollow shaft; and a tool inserted through the elongated hollow shaft.

11. The surgical instrument according to claim 8, characterized in that the surgical instrument is a laparoscopic instrument or an arthroscopic instrument.

12. The surgical instrument according to claim 8, characterized in that the sleeve includes an insulating layer.

The surgical instrument according to claim 8, characterized in that the housing assembly includes pair of handles, the surgical instrument further comprises a rotating articulation portion connected to the housing assembly and including a sleeve for insertion into an incision of a body, the sleeve having an open end and an elongated hollow shaft for receiving a first tool for insertion into the hollow shaft through the open end, the articulated portion pivots between a closed position and an open position, the articulation portion it is placed in the open position with the sleeve remaining in the body when the first tool changes with a second tool.

The surgical instrument according to claim 13, characterized in that the articulation portion further includes a locking lever for locking the hinge portion in at least the locking position and the open position.

The surgical instrument according to claim 13, characterized in that the housing assembly further includes a slit of the ball receiving for receiving a ball end of a tool when the hinge portion is in the closed position.

16. A surgical instrument, characterized in that it comprises: a pair of handles; a cylinder assembly coupled to the pair of handles; a rotating knob assembly that includes a locking mechanism; an elongated hollow sleeve coupled to the knob; and a tool inserted through at least the knob and the elongated hollow sleeve, wherein the locking mechanism is interconnected so that the assembly of the knob is released with the cylinder assembly such that in a locked position the assembly of the knob is secured to the cylinder assembly and in an unlocked position the knob assembly is separable from the cylinder assembly.

The surgical instrument according to claim 16, characterized in that the cylinder assembly includes at least two cylinders connected to the respective elements of the pair of handles, the cylinders that rotate independently from one another to allow the movement of handles in relation one of the other, the cylinders also rotate together in a fixed relation about an axis that passes through the center of the cylinders to allow the rotation of the handles in a fixed relation on the axis.

18. The surgical instrument according to claim 16, characterized in that the rotating assembly of the knob includes a knob having an opening and a support shaft disposed in the opening and having a groove formed thereon to receive a portion of the locking mechanism. in the blocking position.

19. The surgical instrument according to claim 16, characterized in that the cylinder assembly includes a receiving groove for receiving an end of the tool when the locking mechanism is in the locked position.

20. The surgical instrument according to claim 16, characterized in that it further comprises a rotating articulation portion connected to the cylinder assembly, the articulation portion is rotatable between a closed position and an open position, one end of the tool is exposed when the joint portion is in the open position.

21. A method for replacing a tool of a sleeve of a laparoscopic instrument without removing the sleeve from a body, characterized in that it comprises: rotating a housing assembly of the laparoscopic instrument to expose one end of the tool to be removed; remove the sleeve tool from the laparoscopic instrument without removing the sleeve from the body; and insert a second tool into the laparoscopic instrument.

22. The method according to claim 21, characterized in that it further comprises registering the exposed end of the tool in at least one of a receiving groove of the ball and a receiving hole of the ball of the receiving part when the portion of the set of Accommodation is in a blocking position.

23. The method according to claim 22, characterized in that the slit of the ball receiver is included in a housing of the housing assembly.

24. The method according to claim 22, characterized in that the hole of the ball receiver is included in a cylinder of the housing assembly.

25. The method according to claim 21, characterized in that a locking lever is depressed to unlock the housing assembly from a locking position.

26. The method according to claim 21, characterized in that the rotation includes rotating the housing part on an axis of the laparoscopic instrument selected from a group consisting of an "X" axis, an axis "Y", and a "Z" axis, where the "X" axis is any axis that lies in the 3-dimensional space occupied by the laparoscopic instrument.

27. The method according to claim 21, characterized in that the rotation includes rotating the housing assembly on a laparoscopic instrument joint, the housing assembly is pivotably coupled to the joint by means of an articulation pin.

28. The method according to claim 21, characterized in that it further comprises holding a pair of handles when rotating the housing assembly, the pair of handles is attached to the housing assembly.

29. The method according to claim 21, further comprising linearly displacing the tool when the housing assembly is in a locked position to manipulate a tool device located at an opposite end of the tool.

30. A laparoscopic instrument characterized in that it comprises: a housing assembly that includes a pair of handles; and a hinge portion rotatably connected to the housing part and including an extension of the tool knob for insertion into an incision of a body, the extension of the knob having an open end and an elongated hollow shaft to receive a first tool for insertion into the hollow shaft through the open end, the hinged portion pivots between a closed position and an open position, the articulation portion is positioned in the open position with the extension of the knob remaining in the body when the first tool is changed with a second tool.

The laparoscopic instrument of claim 30, characterized in that the housing assembly includes a cylinder assembly having at least two cylinders connected to the respective elements of the pair of handles, the cylinders rotating independently of one another to allow movement of the handles in relation to each other, the cylinders also rotate together in a fixed relationship about an axis passing through the center of the cylinders to allow the handles to rotate in a fixed relation on the axis.

32. The laparoscopic instrument of claim 30, characterized in that the articulation in the closed position rotates about an axis perpendicular to an axis of the extension of the knob to achieve the open position.

33. The laparoscopic instrument of claim 30, characterized in that the articulation portion in the closed position rotates about an axis parallel to an axis of the extension of the knob to achieve the open position.

34. The laparoscopic instrument of claim 30, characterized in that the hinge portion further includes a locking lever for locking the hinge portion in at least the locking position and the open position.

35. The laparoscopic instrument of claim 30, characterized in that the housing assembly includes a receiving groove of the ball for receiving a ball end of the first tool and the second tool when the articulation portion is in the closed position.

36. A method for replacing a tool of a laparoscopic instrument, characterized in that it comprises: inserting a laparoscopic instrument into an incision of a body, the laparoscopic instrument having a first tool and pair of handles coupled to the first tool; rotating a laparoscopic instrument housing assembly from a locked position to an open position to expose one end of the first tool; remove the first tool from a sleeve of the laparoscopic instrument and insert a second tool without removing the sleeve from the body; and rotating the housing assembly from the open position to the locking position to attach the second tool to the handles of the laparoscopic instrument.

37. The method according to claim 36, characterized in that it further comprises pressing a locking lever for releasing the housing assembly from the locking position.

38. The method according to claim 36, characterized in that it further comprises pressing the locking lever for releasing the housing assembly from the open position.

39. The method according to claim 36, characterized in that it further comprises rotating one of the handles to cause a linear movement of a tool device of the first tool or of the second tool.

40. The method according to claim 36, characterized in that it further comprises rotating the housing assembly on any axis of the laparoscopic instrument that lies in the 3-dimensional occupied space by the laparoscopic instrument.

41. A method for exchanging the tools in a surgical instrument, characterized in that it comprises: insertion of a first tool through an elongated sleeve of the surgical instrument; moving part of the surgical instrument to allow removal of the first tool from the elongated sleeve; removing the first tool from the elongated sleeve; and insert a second tool in the elongated sleeve.

42. The method according to claim 41, characterized in that the surgical instrument is a laparoscopic instrument or an arthroscopic instrument.

43. The method according to claim 41, characterized in that it further comprises inserting the surgical instrument together with its elongated sleeve through • a cannula in the body.

44. The method according to claim 41, characterized in that the movement includes rotating a housing assembly of the surgical instrument to expose an end of the first tool to be removed.

45. A laparoscopic instrument, characterized in that it comprises a pivotal pivoting handle between at least two locking positions.

46. The laparoscopic instrument of claim 45, characterized in that it further comprises a cylinder attached to the handle and an axis passing through the cylinder, the cylinder is rotatable about the axis to cause the handle to be pivotally pivoted between the at least two positions lockable.

47. The laparoscopic instrument of claim 46, characterized in that it further comprises a second rotatable pivot handle between the two lockable positions with the handle.

48. The laparoscopic instrument of claim 47, characterized in that it further comprises a second cylinder attached to the second handle, the shaft passing through the second cylinder, the second cylinder is rotatable about the axis to cause the second handle to pivot in between the at least two lockable positions.

49. The laparoscopic instrument of claim 45, characterized in that it further comprises: a cylinder attached to the handle; a second handle attached to a second cylinder; a cylinder of the tool coupled to the cylinder and to the second cylinder; an axis that passes through the cylinder, the second cylinder, and the tool cylinder so as to be rotatable between the at least two lockable positions.

50. The laparoscopic instrument of claim 49, characterized in that the shaft includes a plurality of fins disposed along a length of the axis and positioned to lock together at least two of the cylinder, the second cylinder, and the cylinder of the tool while the axis rotates between the at least two lockable positions.

51. The laparoscopic instrument of claim 45, characterized in that it also comprises: a housing; a cylinder attached to the handle; a shaft passing through the cylinder to secure the cylinder along a central axis of the housing, the shaft is inserted through the cylinder; and a pushbutton connected to the shaft to move the axis between a first position and a second position, the first position corresponding to one of the at least two lockable positions, the second position corresponding to an unlocked position.

52. The laparoscopic instrument of claim 51, characterized in that the handle is movable between the at least two lockable positions when the shaft is in the second position.

53. The laparoscopic instrument of claim 45 characterized in that it further comprises: a cylinder of the tool connected to the handle; and a tool having a ball end and one end of the tool, the ball end is detached connected to the tool cylinder in at least two lockable positions.

54. The laparoscopic instrument of claim 53, characterized in that it further comprises a cylinder attached to the handle, the cylinder of the tool is secured to the cylinder in at least one of the at least two lockable positions.

55. A laparoscopic instrument having a transverse axis along which a tip is disposed, the laparoscopic instrument comprising a rotatable trigger handle pivoted between at least two lockable positions on an axis orthogonal to the transverse axis.

56. The laparoscopic instrument of claim 55, characterized in that it further comprises: a trigger cylinder attached to the trigger handle; a cylinder of the tool rotatably secured to the trigger cylinder in the at least two lockable positions; a fastening cylinder attached to a fastening handle, the fastening cylinder rotatably secured to the trigger cylinder when the trigger cylinder is in an unlocked position.

57. The laparoscopic instrument of claim 56, characterized in that it further comprises a finned shaft for axially securing of the trigger cylinder, the tool cylinder, and the attachment cylinder to each other, the finned shaft moving between a first position and a second position, the tool cylinder and the trigger cylinder rotatably secured with respect to each other in the first position, the trigger cylinder and the locking cylinder rotatably secured with respect to each other in the second position, the first position corresponding to one of the at least two lockable positions.

58. A method of using a laparoscopic instrument having a trigger cylinder connected to a handle of the laparoscopic instrument, characterized in that it comprises rotating the trigger cylinder from a first locking position of the cylinder to a second locking position of the cylinder.

59. The method according to claim 58, further comprising unlocking the trigger cylinder of the first locking position of the cylinder before turning the trigger cylinder to the second locking position of the cylinder.

60. The method according to claim 58, characterized in that the rotation includes rotating the trigger cylinder together with a fixing cylinder to a second position of the cylinder, the method further comprising: pressing a push button to unlock the trigger cylinder of the first cylinder locking position; and releasing the pushbutton to lock the trigger cylinder and the locking cylinder in the second locking position of the cylinder.

61. The method according to claim 60, characterized in that it further comprises disengaging the clamping cylinder from at least one thrust pin when pressing the push button.

62. The method according to claim 58, characterized in that it further comprises: positioning an axis in a first position of the shaft to rotatably secure the trigger cylinder to the tool cylinder in the first locking position of the cylinder; pushing the axis of the first position of the shaft to a second position of the shaft to rotatably secure the trigger cylinder to the clamping cylinder in an unlocked position of the cylinder, the trigger cylinder is rotatably released from the tool cylinder in the unlocked position of the cylinder. cylinder; turn the clamping cylinder together with the trigger cylinder to the second position of the cylinder; and pushing the axis of the second position of the shaft to the first position of the shaft to rotatably secure the trigger cylinder to the tool cylinder in the second locking position of the cylinder.

63. The method according to claim 62, characterized in that it further comprises: insertion of a tool in a sleeve of the laparoscopic instrument; and linearly moving the tool to manipulate a tool device located at one end of the tool.

64. The method according to claim 58, characterized in that the linear displacement is performed by rotating a handle that engages the cylinder of the trigger.

65. A laparoscopic instrument, characterized in that it comprises: a first handle that includes a latching mechanism; and a second rotary handle coupled to the first handle and including a locking piece, the first handle and the second handle are in a locked position when the latching mechanism engages with the locking piece, the first handle and the second handle they are in an open position when the latching mechanism is disengaged from the locking piece.

66. The laparoscopic instrument of claim 65, characterized in that the latch mechanism includes at least one locking tooth and the locking piece includes at least one locking tooth, the locking tooth engages the locking tooth in the blocking position.

67. The laparoscopic instrument of claim 65, characterized in that the latch mechanism further includes a latching lever that is pivotally coupled to the first handle.

68. The laparoscopic instrument of claim 67, characterized in that the latch lever is aligned with the first handle in the locked position.

69. The laparoscopic instrument of claim 67, characterized in that a free end of the hooking lever pivots in a direction away from the first handle to achieve the open position.

70. The laparoscopic instrument of claim 67, characterized in that the latching mechanism further includes a limiter of the lever located along the rotational path of the latching lever to limit the rotation of the latching lever.

71. The laparoscopic instrument of claim 70, characterized in that the limiter of the lever is close coupled to the free end of the hooking lever.

72. The laparoscopic instrument of claim 65, characterized in that the latching mechanism includes a part that engages the teeth that lock attached to a free end of a latching lever, the locking piece that includes a part that engages the teeth that block, the hooking lever is pivoted to the first handle at a fixed end, the hooking lever aligns with the first handle in the locked position, the part that engages the locking teeth aligns and engages the part that engages the locking teeth when the first handle is in the locked position.

73. A method for locking and unlocking a first handle of a laparoscopic instrument relative to a second handle, characterized in that it comprises: pushing the first handle towards the second handle to engage a mechanism of hooking the first handle to a locking part of the second handle .

74. The method according to claim 73, characterized in that it further comprises tilting the latching mechanism against the locking piece to secure a plurality of teeth to each other.

75. The method according to claim 74, characterized in that at least one of the plurality of teeth is located in the latching mechanism and a corresponding one of the plurality of teeth is located in the locking part.

76. The method according to claim 73, characterized in that it further comprises rotating the latching mechanism away from the. first handle to unlock the first handle from the second handle.

77. The method according to claim 73, characterized in that it further comprises: mounting the latching mechanism on a pivoting latching lever coupled to the first handle; and rotating a free end of the latching lever to disengage the engagement mechanism from the locking piece.

78. The method according to claim 77, characterized in that it further comprises limiting the rotational movement of the hooking lever using a limiter of the lever.

79. The method according to claim 78, characterized in that the limited lever is coupled to the first handle near the free end of the hooking lever.

80. The method according to claim 77, characterized in that it further comprises rotating the free end of the hooking lever in a direction that is substantially perpendicular to the rotating direction of the first handle toward the second handle.

81. The method according to claim 73, characterized in that it comprises the coupling of the coupling mechanism to a gripping end of the first handle.

82. The method according to claim 73, characterized in that it further comprises the coupling of the locking part to a gripping end of the second handle.

83. A laparoscopic instrument having a pair of handles that are pivotable between a locking position and an open position, characterized in that it comprises: a pivoting latching lever coupled to a trigger handle of the pair of handles at a rotating point; a limiter of the lever coupled to the trigger handle close to a free end of the hooking lever, the limiter of the lever which restrains the rotating movement of the hooking lever; a part that engages the teeth coupled to the trigger handle; and a locking piece coupled to a handle for fixing the pair of handles such that the locking piece is coupled to the part that engages the teeth when the pair of handles are in the locked position, and such that the workpiece Lock is disengaged from the part that engages the teeth when the pair of handles are in the open position.

84. The laparoscopic instrument of claim 83, characterized in that the locking piece is pushed towards the part that engages the teeth by means of a frictional force exerted by at least one pair of teeth that are immobilized.

85. A laparoscopic instrument, characterized in that it comprises: a first handle that includes a latching mechanism; and a second rotary handle coupled to the first handle and including a locking piece, the first handle and the second handle are in a locked position when the latching mechanism engages with the locking piece, the first handle and the second handle are in an open position when the latching mechanism is released from the locking piece.

86. The laparoscopic instrument of claim 85, characterized in that the latching mechanism includes at least one locking tooth and the locking part includes at least one locking tooth, the locking tooth is coupled to the locking tooth in the blocking position.

87. The laparoscopic instrument of claim 85, characterized in that the latch mechanism further includes a latch lever engaged by pivot to the first handle.

88. The laparoscopic instrument of claim 87, characterized in that the latch lever is aligned with the first handle in the locked position.

89. The laparoscopic instrument of claim 87, characterized in that a free end of the hook lever pivots in a direction away from the first handle to achieve the open position.

90. The laparoscopic instrument of claim 87, characterized in that the latch mechanism further includes a limiter of the lever located along the rotational path of the latch lever to limit rotation of the latch lever.

91. The laparoscopic instrument of claim 90, characterized in that the limiter of the lever is next coupled to a free end of the latching lever.

92. The laparoscopic instrument of claim 85, characterized in that the latching mechanism includes a part that engages the teeth locking attached to a free end of a latching lever, the locking piece that includes a part that engages the locking teeth, the coupling lever rotatably engages the first handle at a fixed end, the engagement lever aligns with the first handle in the locked position, the part that engages the locking teeth is aligned and engages the part that engages the locking teeth when the first handle is in the locked position.

93. A method for locking and unlocking a first handle of a laparoscopic instrument relative to a second handle, characterized in that it comprises: pushing the first handle towards the second handle to engage a mechanism for hooking the first handle to a locking part of the second handle.

94. The method according to claim 93, characterized in that it further comprises tilting the latching mechanism against the locking piece to secure a plurality of teeth to each other.

95. The method according to claim 94, characterized in that at least one of the plurality of teeth is located in the latching mechanism and a corresponding one of the plurality of teeth is located in the locking part.

96. The method according to claim 93, characterized in that it further comprises rotating the latching mechanism remote from the first handle to unlock the first handle from the second handle.

97. The method according to claim 93, characterized in that it further comprises: mounting the latching mechanism on a pivoting latch lever coupled to the first handle; and rotating a free end of the latching lever to disengage the engagement mechanism from the locking piece.

98. The method according to claim 97, characterized in that it further comprises limiting the rotating movement of the hooking lever using a limiter of the lever.

99. The method according to claim 98, characterized in that the limited lever is coupled to the first handle near the free end of the hook lever.

100. The method according to claim 97, characterized in that it further comprises rotating the free end of the latching lever in a direction that is substantially perpendicular to the rotating direction of the first handle toward the second handle.

101. The method according to claim 93, characterized in that the coupling also comprises the coupling mechanism to a gripping end of the first handle.

102. The method according to claim 93, characterized in that it further comprises the coupling of the locking part to a gripping end of the second handle.

103. A laparoscopic instrument having a pair of shanks pivoting between a locking position and an open position, characterized in that it comprises: a pivoting latching lever coupled to a trigger handle of the pair of shanks at a pivoting point; a limiter of the lever coupled to the trigger handle close to a free end of the hooking lever, the limiter of the lever which restrains the rotating movement of the hooking lever; a part that engages the teeth coupled to the trigger handle; and a locking piece coupled to the handle fixing the pair of handles such that the locking piece is coupled to the part that engages the teeth when the pair of handles are in the locked position, and such that the locking piece It is disengaged from the part that engages the teeth when the pair of handles are in the open position.

104. The laparoscopic instrument of claim 103, characterized in that the locking part is pushed towards the part that engages the teeth by means of a frictional force exerted by at least one pair of teeth that are immobilized.