WO2006075153A1

WO2006075153A1 - Laparoscopic forceps

Info

Publication number: WO2006075153A1
Application number: PCT/GB2006/000088
Authority: WO
Inventors: Anthony Blacker
Original assignee: Anthony Blacker
Priority date: 2005-01-11
Filing date: 2006-01-11
Publication date: 2006-07-20
Also published as: GB2421912A; GB0500449D0

Abstract

This application relates to laparoscopic forceps comprising: a) a handle assembly (8) comprising a pair of pivotally connected bow members (10) ; b) a tool assembly (12) comprising a pair of jaw members (14) ; c) an elongate body portion (2) extending distally from the handle assembly (8) towards the tool assembly (12) , the elongate body portion (2) defining the longitudinal axis of the forceps, the proximal end of the elongate body portion (2) being pivotally connected to the handle assembly (8) by a universal joint (4) and the distal end of the elongate body portion (2) being pivotally connected to the tool assembly (12) by a universal joint (6) ; d) an actuating mechanism connecting the handle assembly (8) to the tool assembly (12) for effecting synchronised pivotal movement of the handle assembly (8) and the tool assembly (12) relative to the elongate body (2) of the forceps, and e) an opening and closing mechanism to effect simultaneous clamping movement of the jaw members (14) of the tool assembly (12) in response to movement of the bow members (10) of the handle assembly (8) .

Description

SURGICAL INSTRUMENT

This invention relates to laparoscopic forceps, particularly to laparoscopic forceps in which the handle and the forceps jaw mechanism are connected by an actuating mechanism and an opening and closing mechanism which provide synchronised pivotal and clamping movement of the handle assembly and the tool assembly.

Laparoscopic forceps conventionally comprise a handle, a housing carrying an actuator mechanism and a forceps jaw mechanism located at a remote end of the housing. Manual actuation of the handle opens or closes the jaws. A ratchet mechanism may be provided to allow clamping of the jaws. A monopolar, bipolar diathermy or other energy source may be connected to facilitate cauterisation of tissue clamped by the jaws. In conventional laparoscopic forceps the handle comprises a pistol grip arrangement wherein the diathermy connection extends upwardly so that the power cable extends from the handle over a surgeon's hand adjacent the knuckles or thumb. The pistol grip arrangement makes it necessary for a surgeon to raise or lower the elbow in order to rotate the forceps in use. This is inconvenient and can be tiring, particularly as the diathermy cable may pass over the surgeon's elbow.

Instruments for use in minimally invasive surgery are known in the art. For example US-5454827 provides an arthroscopic or endoscopic surgical instrument comprising a handle having a main portion which is to be gripped by the surgeon's hand, a trigger, a rigid stem, an articulated stem section and a basket cutter. The position of the basket cutter is controlled by a control lever located at the proximal end of the main body of the instrument and tissue is removed by the basket cutter by compressing the trigger. The means for rotating the basket cutter and for operating the basket cutter are not located at the same position on the handle assembly. This instrument therefore requires awkward finger movements for use during surgery. However, depending upon the type of operation being performed it is not always possible for the surgeon to operate instruments which require the use of two hands. One example of such an operation is hand-assisted laparoscopy where it would not be possible for a surgeon to operate the instrument provided by US-5454827. Furthermore, the positioning of the instrument within the patient would be less stable due to the surgeon having to use both hands to manipulate the instrument.

US-5997565 discloses forceps comprising a pair of grip pieces and a pair of tip- end forceps pieces in which each grip piece or tip-end forceps piece is pivotally supported to be movable towards or away from the other grip piece or tip-end forceps piece about a first or second fulcrum respectively, an operation transferring member and a line connecting the first and second fulcrum. The tip-end forceps pieces and the grip pieces may pivot in the same direction about an axis perpendicular to the longitudinal axis of the forceps. This movement of the forceps pieces allows operations to be performed on diseased tissues which are not directly in front of the cannula through which the forceps are inserted. However, movement of the tip-end forceps pieces is limited to a single plane perpendicular to the longitudinal axis of the forceps.

Accordingly, the present invention provides laparoscopic forceps comprising: a) a handle assembly comprising a pair of pivotally connected bow members; b) a tool assembly comprising a pair of jaw members; c) an elongate body portion extending distally from the handle assembly towards the tool assembly, the elongate body portion defining the longitudinal axis of the forceps, the proximal end of the elongate body portion being pivotally connected to the handle assembly by a universal joint and the distal end of the elongate body portion being pivotally connected to the tool assembly by a universal joint; d) an actuating mechanism connecting the handle assembly to the tool assembly for effecting synchronised pivotal movement of the handle assembly and the tool assembly relative to the elongate body of the forceps, and e) an opening and closing mechanism to effect simultaneous clamping movement of the jaw members of the tool assembly in response to movement of the bow members of the handle assembly.

The actuating mechanism can enable the handle assembly and the tool assembly to be moved between a first position and a second position. The handle assembly and the tool assembly can be moved to the first position by pivoting the handle assembly and tool assembly within a first plane relative to the elongate body of the forceps. The handle assembly and the tool assembly can be moved to the second position by pivoting the handle assembly and the tool assembly within a second plane relative to the elongate body of the forceps. The first and second planes can be perpendicular to each other.

The jaw members of the tool assembly are preferably openable within the same plane or direction when the tool assembly is in either the first or second positions. The jaw members of the tool assembly can be openable within the same plane or direction relative to the elongate body of the forceps independent of whether the tool assembly has been placed in the first or second position. The present invention therefore has the advantage that the forceps can be used in surgical procedures where complex manipulations, such as for example suturing and knot tying, are required. During these manipulations it is essential that the jaw members of the tool assembly are openable in the desired plane. The present invention therefore enables the surgeon to be able to control the plane within which the jaw members open. The present invention can reduce unnecessary rotation of the forceps during these procedures. If necessary, the surgeon can rotate the entire instrument so that the jaw members are openable in the desired plane.

The actuating mechanism is able to effect synchronized rotational and pivotal movement of the handle assembly and the tool assembly. The surgeon can therefore advantageously use the forceps of the present invention single handedly. The forceps provide the surgeon with a greater feel for the movement of the tool assembly relative to the movement of the handle assembly and therefore the forceps may be placed within the patient and used with improved accuracy. Furthermore, the tool assembly of the forceps can be moved in at least two planes perpendicular to the longitudinal axis of the forceps therefore having the advantage that the tool assembly of the forceps has a greater degree of movement and can be used to more easily access diseased tissue which is not directly opposite the cannula.

The jaw members of the tool assembly may form any suitable instrument which is to be used in the surgery such as graspers, scissors, clamps, dissectors, clip applicators or needle drivers depending on the required function of the instrument. Preferably the jaw members of the tool assembly are interchangeable.

The bows of the handle assembly may be present in any suitable form, for example the bows may be in the form of ring-like finger holds, such as the handle of a pair of scissors, or as a pair of levers which may be pivoted at the proximal end of the instrument.

It is preferred that the jaw members of the tool assembly and the bows of the handle assembly are operated manually. In a preferred embodiment, the longitudinal axis of the handle assembly is aligned with the longitudinal axis of the elongate body portion of the forceps when the forceps are in the resting state.

The actuating mechanism controls the direction of the pivotal movement of the tool assembly relative to the direction of the pivotal movement of the handle assembly. Furthermore, the actuating mechanism controls the degree of pivotal movement of the tool assembly in relation to the pivotal movement of the handle assembly. For example, the tool assembly can pivot in either the same direction as the handle assembly or in the opposite direction to the pivotal movement of the handle assembly. The degree of the pivotal movement of the tool assembly can be greater than, equal to or less than the corresponding degree of pivotal movement of the handle assembly of the forceps depending on the function required.

The handle assembly may include a locking mechanism to secure the orientation of the handle assembly relative to the elongate body portion. The locking mechanism is preferably provided on the handle assembly. The locking mechanism can be, for example . a switch or a lever. The locking mechanism can therefore secure the orientation of the handle assembly and the tool assembly relative to the elongate body portion.

The opening and closing mechanism of the forceps controls the direction of the pivotal movement of the jaw members of the tool assembly in relation to the pivotal movement of the bows of the handle assembly. For example, separation of the bows of the handle assembly in relation to each other, i.e. "opening" the handle assembly, can result in the "opening" of the jaw members of the tool assembly. Furthermore, moving the bows of the handle assembly towards each other, i.e. "closing" the handle assembly, can result in the "closing" of the jaw members of the tool assembly.

Furthermore, the opening and closing mechanism of the forceps controls the degree of movement of the jaw members of the tool assembly relative to the movement of the bows of the handle assembly. For example, the degree of movement of the jaw members of the tool assembly can be greater than, equal to or less than the corresponding movement of the bows of the handle assembly of the forceps depending on the function required.

In a preferred embodiment the bows of the handle assembly are in the same plane as the jaws of the tool assembly. Alternatively, the bows of the handle assembly are in a plane perpendicular or inclined at an angle to the jaws of the tool assembly.

Preferably, the jaws of the tool assembly can be used to grasp an object which is orientated along the longitudinal axis of the elongate body portion of the forceps or separated at a distance from the longitudinal axis of the elongate body portion of the forceps without requiring the surgeon to rotate the entire forceps about an axis.

The actuating mechanism and the opening and closing mechanism of the forceps are preferably provided by cables, pulleys, link rods, electric sensors, electric actuators, connecting rod systems or hydraulics, or a combination thereof.

In a preferred embodiment the opening and closing mechanism comprises pivoted connecting rods connecting the bows of the handle assembly to a cylinder which is present on the proximal end of a hollow piston which is connected to hydraulic tubing. The hydraulic tubing extends from the handle assembly through the elongate body to the tool assembly. Alternatively, the opening and closing mechanism comprises a threaded connecting rod which extends from the handle assembly with one or more universally articulating joints, through the elongate body portion to the tool assembly, a curved rack and pinion which is connected to the bows of the handle assembly and a bush which is connected to the tool assembly. The bush is threaded onto the distal end of the connecting rod and movement of the bows of the handle produces rotary movement of the connecting rod. The rotation of the connecting rod causes the bush to slide along the connecting rod resulting in the jaws of the tool opening or closing depending upon the direction of rotation of the connecting rod.

Preferably, the forceps further include a tensioning system for tensioning at least one of the actuating mechanism and the opening and closing mechanism. The tensioning system is preferably connected to the actuating mechanism.

In a further embodiment it is preferred that the elongate body portion of the forceps is composed of a rigid material. Examples of suitable rigid materials include polymers and metals such as those which are commonly used in surgical forceps. Suitable polymers include certain polypropylenes, polycarbonates, polyesters and polyamides. Suitable metals include certain stainless steel.

Alternatively, the elongate body portion can be formed from a flexible material such as a silicone rubber. The elongate body portion can be supported by a support structure, which may for example be located around the outside of the elongate body portion. The elongate body portion may have one or more grooves formed in it in which the support structure can be received, to reinforce the elongate body portion against unwanted movement. The support can be provided by a component which is less deformable than the material of the elongate body portion.

The invention is further described by way of example but not in any limitative sense with reference to the accompanying drawings, in which:

Figure 1 illustrates the forceps from above; Figure 2 illustrates the handle assembly of the forceps from above;

Figure 3 illustrates the tool assembly of the forceps from above;

Figure 4 illustrates the side view of the forceps in which the bows of the handle assembly are in a plane perpendicular to the jaws of the tool assembly of the forceps and the handle assembly and the tool assembly are in the "closed" position and are pivoted about an axis perpendicular to the longitudinal axis of the forceps;

Figures 5a, 5b and 5c illustrate the forceps from above in which the handle assembly and the tool assembly of the forceps are in the "closed" position and are pivoted about an axis perpendicular to the longitudinal axis of the forceps;

Figure 6 illustrates the forceps from above in which the bows of the handle assembly and the jaw members of the tool assembly are in the "open" position;

Figure 7 illustrates the forceps from above in which the handle assembly and the tool assembly are pivoted in the "open" position about an axis perpendicular to the longitudinal axis of the forceps;

Figure 8 illustrates the forceps from above in which the handle assembly comprises a pair of levers and the opening and closing mechanism comprises a rack and pinion connected to the levers of the handle assembly, a threaded connecting rod extending from the handle assembly, through the elongate body portion to the tool assembly and a bush connected to the tool assembly;

Figure 9 illustrates the forceps from above in which the handle assembly is a pair of bows and the opening and closing mechanism comprises a rack and pinion connected to the bows of the handle assembly, a threaded connecting rod extending from the handle assembly, through the elongate body portion to the tool assembly and a bush connected to the tool assembly; Figure 10 illustrates a number of orientations of the tool assembly 12 relative to the elongate body portion 2 of the forceps;

Figure 11 illustrates various positions of the tool assembly 12 of the forceps when the elongate body portion 2 is rotated about its longitudinal axis;

Figure 12 illustrates a number of positions of the forceps when the tool assembly 12 is pivoted relative to the elongate body portion 2 of the forceps;

Figures 13a and 13b illustrate the distal end of the elongate body portion 2 of the forceps; and

Figures 14a to 14c illustrate the opening-closing mechanism of the tool assembly 12 of the forceps; and

Figure 15 illustrates the universal joint 6 which attaches the tool assembly 12 to the elongate body portion 2 of the forceps.

Referring to the drawings, Figure 1 illustrates the forceps in which an elongate body portion 2 comprises a first articulation device 4 at the proximal end of the elongate body portion 2 and a second articulation device 6 at the distal end of the elongate body portion 2. The first articulation device 4 is connected to the handle assembly 8 of the forceps. The first articulation device 4 is a universal joint. The handle assembly 8 comprises two bows 10 in the form of ring-like finger holds. The second articulation device 6 is connected to the tool assembly 12. The second articulation device 6 is a universal joint. The tool assembly comprises two jaw members 14. The jaw members 14 of the tool assembly 12 are pivotable in the same plane as the bows 10 of the handle assembly 8 of the forceps. The handle assembly 8 is connected to the tool assembly 12 by an opening and closing mechanism 16. The opening and closing mechanism 16 may be any suitable mechanism which is capable of translating the opening or closing movement of the bows 10 of the handle assembly 8 to movement of the jaw members 14 of the tool assembly 12. The handle assembly 8 and the tool assembly 12 can be pivoted about an axis which is perpendicular to the longitudinal axis of the elongate body portion 2. The jaw members 14 of the tool assembly 12 can move by an amount equal to the movement of the bows 10 of the handle assembly 8. The amount of movement of the jaw members 14 of the tool assembly 12 is determined by the opening and closing mechanism 16.

Figure 2 illustrates a further embodiment of the forceps in which the opening and closing mechanism 16 comprises hydraulic tubing which is connected to a hollow piston 18 which is connected to the bows 10 of the handle assembly 8 by pivoted connecting rods 20.

Figure 3 illustrates the tool assembly 12 of the forceps in which the opening and closing mechanism 16 is connected to the tool assembly 12 by a cylinder 22 and a piston 24. The movement of the bows 10 of the handle assembly 8 causes the piston 24 to move the jaw members 14 of the tool assembly 12.

The handle assembly 8 can be pivoted about an axis which is perpendicular to the longitudinal axis of the elongate body portion 2. Figure 4 illustrates the movement of the handle assembly 8 and the corresponding movement of the tool assembly 12 about an axis perpendicular to the longitudinal axis of the elongate body portion 2 of the forceps. The bows 10 of the handle assembly 8 are in a plane perpendicular to the plane of the jaw members 14 of the tool assembly 12. Both the bows 10 of the handle assembly 8 and the jaw members 14 of the tool assembly 12 are in the "closed" position. It is preferred that the tool assembly 12 pivots about the axis in the opposite direction to the movement of the handle assembly 8. Figure 4a illustrates the forceps of the present invention in the "resting" position in which the central axis of the handle assembly 8 is aligned with the longitudinal axis of the elongate body portion 2. In figure 4b the handle assembly 8 is pivoted about an axis which is perpendicular to the longitudinal axis of the elongate body portion 2. The tool assembly 12 pivots in the opposite direction to the handle assembly 8. The tool assembly 12 moves by an equal distance in the opposite direction to the movement of the handle assembly 8. Figures 5a and 5b illustrate the movement of the handle assembly 8 and the reciprocal movement of the tool assembly 12 about a second axis which is perpendicular to the longitudinal axis of the elongate body portion 2. The handle assembly 8 is in the closed position and the bows 10 of the handle assembly 8 are in contact. The tool assembly 12 is also in the closed position and the jaw members 14 of the tool assembly 12 are in contact. The tool assembly 12 pivots about the axis in the opposite direction to the handle assembly 8.

Figure 5a illustrates the forceps in the resting position in which the central axis of the handle assembly 8 is aligned with the longitudinal axis of the elongate body portion 2. In figure 5b the handle assembly 8 has been pivoted about an axis which is perpendicular to the longitudinal axis of the elongate body portion 2 resulting in the tool assembly 12 rotating about pivot points 7 and 9 in the opposite direction about the axis. Figure 5c illustrates the forceps in which the forceps contain a single pivot point T which enables the tool assembly 12 to be rotated relative to the elongate body portion 2.

Figure 6 illustrates the movement of the jaw members 14 of the tool assembly 12 when the bows 10 of the handle assembly 8 are separated into an "open" position. The movement of the bows 10 results in the jaw members 14 of the tool assembly 12 separating into an "open" position.

The handle assembly 8 of the forceps can be pivoted about an axis which is perpendicular to the axis of the elongate body portion 2 when the handle assembly 8 is in the "open" position and the bows 10 are no longer in contact. This movement is illustrated in Figure 7. As a result of the bows 10 of the handle assembly 8 being in the open position the jaws 16 of the tool assembly 12 are also in the open position. In the resting position the central axis of the handle assembly 8 is aligned with the axis of the elongate body portion 2. The handle assembly 8 can be moved above or below the plane of the elongate body portion 2 and the tool assembly 12 moves by an equal distance in the opposite direction.

The forceps may comprise a handle assembly 8 in which the bows 10 are a pair of levers. This is illustrated in figure 8a. The opening and closing mechanism 16 comprises a threaded connecting rod as shown in figures 8a and 9 which extends from the handle assembly with one or more universally articulated joints. The levers or bows 10 are connected to the opening and closing mechanism 16 by a curved rack 26 and a pinion 28. Movement of the levers or bows 10 results in the rotation of the connecting rod 16. Tool assembly 12 is connected to the threaded connecting rod by a bush 30, as shown in figure 8b, which is threaded onto the distal end of the connecting rod 16. The movement of the levers or bows 10 is translated into rotational movement of the connecting rod 16 which results in the bush 30 moving along the connecting rod 16. The movement of the bush along the connecting rod 16 results in the opening or closing of the jaws 14 of the tool 12 assembly.

Figure 10 illustrates the tool assembly 12 of the forceps. In the open 42 and closed 40 positions, the jaw members 14 are aligned along the longitudinal axis of the elongate body portion 2 of the forceps. The tool assembly 12 can be pivoted between a first position Cl and a second position Bl. For example, the tool assembly 12 can be moved from the closed position 40 to the first position Cl by pivoting the tool assembly 12 within a first plane relative to the elongate body portion 2 of the forceps. The tool assembly 12 can be moved from the closed position 40 to the second position Bl by pivoting the tool assembly 12 within a second plane relative to the elongate body portion 2 of the forceps. The first and second planes are perpendicular to each other. In position C2 the jaw members 14 are openable in a direction within the first plane. In position B2 the jaw members 14 are also openable in a direction within the first plane. The jaw members 14 can engage objects which are positioned along the longitudinal axis of the elongate body portion 2 or lie with their axis perpendicular to the longitudinal axis of the elongate body.

The tool assembly 12 can be moved from the first closed position 40 to a third closed position Bl by rotating the tool assembly 12 about a second axis which is substantially perpendicular to the longitudinal axis of the elongate body portion 2 and the first axis. The jaw members 14 can be separated so that the tool assembly 12 is in a third open position B2. The jaw members 14 are able to grasp objects which are spaced apart from, for example perpendicular to, the longitudinal axis of the elongate body portion 2. Rotation of the handle assembly enables the tool assembly 12 to be moved between positions 40, Cl and Bl. The tool assembly 12 can therefore be switched between these positions without requiring the entire instrument to be rotated or twisted about an axis. The tool assembly of the forceps of the present invention is therefore able to fully emulate the human wrist action of the surgeon on the outside of the patient.

Figure 11 illustrates various positions of the tool assembly 12 of the forceps when the elongate body portion 2 is rotated about its longitudinal axis. Similar positions can be envisaged for the handle assembly 8 relative to the elongate body portion 2 of the forceps.

In position A, the tool assembly 12 is aligned with the longitudinal axis of the elongate body portion 2 of the forceps, hi positions C and E the tool assembly 12 is displaced at an angle from the longitudinal axis of the elongate body portion 2 of the forceps. Rotation of the elongate body portion 2 of the forceps about its longitudinal axis causes the forceps to move from positions A, C and E to positions B, D and F respectively. Rotation of the elongate body portion 2 of the forceps about the longitudinal axis causes the tool assembly 12 to be rotated about the longitudinal axis to the same degree.

As shown in Figure 12, the tool assembly 12 is pivotally attached to the distal end of the elongate body portion 2 of the forceps by a universal joint 6. As shown in positions A' to H' of Figure 12, the universal joint 6 allows the tool assembly 12 to be pivoted relative to the longitudinal axis of the elongate body portion 2 of the forceps. Similar positions can be envisaged of the handle assembly 8 relative to the elongate body portion 2 of the forceps. Figure 12 shows various positions of the forceps as the tool assembly 12 is rotated about an axis which extends from the proximal end 200 to the distal end 201 of the tool assembly 12. The angle which is formed between the tool assembly 12 and the longitudinal axis of the elongate body portion 2 of the forceps is maintained as the tool assembly 12 is rotated about this axis.

As shown in Figures 13a and 13b, the distal end of the elongate body portion 2 of the forceps is attached to the tool assembly 12 by a universal joint 6. The universal joint 6 comprises an annular collar 101 which provides an opening 102 through which the opening and closing mechanism 116 of the forceps can extend. The annular collar 101 is attached to two power cables 103 which extend from the distal end of the elongate body portion 2. The two power cables 103 extend parallel to and spaced apart from each other. Power cable 104 extends from the distal end of the elongate body portion 2 through the annular collar 101 to the distal end of the tool assembly 12. In use, the power cables 103 facilitate the movement of the annular collar 101 of the universal joint 6 relative to the elongate body portion 2 so that the tool assembly 12 can be rotated relative to the longitudinal axis of the elongate body portion 2 of the forceps. Power cable 104 enables the distal tip of the tool assembly to be pivoted relative to the annular collar 101 of the universal joint 6.

As shown in Figures 14a to 14c and 15, the opening and closing mechanism 16 of the tool assembly 12 comprises a threaded connecting rod 116 which extends through the opening 102 provided by the annular collar 101 of the universal joint 6. The tool assembly 12 is connected to the threaded connecting rod 116 by a cooperatively threaded bush 117. Rotation of the threaded connecting rod 116 causes the bush 117 to rotate resulting in the bush 117 moving along the threaded connecting rod 116. The movement of the bush 117 along the threaded connecting rod 116 results in the opening or closing of the jaws 114 of the tool assembly 12.

Claims

1. Laparoscopic forceps comprising: a) a handle assembly comprising a pair of pivotally connected bow members; b) a tool assembly comprising a pair of jaw members; c) an elongate body portion extending distally from the handle assembly towards the tool assembly, the elongate body portion defining a longitudinal axis of the forceps, a proximal end of the elongate body portion being pivotally connected to the handle assembly by a universal joint and the distal end of the elongate body portion being pivotally connected to the tool assembly by a universal joint; d) an actuating mechanism connecting the handle assembly to the tool assembly for effecting synchronised pivotal movement of the handle assembly and the tool assembly relative to the elongate body of the forceps, and e) an opening and closing mechanism to effect simultaneous clamping movement of the jaw members of the tool assembly in response to movement of the bow members of the handle assembly.

2. Laparoscopic forceps as claimed in claim 1 in which the jaw members of the tool assembly are openable in the same direction independent of the direction in which the tool assembly is pivoted relative to the elongate body portion of the forceps.

3. Laparoscopic forceps as claimed in either of claims 1 and 2 in which the tool assembly may pivot in the same direction as the handle assembly.

4. Laparoscopic forceps as claimed in either of claims 1 and 2 in which the tool assembly may pivot in an opposite direction as the handle assembly.

5. Laparoscopic forceps as claimed in any one of claims 1 to 4 in which the jaw members are in an open position when the bows are in an open position.

6. Laparoscopic forceps as claimed in any one of claims 1 to 5 in which the bows of the handle assembly are in the same plane as the jaw members of the tool assembly.

7. Laparoscopic forceps as claimed in any one of claims 1 to 5 in which the bows of the handle assembly are in a plane perpendicular or inclined at an angle to the plane of the jaw members of the tool assembly.

8. Laparoscopic forceps as claimed in any one of claims 1 to 7 in which the opening and closing mechanism or actuating mechanism are selected from the group consisting of cables, pulleys, link rods, electric sensors, electric actuators, connecting rod systems or hydraulics, and combinations thereof.

9. Laparoscopic forceps as claimed in any one of claims 1 to 8 in which the pair of jaw members form a grasper, a pair of scissors, a clamp, a dissector, a clip applicator or a needle driver.

10. Laparoscopic forceps as claimed in any one of claims 1 to 9 in which the angular movement of the jaw members of the tool assembly is greater than the corresponding movement of the bows of the handle assembly.

11. Laparoscopic forceps as claimed in any one of claims 1 to 9 in which the angular movement of the jaw members of the tool assembly is less than the corresponding movement of the bows of the handle assembly.

12. Laparoscopic forceps as claimed in any one of claims 1 to 11 in which the opening and closing mechanism or actuating means comprises hydraulic tubing.

13. Laparoscopic forceps as claimed in any one of claims 1 to 11 in which the opening and closing mechanism comprises a threaded connecting rod.

14. Laparoscopic forceps as claimed in any one of claims 1 to 13 in which the handle comprises one or more universally articulating joints.