Surgical instrument for endoscopic surgery

Claim 2

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element, said translation means comprising a stationary handle member and a movable handle member pivotally secured to said stationary handle member, and means on said movable handle member for engaging means affixed to said second tubular element for translating said second tubular element relative to said first tubular element in response to relative movement of said handle members, said means affixed to said second tubular element comprising a gear rack provided with a series of teeth, and said means on said movable handle member comprising at least a toothed gear member in engagement with the teeth of said gear rack, said housing also having means for limiting movement of said gear rack in the forward and reverse direction; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another.

Claim 3

The instrument of claim 1 wherein each of said intermediate leaf spring elements is configured to provide a convex curvature at its joinder with said rear section and a concave curvature at its joinder with its respective jaw.

Claim 4

The instrument of claim 1 wherein said rear section of the jaw piece has a hole extending through and communicating at one end with the interior of said first tubular element and at its other end to the space between said jaws, thereby permitting an ancillary device to be extended through said first tubular element to the jaws.

Claim 5

The instrument of claim 1 wherein said housing has a distal end and a proximal end, and the proximal end of said first tubular element terminates at the proximal end of said housing, thereby adapting said instrument for introduction of an ancillary device.

Claim 6

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; said translation means comprising a stationary handle member and a movable handle member pivotally secured to said stationary handle member, and means on said movable handle member for engaging means affixed to said second tubular element for translating said second tubular element relative to said first tubular element in response to relative movement of said handle members; and means for selectively locking said movable handle member to said stationary handle member to retain the jaws in a selected position determined by translation of said second tubular element relative to said first tubular element.

Claim 7

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; said translation means comprising a stationary handle member and a movable handle member pivotally secured to said stationary handle member, and means on said movable handle member for engaging means affixed to said second tubular element for translating said second tubular element relative to said first tubular element in response to relative movement of said handle members; and means for selectively locking said movable handle member to said stationary handle member to retain the jaws in a selected position determined by translation of said second tubular element relative to said first tubular element.

Claim 8

The instrument of claim 5 wherein the portion of said stationary handle member to which said movable handle member is pivotally secured is bifurcated, and said movable handle member has a tongue section extending into the bifurcated portion of said stationary handle member, said movable handle member being rotatable about a pivot axis extending through said tongue section and said bifurcated portion of said stationary handle member.

Claim 9

The instrument of claim 6 further wherein said pivot axis is a pivot pin that projects from one side of said stationary handle member, and further including a locking lever rotatably attached to said pivot pin, and threaded means on said pivot pin and said stationary handle member, wherein when said locking lever is rotated relative to said pivot pin in a given direction, said bifurcated portion of said stationary handle member is compressed so as to hold said movable handle member against further movement.

Claim 10

A surgical instrument comprising; a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; each of said jaws being provided with a groove located so as to be in alignment with said first tubular element when said jaws are in a closed position, thereby providing a passage extending from the exterior of said housing through said first tubular element and said jaw piece for introduction of an ancillary device even when said jaws are closed.

Claim 11

A surgical instrument comprising; a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; each of said jaws being provided with a groove located so as to be in alignment with said first tubular element when said jaws are in a closed position, thereby providing a passage extending from the exterior of said housing through said first tubular element and said jaw piece for introduction of an ancillary device even when said jaws are closed.

Claim 12

The instrument of claim 8 in which said jaw piece comprises a rear section having a hole extending axially therethrough and each of said jaws is connected to said rear section by an intermediate spring leaf element.

Claim 13

The instrument of claim 9 wherein each said intermediate leaf spring element is configured to provide a convex curvature at its joinder with said rear section and a concave curvature at its joinder with its respective jaw, whereby when said jaws are drawn into closed position so as to grasp tissue which is being addressed, the forward ends of said jaws close on one another before the rear ends of said jaws, whereby there is an absence of forward motion of said jaws so as to reduce trauma to the grasped tissue regardless of the positioning of said jaws.

Claim 14

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; one of said jaws having a cutting blade attached thereto that extends substantially parallel to the axes of said tubular elements, and the other of said jaws having a groove for receiving said cutting blade.

Claim 15

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; and a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; one of said jaws having a cutting blade attached thereto that extends substantially parallel to the axes of said tubular elements, and the other of said jaws having a groove for receiving said cutting blade.

Claim 16

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; a sheath affixed to the forward end of said housing and surrounding and protecting said second tubular element, said sheath extending longitudinally with said second tubular element, whereby when said instrument is placed into an incision and said instrument is operated so as to cause said second tubular element to translate within said housing, said second tubular element will translate within said sheath so as not to cause trauma to the patient.

Claim 17

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; a sheath affixed to the forward end of said housing and surrounding and protecting said second tubular element, said sheath extending longitudinally with said second tubular element, whereby when said instrument is placed into an incision and said instrument is operated so as to cause said second tubular element to translate within said housing, said second tubular element will translate within said sheath so as not to cause trauma to the patient.

Claim 18

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; said first tubular element having a curved configuration, and said second tubular element being made of a material that enables it to assume the same curvature as said first tubular element as it undergoes translational movement.

Claim 19

A surgical instrument comprising: a housing provided with an internal bore, and at least first and second concentrically arranged tubular elements extending longitudinally away from said housing, said first tubular element having proximal and distal ends and being affixed at its proximal end so as to be immobile with respect to said housing, and said second tubular element surrounding said first tubular element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second tubular element to translate longitudinally relative to said first tubular element; a jaw piece affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising at least two jaws which are biased and normally deployed away from one another, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said second tubular element being arranged to slide over said two jaws, whereby when said second tubular element is caused to translate towards the distal end of said first tubular element, said second tubular element will slide over said jaw piece and cause said jaws to close towards one another; said first tubular element having a curved configuration, and said second tubular element being made of a material that enables it to assume the same curvature as said first tubular element as it undergoes translational movement.

Claim 20

A surgical instrument for grasping objects at a remote location comprising: a housing; first and second concentrically arranged longitudinally extending tubes, said first tube having proximal and distal ends and being fixed at said distal end to said housing, and said second tube surrounding said first tube and being arranged to translate longitudinally with respect to said first tube; a unitary preformed jaw piece having at least two jaws, a rear section, and intermediate spring leaf elements connecting each jaw to said rear section, said spring leaf elements being arranged so as to normally bias and deploy said jaws so that they are in an open position relative to one another, whereby when said second tube is caused to translate towards the distal end of said first tube, said second tube will overlap said jaw piece and cause said jaws to close towards one another, each intermediate leaf spring element being configured so as to provide a convex flexure at its joinder with said rear section and a concave flexure at its joinder with its respective jaw.

Claim 21

A surgical instrument for grasping objects at a remote location comprising: a housing; first and second concentrically arranged longitudinally extending tubes, said first tube having proximal and distal ends and being fixed at said distal end to said housing, and said second tube surrounding said first tube and being arranged to translate longitudinally with respect to said first tube; a unitary preformed jaw piece having at least two jaws, a rear section, and intermediate spring leaf elements connecting each jaw to said rear section, said spring leaf elements being arranged so as to normally bias and deploy said jaws so that they are in an open position relative to one another, whereby when said second tube is caused to translate towards the distal end of said first tube, said second tube will overlap said jaw piece and cause said jaws to close towards one another, each intermediate leaf spring element being configured so as to provide a convex flexure at its joinder with said rear section and a concave flexure at its joinder with its respective jaw.

Claim 22

The instrument of claim 14 wherein said rear section of said jaw piece has a hole extending through and communicating at one end with the interior of said first tube and at its other end to the space between said jaws, thereby permitting any device which is extended through said first tube to be presented at the space between the jaws.

Claim 23

The instrument of claim 14 including operating means for causing said second tube to move longitudinally relative to said first tube, said translation means comprising a stationary handle member and a movable handle member pinned to said stationary handle member for rotational movement with respect thereto, and means on said movable handle member for engaging means affixed to said second tube for moving said second tube longitudinally relative to said first tube in accordance with the relative positioning of said handle members.

Claim 24

The instrument of claim 16 including means for selectively locking the movable handle member to said stationary handle member.

Claim 25

The instrument of claim 16 wherein said stationary handle member has a bifurcated section, and said movable handle member has a section that extends into and is pivotally secured to the bifurcated section of said stationary handle member.

Claim 26

The instrument of claim 14 having two elongate jaws that extend lengthwise of said tubes, and further wherein said jaws are each provided with a groove so located that when said jaws are in closed position said grooves confront one another and are in alignment with said first tube.

Claim 27

The instrument of claim 14 including a sheath surrounding and protecting said second tube but being spaced therefrom, said sheath extending longitudinally with said second tubular element away from said housing; whereby when said second tube translates longitudinally with respect to said first tube it will translate within said sheath and not subject said second tube to ambient conditions.

Claim 28

The tool of claim 14 wherein said first tube is of curved configuration, and said second tube is made of a material that enables it to assume the same curvature as said first tubular element as it translates thereover.

Claim 29

A surgical instrument for grasping objects at a remote location comprising: first and second concentrically arranged longitudinally extending tubes, said first tube having proximal and distal ends and being fixed with respect to said second tube, and said second tube surrounding said first tube and being arranged to translate longitudinally with respect to said first tube; a unitary jaw piece comprising a rear section affixed to said first tube at its distal end, at least two jaws, and intermediate spring leaf elements each connecting one of said jaws to said rear section and acting to bias said jaws away from one another to an open position, whereby when said second tube is caused to translate towards the distal end of said first tube, said second tube will overlap said jaw piece and cause said jaws to close towards one another; operating means for causing said second tube to move longitudinally relative to said first tube, said translation means comprising a stationary handle member and a movable handle member pinned to said stationary handle member for rotational movement with respect thereto, and means on said movable handle member for engaging means affixed to said second tube for moving said second tube longitudinally relative to said first tube in accordance with the relative positioning of said handle members; and said operating means comprises a gear rack provided with a series of teeth attached to said second tube, and a toothed element attached to said movable handle member in engagement with the teeth of said gear rack.

Claim 30

A surgical instrument for grasping objects at a remote location comprising: first and second concentrically arranged longitudinally extending tubes, said first tube having proximal and distal ends and being fixed with respect to said second tube, and said second tube surrounding said first tube and being arranged to translate longitudinally with respect to said first tube; a unitary jaw piece comprising a rear section affixed to said first tube at its distal end, at least two jaws, and intermediate spring leaf elements each connecting one of said jaws to said rear section and acting to bias said jaws away from one another to an open position, whereby when said second tube is caused to translate towards the distal end of said first tube, said second tube will overlap said jaw piece and cause said jaws to close towards one another; operating means for causing said second tube to move longitudinally relative to said first tube, said translation means comprising a stationary handle member and a movable handle member pinned to said stationary handle member for rotational movement with respect thereto, and means on said movable handle member for engaging means affixed to said second tube for moving said second tube longitudinally relative to said first tube in accordance with the relative positioning of said handle members; and said operating means comprises a gear rack provided with a series of teeth attached to said second tube, and a toothed element attached to said movable handle member in engagement with the teeth of said gear rack.

Claim 31

The instrument of claim 22 further including means for limiting movement of said second tube relative to said first tube.

Claim 32

A surgical instrument comprising: a housing provided with an internal bore; first and second elongate elements extending longitudinally away from said housing, said first element having proximal and distal ends with said distal end being furthest from said housing, said proximal end of said first element extending into said bore and being affixed to said housing, and said second element being a tubular shaft having proximal and distal ends corresponding to their relative positions to the proximal and distal ends of said first element, said second element concentrically surrounding said first element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second element to translate longitudinally relative to said first element, said translation means comprising a stationary handle member formed integral with said housing, a movable handle member pivotally secured to said stationary handle member, and means on said movable handle member for engaging means affixed to said second element for translating said second tubular element relative to said first element in response to relative movement of said handle members; and a jaw piece in the form of an integral one-piece structure comprising at least two jaws, a rear section affixed to said distal end of said first element, and intermediate leaf spring elements connecting each of said jaws to said rear section, and biasing said jaws away from one another; said second element being arranged to slide over said two jaws when said movable handle member is pivoted relative to said stationary handle member in a predetermined direction, whereby said second element will engage said leaf spring element and thereby force said jaws to close on one another.

Claim 33

A surgical instrument comprising: a housing provided with an internal bore; first and second elongate elements extending longitudinally away from said housing, said first element having proximal and distal ends with said distal end being furthest from said housing, said proximal end of said first element extending into said bore and being affixed to said housing, and said second element being a tubular shaft having proximal and distal ends corresponding to their relative positions to the proximal and distal ends of said first element, said second element concentrically surrounding said first element and being arranged to translate longitudinally with respect to said first tubular element; translation means for causing said second element to translate longitudinally relative to said first element, said translation means comprising a stationary handle member formed integral with said housing, a movable handle member pivotally secured to said stationary handle member, and means on said movable handle member for engaging means affixed to said second element for translating said second tubular element relative to said first element in response to relative movement of said handle members; and a jaw piece in the form of an integral one-piece structure comprising at least two jaws, a rear section affixed to said distal end of said first element, and intermediate leaf spring elements connecting each of said jaws to said rear section, and biasing said jaws away from one another; said second element being arranged to slide over said two jaws when said movable handle member is pivoted relative to said stationary handle member in a predetermined direction, whereby said second element will engage said leaf spring element and thereby force said jaws to close on one another.

Claim 34

A surgical instrument according to claim 24 wherein said jaws have a distal end and a proximal end with the distal ends of said jaws being furthest from said housing, and said leaf spring elements are arranged so that when engaged by said distal end of said second element they will cause the distal ends of said jaws to close before the proximal ends of said jaws.

Claim 35

A surgical instrument comprising: a housing (34) having an internal cavity; first and second concentrically arranged tubular elements (10,8) extending longitudinally away from said housing, said first and second tubular elements each having a proximal end and a distal end, said proximal end of said first tubular element (10) extending into and being fixed to said housing, and said second tubular element (8) surrounding said first tubular element and being arranged to move longitudinally with respect to said first tubular element and said housing, said proximal end of said second tubular element extending into said cavity; a preformed jaw piece (2) affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising a rear section (58) attached to the said distal end of said first tubular element, at least two jaws (4,6), and intermediate leaf spring elements (62,64) connecting each of said jaws to said rear section, said leaf spring elements biasing said jaws so that they are normally deployed away from one another; first and second manually-engagable members (16,14) for holding and operating said instrument, said first manually-engagable member (16) being fixed to said housing and said second manually-engagable member (14) being movable relative to said first manually-engageable member and said housing; and means (36,38,40) providing a motion-translation connection between said second manually-engagable member (14) and said second tubular element (8) whereby bi-directional movement of said second manually-engageable member relative to said first manually-engagable member will cause said second tubular member to undergo bi-directional movement longitudinally relative to said first tubular element; and said second manually-engageable member being movable relative to said first manually-engagable member to an extent such as to cause said second tubular element to move longitudinally relative to said housing and said first tubular element towards the distal end of said first tubular element far enough for said distal end of said second tubular element to slide over said jaw piece and force said leaf spring elements toward one another so as to cause said jaws to close towards one another.

Claim 36

A surgical instrument comprising: a housing (34) having an internal cavity; first and second concentrically arranged tubular elements (10,8) extending longitudinally away from said housing, said first and second tubular elements each having a proximal end and a distal end, said proximal end of said first tubular element (10) extending into and being fixed to said housing, and said second tubular element (8) surrounding said first tubular element and being arranged to move longitudinally with respect to said first tubular element and said housing, said proximal end of said second tubular element extending into said cavity; a preformed jaw piece (2) affixed to said distal end of said first tubular element, said jaw piece being an integral structure comprising a rear section (58) attached to the said distal end of said first tubular element, at least two jaws (4,6), and intermediate leaf spring elements (62,64) connecting each of said jaws to said rear section, said leaf spring elements biasing said jaws so that they are normally deployed away from one another; first and second manually-engagable members (16,14) for holding and operating said instrument, said first manually-engagable member (16) being fixed to said housing and said second manually-engagable member (14) being movable relative to said first manually-engageable member and said housing; and means (36,38,40) providing a motion-translation connection between said second manually-engagable member (14) and said second tubular element (8) whereby bi-directional movement of said second manually-engageable member relative to said first manually-engagable member will cause said second tubular member to undergo bi-directional movement longitudinally relative to said first tubular element; and said second manually-engageable member being movable relative to said first manually-engagable member to an extent such as to cause said second tubular element to move longitudinally relative to said housing and said first tubular element towards the distal end of said first tubular element far enough for said distal end of said second tubular element to slide over said jaw piece and force said leaf spring elements toward one another so as to cause said jaws to close towards one another.

Claim 37

An instrument according to claim 26 wherein said motion translating connection comprises a gear rack (36) connected to and movable with said second tubular element, and gear teeth (38) on said second manually-engagable member engaged with said gear rack, whereby movement of said second manually-engagable member relative to said first manually-engagable member and said housing will cause said second tubular element to move longitudinally relative to said first tubular element.

Claim 38

An instrument according to claim 27 wherein said gear rack is disposed in said cavity.

Claim 39

An instrument according to claim 27 wherein said gear rack forms part of a hollow extension member that is attached to said proximal end of said second tubular element and slidably surrounds said first tubular element, and further including an O-ring disposed between said hollow extension member and said first tubular member so as to prevent fluids from migrating between said hollow extension member and said first tubular member.

Claim 40

An instrument according to claim 26 wherein each jaw has a distal end and a proximal end located closest to said housing, and further wherein said leaf spring elements are contoured so that when said second tubular element slides over said jaw piece, said leaf spring elements will be biased by said second tubular element so as to cause said jaws to close progressively starting with the distal ends of the jaws and then progressing toward the proximal ends of the jaws, whereby the proximal ends of said jaws will make contact last with any tissue disposed between the jaws.