Laparoscopic instruments

Abstract

The object of the present invention is a laparoscopic instrument, comprising: a handle and an articulated handle; a rod-shaped member, attached to the handle at its proximal end; a tissue action actuator, mounted at the distal end of the rod-shaped member; a wire for moving the actuator, the distal end of the wire being connected to the actuator and the proximal end being connected to the handle, wherein the wire is placed inside the rod-shaped member and the movement of the handle is coupled with the movement of the actuator; in addition, the instrument is equipped with an integrated latch mechanism, as well as a locking and release mechanism, wherein the handle is provided with a first slot and a second slot, and the switching handle is provided with a push-back element, the switching handle being rotatably mounted on the handle, wherein in the release position of the switching handle, the push-back element is located in the second slot, is arranged to abut against a toothed rack and disengages the latch mechanism, thereby moving the toothed rack away from the latch, so that the surface of the toothed member does not contact the surface of the latch, and in the locking position of the switching handle, the push-back element is located in the first slot and moved away from the toothed rack of the latch mechanism, so that the surface of the toothed member contacts the surface of the latch. The invention also provides a gripping and manipulating device for laparoscopic instruments.

Description

Technical Field

[0001] The subject of the invention is a laparoscopic instrument. Background Art

[0002] In surgical manipulation of internal organs using a laparoscopic method, different types of surgical instruments are used to hold, deflect, and cut tissue of the organ being manipulated or an organ connected to the organ being manipulated. One of the most commonly used instruments is an instrument provided with a tissue-gripping clamp coupled to a mechanism for holding the jaws of the clamp in a fixed reciprocating operating position to ensure a certain tissue compression, which must be temporarily maintained due to the progress of the operation. The operating position is also understood to refer to the holding of the tissue to allow temporary deflection of the tissue. Activities such as grasping and tissue cutting can be performed multiple times during the operation, and therefore, the structure of the laparoscopic instrument should be ergonomic. It is expected that the laparoscopic instrument should be manipulated using one hand, for example using the fingers of one hand.

[0003] Laparoscopic instruments provided with a handle are known from the prior art, wherein the handle may be of two parts, such as a scissor type, for which pulling the parts of the handle towards each other causes the manipulation of the instrument actuator. Instruments having a handle to which a handle for manipulating the actuator is attached are known. The instrument handle is equipped with a mechanism for maintaining the position of the handle.

[0004] A laparoscopic instrument is known from document EP0598607B1, which has a handle to which the handle is tightened to manipulate the clamp. The instrument is equipped with a latch mechanism, which comprises an arcuate rack integrated in the handle and a latch arranged on the handle, wherein the latch covers the toothed member on the longitudinal support. A deflection handle is mounted on the handle, which is suitable for occupying two positions, wherein the handle remains in continuous contact with the longitudinal support. At one position of the deflection handle, the rack remains engaged with the toothed member, and at another position, the rack deforms the longitudinal support so that the toothed member is pushed back and disengaged, thereby making the latch mechanism inoperative. The disclosed latch mechanism consists of many elements, and in addition, the efficiency of the mechanism may be weakened with the loss of elastic properties of the elements constituting it.

[0005] Document EP2471472A1 discloses a laparoscopic instrument comprising two pull handles that can be used to close and open the clamps. The handles are provided with a latch mechanism. A rotatably mounted latch in the form of a double handle is arranged on a fixed handle, which cooperates with an arcuate rack fixed to a movable handle. One end of the handle is provided with a toothed piece, and the other end of the handle is pushed up or down depending on whether the position of the jaws needs to be locked or released. The disclosed latch mechanism is also made of many components and is too complicated in terms of its function.

[0006] Document EP2077774B1 discloses a tubular laparoscopic instrument for separating or cutting tissue. The instrument is equipped with a latch mechanism comprising a rack and a latch fixed to a handle and a handle fastened thereto. The rack acts as a flat spring and ensures that the latch mechanism remains in a locked position. The disclosed instrument does not have a handle to allow the latch mechanism to be permanently disengaged. In order to disengage the latch mechanism elements, the operator of the instrument must tilt the rack downwards with the other hand and hold the rack until the handle is completely tilted from the handle. Summary of the invention

[0007] The object of the present invention is a laparoscopic instrument comprising: a handle and an articulated handle; a rod-shaped member attached to the handle at its more proximal end; a tissue action actuator mounted at the more distal end of the rod-shaped member; a wire for moving the actuator, the more distal end of the wire being connected to the actuator and the more proximal end being connected to the handle, wherein the wire is placed inside the rod-shaped member and the movement of the handle is coupled to the movement of the actuator; in addition, the instrument is equipped with an integrated latch mechanism, which comprises a rack and a latch and is designed to keep the actuator in an operating position by keeping the handle in position relative to the handle; and a locking and releasing mechanism, which is equipped with a switching handle to keep the latch mechanism engaged and disengage the latch mechanism, characterized in that the handle is provided with a first slot and a second slot, and the switching handle is provided with a push-back element, and the switching handle is rotatably mounted on the handle, wherein, in the release position of the switching handle, the push-back element is located in the second slot, is arranged to abut against the rack and disengage the latch mechanism, thereby moving the rack away from the latch so that the surface of the toothed member does not contact the surface of the latch, and in the locking position, the push-back element is located in the first slot and moved away from the rack of the latch mechanism so that the surface of the toothed member contacts the surface of the latch.

[0008] Preferably, the instrument is provided with a knob rotation indicator mechanism comprising a latch mechanism, said rotation indicator mechanism comprising a latch mechanism and a sleeve inserted on said shaft, wherein said sleeve is provided with a flange with a plurality of recesses.

[0009] The latch mechanism is arranged in the handle, wherein a spherical element determining the position of the knob moves in a direction parallel to the axis of the rod.

[0010] The switch handle may be secured in the first opening of the handle using a latch pin.

[0011] The shaft of the instrument is preferably mounted in a swivel position, and the angular position of the shaft relative to the handle is set by a knob mounted on the shaft.

[0012] Preferably, the actuator of the instrument is selected from the group consisting of clamping jaws, window jaws, toothed jaws, hook jaws, scissors.

[0013] The handle of the instrument is preferably provided with a pin adapted to be mounted in the second opening of the handle.

[0014] The handle of the instrument is preferably provided with a third opening adapted to receive a pivot element for a cord.

[0015] Preferably, a fourth opening is provided beside the third opening to receive a cover portion of the third opening.

[0016] Preferably, the device is characterized in that the handle is provided with an electrical connector.

[0017] The handle and the toothed rack are preferably made from a single plastic element.

[0018] The object of the invention is also a gripping and manipulating device for a laparoscopic instrument, comprising: a handle and an articulated handle, wherein the handle is suitable for attaching a rod-shaped element together with an actuator for acting on tissue, wherein the proximal end of a wire suitable for moving the actuator is articulated to the handle, wherein the movement of the actuator is coupled to the movement of the handle; in addition, the instrument is provided with an integrated latching mechanism, which includes a rack and a latch and is designed to keep the actuator in the operating position by maintaining the position of the handle relative to the handle; and a locking and releasing mechanism, which is provided with A switching handle for keeping a latch mechanism engaged and disengaging the latch mechanism, characterized in that the handle is provided with a first slot and a second slot, and the switching handle is provided with a push-back element, and the switching handle is rotatably mounted on the handle, wherein, in the release position of the switching handle, the push-back element (43) is located in the second slot, is arranged to abut against the rack and disengage the latch mechanism, thereby moving the rack away from the latch, and in the locking position of the switching handle, the push-back element is located in the first slot and moves away from the rack of the latch mechanism, so that the surface of the toothed member contacts the surface of the latch.

[0019] Preferably, the push-back element of the device is made as a bolt.

[0020] Preferably, the device is characterized in that the handle is provided with a longitudinal opening adapted to receive a rod-shaped member of a laparoscopic instrument.

[0021] The handle of the device is preferably provided with a pin adapted to be mounted in the second opening of the handle.

[0022] The handle of the device is preferably provided with a third opening adapted to receive a pivot element for a cord.

[0023] Preferably, a fourth opening is provided beside the third opening to receive a cover portion of the third opening.

[0024] Preferably, the handle of the device is provided with an electrical connector.

[0025] The handle and the toothed rack are preferably made from a single plastic element.

[0026] Since the latch mechanism elements and the locking and releasing mechanism are integrated with the handle and the handle to a greater extent than in the case of known laparoscopic instruments, the number of mechanism elements is reduced, which significantly reduces the cost of manufacturing the instrument according to the invention. The gripping and manipulating device consists of a minimum number of elements, namely three elements, whereby the elements of the instrument are designed to be made by plastic injection molding using low-cost horizontal injection. The "latch" installation method simplifies the construction of the tool as much as possible, without the need for an additional spindle, which also reduces the installation costs. Due to the very low manufacturing costs, the laparoscopic instrument according to the invention can be used as a disposable instrument, which significantly reduces the cost of treatment. The handle is made so that it includes a plurality of elements that were previously made as separate elements that were coupled together during the assembly process. In addition, the safety of the patient is improved by ensuring that the tool is sterile. According to the present invention, the laparoscopic instrument is ergonomic and safe for the patient when in use, because the triggering of the latch, that is, the latch is engaged, and the deactivation of the latch, that is, the latch is disengaged using the little finger, which does not involve the remaining fingers that can perform surgical activities, and there is no need to interrupt to change the position of the latch, which significantly improves the precision and certainty of the movement during the work of the surgeon. In other words, changing the position of the latch and manipulating the instrument can be performed in parallel. Regardless of the position of the handle, the latch position handle remains within the reach of the little finger, and it is impossible to accidentally trigger or deactivate the clamping applied to the tissue in this position, making the procedure performed by the surgeon smoother and safer. In addition, the laparoscopic instrument according to the present invention enables the auditory control of the change of the angular position of the actuator of the clamp, which can be caused by the surgeon intentionally or unintentionally, which is understandable because the particularity of the endoscopic procedure limits the surgeon to observe the movement of the hand and the instrument. In the instrument according to the present invention, the implementation of the rotation function of the instrument rod can be clearly perceived or heard by a series of clicks, which allows the auditory control of the rotation of the actuator. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] The purpose of the present invention is described below in conjunction with the embodiments shown in the accompanying drawings, in which:

[0028] Figure 1 The laparoscopic instruments are shown in a stereoscopic view,

[0029] Figure 2 The laparoscopic instruments are shown in exploded view.

[0030] Figure 3The laparoscopic instrument is shown in longitudinal section with the locking and release mechanism in the locked position.

[0031] Figure 4 Shows Figure 3 The enlarged picture of

[0032] Figure 5 The laparoscopic instrument is shown in longitudinal section with the locking and releasing mechanism in the released position.

[0033] Figure 6 Shows Figure 5 The enlarged picture of

[0034] Figure 7 The clamping jaws are shown in an enlarged view,

[0035] Figure 8 shows a cross section through the instrument shaft and the actuator, and

[0036] Fig. 9 A section through the knob rotation indicator mechanism is shown. DETAILED DESCRIPTION

[0037] In the following description, the terms "proximal" and "distal" are used to refer to longitudinal or arcuate support elements or cord elements of the instrument, where "proximal" refers to the end of the longitudinal element on the handle side and "distal" refers to the end of such an element on the opposite side of the handle.

[0038] According to the first embodiment Figure 1 The laparoscopic instrument 1 shown in FIG. 1 has a handle 2 and a handle 3 suitable for manual operation, wherein the handle 2 and the handle 3 are in the form of scissor-like handles with finger openings. The handle 3 is operated with the thumb and the handle 2 is held with the remaining fingers, wherein the handle 2 points downward when the laparoscopic instrument 1 is used. The handle 3 and the handle 2 are hinged to each other via their upper parts 3A and 2A ( Figure 2 In the upper part 2A of the handle 2, a longitudinal cylindrical opening 4 is provided ( Figure 3), a rod 6 with an m axis is mounted in the longitudinal cylindrical opening by a sleeve 5, wherein the position of the sleeve 5 is determined relative to the handle 3 by a sinker ring 8, and the rod 6 in the form of a tube support passes through the sleeve 5 from the center. The rod 6 is also supported by a knob 9, into which a bolt 10 is inserted and on the rod 6. The knob 9 is used to determine the angular position of the rod 6 and the actuator of the laparoscopic instrument 1. An opening 11 is arranged in the upper part 2A of the handle 2, in which a banana-type electrical connector 12 is mounted together with a spring latch 13. The electrical connector 12 presses the spring latch 13 so that the latch 13 maintains a friction-conducting connection with the rod 6 by spring tension, whereby, in the section from the knob 9 to the actuator of the laparoscopic instrument 1, the rod 6 is surrounded by an insulating foil 6A, for example made of a heat shrink material. The laparoscopic instrument provided with the electrical connector can be used as a monopolar instrument in laparoscopic surgery. The banana-type electrical connector 12 is a standard connector used in electrosurgery to supply power to the actuator. The connector 12 is arranged at an angle of 55 degrees to the axis of the rod 6 so that the power cord is positioned so as not to interfere with the movements and precision of the surgeon performing the operation. The handle 3 is mounted to the handle 2 and is hinged on the k axis. The handle 3 is provided in its upper part 3A with two coaxial pivots 15, which are arranged on two opposite sides of the hinged part 3B. The covered hinged part 3B is arranged in the recess 2B of the handle 2, wherein the pivot 15 is inserted in the second opening 16, the k axis of which passes through the wall of the recess 2B, wherein, in the position when the instrument is used, the axis k is below the axis m of the rod 6. In the vicinity of the covered part 3B of the handle 3, there is a wider section 3C of the upper part 3A of the handle 3, in which a cylindrical third opening 19 with an n axis is made. In the upper part 3A, a slotted recess 20 is made, the plane of which is perpendicular to both the k-axis and the n-axis, wherein the k-axis and the n-axis intersect the slotted recess 20. In the third opening 19, a cylindrical pivoting element 21 is arranged, in which a through hole 22 with the p-axis is made, wherein the cylindrical pivoting element 21 is inserted into the third opening 19 symmetrically with respect to the upper part 3A, so that the axis p is arranged in the plane of symmetry of the slotted recess 20 and in the axis k. The more proximal end of the wire 23 is inserted into the through hole 22 to move the jaws 24 of the laparoscopic instrument 1, the pivoting element 21 and the third opening 19 representing a coupling for the wire 23. The more proximal end of the wire 23 is clamped in the cylindrical pivoting element 21 in the opening 25 by a pressure screw 25A. The third opening 19 is closed with a cover 19A, which is latched in a fourth opening 19B arranged beside the third opening 19.

[0039] The laparoscopic instrument may be equipped with an actuator selected from the group consisting of: clamping jaws, window jaws, toothed jaws, hook jaws, scissors known in medical terminology as grasping forceps, different types of dissectors, and scissors. The laparoscopic instrument shown in this embodiment uses a clamp 24 comprising two window jaws 26, 27 which are connected by a support 29 ( Figure 1 ) is rotatably mounted on the r axis ( Figure 7 Each window clamp jaw 26, 27 is made as a double handle, the arm indicated by 26A, 27A respectively having a clamping surface 30, 31, and the other arm indicated by 26B, 27B respectively provided with an opening 32, 33, in which a susceptible cord indicated by 34, 35 respectively is inserted. The cord 34, 35 is, for example, a braided steel cable, connected to the more distal tubular end of the cord 23 by using pressure to clamp the end in the tube after previously passing the cord through the opening 32, 33 ( Figure 8 ).

[0040] The handle 2 and the handle 3 both form a gripping and manipulating device. The handle 2 is provided with a first central element 2D and a first gripping element 2E, while the handle 3 is provided with a second central element 3D and a second gripping element 3E ( Figure 2 The laparoscopic instrument 1 is provided with a latch mechanism 36, which comprises a rack 37 and a toothed member 38 cooperating with the rack and acting as a latch ( Figure 3 ). An arcuately shaped rack 37 is integrated with the second clamping element 3E, and the rack 37 is provided with a plurality of teeth 39, which are suitable for cooperating with the teeth 38 arranged on the first clamping element 2E. The rack 37 is arranged so that the teeth 39 of the rack 37 are in contact with the teeth 38, i.e., engaged with the teeth 38. The teeth 39 and the teeth 38 are both triangular in shape. Between each tooth 39, a recess is provided to match the tooth 38. During the movement of pulling the handle 3 toward the handle 2 - marked as the G direction - i.e., during the movement of the second clamping element 3E toward the first clamping element 2E, the tooth 39 jumps over the tooth 38, i.e., the subsequent surface 39A of the tooth 39 is in contact with the surface 38A of the tooth 38 ( Figure 4), while the rack 37 is tilted to allow the tooth 39 to jump over. The movement of the handle 3 in the G direction affects the clamping of the jaws, i.e. the clamping of the handle 3 into the handle 2 brings the jaws 26, 27 or any other actuator closer together. Once the person performing the treatment reaches the required operating position, in this case clamping, i.e. the required position of the jaws 26, 27 relative to each other, and after stopping the tightening movement of the handle 3 towards the handle 2, the tooth 38 is kept in the recess between the teeth 39. Since the surface 39B of the tooth 39 rests against the surface 38B of the tooth 38, a self-releasing movement of the handle 3 and thus of the clamp is impossible. The laparoscopic instrument 1 is provided with a locking and releasing mechanism 40, which is designed to maintain two positions - a locking position, in which the jaws can be clamped at any degree of clamping and maintained as such, and a release position, in which the person performing the operation can freely clamp and release the clamp, but cannot keep the jaws clamped. The locking and releasing mechanism 40 comprises a device which is hinged on the first clamping element 2E and is provided at the first opening 47 ( Figure 2 ) in the switching handle 41, wherein the t axis of the coupling 42 is substantially parallel to the k axis and the n axis. The switching handle 41 is provided with a push-back element 43, which can maintain the position according to the position of the switching handle 41 in the first slot 45 for the locking position or in the second slot 46 for the releasing position ( Figure 4 and Figure 6 ). The push-back element 43 is a movement limiter for the switch handle 41, which in the embodiment shown is a cylindrical bolt. The switch handle 41 is suitable for changing its position from the locked position to the released position and vice versa by pressing the tip 44. The coupling 42 of the switch handle 41 includes two opposite pivots 41A arranged on the arms 41B of the switch handle 41. The arms 41B are flexible to allow them to be slightly tilted during installation on the handle 2, so that the switch handle 41 is attached using a latch by inserting the pin 41A into the first opening 47 in the handle 2.

[0041] In such Figure 3 and Figure 4 In the locked position of the locking and releasing mechanism 40 shown, the switching handle 41 is in the locked position, and the latch mechanism 36 works as described above, that is, in the embodiment shown, the actuator can be kept in the proper operating position, and the jaws 26, 27 of the jaws 24 of the laparoscopic instrument 1 are clamped by the person performing the operation. Figure 5 and Figure 6 In the embodiment shown in FIG. 2 , the locking and releasing mechanism 40 is in the releasing position and the handle 3 can be withdrawn in the direction marked R. The switching handle 41 is in the releasing position in which the push-back element 43 rests against the second slot 46 of the clamping element 2E.

[0042] The handle 2, the handle 3, the cover 19A and the switch handle 41 are made of one type of plastic, such as ABS, by using the most cost-effective horizontal injection method. The handle 3 and the rack 37 can form a single piece obtained by this method.

[0043] The laparoscopic instrument is provided with a rotation indicator mechanism 48 ( Fig. 9 ), the rotation indicator mechanism comprises a sleeve 5 inserted on a rod 6 and a latch mechanism 50, wherein the sleeve 5 is provided with a flange 5A having a plurality of recesses 5B designed to cooperate with a spherical element 51 of the latch mechanism 50. The spherical element 51 is inserted into a sleeve 52 and pressed against the flange 5A by a spring 53, wherein the sleeve 52 is placed in an opening 54 of the handle 2. The spherical element 51 has the ability to move in a direction parallel to the m-axis of the handle 2. While setting the desired position of the actuator by turning the knob 9, the person performing the operation can hear a series of clicks of the latch mechanism 50. Whether or not the repositioning of the actuator is assessed audibly, the person performing the operation senses the continuous latching of the latch mechanism 50 with his or her hand. The person performing the operation obtains information about the intentional or unintentional rotation of the actuator located in the patient's body during treatment without having to look at the handle of the laparoscopic instrument.

Claims

1. Laparoscopic instruments, comprising: handles and articulated handles; a rod-like member attached at a proximal end thereof to the handle; A tissue action actuator, which is mounted at the distal end of the rod-shaped member; a wire rope, which is used to move the actuator, the distal end of the wire rope is connected to the actuator and the proximal end is connected to the articulated handle, wherein the wire rope is placed in the rod-shaped member and the movement of the articulated handle is coupled with the movement of the actuator; in addition, the laparoscopic instrument is equipped with an integrated first latch mechanism, the first latch mechanism includes a rack and a latch, and is designed to maintain the position of the articulated handle relative to the handle to maintain the actuator in an operating position; and is equipped with a locking and releasing mechanism, the locking and releasing mechanism is equipped with a switching handle to keep the first latch mechanism engaged and to disengage the first latch mechanism, characterized in that the handle (2) is provided with a first slot (45) and a second slot (46), and the switching handle (41) is provided with a push-back element (43), and the switching handle (41) is rotatably mounted on the handle (2), wherein, in the release position of the switching handle (41), the push-back element (43) is located in the second slot (46), is arranged to abut against the rack (37) and disengage the first latch mechanism (36), thereby moving the rack (37) away from the latch (38), so that the surface (39A) of the toothed member (39) of the rack (37) does not contact the surface (38A) of the latch (38), In the locked position of the switching handle (41), the push-back element (43) is located in the first slot (45) and is moved away from the rack (37) of the first latch mechanism (36), so that the surface (39A) of the toothed member (39) contacts the surface (38A) of the latch (38).

2. The laparoscopic instrument according to claim 1, characterized in that: The rod-shaped member (6) is rotatably mounted and the angular position of the rod-shaped member (6) relative to the handle (2) is set by a knob (9) mounted on the rod-shaped member (6).

3. The laparoscopic instrument according to claim 2, characterized in that: The laparoscopic instrument is provided with a rotation indicator mechanism (48) for the rotation knob (9).

4. The laparoscopic instrument according to claim 3, characterized in that: The rotation indicator mechanism (48) for the knob (9) comprises a second latch mechanism (50), the rotation indicator mechanism (48) comprising a second latch mechanism (50) and a sleeve (5) inserted on the rod-shaped member (6), wherein the sleeve (5) is provided with a flange (5A) with a plurality of recesses (5B).

5. The laparoscopic instrument according to claim 4, characterized in that: The second latching mechanism (50) is arranged in the handle (2), wherein a spherical element (51) determining the position of the knob (9) moves in a direction parallel to the axis (m) of the rod (6).

6. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The switch handle (41) is attached to a first opening (47) in the handle (2) by means of a first pivot member (41A).

7. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The actuator is selected from the group consisting of a clamping jaw, a window jaw, a toothed jaw, a hook jaw, and a scissors.

8. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The hinged handle (3) is provided with a second pivot member (15) adapted to be mounted in a second opening (16) in the handle (2).

9. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The articulated handle (3) is provided with a third opening (19) adapted to receive a pivoting element (21) for a cord (23).

10. The laparoscopic instrument according to claim 9, characterized in that: A fourth opening (19B) is provided beside the third opening (19) to receive the cover portion (19A) of the third opening (19).

11. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The handle (2) is provided with an electrical connector (12).

12. The laparoscopic instrument according to any one of claims 1 to 5, characterized in that: The articulated handle (3) and the toothed rack (37) are a single plastic component.

13. Devices for holding and manipulating laparoscopic instruments, including: A handle and an articulated handle, wherein the handle is suitable for attaching a rod-shaped member together with an actuator for acting on tissue, wherein the proximal end of a wire rope suitable for moving the actuator is hinged to the articulated handle, wherein the movement of the actuator is coupled to the movement of the articulated handle; in addition, the laparoscopic instrument is provided with an integrated first latch mechanism, the first latch mechanism includes a rack and a latch, and is designed to maintain the actuator in an operating position by maintaining the position of the articulated handle relative to the handle; and a locking and releasing mechanism is provided, the locking and releasing mechanism is provided with a switching handle to keep the first latch mechanism engaged and to disengage the first latch mechanism, characterized in that the handle (2) is provided with a first slot (45) and a second slot (46), and the switching handle (41) is provided with a push-back element (43), and the switching handle (41) is rotatably mounted on the handle (2), wherein, in the release position of the switching handle (41), the push-back element (43) is located in the second slot (46), is arranged to abut against the rack (37) and disengage the first latch mechanism (36), thereby moving the rack (37) away from the latch (38), so that the surface (39A) of the toothed member (39) of the rack (37) does not contact the surface (38A) of the latch (38), In the locked position of the switching handle (41), the push-back element (43) is located in the first slot (45) and is moved away from the rack (37) of the first latch mechanism (36), so that the surface (39A) of the toothed member (39) contacts the surface (38A) of the latch (38).

14. The device according to claim 13, characterized in that The push-back element (43) is made as a bolt.

15. The device according to claim 13 or 14, characterized in that The handle (2) is provided with a longitudinal opening (4), which is suitable for receiving the rod-shaped member (6) of the laparoscopic instrument.

16. The device according to claim 13 or 14, characterized in that The hinged handle (3) is provided with a second pivot member (15), which is suitable for being mounted in a second opening (16) in the handle (2).

17. The device according to claim 13 or 14, characterized in that The articulated handle (3) is provided with a third opening (19) adapted to receive a pivoting element (21) for the cord (23).

18. The device according to claim 17, characterized in that A fourth opening (19B) is provided beside the third opening (19) to receive the cover portion (19A) of the third opening (19).

19. The device according to claim 13 or 14, characterized in that The handle (2) is provided with an electrical connector (12).

20. The device according to claim 13 or 14, characterized in that The articulated handle (3) and the toothed rack (37) are a single plastic component.

Images