LAPAROSCOPIC SURGICAL INSTRUMENT

Abstract

A laparoscopic surgical instrument including a connection assembly, an end effector, and a manipulation unit. The instrument also includes a means for transmitting motion from the manipulation unit to the end effector. The means for transmitting motion may include a means for transmitting first rotational movement of the manipulation unit to the end effector in a way such that the end effector rotates around an axis that is orthogonal to the axis of the connection assembly. The means for transmitting motion may also include a means for transmitting a second rotational movement to the end effector in a way such that the end effector rotates around it's own axis that is parallel to the axis of the manipulation unit.

Claims

1. A laparoscopic surgical instrument, comprising: a connection assembly having an axis, a first end, and a second end; an end effector having an axis of rotation incident to the axis of the connection assembly at the second end of the connection assembly, said end effector being mounted on the second end of the connection assembly; a manipulation unit having an axis of rotation incident to the axis of the connection assembly at the first end of the connection assembly, said manipulation unit being mounted on the first end of the connection assembly; and a means for transmitting motion from the manipulation unit to the end effector; wherein the means for transmitting motion comprises at least one of: a means for transmitting, to the end effector, a first rotational movement of the manipulation unit around a first axis that is along a plane orthogonal to the axis of the connection assembly and incident to the axis of the connection assembly at the first end of the connection assembly, in such a way that the end effector rotates around an axis orthogonal to the axis of the connection assembly and incident to the axis of the connection assembly at the second end of the connection assembly; and a means for transmitting, to the end effector, a second rotational movement of the manipulation unit around its axis, in such a way that the end effector rotates around its axis parallel to the axis of the manipulation unit.

2. The instrument according to claim 1, wherein the means for transmitting the first rotational movement comprises: a first bevel gear firmly connected with the manipulation unit and having the vertex located in correspondence with the first end of the connection assembly; a second bevel gear forming with the first bevel gear a first gear assembly, in such a way that a rotation of the first bevel gear around an axis of the first bevel gear causes a rotation of the second bevel gear around an axis of the second bevel gear; a third bevel gear firmly connected with the end effector and having the vertex in correspondence with the second end of the connection assembly; a fourth bevel gear forming with the third bevel gear a second gear assembly, in such a way that a rotation of the fourth bevel gear around an axis of the fourth bevel gear causes a rotation of the third bevel gear around an axis of the third bevel gear; and a tube aligned with the axis of the connection assembly, said tube cooperating with the second bevel gear and the fourth bevel gear in such a way that a rotation of the second bevel gear around the axis of the second bevel gear causes a rotation of the fourth bevel gear around the axis of the fourth bevel gear.

3. The instrument according to claim 2, wherein the means for transmitting the second rotational movement comprises: a first shaft firmly connected with the manipulation unit; a second shaft firmly connected with the end effector; a third shaft aligned with the axis of the connection assembly; a first Cardan joint centered in correspondence of the first end of the connection assembly; and a second Cardan joint centered in correspondence of the second end of the connection assembly.

4. The instrument according to claim 3, wherein the connection assembly comprises a frame housing the tube, and wherein the tube is a hollow tube that houses the third shaft.

5. The instrument according to claim 4, comprising a brake block mounted on the frame, said brake block being configured to avoid the unintentional rotation of the frame around the axis of the connection assembly, when the first shaft, the third shaft and the second shaft are aligned along the axis of the connection assembly.

6. The instrument according to claim 1, wherein the means for transmitting the first rotational movement comprises: a first shaft firmly connected with the manipulation unit; a second shaft firmly connected with the end effector; a third shaft aligned with the axis of the connection assembly, wherein a first end of the third shaft coincides with the first end of the connection assembly, and wherein a second end of the third shaft coincides with the second end of the connection assembly; a fourth shaft integrally connected with the first shaft, said fourth shaft being connected with the third shaft by a first flexure hinge having a center of rotation coinciding with the first end of the third shaft; a fifth shaft integrally connected with the second shaft, said fifth shaft being connected with the third shaft by a second flexure hinge having a center of rotation coinciding with the second end of the third shaft; a sixth shaft connected to a first portion of the fourth shaft by a third flexure hinge, wherein the sixth shaft is connected to a first portion of the fifth shaft by a fourth flexure hinge; and a seventh shaft connected to a second portion of the fourth shaft by a fifth flexure hinge, wherein the seventh shaft is connected to a second portion of the fifth shaft by a sixth flexure hinge.

7. The instrument according to the claim 6, wherein the first flexure hinge, the second flexure hinge, the third flexure hinge, the fourth flexure hinge, the fifth flexure hinge and the sixth flexure hinge comprise a circular flexure hinges.

8. The instrument according to claim 1, wherein the means for transmitting the second rotational movement comprises: a first shaft connected to the manipulation unit; a second shaft connected to the end effector; a third shaft aligned with the axis of the connection assembly; a first torque coil having a first end and a second end, wherein the first end of the first torque coil is connected to a first end of the first shaft, wherein the second end of the first torque coil is connected to a first end of the third shaft, and wherein the first end of the connection assembly is positioned between the first end of the first torque coil and the second end of the first torque coil; and a second torque coil having a first end and a second end, wherein the first end of the second torque coil is connected to a second end of the third shaft, wherein the second end of the second torque coil is connected to a first end of the second shaft, wherein the second end of the connection assembly is positioned between the first end of the second torque coil and the second end of the second torque coil.

9. The instrument according to claim 8, wherein the second torque coil is connected to the end effector and configured to convert a translational movement of the second torque coil along a longitudinal axis of the second torque coil to open and/or close the two arms of the end effector, wherein the translational movement of the second torque coil is caused by transmission of the third shaft, of a translational movement of the first torque coil along a longitudinal axis of the first torque coil.

10. The instrument according to claim 3, wherein the manipulation unit comprises: a handle; a drum brake connecting the handle to the first shaft, said drum brake comprising: a clutch pad; a compression pad; a spring connecting the clutch pad and the compression pad; and a drum pulley firmly connected with the first shaft; a handling ring firmly connected with the drum pulley in such a way that a rotation of the handling ring around an axis of the handling ring causes a rotation of the drum pulley around an axis of the drum pulley and causes a rotation of the first shaft around an axis of the first shaft.

11. A laparoscopic surgical instrument, comprising: a connection assembly having an axis; an end effector mounted on a first end of the connection assembly, said end effector comprising a first arm and a second arm; a manipulation unit mounted on a second end of the connection assembly, said manipulation unit comprising a trigger, a pulley firmly connected with the trigger, and an idle pulley; a means for transmitting motion from the manipulation unit to the end effector; a first shaft firmly connected to the manipulation unit; and a second shaft connected to the end effector; wherein the end effector comprises: a first arm; a second arm; a pulley connected to the first arm; a first gear connected to the second arm; and a second gear forming a gear assembly with the first gear, wherein the second gear is concentric and integrally connected with the pulley; wherein the means for transmitting motion comprises a cable connecting the pulley of the manipulation unit with the pulley of the end effector, said cable comprising two branches that wrap around each of the pulley of the manipulation unit and the pulley of the end effector, wherein the two branches are separated by the idle pulley.

12. The instrument according to claim 11, wherein the connection assembly further comprises a sheath having a first end connected to the first shaft and a second end connected to the second shaft, wherein the two branches of the cable are separated from one another.

13. The instrument according to claim 1, wherein the end effector is at least one of a clamp, or a scissor, and a grasper.

14. A laparoscopic surgical instrument suitable to cooperate with an instrument holder for at least a partial insertion of said laparoscopic surgical instrument through an incision into a patient cavity, said instrument comprising: a connection assembly having an axis, a first end, and a second end, wherein the connection assembly comprises a frame; an end effector having an axis of rotation incident to the axis of the connection assembly at the second end of the connection assembly, wherein the end effector is mounted on the second end of the connection assembly; a manipulation unit having an axis of rotation incident to the axis of the connection assembly at the first end of the connection assembly, wherein the manipulation unit is mounted on the first end of the connection assembly; a means for transmitting at least a rotational movement of the manipulation unit around the axis of the manipulation unit, to the end effector, in such a way that the end effector rotates around the axis of the end effector, wherein the axis of the end effector is parallel to the axis of the manipulation unit; and a blocking device mounted on the frame and configured to avoid the unintentional rotation of the frame around the axis of the connection assembly, wherein the blocking device comprises: a support structure with means for docking the blocking device to the instrument holder; two truncated cone rolls, wherein the frame is placed between the two truncated cone rolls; and a lever configured to allow the two truncated cone rolls to translate from a first position in which the two truncated cone rolls are not in contact with the frame to a second position in which the two truncated cone rolls are in contact with the frame preventing, by friction, the rotation of the frame around the axis of the connection assembly, such that the translation of the frame along the axis of the connection assembly is maintained as allowable.

15. Kit for laparoscopy interventions comprising: a laparoscopic surgical instrument; and an instrument holder for at least a partial insertion of said laparoscopic surgical instrument through an incision into a patient cavity, wherein the instrument holder has a means for docking the instrument holder to a blocking device that has a support structure, wherein the support structure has means for docking the blocking device to the instrument holder, and wherein the means for docking the instrument holder to the blocking device is configured to cooperate with the means of the support structure for docking the blocking device to the instrument holder.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0048] The description refers to the accompanying drawings, in which:

[0049] FIG. 1a is a schematic representation of the degree of freedom of a trocar of the prior art and any surgical laparoscopic instrument of the prior art inserted in such a trocar;

[0050] FIG. 2 is a schematic representation of the laparoscopic surgical instrument of the present invention showing the rotational movements transmitted from the manipulation unit to the end effector;

[0051] FIG. 3 is a side view of a fifth embodiment of the instrument of the present invention with the first shaft, the second shaft and the third shaft aligned and the closed clamp;

[0052] FIG. 4 is a side view of a fifth embodiment of the instrument of the present invention with the first shaft, the second shaft and the third shaft aligned and the open clamp;

[0053] FIG. 5a is a top view of a of a fifth embodiment of the instrument of the present invention with the first shaft and second shaft rotated around the first axis (U.sub.1) and the axis (U.sub.1′), respectively;

[0054] FIG. 5b is a side view of a fifth embodiment of the instrument of the present invention with the first shaft and second shaft rotated around the first axis (U.sub.1) and the axis (U.sub.1′), respectively;

[0055] FIG. 6a is a side view of a detail of the fifth embodiment of the present invention, said detail being relative to the means for transmitting the first rotational movement, in correspondence of the manipulation unit;

[0056] FIG. 6b is a side view of a detail of the fifth embodiment of the instrument the present invention, said detail being relative to the means for transmitting the first rotational movement, in correspondence of the end effector;

[0057] FIG. 7a is a top view of a fifth embodiment of the instrument of the present invention with the first shaft and second shaft rotated around the second axis (U.sub.2) and the axis (U.sub.2′), respectively;

[0058] FIG. 7b is a side view of a fifth embodiment of the instrument of the present invention with the first shaft and second shaft rotated around the second axis (U.sub.2) and the axis (U.sub.2′), respectively;

[0059] FIG. 8a is a side view of a detail of the fifth embodiment of the instrument of the present invention, said detail being relative to the means for transmitting the second rotational movement, in correspondence of the manipulation unit;

[0060] FIG. 8b is a side view of a detail of the fifth embodiment of the instrument of the present invention, said detail being relative of the means for transmitting the second rotational movement, in correspondence of the end effector;

[0061] FIG. 9a is a side view of a detail of the fifth embodiment of the instrument the present invention, said detail being relative to the brake block;

[0062] FIG. 9b is a top view of a detail of the fifth embodiment of the instrument the present invention, said detail being relative to the brake block;

[0063] FIG. 10a is a perspective view of the fifth embodiment of the instrument of the present invention the first shaft, the second shaft and the third shaft being aligned;

[0064] FIG. 10b is a perspective view of the fifth embodiment of the instrument of the present invention, when the first shaft is rotated, around the second axis (U.sub.2), of an angle less than 90° with respect to the third shaft, the second axis (U.sub.3) being coincident with the axis (U.sub.3) of the connection assembly and;

[0065] FIG. 10c is a perspective view of the of the fifth embodiment of the instrument of the present invention, when the first shaft is rotated, around the second axis (U.sub.2), of an angle of ° 90°, with respect to the third shaft, the second axis (U.sub.2) being coincident with the axis (U.sub.3) of the connection assembly;

[0066] FIG. 11 is a perspective view of the of the fifth embodiment of the instrument of the present invention when the first shaft is rotated, around the second axis (U.sub.2), of an angle of 90°, with respect to the third shaft and, around a fourth axis (U.sub.4) orthogonal to the axis (U.sub.3) and to the first axis (U.sub.1), the second axis (U.sub.2) being coincident with the axis (U.sub.3) of the connection assembly;

[0067] FIG. 12 is a schematic representation of a sixth and thirteenth embodiments of the laparoscopic surgical instrument of the present invention;

[0068] FIG. 13 is a schematic representation of a detail of the sixth and thirteenth embodiment of the laparoscopic surgical instrument of the present invention, said detail being relative to an example of flexure hinge comprised in the means for transmitting the first rotational movement;

[0069] FIG. 14 is a schematic representation of a sixth and thirteenth embodiment of the laparoscopic surgical instrument of the present invention;

[0070] FIG. 15 is a longitudinal section of a detail of the instrument of the present invention, said detail being relative to the manipulation unit;

[0071] FIG. 16a is a first perspective view of the detail of the fifth embodiment of the instrument of the present invention, said detail being relative to the end effector;

[0072] FIG. 16b is a second perspective view of the detail of the end effector of the fifth embodiment of the instrument of the present invention said detail being relative to the end effector;

[0073] FIG. 17 is a perspective view of a detail of the instrument of the present invention, said detail being relative to block element of the spontaneous rotation of the axis of the connection assembly of the present invention;

[0074] FIG. 18a is a perspective view of detail of the kit of the present invention, said detail being relative to block element of the spontaneous rotation axis of the connection assembly of the present invention;

[0075] FIG. 18b is a perspective view of detail of the kit of the present invention, said detail being relative to the trocar;

[0076] FIG. 19a is a side view of a detail of the instrument of the present invention, said detail being relative to the first embodiment of the handle; and

[0077] FIG. 19b is a side view of a detail of the instrument of the present invention, said detail being relative to a second embodiment of the handle.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0078] Referring to FIG. 1, and as already mentioned above, the instruments of the prior art when in use, are inserted in an instrument holder, known as trocar (6), that guides the insertion of the laparoscopic surgical instrument through an incision into a patient cavity. The trocar (6), and, therefore, whichever instrument inserted in it, has four degrees of freedom. The first one is a translational degree of freedom (3) along the axis of the rectilinear cannula (5) of the trocar (6). The other three degrees of freedom are rotational degrees. They are, in particular: a first rotational degree (4) around an axis parallel to the cannula (5); a second rotational degree (1) around a first axis perpendicular to the cannula (5); and a third rotational degree (2) around a second axis, said second axis being perpendicular to the first axis.

[0079] Referring to FIGS. 2, 3, 4, 6a, 6b, 8a, 8b, 12 and 14, the instrument of the present invention comprises: [0080] a connection assembly (201) having an axis (U.sub.3), a first end (A) and a second end (B); [0081] an end effector (301) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201); [0082] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201); [0083] means for transmitting motion (111, 211, 311, 411, 110, 210, 310, 400, 400′, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911, 110″, 210″, 310″, 91, 92) from the manipulation unit (101) to the end effector (301);

[0084] The means for transmitting motion (111, 211, 311, 411, 110, 210, 310, 400, 400′, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911, 110″, 210″, 310″, 91, 92) comprise at least: [0085] means for transmitting (111, 211, 311, 411, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) a first rotational movement of the manipulation unit (101) around a first axis (U.sub.1) belonging to a plane orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201), to the end effector (301), in such a way that the end effector (301) rotates around an axis (U.sub.1′) orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201); and [0086] means for transmitting (110, 210, 310, 400, 400′, 110″, 210″, 310″, 91, 92) a second rotational movement of the manipulation unit (101) around its own axis (U.sub.2) to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′), the axis (U.sub.2′), of the end effector (301) being parallel to the axis (U.sub.2) of the manipulation unit (101).

[0087] The instrument of the present invention, has, therefore, at least two rotational degrees of freedom (θ.sub.1, θ.sub.2), in addition to the degrees of freedom guaranteed by the movements of the trocar wherein the instrument have to be inserted when in use during the surgical interventions. The first rotational degree of freedom (θ.sub.1) is associated to the first rotational movement described above and the second rotational degree of freedom (θ.sub.2) is associated to the second rotational movement. Assuming that the instrument is inserted in the patient's cavity through a patient's surface (10), the working field of the instrument is divided into two main volumes: the first one (11) outside the patient's cavity and the second one inside the patient's cavity (11′). The rotations (θ.sub.1, θ.sub.2) of manipulation unit (101) are applied in the first volume (11) and are transmitted through means, coinciding with or placed in, the connection assembly (201), to the end effector, which rotates into the second volume (11′). The connection assembly (201), thus, passes through the patient's surface (10).

[0088] Referring to FIGS. 1, 2, 10a, 10b, 10c and 11, in addition to the two rotational degrees of freedom (θ.sub.1, θ.sub.2) cited above, the instrument of the present invention can be used to transmit another rotation (θ.sub.4) from the manipulation unit (101) to the end effector (301), said another rotation (θ.sub.4) being around a second axis (U.sub.4), orthogonal to axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201). This another rotation (θ.sub.4) is transmitted to the end effector (301) in such a way that the end effector (301) rotates around an axis (U.sub.4) parallel to the second axis (U.sub.4) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201).

[0089] Such additional rotation (θ.sub.4) can be performed using the instrument as in the followings. Starting from a position in which the manipulation's unit (101) own axis (U.sub.2), and the end effector's (301) own axis (U.sub.2) are both aligned with the axis (U.sub.3) of the connection assembly (201), the manipulation unit (101) can be rotated of 90° around its own axis (U.sub.2) and then rotated around to the second axis (U.sub.4), by using the same means that allow for the rotation of the manipulation unit (101) around the first axis (U.sub.1). The rotation of the manipulation unit (101) around the second axis (U.sub.4) can be, thus, transmitted to the end effector (301), thanks to the same means for transmitting the first rotational movement from the manipulation unit (101) to the end effector (301).

[0090] Referring to the FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a and 8b, a first embodiment of the instrument of the present invention, the connection assembly (201) comprises a cylindrical frame (100). The means for transmitting (111, 211, 311, 411) the first rotational movement comprise: [0091] a first bevel gear (111) firmly connected with the manipulation unit (101) and having the vertex located in correspondence with the first end (A) of the connection assembly (201); [0092] a second bevel gear (211) forming with the first bevel gear (111) a first gear assembly, in such a way that a rotation of the first bevel gear (111) around its own axis causes a rotation of the second bevel gear (211) around its own axis; [0093] a third bevel gear (311) firmly connected with the end effector (301) and having the vertex in correspondence with the second end (B) of the connection assembly (201); [0094] a fourth bevel gear (411) forming with the third bevel gear (311) a second gear assembly, in such a way that a rotation of the fourth bevel gear (411) around its own axis causes a rotation of the third bevel gear (311) around its own axis; and [0095] a hollow tube (70) aligned with the axis (U.sub.3) of the connection assembly (201) and hosed in the frame (100), said tube (70) cooperating with the second bevel gear (211) and the fourth bevel gear (411) in such a way that a rotation of the second bevel gear (211) around its own axis causes a rotation of the fourth bevel gear (411) around its own axis.

[0096] The means for transmitting (110, 210, 310, 400, 400′) the second rotational movement comprise: [0097] a first shaft (110) firmly connected with the manipulation unit (101); [0098] a second shaft (210) firmly connected with the end effector (301); [0099] a third shaft (310) aligned with the axis (U.sub.3) of the connection assembly (201), said third shaft (310) being housed in the tube (70); [0100] a first Cardan joint (400) centered in correspondence of the first end (A) of the connection assembly (201); and [0101] a second Cardan joint (400′) centered in correspondence of the second end (B) of the connection assembly (201).

[0102] Referring to the FIGS. 9a and 9b, the first embodiment of the instrument of the present invention comprises also a brake block (60) mounted on the frame (100), said brake block (60) being configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), when the first shaft (110), the third shaft (310) and the second shaft (210) are aligned along the axis (U.sub.3) of the connection assembly (201).

[0103] Referring to the FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 19a and 19b, a second embodiment of the present invention comprises all the features mentioned above relatively to the first embodiment but, additionally, the manipulation unit (101) of the second embodiment comprises: [0104] a handle (500, 500′); [0105] a drum brake connecting the handle (500, 500′) to the first shaft (110, 110′, 110″), said drum brake comprising: [0106] a clutch pad (41); [0107] a compression pad (42); [0108] a spring (43) connecting the clutch pad and the compression pad (42); and [0109] a drum pulley (44) firmly connected with the first shaft (110, 110′, 110″); [0110] a handling ring (501, 501′) firmly connected with the drum pulley (44) in such a way that a rotation of the handling ring (501, 501′) around its own axis causes a rotation of the drum pulley (44) and, thus, of the first shaft (110, 110′, 110″) around their own axes.

[0111] Referring to the FIGS. 2, 3, 4, 15, 16a, 16b, 19a and 19b a third embodiment of the present invention comprises: [0112] a connection assembly (201) having an axis (U.sub.3); [0113] an end effector (301) mounted on a first end of the connection assembly (201), said end effector (301) comprising: [0114] a first arm (161); [0115] a second arm (162); [0116] a pulley (171) firmly connected with the first arm (161); [0117] a first gear (152) firmly connected with the second arm (162); [0118] a second gear (151) forming a gear assembly (151, 152) with the first gear (152), said second gear (151) being concentric and integrally connected with the pulley (171); and [0119] a manipulation unit (101) mounted on a second end of the connection assembly (201), said manipulation unit (101) comprising: [0120] a trigger (502, 502′); [0121] a pulley (503) firmly connected with the trigger (502, 502′); and [0122] an idle pulley (504); and [0123] a first shaft firmly connected with the manipulation unit (101); and [0124] a second shaft firmly connected with the end effector (301).

[0125] In order to allow for the movement (a) of the two arms (161, 162), determining the opening and closing of the end effector (301) the instrument comprises means for transmitting motion from the manipulation unit (101) to the end effector (301), comprising a cable, not shown in the figures, which connects the pulley (503) of the manipulation unit (101) with the pulley (171) of the end effector (301), said cable being divided into two portions by means of the idle pulley (504), before to be wrapped around the pulley (503) of the manipulation unit (101).

[0126] Said cable, in particular, is inserted in a sheath of the connection assembly (201) that has a first end firmly connected to the first shaft and a second end firmly connect to second shaft.

[0127] For the purposes of the present description, the word “sheath” means “a flexible protective outside covering on a cable”. In other words, sheath and cable are similar to sheath and wire for bicycle brake transmission.

[0128] Referring to FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 16a and 16b, a fourth embodiment of the present invention comprises: [0129] a connection assembly (201) having an axis (U.sub.3), a first end (A) and a second end (B); [0130] an end effector (301) having an its own axis (U.sub.2′) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201) and comprising: [0131] a first arm (161); [0132] a second arm (162); [0133] a pulley (171) firmly connected with the first arm (161); [0134] a first gear (152) firmly connected with the second arm (162); [0135] a second gear (151) forming a gear assembly (151, 152) with the first gear (152), said second gear (151) being concentric and integrally connected with the pulley (171); and [0136] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201) and comprising: [0137] a trigger (502, 502′); [0138] a pulley (503) firmly connected with the trigger (502, 502′); and [0139] an idle pulley (504); [0140] means for transmitting (111, 211, 311, 411, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) a first rotational movement of the manipulation unit (101) around a first axis (U.sub.1) belonging to a plane orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201), to the end effector (301), in such a way that the end effector (301) rotates around an axis (U.sub.1′) orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201); [0141] means for transmitting (110, 210, 310, 400, 400′, 110″, 210″, 310″, 91, 92) a second rotational movement of the manipulation unit (101) around its own axis (U.sub.2) to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′).

[0142] Referring to 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 16a and 16b, the connection assembly (201) comprises a cylindrical frame (100). The means for transmitting (111, 211, 311, 411) the first rotational movement comprise: [0143] a first bevel gear (111) firmly connected with the manipulation unit (101) and having the vertex located in correspondence with the first end (A) of the connection assembly (201); [0144] a second bevel gear (211) forming with the first bevel gear (111) a first gear assembly, in such a way that a rotation of the first bevel gear (111) around its own axis causes a rotation of the second bevel gear (211) around its own axis; [0145] a third bevel gear (311) firmly connected with the end effector (301) and having the vertex in correspondence with the second end (B) of the connection assembly (201); [0146] a fourth bevel gear (411) forming with the third bevel gear (311) a second gear assembly, in such a way that a rotation of the fourth bevel gear (411) around its own axis causes a rotation of the third bevel gear (311) around its own axis; and [0147] a hollow tube (70) aligned with the axis (U.sub.3) of the connection assembly (201) of the connection assembly (201) and housed in the frame (100), said tube (70) cooperating with the second bevel gear (211) and the fourth bevel gear (411) in such a way that a rotation of the second bevel gear (211) around its own axis causes a rotation of the fourth bevel gear (411) around its own axis.

[0148] The means for transmitting (110, 210, 310, 400, 400′) the second rotational movement comprise: [0149] a first shaft (110) firmly connected with the manipulation unit (101); [0150] a second shaft (210) firmly connected with the end effector (301); [0151] a third shaft (310) aligned with the axis (U.sub.3) of the connection assembly (201), said third shaft (310) being housed in the tube (70); [0152] a first Cardan joint (400) centered in correspondence of the first end (A) of the connection assembly (201); and [0153] a second Cardan joint (400′) centered in correspondence of the second end (B) of the connection assembly (201).

[0154] In order to allow for the movement (a) of the two arms (161, 162), determining the opening and closing of the end effector (301) the instrument comprises means for transmitting motion from the manipulation unit (101) to the end effector (301), comprising a cable, not shown in the figures, which connects the pulley (503) of the manipulation unit (101) with the pulley (171) of the end effector (301), said cable being divided into two portions by means of the idle pulley (504), before to be wrapped around the pulley (503) of the manipulation unit (101). Said cable, in particular, is inserted in a sheath of the connection assembly (201) that has a first end firmly connected to the first shaft and a second end firmly connect to second shaft.

[0155] Referring to the FIGS. 9a and 9b, also the fourth embodiment of the instrument of the present invention comprises also a brake block (60) mounted on the frame (100), said brake block (60) being configured to avoid) the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), when the first shaft (110), the third shaft (310) and the second shaft (210) are aligned along the axis (U.sub.3) of the connection assembly (201).

[0156] Referring to the FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 16a, 16b and 19a and 19b, a fifth embodiment of the present invention comprise all the features mentioned above relatively to the fourth embodiment but, additionally, the manipulation unit (101) of the fifth embodiment comprises: [0157] a handle (500, 500′); [0158] a drum brake connecting the handle (500, 500′) to the first shaft (110, 110′, 110″), said drum brake comprising: [0159] a clutch pad (41); [0160] a compression pad (42); [0161] a spring (43) connecting the clutch pad and the compression pad (42); and [0162] a drum pulley (44) firmly connected with the first shaft (110, 110′, 110″); [0163] a handling ring (501, 501′) firmly connected with the drum pulley (44) in such a way that a rotation of the handling ring (501, 501′) around its own axis causes a rotation of the drum pulley (44) and, thus, of the first shaft (110, 110′, 110″) around their own axes.

[0164] Referring to the FIGS. 2, 12, 13 and 14 in a sixth embodiment of the instrument of the present invention, the means for transmitting (310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) the first rotational movement comprise: [0165] a first shaft (110′) firmly connected with the manipulation unit (101); [0166] a second shaft (210′) firmly connected with the end effector (301); [0167] a third shaft (310′) aligned with the axis (U.sub.3) of the connection assembly (201), the first end of the third shaft (310′) coinciding with the first end (A) of the connection assembly (201) and the second end of the third shaft (310′) coinciding with the second end (B) of the connection assembly (201); [0168] a fourth shaft (410) connected with the third shaft (310′) by means of a first flexure hinge (411) having the center of rotation coinciding with the first end (A) of the third shaft (310′); [0169] a fifth shaft (510) connected with the third shaft (310′) by means of a second flexure hinge (511) having the center of rotation coinciding with the second end (B) of the third shaft (310′); [0170] a sixth shaft (610) connected to a first portion (H.sub.1A) of the fourth shaft (410) by means of a third flexure hinge (611) and to a first portion (H.sub.4B) of the fifth shaft (510) by means of a fourth flexure hinge (711); and [0171] a seventh shaft (710) connected to a second portion (AH.sub.2) of the fourth shaft (410) by means of a fifth flexure hinge (811) and to a second portion (BH.sub.3) of the fifth shaft (510) by means of a sixth flexure hinge (911).

[0172] The first flexure hinge (411), the second flexure hinge (511), the third flexure hinge (611), the fourth flexure hinge (711), the fifth flexure hinge (811) and the sixth flexure hinge (911) are, preferably but not exclusively, circular flexure hinges. The means for transmitting (110″, 210″, 310″, 91, 92) the second rotational movement, instead, comprise: [0173] a first shaft (110″) firmly connected with the manipulation unit (101); [0174] a second shaft (210″) firmly connected with the end effector (301); [0175] a third shaft (310″) aligned with the axis (U.sub.3) of the connection assembly (201); [0176] a first torque coil (91) having a first end (A′) connected to a first end of the first shaft (110″) and a second end (A″) connected to a first end of the third shaft (310″), the first end (A) of the connection assembly (201) being comprised between the first end (A′) and the second end (A″) of the first torque coil (91); and [0177] a second torque coil (92) having a first end (B′) connected to a second end of the third shaft (310″) and a second end (B″) connected to a first end of the second shaft (210″), the second end (B) of the connection assembly (201) being comprised between the first end (B′) and the second end (B″) of the second torque coil.

[0178] In order to perform the opening and closing of the end effector, the second torque coil (92) is connected to the end effector (301) by means (900) for converting a translational movement (s) of the second torque coil (92) along its own longitudinal axis, in the movement (a) of opening/closing of the two arms of the end effector, the translational movement (s) of the second torque coil (92) along its own longitudinal axis being caused by the transmission, by means of the third shaft (310″), of a translational movement of the first torque coil (91) along its own longitudinal axis. The first torque coil (91) and the second torque coil (92) can be inserted inside a first sheath (91′) and a second sheath (92′), respectively. The first shaft (110″) is housed inside a first hollow tube (800), the second shaft (210″) is housed inside a second hollow tube (802) and the third shaft (310″) is housed inside a third hollow tube (801). The first sheath (91′) has a first end that is firmly connected to the first hollow tube (800) and a second end that is firmly connected to the third hollow tube (801). The second sheath (92′) has a first end that is firmly connected to the third hollow tube (801) and a second end that is firmly connected to the second hollow tube (802).

[0179] Referring to the FIG. 2, 17, 18a, 18b, a seventh embodiment of the present invention comprises: [0180] a connection assembly (201) having an axis (U.sub.3), a first end (A) and a second end (B), said connection assembly comprising a frame (100); [0181] an end effector (301) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201); [0182] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201); [0183] means for transmitting at least a rotational movement of the manipulation unit (101) around its own axis (U.sub.2), to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′), the axis (U.sub.2′), of the end effector (301) being parallel to the axis (U.sub.2) of the manipulation unit (101); [0184] a blocking device (50) mounted on the frame (100) configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), said device (50) comprising: [0185] a support structure (30) with means for docking (31, 32) the device (50) to an instrument holder (80) with which the instrument can cooperate, said instrument holder (80) being configured to be at least partial inserted of said laparoscopic surgical instrument through an incision into a patient cavity; [0186] two truncated cone rolls (81, 82), the frame (100″) being placed between the two truncated cone rolls (81, 82); and [0187] a lever (70) configured to allow the two truncated cone rolls (81, 82) to translate from a first position in which the two truncated cone rolls (81, 82) are not in contact with the frame (100) to a second position in which the two truncated cone rolls (81, 82) are in contact with the frame (100) preventing by friction the rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), the translation of the frame (100) along the axis (U.sub.3) of the connection assembly (201) being maintained allowable.

[0188] Referring to the FIGS. 2, 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 17, 18a and 18b, an eight embodiment of the instrument of the present invention comprises: [0189] a connection assembly (201) having an axis (U.sub.3), said connection assembly (201) comprising a frame (100); [0190] an end effector (301) having an its own axis (U.sub.2′) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201); [0191] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201); [0192] a blocking device (50) mounted on the frame (100) configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), said device (50) comprising: [0193] a support structure (30) with means for docking (31, 32) the device (50) to an instrument holder (80) with which the instrument can cooperate, said instrument holder (80) being configured to be at least partial inserted of said laparoscopic surgical instrument through an incision into a patient cavity; [0194] two truncated cone rolls (81, 82), the frame (100″) being placed between the two truncated cone rolls (81, 82); and [0195] a lever (70) configured to allow the two truncated cone rolls (81, 82) to translate from a first position in which the two truncated cone rolls (81, 82) are not in contact with the frame (100) to a second position in which the two truncated cone rolls (81, 82) are in contact with the frame (100) preventing by friction the rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), the translation of the frame (100) along the axis (U.sub.3) of the connection assembly (201) being maintained allowable; [0196] means for transmitting (111, 211, 311, 411, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) a first rotational movement of the manipulation unit (101) around a first axis (U.sub.1) belonging to a plane orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201), to the end effector (301), in such a way that the end effector (301) rotates around an axis (U.sub.1′) orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201); and [0197] means for transmitting (110, 210, 310, 400, 400′, 110″, 210″, 310″, 91, 92) a second rotational movement of the manipulation unit (101) around its own axis (U.sub.2) to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′), the axis (U.sub.2′), of the end effector (301) being parallel to the axis (U.sub.2) of the manipulation unit (101).

[0198] The connection assembly (201) comprises a cylindrical frame (100). The means for transmitting (111, 211, 311, 411) the first rotational movement comprise: [0199] a first bevel gear (111) firmly connected with the manipulation unit (101) and having the vertex located in correspondence with the first end (A) of the connection assembly (201); [0200] a second bevel gear (211) forming with the first bevel gear (111) a first gear assembly, in such a way that a rotation of the first bevel gear (111) around its own axis causes a rotation of the second bevel gear (211) around its own axis; [0201] a third bevel gear (311) firmly connected with the end effector (301) and having the vertex in correspondence with the second end (B) of the connection assembly (201); [0202] a fourth bevel gear (411) forming with the third bevel gear (311) a second gear assembly, in such a way that a rotation of the fourth bevel gear (411) around its own axis causes a rotation of the third bevel gear (311) around its own axis; and [0203] a hollow tube (70) aligned with the axis (U.sub.3) of the connection assembly (201) and housed in the frame (100), said tube (70) cooperating with the second bevel gear (211) and the fourth bevel gear (411) in such a way that a rotation of the second bevel gear (211) around its own axis causes a rotation of the fourth bevel gear (411) around its own axis.

[0204] The means for transmitting (110, 210, 310, 400, 400′) the second rotational movement comprise: [0205] a first shaft (110) firmly connected with the manipulation unit (101); [0206] a second shaft (210) firmly connected with the end effector (301); [0207] a third shaft (310) aligned with the axis (U.sub.3) of the connection assembly (201), said third shaft (310) being housed in the tube (70); [0208] a first Cardan joint (400) centered in correspondence of the first end (A) of the connection assembly (201); and [0209] a second Cardan joint (400′) centered in correspondence of the second end (B) of the connection assembly (201).

[0210] Referring to the FIGS. 9a and 9b, also the eight embodiment of the instrument of the present invention comprises also a brake block (60) mounted on the frame (100), said brake block (60) being configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), when the first shaft (110), the third shaft (310) and the second shaft (210) are aligned along the axis (U.sub.3) of the connection assembly.

[0211] Referring to the FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 17, 18a, 18b, 19a and 19b, a ninth embodiment of the present invention comprises all the features mentioned above relatively to the eight embodiment but, additionally, the manipulation unit (101) of the ninth embodiment comprises: [0212] a handle (500, 500′); [0213] a drum brake connecting the handle (500, 500′) to the first shaft (110, 110′, 110″), said drum brake comprising: [0214] a clutch pad (41); [0215] a compression pad (42); [0216] a spring (43) connecting the clutch pad and the compression pad (42); and [0217] a drum pulley (44) firmly connected with the first shaft (110, 110′, 110″); [0218] a handling ring (501, 501′) firmly connected with the drum pulley (44) in such a way that a rotation of the handling ring (501, 501′) around its own axis causes a rotation of the drum pulley (44) and, thus, of the first shaft (110, 110′, 110″) around their own axes.

[0219] Referring to the FIGS. 2, 3, 4, 15, 16a, 16b, 17, 18a, and 18b, a tenth embodiment of the present invention comprises: [0220] a connection assembly (201) having an axis (U.sub.3) of the connection assembly (201) and comprising a frame (100); [0221] an end effector (301) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201) and comprising: [0222] a first arm (161); [0223] a second arm (162); [0224] a pulley (171) firmly connected with the first arm (161); [0225] a first gear (152) firmly connected with the second arm (162); [0226] a second gear (151) forming a gear assembly (151, 152) with the first gear (152), said second gear (151) being concentric and integrally connected with the pulley (171); and [0227] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201) and comprising: [0228] a trigger (502, 502′); [0229] a pulley (503) firmly connected with the trigger (502, 502′); and [0230] an idle pulley (504); [0231] a first shaft firmly connected with the manipulation unit (101); [0232] a second shaft firmly connected with the end effector (301); [0233] means for transmitting at least a rotational movement of the manipulation unit (101) around its own axis (U.sub.2), to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′), the axis (U.sub.2′), of the end effector (301) being parallel to the axis (U.sub.2) of the manipulation unit (101); [0234] a blocking device (50) mounted on the frame (100) configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), said device (50) comprising: [0235] a support structure (30) with means for docking (31, 32) the device (50) to the instrument holder (80); [0236] two truncated cone rolls (81, 82), the frame (100″) being placed between the two truncated cone rolls (81, 82); and [0237] a lever (70) configured to allow the two truncated cone rolls (81, 82) to translate from a first position in which the two truncated cone rolls (81, 82) are not in contact with the frame (100) to a second position in which the two truncated cone rolls (81, 82) are in contact with the frame (100) preventing by friction the rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), the translation of the frame (100) along the axis (U.sub.3) of the connection assembly (201) being maintained allowable.

[0238] In order to allow for the movement (a) of the two arms (161, 162), determining the opening and closing of the end effector (301) the instrument comprises means for transmitting motion from the manipulation unit (101) to the end effector (301), comprising a cable, not shown in the figures, which connects the pulley (503) of the manipulation unit (101) with the pulley (171) of the end effector (301). Said cable, in particular, is inserted in a sheath of the connection assembly (201) that has a first end firmly connected to the first shaft and a second end firmly connect to second shaft. Said cable comprises two branches that wrap around the pulley (503) of the manipulation unit (101) and the pulley (171) of the end effector (301), the two branches being separated by means of the idle pulley (504), before to be wrapped around the pulley (503) of the manipulation unit (101). Before to be wrapped around the pulley (171) of the end effector, instead, the two branches are separated because they slide on the walls of the sheath itself.

[0239] Referring to FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 16a, 16b, 17, 18a, and 18b, an eleventh embodiment of the present invention comprises: [0240] a connection assembly (201) having an axis (U.sub.3), a first end (A) and a second end (B); [0241] an end effector (301) having an its own axis (U.sub.2′) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201) and comprising: [0242] a first arm (161); [0243] a second arm (162); [0244] a pulley (171) firmly connected with the first arm (161); [0245] a first gear (152) firmly connected with the second arm (162); [0246] a second gear (151) forming a gear assembly (151, 152) with the first gear (152), said second gear (151) being concentric and integrally connected with the pulley (171); and [0247] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A) of the connection assembly (201) and comprising: [0248] a trigger (502, 502′); [0249] a pulley (503) firmly connected with the trigger (502, 502′); and [0250] an idle pulley (504); [0251] means for transmitting (111, 211, 311, 411, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) a first rotational movement of the manipulation unit (101) around a first axis (U.sub.1) belonging to a plane orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201), to the end effector (301), in such a way that the end effector (301) rotates around an axis (U.sub.1′) orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201); [0252] means for transmitting (110, 210, 310, 400, 400′, 110″, 210″, 310″, 91, 92) a second rotational movement of the manipulation unit (101) around it own axis (U.sub.2) to the end effector (301), in such a way that the end effector (301) rotates around it own axis (U.sub.2′); and [0253] a blocking device (50) mounted on the frame (100) configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), said device (50) comprising: [0254] a support structure (30) with means for docking (31, 32) the device (50) to the instrument holder (80); [0255] two truncated cone rolls (81, 82), the frame (100″) being placed between the two truncated cone rolls (81, 82); and [0256] a lever (70) configured to allow the two truncated cone rolls (81, 82) to translate from a first position in which the two truncated cone rolls (81, 82) are not in contact with the frame (100) to a second position in which the two truncated cone rolls (81, 82) are in contact with the frame (100) preventing by friction the rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), the translation of the frame (100) along the axis (U.sub.3) of the connection assembly (201) being maintained allowable.

[0257] Referring to 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 16a and 16b, the connection assembly (201) comprises a cylindrical frame (100). The means for transmitting (111, 211, 311, 411) the first rotational movement comprise: [0258] a first bevel gear (111) firmly connected with the manipulation unit (101) and having the vertex located in correspondence with the first end (A) of the connection assembly (201); [0259] a second bevel gear (211) forming with the first bevel gear (111) a first gear assembly, in such a way that a rotation of the first bevel gear (111) around its own axis causes a rotation of the second bevel gear (211) around its own axis; [0260] a third bevel gear (311) firmly connected with the end effector (301) and having the vertex in correspondence with the second end (B) of the connection assembly (201); [0261] a fourth bevel gear (411) forming with the third bevel gear (311) a second gear assembly, in such a way that a rotation of the fourth bevel gear (411) around its own axis causes a rotation of the third bevel gear (311) around its own axis; and [0262] a hollow tube (70) aligned with the axis (U.sub.3) of the connection assembly (201) and housed in the frame (100), said tube (70) cooperating with the second bevel gear (211) and the fourth bevel gear (411) in such a way that a rotation of the second bevel gear (211) around its own axis causes a rotation of the fourth bevel gear (411) around its own axis.

[0263] The means for transmitting (110, 210, 310, 400, 400′) the second rotational movement comprise: [0264] a first shaft (110) firmly connected with the manipulation unit (101); [0265] a second shaft (210) firmly connected with the end effector (301); [0266] a third shaft (310) aligned with the axis (U.sub.3) of the connection assembly (201), said third shaft (310) being housed in the tube (70); [0267] a first Cardan joint (400) centered in correspondence of the first end (A) of the connection assembly (201); and [0268] a second Cardan joint (400′) centered in correspondence of the second end (B) of the connection assembly (201).

[0269] In order to allow for the movement (a) of the two arms (161, 162), determining the opening and closing of the end effector (301) the instrument comprises means for transmitting motion from the manipulation unit (101) to the end effector (301), comprising a cable, not shown in the figures, which connects the pulley (503) of the manipulation unit (101) with the pulley (171) of the end effector (301). Said cable, in particular, is inserted in a sheath of the connection assembly (201) that has a first end firmly connected to the first shaft and a second end firmly connect to second shaft. Said cable comprises two branches that wrap around the pulley (503) of the manipulation unit (101) and the pulley (171) of the end effector (301), the two branches being separated by means of the idle pulley (504) before to be wrapped around the pulley (503) of the manipulation unit (101). Before to be wrapped around the pulley (171) of the end effector, instead, the two branches are separated because they slide on the walls of the sheath itself.

[0270] Referring to the FIGS. 9a and 9b, also the eleventh embodiment of the instrument of the present invention comprises also a brake block (60) mounted on the frame (100), said brake block (60) being configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), when the first shaft (110), the third shaft (310) and the second shaft (210) are aligned along the axis (U.sub.3) of the connection assembly (201).

[0271] Referring to the FIGS. 2, 3, 4, 5a, 5b, 6a, 6b, 7a, 7b, 8a, 8b, 15, 16a, 16b and 19a and 19b, a twelfth embodiment of the present invention comprise all the features mentioned above relatively to the eleventh embodiment but, additionally, the manipulation unit (101) of the twelfth embodiment comprises: [0272] a handle (500, 500′); [0273] a drum brake connecting the handle (500, 500′) to the first shaft (110, 110′, 110″), said drum brake comprising: [0274] a clutch pad (41); [0275] a compression pad (42); [0276] a spring (43) connecting the clutch pad and the compression pad (42); and [0277] a drum pulley (44) firmly connected with the first shaft (110, 110′, 110″); [0278] a handling ring (501, 501′) firmly connected with the drum pulley (44) in such a way that a rotation of the handling ring (501, 501′) around its own axis causes a rotation of the drum pulley (44) and, thus, of the first shaft (110, 110′, 110″) around their own axes.

[0279] Referring to the FIGS. 2, 12, 13 and 14, 17, 18a, and 18b, in a thirteenth embodiment of the instrument of the present invention comprises: [0280] a connection assembly (201) having an axis (U.sub.3), said connection assembly (201) comprising a frame (100); [0281] an end effector (301) having an its own axis (U.sub.2′) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B), said end effector (301) being mounted on the second end (B) of the connection assembly (201); [0282] a manipulation unit (101) having an its own axis (U.sub.2) of rotation incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A), said manipulation unit (101) being mounted on the first end (A of the connection assembly (201); [0283] a blocking device (50) mounted on the frame (100) configured to avoid the unintentional rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), said device (50) comprising: [0284] a support structure (30) with means for docking (31, 32) the device (50) to an instrument holder (80) with which the instrument can cooperate, said instrument holder (80) being configured to be at least partial inserted of said laparoscopic surgical instrument through an incision into a patient cavity; [0285] two truncated cone rolls (81, 82), the frame (100″) being placed between the two truncated cone rolls (81, 82); and [0286] a lever (70) configured to allow the two truncated cone rolls (81, 82) to translate from a first position in which the two truncated cone rolls (81, 82) are not in contact with the frame (100) to a second position in which the two truncated cone rolls (81, 82) are in contact with the frame (100) preventing by friction the rotation of the frame (100) around the axis (U.sub.3) of the connection assembly (201), the translation of the frame (100) along the axis (U.sub.3) of the connection assembly (201) being maintained allowable; [0287] means for transmitting (111, 211, 311, 411, 310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) a first rotational movement of the manipulation unit (101) around a first axis (U.sub.1) belonging to a plane orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the first end (A) of the connection assembly (201), to the end effector (301), in such a way that the end effector (301) rotates around an axis (U.sub.1′) orthogonal to the axis (U.sub.3) of the connection assembly (201) and incident to the axis (U.sub.3) of the connection assembly (201) at the second end (B) of the connection assembly (201); and [0288] means for transmitting (110, 210, 310, 400, 400′, 110″, 210″, 310″, 91, 92) a second rotational movement of the manipulation unit (101) around its own axis (U.sub.2) to the end effector (301), in such a way that the end effector (301) rotates around its own axis (U.sub.2′), the axis (U.sub.2′), of the end effector (301) being parallel to the axis (U.sub.2) of the manipulation unit (101).

[0289] The means for transmitting (310′, 110′, 210′, 410, 510, 610, 710, 411, 511, 611, 711, 811, 911) the first rotational movement comprise: [0290] a first shaft (110′) firmly connected with the manipulation unit (101); [0291] a second shaft (210′) firmly connected with the end effector (301); [0292] a third shaft (310′) aligned with the axis (U.sub.3) of the connection assembly (201), the first end of the third shaft (310′) coinciding with the first end (A) of the connection assembly (201) and the second end of the third shaft (310′) coinciding with the second end (B) of the connection assembly (201); [0293] a fourth shaft (410) integrally connected with the first shaft (110′), said fourth shaft (510) being connected with the third shaft (310′) by means of a first flexure hinge (411) having the center of rotation coinciding with the first end (A) of the third shaft (310′); [0294] a fifth shaft (510) integrally connected with the second shaft (210′), said fifth shaft (510) being connected with the third shaft (310′) by means of a second flexure hinge (511) having the center of rotation coinciding with the second end (B) of the third shaft (310′); [0295] a sixth shaft (610) connected to a first portion (H.sub.1A) of the fourth shaft (410) by means of a third flexure hinge (611) and to a first portion (H.sub.4B) of the fifth shaft (510) by means of a fourth flexure hinge (711); and [0296] a seventh shaft (710) connected to a second portion (AH.sub.2) of the fourth shaft (410) by means of a fifth flexure hinge (811) and to a second portion (BH.sub.3) of the fifth shaft (510) by means of a sixth flexure hinge (911).

[0297] The first flexure hinge (411), the second flexure hinge (511), the third flexure hinge (611), the fourth flexure hinge (711), the fifth flexure hinge (811) and the sixth flexure hinge (911) are, preferably but not exclusively, circular flexure hinges. The means for transmitting (110″, 210″, 310″, 91, 92) the second rotational movement, instead, comprise: [0298] a first shaft (110″) firmly connected with the manipulation unit (101); [0299] a second shaft (210″) firmly connected with the end effector (301); [0300] a third shaft (310″) aligned with the axis (U.sub.3) of the connection assembly (201); [0301] a first torque coil (91) having a first end (A′) connected to a first end of the first shaft (110″) and a second end (A″) connected to a first end of the third shaft (310″), the first end (A) of the connection assembly (201) being comprised between the first end (A′) and the second end (A″) of the first torque coil (91); and [0302] a second torque coil (92) having a first end (B′) connected to a second end of the third shaft (310″) and a second end (B″) connected to a first end of the second shaft (210″), the second end (B) of the connection assembly (201) being comprised between the first end (B′) and the second end (B″) of the second torque coil.

[0303] In order to perform the opening and closing of the end effector the instrument comprises second torque coil (92) connected to the end effector (301) by means (900) for converting a translational movement (s) of the second torque coil (92) along its own longitudinal axis, in the movement (a) of opening/closing of the two arms of the end effector, the translational movement (s) of the second torque coil (92) along its own longitudinal axis being caused by the transmission, by means of the third shaft (310″), of a translational movement of the first torque coil (91) along its own longitudinal axis. The first torque coil (91) and the second torque coil (92) can be inserted inside a first sheath (91′) and second sheath (92′), respectively. The first shaft (110″) is housed inside a first hollow tube (800), the second shaft (210″) is housed inside a second hollow tube (802) and the third shaft (310″) is housed inside a third hollow tube (801). The first sheath (91′) has a first end that is firmly connected to the first hollow tube (800) and a second end that is firmly connected to the third hollow tube (801). The second sheath (92′) has a first end that is firmly connected to the third hollow tube (801) and a second end that is firmly connected to the second hollow tube (802).

[0304] In all the embodiments of the instrument detailed above, the end effector (301) can be a clamp (301′, 301′) or a scissor or a grasper.

[0305] Referring to FIGS. 19a and 19b, the manipulation unit (101), can be designed according two different embodiments. The first one (500) is showed in FIG. 19a and the second one (500′) is showed in FIG. 19b. The second embodiment of the handle (500′), differently from the first one (500), has an ergonomic shape that allows the surgeons to move the ring (501′) with the thumb of the same hand used for maneuvering the handle (500) itself.

[0306] Finally, here it is specified that it forms subject matter of the present invention also a kit for laparoscopy interventions comprising: [0307] a laparoscopic surgical instrument according to any of the embodiment described above from the seventh to thirteenth one;
an instrument holder (80) for at least a partial insertion of said laparoscopic surgical instrument through an incision into a patient cavity, said instrument holder (80) being provided with means for docking (80′, 80″) the instrument holder (80) to the blocking device (50), the means for docking (80′, 80″) the instrument holder (80) being configured to cooperate with the means for docking (31, 32) of the support structure (30) of the blocking device (50).