Abstract:
An improved endoscopic tissue grasping apparatus and method provide for enhanced tissue retention. In one separate aspect, an endoscopic tool may include an improved handle comprising a rachet interface for retaining first and second jaw members at in a closed position at a distal end of the tool. In another separate aspect, a tissue grasper is provided in which opposing first and second jaw members may be effectively locked in a closed position by virtue of an articulating linkage arrangement.

Description:
RELATED APPLICATIONS 
       [0001]    This application claims priority to U.S. Provisional Application Ser. No. 61/171,786, filed Apr. 22, 2009, entitled “ENDOSCOPIC TISSUE GRASPING APPARATUS AND METHOD”, the entirety of which is hereby incorporated by reference. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The present invention relates to endoscopic surgical tools, and in particular, to endoscopic tissue grasping apparatus and methods. 
       BACKGROUND OF THE INVENTION 
       [0003]    A variety of endoscopic tools have been developed to access interior surfaces of bodily organs and other vascular tissue. By way of example, endoscopic ligating and complimentary tools have been developed, as disclosed in U.S. Pat. Nos. 6,554,845, and 6,908,427, hereby incorporated by reference in their entirety. 
         [0004]    In conjunction with the use of such endoscopic devices, it is often desirable to maintain the tissue region of interest in a relative stationary position as diagnostic, surgical and/or therapeutic procedures are completed. To date, however, such tissue stabilization has been achieved via the utilization of devices that entail ongoing manipulation of an endoscopic tool by medical personnel throughout the tissue retention time. In turn, such personnel are not able to perform other medical procedures. Further, the approaches utilized to date have entailed the manual application of variable clamping pressures to the tissue region of interest. In this regard, it may be appreciated that the internal tissue region of interest for many endoscopic procedures is quite sensitive and the risk of tissue degradation due to variable gripping pressure is significant, thereby rendering known approaches problematic for many applications. 
       SUMMARY OF THE INVENTION 
       [0005]    In view of the foregoing, a primary objective is to provide an improved endoscopic tool and method for tissue grasping and tissue retention. 
         [0006]    Another objective of the present invention is to provide an improved endoscopic tool and method that may be employed to enhance medical personnel efficiencies attendant to an endoscopic procedure. 
         [0007]    Yet another objective of the present invention is to provide an improved endoscopic tool and method that is user-friendly. 
         [0008]    An additional objective of the present invention is to provide an improved endoscopic tool that is relatively simple in construction and assembly. 
         [0009]    An inventive endoscopic tool is provided for selective tissue grasping and retention. In one feature, the endoscopic tool may include an elongate member, e.g. a flexible elongate member, a tissue grasper located at a distal end of the elongate member, and a handle located at a proximal end of the elongate member. 
         [0010]    In one aspect, the handle of the endoscopic tool may include a shaft member and a grip member extending about at least a portion of the shaft member, wherein the shaft member and grip member are disposed for selective relative movement by a user along a handle axis. One of the shaft member and the grip member may include a pawl, while the other of such members may include a rack comprising teeth spaced along the handle axis so as to define a rachet interface. 
         [0011]    In turn, the endoscopic tool may be provided so that upon first relative movement between the grip member and shaft member by a user, a first relative movement between opposing portions of first and second jaw members comprising the tissue grasper may be realized, wherein the first and second jaw members may move from an open position to a closed position. Correspondingly, the rachet interface may advantageously retain the opposing portions of the first and second jaw members in the closed position, while maintaining a relatively constant level of tissue grasping force. In the later regard, the degree of closure may be selectively established by a user, then maintained by the rachet interface, wherein the user may selectively affect a desired grasping force that is sufficient to stabilize the tissue free from trauma thereto. 
         [0012]    In one approach, the handle axis may be linear, wherein relative movement of the grip member and shaft member of the handle is along such handle axis, and wherein the rachet interface is provided along the same linear handle axis. Such an arrangement yields a compact, user-friendly endoscopic tool which may be provided to facilitate single-hand operation by a user. 
         [0013]    In another aspect, one of the pawl and the rack may be provided to be selectively moveable laterally away from the other by a user so as to permit selective second relative movement between the grip member and the shaft member. Such second relative movement may affect second relative movement between the first and second jaw members of the tissue grasper from a closed position to an open position. 
         [0014]    In a related aspect, a biasing member may be provided for applying a biasing force to oppose the first relative movement between the grip member and the shaft member. In this regard, the biasing force facilitates the rachet interface engagement of the pawl and rack. In turn, upon relative lateral movement of the pawl and the rack away from one another, the biasing force automatically affects the second relative movement between the grip member and the shaft member, and between the first and second jaw members of the tissue grasper. 
         [0015]    An inventive method is also provided for operating an endoscopic tool having an elongate member, a tissue grasper located at a distal end of the elongate member, and a handle located at a proximal end of the elongate member. The method includes the steps of first manually manipulating the handle of the tool to affect first relative movement between a shaft member and a grip member of the handle, wherein one of the grip member and the shaft member includes a pawl and one includes a rack to define a rachet interface therebetween. The method further includes the step of advancing at least one of opposing portions of first and second jaw members comprising a tissue grasper toward the other one, from an open position to a closed position, in mechanical response to the first manually manipulating step, wherein the rachet interface retains the first and second jaw members in the closed position. 
         [0016]    In one aspect, the method may include the steps of second manually manipulating the handle to affect second relative movement between the shaft member and the grip member, and retracting at least one of the opposing portions of the first and second jaw members away from the other one, to an open position, in response to the second manually manipulating step. In the later regard, the method may further provide for applying a biasing force to one of the grip member and shaft member, and selectively releasing such biasing force, wherein said retracting step is realized. 
         [0017]    In another feature, an inventive endoscopic tool for selective tissue grasping and retention is provided that may include a flexible elongate member and a tissue grasper located at a distal end of the elongate member, wherein flexible elongate member may include a first elongate member and a second elongate member. The first and second elongate members may be disposed for relative movement therebetween. 
         [0018]    The tissue grasper may include a first jaw member and a second jaw member. The first jaw member may be disposed for movement between an open position and a closed position in response to a relative movement of distal ends of the first and second elongate members between a first relative position and a second relative position. In turn, tissue is graspable between opposing portions of the first and second jaw members when the first jaw member is in the closed position. 
         [0019]    The tissue grasper may also include a first articulating member moveably interconnected to, and moveable relative to a first axis located in fixed spatial relation to, a distal end of a predetermined one of the first and second elongate members. The first articulating member may be moveable along a first path between a first articulated position and a second articulated position relative to the first axis in response to the relative movement of the distal ends of the first and second elongate members. In turn, the first articulating member may be moveably interconnected to the first jaw member so as to affect movement of the first jaw member between the open position and the closed position in response to relative movement of the distal ends of the first and second elongate members, and so that when the distal ends of the first and second elongate members are disposed in the second relative position a separating force applied to the first jaw member will not affect an application of force to the first articulating member in a direction along the first path (e.g., from the second articulated position to the first articulated position). Accordingly, the first jaw member may be effectively locked in a closed position such that a separating force acting on the first jaw member does not result in the first jaw member opening from the closed position. 
         [0020]    As may be appreciated, such locking feature may advantageously provide for reduced variability in tissue grasping pressure. Further, such feature may yield enhanced personnel efficiencies by facilitating tissue grasping free from the continuous application of force by a user (e.g., free from grasping a handle). 
         [0021]    In one aspect, the distal ends of the first and second elongate members may be disposed for relative axial movement. As such, the first and second relative positions of the distal ends of the first and second elongate members may be axially offset. 
         [0022]    In another aspect, the first articulating member may be pivotally interconnected at the first axis to the distal end of the above-noted, predetermined one of first and second elongate members. In turn, at least a portion of the first path of the first articulating member between the first and second articulated positions may be arcuate. Additionally, the first jaw member may be pivotally interconnected to the first articulating member at a second axis offset from the first axis. The second axis may be located at a first offset position, or first angular position, with respect to the first axis, when the first articulating member is in the first articulated position. Correspondingly, the second axis may be located in a second offset position, or second angular position, with respect to the first axis, when the first articulating member is in the second articulated position. As may be appreciated, the first and second offset positions may be offset. 
         [0023]    Further, the first jaw member may be moveably interconnected to, and moveable relative to a third axis located in fixed spatial relation relative to, the distal end of the above-noted, predetermined one of the first and second elongate members. The first axis and the third axis may be offset. When the first jaw member is in the closed position, the first axis and the second axis, and the first axis and the third axis, may define an included angle at the first axis of at least 90 degrees. As such, any force acting on the first articulating member in response to a separating force applied to the first jaw member does not result in a force in a direction along the first path between the second and first articulated positions of the first articulating member. In turn, undesired movement of the first jaw member between the closed and open positions in response to a separating force may be avoided. 
         [0024]    In some implementations the first axis and the third axis may be disposed orthogonal to, and intersecting, a longitudinal axis of the distal end of the above-noted one of the first and second elongate members. In this regard, the first and second elongate members may be disposed so that, upon relative axial movement thereof, aligned, efficient and predictable responsive movement of the first articulating member and first jaw member may be realized. 
         [0025]    Further, the first jaw member may be pivotally interconnected at the third axis to the distal end of the one of the first and second elongate members. In this regard, the tissue grasper may also include a first shaft member disposed on the third axis that may be fixedly interconnected to the distal end of one of the first and second elongate members. Also, a slot formed in a portion of the first jaw member may be provided for receiving the first shaft member therein. The first shaft member may be disposed for relative movement to and within the slot when the first jaw member is moved between the open and closed positions. 
         [0026]    In still another aspect, the tissue grasper may include a first linkage member moveably interconnected at a fourth axis to the first articulating member and moveably interconnected to, and moveable relative to a fifth axis located in fixed spatial relation relative to, a distal end of the other one of the distal ends of the first and second elongate members (i.e., not the above-noted predetermined end). The first linkage member may be pivotally interconnected to the first articulating member at the fourth axis. The first linkage member may be pivotally interconnected to the distal end of the other one of the first and second elongate members at the fifth axis. 
         [0027]    In some implementations, the first axis, the third axis, and the fifth axis may be arranged orthogonally relative to, and intersecting, a longitudinal axis of the distal end of one of the first and second elongate members. In this regard, the first and second elongate members may be disposed so that, upon relative axial movement thereof, aligned, efficient and predictable response movement of the first articulating member first jaw member and first linkage member may be realized. 
         [0028]    In still another aspect of the tissue grasper, the second jaw member may be disposed for movement between an open position and a closed position in response to the relative movement of the distal ends of the first and second elongate members. In this regard, the tissue grasper may also include a second articulating member moveably interconnected at the first axis to the distal end of one of the first and second elongate members. The second articulating member may be moveable along a second path between a third articulated position, or third angular position with respect to the first axis, and fourth articulated position, or angular position, relative to the first axis in response to the relative movement of the distal ends of the first and second elongate members. 
         [0029]    Furthermore, the second articulating member may be moveably interconnected to the second jaw member as to affect the movement of the second jaw member between the open position and the closed position thereof in response to the relative movement of the distal ends of the first and second elongate members, and so that when the first and second the distal ends of the first and second elongate members are disposed in the second relative position a separating force applied to the second jaw member will not affect an application of force to the second articulating member in a direction along the second path (e.g., from the fourth articulated position to the third articulated position). 
         [0030]    In another aspect, the second articulating member may be pivotally interconnected at the first axis to the distal end of the above-noted, predetermined one of the first and second elongate members. In turn, at least a portion of the second path of the second articulating member between the third and fourth articulated positions may be arcuate. 
         [0031]    The second jaw member may be pivotally interconnected to the second articulating member at a sixth axis offset from the first axis. The sixth axis may be located at a third offset position, or third angular position, with respect to the first axis, when the second articulating member is in the third articulated position. Correspondingly, the sixth axis may be located in a fourth offset position, or fourth angular position, with respect to the first axis, when the second articulating member is in the fourth articulated position. As may be appreciated, the third and fourth offset positions may be offset. 
         [0032]    The second jaw member may be pivotally interconnected to, and moveable relative to, the third axis. When the second jaw member is in the closed position, the first axis and the sixth axis and the first axis and the third axis may define an included angle at the first axis of at least 90 degrees. As such, any force acting on the second articulating member in response to a separating force applied to the second jaw member does not result in a force in a direction along the second path between the fourth and third articulated positions of the second articulating member. In turn, undesired movement of the second jaw member between the closed and open positions in response to a separating force may be avoided. 
         [0033]    In another aspect, the tissue grasper may also include a second slot formed in a portion of the second jaw member for receiving the first shaft member therein. The first shaft member may be disposed for relative movement to and within the second slot when the second jaw member is moved between the open and closed positions. 
         [0034]    Also, a second linkage member may be moveably interconnected (e.g., pivotally interconnected) to the second articulating member at a seventh axis and moveably interconnected to the distal end of the other one of the distal ends of the first and second elongate members (i.e., not the above-noted predetermined one). 
         [0035]    An additional inventive method is also provided for operating an endoscopic tool comprising a flexible elongate member and a tissue grasper located at a distal end of the flexible elongate member wherein the tissue grasper includes first and second jaw members for selective tissue grasping and retention. The method includes moving at least a predetermined one of a first elongate member and a second elongate member of the flexible elongate member relative to the other one between a first relative position and a second relative position. Also, the method includes positioning a first articulating member, moveably interconnected to, and moveable relative to a first axis located in fixed spatial relation relative to, a distal end of one of the first and second elongate members, along a first path between a first articulated position and a second articulated position relative to the first axis in response to the moving step. The method further includes locating the first jaw member, moveably interconnected to the first articulating member, between an open position and a closed position so as to grasp tissue between the first and second jaw members in response to the moving step, wherein when the distal ends of the first and second elongate member are disposed in the second relative position, a separating force applied to the first jaw member will not affect an application of force to the first articulating member in a direction along the first path. 
         [0036]    In one aspect, the moving step may include axially moving a distal end of the above-noted one of the first and second elongate members to a distal end of the other one of the first and second elongate members. In turn, the first relative position and the second relative position may be axially offset. 
         [0037]    Additionally, the positioning step may include pivoting the first articulating member relative to the first axis. In turn, at least a portion of the first path of the articulating member between the first and second articulated positions may be arcuate. 
         [0038]    Further, the locating step may include pivoting the first jaw member with respect to the first articulating member at a second axis offset from the first axis. The second axis may be located at a first offset position when the first articulating member is in the first articulated position, and wherein the second axis is located in a second offset position when the first articulating member is in the second articulated position. As may be appreciated, the first and second offset positions may be offset. 
         [0039]    In another aspect, the locating step may also include situating the first jaw member relative to a third axis located in fixed spatial relation relative to the distal end of the one of the first and second elongate members. The first axis and the third axis may be offset. Accordingly, when the first jaw member is in the closed position, the first axis and the second axis may define an included angle at the first axis of at least 90 degrees. 
         [0040]    In yet another aspect, the method may include translating movement of the above-noted, predetermined one of the first and second elongate members in the moving step to the first articulating member to complete the positioning step with a linkage member. The linkage member may be interconnected at a fourth axis to the first articulating member and moveably interconnected to, and moveable relative to a fifth axis located in fixed spatial relation relative to, a distal end of the other one of the distal ends of the first and second elongate members. Additionally, the method may include maintaining the first axis, the third axis, and the fifth axis in orthogonal intersection with a longitudinal axis of the distal end of the one of the first and second elongate members. 
         [0041]    In yet another aspect, the method may include disposing, or moving, a second articulating member moveably interconnected to, and moveable relative to the first axis is a fixed spatial relation relative to, a distal end of one of the first and second elongate members, along a second path between a third articulated position and a fourth articulated position relative to the first axis in response to the moving step. In this regard, the method may also include orienting the second jaw member, moveably interconnected to the second articulating member, between an open position and a closed position so as to grasp tissue, in response to the moving step, wherein when the distal ends of the first and second elongate members are disposed in the second relative position, a separating force applied to the second jaw member will not affect an application of force to the second articulating member in a direction along the second path. 
         [0042]    In one approach, the orienting step may include pivoting the second jaw member with respect to the second articulating member at a sixth axis offset from the first axis. The sixth axis may be located at a third offset position when the second articulating member is in the third articulated position, and the sixth axis may be located in a fourth offset position when the second articulating member is in the fourth articulated position. As may be appreciated, the third and fourth offset positions are offset. 
         [0043]    The orienting step may also include situating the second jaw member relative to the third axis that is located in a fixed spatial relation relative to the distal end of the above-noted predetermined one of the first and second elongate members. When the second jaw member is in the closed position, the first axis and the sixth axis may define an included angle at the first axis of at least 90 degrees. 
         [0044]    In yet another aspect, the method may include translating movement of the above-noted, predetermined one of the first and second elongate members in the step to the second articulating member to complete the disposing step with a second linkage member interconnected at a seventh axis to the second articulating member. 
         [0045]    In another feature, an inventive endoscopic tool for selective tissue grasping and retention is provided that may include a flexible elongate member having a tissue grasper located at a distal end of the elongate member. The elongate member may include a first elongate member and a second elongate member. The first and second elongate members may be disposed for relative movement therebetween; 
         [0046]    The tissue grasper may include a first jaw member and a second jaw member. At least the first jaw member may be disposed for movement between an open position and a closed position in response to a relative movement of distal ends of the first and second elongate members between a first relative position and a second relative position. Tissue may be graspable between opposing portions of the first and second jaw members when the first jaw member is in the closed position. 
         [0047]    The tissue grasper may also include a first articulating member moveably interconnected to, and moveable relative to a first axis located in fixed spatial relation relative to, a distal end of one of the first and second elongate members, in response to the relative movement of the distal ends of the first and second elongate members. The first jaw member may be moveably attached to, and moveable relative to a third axis in a fixed spatial relation relative to the distal end of one of the first and second elongate members and offset from the first axis. The first articulating member may be moveably interconnected to the first jaw member at a second axis offset from the first axis so as to affect the movement of the first jaw member between the open position and the closed position in response to the relative movement of the distal ends of the first and second elongate members. In this regard, a first length between the second axis and the third axis is longer when in the closed position than in the open position. 
         [0048]    In another aspect, a first distance from a distal end of the first jaw member to the third axis may be shorter when in the closed position than the open position. Accordingly, a ratio between the first length and the first distance may be greater when in the closed position than in the open position. 
         [0049]    In yet another aspect, a first shaft member may be disposed on the third axis and fixedly interconnected to the distal end of the one of the first and second elongate members. Also, a first slot formed in a portion of the first jaw member for receiving the first shaft member therein. The first shaft member may be disposed for relative movement to and within the first slot when the first jaw member is moved between the open and closed positions. 
         [0050]    In another aspect, the first length between the second axis and the third axis may define a first lever arm and the first distance between the distal end of the first jaw member and the third axis may define a second lever arm. Relative movement between the first elongate member and the second elongate member may result in transmission of a force between the first lever arm and the second lever arm. 
         [0051]    In still another aspect, a first linkage member may be moveably interconnected at a fourth axis to the first articulating member and moveably interconnected to, and moveable relative to a fifth axis located in fixed spatial relation relative to, a distal end of the other one of the distal ends of the first and second elongate members. 
         [0052]    In another aspect, the second jaw member may be disposed for movement between an open position and a closed position in response to the relative movement of the distal ends of the first and second elongate members. 
         [0053]    In this regard, the tissue grasper may include a second articulating member that may be moveably interconnected at the first axis to the distal end of one of the first and second elongate members in response to the relative movement of the distal ends of the first and second elongate members. The second jaw member may be moveably attached to, and moveable relative to the third axis. The second articulating member may be moveably interconnected to the second jaw member at a sixth axis offset from the first axis so as to affect the movement of the first jaw member between the open position and the closed position in response to the relative movement of the distal ends of the first and second elongate members. In turn, a second length between the sixth axis and the third axis may be longer when in the closed position than in the open position. 
         [0054]    In one aspect, a second distance from a distal end of the second jaw member to the third axis may be shorter when in the closed position than the open position. Also, a ratio between the second length and the second distance may be greater when in the closed position than in the open position. 
         [0055]    In another aspect, a second slot may be formed in a portion of the second jaw member for receiving the first shaft member therein. The first shaft member may be disposed for relative movement to and within the second slot when the first second member is moved between the open and closed positions. 
         [0056]    In another aspect, the second length between the sixth axis and the third axis may define a third lever arm and the second distance between the distal end of the second jaw member and the third axis may define a fourth lever arm. Relative movement between the first elongate member and the second elongate member may result in transmission of a force between the third lever arm and the fourth lever arm. 
         [0057]    In another aspect, a second linkage member may be moveably interconnected at a seventh axis to the second articulating member and may be moveably interconnected to, and moveable relative to the fifth axis. 
         [0058]    An inventive method is also provided for operating an endoscopic tool having an elongate member, a tissue grasper located at a distal end of the elongate member. The tissue grasper may include first and second jaw members for selective tissue grasping and retention therebetween. The method may include moving at least one of a first elongate member and a second elongate member of the flexible elongate member relative to the other one between a first relative position and a second relative position. The method may also include positioning a first articulating member moveably interconnected to, and moveable relative to a first axis located in fixed spatial relation relative to, a distal end of one of the first and second elongate members along a first path between a first articulated position and a second articulated position relative to the first axis in response to the moving step. Further still, the method may include locating the first jaw member, moveably interconnected to the first articulating member at a second axis offset from the first axis and moveably interconnected to, and moveable with respect to, a third a third axis in a fixed spatial relation relative to the distal end of one of the first and second elongate members and offset from the first axis, between an open position and a closed position so as to grasp tissue between the first and second jaw members in response to the moving step. In turn, a first length between the second axis and the third axis is greater in the closed position than in the open position. 
         [0059]    In one aspect, a first distance between a distal end of the first jaw member and the third axis may be shorter when in the closed position than in the open position. The method may involve increasing a ratio between the first length and the first distance when moving from the open position to the closed position. The method may involve decreasing a ratio between the first length and the first distance when moving from the closed position to the open position. 
         [0060]    In another aspect, the method may include orienting a first slot formed in a portion of the first jaw member with respect to a first shaft member disposed on the third axis in response to the moving step such that the first distance between the distal end of the first jaw member and the third axis is shorter when in the closed position than in the open position. 
         [0061]    In still another aspect, the method may include disposing a second articulating member moveably interconnected to, and moveable relative to the first axis is a fixed spatial relation relative to, a distal end of one of the first and second elongate members, along a second path between a third articulated position and a fourth articulated position relative to the first axis in response to the moving step. The method may also include situating the second jaw member, moveably interconnected to the second articulating member at a fourth axis offset from the first axis and moveably interconnected to, and moveable with respect to, the third axis between an open position and a closed position so as to grasp tissue between the first and second jaw members in response to the moving step. A second length between the fourth axis and the third axis may be greater in the closed position than in the open position. 
         [0062]    In another aspect, a second distance between a distal end of the second jaw member and the third axis may be shorter when in the closed position than in the open position. The method may include increasing a ratio between the second length and the second distance when moving from the open position to the closed position. The method may include decreasing a ratio between the second length and the second distance when moving from the closed position to the open position. 
         [0063]    In another embodiment, the method may include disposing a second slot formed in a portion of the second jaw member with respect to the first shaft member disposed on the third axis in response to the moving step such that the second distance between the distal end of the first jaw member and the third axis is shorter when in the closed position than in the open position. 
         [0064]    Any of the embodiments, arrangements, or the like discussed herein may be used (either alone or in combination with other embodiments, arrangements, or the like) with any of the disclosed aspects. Any feature disclosed herein that is intended to be limited to a “singular” context or the like will be clearly set forth herein by terms such as “only,” “single,” “limited to,” or the like. Merely introducing a feature in accordance with commonly accepted antecedent basis practice does not limit the corresponding feature to the singular (e.g., indicating that a member includes “a pivot member” alone does not mean that the container includes only a single pivot member). Moreover, any failure to use phrases such as “at least one” also does not limit the corresponding feature to the singular (e.g., indicating that a member includes “a pivot member” alone does not mean that the container includes only a single pivot member). Use of the phrase “at least generally,” “at least partially,” or the like in relation to a particular feature encompasses the corresponding characteristic and insubstantial variations thereof. Finally, a reference of a feature in conjunction with the phrase “in one embodiment” does not limit the use of the feature to a single embodiment. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0065]      FIG. 1  is a perspective view of one embodiment of an endoscopic tool illustrating a handle, elongate member, and tissue grasper thereof in disconnected relation for purposes of illustration. 
           [0066]      FIG. 2  is an exploded view of the handle of the endoscopic tool embodiment illustrated in  FIG. 1 . 
           [0067]      FIG. 3A  is a side view of the endoscopic tool embodiment of  FIG. 1  with the handle, elongate member and tissue grasper thereof shown in interconnected relation. 
           [0068]      FIG. 3B  is a side cross-sectional view of the endoscopic tool embodiment shown in  FIG. 3A , such cross-sectional view taken along cut line AA of  FIG. 3A . 
           [0069]      FIG. 4A  is a side view of the endoscopic tool embodiment shown in  FIG. 3A  with a grip member of the handle shown in an advance positioned relative to a shaft member of the handle. 
           [0070]      FIG. 4B  is a side view corresponding with the endoscopic tool embodiment shown in  FIG. 3A  with the grip member of the handle shown in a retracted position relative to the shaft member thereof to affect tissue grasping. 
           [0071]      FIG. 4C  is side view corresponding with the endoscopic tool environment shown on  FIG. 3A  with first and second members of the grip member advanced relative to one another to affect automatic repositioning of the grip member from the retracted position of  FIG. 4B  to the advanced position of  FIG. 4A . 
           [0072]      FIG. 5A  is a side view of a tissue grasper embodiment interconnected to the distal end of the elongate member of the endoscopic tool embodiment shown in  FIG. 1 . 
           [0073]      FIG. 5B  is a top view of the tissue grasper embodiment shown in  FIG. 5A  as interconnected to the distal end of the elongate member of the endoscopic tool embodiment shown in  FIG. 1 . 
           [0074]      FIG. 5C  is a perspective view of the tissue grasper embodiment of  FIG. 5A . 
           [0075]      FIG. 5D  is an exploded view of the tissue grasper embodiment shown in  FIG. 5C . 
           [0076]      FIGS. 6A ,  6 B,  6 C,  6 D,  6 E,  6 F and  6 G illustrate the tissue grasper embodiment of  FIG. 5A , with modified jaw surfaces, and with opposing jaw members progressing from a closed position to an open position. 
           [0077]      FIGS. 6H ,  6 I,  6 J and  6 K illustrate the tissue grasper embodiment of  FIG. 5A , with modified jaw surfaces, and with jaw opposing members progressing from an open position to a closed position. 
           [0078]      FIG. 7A  is an alternate view of the tissue grasper embodiment shown in  FIGS. 6A and 6K  with additional reference features. 
           [0079]      FIG. 7B  is an alternative view of the tissue grasper embodiment shown in  FIG. 6F , with additional reference features. 
           [0080]      FIG. 8A  is an alternate view of the tissue grasper embodiment shown in  FIG. 7A . 
           [0081]      FIG. 8B  is an alternate view of the tissue grasper embodiment shown in  FIG. 7B . 
       
    
    
     DETAILED DESCRIPTION 
       [0082]      FIG. 1  illustrates one embodiment of an endoscopic tool  1  comprising a handle  10 , an elongate member  70  and a tissue grasper  80 . The handle  10  is interconnectable to a proximal end of the elongate member  70 , and the tissue grasper  80  is interconnectable to a distal end of the elongate member  70 . 
         [0083]    The handle  10  may include a shaft member  20  and a grip member  30  that may extend at least partially around the shaft member  20 . In the illustrated embodiment, the shaft member  20  may be provided to extend through an aperture of the grip member  30  that extends along a handle axis  22 . In turn, a proximal end member  60  may be fixedly interconnected to a proximal end of the shaft member  20 . As will be further described, the grip member  30  and shaft member  20  may be provided for relative movement therebetween by a user. By way of example only, the grip member  30  and shaft member  30  may be of molded plastic construction (e.g. ABS plastic, nylon plastic, etc.) 
         [0084]    The elongate member  70  may be of a flexible construction and may include an inner member  72  (e.g. stainless steel wire) that extends through a tubular outer member  74  (e.g. tightly wound stainless steel spring), wherein the inner member  72  and outer member  74  are disposed for relative movement therebetween. In the illustrated embodiment, a proximal end of the inner member  72  may be provided with a connector  76  having an opening therethrough for interconnection to the grip member  30  via a pin  36  that extends through the grip member  30  and connector  76 , wherein co-movement of inner member  72  and grip member  30 . 
         [0085]    The tissue grasper  80  may comprise opposing first and second jaw members  82  and  84  (e.g. of a metal construction). The first and second jaw members  82  and  84  may be provided with opposing distal portions disposed for selective relative movement between an open position, as shown in  FIG. 1 , and a closed position in which the opposing portions may be positioned in juxtaposed relation for tissue retention therebetween. 
         [0086]    In this regard, the first and second jaw members  82  and  84  may be interconnected to the inner member  72  of the elongate member  70 , wherein movement of the inner member  72  affects movement of the first and second jaw members  82  and  84 . The tissue grasper  80  may further include a yolk member  86  fixedly interconnected to the outer member  74  of the elongate member  70 , as will be further described. 
         [0087]    Reference is now made to  FIG. 2  and  FIGS. 3A and 3B . The shaft member  20  may include a plurality of teeth  22  spaced along a length of an outer surface of the shaft member  20  to define a rack  24 . In one approach, rack  24  may be defined by an insert molded metal portion. In the illustrated embodiment, the teeth  22  may each extend about an annular periphery of the shaft member  20 . The shaft member  20  may further include an elongate slot  26  for receipt of the above-noted pin  36  therethrough. As will be further described, the pin  36  may move within and along the elongated slot  26  during relative movement of the shaft member  20  and grip member  30 . 
         [0088]    With further reference to  FIG. 2 , the grip member  30  may comprise a first member  40  and a second member  50 . The first member  40  may include a central aperture  42  that extends therethrough and a laterally extending flange portion  44  near a proximal end thereof. In turn, the second member  50  may include a laterally extending flange portion  52  and a longitudinally extending connector portion  54  that is interconnectable within the aperture  42  of the first member  40 . The connector portion  54  may include a plurality of legs extending away from the flange portion  52  for interconnected positioning within the aperture  42 . In the illustrated embodiment, two opposing leg members  54   a  and  54   b  are illustrated. 
         [0089]    Each of the leg members  54   a  and  54   b  may be provided with a corresponding connector tab  56   a  and  56   b,  respectively, each of which are cantilevered within a corresponding window  58   a  and  58   b,  respectively. The connector tabs  56   a  and  56   b  may each comprise an outer surface that tapers outwardly away from a distal end to a proximal end thereof. In turn, upon insertion of the connector portion  54  into the aperture  42  of the first member  40 , the cantilevered tabs  56   a  and  56   b  may elastically deflect inward and then back outward as tabs  56   a  and  56   b  advance into snap-fit engagement corresponding apertures  46  of the first member  40 . As will be further described, each of the leg members  54   a  and  54   b  may each be further provided with a corresponding inwardly-extending, tooth-shaped pawl  55   a  (shown in phantom lines in  FIG. 2) and 55   b  respectively, located in aligned distal relation with distal ends of the cantilevered tabs  56   a  and  56   b,  respectively. With further reference to  FIG. 2 , the handle  10  may further comprise a biasing member  32  (e.g. a metal spring) for positioning within the shaft member  20  and grip member  30 . In the illustrated embodiment upon assembly, a proximal end of the biasing member  32  may be positioned within a corresponding retention notch  62  provided on a stem  64  of the proximal end member  60 . A distal end of the biasing member  32  may abut pin  36 . 
         [0090]    When assembled, the stem  64  of the proximal end member  60  may be inserted into a proximal end portion of the shaft member  20 . To facilitate such insertion, the proximal end portion of the shaft member  20  may include one or more slits  26  extending distally from the proximal end to allow for elastic deformation of the proximal end portion of the shaft member during receipt of the stem  64  therewithin. After insert positioning of the stem  64  within the proximal end portion of the shaft member  20 , a resilient retention band  34  may be disposed in overlapping relation to the proximal end portion of the shaft member  20  and stem  64  of the proximal end portion member  60  to maintain an axially fixed relation therebetween. In the illustrated arrangement, the proximal end member is axially fixed relative to shaft member  20  that may rotate to an extent relative thereto. 
         [0091]    With further reference to  FIGS. 1 ,  3 A and  3 B, the elongate member  70  may include an interconnect member  78  disposed about a length of the inner member  72  near the proximal end thereof. In turn, the interconnect member  78  may be located within a distal end portion of the shaft member  20  upon assembly, wherein an outer threaded surface portion  78   a  may rotatively engage and interconnect to an inner threaded surface portion  28  of shaft member  20 . 
         [0092]    The elongate member  70  may also optionally include a strain relief member  79  (e.g. tightly wound stainless steel spring) that is positioned about a length outer member  74  at the interface of outer member  74  and shaft member  20 . In this regard, the strain relief member  79  may address bending forces that may be applied to elongate member  70  during use. 
         [0093]    Operation of the endoscopic tool  11  will now be described with reference to  FIGS. 4A-4C  and  FIG. 3B .  FIG. 4A  shows handle  10  with grip member  30  in a first advanced position relative to the shaft member  20 . In the first position the first and second jaw members  82  and  84  are in an open relative position for locating tissue T therebetween. For such tissue locating, the tool  1  may be manipulated via fingers F 1 , F 2  and F 3  of a user positioned as shown. 
         [0094]      FIG. 4B  illustrates retraction of the grip member  30  relative to the shaft  20  so as to close the first and second jaw members  82  and  84  to a closed position with tissue T grasped therebetween. For such retraction, the tool may be manipulated via positioning of fingers F 1 , F 2  an F 3  as shown, wherein finger F 1  may be advanced relative to fingers F 2  and F 3  and/or wherein fingers F 2  and F 3  may be retracted relative to finger F 1  (e.g. a squeezing or pinching action). 
         [0095]    In relation to such retracted positioning of the grip member  30  relative to the shaft member  20 , the pawls  55   a  and  55   b  of the second member  50  of the grip member  30  may interface with the rack  24  of the shaft member  20  in a rachet-like manner, wherein the grip member  30  may be retained in the second position shown in  FIG. 4B . In this regard, the retracted positioning of grip member  30  is illustrated in  FIG. 3B . As shown, the pawls  55   a  and  55   b  are disposed in opposing engaged relation with the teeth  22  of the rack  24 . By virtue of the retracted positioning of the grip member  30 , biasing member  32  may be compressed proximal to pin  36 , wherein a distally-directed biasing force may applied by the biasing member  32  to the grip member  30 . 
         [0096]    To release the grip member  30  from the retracted position, the flange portion  52  of the second member  50  may be distally advanced relative to the flange portion  42  of the first member  40 . In turn, upon such advancement a tapered leading edge surface at the distal end of each of the leg members  54   a  and  54   b  may interface with opposingly-tapered, leading edge surfaces provided about an inward ledge  48  within the aperture  42  of the first member  40 . Upon advancement of the flange portion  52  of the second member  50  relative to the flange portion  42  of the first member  40 , the tapered leading edge surface at the distal end of each of the leg member  54   a  and  54   b  may advance distally with respect to the inward ledge having opposing-tapered surfaces. Accordingly, the relative distal movement of the leading edge surfaces of the leg members  54   a  and  54   b  may result in a lateral movement of the leg members  54   a  and  54   b  with respect to the shaft member. That is, the interface of the noted tapered surfaces forces each of the leg members  54   a  and  54   b  to elastically deflect outward to a sufficient degree to permit pawls  55   a  and  55   b  to disengage from the teeth  22  of the rack  24 , wherein the biasing force of biasing member  32  automatically returns the grip member  30  from the retracted position shown in  FIG. 4B  back to the initial first position shown on  FIG. 4C . 
         [0097]    To realize tissue release by first and second jaw members  52   a  and  52   b,  fingers F 1 , F 2  and F 3  of a user may be positioned as shown in  FIG. 4C . Then, finger F 1  may be advanced relative to fingers F 2  and F 3  and/or fingers F 2  and F 3  may be retracted relative to finger F 1  so as to release the rachet interface (e.g. a squeezing or pinching action), wherein the biasing member  32  functions to automatically advance the grip member  30  so as to open the first and second jaw members  82  and  84 . 
         [0098]    In relation to the described endoscopic tool embodiment  1 , the tissue grasper  80  may comprise known arrangements in which opposing jaw members pivot between open/closed positions in response to the advancement/retraction or retraction/advancement of an interconnection member that extends to a handle operable by a user. Optionally, a novel tissue grasper may be employed. 
         [0099]    For instance, in conjunction with the endoscopic tool described in  FIGS. 1-5B , a novel tissue grasper  80  disposed at a distal end of the elongate member  70  may also be provided as shown in  FIG. 1 . Manipulation of the tissue grasper  80  at the distal end of the elongate member  70  may be realized through relative movement of the inner member  72  and outer member  74 . 
         [0100]    For instance, the inner member  72  and the outer member  74  may represent a first elongate member and a second elongate member, respectively that are moveable with respect to one another. For purposes of illustration, continued reference will be made to a first elongate member and a second elongate member. However, in various embodiments, the inner member  72  may be the first elongate member or second elongate member and the outer member  74  may be the other of the first elongate member or second elongate member. Therefore, reference to a first or second elongate member is not intended to be limited to either the inner member  72  or outer member  74 , unless otherwise specified. 
         [0101]    In this regard, the first and second elongate member may be moved between a first and second relative position (e.g., by manipulating the handle  10 ). In addition, the first jaw member  82  and the second jaw member  84  may move between an open and a closed position. When in the closed position, tissue may be retained and grasped between the first jaw member  82  and the second jaw member  84 , and when in the open position the first jaw member  82  and the second jaw member  84  may be generally capable of grasping tissue lying within, intersecting, or adjacent to a grasping plane as will be described further below. In different implementations, the open position and the closed position of the first jaw  82  and the second jaw  84  may correspond with a first relative position of the first and the second elongate members or a second relative position of the first and the second elongate members. 
         [0102]    Another embodiment of such a tissue grasper  100  is shown in  FIGS. 5A-5D . The tissue grasper  100  may also be employed in various arrangements other than in combination with the embodiment of endoscopic tool  1  described hereinabove. 
         [0103]    For purposes of illustration, however,  FIGS. 5A-D  show the tissue grasper  100  interconnected to the distal end of the elongate member  70  of the endoscopic tool  1  described hereinabove. To facilitate illustration of the tissue grasper  100 , a yolk member  170  thereof is not shown in  FIGS. 5A ,  5 C and  5 D, nor is the outer member  74  of the elongate member  70  to which the yolk member may be fixedly interconnected. The yolk member  170  is shown in broken lines in  FIG. 5B , along with a portion of the outer member  74 . Such components and their interconnection will be addressed hereinbelow. 
         [0104]    Tissue grasper  100  may generally be moved between an open position and a closed position. The open position and the closed position of tissue grasper  100  may correspond to the first relative position and the second relative position of the first and the second elongate members (e.g., inner member  72  and outer member  74 ). Furthermore, as shown in  FIG. 5B , a yoke  170  may engage portions of the tissue grasper  100 . In this regard, the tissue grasper  100  may be provided in a fixed spatial relation relative to the distal end of one of the elongate members (e.g., the first or the second elongate member). For instance, the yoke  170  may act to maintain portions of the tissue grasper  100  in a fixed spatial relation relative to the distal portion of either the first or the second elongate members. 
         [0105]    A first jaw member  110  and an opposing second jaw member  130  having opposing shaped surfaces may be provided. The first jaw member  110  may be interconnected to the distal end of either the first or the second elongate member via a first articulating member  120  and a second articulating or linkage member  122 . Similarly, a second jaw member  130  may be interconnected to the distal end of inner member  72  via a first or second articulating member  140  and a second articulating or second linkage member  142 . As will be described, the first and second linkage members  122 ,  142  translate or communicate, movement of a distal end of at least one of the first and second elongate members to the first and second articulating members  120 ,  140 , respectively. 
         [0106]    The first articulating member  120  may be moveable with respect to an axis A-A. In this regard, axis A-A may be maintained in a fixed spatial relation relative to one of the ends of the first or second elongate members. For instance, the axis A-A may coincide with a shaft  162  which is engaged by the yoke  170  and thereby maintained in a fixed spatial relation relative to the distal end of one of the elongate members. That is, the yoke  170  may be interconnected to either the first or second elongate member, the axis A-A may be maintained in a fixed spatial relation relative to the interconnected first or the second elongate member. As may be appreciated, since axis A-A may be positioned in fixed spatial relation relative to one of the first or the second elongate members, the other of the first and second elongate members (e.g., to which axis A-A is not in a fixed spatial relation) may engage the articulating member  120  to produce movement thereof relative to axis A-A. 
         [0107]    In this regard, the movement of the articulating member  120  may define a first path between a first articulated position and a second articulated position that may correspond to movement of the first and the second elongate members between the first relative position and the second relative position. In one embodiment, the first articulating member  120  may be rotatable with respect to axis A-A. As such, at least a portion of the first path may be arcuate between the first and the second articulated positions. That is, any one fixed point on the articulating member  120  may move on an arc between the first and the second articulated positions. Thus, movement of the first articulated member beyond the first or the second articulated positions (that is, outside the range of motion between the first and second articulated position) may not be movement of the first articulated member along the first path. Stated differently, the first path may not extend beyond a range between the first articulated position and the second articulated position. In addition, the first articulated position and the second articulated position may further correspond to the open position and the closed position of the first jaw member  110 . 
         [0108]    The first jaw member  110  may be moveable with respect to the first articulating member  120  relative to an axis B-B that intersects both the first jaw member and the first articulating member  120 . In one embodiment, rotation of the first articulating member  120  about axis A-A may also result in movement of the first jaw member  110  with respect to the first articulating member  120  at axis B-B. 
         [0109]    The first articulating member  120  may rotate in a first direction when moving from the first articulated position to the second articulated position and the second direction when moving from the second articulated position to the first articulated position. As the first or the second articulated position may be associated with the open position and the other of the first or the second articulated position may correspond to the closed position of the first jaw member  110 , rotation of the first articulating member  120  along the first path between the first articulated position and the second articulated position may result in the first jaw member  110  moving between the open position and the closed position. 
         [0110]    Additionally, the first jaw member  110  may also move with respect to an axis C-C. Axis C-C may also be located in a fixed spatial relation relative to the distal end of one of the first or the second elongate members. In this regard, axis C-C may coincide with a shaft  160  which is engaged by the yoke  170 . As the yoke  170  is disposed at the distal end of one of the first or the second elongate members, axis C-C may also be at a fixed spatial relation relative to the distal end of one of the elongate members. In this regard, axis A-A and axis C-C may be arranged in a fixed spatial relation relative to one another. That is, axis A-A and axis C-C may be spaced apart or offset. 
         [0111]    Movement of the first articulating member  120  between the first articulated position and the second articulated position and the corresponding movement of the first jaw member  110  between the open position and the closed position may result in the first jaw member  110  moving with respect to axis C-C. For instance, jaw member  110  may pivot with respect to axis C-C in order to move from the open position to the closed position. 
         [0112]    The first articulating member  120  may also be moveable with respect to a first linkage member  122 . The first linkage member  122  may be moveable with respect to an axis D-D that also intersects the first articulating member  120  such that the first articulating member may move with respect to axis D-D. The first linkage member  122  may also move with respect to an axis E-E that intersects the distal end of one of the first or the second elongate members. For illustrative purposes, the first linkage member  122  is shown as being moveable with respect to the inner member  72  at axis E-E, yet as discussed above the first linkage member  122  could be moveable at axis E-E with respect to the outer member  74  (e.g., in a case where the yoke  170  was attached to a distal end of the inner member). In this regard, the first linkage member  122  may move when the first and the second elongate members are moved between their first relative position and the second relative position. That is, axis E-E may move with respect to axis A-A and axis C-C upon movement of the first and the second elongate members between the first relative position and the second relative position. 
         [0113]    In one embodiment, the first linkage member  122  is curved along a length between the axis E-E and the axis D-D. For instance, the first linkage member  122  may generally curve away from a longitudinal axis of the distal end of the first or second elongate members. In this regard, axis D-D may be offset from axis E-E such that axis D-D is offset from the longitudinal axis of the distal end of the first or second elongate members. In this regard, the first linkage member  122  may include a portion at an end of the first linkage member  122  that is movably connected to the first articulating member  120  at axis D-D such that the end portion of the first linkage member  122  may be substantially perpendicular with respect to axis A-A and axis D-D at some point during the movement of the tissue grasper  100  between the closed and open positions. 
         [0114]    In one embodiment, the first and the second elongate member may be disposed for axial movement with respect to one another. In this regard, the first and the second relative positions may correspond to a first relative axial position and a second relative axial position between the distal ends of the first and the second elongate members. The axial position associated with the first relative position may be offset from the axial position associated with the second relative position. In other words, axis E-E may move with respect to axis A-A such that axis E-E and axis A-A are disposed at a first axial relative position when the first and the second elongate members are in the first relative position and axis A-A and axis E-E may be disposed at a second axial relative position when the first and the second members are disposed in the second relative position. In this regard, axis A-A and axis E-E may move axially with respect to one another in response to axial movement of the first and the second elongate members between the first and the second relative position. 
         [0115]    In any case, the first linkage member  122  may be moveable with respect to axis E-E and axis D-D. The first linkage member  122  may rotate with respect to axis E-E and may in turn cause the first articulating member  120  to rotate between the first articulated position and the second articulated position along the first path. In this regard, the first linkage member  122  may rotate with respect to the first articulating member  120  and axis D-D. As the first articulating member  120  rotates between the first articulated position and the second articulated position, the movement of the first articulating member  120  may also result in movement of the first jaw member  110  with respect to axis B-B. In fact, axis B-B may move from a first offset position to a second offset position. That is, when the first articulating member  120  is at the first articulated position, the axis B-B may be in the first offset position. As the first articulating member  120  moves between the first articulated position and the second articulated position, axis B-B may move therewith. Thus, when the first articulating member  120  is in the second articulated position, axis B-B may be in the second offset position. The first and the second offset positions may be offset. 
         [0116]    Additionally, the embodiment depicted in  FIG. 5C  may include a second jaw member  130  moveable between an open and a closed position. Furthermore, a second articulating member  140  may be provided that is also moveable with respect to axis A-A. The second articulating member  140  may be moveable between a third articulated position and a fourth articulated positions that corresponds with the movement of the first and the second elongate members between the first and the second relative position. For instance, the second articulating member  140  may move between the third and the fourth articulated positions with respect to axis A-A. Accordingly, the second articulating member  140  may move along a second path between the third and the fourth articulated positions. Thus, movement of the second articulated member beyond the third or the fourth articulated positions (that is, outside the range of motion between the third and fourth articulated position) may not be movement of the second articulated member along the second path. Stated differently, the second path may not extend beyond a range between the third articulated position and the fourth articulated position. In one embodiment, the second articulated member  140  may pivot with respect to axis A-A. As such, the second path may be at least partially arcuate. 
         [0117]    The second jaw member  130  may move with respect to an axis F-F that also intersects the second articulating member  140 . In one embodiment, the second jaw member  130  may pivot with respect to axis F-F. Axis F-F may move commensurately with the second articulating member  140  as the second articulating member  140  moves between the third and the fourth articulated position. In this regard, axis F-F may be at the third offset position when the second articulating member  140  is in a third articulated position and axis F-F may be in a fourth offset position when the second articulated member  140  is in the fourth articulated position. 
         [0118]    The second articulating member  140  may also be moveable with respect to a second linkage member  142 . The second linkage member  142  may also move with respect to an axis G-G that also intersects the second articulating member  140 . In one embodiment, the second articulating member  140  may pivot with respect to the axis G-G. The second linkage member  142  may move with respect to axis E-E. 
         [0119]    In one embodiment, the second linkage member  142  is curved along a length between the axis E-E and the axis F-F. For instance, the second linkage member  142  may generally curve away from a longitudinal axis of the distal end of the first or second elongate members. In this regard, axis F-F may be offset from axis E-E such that axis F-F is offset from the longitudinal axis of the distal end of the first or second elongate members. In this regard, the second linkage member  142  may include a portion at an end of the second linkage member  142  that is movably connected to the second articulating member  140  at axis F-F such that the end portion of the second linkage member  142  may be substantially perpendicular with respect to axis A-A and axis F-F at some point during the movement of the tissue grasper  100  between the closed and open positions. 
         [0120]    In this regard, as axis E-E is moved with respect to axis A-A, the second linkage member  142  may move with respect to axis E-E as well as axis G-G. The movement of axis G-G may also result in movement of the second articulating member  140  between the third and the fourth articulated position. As the second articulating member  140  moves between the third and the fourth articulated position, movement of the second articulating member  140  about axis F-F may also impose movement of the second jaw member  130  about axis F-F. In this regard, as articulating member  140  moves between the third and the fourth position the second jaw member  130  may move between the open and the closed position. As such, similar to the movement of the components discussed with respect to the first jaw member  110 , the second jaw member  130  may be moved between the open and the closed position corresponding to movement of the second articulating member  140  between the third and the fourth articulated position and also corresponding to the movement of the first and the second elongate member between the first and the second relative position. 
         [0121]    The second jaw member  130  may also move with respect to axis C-C when moving between the open and the closed position. Like the first jaw member  110 , the second jaw member  130  may pivot with respect to axis C-C when moving from the open to the closed position. 
         [0122]    With continued reference to  FIGS. 5A-5D , but stated differently, the first articulating member  120  may be pivotably interconnected to the first jaw member  110  via pivot member  124  (located on axis B-B), wherein the first jaw member  110  and the first articulating member  120  may each pivot relative to the pivot member  124 . The pivot member  124  may be disposed on the first articulating member  120  such that the pivot member  124  (and axis B-B) are at a first angular position with respect to axis A-A when the first articulating member  120  is in the first articulated position and at a second angular position with respect to axis A-A when the first articulating member is in the second articulated position. The first articulating member  120  may be pivotably interconnected to the first linkage member  122  via pivot member  126  (located on axis D-D), wherein the first articulating member  120  and the first linking member  122  may each pivot relative to the pivot member  126 . 
         [0123]    Further, the first linkage member  122  may be pivotably interconnected to the distal end of the first or the second elongate member. In one embodiment, the first linkage member  122  may be pivotably interconnected to the inner member  72  via a pivot member  150  (located on axis E-E), wherein the first linkage member  122  may pivot relative to the pivot member  150  (located on axis E-E). 
         [0124]    In like fashion, the second jaw member  130  may be pivotably interconnected to the second articulating member  140  via pivot member  144  (located on axis F-F), wherein the second jaw member  130  and second articulating member  140  may each pivot relative to the pivot member  144 . 
         [0125]    The second articulating member  140  may be pivotably interconnected to the second linkage member  142  via pivot member  146  (located on axis (G-G). In one embodiment, the second articulating member  140  and the second linkage member  142  may pivot with respect to one another at an axis G-G. The first articulating member  140  and the second linkage member  142  may each pivot relative to the pivot member  146 . Further, the second linkage member  142  may be pivotably interconnected to the distal end of one of the first or the second elongate members. In one embodiment, the second linkage member  142  is connected to the inner member  72  via a pivot member  150 , wherein the second linkage member  142  may pivot relative to the pivot member  150 . 
         [0126]    As shown in  FIG. 5C  the first jaw member  110  may include a slot  112  passing therethrough. Similarly, as shown in  FIG. 5D  the second jaw member  130  may be provided with a slot  114  passing therethrough. In turn, the tissue grasper  100  may further include a first shaft  160  (coinciding with axis C-C) fixedly interconnected to a yolk member (not shown in  FIGS. 5A ,  5 C, and  5 D). The yolk member  170  may be fixedly interconnected to the distal end of the first or the second elongate member. For instance, as shown, the yolk member  170  may be interconnected to the distal end of the external member  74  of the endoscopic tool  1 . The first shaft  160  may be disposed through the slot  112  of the first jaw member  110  and the slot  114  of the second jaw member  130 . As will become apparent herein below, first jaw member  110  and the second jaw member  130  may move relative to the first shaft member  160  in response to movement of the first elongate member with respect to the second elongate member and of the rotation of the first articulating member  120  and the second articulating member  140 , respectively. In the illustrated approach, slot  112  of the first jaw member  110  and slot  114  of the second jaw member  130  may slide relative to the first shaft  160 . In addition, the first jaw member  110  and second jaw member  130  may also pivot with respect to the first shaft  160 . Accordingly, the first and second jaw members  110  and  130  may pivotally and slidingly engage the first shaft  160 . In turn, and as will be further described, the distance between the first shaft  160  and distal ends of first and second jaw members  110 ,  130  is less in the closed jaw position than in the open jaw position. Conversely, a distance between the first shaft  160  and the pivot member  124  is greater in the closed jaw position than the open jaw position. As may be appreciated, such arrangement facilitates the realization of increased grasping forces in response to a user&#39;s manipulation of handle  10  to effect relative movement of the distal ends of the first elongate member and second elongate member. 
         [0127]    As further illustrated by  FIGS. 5C , the tissue grasper  100  may further include a second shaft  162  coinciding with axis A-A extending through each of the first and second articulating members  120  and  140 . In turn, the second shaft  162  may be interconnected to the referenced yolk member of the tissue grasper  100  (not shown in  FIG. 5C ), wherein such yolk member may be fixedly interconnected to the distal end of the external member  74  of the endoscopic tool  1 . Accordingly, the first shaft  160  and the second shaft  162  may be arranged in a fixed apart fashion and held thusly by the yolk member (not shown). As it will become apparent hereinbelow, the first articulating member  120  and the second articulating members  140  may each pivot about the second shaft  162  in response to advancement/retraction of the inner member  72 . 
         [0128]    Reference is now made to  FIGS. 6A-6K , which illustrate the opening and the closing of a modified tissue grasper  100   a.  In this regard, the modified tissue grasper  100   a  may be of the same construction as tissue grasper  100  described hereinabove, with the exception that the opposing face portions of the first jaw member  110  and second jaw member  130  have been modified as illustrated. In turn, the reference numerals utilized in relation to the description associated with  FIGS. 5A-5C  are also utilized in relation to  FIGS. 6A-6K . 
         [0129]    As shown in  FIG. 6A , the tissue grasper  100   a  may include a yoke member  170  affixed to an outer member  74 . For purposes of illustration, the yoke  170  may be affixed to the outer member  74  such that axis A-A and axis C-C are in a fixed spatial relation relative to the outer member  74 . In conjunction, the inner member  72  may be in a fixed spatial relation relative to axis E-E. That is, yoke  170  may be provided in a fixed spatial relation between the distal end of the outer member  74  and axis A-A and axis C-C while inner member  72  may be provided in a fixed spatial relation with axis E-E. Thus, movement of axis E-E with respect to axis A-A and axis C-C may be facilitated. 
         [0130]    As shown in  FIG. 6B , the first elongate member and second elongate member may have begun to move between the first relative positions to the second relative position. This may result in the first linkage member  122  moving with respect to axis E-E and axis D-D. Additionally, axis E-E may move relative to axis A-A. In  FIG. 6B , the relative movement of axis E-E to axis A-A may cause the first linkage member  122  to initiate rotation of the first articulating member  120  from the first articulated position towards the second articulated position along the first path. The first articulating member  120  may rotate along the first path between the first articulated position and the second articulated position with respect to axis A-A and in turn the first jaw member  110   a  may begin to move from the closed position to the open position by moving with respect to axis B-B as the first articulating member also moves with respect to axis B-B. 
         [0131]      FIG. 6C  depicts the tissue grasper  100   a  as the first and the second elongate members have progressed further between the first relative position and the second relative position as was shown in  FIG. 6B . Axis E-E may continue to move with respect to axis A-A such that the first articulating member  120  continues to rotate about axis A-A along the first path in response to movement of the first and the second elongate members from the first relative position to the second relative position. Additionally, the first articulating member  120  may continue to move such that the position of axis B-B moves toward the second offset position which, in turn, may result in continued movement of the first jaw member  100   a  from the closed toward the open position. As the first and the second elongate members continue to move from the first relative position to the second relative position, the movements described above may continue as shown in  FIGS. 6D and 6E  until at  FIG. 6F  the first and the second elongate members have moved completely from the first relative position to the second relative position such that the first articulating member  120  has moved from the first articulated position to the second articulated position and the first jaw member  110   a  has moved from the closed position to a the open position. 
         [0132]    In other words, the first and the second linkage members  122  and  142  may be at least partially laterally advanced with respect to the second shaft  162 . Accordingly, a tangential force component  128  may be imparted on the first and the second articulating members  120  and  140  along the first and the second paths, such that the first and the second articulating members  120  and  140  may be rotated about the second shaft  162  along the first and the second paths, respectively. The pivot members  124  and  144  may be rotated along with the first articulating member  120  and the second articulating member  140 , respectively. This may cause the jaw members  110   a  and  130   a  to move with respect to the first shaft  160  (e.g., pivot about the first shaft  160 ). Accordingly, the jaw members  110   a  and  130   a  move relative to the first shaft  160  such that the first shaft  160  moves laterally along the slots  112  and  114  while the jaw member  110   a  and  130   a  also pivot about the first shaft  160 . Accordingly, the jaw members  110   a  and  130   a  are progressively moved to the open position. 
         [0133]    Reference is now made to  FIG. 6F  which shows the tissue grasper  100   a  in the open position. In such position, the slot  112  of the first jaw member  110   a  and slot of the second jaw member  130   a  have advanced relative to first shaft member  160 . In such position, the tissue grasper  100   a  may be located for grasping a tissue region of interest. 
         [0134]    The embodiment depicted in  FIGS. 6A and 6F  may have a grasping plane  700 . The grasping plane  700  generally may be arranged such that axis A-A, C-C, and E-E are all disposed within in the grasping plane  700 . As can be seen in  FIG. 6F , when in the open position the jaw members  110   a,    130   a  may be placed adjacent to tissue that lies on, adjacent to, or intersects the grasping plane  700  such that when the jaw members are in the closed positioned as shown in  FIG. 6A  the tissue may be retained between the jaw members  110   a,    130   a.  It should be noted that the axis A-A, C-C, and E-E may be lie within the grasping plane  700  in both the open and the closed position. 
         [0135]    Moreover, the axis A-A, C-C, and E-E may also be orthogonal relative to and intersecting a longitudinal axis of a distal end of one of the first or second elongate members. For instance, the axis A-A, C-C and E-E may be orthogonal relative to and intersecting a longitudinal axis of the internal member  72 . 
         [0136]    Reference is now made to  FIGS. 6F-6K  which progressively illustrate closure of the first and the second jaw members  110   a  and  130   a  in response to relative movement of first and the second elongate members. The yolk member  170  is not shown for purposes of clarity.  FIG. 6K  illustrates the tissue grasper  100   a  in the closed position, wherein slot  112  of first jaw member  110   a  and the slot of the second jaw member  130   a  are retracted relative to first shaft  160 . 
         [0137]      FIGS. 6G ,  6 H,  6 I and  6 J show a progression as the first and the second elongate members move from the second position toward the first position such that the first articulating member  120  moves from the second articulated position to the first articulated position along the first path and the first jaw member  110   a  moves from the open position to the closed position along the second path. During this progression, axis E-E may move with respect to axis A-A in a direction opposite of the direction in which axis E-E moved during the opening shown in  FIGS. 6A-6E . Additionally, the articulating member  120  may move in a direction along the first path between the first articulating member and the second articulated position in the direction opposite that which it traveled when moving from the first articulated position to the second articulated position. Similarly, the first jaw member  110   a  may move in the opposite direction from the open position to the closed position as it did from the closed position to the open position. 
         [0138]    In this regard, movement of the first and the second elongate members from the first relative position to the second relative position may result in the first articulating member  120  moving from the first articulated position to the second articulated position, the second articulating member  140  moving from the third articulated position to the fourth articulated position, the second jaw member  130   a  moving from the closed position to the open position, and the first jaw member  110   a  moving from the closed position to the open position. Conversely, movement of the first and the second elongate members from the second relative position to the first relative position may result in movement of the first articulating member  120  from the second articulated position to the first articulated position, the second articulating member  140  moving from the fourth articulated position to the third articulated position, the second jaw member  130   a  moving from the open position to the closed position, and the first jaw member  110   a  moving from the open position to the closed position. 
         [0139]    The closed positioning of the tissue grasper  100   a  may typically be employed during positioning of the tissue grasper  100   a  relative to a tissue region of interest. As shown in  FIG. 6A , tissue grasper  100   a  may include a yolk member  170 , as a referenced above. The yolk member  170  may include a proximal end portion  172  for fixed interconnection to one of the first or the second elongate members (e.g., the external member  74  (not shown) of the endoscopic tool  1 ). As shown in  FIG. 6A , first shaft  160  and the second shaft  162  may be interconnected to the yolk member  170 . 
         [0140]    As may be appreciated, the first and second jaw members  110   a  and  130   a  are effectively locked in the closed position shown in  FIG. 6K  by virtue of the illustrated and described arrangement. 
         [0141]      FIGS. 7A and 7B  show the tissue grasper  100   a  in closed position and a fully opened position, respectively. In  FIG. 7A , the tissue grasper  100   a  may be effectively locked such that a separating force  702  acting one the first jaw member  110   a  or second jaw member  130   a  may be resisted. The separating force  702  may include a force acting normally to the opposing face portions of the jaw member  110   a  and  130   a.  Thus, the separating force  702  may at least be partially directed in a manner with respect to the first jaw member  110   a  or second jaw member  130   a  such that the jaw member are urged toward the open position. As described above, movement of the first jaw member  110   a  from the closed position to the open position results in a corresponding movement of the first articulating member between the first and the second articulated positions. As depicted in  FIG. 7A , the separating force  702  may act on the first jaw member  110   a  yet no force may be affected to the first articulating member  120  that will result in movement of the first articulating member along the first path (i.e., between the first articulated position shown in  FIG. 7A  and the second articulated position shown in  FIG. 7B ). 
         [0142]    As such, the first jaw member  110   a  will not move from the closed position to the open position upon application of the separating force  702  to the jaw member  110   a  when the tissue grasper  100   a  is in the closed position as shown in  FIG. 7A . This may be due in part to lack of movement of the first articulating member  120  as no force is not acting on the first articulating member  120  to move the first articulating member  120  along the first path between the first and the second articulated position. For example, in  FIG. 7A , a separating force  702  acting on the first jaw member  110   a  may tend to cause the first jaw member  110   a  to attempt to pivot with respect to axis C-C. A rotation about axis C-C may also correspond in force acting at axis B-B with respect to axis A-A. 
         [0143]    However, in  FIG. 7A , all force transferred from the separating force  702  acting on the first jaw member  110   a  may result in axis B-B simply being urged towards axis A-A as shown by the resulting force  704 . That is, no resulting tangential force (e.g., force  128  as shown in  FIGS. 6B-6E ) may be affected to the first articulating member  120 . Thus, the articulating member  120  may not be rotated between the first and the second articulated position. That is, based on the arrangement of the first articulating member  120  with respect to the first jaw member  110   a,  any resulting force  704  acting between axis B-B and axis A-A may be directed along the direction between axis A-A and B-B as shown in  FIG. 7A . 
         [0144]    As stated above, movement of the first jaw member  110   a  includes a corresponding movement of the first articulating member  120 . In  FIG. 7A , the separating force  702  acting on jaw member  110   a  does not result in force acting on the first articulating member  120  at axis B-B along the first path. That is, the spatial arrangement of the first articulating member  120  with respect to the first jaw member  110   a  does not result in rotation upon receiving a separating force  702  on the first jaw member  110   a  because no force acts on the first articulating member  120  along the first path (e.g., tangentially to the first articulating member  120  with respect to axis A-A). 
         [0145]    As shown in  FIG. 8A , the arrangement of axis C-C, axis A-A and axis B-B may include an angle  800  therebetween that is substantially a  90 ° angle when the tissue grasper  100   a  is in the closed position. In so much as the angle  800  formed by axis C-C, axis A-A, and axis B-B forms at least a 90 degree angle, the any resulting force vector  704  acting on the first articulating member  120  at axis B-B may be directed toward axis A-A such that no component of the vector extends in a tangential direction with respect to the first articulating member  120  and axis A-A. As no tangential force acts on the articulating member  120 , as is required to move the articulating member  120  along the first path between the first articulated member and the second articulated member, the tissue grasper assembly  100   a  in turn may not move between the closed and the open position. That is, movement between the closed and the open position of the jaw member  110   a  is effectively resisted because no force results from an application of the separation force on  110   a  onto the first articulating member  120  tending to move the articulating member  120  along the first path between the first and the second articulated position. 
         [0146]    Stated differently, the opening force  702  may be transferred to pivot member  124 . The result may be a resultant force  704  acting on the first articulating member  120  at the pivot member  124 . Because when in closed position as shown in  FIG. 8A , the first angular position (represented by the axis  806 ) of the pivot member  124  may be substantially perpendicular to an axis segment  804  defined between the centerlines of the first shaft  160  and the second shaft  162 , any resulting force  704  acting on the pivot member  124  may be directed perpendicularly to the axis segment  804  and in a radial direction with respect to the first articulating members  120 . That is, the resulting force  704  acts substantially radially on the first articulating member  120 . As no tangential force component acts on the first articulating member  120  as a result of the arrangement of the components, the first articulating member  120  may not rotate in response to the application of the opening forces  702  to the first jaw member  110   a.    
         [0147]    Alternatively, the angle  800  may be greater than 90 degrees As such, a resultant force  704  acting on the first or the second articulating members  120  or  140  may cause the first articulating member  120  to receive a tangential force in a direction not along the first path. However, any further rotation of the first articulating member  120  beyond the first path may be impeded or prevented by interference between the first jaw member  110   a  and the second shaft  162 . Accordingly, any resultant tangential force acting with respect to the first articulating member  120  may be resisted as the first jaw member  110   a  interferes with the second shaft  162  such that any rotation of the first articulating member  162  is resisted. Furthermore, as the resulting tangential force acting on the first articulating member  120  when the angle  800  is greater than 90 degrees urges the first articulating member  120  away from the second articulated position, the resultant force does not act along the first path. As stated above, the first path may run from the first articulated position to the second articulated position. As the first articulating member  120  may be in the first articulated position as shown in  FIG. 8A , any resultant tangential force when the angle  800  is greater than 90 degrees will urge the first articulating member  120  away from the second articulated position. Thus, the resultant tangential force will not act along the first path spanning between the first articulated position and the second articulated position. 
         [0148]    However, when the tissue grasper  100   a  is in the open position or is between the open position and the closed position, axis B-B, axis A-A, and axis C-C may form an included angle  800 ′ of less than 90 degrees. Thus, the tissue grasper  100   a  may not be locked as a resulting force may include a force vector urging the first articulating member  120  along the first path. Thus, when the included angle  800 ′ between axis B-B, axis A-A, and axis C-C is less than 90 degrees, the tissue grasper may not be in a locked position. 
         [0149]    While the above locking of the tissue grasper  100   a  has been primarily discussed with regard to the first articulating member  120  resisting an opening force, it is to be understood that the same principles apply with respect to the second articulating member  140 . That is, axis A-A, axis C-C, and axis F-F may form at least a 90 degree angle when in the closed position such that no tangential force results from a separating force  702  on the second articulating member to cause it to move in the second path. Thus, the second jaw member  130   a  may also resist movement to the open position when in the closed position. 
         [0150]    As noted above, it will be appreciated that when in the closed arrangement, the transfer of forces resulting from the relative movement of the first and second elongate member may be greater when the tissue grasper  100   a  is in the closed jaw position than when in the open jaw position. This may result from changing dimensions of lever arms. For instance, a first lever arm may be defined between axis B-B and axis C-C. Movement of this lever arm may effect and thereby correspond to movement of the first jaw member  110   a  including a distal end thereof. Accordingly a second lever arm may be defined from the distal end of the first jaw member  110   a  to axis C-C. 
         [0151]    When in the closed jaw position, a length of the first lever arm may be greater than when in the open jaw position. Conversely, the length of the second lever arm may be less when in the closed jaw position than when in the open jaw position. Accordingly, the ratio of the first lever arm to the second lever arm may be greater when in the closed jaw position than when in the open jaw position. As such, the mechanical advantage realized by the lever arms may be greater when in the closed jaw position than in the open jaw position. 
         [0152]    Similarly, the second jaw member  130   a  may have similar characteristics. That is, a third lever arm may extend from axis F-F to axis C-C. The length of this lever arm may be greater when in the closed jaw position than when in the open jaw position. A corresponding fourth lever arm having a distance from a distal end of the second jaw member  130   a  to axis C-C may be shorter when in the closed jaw position than when in the open jaw position. Accordingly, a ratio between the third and forth lever arms may be greater when in the closed jaw position such that the mechanical advantage realized may be greater when the second jaw member  130   a  is in the closed jaw position than when in the open jaw position. 
         [0153]    The embodiment descriptions provided hereinabove are strictly for purposes of illustration and are not intended to limit the scope of the present invention. Modifications, additions and adaptations will be apparent to those skilled in the art and are intended to be within the scope of the present invention.