Abstract:
Instrument handles isolate the functions of supporting the instrument and actuating controls on the instrument. An instrument handle may be grasped and supported by the less dexterous digits and palm of a human hand, and controls mounted on the instrument handle may be actuated by the more dexterous digits. The instrument handle may couple to an end effector so that the hand, wrist, elbow, and shoulder remain in a comfortable position when the end effector is positioned to act effectively on a selected portion of a workpiece, such as a surgical site.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]    This application claims the benefit of the filing date of: 
         [0002]    U.S. Provisional Patent Application No. 61/311,058, which was filed on Mar. 5, 2010, is entitled ERGONOMIC SURGICAL INSTRUMENT HANDLE, and carries Attorney&#39;s docket no. IWO-5 PROV. The contents of U.S. Application No. 61/311,058 are hereby incorporated by reference as part of this application. 
         [0003]    This application also claims the benefit of the filing date of: 
         [0004]    U.S. Provisional Patent Application No. 61/373,385, which was filed on Aug. 13, 2010, is entitled ERGONOMIC SURGICAL INSTRUMENT HANDLE, and carries Attorney&#39;s docket no. IWO-8 PROV. The contents of U.S. Application No. 61/373,385 are hereby incorporated by reference as part of this application. 
     
    
     BACKGROUND OF THE INVENTION  
       [0005]    The present disclosure relates to handle designs for improved stability, comfort, and control. While the present disclosure is made in the context of handles for surgical instruments, such as arthroscopic, laparoscopic, endoscopic, minimally invasive instruments, or other instruments, among others, the principles embodied in the present disclosure may be applicable outside the fields of surgery or medical devices. 
         [0006]    Most manually actuated instruments used in the areas of arthroscopic or laparoscopic surgery are supported, or grounded, by the thumb and one or more of the fingers of a user&#39;s hand. Typically, such instruments are supported by inserting the thumb through a loop on a rear handle, which may be a stationary handle, and inserting one or more fingers through a loop on a front handle, which may be a movable handle. These instruments are often actuated by opening or closing the opposing handles with the thumb and finger(s) of the working hand. Such an arrangement may make it difficult to keep a working tip, or end effector, of the instrument stabilized at a precise location relative to a patient&#39;s anatomy, because the fingers that must stabilize the end effector are the same ones that must move to actuate the end effector. It can be difficult or fatiguing for a user to adequately compensate for actuation movement in such an arrangement. 
         [0007]    Many manually actuated arthroscopic or laparoscopic instruments are designed as a set of several instruments, all with a consistent handle design and a consistent orientation between the handle and the end effector for all instruments in the set. Some instrument sets vary the end effector orientation by including some up- or down-angle end effectors. However, users may find themselves routinely adopting uncomfortable or injurious postures in order to simultaneously position an end effector in a desired orientation relative to a patient&#39;s anatomy, and position the hand to actuate the end effector. Occupational exposure to exaggerated postures may result in long term effects to the user, and have the potential to limit the efficacy of the instruments used. 
         [0008]    There is a need for instrument handles that isolate the functions of supporting the instrument and actuating the instrument. There is a need for a set of instrument handles, working shafts, or both, that provides different orientations between the user&#39;s hand and the end effector, so that a user may select from the set a handle and/or shaft that positions the end effector appropriately for a given application while permitting a comfortable, safe working posture. 
       SUMMARY OF THE INVENTION  
       [0009]    The present disclosure sets forth instrument handles that isolate the functions of supporting the instrument and actuating the instrument. In many of the disclosed embodiments, the handle may be stabilized by less dexterous portions of the hand, thus leaving more dexterous portions of the hand free to actuate the instrument. In some embodiments, the handle may be stabilized by the ulnar three fingers (middle, ring, and little fingers) and the palm or base of the thumb (thenar eminence), and may be actuated by the index finger and/or thumb. 
         [0010]    The present disclosure sets forth instrument handles that provide different orientations between the user&#39;s hand and the end effector. These handles permit the user to keep their shoulder, elbow, wrist, and hand in an ergonomically neutral position for a wide variety of end effector orientations. 
         [0011]    An ergonomically neutral position or posture minimizes stress and fatigue on muscles and joints during activity, thereby reducing the possibility of neuromuscular disorders or repetitive strain injuries to the body part or parts. A posture in which the upper arm hangs relaxed from the shoulder with the hands, wrists, and forearms straight, in-line and roughly parallel to the floor may be described as an ergonomically neutral position. The forearms may be rotated so that the thumbs are slightly elevated relative to the little fingers. 
         [0012]    In some embodiments of the present disclosure, a shaft may extend from the handle in line with the user&#39;s forearm. In other embodiments, the shaft may extend from the handle obliquely relative to the forearm. In still other embodiments, the shaft may be bent, curved, or twisted. In some embodiments, the handle may sit more squarely in the hand and in other embodiments, the handle may be more inclined within the hand. Some embodiments position the working shaft of the instrument beside the index finger, while others position the working shaft of the instrument between the index and middle fingers. Each of these embodiments may permit the user to keep their shoulder, elbow, wrist, and hand in an economically neutral position for a particular end effector orientation. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         [0013]      FIG. 1A  is a side perspective view of an instrument handle; 
           [0014]      FIG. 1B  is a top perspective view of the handle of  FIG. 1A  operatively assembled with an operative component; 
           [0015]      FIG. 1C  is a top view of the handle and operative component of  FIG. 1B ; and 
           [0016]      FIG. 1D  is a right view of the handle and operative component of  FIG. 1B ; 
           [0017]      FIG. 2  is another side perspective view of the handle of  FIG. 1A ; 
           [0018]      FIG. 3  is a side view of the handle of  FIG. 1A ; 
           [0019]      FIG. 4  is a top perspective view of the handle of  FIG. 1A ; 
           [0020]      FIG. 5  is a bottom perspective view of the handle of  FIG. 1A ; 
           [0021]      FIG. 6  is a side perspective view of another instrument handle; 
           [0022]      FIG. 7  is a side perspective view of the handle of  FIG. 6 ; 
           [0023]      FIG. 8  is another side perspective view of the handle of  FIG. 6 ; 
           [0024]      FIG. 9  is a top perspective view of the handle of  FIG. 6 ; 
           [0025]      FIG. 10  is a bottom perspective view of the handle of  FIG. 6 ; 
           [0026]      FIG. 11  is a side view of yet another instrument handle; 
           [0027]      FIG. 12  is a top perspective view of the handle of  FIG. 11 ; 
           [0028]      FIG. 13  is a side view of yet another instrument handle; 
           [0029]      FIG. 14  is a bottom perspective view of the handle of  FIG. 13 ; 
           [0030]      FIG. 15  is a top perspective view of the handle of  FIG. 13 ; 
           [0031]      FIG. 16  is a side perspective view of yet another instrument handle; 
           [0032]      FIG. 17  is another side perspective view of the handle of  FIG. 16 ; 
           [0033]      FIG. 18  is a side view of the handle of  FIG. 16 ; 
           [0034]      FIG. 19  is a top perspective view of the handle of  FIG. 16 ; 
           [0035]      FIG. 20  is a bottom perspective view of the handle of  FIG. 16 ; 
           [0036]      FIG. 21  is a side perspective view of yet another instrument handle; 
           [0037]      FIG. 22  is another side perspective view of the handle of  FIG. 21 ; 
           [0038]      FIG. 23  is a side view of the handle of  FIG. 21 ; 
           [0039]      FIG. 24  is another side view of the handle of  FIG. 21 ; 
           [0040]      FIG. 25  is a top perspective view of the handle of  FIG. 21 ; 
           [0041]      FIG. 26  is a bottom perspective view of the handle of  FIG. 21 ; and 
           [0042]      FIG. 27  is a side perspective view of yet another instrument handle. 
       
    
    
     DETAILED DESCRIPTION  
       [0043]    While certain embodiments have been shown and described in detail below, it will be clear to the person skilled in the art upon reading and understanding this disclosure that changes, modifications, and variations may be made and remain within the scope of the systems, kits, components, and methods described herein. Furthermore, while various features are grouped together in the embodiments for the purpose of streamlining the disclosure, it is appreciated that features from different embodiments may be combined to form additional embodiments which are all contemplated within the scope of the present disclosure. 
         [0044]    The following description and accompanying drawings are offered by way of illustration only. In particular, while the present disclosure sets forth an embodiment in the context of handles for surgical instruments, one of skill in the art will appreciate that the components, systems, kits, and methods may be applicable to handles in other fields. 
         [0045]    Not every feature of each embodiment is labeled in every figure in which that embodiment appears, in order to keep the figures clear. Similar reference numbers (for example, those that are identical except for the first numeral) are used to indicate similar features in different embodiments. 
         [0046]    Standard medical planes of reference and descriptive terminology are employed in this specification. A sagittal plane divides a body into right and left portions. A mid-sagittal plane divides the body into equal right and left halves. A coronal plane divides a body into anterior and posterior portions. A transverse plane divides a body into superior and inferior portions. Anterior means toward the front of the body. Posterior means toward the back of the body. Superior means toward the head. Inferior means toward the feet. Medial means toward the midline of the body. Lateral means away from the midline of the body. Axial means toward a central axis of the body. Abaxial means away from a central axis of the body. These descriptive terms may be applied to an animate or inanimate body. Ipsilateral means on the same side of the body. Contralateral means on the opposite side of the body. 
         [0047]    Referring to  FIGS. 1A-5 , an instrument handle  100  may include a frame  110 , a first control  130 , and a second control  150 . Handle  100  may be bilaterally symmetric about a mid-sagittal plane  101 . Referring to  FIGS. 1B-1D , handle  100  may be operatively assembled to an operative component  10  to form a complete surgical instrument. Handle  100  may be permanently or releasably coupled to operative component  10 . Handle  100  may couple to any one of a plurality of different operative components  10 . 
         [0048]    Frame  110  may include a fitting  102 , a body portion  114 , a finger portion  104 , and a palm portion  106 . Body portion  114 , finger portion  104 , and palm portion  106  may be arranged around three sides of frame  110 . Frame  110  may be bilaterally symmetric about the mid-sagittal plane  101  of handle  100 . Furthermore, fitting  102 , body portion  114 , finger portion  104 , and palm portion  106  may each be bilaterally symmetric about the mid-sagittal plane  101  of handle  100 . 
         [0049]    Fitting  102  may be described as a docking feature or connection feature to connect handle  100  to operative component  10 . For example, fitting  102  may be a socket, as shown in  FIGS. 1A-5 , a through hole, or a protrusion. 
         [0050]    Body portion  114  may be described as a portion of the frame  110  which supports fitting  102 , first control  130 , and second control  150 . Fitting  102  may be carried on a front segment of body portion  114 , as illustrated. Body portion  114  may extend generally in line with fitting  102 . However, body portion  114  may extend in another orientation relative to fitting  102 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand. In other words, the orientation between body portion  114  and fitting  102  may set an orientation between the mid-sagittal plane  101  and a center longitudinal axis of the shaft  14 . The center longitudinal axis may lie in the mid-sagittal plane  101  in line with the body portion  114  or at an angle to body portion  114 . The center longitudinal axis may lie parallel to, and offset from, the mid-sagittal plane  101 . The center longitudinal axis may lie at an angle to the mid-sagittal plane  101  so that the center longitudinal axis intersects the mid-sagittal plane  101 . 
         [0051]    Finger portion  104  may be described as a portion of the frame  110  for contacting one or more of the fingers of a human hand. Finger portion  104  may extend transversely from body portion  114 , and may be located close to fitting  102 . Finger portion  104  may include one or more indentations  108 .  FIGS. 1A-5  illustrate three indentations  108  which are sized, shaped, and positioned to fit the ulnar three fingers of a human hand. Finger portion  104  may also include one or more finger rests  116 .  FIGS. 1A-5  illustrate a finger rest  116  which is sized, shaped, and positioned to fit the outer side of the little finger. The indentations  108  and/or finger rests  116  may increase the accuracy or security with which a user can grasp handle  100 . 
         [0052]    Palm portion  106  may be described as a portion of the frame  110  for contacting the palm of a human hand. For example, palm portion  106  may contact the palm or thenar eminence of a human hand. Palm portion  106  may extend transversely from a rear segment of body portion  114  opposite the front segment, as illustrated, and thus may be located at a distance from fitting  102 . Palm portion  106  may blend smoothly with body portion  114 . Palm portion  106  may also connect to finger portion  104  at a distance from body portion  114 , and may blend smoothly with finger portion  104 . 
         [0053]    Frame  110  may include one or more apertures  112  between body portion  114 , finger portion  104 , and palm portion  106 . The embodiment of  FIGS. 1A-5  is shown with a large aperture  112  which hollows out a central portion of frame  110  so that body portion  114 , finger portion  104 , and palm portion  106  form a continuous perimeter around aperture  112 . The apertures  112  may reduce the mass of frame  110 , making the handle  100  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  110 . 
         [0054]    First control  130  may be described as an actuator for a first action or first mechanism of a surgical instrument. First control  130  may actuate a mechanical linkage within handle  100  and/or operative component  10 . For example, first control  130  may actuate a mechanism that pushes, pulls, or rotates at least a portion of the surgical instrument, such as a portion of an inner or outer shaft of the operative component  10 , or an end effector  12 . First control  130  may alternatively energize an electrical circuit within handle  100  and/or operative component  10 . The electrical circuit may provide a direct effect such as radio frequency ablation, cautery, imaging, ultrasonics, global positioning system (GPS), or electrical stimulation, among others. The electrical circuit may alternatively be coupled to a mechanical or electro-mechanical mechanism which provides a direct effect. First control  130  may alternatively energize a hydraulic circuit, such as suction or irrigation, among others. Some examples of a first control  130  are a lever, a button, a trigger, a toggle, a slider, a knob, a dial, a wheel, a plunger, or a switch. First control  130  may be biased to remain in a default, or normal, position unless actively actuated by a user. First control  130  may alternatively remain in the last selected position or setting until actuated by the user to another position or setting. First control  130  may include a plurality of settings. For example, first control  130  may be a three-position sliding switch, or a knob that can be turned to any desired rotational setting. First control  130  may be subdivided into separate portions, each portion controlling a corresponding one of the plurality of settings. For example, first control  130  may comprise a first button stacked over a second button, so that pressing the first button lightly actuates a first mechanism, and pressing the first button more heavily depresses the second button, actuating a second mechanism. In another example, first control  130  may be divided into left and right halves, each half independently operable. First control  130  may be at least partially integrally formed with frame  110 , or may be formed as a separate part and assembled to frame  110 .  FIGS. 1A-5  illustrate a first control  130  which is a spring biased lever or trigger that protrudes obliquely from the body portion  114  opposite the finger and palm portions  104 ,  106  at a distance from the fitting  102 . The illustrated first control  130  is hinged to the body portion  114  near the blend with palm portion  106  and is spring biased away from the body portion  114 . The illustrated first control  130  is actuated by pressing the first control  130  toward the body portion  114 , and automatically returns to the illustrated position when released. 
         [0055]    Second control  150  may be described as an actuator for a second action or a second mechanism of a surgical instrument. Second control  150  may share one, some, or all of the characteristics set forth for first control  130 . Second control  150  may embody a different subset of characteristics than first control  130 .  FIGS. 1A-5  illustrate a second control  150  which is a spring biased lever or trigger that protrudes transversely from the body portion  114  opposite the finger and palm portions  104 ,  106  near the fitting  102 . The illustrated second control  150  is hinged to the body portion  114  near the finger portion  104  and is spring biased toward the fitting  102 . The illustrated second control  150  is actuated by pulling the second control  150  away from the fitting  102  with the index finger, and automatically returns to the illustrated position when released. 
         [0056]    Referring to  FIGS. 1B-1D , operative component  10  includes a working segment, or an end effector  12  which performs one or more actions, such as a surgical function. For example, end effector  12  may bite, grasp, shear, cut, lift, poke, and/or punch. In these examples, end effector  12  may be described as a biter, a grasper, a scissors, a side cutter, an awl, and/or a punch. Operative component  10  may also be generally referred to as an end effector. For each of the examples, end effector  12  may have a functional plane  21  which relates to the direction of action of the end effector  12 . For example, an end effector  12  with jaws may have a functional plane  21  where the jaws touch when closed. In another example, a cutting end effector  12  may have a functional plane  21  that intersects a cutting edge of the end effector  12 . In yet another example, an end effector  12  with a rotating side-cutting burr inside a windowed outer housing may have a functional plane  21  through the axis of rotation of the burr and bisecting the window. Alternately, a functional plane  21  may lie across the window. 
         [0057]    End effector  12  may be mounted on a shaft  14  to position the end effector  12  a desired distance away from handle  100  when operative component  10  is operatively assembled with handle  100 . For example, shaft  14  may be long enough to pass through a surgical cannula and across a full width of a joint space. Shaft  14  may also include one or more bends, curves, or twists  16  in order to position end effector  12  in a desired orientation relative to the surgical anatomy when handle  100  is held in a physiologically neutral position. Shaft  14  may include a center longitudinal axis  23  relating to an end of the shaft  14  opposite the end effector  12 ; if bent, shaft  14  may include additional center longitudinal axes  25  relating to each additional portion of the shaft  14 . The end of the shaft  14  opposite the end effector  12  may be described as a connection segment because it can serve to connect end effector  12  to handle  100 .  FIGS. 1B-1C  illustrate an operative component  10  with an end effector  12  configured as a grasper. In the illustrated example, the functional plane  21  is a plane at which the grasper jaws meet when closed. In the illustrated example, the shaft  14  is straight except for bend  16 , thus shaft  14  has an axis  23  and an additional axis  25 . 
         [0058]    It can be appreciated from  FIGS. 1B-D  that the plane  21  lies at a compound angle to plane  101  in the illustrated example. This may be best seen in  FIGS. 1C-D , where plane  21  is at a first angle to plane  101  when viewed from the top ( FIG. 1C ), and at a second angle to plane  101  when viewed from the right ( FIG. 1D ). In other examples, however, the functional plane  21  may be at some other orientation, such as a single angle, parallel, or coplanar. By orienting the functional plane  21  as required to reach the relevant anatomy, while orienting the mid-sagittal plane  101  of the handle  100  as required to maintain a neutral wrist, elbow, and arm position, the handles and systems of the present disclosure reduce the need for a user to endure uncomfortable and potentially harmful postures. 
         [0059]    In use, handle  100  may be grasped by a human hand so that the palm portion  106  rests against the palm or thenar eminence; the finger portion  104  rests against the middle, ring, and little fingers with the little finger in an indentation  108  adjacent to the finger rest  116 , the middle finger in an indentation  108  adjacent to the fitting  102 , and the ring finger in an indentation  108  between the middle and little fingers; the thumb rests on the first control  130 ; the index finger rests on the second control  150 ; and the fitting  102  is positioned between the index and middle fingers so that a shaft  14  of an operative component may extend between the index and middle fingers. In use, handle  100  is supported between the palm or thenar eminence and the middle, ring, and little fingers so that the thumb and index finger are free to operate the first and second controls  130 ,  150  respectively. Furthermore, it can be appreciated that, in use, handle  100  is completely contained within the user&#39;s hand so that there is no projecting hardware other than the operative component  10 . 
         [0060]    Handle  100  may rest in a user&#39;s hand in a square orientation so that the shaft  14  extends from the handle  100  generally parallel to the forearm of the user. The illustrated handle  100  may be suited to situations in which the end effector  12  approaches the anatomy straight on. In other examples of handle  100 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  114  to fitting  102 . 
         [0061]    Operative component  10  may be advantageously stabilized and controlled when the shaft  14  is between the index and middle fingers. When the shaft  14  is between the index and middle fingers, the wrist becomes the primary joint for biomechanical control of the end effector  12 , and motion at the elbow and shoulder may be unnecessary. 
         [0062]    Referring to  FIGS. 6-10 , an instrument handle  200  may include a frame  210 , a first control  230 , and a second control  250 . Handle  200  may be bilaterally symmetric about a mid-sagittal plane like handle  100 . Handle  200  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  200  may be permanently or releasably coupled to operative component  10 . Handle  200  may couple to any one of a plurality of different operative components  10 . 
         [0063]    Frame  210  may include a fitting  202 , a body portion  214 , a finger portion  204 , and a palm portion  206 . Body portion  214 , finger portion  204 , and palm portion  206  may be arranged around three sides of frame  210 . Frame  210  may be bilaterally symmetric about the mid-sagittal plane of handle  200 . Furthermore, fitting  202 , body portion  214 , finger portion  204 , and palm portion  206  may each be bilaterally symmetric about the mid-sagittal plane of handle  200 . 
         [0064]    Fitting  202  may be described as a docking feature or connection feature to connect handle  200  to operative component  10 . For example, fitting  202  may be a socket, as shown in  FIGS. 6-10 , a through hole, or a protrusion. 
         [0065]    Body portion  214  may be described as a portion of the frame  210  which supports fitting  202 , first control  230 , and second control  250 . Fitting  202  may be carried on a front segment of body portion  214 , as illustrated. Body portion  214  may extend generally in line with fitting  202 . However, body portion  214  may extend in another orientation relative to fitting  202 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0066]    Finger portion  204  may be described as a portion of the frame  210  for contacting one or more of the fingers of a human hand. Finger portion  204  may extend obliquely from body portion  214  opposite fitting  202 . Finger portion  204  may include one or more indentations like handle  100 . However,  FIGS. 6-10  illustrate a finger portion  204  which is smooth, broad, and gently rounded. Finger portion  204  may also include one or more finger rests  216 .  FIGS. 6-10  illustrate a finger rest  216  which is sized, shaped, and positioned to fit the outer side of the little finger. The illustrated example of finger rest  216  is formed as an enlarged partial loop. The indentations and/or finger rests  216  may increase the accuracy or security with which a user can grasp handle  200 . 
         [0067]    Palm portion  206  may be described as a portion of the frame  210  for contacting the palm of a human hand. For example, palm portion  206  may contact the palm or thenar eminence of a human hand. Palm portion  206  may extend obliquely from body portion  214  opposite fitting  202  and generally parallel to finger portion  204 . Palm portion  206  may blend smoothly with body portion  214 . Palm portion  206  may also blend smoothly into finger rest  216 . 
         [0068]    Frame  210  may include one or more apertures  212  between body portion  214 , finger portion  204 , and palm portion  206 . The embodiment of  FIGS. 6-10  is shown with four large apertures  212  which hollow out a central portion of frame  210  so that body portion  214 , finger portion  204 , and palm portion  206  form a continuous perimeter around the apertures  212 . The apertures  212  may reduce the mass of frame  210 , making the handle  200  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  210 . 
         [0069]    First control  230  and second control  250  may be described as actuators for first and second mechanisms, respectively, of a surgical instrument. First and second controls  230 ,  250  may share one, some, or all of the characteristics set forth for first control  130 . First and second controls  230 ,  250  may embody different subsets of characteristics than first control  130 .  FIGS. 6-10  illustrate examples of first and second controls  230 ,  250 . The illustrated first control  230  is a spring biased lever or trigger that protrudes obliquely from the body portion  214  opposite the finger portion  204  and at a distance from the fitting  202 . The illustrated first control  230  is hinged to the body portion  214  near the blend with palm portion  206  and is spring biased away from the body portion  214 . The illustrated first control  230  is actuated by pressing the first control  230  toward the body portion  214 , and automatically returns to the illustrated position when released. The illustrated second control  250  is a spring biased lever or trigger that protrudes transversely from the body portion  214  opposite first control  230  and at a distance from the fitting  202 . The illustrated second control  250  and the finger portion  204  are on the same side of the fitting  202 . The illustrated second control  250  is hinged to the body portion  214  and is spring biased toward the fitting  102 . The illustrated second control  250  is actuated by pulling the second control  250  away from the fitting  202  with the index finger, and automatically returns to the illustrated position when released. 
         [0070]    In use, handle  200  may be grasped by a human hand so that the palm portion  206  rests against the palm or thenar eminence; the finger portion  204  rests against the middle, ring, and little fingers with the little finger adjacent to the finger rest  216 ; the thumb rests on the first control  230 ; the index finger rests on the second control  250 ; and the fitting  202  is positioned beside the index finger so that a shaft  14  of an operative component may extend beside the index finger. In use, handle  200  is supported between the palm or thenar eminence and the middle, ring, and little fingers so that the thumb and index finger are free to operate the first and second controls  230 ,  250 . Furthermore, it can be appreciated that, in use, handle  200  is completely contained within the user&#39;s hand so that there is no projecting hardware other than the operative component  10 . 
         [0071]    Handle  200  may rest in a user&#39;s hand in a forwardly-inclined orientation so that the shaft  14  extends from the handle  200  generally parallel to the forearm of the user. The illustrated handle  200  may also be suited to situations where the end effector  12  approaches the anatomy from below. In other examples of handle  200 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  214  to fitting  202 . It can also be appreciated that handle  200  may be favorably adapted for a user having a smaller grip span. 
         [0072]    Referring to  FIGS. 11-12 , an instrument handle  300  may include a frame  310 . Handle  300  may be bilaterally symmetric about a mid-sagittal plane like handle  100 . Handle  300  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  300  may be permanently or releasably coupled to operative component  10 . Handle  300  may couple to any one of a plurality of different operative components  10 . 
         [0073]    Frame  310  may include a fitting  302 , a body portion  314 , a finger portion  304 , and a palm portion  306 . Body portion  314 , finger portion  304 , and palm portion  306  may be arranged around three sides of frame  310 . Frame  310  may be bilaterally symmetric about the mid-sagittal plane of handle  300 . Furthermore, fitting  302 , body portion  314 , finger portion  304 , and palm portion  306  may each be bilaterally symmetric about the mid-sagittal plane of handle  300 . 
         [0074]    Fitting  302  may be described as a docking feature or connection feature to connect handle  300  to operative component  10 . For example, fitting  302  may be a socket, a through hole, or a protrusion. 
         [0075]    Body portion  314  may be described as a portion of the frame  310  which supports fitting  302 . Body portion  314  may extend generally in line with fitting  302 . However, body portion  314  may extend in another orientation relative to fitting  302 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0076]    Finger portion  304  may be described as a portion of the frame  310  for contacting one or more of the fingers of a human hand. Finger portion  304  may extend obliquely from body portion  314  opposite fitting  302 . Finger portion  304  may include one or more indentations like handle  100 . However,  FIGS. 11-12  illustrate a finger portion  304  which is smooth, broad, and gently rounded. Finger portion  304  may also include one or more finger rests  316 .  FIGS. 11-12  illustrate a finger rest  316  which is sized, shaped, and positioned to fit the outer side of the little finger. The indentations and/or finger rests  316  may increase the accuracy or security with which a user can grasp handle  300 . 
         [0077]    Palm portion  306  may be described as a portion of the frame  310  for contacting the palm of a human hand. For example, palm portion  306  may contact the palm or thenar eminence of a human hand. Palm portion  306  may extend obliquely from body portion  314  opposite fitting  302  and generally parallel to finger portion  304 . Palm portion  306  may blend smoothly with body portion  314 . Palm portion  306  may connect to finger portion  304  opposite body portion  314 . 
         [0078]    Frame  310  may include one or more apertures  312  between body portion  314 , finger portion  304 , and palm portion  306 . The embodiment of  FIGS. 11-12  is shown with a large aperture  312  which hollows out a central portion of frame  310  so that body portion  314 , finger portion  304 , and palm portion  306  form a continuous perimeter around the aperture  312 . The aperture  312  may reduce the mass of frame  310 , making the handle  300  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  310 . 
         [0079]    In use, handle  300  may be grasped by a human hand so that the palm portion  306  rests against the palm or thenar eminence; the finger portion  304  rests against the middle, ring, and little fingers with the little finger adjacent to the finger rest  316 ; and the fitting  302  is positioned beside the index finger so that a shaft  14  of an operative component may extend beside the index finger. In use, handle  300  is supported between the palm or thenar eminence and the middle, ring, and little fingers. Furthermore, it can be appreciated that, in use, handle  300  is completely contained within the user&#39;s hand so that there is no projecting hardware other than the operative component  10 . 
         [0080]    Handle  300  may rest in a user&#39;s hand in an orientation that allows shaft  14  to extend from the handle  300  generally parallel to the forearm of the user. The illustrated handle  300  may be suited to situations in which the end effector  12  approaches the anatomy straight on. In other examples of handle  300 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  314  to fitting  302 . 
         [0081]    Referring to  FIGS. 13-15 , an instrument handle  400  may include a frame  410 , a first control  430 , and a second control  450 . Handle  400  may be bilaterally symmetric about a mid-sagittal plane like handle  100 . Handle  400  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  400  may be permanently or releasably coupled to operative component  10 . Handle  400  may couple to any one of a plurality of different operative components  10 . 
         [0082]    Frame  410  may include a fitting  402 , a body portion  414 , a finger portion  404 , and a palm portion  406 . Body portion  414 , finger portion  404 , and palm portion  406  may be arranged around three sides of frame  410 . Frame  410  may be bilaterally symmetric about the mid-sagittal plane of handle  400 . Furthermore, fitting  402 , body portion  414 , finger portion  404 , and palm portion  406  may each be bilaterally symmetric about the mid-sagittal plane of handle  400 . 
         [0083]    Fitting  402  may be described as a docking feature or connection feature to connect handle  400  to operative component  10 . For example, fitting  402  may be a socket, a through hole, or a protrusion. 
         [0084]    Body portion  414  may be described as a portion of the frame  410  which supports fitting  402 , first control  430 , and second control  450 . Body portion  414  may extend generally in line with fitting  402 . However, body portion  414  may extend in another orientation relative to fitting  402 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0085]    Finger portion  404  may be described as a portion of the frame  410  for contacting one or more of the fingers of a human hand. Finger portion  404  may be transverse to body portion  414  near fitting  402 . Finger portion  404  may include one or more indentations like handle  100 . However,  FIGS. 13-15  illustrate a finger portion  404  which is smooth, broad, and gently rounded. Finger portion  404  may also include one or more rests  416 .  FIGS. 13-15  illustrate a rest  416  which is sized, shaped, and positioned to fit the web between the thumb and index finger. The illustrated example of rest  416  is formed as an extended tail where the body portion  414  and the palm portion  406  meet. The indentations and/or rests  416  may increase the accuracy or security with which a user can grasp handle  400 . 
         [0086]    Palm portion  406  may be described as a portion of the frame  410  for contacting the palm of a human hand. For example, palm portion  406  may contact the palm or thenar eminence of a human hand. Palm portion  406  may extend transversely from body portion  414  opposite fitting  402  and generally parallel to finger portion  404 . Palm portion  406  may connect to finger portion  404  opposite body portion  414 . 
         [0087]    Frame  410  may include one or more apertures  412  between body portion  414 , finger portion  404 , and palm portion  406 . The embodiment of  FIGS. 13-15  is shown with a large aperture  412  which hollows out a central portion of frame  410  so that body portion  414 , finger portion  404 , and palm portion  406  form a perimeter around the aperture  412 . The apertures  412  may reduce the mass of frame  410 , making the handle  400  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  410 . Frame  410  may also be hollowed out in the vicinity of body portion  414 , palm portion  406 , and second control  450 . 
         [0088]    First control  430  and second control  450  may be described as actuators for first and second mechanisms, respectively, of a surgical instrument. First and second controls  430 ,  450  may share one, some, or all of the characteristics set forth for first control  130 . First and second controls  430 ,  450  may embody different subsets of characteristics than first control  130 .  FIGS. 13-15  illustrate examples of first and second controls  430 ,  450 . The illustrated first control  430  is a spring biased lever or trigger that protrudes obliquely from the body portion  414  opposite the finger and palm portions  404 ,  406  and at a distance from the fitting  402 . The illustrated first control  430  is hinged to the body portion  414  near the intersection with palm portion  406  and is spring biased away from the body portion  414 . The illustrated first control  430  is actuated by pressing the first control  430  forward toward the body portion  414 , and automatically returns to the illustrated position when released. The illustrated second control  450  is a spring biased lever or trigger that protrudes transversely from the body portion  414  opposite first control  430  generally in line with finger portion  404  and at a distance from the fitting  402 . The illustrated second control  450  and the finger portion  404  are on the same side of the fitting  402 . The illustrated second control  450  is hinged to the body portion  414  and is spring biased toward the fitting  102 . The illustrated second control  450  is actuated by pulling the second control  450  away from the fitting  402  with the index finger, and automatically returns to the illustrated position when released. 
         [0089]    In use, handle  400  may be grasped by a human hand so that the palm portion  406  rests against the palm or thenar eminence; the finger portion  404  rests against the middle, ring, and little fingers with the web between the thumb and index finger adjacent to rest  416 ; the thumb rests on the first control  430 ; the index finger rests on the second control  450 ; and the fitting  402  is positioned beside the index finger so that a shaft  14  of an operative component may extend beside the index finger. In use, handle  400  is supported between the palm or thenar eminence and the middle, ring, and little fingers so that the index finger and thumb are free to operate the first and second controls  430 ,  450 . Furthermore, it can be appreciated that, in use, handle  400  is substantially contained within the user&#39;s hand so that there is no projecting hardware other than the rest  416  and the operative component  10 . 
         [0090]    Handle  400  may rest in a user&#39;s hand in a square orientation so that the shaft  14  extends from the handle  400  generally parallel to the forearm of the user. The illustrated handle  400  may be suited to situations where the end effector  12  approaches the anatomy straight on. In other examples of handle  400 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  414  to fitting  402 . 
         [0091]    Referring to  FIGS. 16-20 , an instrument handle  500  may include a frame  510 , a first control  530 , and a second control  550 . Handle  500  may be bilaterally symmetric about a mid-sagittal plane like handle  100 . Handle  500  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  500  may be permanently or releasably coupled to operative component  10 . Handle  500  may couple to any one of a plurality of different operative components  10 . 
         [0092]    Frame  510  may include a fitting  502 , a body portion  514 , a finger portion  504 , and a palm portion  506 . Body portion  514 , finger portion  504 , and palm portion  506  may be arranged around three sides of frame  510 . Frame  510  may be bilaterally symmetric about the mid-sagittal plane of handle  500 . Furthermore, fitting  502 , body portion  514 , finger portion  504 , and palm portion  506  may each be bilaterally symmetric about the mid-sagittal plane of handle  500 . 
         [0093]    Fitting  502  may be described as a docking feature or connection feature to connect handle  500  to operative component  10 . For example, fitting  502  may be a socket, a through hole as shown in  FIGS. 16-20 , or a protrusion. 
         [0094]    Body portion  514  may be described as a portion of the frame  510  which supports first control  530  and second control  550 . Body portion  514  may also support fitting  502 . Body portion  514  may extend generally parallel to fitting  502 . However, body portion  514  may extend in another orientation relative to fitting  502 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0095]    Finger portion  504  may be described as a portion of the frame  510  for contacting one or more of the fingers of a human hand. Finger portion  504  may be transverse to body portion  514 . Finger portion  504  may support fitting  502 . Finger portion  504  may include one or more indentations  508  like handle  100 .  FIGS. 16-20  illustrate a finger portion  504  which has three indentations  508 . Finger portion  504  may also include one or more rests, which may be finger rests, web rests, or thumb rests. However,  FIGS. 16-20  illustrate a handle  500  without prominent rests. The indentations  508  and/or rests may increase the accuracy or security with which a user can grasp handle  500 . 
         [0096]    Palm portion  506  may be described as a portion of the frame  510  for contacting the palm of a human hand. For example, palm portion  506  may contact the palm or thenar eminence of a human hand. Palm portion  506  may extend transversely from body portion  514  opposite fitting  502  and generally parallel to finger portion  504 . Palm portion  506  may connect to finger portion  504  opposite body portion  514 . 
         [0097]    Frame  510  may include one or more apertures  512  between body portion  514 , finger portion  504 , and palm portion  506 . The embodiment of  FIGS. 16-20  is shown with two apertures  512  which hollow out a central portion of frame  510  so that body portion  514 , finger portion  504 , and palm portion  506  form a perimeter around the apertures  512 . The apertures  512  may reduce the mass of frame  510 , making the handle  500  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  510 . 
         [0098]    First control  530  and second control  550  may be described as actuators for first and second mechanisms, respectively, of a surgical instrument. First and second controls  530 ,  550  may share one, some, or all of the characteristics set forth for first control  130 . First and second controls  530 ,  550  may embody different subsets of characteristics than first control  130 .  FIGS. 16-20  illustrate examples of first and second controls  530 ,  550 . The illustrated first control  530  is a spring biased lever or trigger that protrudes obliquely from the body portion  514  opposite the finger and palm portions  504 ,  506 . The illustrated first control  530  is hinged to the front of body portion  514  near the intersection with finger portion  504  and is spring biased away from the body portion  514 . The illustrated first control  530  is actuated by pressing the first control  530  down toward the body portion  514 , and automatically returns to the illustrated position when released. The illustrated second control  550  is a spring biased lever or trigger that protrudes transversely from the body portion  514  opposite first control  530  generally in line with finger portion  504 . The illustrated second control  550  and the finger portion  504  are on opposite sides of the fitting  502 . The illustrated second control  550  is hinged to the front of body portion  514  and is spring biased toward the fitting  102 , i.e., the front of body portion  514 .  FIGS. 16-20  illustrate an arrangement in which the first and second controls  530 ,  550  share a single hinge. The illustrated second control  550  is actuated by pulling the second control  550  back from the fitting  502  with the index finger, and automatically returns to the illustrated position when released. 
         [0099]    In use, handle  500  may be grasped by a human hand so that the palm portion  506  rests against the palm or thenar eminence; the middle, ring, and little fingers rest against the finger portion  504  in the indentations  508 ; the thumb rests on the first control  530 ; the index finger rests on the second control  550 ; and the fitting  502  is positioned between the index and middle fingers so that a shaft  14  of an operative component may extend between the index and middle fingers. In use, handle  500  is supported between the palm or thenar eminence and the middle, ring, and little fingers so that the index finger and thumb are free to operate the first and second controls  530 ,  550 . Furthermore, it can be appreciated that, in use, handle  500  is completely contained within the user&#39;s hand so that there is no projecting hardware other than the operative component  10 . 
         [0100]    Handle  500  may rest in a user&#39;s hand in an upright orientation. Handle  500  may also be suited to situations where the end effector  12  approaches the anatomy straight on. In other examples of handle  500 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  514  to fitting  502 . It can also be appreciated that handle  500  may be favorably adapted for a user having a smaller grip span. 
         [0101]    Referring to  FIGS. 21-26 , an instrument handle  600  may include a frame  610 , a first control  630 , and a second control  650 . Handle  600  may be bilaterally symmetric about a mid-sagittal plane like handle  100 . Handle  600  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  600  may be permanently or releasably coupled to operative component  10 . Handle  600  may couple to any one of a plurality of different operative components  10 . 
         [0102]    Frame  610  may include a fitting  602 , a body portion  614 , a finger portion  604 , and a palm portion  606 . Body portion  614 , finger portion  604 , and palm portion  606  may be arranged around three sides of frame  610 . Frame  610  may be bilaterally symmetric about the mid-sagittal plane of handle  600 . Furthermore, fitting  602 , body portion  614 , finger portion  604 , and palm portion  606  may each be bilaterally symmetric about the mid-sagittal plane of handle  600 . 
         [0103]    Fitting  602  may be described as a docking feature or connection feature to connect handle  600  to operative component  10 . For example, fitting  602  may be a socket, a through hole as shown in  FIGS. 21-26 , or a protrusion. 
         [0104]    Body portion  614  may be described as a portion of the frame  610  which supports first control  630  and second control  650 . Body portion  614  may also support fitting  602 . Body portion  614  may extend generally parallel to fitting  602 . However, body portion  614  may extend in another orientation relative to fitting  602 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0105]    Finger portion  604  may be described as a portion of the frame  610  for contacting one or more of the fingers of a human hand. Finger portion  604  may be transverse to body portion  614 . Finger portion  604  may support fitting  602 . Finger portion  604  may include one or more indentations  608  like handle  100 .  FIGS. 21-26  illustrate a finger portion  604  which has three indentations  608 . Finger portion  604  may also include one or more rests, which may be finger rests, web rests, or thumb rests. However,  FIGS. 21-26  illustrate a handle  600  without prominent rests. The indentations  608  and/or rests may increase the accuracy or security with which a user can grasp handle  600 . 
         [0106]    Palm portion  606  may be described as a portion of the frame  610  for contacting the palm of a human hand. For example, palm portion  606  may contact the palm or thenar eminence of a human hand. Palm portion  606  may extend transversely from body portion  614  opposite fitting  602  and generally parallel to finger portion  604 . Palm portion  606  may connect to finger portion  604  opposite body portion  614 . 
         [0107]    Frame  610  may include one or more apertures  612  between body portion  614 , finger portion  604 , and palm portion  606 . The embodiment of  FIGS. 21-26  is shown with two apertures  612  which hollow out a central portion of frame  610  so that body portion  614 , finger portion  604 , and palm portion  606  form a perimeter around the apertures  612 . The apertures  612  may reduce the mass of frame  610 , making the handle  600  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  610 . 
         [0108]    First control  630  and second control  650  may be described as actuators for first and second mechanisms, respectively, of a surgical instrument. First and second controls  630 ,  650  may share one, some, or all of the characteristics set forth for first control  130 . First and second controls  630 ,  650  may embody different subsets of characteristics than first control  130 .  FIGS. 21-26  illustrate examples of first and second controls  630 ,  650 . The illustrated first control  630  is a spring biased plunger that protrudes transversely from the body portion  614  opposite the finger and palm portions  604 ,  606 . The illustrated first control  630  is mounted to the body portion  614  between finger portion  604  and palm portion  606 , and is spring biased to protrude from the body portion  614 . The illustrated first control  630  is actuated by pressing the first control  630  down toward the body portion  614 . First control  630  may automatically return to the protruding position when released. Alternately, first control  630  may remain in the depressed position until depressed again, at which point first control may return to the protruding position.  FIGS. 23-24  show first control  630  in the protruding and depressed positions. The illustrated second control  650  is a spring biased lever or trigger that protrudes transversely from the body portion  614  opposite first control  630  generally in line with finger portion  604 . The illustrated second control  650  and the finger portion  604  are on opposite sides of the fitting  602 . The illustrated second control  650  is hinged to the front of body portion  614  and is spring biased toward the fitting  102 , i.e., the front of body portion  614 . The illustrated second control  650  is actuated by pulling the second control  650  back from the fitting  602  with the index finger, and automatically returns to the illustrated position when released. 
         [0109]    In use, handle  600  may be grasped by a human hand so that the palm portion  606  rests against the palm or thenar eminence; the middle, ring, and little fingers rest against the finger portion  604  in the indentations  608 ; the thumb rests on the first control  630 ; the index finger rests on the second control  650 ; and the fitting  602  is positioned between the index and middle fingers so that a shaft  14  of an operative component may extend between the index and middle fingers. In use, handle  600  is supported between the palm or thenar eminence and the middle, ring, and little fingers so that the index finger and thumb are free to operate the first and second controls  630 ,  650 . Furthermore, it can be appreciated that, in use, handle  600  is completely contained within the user&#39;s hand so that there is no projecting hardware other than the operative component  10 . 
         [0110]    It can be appreciated that handle  600  may rest in a user&#39;s hand in an upright orientation. Handle  600  may also be suited to situations where the end effector  12  approaches the anatomy straight on. In other examples of handle  600 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  614  to fitting  602 . It can also be appreciated that handle  600  may be favorably adapted for a user having a smaller grip span. 
         [0111]    Referring to  FIG. 27 , an instrument handle  700  may include a frame  710 , an arm  770 , a first control  730 , and a second control  750 . One or more portions of handle  700  may be bilaterally symmetric about a mid-sagittal plane. Handle  700  may be operatively assembled to an operative component  10  to form a complete surgical instrument like handle  100 . Handle  700  may be permanently or releasably coupled to operative component  10 . Handle  700  may couple to any one of a plurality of different operative components  10 . 
         [0112]    Frame  710  may include a fitting  702 , a body portion  714 , and a palm portion  706 . One or more portions of frame  710  may be bilaterally symmetric about the mid-sagittal plane of handle  700 . Furthermore, fitting  702 , body portion  714 , and palm portion  706  may each be bilaterally symmetric about the mid-sagittal plane of handle  700 . 
         [0113]    Fitting  702  may be described as a docking feature or connection feature to connect handle  700  to operative component  10 . For example, fitting  702  may be a socket, a through hole, or a protrusion. 
         [0114]    Body portion  714  may be described as a portion of the frame  710  which supports fitting  702 , arm  770 , first control  730 , and second control  750 . Body portion  714  may extend generally parallel to fitting  702 . However, body portion  714  may extend in another orientation relative to fitting  702 , such as oblique or transverse, in order to position a shaft  14  of an operative component  10  in a desired orientation relative to a user&#39;s hand, as described for handle  100 . 
         [0115]    Palm portion  706  may be described as a portion of the frame  710  for contacting the palm of a human hand. For example, palm portion  706  may contact the palm or thenar eminence of a human hand. Palm portion  706  may extend obliquely from body portion  714  opposite fitting  702 . In the illustrated embodiment, palm portion  706  is a portion of an inner surface of a loop  718  which is sized, shaped, and positioned to encircle the base of a thumb of a human hand. Alternately, palm portion  706  may resemble other palm portions disclosed herein. 
         [0116]    Frame  710  may include one or more apertures  712 . The embodiment of  FIG. 27  is shown with an aperture  712  which hollows out a central portion of loop  718 . The aperture  712  may reduce the mass of frame  710 , making the handle  700  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate frame  710 . 
         [0117]    Arm  770  may be described as a projection from frame  710 . Arm  770  may extend obliquely from body portion  714  near fitting  702 , and may extend obliquely relative to palm portion  706  as well. Arm  770  may be fixed or movable relative to frame  710 . For example, arm  770  may be integrally formed with, welded to, or fastened to frame  710 . In another example, arm  770  may be hinged to frame  710  so that arm  770  may be positioned relatively closer to, or farther from, palm portion  706 . If movable, arm  770  may also be biased to remain in a nominal position unless actuated by a user. If movable, arm  770  may further be described as an actuator for a mechanism of a surgical instrument, as will be discussed below. Arm may include a finger portion  704 . 
         [0118]    Finger portion  704  may be described as a portion of arm  770  for contacting one or more of the fingers of a human hand. Finger portion  704  may extend obliquely relative to body portion  714 . Finger portion  704  may include one or more indentations  708  like handle  100 . However,  FIG. 27  illustrates a finger portion  704  which is smooth, broad, and gently rounded. Finger portion  704  may also include one or more rests, which may be finger rests, web rests, or thumb rests. However,  FIG. 27  illustrates a handle  700  without prominent rests. The indentations and/or rests may increase the accuracy or security with which a user can grasp handle  700 . In the illustrated embodiment, finger portion  704  is a portion of an inner surface of a loop  720  which is sized, shaped, and positioned to encircle the ulnar three fingers of a human hand. 
         [0119]    Arm  770  may include one or more apertures  712 . The embodiment of  FIG. 27  is shown with an aperture  712  which hollows out a central portion of loop  720 . The aperture  712  may reduce the mass of arm  770 , making the handle  700  lighter and easier to use for long periods of time. Reducing mass may decrease manufacturing costs by reducing the amount of material required to fabricate arm  770 . 
         [0120]    First control  730  and second control  750  may be described as actuators for first and second mechanisms, respectively, of a surgical instrument. First and second controls  730 ,  750  may share one, some, or all of the characteristics set forth for first control  130 . First and second controls  730 ,  750  may embody different subsets of characteristics than first control  130 .  FIG. 27  illustrates examples of first and second controls  730 ,  750 . The illustrated first control  730  is a spring biased lever or trigger that protrudes transversely from the body portion  714  opposite the finger and palm portions  704 ,  706 . The illustrated first control  730  is mounted to the body portion  714  between fitting  702  and palm portion  706 , and may be spring biased toward the rear of body portion  714 . Alternately, first control  730  may be biased toward the front of body portion  714 , i.e., toward fitting  702 . In another alternative, first control  730  may be biased to a middle position and movable forward and backward relative to the body portion  714 . The illustrated first control  730  may be actuated by pressing the first control  730  forward toward the fitting  702  or by pulling the first control  730  backward away from the fitting  702 . First control  730  may automatically return to the nominal biased position when released. Alternately, first control  730  may remain in the forward or backward position until pressed again, at which point first control may return to the nominal position. The illustrated second control  750  is a spring biased lever or trigger that protrudes transversely from the body portion  714  opposite first control  730  near fitting  702  and finger portion  704 . The illustrated second control  750  and the finger portion  704  are on the same side of the fitting  702 . The illustrated second control  750  is hinged to the front of body portion  714  and is spring biased toward the fitting  102 , i.e., the front of body portion  714 . The illustrated second control  750  is actuated by pulling the second control  750  back from the fitting  702  with the index finger, and automatically returns to the illustrated position when released. 
         [0121]    In use, handle  700  may be grasped by a human hand so that the palm portion  706  rests against the palm or thenar eminence with the thumb protruding through the loop  718 ; the middle, ring, and little fingers rest against the finger portion  704  with the middle, ring, and little fingers protruding through the loop  720 ; the thumb rests on the first control  730 ; the index finger rests on the second control  750 ; and the fitting  702  is positioned beside the index finger so that a shaft  14  of an operative component may extend beside the index finger. In use, handle  700  may be supported by the palm or thenar eminence alone so that the fingers and thumb are free to operate a movable embodiment of the arm  770 , the first control  730 , and the second control  750 . Handle  700  may also be at least partially supported by the middle, ring, and little fingers on a fixed or movable embodiment of the arm  770  so that the index finger and thumb are free to operate the first and second controls  730 ,  750 . 
         [0122]    While the illustrated handle  700  may rest in a user&#39;s hand so that the shaft  14  extends from the handle  700  generally parallel to the forearm of the user, in other examples of handle  700 , shaft  14  may extend obliquely or transversely relative to the forearm, as established by the orientation of body portion  714  to fitting  702 . 
         [0123]    In other examples of handles according to the present disclosure, only one control may be provided. In still other examples, more than two controls may be provided. In other examples, one or more of the controls may be replaced with static features that serve as additional rests. For example, first control  130  of handle  100  may be replaced with a static rest so that the index finger may be used to further stabilize the handle  100  in use. Any handle within the scope of the present disclosure may be further modified by including a web rest like rest  416 , or a thumb rest. 
         [0124]    Handles according to the present disclosure may be fabricated from metal, polymer, ceramic, elastomer, wood, glass, composite material, and combinations thereof. A single handle, or a single component part of a handle, may be fabricated from a combination of materials in order to provide an appropriate material for each feature of the handle or part. 
         [0125]    Handles of the present disclosure may be configured for unlimited repeated use, limited repeated use, or single use. Handles for unlimited repeated use may be designed more robustly and may be made from materials that are less susceptible to wear, corrosion, bending, cracking, or breaking. Handles for unlimited repeated use in a surgical setting may also be designed for easy cleaning and for repeated steam sterilization. Handles for single use may be designed to minimize cost of goods by selecting economical materials, fabrication methods, manufacturing processes, inspection methods, and tooling. For example, a single-use handle may incorporate an over-molded handle and an inner machined core, where the core is fabricated in a single set-up on a high-speed machine tool center. Single-use handles may have no provision for cleaning or sterilization. Single-use handles may also incorporate materials that degrade during steam sterilization, for example as a deterrent to off-label reuse. 
         [0126]    The handles set forth in the present disclosure may be provided in a kit which includes several different handle styles. The kit may include several versions of a single handle style, each with a different orientation of body portion to fitting. The kit may include different handle styles and different orientations of body portion to fitting. 
         [0127]    The handles of the present disclosure may also be provided in a kit which includes several different operative components. For example, the operative components may differ in the types of end effectors provided, the shaft configuration (straight, bent, twisted), shaft length. 
         [0128]    Any of the kits may be presented in a case or tray which organizes and positions the contents for easy selection and use. For example, a case may hold a selection of handles so that a user may select and grasp the handle in the proper functional orientation in one motion. In another example, a case may hold a selection of operative components so that a user may couple or decouple a handle and a selected operative component without releasing the user&#39;s functional grasp of the handle. 
         [0129]    While the present disclosure has been made in the context of handles for surgical instruments, the systems and methods described herein may have a broad range of applications beyond the fields of surgery or medical devices. 
         [0130]    It should be understood that the present components, systems, kits, apparatuses, and methods are not intended to be limited to the particular forms disclosed. Rather, they are intended to include all modifications, equivalents, and alternatives falling within the scope of the claims. They are further intended to include embodiments which may be formed by combining features from the disclosed embodiments. 
         [0131]    The claims are not to be interpreted as including means-plus- or step-plus-function limitations, unless such a limitation is explicitly recited in a given claim using the phrase(s) “means for” or “step for,” respectively. 
         [0132]    The term “coupled” is defined as connected, although not necessarily directly, and not necessarily mechanically. 
         [0133]    The use of the word “a” or “an” when used in conjunction with the term “comprising” in the claims and/or the specification may mean “one,” but it is also consistent with the meaning of “one or more” or “at least one.” The term “about” means, in general, the stated value plus or minus 5%. The use of the term “or” in the claims is used to mean “and/or” unless explicitly indicated to refer to alternatives only or the alternative are mutually exclusive, although the disclosure supports a definition that refers to only alternatives and “and/or.” 
         [0134]    The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”) and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a method or device that “comprises,” “has,” “includes” or “contains” one or more steps or elements, possesses those one or more steps or elements, but is not limited to possessing only those one or more elements. Likewise, a step of a method or an element of a device that “comprises,” “has,” “includes” or “contains” one or more features, possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.