Universal handle for medical instruments

A universal handle for medical instruments includes a first member movably disposed within a housing for detachably mounting a first medical instrument, a bias member for moving the first member toward a retracted or extended position near one end of the housing, a locking mechanism for engaging the first member in the retracted or extended position to prevent the bias member from moving the first member into the retracted or extended position, and a releasing mechanism including an operating member movable in response to a reduction in force acting on a component of the handle for triggering release of the locking mechanism to permit the bias member to move the first member to the retracted or extended position. A second member for detachably mounting a second medical instrument can be held stationary relative to the housing or can be movably disposed within the housing between extended and retracted positions. Opposite ends of the universal handle can be configured to provide at least one of a retracting and a protruding function as desired.

BACKGROUND OF THE INVENTION 
1. Field of the Invention 
The present invention relates to medical procedures and instruments and, 
more particularly, to a universal handle providing a retracting and/or a 
protruding function for medical instruments. 
2. Brief Description of the Related Art 
Penetrating instruments are widely used in medical procedures to gain 
access to anatomical cavities ranging in size from the abdomen to small 
blood vessels, such as veins and arteries, epidural, pleural and 
subarachnoid spaces, heart ventricles and spinal and synovial cavities. 
Use of penetrating instruments has become an extremely popular and 
important first step in endoscopic, or minimally invasive, surgery to 
establish an endoscopic portal for many various procedures, such as 
laproscopic procedures in the abdominal cavity. Such penetrating 
instruments typically include a cannula or portal sleeve and a penetrating 
member disposed within the cannula and having a sharp tip for penetrating 
an anatomical cavity wall with the force required to penetrate the cavity 
wall being dependent upon the type and thickness of the tissue forming the 
cavity wall. Once the wall is penetrated, it is desirable to protect the 
sharp tip of the penetrating member from inadvertent contact with or 
injury to tissue or organ structures in or forming the cavity in that, 
once penetration is achieved, the lack of tissue resistance can result in 
the sharp tip traveling too far into the cavity and injuring adjacent 
tissue or organ structures. 
Various safety penetrating instruments have been proposed, generally 
falling into protruding and retracting categories. In protruding safety 
penetrating instruments, a safety member is spring-biased to protrude 
beyond the tip of the penetrating member in response to the reduced force 
on the distal end of the safety member upon entering into the anatomical 
cavity. The safety member can be disposed around the penetrating member in 
which case the safety member is frequently referred to as a shield, or the 
safety member can be disposed within the penetrating member in which case 
the safety member is frequently referred to as a probe. In retracting 
safety penetrating instruments, the penetrating member is retracted into 
the cannula upon entry into the anatomical cavity in response to distal 
movement of a component of the safety penetrating instrument such as the 
penetrating member, the cannula, a probe or a safety member such as a 
shield or probe. 
A disadvantage of safety penetrating instruments in general is that 
relatively complex mechanisms are required to retract a penetrating member 
or protrude a safety member such that integral construction of the safety 
penetrating instruments requires sterilization or disposal of the entire 
unit after use, significantly increasing the cost of utilizing such 
instruments. Another disadvantage of the prior art instruments is that 
penetrating components, such as the penetrating member and safety member, 
are not interchangeable between penetrating instruments. As such, if the 
type or size of a penetrating component is not correct for the 
application, an entirely new safety penetrating instrument must be 
selected. Moreover, there is no flexibility to selectively match a 
particular penetrating component with a particular protruding or 
retracting power. 
SUMMARY OF THE INVENTION 
Accordingly, it is a primary object of the present invention to overcome 
the above-mentioned disadvantages of the prior art and to reduce the cost 
of using medical instruments by locating retracting and/or protruding 
mechanisms within a universal handle configured to detachably mount the 
medical instruments. 
It is another object of the present invention to facilitate disposal of 
medical instruments and reuse of mechanisms used for retracting and/or 
protruding the medical instruments in order to reduce the cost of using 
the medical instruments. 
Yet another object of the present invention is to standardize protruding 
and/or retracting mechanisms disposed within a universal handle configured 
to detachably mount a variety of medical instruments. 
Still another object of the present invention is to utilize opposite ends 
of a universal handle for selectively protruding and/or retracting medical 
instruments. 
Some of the advantages of the universal handle of the present invention are 
that, once use of a medical instrument has been exhausted, the medical 
instrument can be easily and safely removed from the universal handle such 
that the universal handle can subsequently be used in conjunction with 
another medical instrument. Thus, if the medical instruments are to be 
discarded, it is not necessary to discard the universal handle that 
contains retracting and/or protruding mechanisms. Such a universal handle 
greatly minimizes the cost of using medical instruments because only the 
instruments themselves need be thrown away without disposing of the 
universal handle that contains the retracting and/or protruding 
mechanisms. Thus, the universal handle of the present invention can be 
used many times over without the need for disposal. Also, by utilizing 
opposite ends of the universal handle to selectively protrude or retract 
medical instruments, the number of handles required to be kept on hand for 
performing the above functions is reduced. 
The present invention is generally characterized in a universal handle for 
medical instruments including a housing having proximal and distal ends; a 
first member disposed within the housing for detachably mounting a first 
medical instrument, the first member being movable between an extended 
position proximate the distal end of the housing and a retracted position 
proximate the proximal end of the housing; retracting means for moving the 
first member proximally toward the retracted position; locking means for 
engaging the first member in the extended position to prevent the 
retracting means from moving the first member into the retracted position; 
and releasing means including an operating member movable distally in 
response to a reduction in force acting on a component of the handle for 
triggering release of the locking means to permit the retracting means to 
move the first member to the retracted position. 
Another aspect of the present invention is generally characterized in a 
universal handle for medical instruments including a housing having 
proximal and distal ends; a first member disposed within the housing for 
detachably mounting a first medical instrument, the first member being 
movable between a retracted position proximate the proximal end of the 
housing and an extended protruding position proximate the distal end of 
the housing; extending means for moving the first member from the 
retracted position to the extended protruding position; locking means for 
engaging the first member in the retracted position to prevent the 
extending means from moving the first member into the extended position; 
and releasing means including an operating member carried by a component 
of the handle for triggering release of the locking means in response to a 
reduction in force acting on the component so as to permit the extending 
means to move the first member to the extended position. 
Yet another aspect of the present invention is characterized in a universal 
handle for medical instruments including a housing having first and second 
opposed ends; a first member disposed within the housing and having first 
and second opposed ends, the first end having a configuration for mounting 
a first medical instrument, the first member being movable between a rest 
position proximate the first end of the housing and a retracted position 
proximate the second end of the housing; a second member disposed within 
the housing and having first and second opposed ends, the second end of 
the second member having a configuration for detachably mounting a second 
medical instrument, the second member being movable between an extended 
position proximate the second end of the housing and a retracted position 
proximate the first end of the housing; bias means for biasing the first 
and second members toward the first end of the housing; locking means for 
locking the first member in the retracted position and the second member 
in the extended position; and releasing means including an operating 
member carried by a component of the handle for triggering release of the 
locking means in response to a reduction in force acting on the component 
so as to permit the bias means to move the first and second members toward 
the first end of the housing. 
Other objects and advantages of the present invention will become apparent 
from the following description of the preferred embodiments taken in 
conjunction with the accompanying drawings, wherein like parts in each of 
the several figures are identified by the same reference characters.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
The universal handle of the present invention is described hereinafter for 
use in holding medical instruments of the type used to form portals in 
anatomical cavity walls for the introduction of fluids and various 
surgical and diagnostic instruments into the cavity. It is understood, 
however, that the universal handle and method of the present invention can 
be used to hold any type of medical instrument as well as to provide a 
retracting and/or extending or protruding function to any medical 
instruments held. By "medical instrument," therefore, is meant any type of 
implement having a configuration useful for medical purposes including, 
for example, penetrating members such as trocars and needles, cannulae 
such as portal sleeves and catheters, safety shields and probes, cutting 
members such as blades, hooks, biopsy tools and viewing instruments such 
as endoscopes. 
A handle 40 according to the present invention is illustrated in FIGS. 1 
and 2 carrying a needle 42 for penetrating a wall of an anatomical cavity 
and a catheter 44 slidable over the needle for placement in the anatomical 
cavity wall. As best seen in FIG. 2, needle 42 has a cylindrical base 46 
at a proximal end with a central recess 48 formed therein and a beveled 
distal end 50. Catheter 44 includes an elongate tubular portion 52 with a 
round flange 54 at a proximal end. Needle 42 and catheter 44 are 
representative of the types of conventional medical instruments that can 
be used with the handle of the present invention. It will be appreciated, 
however, that medical instruments other than needles and catheters can be 
used. 
Universal handle 40 according to the present invention includes a housing 
56, a tubular mounting member 58 slidably disposed within the housing, and 
a retracting mechanism for locking the tubular member in an extended 
position within the housing and for releasing the tubular member to be 
moved proximally to a retracted position in response to a reduction in 
force acting on the tubular member. 
Housing 56 can be made of any medically-acceptable material depending on 
the desirability of being sterilizable for reuse or disposable for single 
patient use and can have any desirable configuration to facilitate 
grasping by the user. The housing shown is generally rectangular with 
opposed proximal and distal end walls 62 and 64 disposed transverse of 
perpendicular to a longitudinal axis of the handle, spaced top and bottom 
walls 66 and 68, and laterally spaced sidewalls 70 and 72. A longitudinal 
slot 74 is formed at the bottom of an elongate, trough-like recess 76 
defined in the housing top wall 66 to accommodate a knob 78 as will be 
described in more detail below. 
Tubular member 58 includes a first cylindrical portion 80 extending through 
an opening 82 formed in the distal end wall 64 of the housing, a 
cylindrical nub 84 of decreased diameter carried on a distal face 86 of 
the first cylindrical portion, a round flange 88 carried or formed at a 
proximal end of the first cylindrical portion and a second cylindrical 
portion 90 of decreased diameter extending proximally from the flange. The 
second cylindrical portion 90 is telescopically fitted over a guide tube 
92 extending from the proximal end wall 62 of the housing in longitudinal 
alignment with the opening 82 in the distal end wall 64 to permit sliding 
movement of the tubular member within the housing. 
A collar or chuck 94 having a generally trapezoidal cross-section extends 
from distal end wall 64 and is split longitudinally to form opposed 
wedge-shaped jaws 96 and 98 which, when closed together, form a distal 
retaining surface 99 preventing proximal movement of the base of the 
catheter 44. A cylindrical bore 101 is defined between the closed jaws in 
axial alignment with the opening 82 in the distal end wall and is 
configured to guide medical instruments toward the distal end of the 
tubular member 58 and to align mating portions of the instruments with the 
cylindrical nub 84 thereby easing attachment. The first cylindrical 
portion 80 of the tubular member is telescopically received within the 
bore 101 and is slidingly movable therein. The jaws 96 and 98 are 
pivotally mounted on pins or hinges 100 and 102 secured to the housing at 
opposite ends of the distal end wall 64 so that the jaws can be rotated 
apart as shown in FIG. 7 to expose the distal end of the tubular member 
58. The jaws are preferably spring-biased toward one another, for example 
using torsion springs (not shown). Alternatively, or in addition to being 
spring-biased toward one another the jaws can be held together in the 
closed condition by use of detents or any other suitable latching 
mechanism. 
A rail member 104 is disposed in housing 56 and is generally U-shaped 
including a forward wall 106 disposed transverse of perpendicular to a 
longitudinal axis of the housing, a rearward wall 108 in configuration 
parallel to forward wall 106 and a side wall 110 transversely joining the 
forward and rearward rail member walls. Tubular member flange 88 is 
disposed between the rail member forward and rearward walls with the rail 
member forward wall 106 having an opening therein allowing passage 
therethrough by the first cylindrical portion 80 of the tubular member 58. 
The rail member forward and rearward walls are disposed parallel or 
substantially parallel to flange 88, and a bias member 112 is connected 
between flange 88 and the rail member rearward wall 108 to bias the 
tubular member distally. As shown, bias member 112 includes a helical coil 
spring disposed around the second cylindrical portion 90 of the tubular 
member and mounted in compression between flange 88 and the rail member 
rearward wall 108 to bias the tubular member distally causing flange 88 to 
abut the rail member forward wall 106. However, bias member 112 can 
include various other types of springs as well as other types of bias 
devices including compression springs, tension springs, torsion springs, 
pan springs, leaf springs, rubber, plastic or magnets, for example. Rail 
member forward wall 106 extends toward the top wall 66 of housing 56, and 
a retracting member 114 is mounted between the rail member forward wall 
106 and the distal end wall 64 of housing 56 to bias the tubular member 58 
in a proximal direction to a retracted position within the housing as will 
be explained further below. The retracting member 114 can include a 
helical coil spring mounted in compression between the rail member forward 
wall 106 and the distal end wall 64 of the housing as shown, or the 
retracting member can include any other type of spring or other bias 
devices as discussed above for bias member 112. 
A post 116 extends upward from the rail member forward wall 106 through 
slot 74 in the housing top wall 66 to terminate at knob 78 positioned in 
the elongate, trough-like recess 76 formed in the housing top wall 66. 
Slot 74 and recess 76 extend longitudinally in parallel with the 
longitudinal axis of the handle 40. A stop 77 extends from the lateral 
side wall 110 of the rail-member and is disposed between the rail member 
forward and rearward walls to limit proximal movement of the tubular 
member flange 88 relative to the rail member. 
A locking and releasing mechanism 118 for locking the tubular member 58 in 
an extended position proximate the distal end of the housing and for 
releasing the tubular member to allow the tubular member to move to a 
retracted position proximate the proximal end of the housing includes a 
latch or locking spring 120, made of a strip of resilient material, formed 
to have a substantially flat base 122 secured to the bottom wall 68 of 
housing 56 and a bend 124 joining the base 122 with an upwardly angled arm 
126 spaced from the base. Arm 126 carries or forms a latch 128 having a 
proximal angled latching surface 130 joining a distal latching surface 132 
disposed substantially transverse to the longitudinal axis of the handle 
and substantially parallel to the rail member rearward wall 108. Arm 126 
has an extension 134 positioned distally of latch 128, and a releasing 
member or trigger 136 is juxtaposed with extension 134. The trigger 136 is 
pivotally mounted in housing 56 on a pin 138 secured to a wall or walls of 
the housing or structure supported in the housing, and the trigger is 
generally L-shaped with a leg 140 overlying extension 134 and a leg 142 
extending transversely from leg 140 but at a slight angle toward the 
proximal end of the handle. A torsion spring (not shown) is coiled around 
pin 138 and fixed to trigger 136 to bias the trigger counterclockwise, 
looking at FIG. 2, such that leg 140 is biased toward extension 134. 
In use, the handle 40 is typically supplied in the condition shown in FIG. 
5 but without any medical instruments attached. In the condition shown, 
the tubular member 58 is in a retracted position where the rail member 
rearward wall 108 is adjacent the proximal end wall 62 of the housing, 
flange 88 abuts the forward wall 106 of rail member 104 due to the bias of 
bias member 112, and knob 78 is disposed at a proximal end of slot 74 due 
to the bias of retracting member 114. 
Medical instruments can be attached to the handle 40 in a variety of ways, 
depending on the number and proximal configuration of the instruments. For 
example, in the case of a single medical instrument, such as needle 42, 
the proximal end of the instrument can be advanced proximally toward the 
tubular member 58 with the jaws 96 and 98 open as shown in FIG. 7, or 
closed as shown in FIG. 2, to frictionally couple the proximal end of the 
instrument with the cylindrical nub 84 at the distal end of the tubular 
member 58 so that the medical instrument and the tubular member will move 
together. If the jaws are opened to attach the medical instrument, the 
cylindrical nub 84 at the distal end of the tubular member will be exposed 
and, consequently, the proximal end of the instrument can be grasped and 
directly pushed onto the cylindrical nub to couple the instrument with the 
tubular member. If the proximal end of the medical instrument is about the 
same size as the bore, the jaws can be left closed and the medical 
instrument grasped distally of the proximal end so as to be advanced into 
the bore which will then serve as a guide centering the proximal end of 
the medical instrument with the nub to ease engagement. 
In the case of two medical instruments being mounted, such as the needle 42 
and catheter 44 shown, one is typically attached to the tubular member 58 
in a manner to move with the tubular member and the other medical 
instrument is engaged by the jaws 96 and 98 in a manner to prevent 
movement. For needle 42 and catheter 44, the needle is telescopically 
received within the catheter and is held therein by frictional contact 
under normal handling conditions such that it will not easily fall off. 
Thus, the needle 42 can be attached to the tubular member of handle 40 in 
the manner previously described and the catheter 44 can be slid proximally 
over the needle until the base 54 of the catheter abuts the distal 
retaining surface 99 formed by the jaws 96 and 98 when the jaws are 
closed. Catheter 44 is then retained in place and prevented from moving 
further proximally by the jaws while the needle 42 is free to move within 
the catheter. 
Alternatively, opposed surfaces of the jaws 96 and 98 can be configured to 
define a space, such as the annular recess shown in phantom at 161 in FIG. 
2, for receiving and restraining the proximal end of the medical 
instrument to be held stationary when the jaws are closed; and, when 
opposed surfaces of the jaws are configured to engage the proximal end of 
a medical instrument, such as the base 54 of catheter 44, the jaws will 
normally be opened to permit positioning of the medical instrument between 
the jaws. 
With one or more medical instruments attached, the handle 40 can be 
manually cocked or loaded to permit retraction of a medical instrument or 
left uncocked for use as a normal handle without retraction of a medical 
instrument. Operation of the retracting feature of the handle 40 will now 
be described with reference to use of a needle 42 and catheter 44 for 
penetrating an anatomical cavity. With needle 42 and catheter 44 attached 
to the handle 40 and prior to commencing penetration of the anatomical 
cavity wall W, knob 78 is grasped and manually moved distally to move the 
tubular member 58 and needle 42 distally against the bias of the 
retracting member 114 until the rearward wall 108 of rail member 104 rides 
over latch 128 by engaging the proximal latching surface 130 to move arm 
126 toward base 122. At this time, the user can feel the rail member 104 
lock into place in engagement with the distal latching surface 132 as arm 
126 springs back and can also visually determine that the tubular member 
is locked in the extended position by noting the position of knob 78 
within slot 74. 
The handle 40 is now in the position illustrated in FIG. 2 with the tubular 
member 58 and needle 42 locked in the extended position by locking and 
releasing mechanism 118. In the extended position, the distal end of the 
catheter 44 is preferably spaced proximally of the beveled distal end 50 
of the needle a distance x equal to the distance between the rail member 
forward wall 106 and the stop 77 so that the beveled distal end of the 
needle protrudes distally from the catheter in the extended position and 
lines up smoothly with the distal end of the catheter during penetration. 
In order to penetrate the anatomical cavity wall W, handle 40 is gripped 
and needle 42 is pushed against the anatomical cavity wall. Referring now 
to FIG. 3, the force from tissue contact on the distal end 50 of the 
needle 42 causes the tubular member 58 to move proximally within the 
housing 56 as the distal end of the needle penetrates into the cavity 
wall. The force from tissue contact on the distal end of the needle also 
causes the operating member formed by flange 88 of the tubular member to 
move proximally until the flange abuts the stop 77 carried by rail member 
104 which serves as an abutment limiting proximal movement of the tubular 
member relative to the rail member. The distal end of the catheter 44 is 
now aligned with the beveled tip 50 of the needle 42 to ease penetration. 
As the tubular member flange 88 moves proximally, the operating member 
formed thereby engages leg 142 to pivot trigger 136 clockwise, looking at 
FIG. 3, to allow the operating member to pass over the trigger. The 
clockwise pivotal movement of trigger 136 does not cause movement of the 
latch 128 since there is no engagement by either leg 140 or 142 with arm 
extension 134. Once the operating member passes by leg 142, the torsion 
spring biasing the leg returns trigger 136 to its normal position with leg 
140 overlying arm extension 134. Since the rail member 104 remains 
stationary during penetration of the anatomical cavity wall, no force is 
required to overcome the bias of retracting member 114. 
Once the distal end 50 of the needle 42 has passed through the anatomical 
cavity wall W, a reduction in the force from tissue contact on the distal 
end of the needle causes the tubular member 58 to move distally under the 
bias of bias member 112. As the tubular member moves distally, flange 88 
engages leg 142 of trigger 136 causing the trigger to pivot 
counterclockwise looking at FIG. 4 and causing leg 140 to engage arm 
extension 134 moving the arm 126 toward base 122 against the resilient 
force of spring strip 120. The movement of arm 126 away from the 
longitudinal axis of the handle causes latch 128 to move out of engagement 
with the rail member rearward wall 108 thereby allowing retracting member 
114 to move the tubular member 58 proximally to the retracted position 
where the rail member rearward wall 108 is disposed proximate the proximal 
end wall 62 of the housing and the distal end 50 of the needle 42 is 
retracted within the catheter 44 as illustrated in FIG. 5, thereby 
protecting tissue within the anatomical cavity from inadvertent contact 
with the distal end 50 of the needle. With the distal end of the catheter 
44 located within the anatomical cavity, the handle 40 can be withdrawn 
from the catheter 44 as shown in FIG. 6 such that the needle 42 remains 
attached to the handle, leaving the catheter in place to form a portal in 
the anatomical cavity wall for passage of fluids and/or medical 
instruments. The needle 42 can then be removed from the handle 40 by 
separating the jaws 96 and 98, for example, and dislodging the base 46 of 
the needle 42 from the cylindrical nub 84 at the end of the tubular member 
58 as shown in FIG. 7. Since jaws 96 and 98 can be opened to expose the 
base 46 of the needle 42, the user can grasp the needle near the proximal 
end for removal thereby avoiding body fluids and tissue which may be 
carried on or near the distal end 50 of the needle. The handle 40 can then 
be sterilized and prepared for use with new medical instruments in the 
manner previously described. 
It will also be appreciated that if the first medical instrument is a 
penetrating member and the second a safety sheath, the penetrating member 
and safety sheath can be attached to the handle and passed through a 
separate portal sleeve so that the penetrating member is retracted into 
the safety sheath and both the safety sheath and the penetrating member 
can be removed together with the handle maintaining the tip of the 
penetrating member in a protected condition within the sheath and leaving 
the separate portal sleeve in place within the wall of the anatomical 
cavity to form a portal for the introduction of medical instruments and/or 
fluids. 
A modification of the universal handle 40 of the present invention is shown 
in FIG. 8 at 146 wherein the upwardly angled arm 126 of locking spring 120 
extends from a distal end of the base 122 and arm extension 134 terminates 
proximally in an upwardly turned portion 148 extending transversely toward 
the longitudinal axis of the housing to form a latching surface for 
engaging the rail member rearward wall 108 when the tubular member 58 is 
in the extended position shown. When the tubular member is in the 
retracted position, the upwardly turned portion 148 of arm extension 134 
is disposed between the forward and rearward rail member walls, and the 
handle 146 can be locked in the extended or loaded position by advancing 
the knob 78 distally along the slot 74 formed in the top wall 66 of the 
housing causing the rail member forward wall 106 to engage trigger leg 142 
such that trigger 136 is rotated counterclockwise looking at FIG. 8 to 
drive trigger leg 140 against arm extension 134. Depression of arm 
extension 134 toward base 122 causes the upwardly turned portion 148 of 
the spring to move away from the longitudinal axis of the housing allowing 
rail member rearward wall 108 to pass over the turned portion toward the 
extended position. Once cocked or loaded, use of the universal handle 146 
is essentially the same as for handle 40 with the exception that 
counterclockwise rotation of trigger 136 for handle 146 causes 
disengagement of the upwardly turned portion 148 at the proximal end of 
arm extension 134. 
FIG. 9 illustrates another modification of a universal handle according to 
the present invention wherein the locking spring of the modified handle 
152 includes a flat base 154 secured to the proximal end wall 62 of the 
housing and a bend 156 joining the base with an arm 158 extending 
perpendicularly from the base in a distal direction. Arm 158 carries or 
forms a U-shaped latch 160 extending transversely toward the longitudinal 
axis of the housing for engaging the rail member rearward wall 108 when 
the tubular member 58 is in the extended position. A portion of the arm 
158 extends distally beyond the latch 160 to be positioned beneath trigger 
leg 140 so that counterclockwise rotation of the trigger 136 causes the 
arm 158 to move away from the longitudinal axis of the handle. Also in 
FIG. 9, opposed inner faces or surfaces of jaws 96 and 98 are shown 
forming an annular recess 161 for receiving the base of a medical 
instrument, such as a catheter, to hold the medical instrument in a fixed 
position relative to the housing. It will be appreciated, however, that 
other gripping or clamping configurations can be defined depending on the 
shape of the proximal end of the medical instrument to be held and the 
force holding the jaws together. 
In FIG. 10, an adapter 162 is shown engaging a proximal base portion 46 of 
a hollow needle 42 to prevent contamination of the handle by fluids 
entering the needle during penetration of an anatomical cavity wall and to 
convert the proximal end of the needle for use with the universal handle 
of the present invention. The adapter 162 includes a cylindrical body 163 
having an adapter protrusion 164 at a distal end engagable with the 
proximal end of a medical instrument, such as the base portion 46 of the 
hollow needle 42, and an adapter socket or recess 166 at a proximal end 
engagable with the distal end 84 of a mounting member, such as tubular 
member 58. In use, an adapter 162 is selected having a distal protrusion 
164 configured to mount the proximal end of a medical instrument to be 
coupled with a universal handle according to the present invention. The 
adapter 162 is inserted into the proximal end of the medical instrument 
and is held in place by frictional engagement. The medical instrument will 
then move with the adapter so that when the adapter is mounted on the 
distal end of the mounting member, movement of the mounting member will be 
imparted to the medical instrument. It will be appreciated, therefore, 
that use of an adapter permits medical instruments having various proximal 
end configurations to be mounted on the universal handle of the present 
invention. Accordingly, the distal end of the adapter can have any 
configuration suitable for engaging the proximal end of a medical 
instrument, including threaded or unthreaded protrusions or sockets, Luer 
locks or detent structures, for example; and the proximal end of the 
adapter can have any configuration suitable for engaging the distal end of 
a mounting member, including threaded or unthreaded protrusions or 
sockets, Luer locks or detent structures, for example. 
A further modification of the universal handle according to the present 
invention is illustrated in FIG. 11 wherein the modified handle 168 is 
configured to move a first medical instrument, such as a cannula, distally 
from a retracted position exposing the distal end of a second medical 
instrument, such as a penetrating member, to an extended protruding 
position shielding the distal end of the second medical instrument. 
Housing 56 and tubular member 58 for handle 168 are similar to those 
previously described with the exception of an annular rim 170 formed on an 
inside surface of the second cylindrical portion 90 of the tubular member 
58 and a stop member 171 configured to engage the rail member 104. Guide 
tube 92 extends through the annular rim 170 and terminates distally at a 
transverse flange 172 which serves as a stop or abutment for rim 170 
limiting distal movement of the tubular member relative to the housing. 
Stop member 171 extends from a wall or walls of the housing and is 
distally spaced from the rail member forward wall 106 to limit distal 
movement of the rail member within the housing. As shown, stop member 171 
includes a wall having an opening formed therethrough for passage of a 
first cylindrical portion 174 of the rail member. Alternatively, stop 
member 171 could include a pair of posts, for example, extending from 
lateral side walls of the housing on opposite sides of the rail member and 
positioned between the rail member forward wall 106 and proximal end wall 
64 of the housing. 
With reference to FIGS. 11 and 12, it can be seen that rail member 104 for 
handle 168 includes first cylindrical portion 174 extending distally from 
the rail member forward wall 106 through the opening 82 in the distal end 
wall 64 of the housing, and a second cylindrical portion 176 extending 
proximally from the rail member rearward wall 108 to abut the proximal end 
wall 62 of the housing when the rail member is in the loaded, retracted 
position shown in FIG. 11. First and second cylindrical portions 80 and 90 
of the tubular mounting member 58 are telescopically fitted within the 
first and second cylindrical portions 174 and 176 of the rail member, 
respectively, for sliding movement therein. Flange 88 of the tubular 
member is disposed between the forward and rearward walls 106 and 108 of 
the rail member distally of stop 77 attached to the rail member sidewall 
110. 
An extending member 178 is disposed around the second cylindrical portion 
176 of the rail member within a cylindrical guide wall 177 extending from 
the proximal end wall 62 of the housing and is held in compression between 
the proximal end wall 62 of the housing and the rail member rearward wall 
108 to bias the rail member 104 in a distal direction relative to the 
housing. The first cylindrical portion 174 of the rail member 104 carries 
a receptacle, socket or collar 179 at a distal end for receiving the 
proximal end of a medical instrument so that the rail member can also 
serve as a mounting member. The receptacle 179 is disposed externally of 
the housing and includes an annular flange 180 extending part way around 
the distal end of the first cylindrical portion 174, a semicylindrical 
wall 182 extending distally from a peripheral edge of the flange 180 and 
an inwardly extending lip 184 formed along a distal edge of the wall. The 
receptacle 179 is movable within bore 101 formed between jaws 96 and 98 
but is prevented from moving beyond the jaws by engagement of the stop 
member 171 with the forward wall 106 of the rail member. Thus, any 
instrument held in the receptacle is prevented from becoming laterally 
dislodged from the collar during movement of the rail member relative to 
the housing. It will also be appreciated that lip 184 can be configured to 
engage the proximal end of an instrument to prevent distal movement of the 
instrument from the receptacle. 
Stop 77 for handle 168 is mounted on the rail member side wall 110 for 
limiting proximal movement of the tubular member flange 88 relative to the 
rail member 104 and, thus, any medical instrument carried at the distal 
end 84 of the tubular member. A bias member 112 is disposed around the 
tubular member 58 and is held in compression between the rail member 
rearward wall 108 and the tubular member flange 88 to bias the tubular 
member flange distally toward the rail member forward wall 106. 
Locking and releasing mechanism 118 for handle 168 is similar to that shown 
in FIG. 2 but with upwardly angled arm 126 extending from the distal end 
186 of the base 122 to form an angled distal latching surface 130 and a 
proximal latching surface 132 parallel to rail member forward wall 106. 
Arm extension 134 extends horizontally from a bottom end of the proximal 
latching surface 132 and is juxtaposed with the horizontal leg 140 of 
trigger 136. 
In use, handle 168 is normally supplied in the condition shown in FIG. 14 
with the rail member 104 in the unloaded, extended position. In the 
extended position shown, rail member forward wall 106 abuts stop 171 due 
to the bias of extending member 178 and tubular member 58 is in a rest 
position where flange 88 abuts rail member forward wall 106 due to the 
bias of bias member 112. A first medical instrument, such as catheter 44, 
is fitted within the semicylindrical receptacle 179 at the distal end of 
the rail member 104 with the wedge-shaped jaws 96 and 98 of the housing 
collar 94 pivoted apart to be in the open condition. The base of a second 
medical instrument, such as a needle 42 disposed within the catheter 44, 
is then seated on the cylindrical nub 84 at the distal end of the tubular 
mounting member 58 and the jaws closed. The handle 168 is cocked or loaded 
by drawing the knob 78 proximally along slot 74 to move the rail member 
104 proximally against the bias of extending member 178 until the rail 
member forward wall 106 is engaged by the proximal latching surface 132 of 
the latch spring as shown in FIG. 11. If a catheter is being held by the 
handle, the distal end of the catheter is now preferably proximally spaced 
from the distal end of the needle disposed within the catheter such that 
the sharp distal end of the needle is exposed. 
When the second medical instrument carried by the tubular member is 
advanced against a surface, for example to penetrate an anatomical cavity 
wall, the counterforce on the instrument will cause the tubular member 58 
to move proximally within the housing against the distal bias of bias 
member 112. At the same time, the operating member formed by flange 88 of 
the tubular member engages leg 142 of trigger 136 to pivot the trigger 
counterclockwise, looking at FIG. 13, thereby allowing the operating 
member to move past the trigger leg 142. The counterclockwise pivotal 
movement of trigger 136 does not cause movement of the latch 128 since 
there is no engagement by either leg 140 or 142 with arm extension 134. 
Once the operating member passes by leg 142, a torsion spring returns 
trigger 136 to its normal position with leg 140 adjacent arm extension 134 
as shown in FIG. 13. Accordingly, during advancement of the second medical 
instrument against a surface, no force is required to overcome the bias of 
extending member 178. 
Once the distal end of the second medical instrument has passed through the 
surface, a reduction in force from contact with the surface will cause the 
second medical instrument to move distally under the bias of bias member 
112. As the second medical instrument moves distally, flange 88 of the 
tubular member engages leg 142 of trigger 136 causing the trigger to pivot 
clockwise looking at FIG. 13 and causing leg 140 to engage arm extension 
134 moving arm 126 toward base 122 against the force of spring strip 120. 
The movement of arm 126 away from the longitudinal axis of the handle 
causes latch 128 to move out of engagement with the rail member forward 
wall 106 thereby allowing extending member 178 to move the rail member 
distally to the extended protruding position illustrated in FIG. 14. If 
the first medical instrument is a cannula and the second medical 
instrument is a penetrating member, movement of the rail member distally 
from the retracted position shown in FIG. 11 to the extended position 
shown in FIG. 14 will preferably cause the cannula to protrude beyond the 
distal end of the penetrating member to protect tissue within an 
anatomical cavity from inadvertent contact with the distal end of the 
penetrating member. With the cannula placed in the anatomical cavity wall, 
jaws 96 and 98 can be pivoted away from one another on pins or hinges 100 
and 102 releasing the proximal end of the cannula from the semicylindrical 
receptacle 179 so that the handle can be withdrawn with the penetrating 
member from the cavity leaving the cannula in place to serve as a portal 
through the anatomical cavity wall. It will also be appreciated that if 
the second medical instrument is a penetrating member and the first a 
safety member such as a safety shield or probe, the penetrating member and 
safety member can be attached to the handle and passed through a separate 
portal sleeve so that the safety shield or probe will be extended beyond 
the distal tip of the penetrating member upon penetrating into the 
anatomical cavity and both the safety member and the penetrating member 
can be removed together with the handle so that the tip of the penetrating 
member will be maintained in a protected position within the safety member 
while the separate portal sleeve will be left in place to form a portal 
within the wall of the cavity. 
The modified handle 192 shown in FIG. 15 is similar to handle 168 shown in 
FIGS. 11-14 but with a different locking spring. Locking spring 194 for 
handle 192 includes a flat base 196 secured to the bottom wall 68 of the 
housing 56 and a U-shaped bend 198 joining the distal end of an arm 200 
with a distal end 202 of the base. Arm 200 extends substantially parallel 
to a longitudinal axis of the handle and terminates proximally at an 
upwardly angled portion 204 forming a latch for engaging the distal face 
of the rail member rearward wall 108 when the rail member 104 is in the 
retracted position shown. Trigger 136 is positioned in the housing 56 with 
leg 140 overlying the arm 200 and leg 142 positioned proximally of the 
operating member formed by the tubular member flange 88 so that projection 
of the rail member 104 to the extended position is triggered by 
distally-biased movement of the tubular member 58. From the extended 
position, the handle 192 is cocked or loaded by advancing knob 78 
proximally along slot 74 formed in the housing top wall 66 to cause rail 
member rearward wall 108 to slide over the upwardly angled portion 204 
depressing the arm 200 away from the longitudinal axis of the handle and 
towards the base 196. When rail member rearward wall 108 passes over the 
angled portion 204, the arm 200 springs back toward the longitudinal axis, 
latching the rail member rearward wall in the retracted position shown in 
FIG. 15. 
FIG. 16 illustrates another modification of the handle shown in FIGS. 11-14 
wherein the locking spring of the modified handle 206 includes a flat base 
208 secured to the distal end wall 64 of the housing and a bend 210 
joining the base with an arm 212 extending perpendicularly from the base 
in a proximal direction. Arm 212 is doubly folded intermediate its length 
to form a U-shaped latch 214, like latch 160 for handle 152, for engaging 
the distal face of the rail member forward wall 106 when the rail member 
is in the retracted position. Also shown is a tapered control button 216, 
similar to that shown and described in applicant's copending patent 
application Ser. No. 08/083,220, which extends transversely or into the 
plane of the drawing between lateral sidewalls 70 and 72. Control button 
216 is located proximate arm 212 of the locking spring within a curved 
portion 213 of the arm and is tapered along its length to form a wedge 
which, when depressed, moves the arm away from the longitudinal axis of 
the housing to disengage the latch. Operation of the control button 216 to 
disengage the latch allows rail member forward wall 106 to pass over latch 
214 for manual loading of the handle and can also be used to unload the 
handle so that, for example, the handle can be used merely to hold a 
medical instrument without providing a retracting or extending function. 
A further modification of the handle according to the present invention is 
shown in FIG. 17 wherein the modified handle 218 is similar to handle 168 
illustrated in FIGS. 11-14 but with the bias member 112 disposed around 
the guide tube 92 and held in compression between the proximal end wall 62 
of the housing and the proximal end or rim 170 of the tubular member 58. 
The location of the bias member 112 for handle 218 is particularly 
advantageous in that when the rail member 104 and tubular member 58 are to 
be stored for extended periods of time, bias springs 112 and 178 can be 
maintained in extended positions such that the resilience of the springs 
remains substantially unaffected over time. Moreover, in the handle of 
FIG. 17, rail member forward wall 106 extends toward housing upper wall 66 
with a post 116 extending from the rail member forward wall 106 through a 
slot 74 formed proximate the distal end of the housing and terminating at 
a knob 78 disposed within an elongate recess 76. 
The modified handle 220 shown in FIG. 18 differs from handle 168 
illustrated in FIGS. 11-14 primarily in the distal configuration of the 
rail member 104 and the position of stops 77. Rail member 104 for handle 
220 is similar to that shown in FIG. 11 but with a cylindrical socket 222 
and an annular ridge or seat 224 formed at the bottom or proximal end of 
the cylindrical socket for receiving and frictionally engaging the base 54 
of a catheter 44 or other medical instrument. As a result, jaws are not 
needed to retain and guide a medical instrument such as a catheter 44 held 
within the socket 222 as the medical instrument is advanced to an extended 
position protruding beyond the distal end of a needle 42 or other medical 
instrument. Annular ridge 224 is configured to allow passage of a needle 
base 46, for example, so that the base at the proximal end of the needle 
can mate with the distal end of tubular member 58, which forms a 
cylindrical recess 226 for receiving and frictionally engaging the 
exterior surface of the needle base. A wall 228 at the bottom of recess 
226 forms a stop limiting proximal movement of the needle base relative to 
the tubular member. Stops 77 for handle 220 extend from a wall or walls of 
the rail member through slots 229 formed in the tubular member 58 to limit 
movement of the tubular member relative to the rail member. The length of 
slots 229 is preferably equal to the distance between the catheter distal 
end and needle distal end when a catheter is mounted to be retracted so 
that the distal ends of the catheter and needle will line up in response 
to the force from tissue contact when the needle is pressed against 
anatomical tissue to be penetrated. Operation of the handle 220 is 
essentially the same as for handle 168 with the exception that medical 
instruments such as the needle 42 and catheter 44 are mounted without the 
use of jaws. 
FIG. 19 illustrates a modification of the handle shown in FIG. 18 wherein 
the modified handle 232 is configured to mount a penetrating member in the 
form of a trocar 234 and a cannula in the form of a portal sleeve 236. 
Trocar 234 includes a cylindrical obturating body 238 with an externally 
threaded proximal end 240 and facets 242 at a distal end conjoining to 
form a tissue penetrating tip 244. Portal sleeve 236 is telescopically 
fitted over trocar 234 and includes a distal end 246 and an externally 
threaded proximal end 248. Cylindrical socket 222 for handle 232 is 
internally threaded at 250 to receive the proximal end 248 of portal 
sleeve 236. Similarly, the cylindrical recess 226 at the distal end of 
tubular member 58 is internally threaded at 252 to threadedly receive the 
proximal end 240 of trocar 234. Use of handle 232 is essentially the same 
as for handle 168 with the exception that the housing 56 or portal sleeve 
236 must be rotated or unscrewed after penetration to release the portal 
sleeve from the handle so that the trocar 234 can be withdrawn from the 
anatomical cavity along with the handle 232 leaving the portal sleeve in 
place to serve as a portal for introducing medical instruments into the 
anatomical cavity. Alternatively, trocar 234 and sleeve 236 can be 
inserted through a larger cannula or portal sleeve so that sleeve 236 
functions as a safety shield and is thereafter withdrawn from the larger 
cannula along with the trocar. 
FIG. 20 shows another modification of the handle according to the present 
invention which performs a similar protruding or extending function as 
that described in connection with FIGS. 11-19. The major difference 
between the handle 254 shown in FIG. 20 and the other handles resides in 
the location of the extending member 178 and the bias member 112. In FIG. 
20, the rail member 104 has only a rearward wall or flange 108 which 
engages latch 128 of the locking spring 120 due to the force of the 
extending member 178 acting on the rearward wall 108 of the rail member. 
The extending member 178 is mounted in compression between the proximal 
end wall 62 of the housing and the rearward wall 108 of the rail member 
104 and is disposed around a control rod 256 connected between proximal 
and distal end walls 62 and 64 of the housing. 
Referring still to FIG. 20, the bias member 112 is disposed around guide 
tube 92 and is held in compression between the proximal end wall 62 and 
the annular flange portion 88 of the tubular mounting member 58. Guide 
tube 92 is received within the tubular member 58 and bias member 112 
applies a distal biasing force to the tubular member 58 which resists 
movement of the tubular member toward the proximal end wall. Moreover, in 
the handle of FIG. 20, there is a projection 258 having an L-shaped 
cross-section that is integral with and extends from the proximal end wall 
62. The L-shaped projection 258 limits distal movement of the tubular 
member 58 within the housing. That is, the movement of the tubular member 
58 due to the biasing force of bias member 112 is limited by the 
engagement of the annular flange portion 88 of the tubular member 58 with 
a retaining shoulder portion 260 of the L-shaped projection 258. The 
function of the L-shaped projection 258 is to prevent the tubular member 
258 from extending beyond the retaining shoulder portion 260 so that the 
distal end of the tubular member will not extend too far toward the distal 
end of the housing. An annular protrusion 262 extends inwardly from the 
L-shaped projection 258 and serves as a stop to limit the movement of the 
annular flange portion 88 in the proximal direction. 
The handle shown in FIG. 20 operates in a manner similar to those 
previously described in that, when an external force is applied to the 
tubular member 58, as in the case of a resistant force caused by tissue 
contact during penetration, the tubular member 58 is moved proximally 
against the bias of bias member 112 and passes over leg 142 of trigger 136 
without disengaging the rail member rearward wall 108 from the latch 128 
formed by spring 120. However, upon penetration, the force from tissue 
contact is reduced to a level below the biasing force of the bias member 
and the tubular member 58 will move in a distal direction into contact 
with leg 142 forcing the spring 120 downward until the rail member 
rearward wall 108 is not retainingly engaged by the latch 128 formed by 
spring 120. When this occurs, the biasing force of the extending member 
178 will act on the rail member rearward wall 108 to protrude or extend 
the rail member 104 toward the distal end wall 64 of the housing. Thus, 
any instrument mounted by the rail member will be moved to an extended 
position where the distal end of the instrument protrudes beyond the 
distal end of another instrument mounted by the tubular member, for 
example, to serve as a safety shield. 
FIG. 21 illustrates still another modification of the universal handle 
according to the present invention wherein a first end of the modified 
handle 264 is configured to move a medical instrument, such as a cannula, 
distally from a retracted position to an extended position and a second 
end of the modified handle is configured to move a medical instrument, 
such as a penetrating member, proximally from an extended position to a 
retracted position. The modified handle 264 includes a housing 266 having 
opposed first and second end walls 268 and 270, a rail member 272 movable 
within the housing between the end walls, first and second tubular 
mounting members 274 and 276 mounted by the rail member for sliding 
movement, and a combination retracting and protruding mechanism for 
locking the rail member in a first position proximate one of the end walls 
and for releasing the rail member to be moved toward the other end wall in 
response to a reduction in force acting on either the first or second 
tubular members. 
Rail member 272 is similar to that shown in FIG. 12 at 104 but without a 
second cylindrical portion. More specifically, the rail member 272 for 
handle 264 includes a first flange or wall 278 disposed transverse or 
perpendicular to a longitudinal axis of the housing, a second flange or 
wall 280 disposed between the first flange 278 and the second end wall 270 
in configuration parallel to the first flange 278, a side wall 282 
transversely joining the first and second flanges of the rail member, a 
cylindrical portion 284 extending from the first rail member flange and 
through an opening in the first end wall 268 of the housing, and a 
semicylindrical receptacle 286, similar to receptacle 179, carried at a 
distal end of the cylindrical portion 284 externally of the housing for 
receiving the proximal end of a medical instrument. The second rail member 
flange 280 extends toward the top wall 288 of housing 266 and a post 290 
extends from the second rail member flange 280 through a slot 292 in the 
housing top wall 288 to terminate at a knob 294 positioned in an elongate, 
trough-like recess 296 formed in the housing top wall. Slot 292 and recess 
296 extend longitudinally in parallel with the longitudinal axis of the 
handle 264. A bias member 298 is mounted between the second rail member 
flange 280 and the second end wall 270 of the housing to bias the rail 
member 272 toward the first end wall 268. The bias member 298 can include 
a helical coil spring mounted in compression between the second rail 
member flange 280 and the second end wall 270 of the housing as shown, or 
the bias member can include any other type of spring or other bias device 
as discussed above. 
The first tubular mounting member 274 includes a hollow cylindrical body 
300 telescopically fitted within the cylindrical portion 284 of rail 
member 272 for sliding movement therein. The cylindrical body 300 extends 
from a transverse flange 304 disposed between the rail member flanges 278 
and 280 and terminates within the cylindrical portion 284 at an annular 
step or shoulder 301 joining the cylindrical body with a diametrically 
smaller cylindrical nub 302 having external threads 303. A stop 306 
extends perpendicularly from the top wall of the housing in the direction 
of the first tubular member to serve as an abutment member for engaging 
the flange 304 of the first tubular member to limit movement of the first 
tubular member relative to the housing in the direction of the first end 
wall 268. 
The second tubular mounting member 276 includes a first cylindrical portion 
308 slidably disposed within aligned openings formed in the second rail 
member flange 280 and the second end wall 270 of the housing, a 
cylindrical nub 310 with external threads 311 carried at an end of the 
first cylindrical portion passing through the opening in the second end 
wall 270, a round flange 312 disposed at the opposite end of the first 
cylindrical portion between first and second rail member flanges 278 and 
280, and a second cylindrical portion 314 extending from the flange 312 in 
the direction of the first end wall 268 to be telescopically received 
within the hollow body 300 of the first tubular member 274 for sliding 
movement therein. 
A second bias member 316 is connected between flange 304 of the first 
tubular member and flange 312 of the second tubular member to bias the 
tubular members apart and into rest positions where they abut first and 
second rail member flanges 278 and 280, respectively. As shown, bias 
member 316 includes a helical coil spring disposed around the second 
cylindrical portion 314 of the second tubular member and mounted in 
compression between flanges 304 and 312. However, bias member 316 can 
include various other types of springs as well as other types of bias 
devices including compression springs, tension springs, torsion springs, 
pan springs, leaf springs, rubber, plastic or magnets, for example. 
Locking and releasing mechanism 318 for locking the rail member in a 
loaded, cocked position proximate the second end wall of the housing and 
for releasing the rail member to allow the bias member to move the rail 
member toward the first end wall of the housing includes a latch or 
locking spring 320, made of a strip of resilient material, formed to have 
a substantially flat base 322 secured to the bottom wall 323 of the 
housing and a bend 324 joining the base 322 with an upwardly angled arm 
326 spaced from the base. Arm 326 carries or forms a latch 328 having an 
angled latching surface 330 joining a transverse latching surface 332 
disposed substantially perpendicular to the longitudinal axis of the 
handle and substantially parallel to the first rail member flange. Arm 326 
has a horizontal extension 334 extending from a bottom of the transverse 
latching surface, and a pair of spaced releasing members or triggers 336 
and 337 juxtaposed with extension 334. Trigger 336 is pivotally mounted in 
the housing on a pin 338 secured to a wall or walls of the housing or 
structure supported in the housing and is generally L-shaped with a leg 
340 overlying extension 334 and a leg 342 extending transversely from leg 
340 but at a slight angle toward the second end wall of the handle. A 
torsion spring (not shown) is coiled around pin 338 and fixed to trigger 
336 to bias the trigger clockwise, looking at FIG. 21, such that leg 340 
is biased toward extension 334. The trigger 337 is pivotally mounted in 
the housing on a pin 339 secured to a wall or walls of the housing or 
structure supported in the housing, and is also generally L-shaped with a 
leg 341 overlying extension 334 and a leg 343 extending transversely from 
leg 340 but at a slight angle toward the first end wall of the housing. A 
torsion spring (not shown) is coiled around pin 339 and fixed to trigger 
337 to bias the trigger counterclockwise, looking at FIG. 21, such that 
leg 341 is biased toward extension 334. 
Jaws 344 and 346 proximate the first end wall 268 of the housing are the 
same as the jaws shown in FIG. 11, and jaws 348 and 350 proximate the 
second end wall 270 are the same as the jaws shown in FIG. 2. It will be 
appreciated, however, that opposed surfaces of jaws 348 and 350 can also 
be configured to define a space, such as the annular recess shown in 
phantom at 161 in FIG. 21, for receiving the proximal end of a medical 
instrument to prevent movement of the instrument relative to the housing. 
In use, the modified universal handle 264 is preferably supplied in the 
unloaded condition shown in FIG. 23 wherein the bias member 298 is in an 
extended condition, the first tubular member flange 304 abuts stop member 
306 and the knob 294 is disposed at the end of slot 292 closest the first 
end wall of the housing. Prior to cocking the handle, medical instruments 
such as penetrating members and cannulas are mounted on either side of the 
handle depending on the desirability of having one instrument retract or 
protrude relative to the other instrument or the housing. For purposes of 
clarity, operation of the handle 264 will be explained without reference 
to any particular type of medical instruments. 
Referring still to FIG. 23, the handle 264 is cocked or loaded by sliding 
knob 294 along slot 292 towards the opposite end of the slot until the 
first rail member flange 278 slides over the latch 328 and is engaged by 
the transverse latching surface 332. The handle 264 is now in the cocked 
or loaded condition shown in FIG. 21. When a first initial external force 
F.sub.1 is exerted on the first tubular member 274 in the loaded 
condition, causing it to move against the biasing force of the second bias 
member 316, the operating member formed by the flange 304 of the first 
tubular member 274 passes over transverse leg 342 of the trigger 336 
causing the trigger to rotate counterclockwise looking at FIG. 21 without 
releasing the engagement of the latch 328 with the first flange 278 of 
rail member 272. However, when the force being applied to the first 
tubular member is reduced to a level below the biasing force of the second 
bias member 316, the first tubular member 274 moves back toward the 
trigger mechanism 336 as shown in FIG. 22 and engages the transverse leg 
342 of the trigger mechanism causing the trigger 336 to rotate clockwise 
looking at FIG. 22, thereby forcing arm extension 334 of locking spring 
320 downward and releasing the first flange 278 of the rail member 272 
from the latch 328 formed by the upwardly angled arm 326. The biasing 
force of the first bias member 298 then moves the rail member 272 in the 
direction opposite that of the first initial external force, so that the 
collar 286 and any instrument held in the collar are moved away from the 
housing toward the extended position shown in FIG. 23. Accordingly, if the 
first tubular member 274 is adapted to receive the proximal end of a 
needle, for example, and the rail member 272 is configured to receive the 
proximal end of a catheter surrounding the needle (for example as shown in 
FIG. 2), the outward movement of the rail member 272 can be designed to 
travel to a point whereby the distal end of the catheter will cover the 
sharp tip of the needle. 
It will also be appreciated that if the first tubular member is adapted to 
couple with a penetrating member and the rail member a safety member such 
as a safety shield or probe, the penetrating member and safety member can 
be attached to the handle and passed through a separate portal sleeve so 
that the safety shield or probe will be extended beyond the distal tip of 
the penetrating member upon penetrating into the anatomical cavity and 
both the safety member and the penetrating member can be removed together 
with the handle so that the tip of the penetrating member will be 
maintained in a protected position within the safety member while the 
separate portal sleeve will be left in place to form a portal within the 
wall of the cavity. 
On the other hand, when a second initial external force F.sub.2 is applied 
to the second tubular member 276 of a cocked handle, as shown in FIG. 21, 
the second tubular member is moved against the biasing force of the second 
bias member 316, and the operating member formed by flange 312 of the 
second tubular member 276 passes over the transverse leg 343 of the second 
trigger 337 causing the trigger to rotate clockwise looking at FIG. 21 
without disengaging the latch 328 from the first flange portion 278 of the 
rail member 272. However, when the applied force is reduced to a level 
below the biasing force of the second bias member 316, the second bias 
member will move the second tubular member 276 in the direction opposite 
the initial external force, toward the second end wall 270 of the housing, 
whereby the annular flange 312 of the second tubular member contacts the 
transverse leg 343 of the second trigger mechanism 337 as shown in FIG. 
24, rotating the trigger counterclockwise looking at FIG. 24, and thereby 
forcing the arm extension 334 of locking spring 320 in a downward 
direction away from the longitudinal axis of the handle which releases the 
engagement of the first flange portion 278 of rail member 272 from the 
shoulder or latch 328 of the spring arm 320. When this occurs, bias member 
298 moves the rail member 272 in the same direction as the second initial 
external force to the extended position proximate the first end wall 268 
of the housing 266. Movement of the rail member 272 toward the first end 
wall 268 causes rail member flange 280 to engage the flange 312 of the 
second tubular member 276, carrying the second tubular member in the 
direction of the first end wall to a retracted position relative to the 
housing as shown in FIG. 25. Accordingly, if the second tubular member 276 
is adapted to receive the proximal end of a needle and the jaws 348 and 
350 are adapted to receive or support a proximal end of a catheter 
surrounding the needle (for example as shown in FIG. 2), the inward 
movement of the second tubular member 276 can be designed to travel to a 
point whereby the distal end of the needle will be disposed proximally of 
the distal end of the catheter so as to be shielded by the catheter. 
It will also be appreciated that if the second tubular member is adapted to 
couple with a penetrating member and the jaws a safety sheath, the 
penetrating member and safety sheath can be attached to the handle and 
passed through a separate portal sleeve so that the penetrating member is 
retracted into the safety sheath and both the safety sheath and the 
penetrating member can be removed together with the handle maintaining the 
tip of the penetrating member in a protected condition within the sheath 
and leaving the separate portal sleeve in place within the wall of an 
anatomical cavity to form a portal for the introduction of medical 
instruments and/or fluids. 
The modified handle 360 illustrated in FIG. 26 is similar to the handle 264 
shown in FIG. 21 but with a pistol grip 362 secured to the bottom wall 323 
of the handle housing and a pair of plugs 364 and 366 adapted to fit 
within the openings 368 and 370 in the first and second end walls 268 and 
270, respectively. Pistol grip 362 is pivotally mounted on a post 372 
projecting downward from a plate 374 secured to the bottom wall 323 of the 
handle housing 266. Handle grip 362 extends at an angle relative to the 
plate and is locked in a plurality of pivoted positions relative to the 
post by a pair of ball detents 376 and 378 extending from opposite sides 
of the post and engaging mating structure within the handle grip such that 
the handle grip can be manually rotated from one position to another to 
selectively utilize opposite ends of the handle for holding medical 
instruments. Plugs 364 and 366 each have a hollow cylindrical portion 380 
configured to fit snugly within openings 368 and 370 formed in the first 
and second end walls 268 and 270, and a round flange 382 at one end of the 
hollow cylindrical portion to close the cylindrical portion and abut the 
end walls of the housing while providing a graspable rim for removing the 
plugs. When inserted into openings 368 and 370, plugs 364 and 366 operate 
to seal the handle housing 266 thereby preventing contamination of the 
interior of the housing during storage and also providing means for 
capping the handle after use to protect medical personnel from any body 
fluids or tissue introduced into the handle during a procedure. The handle 
360 of FIG. 26 is also shown with outer ends of the first and second 
tubular members 274 and 276 and opposite ends of the rail member 272 
having recesses 384 which define female portions of a detent coupling 
structure for detachably mating with protruding male portions formed at 
the proximal end of a medical instrument, such as the male detents 386 
shown on the instrument 388 illustrated in FIG. 27. As shown, any medical 
instrument mated with the detents in the second cylindrical portion 390 of 
the rail member 272 will be moved along with the rail member and the 
second tubular member 276 toward the first end 268 of the housing when the 
handle is triggered. In FIG. 28, however, the second cylindrical portion 
390 abuts the second end wall 270 of the housing and any medical 
instrument mounted within opening 374 is held stationary by engagement 
with detents 384 formed in the second end wall while the rail member 272 
and the second tubular member 276 are moved toward the first end wall 268 
of the housing. 
From the above, it will be appreciated that the universal handle of the 
present invention can hold any type of medical instrument having a 
proximal end configured to mate with a mounting member of the universal 
handle or by use of adapters that couple the proximal ends of the 
instruments with mounting members of the handle. By "mounting member" is 
meant any handle component or combination of components having a 
configuration to mount a medical instrument, including but not limited to 
the housing recesses, jaws, rail members and tubular members disclosed 
herein. The universal handle can retract or extend a medical instrument 
relative to the housing and/or another medical instrument, for example to 
shield the distal end of a medical instrument such as a penetrating member 
after the wall of an anatomical cavity has been penetrated. Additionally, 
the universal handle of the present invention permits development of a 
modular system whereby, for example, medical personnel can match medical 
instruments with an appropriate handle having a desired characteristic, 
such as a retracting or extending force or power, to suit the particular 
procedure being performed. Use of the universal handle also reduces waste 
and minimizes the exposure of medical personnel to body fluids and the 
like by facilitating disposal of exhausted medical instruments and reuse 
of the universal handle with new medical instruments, thereby reducing 
cost and simplifying sterilization procedures as well. It will also be 
appreciated that by combining retracting and extending mechanisms in one 
universal handle the number of parts required for performing retracting 
and extending functions can be reduced and the efficiency of medical 
personnel can be increased by reducing the number of handles from which 
medical personnel must choose in order to obtain one or both of a 
retracting and extending function. 
When both retracting and extending mechanisms are provided in a single 
handle, they can be coupled with mounting members on opposite sides of the 
handle, as shown, allowing medical personnel to select a side of the 
handle corresponding to the desired function, or the retracting and 
extending mechanisms can be coupled with mounting members on a single side 
of the universal handle for retracting one member while extending the 
other. Various mechanisms that can be simply modified to achieve 
retraction and extension of medical instruments from a single side of a 
universal handle of the present invention are disclosed in applicant's 
pending applications Ser. No. 08/279,170 and 08/279,172 filed Jul. 22, 
1994, the disclosures of which are incorporated herein by reference. 
The components of the universal safety handle of the present invention can 
be made of any suitable, medical grade material to permit sterilization 
for reuse or for single patient use. The components can be made of 
multiple parts of various configurations and materials to reduce cost. 
Furthermore, various valves, stopcocks and seals can be mounted within the 
housing to control fluid flow through the various mounting members, and 
conventional electrical connectors can be mounted on the handle and 
coupled with members of the handle to perform electrosurgery such as 
cautery and cutting. 
The mounting members of the universal handle can have any configuration for 
mating with the proximal ends of medical instruments to be carried, 
including threaded or smooth projecting portions or nubs, conventional 
detent structures, sockets or collars, opposed jaws, Luer locks and/or any 
other type of coupling mechanism so long as the medical instruments can be 
easily attached to the mounting members for use and detached when 
exhausted. Preferably, proximal ends of the medical instruments are 
covered during use and accessible for being detached following use in 
order to provide an uncontaminated surface for being grasped when the 
instruments are to be removed. The mounting members of the universal 
handle can be configured to hold medical instruments in fixed positions 
relative to the handle housing or to permit movement of the instruments in 
response to forces acting on the medical instruments. Thus, for example, 
retaining portions of the jaws or rail members disclosed herein can be 
spring-biased to permit proximal and/or distal movement of the medical 
instruments mounted therein as desired. When jaws are provided for 
mounting the proximal end of a medical instrument, such as a cannula, bias 
springs, detent mechanisms, ring collars or any other suitable mechanisms 
can be used to draw and/or latch the jaws together around the medical 
instrument to hold or clamp the medical instrument while a second medical 
instrument, such as a needle disposed within a cannula, is retracted. 
Although two jaws are shown and described herein for mounting a medical 
instrument, it will be appreciated that any number of jaws having 
cooperating or opposed surfaces for retaining a medical instrument can be 
used. 
The rail members can have various configurations to be engaged by the latch 
and released by operation of the trigger. Preferably, the rail members 
will have a configuration to serve as a stop or abutment for the operating 
member as exemplified herein by the U-shaped portions of the various rail 
members. When knobs are provided for manually moving the various members 
within the housing, the knobs can be coupled with the members directly or 
via any rail members mounting the members. Indicator strips can also be 
attached to the knobs in a manner to be visible through slots in the 
housing through which the knobs protrude. The indicator strips can be 
color coded and/or provided with other markings to indicate the position 
of the members to which the knobs are attached. 
Release of the locking mechanisms can be triggered by movement of an 
operating member carried on any member of the universal handle movable in 
response to a reduction in force acting on the member, such as when a 
penetrating instrument carried by the handle enters an anatomical cavity. 
As described above, operating members are carried by one or more of the 
mounting members movable within the handle housing to limit the number of 
components in the handle; however, operating members could be carried on 
additional members movable in response to a reduction in force acting on 
the additional members such as, for example, a probe or rod in or 
alongside one of the mounting members and biased to protrude from the 
handle housing and/or a medical instrument carried by the housing. 
The locking and releasing mechanisms require only a latch for locking the 
rail member in retracted or extended positions and a trigger for releasing 
the latch in response to distally biased movement of the operating member; 
and, thus, it will be appreciated that various mechanisms can be employed 
to produce the locking and releasing functions such as, for example, 
multiple movably or pivotally mounted cams or pawls. It will be 
appreciated that the locking and releasing mechanism can be designed and 
arranged in the housing in various ways to minimize the length of the 
housing and, therefore, the overall length of the handle. Various locking 
and releasing mechanisms that can be simply modified for use in the handle 
of the present invention are disclosed in applicant's pending applications 
Ser. No. 07/800,507, filed Nov. 27, 1991, Ser. No. 07/805,506, filed Dec. 
6, 1991, Ser. No. 07/808,325, filed Dec. 16, 1991, Ser. No. 07/848,838, 
filed Mar. 10, 1992, Ser. No. 07/868,566 and Ser. No. 07/868,578, filed 
Apr. 15, 1992, Ser. No. 07/929,338, filed Aug. 14, 1992, Ser. No. 
07/845,177, filed Sep. 15, 1992, Ser. No. 07/945,177, filed Sep. 15, 1992, 
Serial No. 08/079,586, filed Jun. 22, 1993, Ser. No. 08/195,512, filed 
Feb. 14, 1994, Ser. No. 08/196,029, filed Feb. 14, 1994, Ser. No. 
08/196,027, filed Feb. 14, 1994, Ser. No. 08/195,178, filed Feb. 14, 1994, 
Ser. No. 08/237,734, filed May 4, 1994, Ser. No. 08/247,205, filed May 20, 
1994, Ser. No. 08/254,007, filed Jun. 3, 1994 and Ser. No. 08/260,439, 
filed Jun. 15, 1994, the disclosures of which are incorporated herein by 
reference. The above applications disclose automatically retracting safety 
penetrating instruments such that modification of the locking and 
releasing mechanisms requires configuring the latches to lock a rail 
member in a retracted or extended position. The above applications also 
disclose various bias arrangements useful with the handle of the present 
invention. Other locking and releasing mechanisms that can be used in the 
handle of the present invention are disclosed in applicant's pending 
applications Ser. Nos. 08/279,170 and 08/279,172 filed Jul. 22, 1994. 
One or more control buttons such as the control buttons described in 
applicant's copending patent application Ser. No. 08/083,220, filed Jun. 
24, 1993 can be mounted next to any latch for manually disengaging the 
latch to prevent locking of the handle in the loaded position. In 
addition, any latch arm or separate spring can carry a secondary pawl or 
latch at one end for locking a movable member in an extended or retracted 
position and can then be released by use of a control button as described 
above. It will thus also be appreciated that the movable members of the 
universal handle of the present invention can be locked in fixed positions 
to permit use of the instruments without any movement relative to the 
handle. 
The various features of the disclosed embodiments can be combined dependent 
upon the medical instruments to be carried and the procedure to be 
performed with a particular universal handle. 
Inasmuch as the present invention is subject to many variations, 
modifications and changes in detail, it is intended that all subject 
matter discussed or shown in the accompanying drawings be interpreted as 
illustrative only and not be taken in a limiting sense.