PATENT DOCUMENT

Abstract:
Instrument handles are adjustable relative to an end effector of the instrument. The handles may be releasably locked in selected positions and/or orientations relative to the end effector. When the lock is released, the handles may be moved to a different position and/or orientation relative to the end effector, and locked in place. The handles may pivot relative to the end effector around one or more joints. The handles may pivot about an axis of a hinge joint or a point of a ball and socket joint. The axis of the hinge joint may be aligned parallel or perpendicular to a center longitudinal axis of the end effector, or of a shaft between the handles and the end effector.

Full Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of: 
         [0002]    U.S. Provisional Patent Application No. 61/442,510, which was filed on Feb. 14, 2011, is entitled: ADJUSTABLE LAPAROSCOPIC INSTRUMENT HANDLE, and carries Attorney&#39;s docket No. MLI-97 PROV. The contents of U.S. Application No. 61/442,510 are hereby incorporated by reference in its entirety as part of this application. 
     
    
     BACKGROUND 
       [0003]    The present disclosure relates to instruments with adjustable handles. While the present disclosure is made in the context of laparoscopic instruments for the purposes of illustrating the concepts of the design, it is contemplated that the present design and/or variations thereof may be suited to other types of surgical instruments, such as arthroscopic, endoscopic, orthopedic, neurologic, cardiologic, suture passing, stapling, or minimally invasive instruments, among others. Furthermore, the principles embodied in the present disclosure may be applicable outside the fields of surgery or medical devices. 
         [0004]    Laparoscopy is an established field of surgery, but opportunities remain for improvement to the instruments. Existing laparoscopic instruments may present significant challenges to a surgeon. For example, the design of laparoscopic instruments may force a surgeon to place his hands, arms, and/or body in non-ergonomic, uncomfortable, and sometimes physically harmful positions. Articulated instrument tips have been introduced. In at least some of these designs, the handle position and/or orientation may be altered in order to reposition and/or reorient the end effector. However, the handle position and/or orientation tends to be dependent on, or tied to, the end effector position and/or orientation. 
         [0005]    There is a need for instrument designs that improve the ergonomics of the instruments in the user&#39;s hands. There is a need for instrument designs in which the handle position and/or orientation is independent of the end effector position and/or orientation. There is a need for instrument designs in which the user may adjust the instrument to keep the hands, arms, and/or body in an ergonomically appropriate or physiologically neutral position while positioning and/or orienting the end effector, or a working shaft of the instrument, to perform a procedure. There is also a need for instruments that reduce or eliminate the need to switch between different handle styles in the course of a procedure. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0006]      FIG. 1  is an isometric view of a surgical instrument with an adjustable handle section according to one embodiment of the present disclosure; 
           [0007]      FIG. 2  is a side view of the surgical instrument of  FIG. 1  with the handles of the surgical instrument in a “drop-down” position; 
           [0008]      FIG. 3  is a side view of the surgical instrument of  FIG. 1  with the handles of the surgical instrument in an “in-line” position; 
           [0009]      FIG. 4  is a side view of the surgical instrument of  FIG. 1  with the handles of the surgical instrument in an “up-angled” position; 
           [0010]      FIG. 5  is an exploded view of the surgical instrument of  FIG. 1 ; 
           [0011]      FIG. 6A  is an isometric view of a first handle according to one embodiment of the present disclosure; 
           [0012]      FIG. 6B  is another isometric view of the first handle of  FIG. 6A ; 
           [0013]      FIG. 6C  is an enlarged isometric view of the distal end of the first handle of  FIGS. 6A and 6B . 
           [0014]      FIG. 7A  is an isometric view of a second handle according to one embodiment of the present disclosure; 
           [0015]      FIG. 7B  is an isometric view of the second handle of  FIG. 7A ; 
           [0016]      FIG. 8A  is an isometric view of a pivot housing according to one embodiment of the present disclosure; 
           [0017]      FIG. 8B  is a top view of the pivot housing of  FIG. 8A  having a section line  8 C- 8 C; 
           [0018]      FIG. 8C  is a cross-sectional side view of the pivot housing of  FIG. 8B , taken along the section line  8 C- 8 C in  FIG. 8B ; 
           [0019]      FIG. 9  is a perspective view of a locking member according to one embodiment of the present disclosure; 
           [0020]      FIG. 10  is a perspective view of a connector according to one embodiment of the present disclosure; 
           [0021]      FIG. 11A  is a perspective view of a pivot pin according to one embodiment of the present disclosure; 
           [0022]      FIG. 11B  is a front view of the pivot pin of  FIG. 11A  having a section line  11 C- 11 C; 
           [0023]      FIG. 11C  is a cross-sectional side view of the pivot pin of  FIG. 11B , taken along the section line  11 C- 11 C in  FIG. 11B . 
           [0024]      FIG. 12  is an isometric view of an actuator according to one embodiment of the present disclosure; 
           [0025]      FIG. 13A  is an isometric view of a rotation knob according to one embodiment of the present disclosure; 
           [0026]      FIG. 13B  is a front view of the rotation knob of  FIG. 13A  having a section line  13 C- 13 C; 
           [0027]      FIG. 13C  is a cross-sectional side view of the rotation knob of  FIG. 13B , taken along the section line  13 C- 13 C in  FIG. 13B ; 
           [0028]      FIG. 14A  is a top view of the surgical instrument shown in  FIG. 3  having a section line  14 B- 14 B; 
           [0029]      FIG. 14B  is a cross-sectional side view of the surgical instrument of  FIG. 14A , taken along the section line  14 B- 14 B in  FIG. 14A ; 
           [0030]      FIG. 15  shows an enlarged view of the encircled area in  FIG. 14B ; 
           [0031]      FIG. 16  is an isometric view of a surgical instrument with an adjustable handle section according to another embodiment of the present disclosure; 
           [0032]      FIG. 17  is a side view of the surgical instrument of  FIG. 16  with the handles of the surgical instrument in a “drop-down” position and the second handle in an “at rest” position; 
           [0033]      FIG. 18  is a side view of the surgical instrument of  FIG. 16  with the handles of the surgical instrument in the “in-line” position and the second handle moved forward; 
           [0034]      FIG. 19  is a side view of the surgical instrument of  FIG. 16  with the handle section of the surgical instrument in the “in-line” position; 
           [0035]      FIG. 20  is a side view of the surgical instrument of  FIG. 16  with the handle section of the surgical instrument in the “up-angled” position; 
           [0036]      FIG. 21  is an exploded view of the surgical instrument of  FIG. 16 ; 
           [0037]      FIG. 22A  is an isometric view of a first handle in accordance with another embodiment of the present disclosure; 
           [0038]      FIG. 22B  is another isometric view of the first handle of  FIG. 22A ; 
           [0039]      FIG. 22C  shows an enlarged isometric view of the distal end of the first handle of  FIGS. 22A and 22B ; 
           [0040]      FIG. 23A  is an isometric view of a second handle in accordance with another embodiment of the present disclosure; 
           [0041]      FIG. 23B  shows an enlarged view of the encircled area in  FIG. 23A ; 
           [0042]      FIG. 23C  is another isometric view of the second handle of  FIG. 23A ; 
           [0043]      FIG. 23D  shows an enlarged view of the encircled area in  FIG. 23C ; 
           [0044]      FIG. 24  is an exploded isometric view of a multi-component second handle in accordance with another embodiment of the present disclosure; 
           [0045]      FIG. 25A  is an isometric view of a ratcheting mechanism in accordance with one embodiment of the present disclosure; 
           [0046]      FIG. 25B  is an exploded view of the ratcheting mechanism of  FIG. 25A ; 
           [0047]      FIG. 26A  is an isometric view of the ratchet body shown in  FIGS. 25A and 25B ; 
           [0048]      FIG. 26B  is a top view of the ratchet body of  FIG. 26A ; 
           [0049]      FIG. 26C  is a side view of the ratchet body of  FIG. 26A ; 
           [0050]      FIG. 27  is an isometric view of a locking member in accordance with one embodiment of the present disclosure; 
           [0051]      FIG. 28  is an isometric view of a ramp according to one embodiment of ratcheting mechanism; 
           [0052]      FIG. 29A  is an isometric view of a connector according to one embodiment of the present disclosure; 
           [0053]      FIG. 29B  is another isometric view of the connector of  FIG. 29A ; 
           [0054]      FIG. 29C  is a top view of the connector of  FIG. 29A  having a section line  29 D- 29 D; 
           [0055]      FIG. 29D  is a cross-sectional side view of the connector of  FIG. 29C , taken along the section line  29 D- 29 D in  FIG. 29C ; 
           [0056]      FIG. 30A  is an isometric view of a pivot housing in accordance with one embodiment of the present disclosure; 
           [0057]      FIG. 30B  is a top view of the pivot housing a  FIG. 30A  having a section line  30 C; 
           [0058]      FIG. 30C  is a cross-sectional side view of the pivot housing of  FIG. 30B , taken along the section line  30 C- 30 C in  FIG. 30B ; 
           [0059]      FIG. 31A  is an isometric view of a working shaft section in accordance with one embodiment of the present disclosure; 
           [0060]      FIG. 31B  is another isometric view of the working shaft section of  FIG. 31A ; 
           [0061]      FIG. 32  is an exploded view of the working shaft section of  FIGS. 31A and 31B ; 
           [0062]      FIG. 33  is an isometric view of a rotation knob according to one embodiment of the present disclosure; 
           [0063]      FIG. 34  is an isometric view of a control member according to one embodiment of present disclosure; 
           [0064]      FIG. 35  is an isometric view of a working shaft collet; 
           [0065]      FIG. 36A  is an isometric view of a second hollow body according to one embodiment of the present disclosure; 
           [0066]      FIG. 36B  is another isometric view of the second hollow body of  FIG. 36A ; 
           [0067]      FIG. 37A  is an isometric view of a working rod according to one embodiment of the present disclosure; 
           [0068]      FIG. 37B  is another isometric view of the working rod of  FIG. 37A ; 
           [0069]      FIG. 38A  is a side view of the working shaft section of  FIG. 31A  having a section line  38 B- 38 B; 
           [0070]      FIG. 38B  is a cross-sectional side view of the working shaft section in  FIG. 38A , taken along the section line  38 B- 38 B in  FIG. 38A ; 
           [0071]      FIG. 39A  is a side view of the working shaft section of  FIG. 31A  having a section line  39 B- 39 B; 
           [0072]      FIG. 39B  is a cross-sectional side view of the working shaft section and  FIG. 39A , taken along the section line  39 B- 39 B in  FIG. 39A ; 
           [0073]      FIG. 40A  is a top view of the surgical instrument of  FIG. 17  with the handle section in the “drop-down” position and with the second handle in the “at rest” position having a section line  40 B- 40 B; 
           [0074]      FIG. 40B  is a cross-sectional side view of the surgical instrument in  FIG. 40A , taken along the section line  40 B- 40 B in  FIG. 40A ; 
           [0075]      FIG. 41  is an enlarged view of the encircled area shown in  FIG. 40B ; 
           [0076]      FIG. 42A  is a top view of the surgical instrument of  FIG. 18  with the handle section in the “drop-down” position and with the second handle in a “forward” position having a section line  42 B- 42 B; 
           [0077]      FIG. 42B  is a cross-sectional side view of the surgical instrument of  FIG. 42A , taken along the section line  42 B- 42 B in  FIG. 42A ; 
           [0078]      FIG. 43  is an enlarged view of the encircled area shown in  FIG. 42B ; 
           [0079]      FIG. 44  is an isometric view of a surgical instrument with an adjustable handle section according to another embodiment of the present disclosure; 
           [0080]      FIG. 45  is a side view of the surgical instrument of  FIG. 44  with the handles of the surgical instrument in a “drop-down” position; 
           [0081]      FIG. 46  is a side view of the surgical instrument of  FIG. 44  with the handle section of the surgical instrument in an “up-angled” position; 
           [0082]      FIG. 47  is an exploded view of the surgical instrument of  FIG. 44 ; 
           [0083]      FIG. 48A  is an isometric view of the handle section of the surgical instrument of  FIG. 44 ; 
           [0084]      FIG. 48B  is an exploded view of the handle section of  FIG. 48A ; 
           [0085]      FIG. 49  is an isometric view of the surgical instrument of  FIG. 44  with the handle section separated from the working shaft section; 
           [0086]      FIG. 50A  is an enlarged view of the working shaft section of  FIG. 49 ; 
           [0087]      FIG. 50B  is an exploded view of the working shaft section of  FIG. 50A ; 
           [0088]      FIG. 51A  is an isometric view of a first handle in accordance with another embodiment of the present disclosure; 
           [0089]      FIG. 51B  is another isometric view of the first handle of  FIG. 51A ; 
           [0090]      FIG. 51C  is an enlarged view of the encircled area in  FIG. 51B ; 
           [0091]      FIG. 52A  is an isometric view of a second handle in accordance with another embodiment of the present disclosure; 
           [0092]      FIG. 52B  shows an enlarged view of the encircled area in  FIG. 52A ; 
           [0093]      FIG. 53A  is an isometric view of the pivot housing in accordance with another embodiment of the present disclosure; 
           [0094]      FIG. 53B  is another isometric view of the pivot housing of  FIG. 53A ; 
           [0095]      FIG. 54A  is an isometric view of a locking member in accordance with another embodiment of the present disclosure; 
           [0096]      FIG. 54B  is an isometric view of the pivot pin in accordance with another embodiment of the present disclosure; 
           [0097]      FIG. 55A  is an isometric view of a connector in accordance with another embodiment of the present disclosure; 
           [0098]      FIG. 55B  is an isometric view of the ratchet mechanism in accordance with another embodiment of the present disclosure; 
           [0099]      FIG. 56A  is an isometric view of a rotation knob according to another embodiment of the present disclosure; 
           [0100]      FIG. 56B  is another isometric view of the rotation knob of  FIG. 56A ; 
           [0101]      FIG. 56C  say front view of the rotation knob of  FIG. 56A  having a section line  56 E- 56 E; 
           [0102]      FIG. 56D  is a side view of the rotation knob of  FIG. 56A ; 
           [0103]      FIG. 56E  is a cross-sectional side view of the rotation knob of  FIG. 56C , taken along the section line  56 E- 56 E in  FIG. 56C ; 
           [0104]      FIG. 57A  is a top view of the surgical instrument shown in  FIG. 45  with the second handle in the “at rest” position and having a section line  57 B; 
           [0105]      FIG. 57B  is a cross-sectional side view of the surgical instrument of  FIG. 57A , taken along the section line  57 B- 57 B in  FIG. 57A ; 
           [0106]      FIG. 58  shows an enlarged view of the encircled area in  FIG. 57B ; 
           [0107]      FIG. 59A  is a top view of the surgical instrument shown in  FIG. 45  with the second handle in the “forward” position and having a section line  59 B- 59 B; 
           [0108]      FIG. 59B  is a cross-sectional side view of the surgical instrument of  FIG. 59A , taken along the section line  59 B- 59 B in  FIG. 59A ; 
           [0109]      FIG. 59C  is an enlarged view of the encircled area in  FIG. 59B ; 
           [0110]      FIG. 60  is an isometric view of a surgical instrument with an adjustable handle section according to another embodiment of the present disclosure; 
           [0111]      FIG. 61  is a side view of the surgical instrument of  FIG. 60  with the handles of the surgical instrument in a “drop-down” position and with the second handle in an “at rest” position; 
           [0112]      FIG. 62  is a side view of the surgical instrument of  FIG. 61  with the second handle pivoted toward the first handle; 
           [0113]      FIG. 63  is a side view of the surgical instrument of  FIG. 61  with the second handle in a “forward” position; 
           [0114]      FIG. 64  is a side view of the surgical instrument of  FIG. 60  with the handles of the surgical instrument in an “angled-up” position; 
           [0115]      FIG. 65  is a side view of the surgical instrument of  FIG. 64  with the second handle pivoted toward the first handle; 
           [0116]      FIG. 66  is an exploded view of the surgical instrument of  FIG. 60 ; 
           [0117]      FIG. 67A  is an isometric view of a first handle according to another embodiment of the present disclosure; 
           [0118]      FIG. 67B  is another isometric view of the first handle of  FIG. 67A ; 
           [0119]      FIG. 67C  is an enlarged isometric view of the distal end of the first handle of  FIGS. 67A-67B ; 
           [0120]      FIG. 68A  is an isometric view of a portion of a second handle according to another embodiment of the present disclosure; 
           [0121]      FIG. 68B  is an enlarged view of the encircled area in  FIG. 68A ; 
           [0122]      FIG. 68C  is another isometric view of the portion of the second handle in  FIG. 68A ; 
           [0123]      FIG. 68D  is an enlarged view of the encircled area in  FIG. 68C ; 
           [0124]      FIG. 69A  is an isometric view of a pivot housing according to another embodiment of the present disclosure; 
           [0125]      FIG. 69B  is another isometric view of the pivot housing in  FIG. 69A ; 
           [0126]      FIG. 70A  is a top view of the pivot housing in  FIGS. 69A-69B  having a section line  70 B; 
           [0127]      FIG. 70B  is a cross-sectional side view of the pivot housing in  FIG. 70A , taken along the section line  70 B- 70 B; 
           [0128]      FIG. 71A  is an isometric view of a locking member according to another embodiment of the present disclosure; 
           [0129]      FIG. 71B  is an isometric view of an actuator according to another embodiment of the present disclosure; 
           [0130]      FIG. 72A  is an isometric view of a connector according to another embodiment of the present disclosure; 
           [0131]      FIG. 72B  is another isometric view of the connector in  FIG. 72A ; 
           [0132]      FIG. 73A  is an isometric view of a rotation knob according to another embodiment of the present disclosure; 
           [0133]      FIG. 73B  is another isometric view of the rotation knob in  FIG. 73A ; 
           [0134]      FIG. 73C  is a front view of the rotation knob in  FIG. 73A  having section lines  73 D- 73 D and  73 E- 73 E; 
           [0135]      FIG. 73D  is a cross-sectional side view of the rotation knob in  FIG. 73C , taken along the section line  73 D- 73 D; 
           [0136]      FIG. 73E  is a cross-sectional side view of the rotation knob in  FIG. 73C , taken along the section line  73 C- 73 C; 
           [0137]      FIG. 74A  is a top view of the surgical instrument shown in  FIG. 61  having a section line  74 B- 74 B; 
           [0138]      FIG. 74B  is a cross-sectional side view of the surgical instrument of  FIG. 74A , taken along the section line  74 B- 74 B in  FIG. 74A ; 
           [0139]      FIG. 75  is an enlarged view of the encircled area in  FIG. 74B ; 
           [0140]      FIG. 76A  is a top view of the surgical instrument shown in  FIG. 62  having a section line  76 B- 76 B; 
           [0141]      FIG. 76B  is a cross-sectional side view of the surgical instrument of  FIG. 76A , taken along the section line  76 B- 76 B in  FIG. 76A ; 
           [0142]      FIG. 77  is an enlarged view of the encircled area in  FIG. 76B ; 
           [0143]      FIG. 78A  is a top view of the surgical instrument shown in  FIG. 63  having a section line  78 B- 78 B; 
           [0144]      FIG. 78B  is a cross-sectional side view of the surgical instrument of  FIG. 78A , taken along the section line  78 B- 78 B in  FIG. 78A ; 
           [0145]      FIG. 79  is an enlarged view of the encircled area in  FIG. 78B ; 
           [0146]      FIG. 80A  is a top view of the surgical instrument shown in  FIG. 64  having a section line  80 B- 80 B; 
           [0147]      FIG. 80B  is a cross-sectional side view of the surgical instrument of  FIG. 80A , taken along the section line  80 B- 80 B in  FIG. 80A ; 
           [0148]      FIG. 81  is an enlarged view of the encircled area in  FIG. 80B ; 
           [0149]      FIG. 82A  is a top view of the surgical instrument shown in  FIG. 65  having a section line  82 B- 82 B; 
           [0150]      FIG. 82B  is a cross-sectional side view of the surgical instrument of  FIG. 82A , taken along the section line  82 B- 82 B in  FIG. 82A ; 
           [0151]      FIG. 83  is an enlarged view of the encircled area in  FIG. 82B ; 
           [0152]      FIG. 84  is an isometric view of a surgical instrument with an adjustable handle section according to another embodiment of the present disclosure; 
           [0153]      FIG. 85  is a side view of the surgical instrument of  FIG. 84  with the handles of the surgical instrument in a “drop-down” position; 
           [0154]      FIG. 86  is a side view of the surgical instrument of  FIG. 84  with the handles of the surgical instrument in an “in-line” position; 
           [0155]      FIG. 87  is a side view of the surgical instrument of  FIG. 84  with the handles of the surgical instrument in an “up-angled” position; 
           [0156]      FIG. 88  is exploded view of the surgical instrument of  FIG. 84 ; 
           [0157]      FIG. 89A  is an isometric view of the surgical instrument of  FIG. 84  with the working shaft section removed; 
           [0158]      FIG. 89B  is an enlarged view of the encircled area in  FIG. 89A ; 
           [0159]      FIG. 90A  is an isometric view of a working shaft section according to one embodiment of the present disclosure; 
           [0160]      FIG. 90B  is an exploded view of the working shaft section in  FIG. 90A ; 
           [0161]      FIG. 91A  is an isometric view of a first handle according to another embodiment of the present disclosure; 
           [0162]      FIG. 91B  is another isometric view of the first handle in  FIG. 91A ; 
           [0163]      FIG. 91C  is an enlarged view of the encircled area in  FIG. 91A ; 
           [0164]      FIG. 92A  is an isometric view of a second handle according to another embodiment of the present disclosure; 
           [0165]      FIG. 92B  is an enlarged view of the encircled area in  FIG. 92A ; 
           [0166]      FIG. 92C  is another isometric view of the second handle in  FIG. 92A ; 
           [0167]      FIG. 93A  is an isometric view of a pivot housing according to another embodiment of the present disclosure; 
           [0168]      FIG. 93B  is another isometric view of the pivot housing in  FIG. 93A ; 
           [0169]      FIG. 93C  is a top view of the pivot housing in  FIG. 93A  having a section line  93 D- 93 D; 
           [0170]      FIG. 93D  is a cross-sectional side view of the pivot housing in  FIG. 93C , taken along the section line  93 D- 93 D in  FIG. 93C ; 
           [0171]      FIG. 94A  is an isometric view of a connector according to another embodiment of the present disclosure; 
           [0172]      FIG. 94B  is another isometric view of the connector in  FIG. 94A ; 
           [0173]      FIG. 95A  is an isometric view of a rotation knob according to another embodiment of the present disclosure; 
           [0174]      FIG. 95B  is a side view of the rotation knob in  FIG. 95A  having a section line  95 C- 95 C; 
           [0175]      FIG. 95C  is a cross-sectional side view of the rotation knob in  FIG. 95B , taken along the section line  95 C- 95 C in  FIG. 95B ; 
           [0176]      FIG. 96A  is a top view of the surgical instrument shown in  FIG. 85  having a section line  96 B- 96 B; 
           [0177]      FIG. 96B  is a cross-sectional side view of the surgical instrument shown in  FIG. 96A , taken along the section line  96 B- 96 B in  FIG. 96A ; 
           [0178]      FIG. 97  is an enlarged view of the encircled area in  FIG. 96B . 
       
    
    
     DETAILED DESCRIPTION 
       [0179]    While certain embodiments are shown and described in detail below by way of illustration only, 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 technology 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 disclosed technology. 
         [0180]    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) may be used to indicate similar features in different embodiments. 
         [0181]    In  FIGS. 1-15 , a surgical instrument  100  in accordance with one embodiment of the present disclosure is illustrated.  FIG. 1  shows an isometric view of a surgical instrument  100  having a working shaft section  174  at its distal end, a handle section  101  at its proximal end, and a pivot section  140  intermediate the working shaft section  174  and the handle section  101 . The handle section  101  may include a first handle  102  and a second handle  122 , as will be discussed in more detail below. 
         [0182]      FIG. 2  shows a side view of the surgical instrument  100  of  FIG. 1  with the handle section  101  adjusted in a “drop-down” position relative to a longitudinal axis  183  of the working shaft section  174 . The surgeon can use this handle orientation for high precision activities with his or her fingers in the finger loops  110 ,  130  to give the surgeon more precise control over an end effector (not shown) disposed at the distal end of the working shaft  182 . It is to be understood, that the surgical instruments disclosed herein can be used with any end effector, including, but not limited to: grasping jaws, dissectors, suture passers, staplers, tissue cutters, as well as any other end effector known in the art. Moreover, in some embodiments of the present disclosure, adjusting the angular position of the handle section  101  relative to the working shaft section  174  will not affect the end effector. For example, if the end effector is grasping jaws, then adjusting the angular position of the handle section  101  relative to the working shaft section  174  will not cause the grasping jaws to open, close, rotate or otherwise move in any substantial manner. Moreover, the mechanical advantage of the grasping jaws would remain substantially constant as the handle section  101  pivots. The range of motion of the jaws, as well as the range of forces that can be applied to the jaws by the surgeon, would also remain substantially constant as the handle section  101  pivots. In other words, these embodiments allow for the ergonomic adjustment of the handle section  101  to improve the surgeon&#39;s comfort without interfering with the normal operation of the end effector. In other embodiments, adjusting the angular position of the handle section  101  relative to the working shaft section  174  will not “substantially” affect the end effector. In other words, the end effector will substantially remain in the same functional state as the handle section  101  pivots, or will not deviate from the same functional state in an unsatisfactory manner, as the handle section  101  pivots. 
         [0183]      FIG. 3  shows a side view of the surgical instrument  100  of  FIG. 1  with the handle section  101  adjusted in an “in-line” position relative to the longitudinal axis  183  of the working shaft section  174 . This handle orientation is similar to traditional “in-line” laparoscopic instruments such as needle holders. In some procedures, the “in-line” orientation may combine the best of both the “drop-down” and “in-line” configurations where the finger loops are still available for use in high precision tasks, such as grasping and positioning a needle, while also allowing the surgeon to grasp the handles in other ergonomic ways to perform different tasks that do not require as much precision, such as manipulating the needle inside of the patient. 
         [0184]      FIG. 4  shows a side view of the surgical instrument  100  of  FIG. 1  with the handle section  101  adjusted in an “angled-up” position relative to the working shaft section  174 . This handle position orientation may provide the surgeon an ergonomically viable interface with the instrument  100  in the face of awkward approach angles to the patient, as dictated by the variable and unpredictable requirements of surgery. 
         [0185]      FIGS. 2-4  illustrate a reference system for measuring an angle α formed between the working shaft section  174  and the handle section  101 . The reference system includes the longitudinal axis  183  corresponding to the working shaft section  174 , a handle section axis  121  corresponding to the handle section  101 , and an angle α defining the angular relationship between the longitudinal axis  183  and the handle section axis  121 . Referring to  FIG. 3 , the handle section axis  121  may be defined when the handle section  101  is positioned in the “in-line” position. For example, when the handle section  101  is in the “in-line” position, the handle section axis  121  may be parallel to, or in-line with, the longitudinal axis  183 . In some embodiments of the present disclosure, when the handle section axis  121  is parallel with the longitudinal axis  183 , then the angle α corresponds to 0°, as seen in  FIG. 3 . If the handle section  101  is raised above the “in-line” position into an “angled-up” position, then the angle α is positive, as shown in  FIG. 4 . If the handle section  101  is lowered from the “in-line” position into a “drop-down” position, then the angle α is negative, as illustrated in  FIG. 2 . However, it is to be understood that other reference systems or ways of measuring a can be used herein without departing from the spirit or scope of the present disclosure. 
         [0186]    In some embodiments, the handle section  101  may have a limited pivot range with respect to the working shaft section  174  that is defined by an angle α max  and an angle α min . In these embodiments, the handle section  101  can pivot upward until the handle section  101  reaches α max , at which point the handle section  101  is prevented from pivoting upward any further. Likewise, the handle section  101  can pivot downward until the handle section  101  reaches α min , at which point the handle section is prevented from pivoting downward any further. Thus, the pivot range of the handle section  101  may be limited to angles which lie between α max  and α min . In certain embodiments, the handle section  101  can be selectively positioned and maintained in an infinite number of angled positions within the pivot range defined by the maximum angle α max  and the minimum angle α min . In other embodiments, the handle section  101  can be selectively positioned and maintained in multiple discrete angled positions within the pivot range between α max  and α min . In yet other embodiments, the handle section  101  can be selectively positioned and maintained in three discrete angled positions within the pivot range between α max  and α min . In a particular embodiment, the handle section  101  can be selectively positioned and maintained in three discrete angled positions corresponding to about −35°, 0°, and 35°. 
         [0187]    In some embodiments, the pivoting range of the handle section  101  may not be limited between a maximum angle α max  and/or a minimum angle α min . For example, some embodiments may have a maximum angle α max  that is any number between 0° and 180° and/or a minimum angle α min  that is any number between 0° and −180°. In one particular embodiment, the maximum angle can be any number between 0° and 90° and the minimum angle can be any number between 0° and −90°. In a preferred embodiment, the maximum angle is about 35° and the minimum angle is about −35°. 
         [0188]    In a method of use, a practitioner may unlock the pivot section  140 , select an angle position, rotate the handle section  101  relative to the working shaft section  175 , until the desired angle position is reached, and relock the pivot section  140 . 
         [0189]      FIG. 5  shows an exploded view of the surgical instrument  100  with its various components.  FIGS. 6A-13C  illustrate the individual components of  FIG. 5  in greater detail. A detailed description of the structure and features for each individual component will be given in a generally proximal to distal direction with reference to  FIGS. 6A-13C . A detailed description of how each of the individual components interrelate with one another will then be given, along with the functional relationships between each component. Methods of using the surgical instrument  100  will also be given to illustrate how a surgeon can utilize the surgical instrument  100  to achieve greater ergonomic postures during surgery. 
         [0190]      FIGS. 6A-6C  show various isometric views of a first handle  102 , according to one embodiment of the present disclosure. The first handle  102  has a proximal end  196  and a distal end  197 . The first handle  102  can have a top surface  105 , a bottom surface  115 , and two side surfaces  104 . The top surface  105  can have a spatulate leaf shape and/or curve downward in the distal to proximal direction to better conform to the surgeon&#39;s palm. In some embodiments, the top surface  105  can have a radius of curvature, or substantially lie along a radius of curvature. In some embodiments, the radius of curvature can be between about 2 and 4 inches. In other embodiments, the radius of curvature can be between about 2.5 inches and 3.5 inches. In a particular embodiment, the radius of curvature is about 2.9 inches. 
         [0191]    The top surface  105  of the first handle  102  may have a convex or rounded shape in the lateral direction between the two side surfaces  104  of the first handle  102 . The top surface  105  is preferably shaped to be substantially wide enough between the two side surfaces  104  to provide adequate comfort to the surgeon&#39;s palm by providing sufficient surface contact area between the top surface  105  and the surgeon&#39;s palm to reduce or eliminate “hot spots” from forming on the surgeon&#39;s palm. The top surface  105  can have a maximum width and a minimum width in the lateral direction between the two side surfaces. In some embodiments, the minimum width of the top surface is located closer to the distal end of the first handle and the maximum width of the top surface is located closer to the proximal end of the first handle. In some embodiments the minimum width is between about 0.25 inches and about 0.75 inches. In a particular embodiment, the minimum width is about 0.5 inches. In some embodiments, the maximum width is between about 0.5 inches and about 1.25 inches. In one embodiment, the maximum width is about 0.88 inches. The location of the minimum width of the top surface can be chosen to correspond to the area of the top surface  105  that the surgeon&#39;s thumb traverses when the surgeon switches between a “finger loop” grip style and a “palm” grip style. Having the minimum width of the top surface in this area of the top surface  105  can allow the surgeon to more easily switch between the “finger loop” grip style and the “palm” grip style because the smaller width makes it easier for the surgeon&#39;s thumb to traverse this area of the handle. 
         [0192]    The top surface  105  may include a raised surface portion  119  to provide extra support for the surgeon&#39;s fingers or thumb in various different gripping styles. Moreover, the side surfaces  104  may include a thumb or finger rest area  108  formed on or into the side surfaces  104  to provide extra support for the surgeon&#39;s thumb when engaged along the side surface  104 . The first handle  102  may have one or more finger loop holes  110  to receive one or more fingers during procedures requiring greater precision. The finger loop hole contact surface  109  may be convex in shape and wide enough to avoid or eliminate any “hot spots” from occurring on the surgeon&#39;s fingers during extended hours of operation. The first handle  102  can have a projection portion  111  at the proximal end of the first handle  102 . The projection portion  111  may provide greater surface area to interact with the surgeon&#39;s palm against the top surface  105 , and also provide a concave-shaped projection recess portion  116  to interact with the surgeons fingers on the opposite side. In some embodiments, the projection portion  111  can include an electrical connector to receive external input. The first handle  102  can also have a bottom surface  115  and a bottom surface recess area  114  having a concave shape configured to interact with one or more of the surgeon&#39;s fingers as needed. 
         [0193]    Any or all of the surfaces of the first handle  102  may include a comfort material (not shown) attached to one or more of the surfaces of the first handle  102 , such as a soft rubber, polymer, or silicone. The comfort material may be applied to the first handle  102  after manufacture, or the comfort material may be integrally formed or molded to the first handle  102  during manufacture by any suitable manufacturing processes including, but not limited to, bonding or over-molding. 
         [0194]    The distal end of the first handle  102  may include a head portion  112  for receiving a suitably shaped pivot housing  141  into a pivot housing slot  117 . The head portion  112  may have stop pin holes  103  formed through both sides of the head portion  112  for receiving stop pins  168 , as will be discussed in further detail below. The head portion  112  can have a pivot pin hole  106  formed through the head portion  112  configured to receive a pivot pin  164 . The first handle  102  may include a pin hole  107  formed through, or substantially through, the side surfaces  104  of the first handle  102  and configured to receive a pivot pin  135  to pivotably secure a second handle  122 . In this embodiment, the surgical instrument  100  includes a dual pivot design with a first pivot connecting the handle section  101  to the working shaft section  174 , and a second pivot connecting the second handle  122  to the first handle  102 . Moreover, the first and second pivots are not coaxial with each other in this embodiment. 
         [0195]    Referring to  FIGS. 6B-6C , the first handle  102  may include a receiver slot  113  configured and shaped to receive the head portion  127  of a suitable second handle  122 , as will be discussed in further detail below.  FIG. 6C  illustrates the pivot housing slot  117  configured to receive a suitable pivot housing  141  in greater detail.  FIG. 6C  also illustrates an actuator aperture  118  formed within the first handle  102  proximal to the head portion  112  and shaped to allow an actuator  170  to be disposed therein. 
         [0196]    Referring now to  FIGS. 7A-7B , a second handle  122  in accordance with one embodiment of the present disclosure is shown. The second handle  122  can have a proximal end  137  and a distal end  138 . The second handle  122  can also have a top surface  126 , a bottom surface  134 , and two side surfaces  136 . Each of the aforementioned surfaces may have a generally rounded or convex shape to increase comfort. The top surface  126  of the second handle  122  may have a slight “S-shaped” curvature formed therein moving in the distal to proximal direction. The distal end of the second handle  122  may include a head portion  127  configured to interact with the receiver slot  113  of the first handle  102 , as shown in  FIGS. 6A-6C . 
         [0197]    The second handle  122  may have one or more finger loop holes  130  configured to receive one or more of the surgeon&#39;s fingers during procedures that require greater precision. The inner contact surface  129  of the finger loop hole  130  may have a rounded or convex shape to comfortably engage the fingers of the surgeon. 
         [0198]    The second handle  122  may have at least one finger contact surface. Moreover, the at least one finger contact surface can be configured to substantially lie along a radius of curvature. The radius of curvature can be between about 1.5 and 3.5 inches in some embodiments. In other embodiments, the radius of curvature may be between about 2 inches and 3 inches. In a particular embodiment, the radius of curvature is about 2.5 inches. 
         [0199]    The second handle  122  can have a finger loop  130  defining a first finger contact surface  139  configured to receive the surgeon&#39;s ring finger and middle finger, a projection  132  configured to receive the surgeon&#39;s pinky finger, and a recess portion  188  having a third finger contact surface  128  configured to receive the surgeon&#39;s index finger. Moreover, one or more of these finger contact surfaces can substantially lie along a radius of curvature. For example, the first and second finger contact surfaces can substantially lie along a radius of curvature of about 2.5 inches and the third finger contact surface can be offset from the radius of the curvature of the first and second finger contact surfaces by about 0.0625 inches. 
         [0200]    Any or all of the surfaces of the second handle  122  may include a comfort/grip-enhancing material (not shown) attached to one or more of the surfaces of the second handle  122 , such as a soft rubber, polymer, or silicone material. The comfort/grip-enhancing material may be applied to the second handle  122  after manufacture, or alternatively the comfort/grip-enhancing material may be integrally formed or molded to the second handle  122  during manufacture by several manufacturing processes, such as, bonding or over-molding. 
         [0201]    Continuing with  FIGS. 7A-7B , the head portion  127  of the second handle  122  can have a latch release cavity  123  formed through the head portion  127 . The latch release cavity  123  may have an oblong or elongated oval shape configured to receive a second handle pivot pin  135  to allow the second handle pivot pin  135  to move translationally within the latch release cavity  123 . The latch release cavity  123  can have a spring detent  124  just below the latch release cavity  123  to help control and bias the translational movement of the second handle pivot pin  135 , as will be discussed in greater detail below. The head portion  127  can have an actuator bore  133  formed through the head portion  127  and in communication with an actuator connection recess  125  on the opposite side of the head portion  127 . 
         [0202]    In other embodiments, the second handle  122  may comprise an alternative control member such as a trigger, a button, a lever, a truncated handle or any other structure suitable for a surgical instrument. In some embodiments, the second handle  122  may be omitted entirely. 
         [0203]      FIGS. 8A-8C  show a pivot housing  141 , in accordance with one embodiment of the present disclosure. The pivot housing  141  may include a hollow shaft  142  at its distal end and a pivot head portion  156  at its proximal end. The pivot head portion  156  may have a top surface  143 , a bottom surface  154 , side surfaces  147 , a top angled surface  144 , and a bottom angled surface  149 . The top surface  143  and the bottom surface  154  may have partially spherical shapes configured to receive a suitable rotation knob  175  and allow the rotation knob  175  to rotate freely about the pivot head portion  156 . The pivot head portion  156  may include a pivot pin hole  148  formed through the pivot head portion  156  between the sides  147 . Additionally, the pivot head portion  156  may include stop pin slots  152  formed through the pivot head portion  156  having elongated and curved oval shapes. The pivot head portion  156  may also include one or more locking teeth  145  formed in a proximal surface of the pivot head portion  156 . 
         [0204]    With reference to  FIG. 8B , the hollow shaft  142  may have a larger diameter portion  151  wherein the larger diameter portion  151  may include an annular groove  150  formed therein. The annular groove  150  may be shaped and configured to receive a retaining pin  180  to allow the rotation knob  175  to rotate freely about the pivot housing  141 , while keeping the rotation knob  175  from moving translationally with respect to the working shaft  182 . The hollow shaft  142  can have an inner bore  155  shaped to receive a suitable restoring spring  173 . The inner bore  155  may be in communication with the pivot pin hole  148  and a proximal opening  146  in the pivot head portion  156 . The proximal opening  146  may open wider moving in the distal to proximal direction with diverging top and bottom surfaces  153 . 
         [0205]      FIG. 9  shows a locking member  158  in accordance with one embodiment of the present disclosure. The locking member  158  may have a locking surface  163  including one or more locking teeth  159  formed in a surface of the locking member  158  and configured to engage the locking surface  157  of the pivot housing  141 , which can also include teeth  145 , in some embodiments. 
         [0206]      FIG. 10  shows a connector  160  in accordance with one embodiment of the present disclosure. The connector  160  can have a bore  161  formed through the connector  160  and a radially chamfered surface formed in one end of the connector  160 . 
         [0207]      FIGS. 11A-11C  show various views of a pivot pin  164  in accordance with one embodiment of the present disclosure. The pivot pin  164  may have a guide hole  169  formed through the center of the pivot pin  164 . The guide hole  169  can restrain the actuator  170  along the centerline of the joint as the handle section  101  pivots relative to the working shaft section  182 . The guide hole  169  may have a distal end  166  and a proximal end  167  as shown in  FIG. 11C . The distal end  166  of the guide hole  169  can be smaller in diameter than the proximal end  167  of the guide hole  169 . The distal end  166  of the guide hole  169  can have a chamfered surface. The proximal end  167  of the guide hole  169  can also have a chamfered surface  165  which may be larger than the chamfered surface of the distal end  166  of the guide hole  169 , as shown in  FIGS. 11B and 11C . 
         [0208]      FIG. 12  shows one embodiment of an actuator  170  that may be used in the present disclosure. The actuator  170  can have a distal connector  171  at its distal end and a proximal connector  172  at its proximal end. The distal connector  171  may have a partially spherical shape and a hollow center, as can be seen in  FIG. 12 . The proximal connector  172  may have a solid spherical shape. However, it is to be understood that the proximal connector  172  and the distal connector  171  may assume any shape that can provide adequate operation of the actuator  170  according to the present disclosure. The actuator  170  may be formed of a flexible material to allow the actuator  170  to bend along its length when the handle section  101  pivots relative to the working shaft section  174 . The actuator  170  can preferably be formed of a material that substantially resists tension forces that are applied to the actuator  170  between the distal connector  171  and proximal connector  172 . In one embodiment the actuator  170  may be an elongated flexible member or a cable. In other embodiments, the actuator  170  may be made of a rigid or semi-rigid segmented linkage that can be restrained to the centerline of the joint. For example, the actuator  170  may be two rigid portions connected by a flexible portion disposed between the two rigid portions. 
         [0209]      FIGS. 13A-13C  show one embodiment of a rotation knob  175  in accordance with the present disclosure. The rotation knob  175  can have an outer surface that is larger in diameter at its proximal end  178  and smaller in diameter at its distal end  177 . The outer surface of the rotation knob  175  can be sized and shaped to engage with a surgeon&#39;s finger or thumb to facilitate rotation of the rotation knob  175 . For example, the rotation knob  175  can have one or more ribs  181  and one or more depressions  176  formed in the outer surface of the rotation knob  175 . The spacing of the ribs  181  and the size and depth of the depressions  176  are preferably sized to fit the width and shape of the average surgeon&#39;s fingers and/or thumb. However, it is to be understood that the size and shape of the depressions  176 , as well as the number and spacing of the ribs  181 , may be varied in any fashion or tailored in any way so as to fit any size finger or thumb. The rotation knob  175  is preferably located close enough to the handle section  101  to allow the surgeon to rotate the rotation knob  175  with one hand. For example, the surgeon may grasp the handle section  101  with one hand and use the thumb or index finger of the same hand to rotate the rotation knob  175 . With reference to  FIG. 13C , the rotation knob  175  may have an inner chamber  179  formed within the rotation knob  175  and shaped to receive a suitable pivot housing  141 , as shown in  FIG. 5  and  FIGS. 8A-8C . 
         [0210]    Referring back to  FIG. 5 , a working shaft  182  may be engaged with the rotation knob  175  such that rotating the rotation knob  175  will rotate the working shaft  182  and orient an end effector (not shown) disposed at the distal end of the working shaft  182 . In other embodiments, the working shaft  182  may not be fixedly attached to the rotation knob  175 . For example, the rotation knob  175  may be fixedly attached to a working rod (not shown) which may run through the working shaft  182  with the working rod connected to the end effector. In this embodiment, rotating the rotation knob  175  will rotate the working rod disposed within the working shaft  182  in order to rotate and Orient the end effector. Furthermore, rotation of the end effector may be prevented, under certain circumstances, by means that are known in the art. For example, rotation of the end effector may be prevented while tensile and/or compression loads are transmitted through the working shaft section  174 . Moreover, any of the surgical instruments disclosed herein may also include ratcheting mechanisms to lock the end effector in one or more positions. For example, if the end effector is a set of jaws, actuating the ratcheting mechanism may lock the jaws or keep the jaws from opening wider. The ratcheting mechanism may provide discrete “locked” positions, or alternatively, the ratcheting mechanism may provide an infinite number of “locked” positions, as will be discussed in greater detail below. 
         [0211]    Continuing with  FIG. 5 , a retaining pin  180  may be inserted through an aperture formed in the side of the rotation knob  175 . The retaining pin  180  may project, at least partially, into the inside of the inner chamber  179  of the rotation knob  175  and engage an annular groove  150  formed within the larger diameter portion  151  of the hollow shaft  142  of the pivot housing  141 . In this configuration, the retaining pin  180  will not permit the rotation knob  175  to move translationally with respect to the longitudinal axis  183  of the working shaft  182 , yet the retaining pin  180  will allow the rotation knob  175  to rotate freely about the longitudinal axis of the working shaft  182 . 
         [0212]      FIG. 5  shows a restoring spring  173  that can be used in some embodiments of the present disclosure to keep the actuator  170  under constant tension. The actuator  170  may be threaded through the bore  161  of the connector  160  such that the distal connector  171  of the actuator  170  engages the chamfered surface  162  of the connector  160  when the actuator  170  is pulled in the proximal direction by the surgeon. The actuator  170  can be threaded through the restoring spring  173 , the inner bore  155  of the pivot housing  141 , the guide hole  169  of the pivot pin  164  disposed within the pivot pin hole  148  of the pivot housing  141 , and through the actuator bore  133  of the second handle  122  such that the proximal connector  172  of the actuator  170  can be disposed within the actuator connection recess  125  of the second handle  122 . The restoring spring  173  may be disposed within the inner bore  155  of the hollow shaft  142  of the pivot housing  141 . The restoring spring  173  can exert a force on the proximal end of the connector  160  to move the connector  160  in the distal direction and keep the actuator  170  under constant tension. Accordingly, if the second handle  122  is “sprung,” then the second handle  122  has a natural or normal position to which it returns when the second handle  122  is at rest. A “sprung” second handle  122  may be useful when the instrument  100  is used in a “palm” grip style. In this configuration, the “sprung” handle provides a natural resistance to the surgeon&#39;s hand that allows the surgeon to retain the handle section  101  with the surgeon&#39;s palm independent of the finger loops. However, it will be noted that other embodiments can have second handles  122  that are “unsprung.” In this configuration, the second handle  122  may be at rest in any position when the second handle  122  is not acted upon by the surgeon. 
         [0213]    The pivot head portion  156  of the pivot housing  141  may be inserted into the pivot housing slot  117  of the first handle  102  such that the pivot pin hole  148  of the pivot housing  141  and the pivot pin hole  106  of the first handle  102  are in alignment. A pivot pin  164  may then be inserted through the pivot pin hole  106  of the first handle  102  and into the pivot pin hole  148  of the pivot housing  141 . The guide hole  169  of the pivot pin  164  may be oriented such that the distal end  166  of the guide hole  169  faces toward the working shaft  182  and the proximal end  167  of the guide hole  169  faces the handle section  101 . Stop pins  168  may also be inserted through the stop pin holes  103  of the first handle  102  and into the stop pin slots  152  of the pivot housing  141 . 
         [0214]    Continuing with  FIG. 5 , the head portion  127  of the second handle  122  may be inserted into the second handle receiver slot  113  of the first handle  102  and secured to the first handle  102  by a pivot pin  135  inserted through the pin hole  107  of the first handle  102  and through the latch release cavity  123  of the second handle  122 . The force of the spring detent  124  combined with the constant tension of the actuator  170  will keep the pivot pin  135  in the proximal end of the latch release cavity  123  when the second handle  122  is at rest (see  FIG. 15 ). Furthermore, a locking member  158  can be inserted into the cavity  120  of the first handle  102  (see  FIG. 6C ) with the locking teeth  159  of the locking member  158  facing distally so as to engage the locking teeth  145  formed in the surface of the pivot housing  141 . The proximal end of the locking member  158  may be attached to a surface of the head portion  127  of the second handle  122  disposed within the second handle receiver slot  113  of the first handle  102 . The locking member  158  may be fixedly or rigidly engaged with the head portion  127 , or a surface of the head portion  127 , of the second handle  122 . In other embodiments, there may be a mechanical junction between the second handle  120  and the locking member  158 . Alternatively, or in addition to, the locking member  158  may be pivotably connected to the head portion  127  of the second handle  122 . The locking member  158  may also be spring biased to aid the engagement or the disengagement of the locking teeth  159  of the locking member  158  with the locking teeth  145  of the pivot housing  141 . 
         [0215]    Referring to  FIGS. 14A-15 , the operation of the surgical instrument  100  will be explained in more detail along with the functional relationships between the various components of the surgical instrument  100 . At rest, the restoring spring  173  pushes distally on the connector  160  to keep the actuator  170  under constant tension. Furthermore, the spring detent  124  biases the second handle pivot pin  135  toward the proximal and of the latch release cavity  123 . The locking teeth  159  of the locking member  158  can be engaged with the locking teeth  145  of the pivot housing  141  such that the handle section  101  is not free to pivot with respect to the working shaft section  174 . 
         [0216]    In a method of use, a practitioner may disengage the locking member  158  to allow the handle section the pivot, pivot the handle section to a desired angle position, and reengage the locking mechanism to prevent the handle section from pivoting. 
         [0217]    In operation, a surgeon may grasp the handle section  101  with his or her hand and squeeze the second handle  122  to move the second handle  122  closer to the first handle  102 . The second handle will tend to pivot in a counterclockwise direction around the second handle pivot pin  135 , pulling the actuator  170  toward the surgeon and engaging an end effector (not shown) connected to the distal connector  171  of the actuator  170 . Pulling the actuator  170  in this fashion creates a tensile load down the actuator  170  which may be transferred to an inner shaft (not shown) connected to the distal connector  171  of the actuator  170  to operate the end effector. In other embodiments, the relative locations of the second handle pivot and  135  and an actuator connection recess  125  may be reversed such that compressing the handles together creates a compressive load down the working shaft and/or a linear motion away from the surgeon. 
         [0218]    In a method of use, a practitioner may control an end effector by moving the first and second handles relative to each other to cause the actuator  170  to affect the end effector. 
         [0219]    As seen in  FIG. 15 , the size and shape of the guide hole  167  in the pivot pin  164 , along with the size and shape of the proximal opening  146  of the pivot housing  141 , can allow the actuator  170  to bend upward or downward as the handle section  101  pivots upward or downward. In this embodiment, the actuator  170  defines an actuation path length between the second handle and the proximal end of an actuator target, such as a working rod (not shown), connected to an end effector (not shown). As the handle section  101  pivots relative to the working shaft section  174 , the actuation path length remains substantially constant because the actuator  170  is restrained to the centerline of the joint through the pivot pin  164 . Thus, pivoting the handle section  101  in either direction will not substantially move or otherwise affect the end effector. Moreover, the actuator  170  can be kept under constant tension by the restoring spring  173 , independent of which ever pivot position the handle section  101  assumes. 
         [0220]    Embodiments of the present disclosure allow the second handle  122  to control whether or not the handle section  101  can pivot. In these embodiments, the second handle  122  can be positioned in a first position to lock the pivot section  140  and prevent the handle section  101  from pivoting relative to the working shaft section  174 . The second handle  122  can also be positioned in a second position to unlock the pivot section  140  and allow the handle section  122  to pivot relative to the working shaft section  174 . 
         [0221]    In one embodiment, the second handle  122  can control whether or not the handle section  101  can pivot utilizing a system including a pivot pin  135 , a latch release cavity  123  formed within the second handle  122 , a spring detent  124  and a locking member  158  engaged with the second handle  122 . The second handle  122  may be pivotably engaged to the first handle  102  by the pivot pin  135  disposed within the latch release cavity  123  of the second handle  102  threaded through the pin holes  107  formed in the first handle  102 . At rest, the second handle  122  is in a first position with the spring detent  124  imposing a bias force upon the pivot pin  135  forcing the head portion  127  of the second handle  122  to move in the distal direction and the pivot pin  135  to move into the proximal end of the latch release cavity  123 . The locking member  158  engaged with the second handle  122  may also move in the distal direction along with the head portion  127  of the second handle  122  to allow the pivot section  140  to lock. 
         [0222]    To unlock the pivot section  140 , the surgeon can apply and maintain a counterclockwise force on the second handle  122  to force the second handle  122  into a second position that will allow the pivot section  140  to unlock and permit the handle section  101  to pivot. With sufficient counterclockwise force on the second handle  122 , the biasing force of the spring detent  124  is overcome allowing the head portion  127  of the second handle  122  to move in the proximal direction forcing the pivot pin  135  into the distal end of the latch release cavity  123 . The locking member  158  engaged with the second handle  122  may also move in the proximal direction with the head portion  127  of the second handle  122  to allow the pivot section  140  to unlock. 
         [0223]    In some embodiments, the pivot housing  141  includes a first locking surface  157  and the locking member  158  includes a second locking surface  163 . The first and second locking surfaces can be any size, shape, or texture. The first and second locking surfaces can made from any suitable materials that will allow the first and second locking surfaces to interact with each other to lock the pivot section  140 . For example, the first and second locking surfaces may be relatively smooth and made from frictional materials that allow the locking surfaces to frictionally engage with one another at any point and at any angle. For example, the first and second locking surfaces may be smooth and made of rubber, or a rubber-like material, such that when the first and second locking surfaces are pressed together frictional forces keep the pivot section  140  locked. It is to be understood that the term rubber, or rubber-like material, includes any naturally occurring or synthetic material exhibiting frictional properties suitable to substantially lock the pivot section  140 . In this manner, the handle section can be selectively positioned and locked in an infinite number of angled positions relative to the longitudinal axis of the working shaft section over a range of angles defined by α max  and α min . 
         [0224]    Some embodiments provide for an infinite number of different angled positions that the handle section  101  can assume in a single plane. In other embodiments, the handle section  101  can be angled in multiple planes with respect to the working shaft section  174 . Thus, it is envisioned that a pivot joint section  140  having a multi-axial or poly axial articulation can be utilized. In other embodiments, the handle section  101  can be angled in multiple planes with respect to the working shaft section  174  utilizing a discrete number of different angle positions for one or more of the planes. In yet other embodiments, the handle section  101  can be angled in multiple planes with respect to the working shaft section  174  utilizing an infinite number of different angle positions for one or more of the planes. In each of these embodiments, it is envisioned that a similarly functioning latch component may be utilized to lock the pivot joint section in each of its respective planes of movement. 
         [0225]    In other embodiments, the handle section  101  can be selectively positioned in multiple discrete angled positions relative to the longitudinal axis  183  of the working shaft section  174  over a range of angles defined by an angle α max  and an angle α min . In another embodiment, the handle section  101  can be selectively positioned in three discrete angled positions relative to the longitudinal axis  183  of the working shaft section  174 . In a particular embodiment, the handle section  101  can be selectively positioned in 3 discrete angled positions corresponding to about 35°, 0°, and −35°. 
         [0226]    In some embodiments, the first locking surface  157  of the pivot housing  141  and the second locking surface  163  of the locking member  158  may comprise one or more locking teeth  145 ,  159 . In this embodiment, the locking teeth  145 ,  159  may interact with each other to lock the pivot section  140 . In order to pivot the handle section  101  with respect to the working shaft section  174 , the locking teeth  159  of the locking member  158  may be disengaged from the locking teeth  145  of the pivot housing  141 . A surgeon may disengage the locking teeth  159  of the locking member  158  from the locking teeth  145  of the pivot housing  141  by rotating the second handle  122  in a clockwise direction, about the second handle pivot pin  135 . Rotating the second handle  122  in the clockwise direction with enough force will overcome the spring bias of the spring detent  124  and force the second handle  122  to move translationally with respect to the pivot pin  135  such that the distal end of the latch release cavity  123  moves proximally toward the pivot pin  135  to receive the pivot pin  135  into the distal end of the latch release cavity  123 . At this point, the head portion  127  of the second handle  122  has moved proximally enough to disengage the locking member  158  from the pivot housing  141  allowing the handle section  101  to pivot. The surgeon may continue to apply a clockwise force to the second handle  122  to keep the locking member  158  disengaged while he or she rotates the handle section  101  to the new desired angular position. The surgeon may then stop applying the clockwise rotational force to the second handle  122  and allow the spring bias of the spring detent  124  to force the second handle  122  to move back in the distal direction and allow the proximal end of the latch release cavity  123  to receive the second handle pivot pin  135 . Once the second handle  122  moves back in the distal direction, the locking teeth  159  of the locking member  158  can engage the locking teeth  145  of the pivot housing  141 , locking the handle section  101  in the desired angular position and preventing the handle section  101  from pivoting with respect to the working shaft section  174 . 
         [0227]    In some embodiments, the number of different angled positions the handle section  101  can assume can be dependent on the number, size, and shape of the locking teeth  145  of the pivot housing  141  and the locking teeth  159  of the locking member  158 . For example, increasing the number of locking teeth  145  on the pivot housing  141  will result in a greater number of discrete angled positions that the handle section  101  can assume. However, increasing the number of locking teeth  145  on the pivot housing  141  may result in smaller locking teeth  145 ,  159  which may result in teeth that are not mechanically strong enough to the withstand forces applied to the teeth during normal operation of the surgical instrument  100 . 
         [0228]    In some embodiments, it may be desirable to limit how much the handle section  101  may pivot in relation to the working shaft section  174  of the surgical instrument  100 . Stop pins  168  disposed within the stop pin slots  152  of the pivot housing  141  can be used to limit how far the handle section  101  may pivot. Continuing with  FIG. 15 , as the handle section  101  pivots in the upward direction the stop pins  168  will rotate counterclockwise in their respective stop pin slots  152 , about the pivot pin  164 . In this embodiment, if the surgeon continues to rotate the handle section  101  in the counterclockwise position, eventually the stop pins will contact the ends of their respective stop pin slots  152  preventing further rotation in the counterclockwise direction. Likewise, if the surgeon continues to rotate the handle section  101  in the clockwise direction, eventually the stop pins  168  will contact the opposite ends of their respective stop pin slots  152  preventing further rotation in the clockwise direction. Alternatively, or in addition thereto, the pivot housing  141  may include a top angled surface  144  and a bottom angled surface  149  which may act as “hard stops” to interact with complementary surfaces of the first handle  102  or the second handle  122  to prevent further rotation in either the clockwise or the counterclockwise direction. 
         [0229]    In  FIGS. 16-43 , a surgical instrument  200  in accordance with another embodiment of the present disclosure is illustrated.  FIG. 16  shows an isometric view of a surgical instrument  200  having a working shaft section  274  at its distal end, a handle section  201  at its proximal end, and a pivot section  240  intermediate the working shaft section  274  and the handle section  201 . The handle section  201  may include a first handle  202  and a second handle  222 . 
         [0230]      FIG. 17  shows a side view of the surgical instrument  200  of  FIG. 16  with the handle section  201  adjusted in a “drop-down” position relative to the longitudinal axis  283  of the working shaft section  274 , similar to other embodiments disclosed herein. The surgical instrument of  FIG. 16  also shows the second handle  22  in the “at rest” or biased position. 
         [0231]      FIG. 18  shows a side view of the surgical instrument  200  of  FIG. 16  with the handle section  201  adjusted in a “drop-down” position relative to the longitudinal axis  283  of the working shaft section  274  and with the second handle  22  in the “forward” or unlocked position. 
         [0232]      FIG. 19  shows a side view of the surgical instrument  200  of  FIG. 16  with the handle section  201  adjusted in an “in-line” position relative to the longitudinal axis  283  of the working shaft section  274 . 
         [0233]      FIG. 20  shows a side view of the surgical instrument  200  of  FIG. 16  with the handle section  201  adjusted in an “angled-up” position relative to the working shaft section  274 . 
         [0234]      FIG. 21  shows an exploded view of the surgical instrument  200  with its various components.  FIGS. 22A-37B  illustrate the individual components of  FIG. 21  in greater detail. A detailed description of the structure and features for each individual component will be given in a generally proximal to distal direction with reference to  FIGS. 22A-37B . A detailed description of how each of the individual components interrelate with one another will then be given, along with the functional relationships between each component. Methods of using the surgical instrument  200  will also be given to illustrate how a surgeon can utilize the surgical instrument  200  to achieve greater ergonomic postures during surgery. 
         [0235]      FIGS. 22A-22C  show various isometric views of a first handle  202 , according to one embodiment of the present disclosure. The first handle  202  has a proximal end  296  and a distal end  297 . The first handle  202  can have a top surface  205 , a bottom surface  215 , and two side surfaces  204 . The top surface  205  can have a spatulate leaf shape and/or curve downward in the distal to proximal direction to better conform to the surgeon&#39;s palm. In some embodiments, the top surface  105  can have a radius of curvature, or substantially lie along a radius of curvature. In some embodiments, the radius of curvature can be between about 2 and 4 inches. In other embodiments, the radius of curvature can be between about 2.5 inches and 3.5 inches. In a particular embodiment, the radius of curvature is about 2.9 inches. 
         [0236]    The top surface  205  of the first handle  202  may have a convex or rounded shape in the lateral direction between the two side surfaces  204  of the first handle  202 . The top surface  205  is preferably shaped to be substantially wide enough between the two side surfaces  204  to provide adequate comfort to the surgeon&#39;s palm by providing sufficient surface contact area between the top surface  205  and the surgeon&#39;s palm to reduce or eliminate “hot spots” from forming on the surgeon&#39;s palm. The top surface  205  can have a maximum width and a minimum width in the lateral direction between the two side surfaces. In some embodiments, the minimum width of the top surface is located closer to the distal end of the first handle and the maximum width of the top surface is located closer to the proximal end of the first handle. In other embodiments the minimum width is between about 0.25 inches and about 0.75 inches. In a particular embodiment, the minimum width is about 0.5 inches. In some embodiments, the maximum width is between about 0.5 inches and about 1.25 inches. In one embodiment, the maximum width is about 0.88 inches. The location of the minimum width of the top surface can be chosen to correspond to the area of the top surface  205  that the surgeon&#39;s thumb traverses when the surgeon switches between a “finger loop” grip style and a “palm” grip style. Having the minimum width of the top surface in this area of the top surface  205  can allow the surgeon to more easily switch between the “finger loop” grip style and the “palm” grip style because the smaller width makes it easier for the surgeon&#39;s thumb to traverse this area of the handle. 
         [0237]    The top surface  205  may include a button slot  219  configured to receive a portion of a ratcheting mechanism, such as a button. Moreover, the side surfaces  204  may include a thumb or finger rest area  208  formed on or into the side surfaces  204  to provide extra support for the surgeon&#39;s thumb when engaged along the side surface  204 . The first handle  202  may have one or more finger loop holes  210  to receive one or more fingers during procedures requiring greater precision. The finger loop hole contact surface  209  may be convex in shape and wide enough to avoid or eliminate any “hot spots” from occurring on the surgeon&#39;s fingers during extended hours of operation. The first handle  202  can have a projection portion  211  at the proximal end  296  of the first handle  202 . The projection portion  211  may provide greater surface area to interact with the surgeon&#39;s palm against the top surface  205 . In one embodiment, the projection portion  211  can include an electrical connector to receive external input. The first handle  202  can also have a bottom surface  215  and a bottom surface recess area  214  having a concave shape configured to interact with one or more of the surgeon&#39;s fingers as needed. 
         [0238]    Any or all of the surfaces of the first handle  202  may include a comfort material (not shown) attached to one or more of the surfaces of the first handle  202 , such as a soft rubber, polymer, or silicone. The comfort material may be applied to the first handle  202  after manufacture, or the comfort material may be integrally formed or molded to the first handle  202  during manufacture by any suitable manufacturing processes including, but not limited to, bonding or over-molding. 
         [0239]    The distal end  297  of the first handle  202  may include a head portion  212  for receiving a suitably shaped pivot housing  241  into the pivot housing slot  217 . The head portion  212  may have stop pin holes  203  formed through both sides of the head portion  212  for receiving stop pins  268 , as will be discussed in further detail below. The head portion  212  can have a pivot pin hole  206  formed through the head portion  212  configured to receive a pivot pin  264 . The first handle  202  may include a pin hole  207  formed through, or substantially through, the side surfaces  204  of the first handle  202  and configured to receive a pivot pin  235  to pivotably secure a second handle  222 . In this embodiment, the surgical instrument  200  includes a dual pivot design with a first pivot connecting the handle section  201  to the working shaft section  274 , and a second pivot connecting the second handle  222  to the first handle  202 . Moreover, the first and second pivots are not coaxial with each other in this embodiment. 
         [0240]    Referring to  FIGS. 22B-22C , the first handle  202  may include a receiver slot  213  configured and shaped to receive the head portion  227  of a suitable second handle  222 , as will be discussed in further detail below.  FIG. 6C  illustrates a pivot housing slot  217  configured to receive a suitable pivot housing  241 , in greater detail.  FIG. 6C  also illustrates an actuator aperture  218  formed within the first handle  202  proximal to the head portion  212  and shaped to allow an actuator  270  to be disposed therethrough. The first handle  202  may also have a ratchet slot  298  formed therein and configured to receive a suitable ratcheting mechanism, as will be discussed in greater detail below. 
         [0241]    Referring now to  FIGS. 23A-23D , a second handle  222  in accordance with one embodiment of the present disclosure is shown. The second handle  222  can have a proximal end  237  and a distal end  238 . The second handle  222  can also have a top surface  226 , a bottom surface  234 , and two side surfaces  236 . Each of the aforementioned surfaces may have a generally rounded or convex shape to increase comfort. The top surface  226  of the second handle  222  may have a slight “S-shaped” curvature formed therein moving in the distal to proximal direction. The distal end  238  of the second handle  222  may include a head portion  227  configured to interact with the receiver slot  213  of the first handle  202 , as shown in  FIGS. 22A-22C . The second handle  222  can have retainer members  286 , a ramp pivot hole  284  and a ramp pivot slot, which will be discussed in greater detail below. 
         [0242]    The second handle  222  may have one or more finger loop holes  230  configured to receive one or more of the surgeon&#39;s fingers during procedures that require greater precision. The inner contact surface  229  of the finger loop hole  230  may have a rounded or convex shape to comfortably engage the fingers of the surgeon. 
         [0243]    The second handle  222  may have at least one finger contact surface. Moreover, the at least one finger contact surface can be configured to substantially lie along a radius of curvature. The radius of curvature can be between about 1.5 and 3.5 inches in some embodiments. In other embodiments, the radius of curvature may be between about 2 inches and 3 inches. In a particular embodiment, the radius of curvature is about 2.5 inches. 
         [0244]    In one embodiment, the second handle  222  can have a finger loop  230  defining a first finger contact surface  239  configured to receive the surgeon&#39;s ring finger and middle finger, a projection  232  configured to receive the surgeon&#39;s pinky finger, and a recess portion  288  forming a third finger contact surface  228  configured to receive the surgeon&#39;s index finger. Moreover, one or more of these finger contact surfaces can substantially lie along a radius of curvature. For example, the first and second finger contact surfaces can substantially lie along a radius of curvature of about 2.5 inches and the third finger contact surface can be offset from the radius of the curvature of the first and second finger contact surfaces by about 0.0625 inches. 
         [0245]    Any or all of the surfaces of the second handle  222  may include a comfort/grip-enhancing material (not shown) attached to one or more of the surfaces of the second handle  222 , such as a soft rubber, polymer, or silicone material. The comfort/grip-enhancing material may be applied to the second handle  222  after manufacture, or alternatively the comfort/grip-enhancing material may be integrally formed or molded to the second handle  222  during manufacture by several manufacturing processes, such as, bonding or over-molding. 
         [0246]    Continuing with  FIGS. 23A-23B , the head portion  227  of the second handle  222  can have a latch release cavity  223  formed through the head portion  227 . The latch release cavity  223  may have an oblong or elongated oval shape configured to receive a pivot pin  235  to allow the pivot pin  235  to move translationally within the latch release cavity  223 . The latch release cavity  223  can have a spring detent  224  just below the latch release cavity  223  to help control and bias the translational movement of the pivot pin  235 , as will be discussed in greater detail below. The head portion  227  can have an actuator bore  233  formed through the head portion  227  and in communication with an actuator connection recess  225 . 
         [0247]      FIG. 24  shows one embodiment of a multi-component second handle  222  having a removable top portion  287  which may be attached to the second handle  222  with pins  289  threaded through pin holes  290 . In other embodiments, the second handle  222  may comprise an alternative control member such as a trigger, a button, a lever, a truncated handle or any other structure suitable for a surgical instrument. In some embodiments, the second handle  222  may be omitted entirely. 
         [0248]      FIGS. 25A-26C  show one embodiment of a ratcheting mechanism  300  in accordance with one embodiment of the present disclosure.  FIG. 25A  shows an isometric view of an assembled ratcheting mechanism  300 .  FIG. 25B  shows an exploded view of the ratcheting mechanism  300  of  FIG. 25A . The ratcheting mechanism  300  may include a release member  301  pivotably connected to a ratchet body  310 . The release member  301  may include a button  302  and a wedge release member  303  with the release member  301  configured to be pivotably connected to the ratchet body  310  using a suitable pivot pin  305  threaded through the pin holes  311  of the ratchet body  310  and through the pin hole  304  of the release member  301 . The ratchet mechanism  300  can include a wedge member  306  biased toward one end of the ratcheting mechanism  300 . The wedge member  306  can be disposed within the ratchet body  310  through the wedge member slots  312 . Biasing members  307  can be disposed within the ratchet body  310  and held in place by guide members  308  threaded through the guide member slots  314 . The biasing members  307  can be one or more springs which can impart a substantially constant bias force on the wedge member  306 . The ratcheting mechanism  300  can also include a second ramp support pin  309 . 
         [0249]      FIGS. 26A-26C  show the ratchet body  310  in greater detail. The ratchet body  310  can have one or more first ramps  315  configured to interact with the wedge member  306  from above.  FIG. 28  shows a second ramp  318  which may also interact with the wedge member  306  from below. The second ramp  318  can be pivotably mounted to the second handle  222  using the pivot pin hole  319  formed in the end of the second ramp  318  and a pivot pin  320  threaded through the pivot pin hole  319  of the second ramp  318  and through the pivot holes  284  formed in the second handle  222 , as shown in  FIG. 23B . The second ramp  318  may project outward from the ramp pivot slot  285  formed in the second handle  222 . 
         [0250]      FIG. 41  shows a cross-sectional side view of the surgical instrument  200  with the ratcheting mechanism  300  installed in the surgical instrument  200 . The ratcheting mechanism  300  can be attached to the first handle  202  with a pivot pin  305  and the second ramp support pin  309 , as can be seen in  FIG. 21  and  FIG. 25B .  FIG. 41  shows how the second ramp  318  can be pivotably attached to the second handle  222 . The second ramp can project into the ratcheting mechanism  300  and between the second ramp support pin  309  and the wedge member  306 . The second ramp  318  and the first ramp  315  can be angled with respect to each other such that the surfaces of the second ramp  318  and the first ramp  315  converge closer to each other moving in the distal direction and diverge away from each other moving in the proximal direction. A wedge member  306  disposed between the first ramp  315  and the second ramp  318  can be sized and shaped to interact with the first and second ramps as they angle toward each other in the distal direction and away from each other in the proximal direction. For example, the width of the wedge member  306  can be less than the distance between the surfaces of the second ramp  318  and the first ramp  315  in the proximal direction and greater than the distance between the surfaces of the second ramp  318  in the first ramp  315  in the distal direction. Accordingly, two zones are formed between the first ramp  315  and a second ramp  318 , a free zone in the proximal direction, and an interference zone in the distal direction. One or more biasing members  307  can also be used to impart a biasing force upon the wedge member  306 , forcing the wedge member in the distal direction and into the interference zone. In one embodiment, the one or more biasing members  307  can be one or more springs configured to impart a substantially constant force upon the wedge member  306 . 
         [0251]    In operation, applying a pivot force to the second handle  222 , to pivot the second handle  222  toward the first handle  202 , will cause the second ramp  318  to move in the proximal direction which will also cause the wedge member  306  to move or rotate in the proximal direction. The wedge member  306  enters the free zone allowing the second ramp  318  to continue moving in the proximal direction, allowing the second handle  222  to pivot towards the first handle  202 . However, if a pivot force is applied to the second handle  222  in the opposite direction, then the second ramp will move in the distal direction causing the wedge member  306  to rotate or move in the distal direction, forcing the wedge member  306  into the interference zone where the width of the wedge member  306  is greater than the distance between the two ramps. The second ramp  318  will become “pinched” between the wedge member and the second ramp support pin  309 , preventing the second handle  222  from pivoting away from the first handle  202 . In this manner, the ratcheting mechanism  300  allows the first handle  202  and the second handle  222  to pivot towards each other, while preventing the first handle  202  and the second handle  222  from pivoting away from each other. In this manner, the ratcheting mechanism  300  allows for an infinite number of positional relationships to be selected and maintained between the first handle  202  and the second handle  222 . 
         [0252]    The ratcheting mechanism  300  can be disabled, or released, with a suitable release member  301  that can force the wedge member  306  toward the free zone. The button  302  of the release member  301  can be depressed causing the wedge release member  303  to move in the proximal direction forcing the wedge member  306  into the free zone. As the wedge member  306  enters the free zone, the second ramp  318  is no longer “pinched” between the wedge member  306  and the second ramp support pin  309 . The second ramp is now free to move in the distal direction, along with the second handle  222  which is attached to the second ramp  318 . 
         [0253]      FIG. 27  shows a locking member  258  in accordance with one embodiment of the present disclosure. The locking member  258  may have a locking surface  263  including one or more locking teeth  259  formed in a surface of the locking member  258  and configured to engage the locking surface  257  of a suitable pivot housing  241 , which can also include one or more teeth  245 , and or one or more locking member receiver slots  299 . The locking member  258  can also have projections  260  configured to interact with retainer members  286  formed on the head portion  227  of the second handle  222  to keep the locking member  258  engaged with the second handle  222 . 
         [0254]      FIGS. 29A-29D  show one embodiment of a connector  360  in accordance the present disclosure, and will be discussed in greater detail below. 
         [0255]      FIGS. 30A-30C  show a pivot housing  241 , in accordance with one embodiment of the present disclosure. The pivot housing  241  may include a hollow shaft  242  at its distal end and a pivot head portion  256  at its proximal end. The pivot head portion  256  may have a top surface  243 , a bottom surface  254 , side surfaces  247 , a top angled surface  244 , and a bottom angled surface  249 . The top surface  243  and the bottom surface  254  may have partially spherical shapes configured to receive a suitable rotation knob  275  to allow the rotation knob  275  to rotate freely about the pivot head portion  256 . The pivot head portion  256  may include a pivot pin hole  248  formed through the pivot head portion  256  between the sides  247 . Additionally, the pivot head portion  256  may include stop pin slots  252  formed through the pivot head portion  256  having elongated and curved oval shapes. The pivot head portion  256  may also include one or more locking teeth  245 , and/or one or more locking member receiver slots  299 , formed in a surface of the pivot head portion  256 . 
         [0256]    With reference to  FIG. 30B , the hollow shaft  242  may have a larger diameter portion  251  wherein the larger diameter portion  251  may include an annular groove  250  formed therein. The annular groove  250  may be shaped and configured to receive a retaining pin  280  to allow the rotation knob  275  to rotate freely about the pivot housing  241 , while keeping the rotation knob  275  from moving translationally with respect to the working shaft  282 . The hollow shaft  242  can have an inner bore  255  shaped to receive a suitable restoring spring  273 . The inner bore  255  may be in communication with the pivot pin hole  248  and a proximal opening  246  in the pivot head portion  256 . The proximal opening  246  may open wider moving in the distal to proximal direction with diverging top and bottom surfaces  253 . 
         [0257]      FIG. 31A-31B  show two isometric views of one embodiment of a working shaft section  274 .  FIG. 32  shows an exploded view of the working shaft section  274  of  FIGS. 31A-31B . 
         [0258]      FIG. 33  shows one embodiment of a rotation knob  275  in accordance with the present disclosure. The rotation knob  275  can have an outer surface that is larger in diameter at its proximal end  278  and smaller in diameter at its distal end  277 . The distal end  277  of the rotation knob  275  can form a translation guide  397  with one or more channels  384  formed in the translation guide  397 . The rotation knob  275  can have an annular groove  380  formed in a surface of the translation guide  397  and configured to interact with a suitable retaining pin  385 . The rotation knob  275  can also have one or more longitudinal apertures formed therein and configured to receive springs  382  and spheres  383  therein. 
         [0259]    The outer surface of the rotation knob  275  can be sized and shaped to engage with a surgeon&#39;s finger or thumb to facilitate rotation of the rotation knob  275 . For example, the rotation knob  275  can have one or more ribs  281  and one or more depressions  276  formed in the outer surface of the rotation knob  275 . The spacing of the ribs  281  and the size and depth of the depressions  276  are preferably sized to fit the width and shape of the average surgeon&#39;s fingers and/or thumb. However, it is to be understood that the size and shape of the depressions  276 , as well as the number and spacing of the ribs  281 , may be varied in any fashion or tailored in any way so as to fit any size finger or thumb. The rotation knob  275  is preferably located close enough to the handle section  201  to allow the surgeon to rotate the rotation knob  275  with one hand. For example, the surgeon may grasp the handle section  201  with one hand and use the thumb or index finger of the same hand to rotate the rotation knob  275 . 
         [0260]      FIG. 34  shows one embodiment of a control member  388  that can be used in the present disclosure. The control member can have a proximal end  389  and a distal end  390 . The control member  388  can have a hollow body forming an inner surface with a smaller diameter portion  391  located toward the distal end  390  and a larger diameter portion (not shown) located toward the proximal end  389  of the control member  388 . A chamfered surface  392  can be intermediate the smaller diameter portion  391  and the larger diameter portion. The control member  388  may have one or more translation members  394  engaged with a surface of the control member  388 .  FIG. 35  shows an isometric view of a working shaft collet  396  which can be used to frictionally engage a working shaft  282 . 
         [0261]      FIGS. 36A-36B  show isometric views of a hollow body  372  according to one embodiment of the present disclosure. The hollow body  372  can form an inner chamber and have one or more channels  373  formed in the surface of the inner chamber and configured to interact with the one or more translation members  394  of the control member  388 . The proximal end  376  of the hollow body  372  can have a surface with one or more depressions  374  formed therein and configured to interact with spheres  383  inserted into the longitudinal apertures  381  of the rotation knob  275 . The hollow body  372  may also have a port  375  connected to a surface of the hollow body  372 . The port  375  can be in communication with the inner chamber of the hollow body  372 . The port can be used as an aid in the cleaning process. For example, pressurized water can be forced into the port to help clean the inside of the hollow body  372 . 
         [0262]      FIGS. 37A and 37  B show isometric views of a working rod  350  that may be used with embodiments disclosed herein. The working rod  350  has a proximal end  351  and a distal end  352 . The distal end  352  of the working rod  350  can be configured to attach a suitable end piece  358  for a given end effector (not shown). The proximal end  351  of the working rod  350  can have a connector portion  357  configured to interact with a suitable connector  360  as shown in  FIGS. 29A-29  D. The connector portion  357  can have a larger diameter portion  353 , a smaller diameter portion  354 , a first chamfered surface  355 , and a second chamfered surface  356 . The second chamfered surface  356  can be intermediate the smaller diameter portion  354  and the larger diameter portion  353 . The first chamfered surface  355  can be proximal the larger diameter portion  353 . In some embodiments, the first chamfered surface  355  can be replaced with a partially spherical shaped end piece proximal the larger diameter portion  353 . 
         [0263]    A system for coupling a working rod  350  to the surgical instrument  200  will now be explained with reference to  FIGS. 29A-29  D and  FIGS. 31A-43 .  FIGS. 29A-29D  illustrate one embodiment of a connector  360  which may be used with the surgical instruments disclosed herein. The connector  360  can have a proximal end  361  and a distal end  362 . The proximal end of the connector  360  can have a chamber  365  configured to receive the distal end of a suitable actuator  270 . The proximal end  361  of the connector  360  can also have a channel  367  configured to receive a portion of the distal end of the actuator  270 . The channel  367  can have an offset shape to help thread and retain the distal end of the actuator  270  into the chamber  365 . The distal end of the connector  362  can have one or more apertures  363  configured to receive one or more retaining members (not shown).  FIG. 29D  shows a cross-sectional view of the connector  360 , taken along the section line  29 D- 29 D in  FIG. 29C .  FIG. 29D  shows the inner chamber  366  formed in the connector  360  and configured to receive the proximal end  351  of a suitable working rod  350 . 
         [0264]      FIG. 41  shows a cross-sectional side view of a surgical instrument  200  with a connector  360  disposed therein and engaged with a working rod  350  and the distal end of an actuator  270 . A control member  388  at least partially encloses the connector  360 . In  FIG. 41 , the smaller diameter portion  391  of the control member  388  is above the at least one retaining member  368  forcing the retaining member  368  to project into the smaller diameter portion  354  of the working rod  350  and locking the working rod  350  to the connector  360 . However, the control member  388  may be moved in the distal direction such that the larger diameter portion  393  is above the at least one retaining member  368 . With the control member  388  in this position, the working rod  350  can be pulled out of the inner chamber  366  of the connector  360  because the retaining member  368  can move up into the space formed by the larger diameter portion  393 . 
         [0265]      FIG. 32-39B  illustrate a system for translating the control member  388  between a first zone where the at least one retaining member is maintained in the locking position, and a second zone where the at least one retaining member can move to an unlocked position. The control member  388  can be disposed within the translation guide  397  with the translation members  394  of the control member threaded into the channels  384  of the translation guide  397 . The translation members  394  can also be inserted into the channels  373  formed within the hollow body  372 .  FIG. 38B  shows the translation members  394  of the control member  388  disposed within the channels  373  of the hollow body  372 . Rotating the hollow body  372  clockwise with respect to the rotation knob  275  will translate the control member  388  in the distal direction, allowing the working rod  350  to be unlocked from the connector  360 . Rotating the hollow body  372  counterclockwise with respect to the rotation knob  275  will translate the control member  388  in the proximal direction, locking the working rod  350  to the connector  360 . The one or more channels  384  in the translation member  397  can have a pitch that allows for sufficient translation of the control member  388 , in either direction, using a quarter turn rotation of the hollow body  372  with respect to the rotation knob  275 . The spheres  383  and depressions  374  can interact with each other to produce tactile feedback to help the user know when the quarter turn of the hollow body  372  has been reached in either direction. 
         [0266]    A retaining pin (not shown) may be inserted through an aperture  379  formed in the side of the rotation knob  275 , as seen in  FIG. 33 . The retaining pin may project, at least partially, into the inside of the inner chamber of the rotation knob  275  and engage an annular groove  250  formed within the larger diameter portion  251  of the hollow shaft  242  of the pivot housing  241 . In this configuration, the retaining pin will not permit the rotation knob  275  to move translationally with respect to the longitudinal axis  283  of the working shaft  282 , yet the retaining pin will allow the rotation knob  275  to rotate freely about the longitudinal axis of the working shaft  282 . 
         [0267]    In  FIGS. 44-59C , a surgical instrument  400  in accordance with another embodiment of the present disclosure is illustrated.  FIG. 44  shows an isometric view of a surgical instrument  400  having a working shaft section  474  at its distal end, a handle section  401  at its proximal end, and a pivot section  440  intermediate the working shaft section  474  and the handle section  401 . The handle section  401  may include a first handle  402  and a second handle  422 . 
         [0268]      FIG. 45  shows a side view of the surgical instrument  400  of  FIG. 44  with the handle section  401  adjusted in a “drop-down” position relative to the longitudinal axis  483  of the working shaft section  474 , similar to other embodiments disclosed herein.  FIG. 46  shows a side view of the surgical instrument  400  of  FIG. 44  with the handle section  401  adjusted in an “angled-up” position relative to the working shaft section  474 . 
         [0269]      FIGS. 47-50B  show various exploded views of the surgical instrument  400  for each subsection of the surgical instrument  400 .  FIGS. 51A-56C  illustrate the individual components of  FIGS. 47-50B  in greater detail. A detailed description of the structure and features for each individual component will be given in a generally proximal to distal direction with reference to  FIGS. 51A-56C . A detailed description of how each of the individual components interrelate with one another will then be given, along with the functional relationships between each component. Methods of using the surgical instrument  400  will also be given to illustrate how a surgeon can utilize the surgical instrument  400  to achieve greater ergonomic postures during surgery. 
         [0270]      FIGS. 51A-51C  show various isometric views of a first handle  402 , according to one embodiment of the present disclosure. The first handle  402  has a proximal end  496  and a distal end  497 . The first handle  402  can have a top surface  405 , a bottom surface  415 , and two side surfaces  404 . The top surface  405  can have a spatulate shape and/or curve downward in the distal to proximal direction to better conform to the surgeon&#39;s palm. In some embodiments, the top surface  405  can have a radius of curvature, or substantially lie along a radius of curvature. In some embodiments, the radius of curvature can be between about 2 and 4 inches. In other embodiments, the radius of curvature can be between about 2.5 inches and 3.5 inches. In a particular embodiment, the radius of curvature is about 2.9 inches. 
         [0271]    The top surface  405  of the first handle  402  may have a convex or rounded shape in the lateral direction between the two side surfaces  404  of the first handle  402 . The top surface  405  is preferably shaped to be substantially wide enough between the two side surfaces  404  to provide adequate comfort to the surgeon&#39;s palm by providing sufficient surface contact area between the top surface  405  and the surgeon&#39;s palm to reduce or eliminate “hot spots” from forming on the surgeon&#39;s palm. The top surface  405  can have a maximum width and a minimum width in the lateral direction between the two side surfaces. In some embodiments, the minimum width of the top surface is located closer to the distal end of the first handle and the maximum width of the top surface is located closer to the proximal end of the first handle. In other embodiments the minimum width is between about 0.25 inches and about 0.75 inches. In a particular embodiment, the minimum width is about 0.5 inches. In some embodiments, the maximum width is between about 0.5 inches and about 1.25 inches. In one embodiment, the maximum width is about 0.88 inches. The location of the minimum width of the top surface can be chosen to correspond to the area of the top surface  405  that the surgeon&#39;s thumb traverses when the surgeon switches between a “finger loop” grip style and a “palm” grip style. Having the minimum width of the top surface in this area of the top surface  405  can allow the surgeon to more easily switch between the “finger loop” grip style and the “palm” grip style because the smaller width makes it easier for the surgeon&#39;s thumb to traverse this area of the handle. 
         [0272]    The top surface  405  may include a button slot  419  configured to receive a portion of a ratcheting mechanism, such as a button. Moreover, the side surfaces  404  may include a thumb or finger rest area  408  formed on or into the side surfaces  404  to provide extra support for the surgeon&#39;s thumb when engaged along the side surface  404 . The first handle  402  may have one or more finger loop holes  410  to receive one or more fingers during procedures requiring greater precision. The finger loop hole contact surface  409  may be convex in shape and wide enough to avoid or eliminate any “hot spots” from occurring on the surgeon&#39;s fingers during extended hours of operation. The first handle  402  can have a projection portion  411  at the proximal end  496  of the first handle  402 . The projection portion  411  may provide greater surface area to interact with the surgeon&#39;s palm against the top surface  405 . In one embodiment, the projection portion  411  can include an electrical connector to receive external input. The first handle  402  can also have a bottom surface recess area  414  having a concave shape configured to interact with one or more of the surgeon&#39;s fingers as needed. 
         [0273]    Any or all of the surfaces of the first handle  402  may include a comfort material (not shown) attached to one or more of the surfaces of the first handle  402 , such as a soft rubber, polymer, or silicone. The comfort material may be applied to the first handle  402  after manufacture, or the comfort material may be integrally formed or molded to the first handle  402  during manufacture by any suitable manufacturing processes including, but not limited to, bonding or over-molding. 
         [0274]    The distal end  497  of the first handle  402  may include a head portion  412  for receiving a suitably shaped pivot housing  441  into the pivot housing slot  417 . The head portion  412  may have stop pin holes  403  formed through both sides of the head portion  412  for receiving stop pins  468 , as will be discussed in further detail below. The head portion  412  can have a pivot pin hole  406  formed through the head portion  412  configured to receive a pivot pin  464 . The first handle  402  may include a pin hole  407  formed through, or substantially through, the side surfaces  404  of the first handle  402  and configured to receive a pivot pin  435  to pivotably secure a second handle  422 . In this embodiment, the surgical instrument  400  includes a dual pivot design with a first pivot connecting the handle section  401  to the working shaft section  474 , and a second pivot connecting the second handle  422  to the first handle  402 . Moreover, the first and second pivots are not coaxial with each other in this embodiment. 
         [0275]    Referring to  FIG. 51C , the first handle  402  may include a receiver slot  413  configured and shaped to receive the head portion  427  of a suitable second handle  422 , as will be discussed in further detail below.  FIG. 51C  also illustrates the pivot housing slot  417  configured to receive a suitable pivot housing  441 , in greater detail.  FIG. 51C  also illustrates an actuator aperture  418  formed within the first handle  402  proximal to the head portion  412  and shaped to allow an actuator  470  to be disposed therethrough. The first handle  402  may also have a ratchet slot  498  formed therein and configured to receive a suitable ratcheting mechanism, as will be discussed in greater detail below. 
         [0276]    Referring now to  FIGS. 52A-52B , a second handle  422  in accordance with one embodiment of the present disclosure is shown. The second handle  422  can have a proximal end  437  and a distal end  438 . The second handle  422  can also have a top surface  426 , a bottom surface  434 , and two side surfaces  436 . Each of the aforementioned surfaces may have a generally rounded or convex shape to increase comfort. The top surface  426  of the second handle  422  may have a slight “S-shaped” curvature formed therein moving in the distal to proximal direction. The distal end  438  of the second handle  422  may include a head portion  427  configured to interact with the receiver slot  413  of the first handle  402 , as shown in  FIGS. 51A-51C . The second handle  422  can have retainer members  486 , a ramp pivot hole  484  and a ramp pivot slot (not shown), which will be discussed in greater detail below. 
         [0277]    The second handle  422  may have one or more finger loop holes  430  configured to receive one or more of the surgeon&#39;s fingers during procedures that require greater precision. The inner contact surface  429  of the finger loop hole  430  may have a rounded or convex shape to comfortably engage the fingers of the surgeon. 
         [0278]    The second handle  422  may have at least one finger contact surface. Moreover, the at least one finger contact surface can be configured to substantially lie along a radius of curvature. The radius of curvature can be between about 1.5 and 3.5 inches in some embodiments. In other embodiments, the radius of curvature may be between about 2 inches and 3 inches. In a particular embodiment, the radius of curvature is about 2.5 inches. 
         [0279]    In one embodiment, the second handle  422  can have a finger loop  430  defining a first finger contact surface  439  configured to receive the surgeon&#39;s ring finger and middle finger, a projection  432  configured to receive the surgeon&#39;s pinky finger, and a recess portion  488  forming a third finger contact surface  428  configured to receive the surgeon&#39;s index finger. Moreover, one or more of these finger contact surfaces can substantially lie along a radius of curvature. For example, the first and second finger contact surfaces can substantially lie along a radius of curvature of about 2.5 inches and the third finger contact surface can be offset from the radius of the curvature of the first and second finger contact surfaces by about 0.0625 inches. 
         [0280]    Any or all of the surfaces of the second handle  422  may include a comfort/grip-enhancing material (not shown) attached to one or more of the surfaces of the second handle  422 , such as a soft rubber, polymer, or silicone material. The comfort/grip-enhancing material may be applied to the second handle  422  after manufacture, or alternatively the comfort/grip-enhancing material may be integrally formed or molded to the second handle  422  during manufacture by several manufacturing processes, such as, bonding or over-molding. 
         [0281]    Continuing with  FIG. 52B , the head portion  427  of the second handle  422  can have a latch release cavity  423  formed through the head portion  427 . The latch release cavity  423  may have an oblong or elongated oval shape configured to receive a pivot pin  435  to allow the pivot pin  435  to move translationally within the latch release cavity  423 . The latch release cavity  423  can have a spring detent  424  just below the latch release cavity  423  to help control and bias the translational movement of the pivot pin  435 , as will be discussed in greater detail below. The head portion  427  can have an actuator bore  433  formed through the head portion  427  and in communication with an actuator connection recess  425 . 
         [0282]      FIG. 47  shows one embodiment of a multi-component second handle  422  having a removable top portion  487  which may be attached to the second handle  422  with one or more pins  489  threaded through pin holes  490 . In other embodiments, the second handle  422  may comprise an alternative control member such as a trigger, a button, a lever, a truncated handle or any other structure suitable for a surgical instrument. In some embodiments, the second handle  422  may be omitted entirely. 
         [0283]      FIGS. 53A-53B  show a pivot housing  441 , in accordance with one embodiment of the present disclosure. The pivot housing  441  may include a hollow shaft  442  pivot head portion  456 . The pivot head portion  456  may have a top angled surface  444  and a bottom angled surface  449 . The pivot head portion  456  may include a pivot pin hole  448  formed through the pivot head portion  456 . Additionally, the pivot head portion  456  may include stop pin slots  452  formed through the pivot head portion  456  having elongated and curved oval shapes. The pivot head portion  456  may also include one or more locking teeth  445 , and/or one or more locking member receiver slots  499 , formed in a surface of the pivot head portion  456 . The pivot housing  441  can also have a pin hole  570  configured to receive a pivot pin  559  to pivotably connect a suitable connector  560  within the pivot housing  441 . In some embodiments, the pivot housing  441  can also have an input port  530  to receive external input, such as electricity or a fluid. 
         [0284]      FIG. 54A  shows a locking member  458  in accordance with one embodiment of the present disclosure. The locking member  458  may have one or more locking surfaces  463  including one or more locking teeth  459  formed in a surface of the locking member  458  and configured to engage the locking surface  457  of a suitable pivot housing  441 , which can also include one or more teeth  445 , and or one or more locking member receiver slots  499 . The locking member  458  can also have projections  460  configured to interact with retainer members  486  formed on the head portion  427  of the second handle  422  to keep the locking member  458  engaged with the second handle  422 . 
         [0285]      FIG. 54B  shows an isometric view of a pivot pin  464  according to another embodiment of the present disclosure. The pivot pin  464  may have a guide hole  469  formed through the center of the pivot pin  464  between one or more connecting members  465 . The guide hole  469  can restrain an actuator  470  along the centerline of the joint as the handle section  401  pivots relative to the working shaft section  482 . 
         [0286]      FIG. 55A  illustrates one embodiment of the connector  560  which may be used with the surgical instruments disclosed herein. The connector  560  can have a proximal end  561  and a distal end  562 . The proximal end  561  of the connector  560  can have a pin hole  546  configured to receive a suitable pivot pin (not shown) threaded through the distal end of a suitable actuator  470  to pivotably connect the actuator  470  to the connector  560 . The distal end  562  of the connector  560  can have a connection aperture  548  in communication with a longitudinal aperture  563  configured to receive the proximal end  551  of a suitable working rod  550 .  FIG. 55B  shows a portion of a ratcheting mechanism  500 , similar to other ratcheting mechanisms discussed herein, which can be used in with surgical instruments disclosed herein. 
         [0287]      FIGS. 56A-56E  show a rotation knob  475  in accordance with another embodiment of the present disclosure. The rotation knob  475  can have one or more ribs  481  and one or more depressions  476  formed in the outer surface of the rotation knob  475 . The rotation knob  475  can also have one or more longitudinal apertures  581  configured to receive springs  582  and spheres  583  therein. The rotation knob  475  may also have a port  575  connected to a surface of the rotation knob  475 . The port  575  can be in communication with the inner chamber of the rotation knob  475  and can be used as an aid in the cleaning process. For example, pressurized water can be forced into the port  575  to help clean the inside of the rotation knob  475 . The rotation knob  475  can be held in place with a suitable retaining pin  480  disposed within aperture  579 , similar to other embodiments disclosed herein. 
         [0288]    The operation of the actuator  470  and connector  560  between the second handle  422  and the working rod  550  will now be explained with reference to  FIGS. 57A-59C . Referring to  FIG. 58 , the actuator  470  is pivotably connected to the connector  560  with a suitable pivot pin threaded through pin hole  546 . Rotating the second handle  422  toward the first handle  402  will pull the actuator  470  in the proximal direction causing the connector  560  to pivot toward the proximal direction pulling the working rod  550  in the proximal direction. The working rod  550  can move translationally within the longitudinal aperture  563  of the connector  560  as the connector pivots back and forth. With a suitable actuator  470  having rigid portions, as disclosed in other embodiments herein, the working rod can also be moved in the distal direction by rotating the second handle  422  away from the first handle  402 . The connector  560  can also have an aperture  548  configured to receive the proximal end of a working rod  550  and allow the working rod  550  to be coupled and decoupled from the connector  560 . 
         [0289]    In  FIGS. 60-83 , a surgical instrument  600  in accordance with another embodiment of the present disclosure is illustrated.  FIG. 60  shows an isometric view of a surgical instrument  600  having a working shaft section  674  at its distal end, a handle section  601  at its proximal end, and a pivot section  640  intermediate the working shaft section  674  and the handle section  601 . The handle section  601  may include a first handle  602  and a second handle  622 .  FIGS. 61-65  show side views of the surgical instrument  600  of  FIG. 60  with the handle section  601  and the second handle  622  adjusted in various positions relative to the longitudinal axis  683  of the working shaft section  674 , similar to other embodiments disclosed herein. 
         [0290]      FIG. 66  shows an exploded view of the surgical instrument  600 .  FIGS. 67A-73E  illustrate the individual components of  FIG. 66  in greater detail. A detailed description of the structure and features for each individual component will be given in a generally proximal to distal direction with reference to  FIGS. 67A-73E . A detailed description of how each of the individual components interrelate with one another will then be given, along with the functional relationships between each component. Methods of using the surgical instrument  600  will also be given to illustrate how a surgeon can utilize the surgical instrument  600  to achieve greater ergonomic postures during surgery. 
         [0291]      FIGS. 67A-67C  show various isometric views of a first handle  602 , according to one embodiment of the present disclosure. The first handle  602  has a proximal end  696  and a distal end  697 . The first handle  602  can have a top surface  605 , a bottom surface  615 , and two side surfaces  604 . The top surface  605  can have a spatulate shape and/or curve downward in the distal to proximal direction to better conform to the surgeon&#39;s palm. In some embodiments, the top surface  605  can have a radius of curvature, or substantially lie along a radius of curvature. In some embodiments, the radius of curvature can be between about 2 and 4 inches. In other embodiments, the radius of curvature can be between about 2.5 inches and 3.5 inches. In a particular embodiment, the radius of curvature is about 2.9 inches. 
         [0292]    The top surface  605  of the first handle  602  may have a convex or rounded shape in the lateral direction between the two side surfaces  604  of the first handle  602 . The top surface  605  is preferably shaped to be substantially wide enough between the two side surfaces  604  to provide adequate comfort to the surgeon&#39;s palm by providing sufficient surface contact area between the top surface  605  and the surgeon&#39;s palm to reduce or eliminate “hot spots” from forming on the surgeon&#39;s palm. The top surface  605  can have a maximum width and a minimum width in the lateral direction between the two side surfaces. In some embodiments, the minimum width of the top surface is located closer to the distal end of the first handle and the maximum width of the top surface is located closer to the proximal end of the first handle. In other embodiments the minimum width is between about 0.25 inches and about 0.75 inches. In a particular embodiment, the minimum width is about 0.5 inches. In some embodiments, the maximum width is between about 0.5 inches and about 1.25 inches. In one embodiment, the maximum width is about 0.88 inches. The location of the minimum width of the top surface can be chosen to correspond to the area of the top surface  605  that the surgeon&#39;s thumb traverses when the surgeon switches between a “finger loop” grip style and a “palm” grip style. Having the minimum width of the top surface in this area of the top surface  605  can allow the surgeon to more easily switch between the “finger loop” grip style and the “palm” grip style because the smaller width makes it easier for the surgeon&#39;s thumb to traverse this area of the handle. 
         [0293]    The top surface  605  may include a button slot  619  configured to receive a portion of a ratcheting mechanism, such as a button. Moreover, the side surfaces  604  may include a thumb or finger rest area  608  formed on or into the side surfaces  604  to provide extra support for the surgeon&#39;s thumb when engaged along the side surface  604 . The first handle  602  may have one or more finger loop holes  610  to receive one or more fingers during procedures requiring greater precision. The finger loop hole contact surface  609  may be convex in shape and wide enough to avoid or eliminate any “hot spots” from occurring on the surgeon&#39;s fingers during extended hours of operation. The first handle  602  can have a projection portion  611  at the proximal end  696  of the first handle  602 . The projection portion  611  may provide greater surface area to interact with the surgeon&#39;s palm against the top surface  605 . In some embodiments, the projection portion  611  can include an electrical connector to receive external input. 
         [0294]    Any or all of the surfaces of the first handle  602  may include a comfort material (not shown) attached to one or more of the surfaces of the first handle  602 , such as a soft rubber, polymer, or silicone. The comfort material may be applied to the first handle  602  after manufacture, or the comfort material may be integrally formed or molded to the first handle  602  during manufacture by any suitable manufacturing processes including, but not limited to, bonding or over-molding. 
         [0295]    The distal end  697  of the first handle  602  may include a head portion  612  for receiving a suitably shaped pivot housing  641  into the pivot housing slot  617 . The head portion  612  may have stop pin holes  603  formed through both sides of the head portion  612  for receiving stop pins  668 , as will be discussed in further detail below. The head portion  612  can have a pivot pin hole  606  formed through the head portion  612  configured to receive one or more pivot pins  664 . The first handle  602  may include a pin hole  607  formed through, or substantially through, the side surfaces  604  of the first handle  602  and configured to receive a pivot pin  635  to pivotably secure a second handle  622 . In this embodiment, the surgical instrument  600  includes a dual pivot design with a first pivot connecting the handle section  601  to the working shaft section  674 , and a second pivot connecting the second handle  622  to the first handle  602 . Moreover, the first and second pivots are not coaxial with each other in this embodiment. 
         [0296]    Referring to  FIG. 67C , the first handle  602  may include a receiver slot  613  configured and shaped to receive the head portion  627  of a suitable second handle  622 .  FIG. 67C  also illustrates the pivot housing slot  617  configured to receive a suitable pivot housing  641 , in greater detail.  FIG. 67C  also illustrates an actuator aperture  618  formed within the first handle  602  proximal to the head portion  612  and shaped to allow an actuator  670  to be disposed therethrough. The first handle  602  may also have a ratchet slot  698  formed therein and configured to receive a suitable ratcheting mechanism. 
         [0297]    Referring now to  FIGS. 68A-68D , a portion of a second handle  687  in accordance with one embodiment of the present disclosure is shown. The second handle portion  687  can have a proximal end  637  and a distal end  638 . The second handle portion  687  may include a head portion  627  configured to interact with the receiver slot  613  of the first handle  602 , as shown in  FIGS. 67B-67C . The head portion  627  of the second handle  622  can have a latch release cavity  623  formed through the head portion  627 . The latch release cavity  623  may have an oblong or elongated oval shape configured to receive a pivot pin  635  to allow the pivot pin  635  to move translationally within the latch release cavity  623 . The latch release cavity  623  can have a spring detent  624  just below the latch release cavity  623  to help control and bias the translational movement of the pivot pin  635 , discussed previously. The head portion  627  can have a slot  633  formed therein and configured to receive a suitable rigid member  742 , as shown in  FIG. 71B . The rigid member  742  can be pivotably attached to the second handle portion  687  with a pivot pin  740  threaded through the pin hole  744 . 
         [0298]      FIGS. 69A-70B  show a pivot housing  641 , in accordance with one embodiment of the present disclosure. The pivot housing  641  may include a hollow shaft  642  at its distal end and a pivot head portion  656  at its proximal end. The pivot head portion  656  may have a top surface  643 , a bottom surface  654 , side surfaces  647 , a top angled surface  644 , and a bottom angled surface  649 . The top surface  643  and the bottom surface  654  may have partially spherical shapes configured to receive a suitable rotation knob  675  to allow the rotation knob  675  to rotate freely about the pivot head portion  656 . The pivot head portion  656  may include one or more pivot pin holes  648  formed through the pivot head portion  656  between the sides  647 . Additionally, the pivot head portion  656  may include stop pin slots  652  formed through the pivot head portion  656  having elongated and curved oval shapes. The pivot head portion  656  may also include one or more locking teeth  645 , and/or one or more locking member receiver slots  699 , formed in a surface of the pivot head portion  656 . The hollow shaft  642  may have an annular groove  650  formed therein. The annular groove  650  may be shaped and configured to receive a retaining pin (not shown) to allow the rotation knob  675  to rotate freely about the pivot housing  641 , while keeping the rotation knob  675  from moving translationally with respect to the working shaft  682 . The hollow shaft  642  can have an inner bore  655  in communication with the one or more pivot pin holes  648  and a proximal opening  646  in the pivot head portion  656 . The pivot housing  641  can also have a pin hole  770  to pivotably connect a suitable connector  760  within the pivot housing  641 . 
         [0299]      FIG. 71A  shows a locking member  658  in accordance with one embodiment of the present disclosure. The locking member  658  may have one or more locking surfaces  663  including one or more locking teeth  659  formed in a surface of the locking member  658  and configured to engage the locking surface  657  of a suitable pivot housing  641 , which can also include one or more teeth  645 , and or one or more locking member receiver slots  699 . The locking member  658  can also have projections  660  configured to interact with retainer members  686  formed on the head portion  627  of the second handle  622  to keep the locking member  658  engaged with the second handle  622 . 
         [0300]      FIG. 71B  shows a portion of an actuator  670  according to another embodiment of the present disclosure. The rigid member  742  can have pin holes  744 ,  745  configured to receive suitable pivot pins  740 ,  741  such that the rigid member  742  can be pivotably connected to the second handle  622  and the connector  760 , as can be seen in  FIGS. 74A-83 . 
         [0301]      FIGS. 72A-72B  illustrate another embodiment of a connector  760  which may be used with the surgical instruments disclosed herein. The connector  760  can have a proximal end  761  and a distal end  762 . The proximal end  761  of the connector  760  can have a pin hole  746  configured to receive a suitable pivot pin threaded through the pin hole  745  of the rigid member  742 . The distal end  762  of the connector  760  can have a connection aperture  764  in communication with a longitudinal aperture  763  configured to receive the proximal end  751  of a suitable working rod  750 . 
         [0302]      FIGS. 73A-73E  show a rotation knob  675  in accordance with another embodiment of the present disclosure. The rotation knob  675  can have one or more ribs  681  and one or more depressions  676  formed in the outer surface of the rotation knob  675 . The rotation knob  675  can also have one or more longitudinal apertures  781  configured to receive springs  782  and spheres  783  therein. The rotation knob  675  may also have a port  775  connected to a surface of the rotation knob  675 . The port  775  can be in communication with the inner chamber  679  of the rotation knob  675  and can be used as an aid in the cleaning process. For example, pressurized water can be forced into the port  675  to help clean the inside of the rotation knob  675 . The rotation knob  675  can be held in place with a suitable retaining pin (not shown) disposed within aperture  679 , similar to other embodiments disclosed herein. 
         [0303]    The operation of the actuator  670  between the second handle  622  and the working rod  750  will now be explained with reference to  FIGS. 74A-83 . Referring to  FIG. 75 , the actuator  670 , including the rigid member  742  and the connector  760 , can be used to push or pull the working rod  750 . The rigid member  742  can be pivotably engaged with the second handle  622  and pivotably engaged with the connector  760 . The connector  760  can also be pivotably engaged with the pivot housing  641  about a pivot pin  759 . As the second handle  622  is rotated toward the first handle  602 , the rigid member  742  is pulled in the proximal direction causing the connector  760  to pivot in the proximal direction, pulling the working rod  750  in the proximal direction. Conversely, rotating the second handle  622  away from the first handle  602  pushes the rigid member  742  in the distal direction causing the connector  760  to pivot in the distal direction, pushing the working rod  750  in the distal direction. 
         [0304]    The distance between the pivot pins  635  and  740 , as well as the distance between the pivot pin  635  and the center of force applied to the second handle  622 , can be chosen to obtain a desired mechanical advantage applied to the rigid member  742 . For example, the distance between the pivot pins  635  and  740  can be chosen to be about 0.25 inches and the distance between the pivot pin  635  and the center of force applied to the second handle  622  can be chosen to be about 2.5 inches. In this embodiment, the ratio of these distances (2.5 inches/0.25 inches) would result in the mechanical advantage of about 10. However, it is to be understood that other distances and ratios can be chosen to obtain other mechanical advantages. 
         [0305]    In some embodiments, the location of the pivot pin  741  can be chosen to be substantially coaxial with the pivot pins  664  which control the articulation of the handle section  601  in relation to the working shaft section  674 . In one embodiment, the axis of the pivot pin  741  is substantially coaxial with the axis of the pivot pins  664  when the second handle  622  is in the “at rest” position. If the second handle  622  is maintained in the “at rest” position as the handle section  601  is articulated, then the axes of the pivot pins  741  and  664  will substantially stay aligned with each other as the handle section  601  is articulated in the working rod  750  will not substantially move as the handle section  601  is articulated. 
         [0306]    In other embodiments, the location of the pivot pin  741  relative to the pivot pins  664  can be chosen such that they are not substantially coaxial with each other. In these embodiments, articulating the handle section  601  can cause the working rod  750  to move, affecting the end effector. In these embodiments, the location of the pivot pin  741  relative to the pivot pins  664  is preferably chosen to minimize movement of the end effector as the handle section  601  is articulated. Accordingly, the movement of the end effector may be small and virtually imperceptible to the surgeon. 
         [0307]    In  FIGS. 84-97 , a surgical instrument  800  in accordance with another embodiment of the present disclosure is illustrated.  FIG. 84  shows an isometric view of a surgical instrument  800  having a working shaft section  874  at its distal end, a handle section  801  at its proximal end, and a pivot section  840  intermediate the working shaft section  874  and the handle section  801 . The handle section  801  may include a first handle  802  and a second handle  822 .  FIG. 85  shows a side view of the surgical instrument  800  of  FIG. 84  with the handle section  801  adjusted in a “drop-down” position relative to the longitudinal axis  883  of the working shaft section  874 , similar to other embodiments disclosed herein.  FIG. 86  shows a side view of the surgical instrument  800  of  FIG. 84  with the handle section  801  adjusted in an “in-line” position relative to the working shaft section  874 .  FIG. 87  shows a side view of the surgical instrument  800  of  FIG. 84  with the handle section  801  adjusted in an “angled-up” position relative to the working shaft section  874 . 
         [0308]      FIG. 88  shows an exploded view of the surgical instrument  800 .  FIGS. 91A-95C  illustrate the individual components of  FIG. 88  in greater detail. A detailed description of the structure and features for each individual component will be given in a generally proximal to distal direction with reference to  FIGS. 91A-95C . A detailed description of how each of the individual components interrelate with one another will then be given, along with the functional relationships between each component. Methods of using the surgical instrument  800  will also be given to illustrate how a surgeon can utilize the surgical instrument  800  to achieve greater ergonomic postures during surgery. 
         [0309]      FIGS. 91A-91C  show various isometric views of the first handle  802 , according to one embodiment of the present disclosure. The first handle  802  has a proximal end  896  and a distal end  897 . The first handle  802  can have a top surface  805 , a bottom surface  815 , and two side surfaces  804 . The top surface  805  can have a spatulate shape and/or curve downward in the distal to proximal direction to better conform to the surgeon&#39;s palm. In some embodiments, the top surface  805  can have a radius of curvature, or substantially lie along a radius of curvature. In some embodiments, the radius of curvature can be between about 2 and 4 inches. In other embodiments, the radius of curvature can be between about 2.5 inches and 3.5 inches. In a particular embodiment, the radius of curvature is about 2.9 inches. 
         [0310]    The top surface  805  of the first handle  802  may have a convex or rounded shape in the lateral direction between the two side surfaces  804  of the first handle  802 . The top surface  805  is preferably shaped to be substantially wide enough between the two side surfaces  804  to provide adequate comfort to the surgeon&#39;s palm by providing sufficient surface contact area between the top surface  805  and the surgeon&#39;s palm to reduce or eliminate “hot spots” from forming on the surgeon&#39;s palm. The top surface  805  can have a maximum width and a minimum width in the lateral direction between the two side surfaces. In some embodiments, the minimum width of the top surface is located closer to the distal end of the first handle and the maximum width of the top surface is located closer to the proximal end of the first handle. In other embodiments the minimum width is between about 0.25 inches and about 0.75 inches. In a particular embodiment, the minimum width is about 0.5 inches. In some embodiments, the maximum width is between about 0.5 inches and about 1.25 inches. In one embodiment, the maximum width is about 0.88 inches. The location of the minimum width of the top surface can be chosen to correspond to the area of the top surface  805  that the surgeon&#39;s thumb traverses when the surgeon switches between a “finger loop” grip style and a “palm” grip style. Having the minimum width of the top surface in this area of the top surface  805  can allow the surgeon to more easily switch between the “finger loop” grip style and the “palm” grip style because the smaller width makes it easier for the surgeon&#39;s thumb to traverse this area of the handle. The side surfaces  804  may include a thumb or finger rest area  808  formed on or into the side surfaces  804  to provide extra support for the surgeon&#39;s thumb when engaged along the side surface  804 . The first handle  802  may have one or more finger loop holes  810  to receive one or more fingers during procedures requiring greater precision. The finger loop hole contact surface  809  may be convex in shape and wide enough to avoid or eliminate any “hot spots” from occurring on the surgeon&#39;s fingers during extended hours of operation. The first handle  802  can have a projection portion  811  at the proximal end  896  of the first handle  802 . The projection portion  811  may provide greater surface area to interact with the surgeon&#39;s palm against the top surface  805 . In some embodiments, the projection portion  811  can include an electrical connector to receive external input. 
         [0311]    Any or all of the surfaces of the first handle  802  may include a comfort material (not shown) attached to one or more of the surfaces of the first handle  802 , such as a soft rubber, polymer, or silicone. The comfort material may be applied to the first handle  802  after manufacture, or the comfort material may be integrally formed or molded to the first handle  802  during manufacture by any suitable manufacturing processes including, but not limited to, bonding or over-molding. 
         [0312]    The distal end  897  of the first handle  802  may include a head portion  812  for receiving a suitably shaped second handle  822  and connector  960  within the opening  925 , as will be discussed in more detail below. The head portion  812  can also have lock members  922  configured to interact with complementary shaped lock receivers  923  formed in the pivot housing  841 . The first handle  802  can also have a stop pin slot  852  to limit the articulation of a second handle  822  pivotably connected to the first handle  802 . 
         [0313]      FIGS. 92A-92C  show a second handle  822  in accordance with another embodiment of the present disclosure. The second handle  822  can have a top surface  826 , a finger loop hole  830 , an inner contact surface  829 , a projection  832  defining a contact surface  831  and a recess portion  828 . The second handle  822  can also have a stop pin hole  803 , a pivot pin hole  848 , lock members  922 , and a working rod slot  926 . 
         [0314]      FIGS. 93A-93D  show a pivot housing  841  in accordance with another embodiment of the present disclosure. The pivot housing  841  can have lock receivers  923  formed in one or more sides and configured to interact with lock members  922  formed in the head portion  812  of the first handle  802 . The pivot housing  841  can also have an annular groove  850  configured to receive a retaining pin (not shown) to engage a rotation knob  875 . 
         [0315]      FIGS. 94A-94B  show isometric views of a connector  960  in accordance with the present embodiment. The connector  960  can have lock receivers  923  formed therein, a pivot pin hole  848 , a tab  927 , and a working rod connector portion  961 . 
         [0316]      FIGS. 95A-95C  show various views of a rotation knob  875  according to another embodiment of the present disclosure. The rotation knob  875  can have ribs  881  and depressions  879  formed therein. The rotation knob  875  can also have a port  975  to aid in cleaning, as discussed previously. The rotation knob and  75  can also have an aperture  979  configured to receive a retaining pin (not shown) to engage the retaining knob  875  to the pivot housing  841 . The rotation knob and  75  can also have an inner chamber  879  configured to receive a suitable working rod  950 . 
         [0317]    The operation of the surgical instrument  800  will now be given with reference to  FIGS. 96A-97 . Referring to  FIG. 97 , as the second handle  822  is rotated toward the first handle  802 , the working rod connector portion  961  rotates in the proximal direction pulling the working rod  950  in the proximal direction. As the second handle  822  rotates away from the first handle  802 , the working rod connector portion  961  rotates in the distal direction pushing the working rod  950  in the distal direction. 
         [0318]    Pivoting the handle section  801  relative to the working shaft section  874  will now be explained with reference to  FIGS. 88-94B . The biasing spring  998  is disposed between an inner surface of the pivot housing  841  and the first handle  802 . The biasing spring  998  pushes the first handle  802  toward one side of the pivot housing  841  causing the lock members  922  of the second handle  822  to mate with the lock receivers  923  formed in the connector  960  and the lock members  922  of the first handle  802  to mate with the lock receivers  923  formed in the pivot housing  841 . Thus, the pivot section  840  is locked in this position. The pivot section  840  can be unlocked by grabbing the handle section  801  and applying a counterforce against the biasing spring  998  to disengage the lock members  922  from the lock receivers  923 . The pivot section  840  can then be articulated by maintaining this counterforce and rotating the handle section  801  to the desired location. Once the desired location is obtained, the pivot section  840  can be re-locked by discontinuing the counterforce against the biasing spring  998 , causing the handle section  801  to move translationally such that lock members  922  can engage their respective lock receivers  923 . 
         [0319]    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, and variants thereof. 
         [0320]    Certain elements disclosed herein may be interpreted as means for pivoting the handle section relative to the working shaft section for the various surgical instruments disclosed herein. For example, in the various embodiments set forth above the pivoting means may be element  140  as shown in  FIG. 1 , or element  240  as shown in  FIG. 16 , or element  440  as shown in  FIG. 44 , or element  640  as shown in  FIG. 60 , or element  840  as shown in  FIG. 84 . 
         [0321]    Certain elements disclosed herein may be interpreted as locking means for preventing the handle section from pivoting relative to the working shaft section disclosed herein. For example, in the various embodiments set forth above the locking means may be elements  157  and  163  in  FIGS. 8C and 9 , or elements  263  and  257  in  FIGS. 27 and 30B , or elements  463  and  457  in  FIGS. 53B and 54A , or elements  663  and  657  in  FIGS. 70A and 71A , or elements  923  and  922  in  FIGS. 89B ,  90 B,  91 C,  92 B,  93 A, and  94 A. 
         [0322]    Certain elements disclosed herein may be interpreted as means for pivoting the second handle relative to the first handle for the various surgical instruments disclosed herein. For example, in the various embodiments set forth above the second handle pivoting means may be element  135  in  FIG. 5 , or element  235  in  FIG. 21 , or element  435  in  FIG. 47 , or element  635  in  FIG. 66 , or element  864  in  FIG. 88 . 
         [0323]    Certain elements disclosed herein may be interpreted as actuating means for affecting the end effector. For example, in the various embodiments set forth above the actuating means may be element  170  in  FIG. 5 , or element  270  in  FIG. 21 , or elements  470  and  560  in  FIG. 47 , or elements  742  and  760  in  FIG. 66 , or element  961  in  FIG. 94B . 
         [0324]    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. 
         [0325]    The term “coupled” is defined as connected, although not necessarily directly, and not necessarily mechanically. 
         [0326]    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 term “substantial” or “substantially” means, in general, a deviation from a reference state by an unsatisfactory amount, or a change sufficient to produce an unsatisfactory result. 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.” 
         [0327]    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.