Abstract:
A handle assembly for operating an articulatable surgical instrument is provided and includes a housing; an actuation shaft translatably and rotatably supported in the housing; a first trigger supported on the housing and connected to the actuation shaft, the first trigger being configured to translate the actuation shaft to operate a first function of the surgical instrument; a second trigger supported on the housing and connected to the actuation shaft, the second trigger being configured to rotate the actuation shaft to operate a second function of the surgical instrument; and a second-trigger release supported in the housing, the second-trigger release having a first position blocking actuation of the second trigger and a second position permitting actuation of the second trigger, where the second-trigger release is actuated from the first position to the second position upon and complete actuation of the first trigger.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/249,073, filed on Oct. 6, 2009, the entire content of which is hereby incorporated by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The present disclosure relates to surgical handle assemblies and, more particularly, to handle assemblies for endoscopic suturing and/or stitching devices or the like. 
     2. Background 
     As medical and hospital costs continue to increase, surgeons are constantly striving to develop advanced surgical techniques. Advances in the surgical field are often related to the development of operative techniques which involve less invasive surgical procedures and reduce overall patient trauma. In this manner, the length of hospital stays can be significantly reduced, and, therefore, the hospital and medical costs can be reduced as well. 
     One of the truly great advances in recent years to reduce the invasiveness of surgical procedures is endoscopic surgery. Generally, endoscopic surgery involves incising through body walls for example, viewing and/or operating on the ovaries, uterus, gall bladder, bowels, kidneys, appendix, etc. There are many common endoscopic surgical procedures, including arthroscopy, laparoscopy (pelviscopy), gastroentroscopy and laryngobronchoscopy, just to name a few. Typically, trocars are utilized for creating the incisions through which the endoscopic surgery is performed. Trocar tubes or cannula devices are extended into and left in place in the abdominal wall to provide access for endoscopic surgical tools. A camera or endoscope is inserted through a relatively large diameter trocar tube which is generally located at the naval incision, and permits the visual inspection and magnification of the body cavity. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation, such as, forceps, cutters, applicators, and the like which are designed to fit through additional cannulas. Thus, instead of a large incision (typically 12 inches or larger) that cuts through major muscles, patients undergoing endoscopic surgery receive more cosmetically appealing incisions, between 5 and 10 millimeters in size. Recovery is, therefore, much quicker and patients require less anesthesia than traditional surgery. In addition, because the surgical field is greatly magnified, surgeons are better able to dissect blood vessels and control blood loss. Heat and water loss are greatly reduced as a result of the smaller incisions. 
     In many surgical procedures, including those involved in endoscopic surgery, it is often necessary to suture bodily organs or tissue. The latter is especially challenging during endoscopic surgery because of the small openings through which the suturing of bodily organs or tissues must be accomplished. 
     In the past, suturing of bodily organs or tissue through endoscopic surgery was achieved through the use of a sharp metal suture needle which had attached at one of its ends a length of suture material. The surgeon would cause the suture needle to penetrate and pass through bodily tissue, pulling the suture material through the bodily tissue. Once the suture material was pulled through the bodily tissue, the surgeon proceeded to tie a knot in the suture material. The knotting of the suture material allowed the surgeon to adjust the tension on the suture material to accommodate the particular tissue being sutured and control approximation, occlusion, attachment or other conditions of the tissue. The ability to control tension is extremely important to the surgeon regardless of the type of surgical procedure being performed. 
     However, during endoscopic surgery, knotting of the suture material is time consuming and burdensome due to the difficult maneuvers and manipulation which are required through the small endoscopic openings. 
     Many attempts have been made to provide devices to overcome the disadvantages of conventional suturing. Such prior art devices have essentially been staples, clips, clamps or other fasteners. However, none of these above listed devices overcome the disadvantages associated with suturing bodily tissue during endoscopic surgery. 
     Accordingly, there is a need for improvements in suturing devices which overcome the shortcomings and drawbacks of prior art apparatus. 
     SUMMARY 
     The present disclosure relates to handle assemblies for endoscopic suturing and/or stitching devices or the like. 
     According to an aspect of the present disclosure, a handle assembly for operating an articulatable surgical instrument is provided and includes a housing; an actuation shaft translatably and rotatably supported in the housing; a first trigger supported on the housing and connected to the actuation shaft, the first trigger being configured to translate the actuation shaft to operate a first function of the surgical instrument; a second trigger supported on the housing and connected to the actuation shaft, the second trigger being configured to rotate the actuation shaft to operate a second function of the surgical instrument; and a second-trigger release supported in the housing, the second-trigger release having a first position blocking actuation of the second trigger and a second position permitting actuation of the second trigger, where the second-trigger release is actuated from the first position to the second position upon and complete actuation of the first trigger. 
    
    
     
       DETAILED DESCRIPTION OF THE DRAWINGS 
       The foregoing objects, features and advantages of the disclosure will become more apparent from a reading of the following description in connection with the accompanying drawings, in which: 
         FIG. 1  is a front perspective view of a handle assembly, for an endoscopic suturing device, according to an embodiment of the present disclosure; 
         FIG. 2  is a rear perspective view of the handle assembly of  FIG. 1 ; 
         FIG. 3  is a top, front perspective view of the handle assembly of  FIGS. 1 and 2 , with a housing half-section removed therefrom; 
         FIG. 3A  is a bottom, front perspective view of the handle assembly of  FIGS. 1-3 , with a housing half-section removed therefrom; 
         FIG. 4  is a rear perspective view of the handle assembly of  FIGS. 1-3 , with a housing half-section removed therefrom; 
         FIG. 5  is a perspective view of the operative components of the handle assembly of  FIGS. 1-4 , with the housing removed therefrom, shown in an un-actuated condition; 
         FIG. 5A  is an enlarged view of the indicated area of detail of  FIG. 5 ; 
         FIG. 5B  is a perspective view of the operative components of the handle assembly of  FIGS. 1-5A , with the housing removed therefrom, shown in an actuated condition; 
         FIG. 6  is an exploded perspective view of the handle assembly of  FIGS. 1-5 ; 
         FIG. 7  is an exploded perspective view of an articulation assembly of the handle assembly of  FIGS. 1-6 ; 
         FIG. 8  is an exploded perspective view of a manual needle switching mechanism of the handle assembly of  FIGS. 1-6 ; 
         FIG. 9  is a longitudinal, cross-sectional, side elevational view of the handle assembly of  FIGS. 1-6 , shown in an un-actuated condition; 
         FIG. 9A  is a longitudinal, cross-sectional, side elevational view of the handle assembly of  FIGS. 1-6 , shown in a partially actuated condition; 
         FIG. 10  is a cross-sectional view of the handle assembly of  FIG. 9 , as taken through  10 - 10  of  FIG. 9 ; and 
         FIG. 11  is a cross-sectional view of the handle assembly of  FIG. 9 , as taken through  11 - 11  of  FIG. 9 . 
     
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
     The present disclosure relates to devices, systems and methods for endoscopic, laparoscopic, endoluminal, and/or transluminal suturing. In one embodiment, for example, such a device comprises a handle, handle assembly or other suitable actuating mechanism (e.g., robot, etc.) connected to a proximal end of a flexible, elongated body portion. A neck assembly operatively supported on a distal end of the flexible, elongated body portion allows an end effector, operatively supported at a distal end of the neck assembly, to articulate in response to actuation of articulation cables. The end effector includes a suture needle and a pair of jaws. In operation, the suture needle is passed back and forth through tissue from one jaw to the other. The device is adapted to be placed in a lumen of a flexible endoscope and then inserted into a natural orifice of a patient and transited endoluminally through the anatomy of the natural lumen to a treatment site within or outside the natural lumen. 
     In the drawings and in the description which follow, the term “proximal”, as is traditional, will refer to the end of the device which is closest to the operator, while the term “distal” will refer to the end of the device which is furthest from the operator. 
     Referring now in specific detail to the drawings, in which like reference numbers identify similar or identical elements,  FIGS. 1-11  illustrate an embodiment of a handle assembly, for an end effector of a stitching device, shown generally at  100 . Exemplary end effectors of stitching devices, for use with handle assembly  100 , are shown and described in detail in U.S. patent application Ser. No. 12/442,847, filed on May 4, 2009, entitled FLEXIBLE ENDOSCOPIC STITCHING DEVICES, the entire content of which is incorporated herein by reference. 
     As seen in  FIGS. 1-11 , handle assembly  100  includes a housing  102  having a right-half section  102   a  and a left-half section  102   b  joinable to one another by suitable fastening elements (not shown), such as screws. Handle assembly  100  includes a first trigger  104  and a second trigger  105 , each operatively supported in/on housing  102  and extending therefrom. As will be described in greater detail below, triggers  104 ,  105  are independently movable between a first un-actuated position, as seen in  FIGS. 1-5 , and at least one second actuated position. In use, movement of triggers  104 ,  105  between the first and second positions results in actuation and/or operation of the end effector (not shown). 
     First trigger  104  is pivotally connected to housing  102  at a pivot point “P 1 ” so as to rotate thereabout. First trigger  104  is operatively associated or otherwise connected to an actuation mechanism  110  (see  FIG. 6 ) of handle assembly  100 . In use, movement of first trigger  104  between the first and second positions results in a first function, actuation and/or operation of the end effector. Second trigger  105  is pivotally connected to housing  102  also at pivot point “P 1 ” so as to rotate thereabout. Second trigger  105  is operatively associated or otherwise connected to an actuation mechanism  110  of handle assembly  100 . In use, movement of second trigger  105  between the first and second positions results in a second function, actuation and/or operation of the end effector. It is contemplated that second trigger  105  is nested in first trigger and may include a lip  105   c  (see  FIGS. 9 and 9A ) configured to engage first trigger  104 , when first trigger  104  is moved from an actuated position to an un-actuated position, lip  105   c  of second trigger  105  is engaged by first trigger  104  thereby also moving second trigger  105  from an actuated position to an un-actuated position. 
     First trigger  104  may be biased to the un-actuated position by a suitable biasing member, such as, for example a spring or the like (not shown). 
     First trigger  104  includes a lever arm  104   a  extending therefrom and into housing  102 . A free end of lever arm  104   a  terminates in a head portion  104   b . Lever aim  104   a  extending from first trigger  104  is formed to have a flattened profile and of a resilient material (e.g., spring steel) in order for lever arm  104   a  to deflect in a direction transverse to a plane defined by the flattened lever arm. Lever arm  104   a  of first trigger  104  is curved or biased in a direction out of a plane defined by the plane in which first trigger  104  is actuated. 
     As seen in  FIGS. 3-6 , handle assembly  100  further includes a trigger latch  106  supported in housing  102  and located to selectively engage head portion  104   b . Trigger latch  106  includes a first cam member  106   a  projecting toward first trigger  104 . First cam member  106   a  includes a first distal cam surface  106   a   1  configured and oriented to urge or bias head portion  104   b  of lever arm  104   a  to a non-biased position as first trigger  104  is moved from the un-actuated position to an actuated position. Trigger latch  106  includes a second cam member  106   b  projecting toward first trigger  104 . Second cam member  106   b  is spaced a proximal distance from first cam member  106   a . Second cam member  106   b  includes a distal cam surface  106   b   1  oriented in substantially the same direction as first distal cam surface  106   a   1  of cam member  106   a . In use, as first trigger  104  is actuated past an initial actuation to a fully actuated position, head portion  104   b  of lever arm  104   a  travels from distal cam surface  106   b   1  of cam member  106   a  to distal cam surface  106   b   1  of second cam member  106   b.    
     With continued reference to  FIG. 3 , first cam member  106   a  includes a proximal notch  106   a   2  formed in a proximal surface of first cam member  106   a  and spaced an axial distance from distal cam surface  106   b   1  of second cam member  106   b . In use, as first trigger  104  is released (i.e., moved in a direction away from the fully actuated position), due to the bias of lever arm  104   a , head portion  104   b  thereof is passed from distal cam surface  106   b   1  of second cam member  106   b  to notch  106   a   2  formed in a proximal surface of first cam member  106   a , thereby stopping first trigger  104  from returning completely to the un-actuated position. 
     With continued reference to  FIG. 3 , first cam member  106   a  further includes a proximal cam surface  106   a   3  formed in a proximal surface of first cam member  106   a  and located adjacent notch  106   a   2 . In use, first trigger  104  is re-actuated, thereby separating or lifting head portion  104   b  of lever  104  from or out of notch  106   a   2 . As head portion  104   b  of lever  104  is lifted out of notch  106   a   2 , the bias of lever  104  moved head portion  104   b  out of registration with notch  106   a   2  and into registration with proximal cam surface  106   a   3 . In this manner, as first trigger is re-released or returned to the un-actuated position, head portion  104   b  of lever  104  cams against proximal cam surface  106   a   3  and around first cam member  106   a.    
     In this manner, when first trigger  104  is pulled once, upon release thereof, first trigger  104  is held by trigger latch  106  in a partially actuated position. Then, when first trigger  104  is pulled a second time, upon release thereof, first trigger  104  is able to return to the fully un-actuated position. 
     Second trigger  105  includes a lever arm  105   a  extending therefrom and into housing  102 . A free end of lever arm  105   a  terminates in a head portion  105   b . Head portion  105   b  of lever arm  105   a  of second trigger  105  is received in a slot  334   a  formed in a gear rack  334  of a needle blade actuating assembly  330  (see  FIG. 3 ). Gear rack  334  is slidably supported in housing  102 . The structure and function of gear rack  334  will be described in greater detail below. 
     Handle assembly  100  includes, as seen in  FIGS. 3-6 ,  9  and  9 A, an actuation assembly  110  supported in housing  102  and connected to triggers  104 ,  105 . In particular, actuation assembly  110  includes a drive or actuation shaft  312  rotatably and translatably supported in housing  102 . Actuation shaft  312  may be rigid and includes a distal end connected to a flexible actuation cable or the like not shown. Actuation assembly  110  includes a drive block  114  axially, translatably supported in housing  102 . Actuation block  114  includes a lumen  114   a  (see  FIG. 8 ) through which actuation shaft  312  passes. Actuation shaft  312  is rotatably disposed within actuation block  114  and is inhibited from axial translation relative to actuation block  114  as a result of any number of stops  312   a  provided along the length thereof. Exemplary stops  312   a  include and are not limited to spring clips or ring clamps attached to actuation shaft  312 , a flange projecting from actuation shaft  312  and/or the like. 
     Actuation assembly  110  includes a drive link  116  inter-connecting first trigger  104  and actuation block  114 . As so configured, as first trigger  104  is actuated from the first un-actuated position to a second actuated position, first trigger  104  acts on drive link  116  which in turn acts on actuation block  114  to urge actuation block  114  in a proximal direction. As actuation block  114  is urged in a proximal direction, actuation block  114  moves actuation shaft  312  in a proximal direction, and in turn the actuation cable is moved in a proximal direction. 
     As seen in  FIGS. 4-5B , actuation assembly  110  further includes a second-trigger release  118  rotatably supported in housing  102 . Second-trigger release  118  is biased to a locking condition wherein second-trigger release  118  engages and blocks movement of gear rack  334  of needle blade actuating assembly  330 . In use, as first trigger  104  is actuated to move actuation block  114  to the actuated position, actuation block  114  engages second-trigger release  118  to disengage second-trigger release  118  from gear rack  334  of needle blade actuating assembly  330 . 
     Handle assembly  100  includes an articulation assembly  170  supported on and/or in housing  102 . Articulation assembly  170  may be operatively connected to the end effector in order to impart multiple articulations to the end effector or any other suitable movement or operation to the end effector. 
     As seen in  FIGS. 6 and 7 , articulation assembly  170  includes a pair of knobs or dials  172   a ,  172   b  rotatably supported on or in housing  102 , and a set of gears  174  keyed to and sharing a common rotational axis as dials  172   a ,  172   b . The set of gears  174  includes a first gear  174   a  keyed to first dial  172   a , via a rotation shaft  175   a , and a second gear  174   b  keyed to second dial  172   b.    
     Articulation assembly  170  further includes two pairs of opposed racks  180   a ,  180   b  with each pair being operatively engaged with and disposed on opposed sides of respective first and second gears  174   a ,  174   b . Each pair of racks  180   a ,  180   b  is slidably supported within respective channels  182   a ,  182   b  formed in a support member  182 . Support member  182  includes a central body portion  182   c , and a pair of opposed cap walls  182   d ,  182   e  secured to central body portion  182   c  by suitable screw members  182   f ,  182   g . Screw members  182   f ,  182   g  are disposed one each on opposed sides of racks  180   a ,  180   b . Channels  182   a ,  182   b  are formed between central body portion  182   c  and respective cap walls  182   d ,  182   e . In operation, the dimensions (i.e., widths) of channels  182   a ,  182   b  may be increased/decreased by adjusting screw members  182   f ,  182   g  to either increase/decrease the space between cap walls  182   d ,  182   e  and central body portion  182   c , and thus increase/decrease friction on racks  180   a ,  180   b.    
     Each rack of the pair of racks  180   a ,  180   b  includes an articulation cable (not shown) secured thereto. In this manner, during operation, as each rack of the pair of racks  180   a ,  180   b  is displaced so to is each respective articulation cable. 
     In operation, as first gear  174   a  is rotated in a first direction, due to the rotation of first dial  172   a  and first gear  174   a , the first pair of racks  180   a  are displaced in opposite directions to one another, thus displacing respective articulation cables in opposite directions to one another. It is understood that rotation of first dial  172   a  in an opposite direction and thus rotation of first gear  174   a  in an opposite direction will result in movement and/or displacement of the respective pair of racks  180   a  and articulation cables in opposite directions. Rotation of first dial  172   b  thus may impart an operation, movement or first articulation of the end effector. 
     Also, in operation, as second gear  174   b  is rotated in a first direction, due to the rotation of second dial  172   b  and second gear  174   b , the second pair of racks  180   b  are displaced in opposite directions to one another, thus displacing respective articulation cables in opposite directions to one another. It is understood that rotation of second dial  172   b  in an opposite direction and thus rotation of second gear  174   b  in an opposite direction will result in movement and/or displacement of the respective pair of racks  180   a  and articulation cables in opposite directions. Rotation of second dial  172   b  thus may impart an operation, movement or second articulation of the end effector. 
     As seen in  FIGS. 1-5A , handle assembly  100  includes friction adjustment assembly  173 . Friction adjustment assembly  173  includes a slide switch  115  translatably supported on housing  102 , and a gear rack  116  connected to slide switch  115  and movable therewith. Friction adjustment assembly  173  further includes a first gear  173   a  treadably supported on screw member  182   f  and in operative engagement with gear rack  116 , a second gear  173   b  threadably supported on screw member  182   g , and a reversing gear  173   c  operatively inter connecting first and second gears  173   a ,  173   b.    
     In use or operation, as slide switch  115  is actuated in a first direction, gear rack  116  is actuated in a first direction, and first and second gears  173   a ,  173   b  are actuated in first direction to tighten screws  182   f ,  182   g  and increase the friction on racks  180   a ,  180   b . Also in use or operation, as slide switch  115  is actuated in a second direction, gear rack  116  is actuated in a second direction, and first and second gears  173   a ,  173   b  are actuated in second direction to loosen screws  182   f ,  182   g  and decrease the friction on racks  180   a ,  180   b.    
     The friction on racks  180   a ,  180   b  may be increased or decreased as needed in order to assist in maintaining an articulated orientation of the end effector or to assist or enable the end effector to be articulated or un-articulated. 
     As seen in  FIGS. 3-5A ,  6  and  8 - 9 A, handle assembly  100  further includes a needle loading assembly  300  including a knob  310  rotatably supported on a rear end of housing  102  and configured to enable loading of a surgical needle in the jaws of an end effector (not shown). Knob  310  includes an indicator  310   a , for example, in the form of a rib extending from a side edge thereof, for cooperation with an indicator  102   c  (see  FIGS. 1 and 2 ) formed on housing  102 . Indicators  102   c  and  310   a  provide the user with an indication of a relative state of handle assembly  100  and/or the surgical device based on the relative position of indicators  102   c ,  310   a  to one another. 
     Knob  310  is coupled to a proximal end of actuation shaft  312 , which has been keyed for connection to knob  310 , via a keyed rotation hub  314  rotatably and slidably supported in housing  102 . Keyed rotation hub  314  has a shaped outer surface for receipt in a complementary shaped recess formed in knob  310  such that rotation of knob  310  results in rotation of keyed rotation hub  314 . Keyed rotation hub  314  defines a shaped lumen (not shown) for receipt of a complementary shaped outer surface of keyed shaft  312  such that rotation of knob  310  also results in rotation of keyed shaft  312 . Rotation hub  314  is biased to an advanced or distal position by a biasing member  316 , in the form of a C-spring or the like. Thus, in use, as knob  310  is pulled in a proximal direction relative to housing  102 , rotation hub  314  is also pulled in a proximal direction and biasing member  316  is biased. Upon release of knob  310 , biasing member  316  is free to return to an un-biased condition and thus pull rotation hub  314  and knob  310  in a distal direction relative to housing  102 . 
     As seen in  FIGS. 4 ,  6 ,  8  and  11 , needle loading assembly  300  includes a clutch member  318  rotatably supported in housing  102  and selectively connectable to rotation hub  314 . Clutch member  318  is rotatably disposed about keyed shaft  312 . Clutch member  318  includes a non-circular shaped stem  318   a  extending proximally therefrom and being configured for selective engagement in a complementary recess  314   a  (see  FIGS. 3 ,  3 A,  9  and  9 A) formed in a distal surface of rotation hub  314 . Clutch member  318  includes at least one rib  318   b  formed on an outer surface thereof. 
     As seen in  FIGS. 4 ,  6 ,  8  and  11 , needle loading assembly  300  further includes a clutch driver  320  rotatably supported in housing  102  and selectively engageable by clutch member  318 . Clutch driver  320  a body portion  320   a  rotatably disposed about keyed shaft  312 , and a pair of opposed arms  320   b ,  320   c  extending radially therefrom. Clutch driver  320  further includes a cam wall  320   d ,  320   e  supported on a respective end of arms  320   b ,  320   c . Cam walls  320   d ,  320   e  are spaced radially outward by an amount sufficient to at least partially surround clutch member  318 . Cam walls  320   d ,  320   e  are also configured to selectively operatively engage the at least one rib  318   b  of clutch member  318 . In this manner, as clutch member  318  is rotated in a first direction, the at least one rib  318   a  thereof will engage either cam wall  320   d  and/or  320   e  and transmit rotation to clutch driver  320 . Also, cam walls  320   d ,  320   e  are configured such that rotation of clutch member  318  in a second direction does not result in rotation of clutch driver  320 . 
     Needle loading assembly  300  further includes a spring arm  322 , secured to housing  102 , and in tangential contact with cam walls  320   d ,  320   e  of clutch driver  320 . Spring arm  322  is arranged such that a free end thereof will ride over or across cam walls  320   d ,  320   e  of clutch driver  320  as cam driver  320  is rotated in the first direction due to the rotation of clutch member  318 , and will enter into and between cam walls  320   d ,  320   e  of clutch driver  320  as cam driver  320  is rotated in the second direction due to the rotation of clutch member  318  to thereby limit or block rotation of cam driver  320 . 
     As seen in  FIGS. 3 ,  3 A,  5 ,  8 ,  9  and  9 A, handle assembly  100  further includes a needle blade actuating assembly  330  connected to second trigger  105  and to actuation shaft  312 . In particular, needle blade actuating assembly  330  includes a spur gear  332  supported on and keyed to body portion  320   a  of can driver  320 . In this manner, rotation of cam driver  320  or spur gear  332  results in rotation of the other of cam driver  320  or spur gear  332 . Needle blade actuating assembly  330  further includes a gear rack  334  slidably supported in housing  102 , as described above. Gear rack  334  defines a slot  334   a  for receipt of head portion  105   b  of lever arm  105   a  of second trigger  105 . Gear rack  334  is positioned in housing  102  such that the gear teeth thereof engage with the gear teeth of spur gear  332 . 
     Accordingly, in use, following actuation of first trigger  104  and the release of gear rack  334  by second-trigger release  118 , as described above, as second trigger  105  is actuated from an un-actuated condition, lever arm  105   a  thereof acts on gear rack  334  to translate gear rack  334 . As gear rack  334  is translated the gear teeth thereof cooperate with the gear teeth of spur gear  332  and thus cause spur gear  332  to rotate. As spur gear  332  is rotated, cam driver  320  is also rotated due to spur gear  332  being keyed thereto. As described above, rotation of cam driver  320  in one direction transmits rotation to clutch member  318 , on to rotation hub  314  and then to actuation shaft  312 . Meanwhile, rotation of cam driver  320  in an opposite direction is limited or blocked by spring arm  322 . 
     As can be appreciated, a distal end of keyed shaft  312  is fixedly secured to a proximal end of an actuation shaft (not shown), and a distal end of the actuation shaft may be connected to an actuation cable (not shown) extending in and connected to the end effectors. 
     In use, in order to load a surgical needle into jaws of an end effector, knob  310  is pulled in a proximal direction relative to housing  102  (to disengage rotation hub  314  from clutch member  318 ) and then rotated, thereby rotating keyed shaft  312 , the actuation shaft, and the actuation cable. As knob  310  is rotated, blades that are translatably supported in the jaws of the end effector are translated axially until the distal ends of the blades are out of registration with needle receiving recesses formed in the jaws, as evidenced by the alignment of indicator  310   a  of knob  310  and indicator  102   c  of housing  102 . With the distal ends of the blades out of registration with the needle receiving recesses of the jaws, a surgical needle is inserted into one of the receiving recesses. Knob  310  is then rotated until the distal end of one of the blades engages the surgical needle to hold the surgical needle in the jaw. 
     While the disclosure has been particularly shown and described with reference to particular embodiments, it will be understood by those skilled in the art that various modifications in form and detail may be made therein without departing from the scope and spirit of the invention. Accordingly, modifications such as those suggested above, but not limited thereto, are to be considered within the scope of the invention.