WO2025196740A1

WO2025196740A1 - An agile wristed surgeon-friendly, low cost, multi-degree, indigenous laparoscopic hand instrument

Info

Publication number: WO2025196740A1
Application number: PCT/IB2025/055032
Authority: WO
Inventors: Mariraj Mariappan; Muthukumar Mariappan
Original assignee: Individual
Current assignee: Individual
Priority date: 2024-03-22
Filing date: 2025-05-14
Publication date: 2025-09-25
Anticipated expiration: 2026-09-22

Abstract

The present disclosure discloses an agile wristed surgeon-friendly, multi-degrees, intuitive laparoscopic hand instrument. The laparoscopic hand instrument includes a hand controller module, a motion transmitter module, and an end effector module. The hand controller module comprises a circular shaped head, inner and outer rings formed of a circular head part with grooves and a cylindrical tail part with horizontal projections, a base member, and a handle integrated, via a slot, to a ridge on the bottom member, to allow independent rotation of the handle and the handle cap up to predefined degrees on either side. The motion transmitter module includes a shaft having multiple connecting rods. The end effector module includes an up and down pulley, pulleys A and B stacked and attached to the up and down pulley by a second rivet, and grippers and the up and down pulley configured to move together or independently in accordance with the motion of finger holders and the handle.

Description

AN AGILE WRISTED SURGEON-FRIENDLY, LOW COST, MULTI-DEGREE, INDIGENOUS LAPAROSCOPIC HAND INSTRUMENT

TECHNICAL FIELD:

[0001] The present disclosure generally relates to medical devices. More particularly, the present disclosure relates to an agile wristed surgeon-friendly, low-cost, multi-degrees, indigenous laparoscopic hand instrument for use in minimally invasive surgical procedures.

BACKGROUND:

[0002] Laparoscopic surgery also known as minimally invasive surgery (MIS), band-aid surgery, keyhole surgery, or pinhole surgery is a modem surgical technique with many advantages over traditional open surgical methods. The procedure has gained popularity and is now regularly used in many different operations within the abdominal and pelvic cavities as well as for thoracoscopic and orthopaedic surgery. Laparoscopic surgery has become increasingly prevalent in recent years due to its associated benefits such as reduced patient trauma, faster recovery times, and minimise scarring. In laparoscopic procedures, surgical instruments are introduced through small incisions or ports, allowing surgeons to perform complex surgeries with the aid of video cameras and specialized instruments. However, conventional methods pose several limitations.

[0003] Many techniques have been developed to address the above-mentioned issues. For instance, Patent Document US9138207B2 discloses a method of laparoscopic surgery which comprises inserting a trocar into a body cavity, and passing a shaft of a surgical tool through a wall of a body cavity through an incision not substantially larger than a diameter of said shaft and distant from said trocar, so that a proximal portion of said shaft is external to said cavity and a distal portion of said shaft is internal to said cavity. The method includes passing the distal portion of said shaft from within said body cavity through said trocar until said distal portion emerges from said body cavity, and there attaching an operating tool head to said shaft while said distal shaft portion is outside the body. Further, the method includes retracting said shaft and operating tool head entirely through said trocar to position said attached operating tool head entirely within said cavity, and using a portion of said shaft external to said body cavity to manipulate said operating tool head within said cavity during a surgical procedure.

[0004] Another Patent Document US5350391A discloses a laparoscopic surgical instrument comprising an elongated shaft bearing distal and proximal ends, and a surgical implement pivotably mounted to the distal end of said shaft. The surgical implement comprises a pair of members movable with respect to one another for performing an operative step, and first and second handles pivotally mounted to the proximal end of the shaft, said handles being pivotally movable together relative to the shaft and pivotable relative to each other. The handles are operatively connected to said surgical implement such that pivotable movement of both of said handles together in one direction simultaneously pivots both of said members of said implement together in one direction relative to the shaft, and pivotable movement of said first handle relative to said second handle moves the members of the surgical implement relative to each other to perform said operative step.

[0005] Another Patent Document US5593402A discloses a laparoscopic device comprising an inner cannula having an inner distal end and an inner operative end, a detachable distal tip having a tip locking device thereon, and an outer cannula having an outer distal end and an outer operative end. The outer cannula is dimensioned for insertion of said inner cannula therein and for free rotation there between. The inner cannula is positioned inside said outer cannula, said distal ends including first and second end locking apparatus on said inner and outer distal ends respectively. The first and second end locking apparatus are configured and dimensioned to simultaneously cooperate with said tip locking device of said detachable distal tip upon rotation between said inner distal end and said outer distal end, whereby said detachable distal tip may be selectively locked, relative to said distal ends, against rotational and axial movement. Further, the laparoscopic device comprises a mechanism operatively associated with said inner and outer cannula for providing selective axial locking between said cannulae; where said tip locking device of said detachable distal tip includes an insertion end of said tip having a rotational locking member and axial locking means thereon. The first end locking apparatus includes a slot dimensioned to receive said rotational locking member, thereby providing rotational fixity between said detachable distal tip and said distal ends. The said second end locking apparatus includes a locking lug dimensioned to engage said axial locking means, thereby providing translational fixity between said detachable distal tip and said distal ends.

[0006] Though conventional laparoscopic instruments offer numerous advantages in the prior arts, they do face certain limitations such as lack of optimal flexibility, restricting the range of motion within a surgical site. Additionally, the manipulation of these instruments during laparoscopic procedures may not align intuitively with the desired surgical actions resulting in challenges for surgeons, extended learning curves and potential inefficiencies. Further, the existing instruments are unadaptable to various surgical scenarios, potentially hindering the surgeon’s ability to access specific anatomical structures or perform intricate maneuvers.

[0007] Therefore, there exists a need in the state of the art for an alternative instrument with improved structure, function and usability for performing laparoscopic surgery effectively, overcoming the above said drawbacks.

OBJECTS OF THE PRESENT DISCLOSURE:

[0008] The main object of the present disclosure is to fabricate a highly efficient laparoscopic hand instrument.

[0009] Another object of the present disclosure is to fabricate an agile wristed surgeon- friendly, low cost, multi-degrees, indigenous laparoscopic hand instrument.

[0010] Yet another object of the present disclosure is to fabricate a laparoscopic hand instrument with enhanced maneuverability, reduced fulcrum effect, and improved ergonomic design.

[0011] Further, another object of the present disclosure is to utilize the fabricated laparoscopic hand instrument in minimally invasive surgical procedures.

SUMMARY OF THE PRESENT DISCLOSURE:

[0012] The present disclosure discloses an agile wristed surgeon-friendly, multi-degrees, intuitive laparoscopic hand instrument for use in minimally invasive surgical procedures.

[0013] The laparoscopic hand instrument of the present disclosure includes a hand controller module, a motion transmitter module, and an end effector module. The hand controller module includes a circular shaped head with rectangular openings in rear side and in front side. The hand controller module includes a rectangular projection on the front side opening attached to both sides of a vertical ring by an upper triangular beam and a lower triangular beam formed of 1 mm horizontal slit-1 on both sides of the vertical ring. The vertical ring is engraved with a groove on an outer circumference disposed on the front side. The head is formed of a circular solid thickness in the lower portion with slit-5 in the rear side and a plurality of holes. The head is integrated to an upper part of a circular bottom member having a plurality of projections. A slit-2 is disposed in an upper side of the circular bottom member. The head is housed with an inner ring having a circular head part engraved with a first groove on an outer circumference of the circular head part and a cylindrical tail part having a horizontal first projection perpendicular to the cylindrical tail part. The inner ring is placed inside an outer ring having a circular head part having a slit-3 and engraved with a second groove on an outer circumference of the circular head part and a cylindrical tail part having a slit-3 and a horizontal second projection perpendicular to the cylindrical tail part. The outer ring is rested on a base member having a cylindrical part and a horizontal plate. A slit-4 is provided in both the cylindrical part and the horizontal plate including a plurality of holes. The cylindrical part of the base member is affixed to the circular solid thickness of the head, and the horizontal plate of the base member is affixed to an upper surface of the circular bottom member. An upper opening of the head is closed by a head cap. [0014] In an embodiment, the hand controller module includes a handle having an opened top portion and a closed bottom portion. The opened top portion is closed by a handle cap. The handle having a slot in the top portion is integrated to a ridge disposed in front side of a lower part of the circular bottom member, thereby enabling the handle and the handle cap to rotate independently up to 90 degrees on either side of the ridge.

[0015] In an embodiment, the first projection is adapted to receive a first finger holder, and the second projection is adapted to receive a second finger holder. The first finger holder and the second finger holder are configured to slide right and left either alone or together, thereby actuating pulleys A and B to turn right and left.

[0016] In an embodiment, a rear rectangular opening in the head is closed by a head side cap.

[0017] In an embodiment, the first and second grooves in the inner ring and the outer ring are adapted to receive an inner ring loop wire and an outer ring loop wire.

[0018] In an embodiment, the groove in the vertical ring is adapted to receive a vertical ring loop wire. A moving axis of the vertical ring is perpendicular to the inner ring and the outer ring. 1 mm horizontal slits on both sides of the vertical ring are adapted to receive the inner ring loop wire and the outer ring loop wire.

[0019] In an embodiment, the motion transmitter module includes an elongated shaft having a proximal end and a distal end. The proximal end is integrated to the vertical ring through a shaft holder hitched by a portion 1 and a portion 2, and the distal end is integrated to an up and down pulley holder. A shaft is housed with connecting rods having a proximal end and a distal end. The proximal end of first and second connecting rods are attached to the inner ring loop wire, the proximal end of the third and fourth connecting rods are attached to the outer ring loop wire, and the proximal end of the fifth and sixth connecting rods are attached to the vertical ring loop wire.

[0020] In an embodiment, the end effector module includes an up and down pulley coupled to the up and down pulley holder by a rivet 1 and is looped by up and down loop wire integrated to the distal end of the fifth and sixth connecting rods. The end effector unit includes a pulley A placed over a pulley B and attached with the up and down pulley by a rivet 2. A moving axis of the pulley A and the pulley B is perpendicular to the moving axis of the up and down pulley. The pulley A is looped by a pulley A loop wire integrated to the distal end of the first and second connecting rods, and the pulley B is looped by a pulley B loop wire integrated to the distal end of the third and fourth connecting rods. Further, the end effector module includes a gripper- 1 and a gripper-2 attached to the pulley A and the pulley B, respectively, and adapted to either move along the same direction as the movement of the first finger holder and the second finger holder or to move independently corresponding to the movement of the first finger holder and the second finger holder.

BRIEF DESCRIPTION OF THE DRAWINGS

[0021] FIG. 1 illustrates a perspective view of a laparoscopic hand instrument, in accordance with an embodiment of the present disclosure.

[0022] FIG. 2 illustrates an exploded view of a laparoscopic hand instrument including a hand controller module, a motion transmitter module, and an end effector module, in accordance with an embodiment of the present disclosure.

[0023] FIGs. 3A and 3B illustrate individual parts of the laparoscopic hand instrument, in accordance with an embodiment of the present disclosure.

[0024] FIGs. 4A and 4B illustrate schematic views of grippers of the end effector module in an open position and a closed position, respectively, in accordance with an embodiment of the present disclosure.

[0025] FIGs. 5A and 5B illustrate schematic representations depicting right and left movements of the grippers, respectively, in accordance with an embodiment of the present disclosure.

[0026] FIGs. 6A and 6B illustrate schematic representations depicting up and down movements of the grippers, respectively, in accordance with an embodiment of the present disclosure.

DETAILED DESCRIPTION:

[0027] The following is a detailed description of embodiments of the disclosure depicted in the accompanying drawings. The embodiments are in such details as to clearly communicate the disclosure. However, the amount of detail offered is not intended to limit the anticipated variations of embodiments; on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the scope of the present disclosures as defined by the appended claims.

[0028] The present disclosure discloses an agile wristed surgeon-friendly, multi-degrees, intuitive laparoscopic hand instrument. The laparoscopic hand instrument includes a hand controller module, a motion transmitter module, and an end effector module.

[0029] The hand controller module includes a circular shaped head having front and rear side rectangular openings, and a rectangular projection on the front opening attached to both sides of a vertical ring via upper and lower triangular beams. The vertical ring includes a 1 mm horizontal slit on both sides and engraved with a groove on an outer circumference disposed on the front side. A solid lower portion of the head includes a slit and a plurality of holes. A circular bottom member with upper projections and a slit, is integrally connected to the head. An inner ring is housed within the head, and formed with a circular head part with a circumferential groove and a cylindrical tail part with a first horizontal projection. An outer ring surrounding the inner ring, is formed with a circular head part with a slit and a groove, and a cylindrical tail part with a second horizontal projection.

[0030] The hand controller module includes a base member having a cylindrical portion and a horizontal plate with a slit and a plurality of holes. The cylindrical portion is affixed to the head, and the horizontal plate is affixed to the bottom member. A head cap is provided for closing an upper opening of the head. Further, the hand controller module includes a handle having an open top portion and a closed bottom portion. The open top portion is closed by a handle cap. The handle is integrated via a slot to a ridge on the bottom member, allowing independent rotation of the handle and cap up to 90 degrees on either side.

[0031] The first and second horizontal projections are adapted to receive respective finger holders configured to slide laterally either independently or simultaneously, thereby actuating pulleys A and B. The rear side rectangular opening is closed by a head side cap.

[0032] The grooves on the inner and outer rings are formed for receiving inner and outer ring loop wires, respectively. The vertical ring groove is adapted to receive a vertical ring loop wire, and the movement axis of the vertical ring being perpendicular to that of the inner and outer rings.

[0033] In an embodiment, the motion transmitter module includes an elongated shaft having proximal and distal ends. The proximal end is integrated to the vertical ring via a shaft holder, and the distal end is integrated to an up and down pulley holder. The shaft houses multiple connecting rods. First and second connecting rods are attached to the inner ring loop wire, third and fourth connecting rods are attached to the outer ring loop wire, and fifth and sixth connecting rods are attached to the vertical ring loop wire.

[0034] In an embodiment, the end effector module includes an up and down pulley connected to the pulley holder by a rivet and looped by wires from the fifth and sixth connecting rods. The pulleys A and B are stacked and attached to the up and down pulley by a second rivet. The movement axes of the pulleys A and B are perpendicular to that of the up and down pulley. The pulleys A and B are looped respectively by wires from first and second connecting rods and third and fourth connecting rods. The end effector module includes gripper- 1 and gripper-2 attached to the pulleys A and B, and configured to move either in the same direction or independently in accordance with the motion of the finger holders.

[0035] Various embodiments of the present disclosure will be explained in details with reference to FIGs. 1-6B.

[0036] With reference to FIGs. 1-6B, a laparoscopic hand instrument 1 is disclosed. The laparoscopic hand instrument 1 includes a hand controller module 2, a motion transmitter module 3, and an end effector module 4.

[0037] In an exemplary embodiment, the hand controller unit 2 includes a circular shaped head 5 with rectangular openings 6A, 6B in rear side and in front side. A rectangular projection 45 positioned at the front side opening 6B is connected to both sides of a vertical ring 7 via an upper triangular beam and a lower triangular beam, each incorporating a 1 mm horizontal slit-1 12A and 12B on either side of the vertical ring 7. The vertical ring 7 is engraved with a groove 41 on an outer circumference disposed on the front side of the head 5. The head 5 is formed of a circular solid thickness in a lower portion with a slit-5 44 in the rear side and a plurality of holes. The head 5 is integrated to an upper part of a circular bottom member 8 having a plurality of projections and a slit-2 16 disposed in an upper side of the circular bottom member 8. The head 5 is housed with an inner ring 10 having a circular head part engraved with a first groove 11 on an outer circumference of the circular head part and a cylindrical tail part having a first horizontal projection 13 perpendicular to the cylindrical tail part. The inner ring 10 is placed inside an outer ring 14 having a circular head part having a slit-3 42 and engraved with a second groove 15 on an outer circumference of the circular head part and a cylindrical tail part having a slit-3 42 and a second horizontal projection 17 perpendicular to the cylindrical tail part. The outer ring 14 is rested on a base member 18 having a cylindrical part and a horizontal plate, and a slit-4 43 in both the cylindrical part and the horizontal plate. The horizontal plate is formed with a plurality of holes. [0038] The cylindrical part of the base member 18 is affixed to the circular solid thickness with the slit-5 44 of the head 5. The horizontal plate of the base member 18 is affixed to the upper surface of the circular bottom member 8. An upper opening of head 5 is closed by a head cap 19. A handle 9 having an opened top portion and a closed bottom portion is affixed to the circular bottom member 8. The opened top portion is closed by a handle cap 20. The handle 9 having a slot in the top portion is integrated to a ridge disposed in front side of a lower part of the circular bottom member 8, thereby rotating the handle 9 and the handle cap 20 independently up to 90 degrees on either side of the ridge.

[0039] The first horizontal projection 13 is adapted to receive a first finger holder 21 and the second horizontal projection 17 is adapted to receive a second finger holder 22. The first and second finger holders 21, 22 are configured to slide right and left either alone or together, thereby actuating a pulley A 33 and a pulley B 34 of the end effector module 4 to turn right and left. The rear side rectangular opening 6A in the head 5 is closed by a head side cap 23. The first groove 11 in the inner ring 10 and the second groove 15 in the outer ring 14 are adapted to receive an inner ring loop wire 24 and an outer ring loop wire 25, respectively. The groove 41 in the vertical ring 7 is adapted to receive a vertical ring loop wire 26. A moving axis of the vertical ring 7 is perpendicular to the inner ring 10 and the outer ring 14. The 1 mm horizontal slits 12A and 12B on both sides of the vertical ring 7 are adapted to receive the inner ring loop wire 24 and the outer ring loop wire 25.

[0040] Further, the motion transmitter module 3 includes an elongated shaft 27 having a proximal end and a distal end. The proximal end is integrated to the vertical ring 7 through a shaft holder 28 hitched by a first portion and a second portion. The distal end is integrated to an up and down pulley holder 31. The shaft 27 is housed with connecting rods 29A-29F having a proximal end and a distal end. The proximal ends of the first and second connecting rods 29A, 29B are attached to the inner ring loop wire 24. The proximal ends of the third and fourth connecting rods 29C, 29D are attached to the outer ring loop wire 25. The proximal ends of the fifth and sixth connecting rods 29E, 29F are attached to the vertical ring loop wire 26.

[0041] Furthermore, the end effector module 4 includes an up and down pulley 30 coupled to the up and down pulley holder 31 by a first rivet 32 and looped by an up and down loop wire integrated to the distal ends of the fifth and sixth connecting rods 29E, 29F. The pulley A 33 is placed over the pulley B 34 and attached with the up and down pulley 30 by a second rivet 35. A moving axis of the pulley A 33 and the pulley B 34 is perpendicular to a moving axis of the up and down pulley 30. The pulley A is looped by a pulley A loop wire integrated to the distal ends of the first and second connecting rods 29A, 29B, and the pulley B is looped by a pulley B loop wire integrated to the distal ends of the third and fourth connecting rods 29C, 29D.

[0042] Additionally, the end effector module 4 includes a first gripper 36 and a second gripper 37. The first gripper 36 and the second gripper 37 are attached to the pulley A 33 and the pulley B 34, and adapted to either move along the same direction as the movement of the first finger holder 21 and the second finger holder 22 or to move independently corresponding to the movement of the first and second finger holders 21, 22.

[0043] In an embodiment, the first gripper 36 and the second gripper 37 are adapted to open upon movement of the first and second finger holders 21, 22 away from each other. The first and second grippers 36, 37 stay in contact with each other when the first and second finger holders 21, 22 are close to each other. The first and second grippers 36, 37 move either together or independently with respect to movement of the first and second finger holders 21, 22, as illustrated in FIGs. 4 A and 4B.

[0044] In an embodiment, the right and left movements of the first and second grippers 36, 37 are obtained up to 110 degrees either sides from a longitudinal axis of the shaft 27 upon movement of the first and second finger holders 21, 22 to the extreme degrees on either sides alone or together, as illustrated in FIGs. 5A and 5B.

[0045] In an embodiment, as illustrated in FIGs. 6A and 6B, up and down movements of the up and down pulley 30 is obtained up to 90 degrees from a latitudinal axis of the shaft 27 upon movement of the hand controller module 2 in respect to the vertical ring 7 in same direction. Movements of open/close and right/left of the first and second grippers 36, 37 and up/down movements of the up and down pulley 30 work either independently or together.

[0046] Therefore, the laparoscopic hand instrument 1 features a pulley-cable-rigid rod driven mechanism, thereby enabling the laparoscopic hand instrument 1 to achieve seven degrees of freedom, allowing for a comprehensive range of movements, and enhancing a surgeon's ability to navigate complex anatomical structures with precision. The pulley-cable- rigid rod driven mechanism is adaptable for a wide range of laparoscopic procedures. The multi-degree-of-freedom design and intuitive control of the laparoscopic hand instrument 1 facilitate versatility, eliminating a need for frequent instrument changes during surgery.

[0047] Further, a structure of the laparoscopic hand instrument 1 minimizes a fulcrum effect commonly experienced in traditional laparoscopic instruments. By incorporating a pulley system, the laparoscopic hand instrument 1 allows for smoother and more controlled movements, mitigating the limitations associated with a fixed pivot point. [0048] The multi-degree laparoscopic hand instrument 1 improves manoeuvrability during minimally invasive surgeries. By incorporating the pulley-cable-rigid rod driven mechanism, the laparoscopic hand instrument 1 enable surgeons to navigate complex anatomical structures more effectively, reducing a need for repositioning or employing multiple instruments for specific tasks.

[0049] The laparoscopic hand instrument 1 integrates a real-time tactile feedback system, providing surgeons with a sense of touch during laparoscopic procedures. The real-time tactile feedback system allows for improved depth perception and better control, addressing the limited tactile feedback associated with conventional laparoscopic instruments.

[0050] The laparoscopic hand instrument 1 features an ergonomic design that aligns with natural movements of a human hand. This ergonomic approach reduces surgeon fatigue during prolonged procedures and enhances overall comfort, contributing to improved surgical performance. The laparoscopic hand instrument 1 simplifies a control interface, making the laparoscopic instruments more user-friendly. The intuitive operation allows surgeons to focus on the procedure rather than grappling with complex instrument controls, reducing the learning curve associated with laparoscopic surgery.

[0051] The laparoscopic hand instrument 1 is compatible and minimizes a need for extensive infrastructure modifications, thereby enhancing the feasibility of integrating the pulley-cable-rigid rod driven mechanism into current surgical practices.

[0052] Moreover, the laparoscopic hand instrument 1 is used in minimally invasive surgical procedures as it has enhanced features and overcomes the limitations of the existing instruments.

[0053] Although the present disclosure has now been described in terms of certain preferred embodiments and exemplified with respect thereto, one skilled in the art can readily appreciate that various modifications, changes, omissions, and substitutions may be made without departing from the scope of the following claims.

REFERRALS:

Claims

We Claim:

1. A laparoscopic hand instrument, comprising: a hand controller module, a motion transmitter module, and an end effector module, wherein the hand controller module comprises: a circular shaped head having front and rear side rectangular openings, an inner ring housed within said head, and formed of a circular head part with a first groove and a cylindrical tail part with a first horizontal projection, an outer ring surrounding the inner ring, comprising a circular head part with a slit-3 and a second groove, and a cylindrical tail part with a second horizontal projection, a base member having a cylindrical portion and a horizontal plate with a slit-4 and a plurality of holes, wherein the cylindrical portion is affixed to the head and the horizontal plate is affixed to a bottom member, a handle formed of an open top portion closed by a handle cap and a closed bottom portion, and integrated, via a slot, to a ridge on the bottom member, to allow independent rotation of the handle and the handle cap up to predefined degrees on either side; wherein the motion transmitter module comprises: an elongated shaft having a proximal end integrated to a vertical ring via a shaft holder, and a distal end integrated to an up and down pulley holder, wherein the shaft houses multiple connecting rods, with first and second connecting rods attached to an inner ring loop wire, third and fourth connecting rods attached to an outer ring loop wire, and fifth and sixth connecting rods attached to a vertical ring loop wire; and wherein the end effector module comprises: an up and down pulley connected to the up and down pulley holder by a first rivet and looped by wires from fifth and sixth connecting rods, pulleys A and B stacked and attached to the up and down pulley by a second rivet, wherein the first and second horizontal projections in the hand controller module are adapted to receive first and second finger holders configured to slide laterally either independently or simultaneously, to actuate the pulleys A and B, and first and second grippers attached to the pulleys A and B, and configured to move together or independently in accordance with the motion of the first and second finger holders.

2. The laparoscopic hand instrument of claim 1, wherein the hand controller module comprises a rectangular projection, on the front side rectangular opening, attached to both sides of the vertical ring via upper and lower triangular beams.

3. The laparoscopic hand instrument of claim 1, wherein the vertical ring comprises horizontal slits on both sides and a groove on a front side of the vertical ring.

4. The laparoscopic hand instrument of claim 1, wherein the bottom member comprises a plurality of projections and a slit-2, integrally connected to the head.

5. The laparoscopic hand instrument of claim 1, wherein the hand controller module comprises a head cap closing an upper opening of the head.

6. The laparoscopic hand instrument of claim 1, wherein the first groove of the inner ring and the second groove of the outer ring are adapted to receive an inner ring loop wire and an outer ring loop wire, respectively.

7. The laparoscopic hand instrument of claim 1, wherein a moving axis of the vertical ring is perpendicular to a moving axis of the inner ring and the outer ring.

8. The laparoscopic hand instrument of claim 1, wherein moving axes of the pulleys A and B are perpendicular to moving axis of the up and down pulley.

9. The laparoscopic hand instrument of claim 1, wherein the first and second grippers are adapted to open upon movement of the first and second finger holders away from each other, and close or stay in contact with each other when the first and second finger holders are close to each other.

10. The laparoscopic hand instrument of claim 1, wherein right and left movements of the first and second grippers are attained up to predefined degrees either sides from a longitudinal axis of the shaft, upon movement of the first and second finger holders to extreme degrees on either sides alone or together.

11. The laparoscopic hand instrument of claim 1, wherein up and down movements of the up and down pulley is attained up to predefined degrees from a latitudinal axis of the shaft, upon movement of the hand controller module in respect to the vertical ring in a same direction.

12. The laparoscopic hand instrument of claim 1, wherein the first and second grippers move either together or independently with respect to movement of the first and second finger holders.

13. The laparoscopic hand instrument of claim 1, wherein open and close movements of the first and second grippers, right and left movements of the first and second grippers, and up and down movements of the up and down pulley are facilitated either independently or together, to provide multi-degree-of-freedom actuation of the pulleys A and B and the up and down pulley.