Abstract: An instrument for endoscopic minimally invasive procedures has a shaft with a working end, such as a clamp, scissors, forceps, or the like. Handle portions extend in an opposed relationship and pivot relative to the shaft. When the handle portions are moved about respective pivot points, the working end of the surgical instrument is actuated. The first and second handle portions each have an indented grasping segment in which a surgeon's finger or thumb may rest. The grasping segments have rounded cross-sections to facilitate a surgeon rotating the handle with a finger and another finger or thumb. The indented portions form a narrow portion when the handle is in a closed configuration. There may be a 1:1 ratio between handle movement and that of the working end, and the balance point of the instrument may be at the distal end of the handle.