Abstract: A forceps includes an end effector assembly having first and second jaw members disposed in parallel orientation relative to one another. One or both of the jaw members is movable along a first axis relative to the other jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween. The first and second jaw members are configured to maintain the parallel orientation therebetween upon movement of the jaw members between the spaced-apart and approximated positions. A drive bar is coupled to one or both of the jaw members. The drive bar is selectively movable along a second axis that is different from the first axis between first and second positions for moving the jaw members between the spaced-apart and approximated positions.

Abstract: Endoscopic instrument having a proximal end, a distal end, a longitudinal direction along which the endoscopic instrument extends from the proximal end to the distal end, an end effector on the distal end, which end effector has a first end effector part and a second end effector part, a connecting element on the distal end, on which connecting element the first and second end effector parts are mounted and which connecting element extends along a transverse direction, a first pushing element, a second pushing element, a third pushing element, and a fourth pushing element, wherein the pushing elements each extend along the longitudinal direction and are displaceable relative to one another along the longitudinal direction, and wherein the first pushing element is articulately arranged at the first end effector part, the second pushing element is articulately arranged at the second end effector part, the third pushing element is articulately arranged at the connecting element, and the fourth pushing element is

Abstract: A surgical end effector includes a clevis having a first end to be supported by an elongated tube-like member and two jaws, each having a pivot portion and a working portion. The pivot portions are rotatably coupled to the clevis by two spaced apart pivots. The working portions may include a cutting edge that provide a shearing action as the first and second jaws rotate about their respective pivots. The pivot portion and the working portion of each jaw may be on opposite sides of a bisecting plane. A flexible cable or wire may be coupled to each jaw and extend through a guide way in the other jaw, between the first and second pivots, and through the first end of the clevis. One or more springs may urge the working portions together. A rocking pin pivotally supported by the clevis may constrain the jaws to have opposite motions.

Abstract: A polymeric surgical ligating clip is provided having curved leg members joined by a resilient hinge. A leg member includes a flexible rib protruding from a vessel clamping inner surface and extends longitudinally between the proximal and distal end portions of the leg member. The flexible rib defines a channel extending transversely through the rib along a majority of said length. The flexible rib can collapse and provides better retention of the clip on a vessel. The clip can contain a flexible rib on both legs in an interlocking fashion. Or a plurality of teeth can protrude from a second vessel clamping inner surface of a second leg member. The plurality of teeth can include first and second rows of teeth extending longitudinally on the second leg member, transversely separated from each other on opposite sides of a centerline of the clip.

Abstract: A surgical apparatus for use in endoscopic surgery having a user interface operatively coupled to an articulating tool assembly via an elongate tubular member. Movement at the articulating tool mirrors movement at the user interface thereby providing intuitive operation of the surgical apparatus. The apparatus is configured such that the range of motion of the articulating tool assembly emulates the range of motion of the human wrist.

Abstract: A forceps includes an end effector assembly having first and second jaw members. Each of the jaw members includes a proximal flange extending therefrom. Each of the proximal flanges defines a bifurcated configuration having first and second spaced-apart flange components. The first flange component of the first jaw member is configured to pivotably engage the second flange component of the second jaw member via a first protrusion-aperture coupling. The first flange component of the second jaw member is configured to pivotably engage the second flange component of the first jaw member via a second protrusion-aperture coupling different from the first protrusion-aperture coupling. One or both of the jaw members is pivotable relative to the other about the first and second protrusion-aperture couplings between a spaced-apart position and an approximated position for grasping tissue therebetween.

Abstract: A vessel sealer has a stepped jaw that allows the jaw to have an overall shape and a width that provides desired strength, shape, and functionality while permitting a smaller raised portion to apply the sealing pressure. The smaller area applying the sealing pressure allows an actuating mechanism to apply a clinically desired sealing pressure without exceeding the force or torque limitations of the actuating mechanism and can limit thermal spread during a sealing procedure.

Abstract: A support device for implanting stentless valve prostheses, such as biological heart valves, includes a hub and a plurality of support portions for supporting the stentless valve prosthesis. The hub defines a manipulation axis for the device and is flexibly connected to the support portions to allow displacing the manipulation axis for the device between the support portions.

Abstract: A surgical device includes a first jaw and a second jaw moveable relative to the first jaw between a first position, in which the first and second jaws are aligned within a plane, and a second position, in which the second jaw is in non-parallel correspondence to the plane. The surgical device may include a surgical member, e.g., a cutting and/or stapling element, disposed within the first law, and a second driver configured to cause relative movement of the surgical member in a direction parallel to the plane. The first and second jaws may include a camming arrangement that is configured to move the second jaw between the first and second positions. The camming arrangement may include a channel disposed along at least a portion of one or both of the first and second jaws, and a ball bearing disposed within the channel.

Abstract: A treatment tool of an endoscope including: a movable tip end portion that performs a treatment on a living body; a flexible first coil sheath into which a wire is spirally wound; a flexible second coil sheath into which a wire is spirally wound and which is concentrically fitted onto or into the first coil sheath; a flexible operation wire that is formed into an elongated thin shape, a tip end thereof being connected to the movable tip end portion, and the operation wire being movably inserted into the first coil sheath; and an operation portion for advancing and retracting the operation wire, in which a tip end of the second coil sheath is fixed to the movable tip end and a base end thereof is fixed to the operation portion.

Abstract: Two part laparoscopic tools and surgical methods using such tools are presented. The tools and methods enable use of multiple surgical tools each having wide tool heads to be used in a body cavity using a single wide trocar and one or more narrow incisions, thereby reducing surgical risk and enhancing patient comfort and shortening recovery time. Additional instruments for facilitating laparoscopic surgery are also presented.

Abstract: A surgical instrument includes a handle, and an elongated shaft extending from the handle. An end effector extending from the elongated shaft is in communication with a source of electrosurgical energy and defines an end effector axis. A roll joint couples the end effector to the elongated shaft and includes a first tubular structure extending distally from the elongated shaft and a second tubular structure rotatably coupled to the first tubular structure. The second tubular structure supports the end effector such that the end effector is rotatable about the end effector axis.

Abstract: An apparatus for manipulating tissue during a procedure performed within an eye of a patient is disclosed herein. The apparatus includes a hand-held controller and an elongate member configured to be inserted into the eye of the patient. The elongate member has a proximal end and a distal end, with the proximal end of the elongate member being coupled to the hand-held controller. The elongate member also has a lumen extending through the length of the elongate member. The apparatus further includes a plurality of flexible grasping fibers extending through at least a portion of the lumen and beyond the distal end thereof. The grasping fibers are adjustable by the hand-held controller to advance or retract relative to the elongate member by altering a distance between distal ends of the grasping fibers and the distal end of the elongate member.

Abstract: A forceps includes first and second shaft members each having a jaw member disposed at a distal end thereof. One (or both) of the first and second jaw members is moveable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. The first jaw member includes a jaw frame fixedly engaged to the first shaft member and a disposable jaw housing releasably engageable with the jaw frame. The disposable jaw housing includes a knife assembly disposed therein. The knife assembly includes a knife blade biased toward an initial position, wherein the knife blade is disposed within the jaw housing. The knife blade is moveable between the initial position and an extended position, wherein the knife blade extends at least partially from the jaw housing to cut tissue grasped between the first and second jaw members.

Abstract: In various embodiments, a surgical instrument is disclosed. In one embodiment, the surgical instrument comprises a handle, a shaft assembly extending distally from the handle; and an end effector coupled to a distal end of the shaft assembly. The end effector comprises a jaw assembly having a proximal end and a distal end. The jaw assembly comprises a moveable jaw member and a fixed jaw member. The moveable jaw member is pivotably moveable between an open position and a closed position with respect to the fixed jaw member. In the closed position, the jaw assembly defines a radius of curvature and a smooth taper from the proximal end to the distal end.

Abstract: The invention relates to a surgical instrument, in particular a sliding shaft instrument, with a main part, and a moveable part relative thereto, with a handle attached to the main part, comprising a fixed grip and a grip actuating the moveable part, with at least one guide, through which, in relation to the main part, the moveable part is moveable between an initial position and a working position, and with a sliding surface attached to the movable part and pointing towards the main part, the sliding surface being slid along a guide surface attached to the main part and pointing towards the sliding surface, with at least the sliding surface or the guide surface are assigned to each other for the formation of a washable gap.

Abstract: A surgical tool assembly includes a pair of opposing jaws. Further, a viewing opening may be provided in at least one of the opposing jaws. The viewing opening may extend from an upper to a lower surface of the opposing jaw in which the viewing opening is provided. The viewing opening may include a material retainer provided proximate the lower surface of the opposing jaw in which the viewing opening is provided. The material retainer may include an inclined surface inclined towards a central axis of the viewing opening. A grasping insert may be molded onto a lower surface of the opposing jaw in which the viewing opening is provided and an elastomeric material of the grasping inserts may within the viewing opening, the material of the grasping inserts covering the inclined surface of the first material retainer.

Abstract: This disclosure describes compliant graspers for use in endoscopic surgeries.

Abstract: A forceps includes first and second shafts, each having a jaw member disposed at a distal end thereof. At least one jaw member is moveable from an open to a closed position for grasping tissue therebetween. At least one jaw member is configured for reciprocation of a blade therethrough. A trigger assembly includes a trigger and at least one linkage coupled to the trigger and to the blade such that rotation of the trigger translates the blade between the retracted and the extended position. An interference member moveable between a locked position and an unlocked position is also provided. The interference member is configured to engage the linkage(s) when in the locked position to inhibit translation of the blade from the retracted to the extended position.

Abstract: A forceps includes an end effector assembly having first and second jaw members. Each jaw member includes a bifurcated proximal flange extending therefrom defining first and second spaced-apart flange components. The first flange components are pivotably engaged to one another via a first engagement portion and the second flange components are pivotably engaged to one another via a second engagement portion. One or both of the jaw members is pivotable relative to the other about the first and second engagement portions between an open position and a closed position for grasping tissue therebetween. A guide member is configured for positioning between the proximal flanges of the jaw members. The guide member includes a tab extending transversely therefrom that is configured to operably engaged one of the first and second engagement portions to retain the jaw members in engagement with one another.

Abstract: The teachings provided herein are directed to a methods and devices for treating a hemorrhoid in a subject in a manner that produces substantially less post-procedural pain in the subject, the method minimizing or avoiding a removing or a necrosis of a rectal tissue fold.

Abstract: A bipolar electrosurgical instrument is provided. The bipolar electrosurgical instrument includes first and second shafts each having a jaw member extending from a distal end thereof and a handle disposed at a proximal end thereof for effecting movement of the jaw members relative to one another. A first conductive lead is adapted to connect to a first electrical potential and a second conductive lead is adapted to connect to a second electrical potential. One of the first and second conductive leads extends through the pivot to connect to a respective jaw member.

Abstract: Provided is a manipulator including a first forceps piece and a second forceps piece, which are connected by a pivotal axle and have a gripping part opened or closed on a leading end side thereof. The manipulator includes a manipulation member that is connected to a base end side of the pair of forceps pieces, and moves forward or backward in an axial direction to open or close the gripping part, a first buffer part that has a first spring constant, and undergoes elastic deformation to change a grasping force generated at the gripping part on the basis of the first spring constant and a pulling amount of the manipulation member, and a stopper that regulates the elastic deformation of the first buffer part.

Abstract: A medical device including one or more components positioned to contact contaminants during use of the medical device. The one or more components including one or more limited-use portions transitionable upon use from an initial state, wherein the limited-use portion(s) exhibits a clean appearance, to a used state, wherein the limited-use portion(s) exhibits a contaminated appearance that visually indicates to a user that the at least one component is not further usable.

Abstract: Surgical instruments are provided for performing laparoscopic or similar minimally invasive operations, including two clamping parts, which can move towards one another and which have clamping surfaces for gripping tissue when they are closed. A cutting device has a cutting edge that, in a cutting direction, can be displaced relative to the clamping parts for cutting the gripped tissue. In such an instrument the cutting direction extends at an acute angle to the clamping surfaces when they are closed.

Abstract: A membrane removing forceps may include a plurality of forceps jaws and a plurality of membrane hooks. Each membrane hook may have a membrane hook outer height. Each membrane hook outer height may be less than the average thickness of a membrane, e.g., each membrane hook outer height may be less than the average thickness of an internal limiting membrane. A surgeon may pierce a membrane wherein only the membrane hooks penetrate the membrane, e.g., a surgeon may pierce an internal limiting membrane wherein only the membrane hooks penetrate the internal limiting membrane. The surgeon may then grasp and remove the membrane without damaging an underlying tissue, e.g., the surgeon may then grasp and remove the internal limiting membrane without damaging an underlying retina.

Abstract: In a background-art medical gripping device, when a wall surface of an in vivo tissue has a large tear, a side portion of the tear can be gripped by the gripping device, but the other side portion opposed to the side portion cannot be gripped simultaneously. Therefore, to close the tear, complicated operation is required to be performed using plural gripping devices. A medical gripping device according to the present invention includes a fixed clip, a pair of movable clips made from an elastic material and provided to face the fixed clip, the movable clips having lower ends fixed to the fixed clip and the other ends opened, and a control mechanism which shifts from each other a timing at which a gripping target is gripped between one of the movable clips and the fixed clip and a timing at which the target is gripped between the other movable clip and the fixed clip.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, first and second links attached to both the jaws and the housing, and a driver. The housing, first and second jaws, and first and second links form a linkage mechanism that allows the jaws to engage tissue and be left in vivo.

Abstract: A surgical instrument for supplying energy to tissue may comprise a handle, a trigger, an electrical input, and a shaft extending from the handle. The surgical instrument may comprise an end effector first and second tissue engaging surfaces that are slanted with respect to a transection plane. The end effector may, for example, have an electrode defining a V-shaped cross sectional profile. The end effector may comprise a plurality of raised surfaces that are received by a plurality of indentions when the end effector is in the closed position. The end effector may comprise a cutting member having a plurality of bands.

Abstract: An instrument (10) having a tool (15) of a particularly simple design comprises jaws (16, 17) with jaw supports (46) supported by spaced-apart hinges on a shared socket part 18. The hinge axes (27, 28) of the hinges are oriented parallel relative to each other and are at a distance from each other. A slit (24) for precisely guiding a knife (25) may be provided between the two. The jaw supports (46) of the jaws (16, 17) are guided in their own hinges with minimal play and hence in a precise manner. They are held against each other by transverse interlocking means (37), thereby ensuring a simple assembly and precise guiding.

Abstract: An ultrasonic surgical instrument is provided. The ultrasonic surgical instrument includes a housing having an elongated shaft extending therefrom. A first jaw member disposed at a distal end of the shaft is movable between open and clamping configurations. A pair of second jaw members disposed at the distal end of the shaft are movable between open and clamping configurations. A cutting blade extending to the distal end of the shaft is operably coupled to the housing. The pair of second jaw members and first jaw member are moveable to the clamping configuration to compress tissue of interest for removing moisture therefrom prior to the tissue of interest being treated.

Abstract: A forceps includes an end effector assembly having first and second jaw members movable between a spaced-apart position and an approximated position for grasping tissue therebetween. A knife assembly having a cutting blade disposed at a distal end thereof is also provided. The knife assembly is translatable relative to the end effector assembly between a retracted position and an extended position, wherein the cutting blade extends between the jaw members to cut tissue grasped therebetween. The knife assembly includes a proximal component and a first distal component that includes the cutting blade. The proximal and first distal components are removably coupled to one another to facilitate replacement of the first distal component while the end effector assembly remains in a substantially assembled condition, i.e., without requiring substantial disassembly of the end effector assembly.

Abstract: Exemplary embodiments of apparatus and method for effecting at least one anatomical structure of a body can be provided. For example, at least one first arrangement can be provided which is structured to be at least partially inserted into the body and including an opening. In addition, at least one second arrangement can be provided which configured to increase and/or decrease a size of the opening by a motion thereof in a first direction. Further, at least one third arrangement can be provided which can be coupled to the second arrangement(s), and configured to move at least in a second direction which is at least approximately parallel to the second direction.

Abstract: A forceps for use in surgery for dissecting tissue includes a pair of jaw members movable from an open position in spaced relation relative to one another to a closed position. The jaw members each have an outer housing extending along the length thereof to a distal end of the jaw members. The outer housing of one of the jaw members includes a textured surface at a distal end configured to interface with and dissect tissue during the movement of the jaw members from the closed to open positions. A dissecting tip may be selectively extendable from a channel defined in one of the jaw members to engage and separate tissue when in the extended position.

Abstract: A bipolar electrosurgical instrument is provided. The bipolar electrosurgical instrument includes first and second shafts each having a jaw member extending from a distal end thereof and a handle disposed at a proximal end thereof for effecting movement of the jaw members relative to one another. A first conductive lead is adapted to connect to a first electrical potential and a second conductive lead is adapted to connect to a second electrical potential. One of the first and second conductive leads extends through the pivot to connect to a respective jaw member.

Abstract: A forceps includes a housing, a shaft, and an end effector assembly. The end effector assembly includes first and second jaw members. At least one of the jaw members is moveable with respect to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. A cutting member having a plurality of cutting edges symmetrically-disposed about a longitudinal axis thereof is disposed within the shaft and is longitudinally translatable between a retracted position and an extended position. The cutting member extends between the jaw members to cut tissue grasped therebetween when in the extended position. The cutting member is fixedly-oriented with respect to the shaft and is configured for translation between the jaw members to cut tissue therebetween when the jaw members are rotated with respect to the shaft between about zero degrees and about 180 degrees in at least one of the clockwise and counterclockwise directions.

Abstract: Surgical forceps for gripping internal organs during minimally invasive surgery are provided. The surgical forceps can be a sanitizable sheet in a folded configuration that includes a first elongate region which transitions to a resilient hinge which transitions to a second elongate region, all of which are formed of the same sheet. The first elongate region can further include a first grasper end opposite the resilient hinge and the second elongate region can include a second grasper end opposite the resilient hinge. The resilient hinge can apply a spring force to the first elongate region and the second elongate region that biases the forceps in an open configuration where the first grasper end and the second grasper end are distal from each other. When an external force is applied against the resilient hinge, the first grasper end can close against the second grasper end.

Abstract: A treatment tool for an endoscope includes a forcep sheath, a first forcep cup and a second forcep cup which are attached to a distal end of the forcep sheath, and which cooperate with each other to be openable/closable as a whole, an operation wire which is movably arranged in the forcep sheath along an axial direction thereof, which is connected to the first forcep cup and the second forcep cup, and which opens/closes the first forcep cup and the second forcep cup when moved in its axial direction, wherein a sharp needle-shaped portion is formed on a distal end of the first forcep cup, the sharp needle-shaped portion extending farther than a distal end of the second forcep cup, and the sharp needle-shaped portion is arranged so that at least a portion thereof overlaps the second forcep cup.

Abstract: An apparatus for applying sealant to a target tissue of a surgical site is provided. The apparatus includes a handle, conduit and an end effector. The handle has means configured and adapted for operating the end effector and dispensing biological sealant to the surgical site via the end effector. The conduit stores and/or carries sealant towards the end effector. The end effector is configured to clamp around a body organ or tissue and apply and confine biological sealant in a substantially uniform manner thereto.

Abstract: A medical instrument includes a unitary jaw structure having: a connector portion, a first jaw portion flexibly integral with the connector portion, a first arm portion integral with the first jaw portion, and an actuator portion flexibly integral with the first arm portion for causing rotating motion of the first jaw portion upon linear motion of the actuator portion.

Abstract: An apparatus for applying sealant to a target tissue of a surgical site is provided. The apparatus includes a handle, conduit and an end effector. The handle has means configured and adapted for operating the end effector and dispensing biological sealant to the surgical site via the end effector. The conduit stores and/or carries sealant towards the end effector. The end effector is configured to clamp around a body organ or tissue and apply and confine biological sealant in a substantially uniform manner thereto.

Abstract: Apparatus and methods for delivering a surgical clip to a patient during a minimally invasive surgical procedure are disclosed herein. An exemplary apparatus for isolating an atrial appendage of a patient includes a surgical clip that locks onto the atrial appendage of the patient, and a surgical clip applicator that releasably engages the surgical clip. The surgical clip can include a top portion and a bottom portion. The surgical clip applicator can include a first flexible flap and a second flexible flap. The first and second flexible flaps can be sufficiently rigid to prevent the surgical clip from falling off of the surgical clip applicator when the surgical clip is engaged to the surgical applicator and the surgical clip applicator is in a relaxed state, and sufficiently flexible to facilitate separation of the surgical clip from the surgical clip applicator when the surgical clip is locked onto the atrial appendage.

Abstract: In a medical gripping tool with several branches, one branch includes a first flexurally elastic spar, a second flexurally elastic spar, of which the distal end is connected to the distal end of the first flexurally elastic spar, a rib, which is spaced apart from the proximal ends and from the distal ends of the flexurally elastic spars, and a linear guide for coupling the second flexurally elastic spar to the rib, in such a way that a linear movement of the second flexurally elastic spar relative to the rib is possible.

Abstract: An elongated member and a method of manufacturing an elongated member may include first, second, and third elongated rod mandrels. The first, second, and third elongated rod mandrels may be fixed together at predetermined proximal and distal locations and at a ball tip. The first, second, and third rod mandrels may be disposed within a tubular coupling element and fixed to the tubular coupling element at the ball tip. The tubular coupling element may be placed into abutment with and fixed to the distal end of an elongated shaft.

Abstract: A surgical instrument includes a housing supporting first and second actuators thereon, and an elongated shaft extending distally from the housing. First and second drive members extend through the elongated shaft to operatively couple respective actuators to respective jaw members such that independent manipulation of one of the actuators may induce pivotal movement of an individual jaw member. A locking member is operatively associated with the first and second drive members, and is selectively movable between locked and unlocked positions. When the locking member is in the locked position, the first and second drive members are coupled to one another and move concurrently to drive the jaw members in a bilateral manner. When the locking member is in the unlocked position, the drive members are decoupled from one another and move independently to permit operation of the instrument in a unilateral manner.

Abstract: A bone fixation system includes a bone plate, bone anchors, temporary fixation members, and forceps. The temporary fixation members are configured to be inserted through apertures in the bone plate and into underlying bone segments that are separated by a bone gap. The forceps are configured to apply a force to the temporary fixation members that causes at least one of the underlying bone segments to translate with respect to the other bone segment, thereby reducing or distracting the bone segments without interfering with final fixation by screws of bone segments.

Abstract: A forceps is provided. The forceps includes a housing having a shaft that extends therefrom. The bipolar forceps also includes a hydraulic mechanism that includes a fluid line and a plunger operatively coupled to the fluid line. The plunger is translatable within at least a portion of the shaft from a proximal position to a distal position. An end effector assembly is operatively connected to a distal end of the shaft and includes a pair of first and second jaw members biased in an open configuration. Each of the first and second jaw members configured to receive at least a portion of the plunger when a fluid is caused to flow within the fluid line such that the first and second jaw members move from an open position for positioning to a closed position for grasping tissue.

Abstract: A forceps includes an end effector assembly having first and second jaw members. Each jaw member includes a bifurcated proximal flange extending therefrom defining first and second spaced-apart flange components. The first flange components are pivotably engaged to one another via a first engagement portion and the second flange components are pivotably engaged to one another via a second engagement portion. One or both of the jaw members is pivotable relative to the other about the first and second engagement portions between an open position and a closed position for grasping tissue therebetween. A guide member is configured for positioning between the proximal flanges of the jaw members. The guide member includes a tab extending transversely therefrom that is configured to operably engaged one of the first and second engagement portions to retain the jaw members in engagement with one another.

Abstract: An endoscopic tissue anchor deployment device includes a handle, an elongated shaft defining an internal lumen, and an end effector attached to the distal end of the elongated shaft. A tissue anchor catheter is removably inserted through the lumen of the elongated shaft, the catheter having a tissue anchor assembly that is deployable from its distal end. The handle may include a pin and track assembly that define a series of handle actuation steps corresponding to deployment steps for the deployment device end effector and the tissue anchor catheter. In some embodiments, the handle includes a catheter stop member that prevents movement of the tissue anchor catheter under certain circumstances, and a handle stop member that prevents actuation of the handle under certain circumstances.

Abstract: A manipulator includes a control unit (1), with handle (4) and control buttons (4a-4d), and a connecting arm (2) which, at its proximal end (2a), carries the control unit (1) and, at its distal end (2b), carries a work unit (3). The control buttons (4a-4d) control at least a first inclination motor, which causes a movement of inclination of a tool support (5) of the work unit (3) about a transverse inclination axis (11), and they control the actual rotation of the tool support (5) about its direction of inclination (II) and control the orientation of the direction of inclination (II) about the longitudinal axis (I-I) of the connecting arm (2). A particularly ergonomic manipulator is thus obtained which is easy to learn to use and which efficiently separates the stresses arising from movements of the tool support (5) and the stresses arising from holding and moving the manipulator itself.