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ssss1 Endoscopic surgical instrument components. (A). Working end (jaws of the instrument). (B). Shaft. (C). Handles.

Source: © 2014 Photo courtesy of KARL STORZ SE & CO, KG.

ssss1 Minimally invasive surgical instrument handle types (from left to right): nonlocking (nonratcheted) rings, locking rings with a hemostat ratchet, locking rings with a Manhes ratchet, and straight handle with ratchet for certain endoscopic needle holders.

Source: © 2014 Photo courtesy of KARL STORZ SE & CO, KG.

Most instruments have either ratcheted or nonratcheted ringed handles (ssss1). Ratcheted handles lock via one of several ratchet mechanisms, depending on the manufacturer. Laparoscopic needle holders, however, have a straight handle design with either a hemostat style or a disengageable ratchet locking mechanism to allow for easier manipulation of suture and needle within a body cavity. Ringed handles are held in the same tripod manner as traditional instruments, with the thumb and ring finger in the rings and the index finger stabilizing the shaft. A dial that is easily reached by the index finger allows for 360° rotation of the shaft around its longitudinal axis. Shaft rotation allows for optimal positioning of the instrument jaws when working within a confined space. Handles intended for use with insulated shafts for monopolar or bipolar electrocoagulation also have a high‐frequency connector for application of an electrical current from an electrosurgical generator. Monopolar and bipolar handles and shafts are distinct from one another and cannot be interchanged.