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A surgical tool for minimally invasive surgery. The surgical tool in one embodiment includes a manipulator as a user interface, a proximal universal joint mounted to the manipulator, a hollow elongated member such as a tube mounted to the proximal universal joint, and a distal universal joint mounte

A surgical tool for minimally invasive surgery. The surgical tool in one embodiment includes a manipulator as a user interface, a proximal universal joint mounted to the manipulator, a hollow elongated member such as a tube mounted to the proximal universal joint, and a distal universal joint mounted to the other end of the elongated member. An end effector is mounted to the distal universal joint second end. Pivoting of the first end of the proximal universal joint causes the second end of the distal universal joint to move in a corresponding motion, and cabling operatively couples the proximal and distal universal joints. The proximal and distal universal joints may each include two yokes and a center block. Cabling may include four cables that each engage two round elements at the proximal and distal universal joints mounting locations to the center block.

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1. A surgical tool for use by an operator, comprising: a manipulator adapted to receive at least a portion of the operator's hand, the manipulator having a longitudinal axis and a first angular position;a proximal universal joint having a first end and a second end, the first end of the proximal uni

1. A surgical tool for use by an operator, comprising: a manipulator adapted to receive at least a portion of the operator's hand, the manipulator having a longitudinal axis and a first angular position;a proximal universal joint having a first end and a second end, the first end of the proximal universal joint being mounted to the manipulator, the proximal universal joint including a center block,a proximal yoke at the first end of the proximal universal joint and mounted to the center block at first and second mounting locations,a distal yoke at the second end of the proximal universal joint and mounted to the center block at third and fourth mounting locations,means for pivoting the center block member about two perpendicular coplanar axes through the center block, anda round element at each mounting location between the center block and the proximal or distal yoke, the round elements being independent parts or integral to either of the center block or the yokes;a hollow elongated member having a first end, a second end, and a longitudinal axis, the first end of the elongated member being mounted to the second end of the proximal universal joint;a distal universal joint having a first end and a second end, the first end of the distal universal joint being mounted to the second end of the elongated member, the distal universal joint including a center block,a proximal yoke at the first end of the distal universal joint and mounted to the center block at first and second mounting locations,a distal yoke at the second end of the distal universal joint and mounted to the center block at third and fourth mounting locations,means for pivoting the center block member about two perpendicular coplanar axes through the center block, anda round element at each mounting location between the center block and the proximal or distal yoke, the round elements being independent parts or integral to either of the center block or the yokes;cabling operatively coupling the proximal and distal universal joints, the cabling comprising four cables that each engage two of the round elements at each of the proximal and distal universal joints such that pivoting the proximal yoke of the proximal universal joint causes a corresponding motion of the distal yoke of the distal universal joint; andan end effector mounted to the second end of the distal universal joint, the end effector having a first angular position and a longitudinal axis parallel to the longitudinal axis of the manipulator, wherein at all relative positions of the manipulator and the end effector, the longitudinal axis of the manipulator and the longitudinal axis of the end effector remain parallel, and the degree of rotation of the manipulator about the longitudinal axis of the manipulator from the first angular position of the manipulator is equal to the degree of rotation of the end effector about the longitudinal axis of the end effector from the first angular position of the end effector. 2. The surgical tool of claim 1, wherein pivoting of the first end of the proximal universal joint causes the second end of the distal universal joint to move in a corresponding motion. 3. The surgical tool of claim 1, wherein the end effector comprises a base member and two opposed digits, each digit with a proximal phalange having a first end and a second end, the proximal phalange first end pivotally mounted to the base member, and a distal phalange having a first end and a second, free end, the first end pivotally mounted to the proximal phalange second end. 4. The surgical tool of claim 3, wherein the manipulator comprises a first actuator operable to concurrently control the proximal phalanxes and a second actuator operable to concurrently control the distal phalanxes. 5. The surgical tool of claim 4, wherein the second actuator is mounted to the end of at least a part of the first actuator. 6. The surgical tool of claim 5, wherein the first actuator comprises a first lever assembly adapted to be operable with the operator's thumb, wherein actuating the first lever assembly causes the proximal phalanges to move relative to each other. 7. The surgical tool of claim 6, wherein the first actuator further comprises a second lever assembly adapted to be operable with a finger of the same hand of the operator as the thumb, and wherein advancing the first and second lever assemblies toward each other causes the proximal phalanges to move toward each other. 8. The surgical tool of claim 7, wherein the second actuator comprises a third lever assembly pivotally mounted to the second lever assembly. 9. The surgical tool of claim 8, wherein each lever assembly has a longitudinal axis, and when the longitudinal axis of the third lever assembly is pivoted away from the longitudinal axis of the second lever assembly, the distal phalanges move toward each other. 10. The surgical tool of claim 9, wherein the end effector is control by four end effector control cables, and wherein two cables control the proximal phalanxes and two cables control the distal phalanges. 11. The surgical tool of claim 10, wherein the two cables that control the proximal phalanxes are operatively connected to the first lever assembly. 12. The surgical tool of claim 10, wherein the two cables that control the distal phalanxes are operatively connected to the third lever assembly. 13. The surgical tool of claim 10, wherein the end effector control cables are tensioned with resiliently biased pulleys included in the manipulator. 14. The surgical tool of claim 1, wherein the proximal and distal universal joints are controlled by universal joint control cables, and the end effector is controlled by end effector control cables, and the universal joint control cables and the end effector control cables are anchored in the manipulator and may be adjusted with means for tensioning the universal joint control cables and the end effector control. 15. A surgical tool for use by an operator, comprising: a manipulator adapted to receive at least a portion of the operator's hand;a proximal universal joint having a first end and a second end, the first end of the proximal universal joint being mounted to the manipulator;a hollow elongated member having a first end, a second end, and a longitudinal axis, the first end of the elongated member being mounted to the proximal universal joint;a distal universal joint having a first end and a second end, the first end of the distal universal joint being mounted to the second end of the elongated member; andan end effector mounted to the second end of the distal universal joint,wherein the proximal and distal universal joints are controlled by universal joint control cables, and the end effector is controlled by end effector control cables, and the universal joint control cables and the end effector control cables are anchored in the manipulator and may be adjusted with means for tensioning the universal joint control cables and the end effector control, andwherein the tensioning means comprises vented screws. 16. The surgical tool of claim 15, wherein the universal joint control cables and the end effector control cables have swaged tubing at their proximal ends for abutting the vented screws when the universal joint control cables and the end effector control cables are tightened. 17. An articulation system for a surgical tool, comprising: a proximal universal joint including a proximal end member and a distal end member, the proximal end member of the proximal universal joint having a longitudinal axis and a first angular position, each of the proximal end member and the distal end member of the proximal universal joint including a center member for pivoting of the proximal end member and the distal end member around two substantially coplanar, perpendicular axes through the center member, anda base portion, and opposing arms extending from the base portion, wherein each of the proximal end member and the distal end member are mounted to the center member at the arms of the base portion of the proximal end member and the distal end member, andround elements interposed between the center member and the arms at the mounting locations of the end members to the center member, the round elements being independent parts or integral to the center member or arms;a hollow elongated member having a first end, a second end, and a longitudinal axis, the first end of the elongated member mounted to the distal end member of the proximal universal joint;a distal universal joint including a proximal end member and a distal end member, the proximal end member of the distal universal joint mounted to the second end of the elongated member, the distal end member of the distal universal joint having a longitudinal axis and a first angular position, each of the proximal end member and the distal end member of the distal universal joint including a center member for pivoting of the proximal end member and the distal end member around two substantially coplanar, perpendicular axes through the center member, anda base portion, and opposing arms extending from the base portion, wherein each of the proximal end member and the distal end member are mounted to the center member at the arms of the base portion of the proximal end member and the distal end member, andround elements interposed between the center member and the arms at the mounting locations of the end members to the center member, the round elements being independent parts or integral to the center member or arms; anduniversal joint control cables engaging the round elements of the proximal universal joint and the distal universal joint for connecting the proximal universal joint and the distal universal joint such that pivoting motion of the proximal end member of the proximal universal joint relative to the longitudinal axis of the elongated member exerts force on cables to cause a corresponding pivoting motion of the distal end member of the distal universal joint, wherein at all relative positions of the proximal end member of the proximal universal joint and the distal end member of the distal universal joint the longitudinal axis of the proximal end member of the proximal universal joint and the longitudinal axis of the distal end member of the distal universal joint remain parallel, and the degree of rotation of the proximal end member of the proximal universal joint about the longitudinal axis of the proximal end member of the proximal universal joint from the first angular position of the proximal end member of the proximal universal joint is equal to the degree of rotation of the distal end member of the distal universal joint about the longitudinal axis of the distal end member of the distal universal joint from the first angular position of the distal end member of the distal universal joint. 18. The surgical tool of claim 17, wherein four universal joint control cables operatively connect the proximal and distal universal joints. 19. An articulation system for a surgical tool, comprising: a proximal universal joint including a proximal end member and a distal end member;a hollow elongated member having a first end, a second end, and a longitudinal axis, the first end of the elongated member first end being mounted to the distal end member of the proximal universal joint;a distal universal joint comprising a proximal end member and a distal end member, the proximal end member of the distal universal joint being mounted to the second end of the elongated member; anduniversal joint control cables operatively connecting the proximal and distal universal joints,wherein pivoting motion of the proximal end member of the proximal universal joint relative to the longitudinal axis of the elongated member exerts force on cables to cause a corresponding pivoting motion of the distal end member of the distal universal joint,wherein each end member of the proximal universal joint and the distal universal joint includes a base portion and opposing arms extending from the base portion, wherein each respective proximal end member and distal end member are mounted to a center member at the arms of the proximal end member and the distal end member, and wherein the center members permit pivoting of the proximal and distal end members around two substantially coplanar, perpendicular axes through the center member,wherein the proximal universal joint and the distal universal joint each include round elements interposed between the center member and the arms at the mounting locations of the end members to the center member, and which may be independent parts or integral to the center member or arms, and wherein the round elements are engaged by the universal joint control cables, andwherein each of the four universal joint control cables engages two round elements in each universal joint. 20. A surgical tool for use by an operator, comprising: a manipulator adapted to receive at least a portion of the operator's hand, the manipulator having a longitudinal axis and a first angular position, the manipulator comprising a first actuator including a first lever assembly having a longitudinal axis and adapted to be operable with the operator's thumb, and a second lever assembly having a longitudinal axis and adapted to be operable with a finger of the same hand of the operator as the thumb, anda second actuator including a third lever assembly having a longitudinal axis, and pivotally mounted to the second lever assembly, the second actuator mounted to the end of at least a part of the first actuator,a proximal universal joint having a first end and a second end, the first end of the proximal universal joint mounted to the manipulator, the proximal universal joint including a center block, the center block pivotable around two substantially coplanar, perpendicular axes,a proximal end member including a base portion and opposing arms extending from the base portion, the proximal end member mounted to the center block, anda distal end member including a base portion and opposing arms extending from the base portion, the distal end member mounted to the center block,a hollow elongated member having a first end, a second end, and a longitudinal axis, the first end of the elongated member mounted to the second end of the proximal universal joint;a distal universal joint having a first end and a second end, the first end of the distal universal joint mounted to the second end of the elongated member, the distal universal joint including a center block, the center block pivotable around two substantially coplanar, perpendicular axes,a proximal end member including a base portion and opposing arms extending from the base portion, the proximal end member mounted to the center block, anda distal end member including a base portion and opposing arms extending from the base portion, the distal end member mounted to the center block,an end effector mounted to the second end of the distal universal joint, the end effector having a longitudinal axis parallel to the longitudinal axis of the manipulator and a first angular position, the end effector comprising a base member, andtwo opposed digits, each digit including a proximal phalange having a first end and a second end, the first end of the proximal phalange pivotally mounted to the base member, and a distal phalange having a first end and a second free end, the first end of the distal phalange pivotally mounted to the second end of the proximal phalange; andfour control cables for controlling the end effector, two cables of the four cables controlling the proximal phalanxes and the other two cables of the four cables controlling the distal phalanges, wherein the base portions and center blocks of each of the proximal universal joint and the distal universal joint define openings for receiving the end effector control cables, wherein at all relative positions of the manipulator and the end effector, the longitudinal axis of the manipulator and the longitudinal axis of the end effector remain parallel, and the degree of rotation of the manipulator about the longitudinal axis of the manipulator from the first angular position of the manipulator is equal to the degree of rotation of the end effector about the longitudinal axis of the end effector from the first angular position of the end effector, and wherein the first actuator is operable to concurrently control the proximal phalanxes and the second actuator is operable to concurrently control the distal phalanxes such that actuating the first lever assembly causes the proximal phalanges to move relative to each other, advancing the first and second lever assemblies toward each other causes the proximal phalanges to move toward each other, and pivoting the longitudinal axis of the third lever assembly away from the longitudinal axis of the second lever assembly causes the distal phalanges to move toward each other.