A surgical hand instrument may be inserted through a trocar to facilitate laparoscopic surgery. An end effector, such as a clamp, a spreader or scissors, is actuated by moving a pair of handles between a spread configuration and a contracted configuration. The end effector may be articulated relative to an elongate hollow shaft extending through the trocar with a steering wheel positioned between the pair of handles and operably coupled to the end effector by left and right turn cables and a pair of meshed gear sections.