An instrument for carrying out medical interventions, including a tubular shaft running lengthwise along a shaft longitudinal axis, an instrument head, wherein the instrument head is supported on the tubular shaft in such a way as to be pivotable about an instrument head pivot axis, and at least part of the instrument head is rotatable about an instrument head longitudinal axis, and a wheel gear arrangement for moving the instrument head, wherein at least part of the instrument head can be driven by the wheel gear arrangement for the rotation about the instrument head longitudinal axis, and wherein the instrument head can be driven by the wheel gear arrangement for the pivoting about the instrument head pivot axis.