Despite the well-known benefits of minimally invasive surgery (MIS) to the patients, this surgical technique implies some technical challenges for surgeons. These technical limitations are increased with the introduction of laparoendoscopic single-site (LESS) surgery. In order to overcome some of these technical difficulties, new handheld devices have been developed, providing improved functionalities along with precision-driven and articulating instrument tips. In this chapter, we will review the current status of handheld devices for laparoscopy and LESS surgery. Devices that provide additional and innovative functionalities in comparison with conventional surgical instruments will be considered. Results will be based on studies published in the scientific literature and our experience. These surgical devices will be organized into two main groups, mechanical devices and robotic-driven devices. In general, these instruments intend to simulate the dexterity of movements of a human wrist. Mechanical devices are cheaper and easier to develop, so most of the available handheld instruments fall into this category. The majority of the robotic-driven devices are needle holders with an articulating tip, controlled by an interface implemented on the instrument handle. In general, these handheld devices claim to offer an enhancement of dexterity, precision, and ergonomics.
Part of the book: New Horizons in Laparoscopic Surgery