Abstract
Complex minimally invasive procedures still pose challenges that limit their adoption because they require technical skills that are difficult to develop. One of the most important issues that needs to be addressed is the use of long and stiff instruments that are difficult to manipulate inside the abdomen and are ergonomically unfavorable. The leading solutions are large, console-based robotic systems, but they are too big and too expensive to be widely accepted and universally marketable. The effort to provide the missing link between robotics and laparoscopy have led to the introduction of handheld instrumentation that provides enables surgeons to directly handle the instruments without the mediation of a bulky platform and to move them mimicking the surgeons’ hand motion. The aim of this chapter is to offer an overview of the currently available hand-held electromechanically controlled articulating instruments and to highlight their advantages and drawbacks compared to conventional laparoscopic instrumentation.