Technology and techniques for minimally invasive surgery continue to evolve as medical device manufacturers and clinicians alike look for ways to further minimize the invasiveness, pain, and scarring associated with surgery. At the same time, the economy and health care reform have created challenges for medical device manufacturers. In response to these challenges, mannufacturers competing in the MIS market are developing new products and marketing strategies designed to ease both the economic and environmental impact for providers.

Robotic-driven technology has begun to transform surgery, but not without leaving some surgeons unimpressed. Now Corindus is trying to bring robots to the cath lab -- and this time physicians love the technology because it provides an ergonomically better experience and both enhances the procedure and reduces health problems.

The skill sets of laparoscopy, endoscopy, robotics and even interventional cardiology are all converging to create least invasive surgeries that take laparoscopy as a point of departure but change how surgeons access the abdominal cavity. Start-ups are innovating to supply the new surgical instruments.