The inconvenience of laparoscopic operations lies mainly in the difficulties in mutual understanding between the surgeon and the camera assistant who maneuvers the laparoscope according to the surgeon's instructions. Another problem arises when the operation has to be performed for many hours. In this case, the camera image tends to become unsteady due to fatigue of the camera assistant. The self camera-control by the surgeon gives more stability of the laparoscopic image. A robotic camera assistant, directly under surgeon's control, can help the surgeon control the view better. This review is limited only in the robotic camera holder to replace the assistant camera holder in laparoscopy surgery.

Several types of the camera-holding robotic devices, such as the AESOP, EndoAssist, PMAT and PARAMIS were reviewed respectively.

Most of the camera-holding robotic devices have the advantages, such as elimination of the fatigue of the assistant who holds the camera, elimination of fine motor tremor and small inaccurate movements, delivery of a steady and tremor-free image, nondependency on camera operator, reduced cost of surgery and reduced number of highly skilled staff. Some of them have additional advantages and disadvantages depend on their uniqueness.

There is no fundamental difference between the operation performed with and without the devices, but the machines do contribute to certain aspects of the operations and may help to overcome some of the difficulties encountered in these complex laparoscopy procedures. Unavailability and variability in quality of human camera-holders should not be an obstacle to performing satisfactory laparoscopic surgery. Therefore, some form of standardization of assistance is required and laparoscope-holding systems are a first step in this direction.