A magnetic anchoring and guidance system uses instruments that can be inserted through a laparoscopic port site into the abdomen and then controlled through coupling with an externally held magnet. Use of these tools can improve the ergonomics of laparoscopic surgery, allowing positioning of intra-abdominal instruments that do not require a separate transabdominal trocar. Further developments of this technology have occurred in multiple surgical fields, broadening their utility and improving the instrumentation.