Laparoscopic imaging has remained relatively unchanged since the introduction of the rod-lens system. The intent here is to improve imaging by designing and building sensors and effectors placed directly into the body and controlled remotely. An 11-mm monoscopic insertable pan/tilt endoscopic imaging device with an integrated light source was studied. In vivo testing included simulated appendectomy, nephrectomy, suturing, and running the bowel in a porcine model (n = 6). Subjective impression and time for each procedure were compared using each imaging modality. The insertable imaging device seemed easier and more intuitive to use than a standard laparoscope. Time to perform procedures was better than or equivalent to a standard laparoscope. The insertable camera was subjectively preferred, and times for completion of complex tasks were shorter using the insertable camera. The insertable imaging device has the potential to be an integral part of surgical system platforms.