An insert 30 comprises a rod 32 having a proximal end 34 and a distal end 36. The insert 30 also comprises a tool 38 which is demountably coupled to the distal end 36. Proximal end 34 is formed with a ball 40 which is configured to seat and engage in a socket of a handle 12 of a laparoscopic instrument 10. The rod 32 fits within a sheath 14 of the laparoscopic instrument 10. The distal end 36 of the rod 32 is provided with an attachment head 42 to facilitate the attachment of the tool 38. A linkage mechanism 44 in the attachment head 42 converts the linear motion of the insert 30 (and in particular rod 32) relative to the outer sheath 14 to a pivotal motion.
