A positioning system is provided for use in remotely-controlled surgical procedures. Also provided are methods of manufacture and use of such a positioning system. The positioning system may hold an instrument, and may provide multiple degrees of freedom of movement to the instrument. The positioning system may be coupled to a control unit, such that manipulation of the control unit results in movement of the positioning mechanism, thereby eliminating the need to manually hold and position the instrument. According to some aspects, the positioning system may be hydraulically actuated.
