Background <p>A hallmark of Japanese hand surgery is that hand surgeons have played a leading role in both clinical practice and basic research, developing innovative surgical procedures and medical devices based on the findings of scientific discoveries. The most notable of the many achievements of Japanese hand surgeons are advances in flexor tendon repair, reconstruction of congenital hand anomalies, replantation and tissue transfer using microsurgical techniques, nerve repair and transfer, reconstruction for brachial plexus injuries, various surgical procedures for Kienböck’s disease, and arthroscopic and endoscopic surgery for wrist disorders and carpal tunnel syndrome. These innovations have contributed substantially to developments in hand surgery globally through peer-reviewed publications and international conferences.</p> Purpose <p>and conclusions.</p> <p>Close collaboration between hand surgeons, basic researchers, engineers, and industry partners has resulted in development of practical technologies that address previously unmet clinical needs in hand surgery, with these developments being based on numerous research findings. Following successful clinical trials, several of these innovations have achieved regulatory approval in Japan. Recent representative examples include a computer simulation-based surgical planning system for osteotomy, a peripheral nerve conduit for nerve regeneration, and a total wrist arthroplasty implant. This review provides an overview of these devices, highlighting the process for their development and clinical applications.</p>