Minimally invasive surgery is going through a rapid phase of evolution and over a relatively short time we have witnessed progress from simple ablative procedures such as the division of adhesions and destruction of endometriosis to far more complex operations such as laparoscopic myomectomy, hysterectomy, and, perhaps the hardest of all, cul-de-sac dissection and resection of bowel involved in dense fibrotic endometriosis. Some of these newer procedures reach the very limits of technical virtuosity and are extremely time consuming and will need careful appraisal before their true place in clinical gynecology is established.