Laparoscopic or 'minimally invasive' surgery has become the gold standard procedure in cholecystectomy, fundoplication and adrenelectomy and has major advantages in appendicectomy and for diagnosis of pain/mass of unknown origin in the abdomen. However, because of its mass acceptance by patients and surgeons, there are some ethical issues which need to be addressed. 'When an innovative treatment is introduced into clinical practice, rigorous testing is mandatory for the protection of individual patients and the just use of limited resources. This holds true with greater force in the light of evidence that many innovations show no advantage over existing treatments when they are subjected to properly controlled study'.