Minimal access surgery is the most important revolution in surgical technique since the early 1900s. Its development was facilitated by the introduction of miniaturised instruments and advanced optics with good image reproduction. Laparoscopic cholecystectomy was the first procedure to be widely accepted all over World, and several others are now well established. Other laparoscopic procedures are being validated, but further use of the technique may partly depend on the development of new enabling technologies. For example, a virtual reality laparoscopic simulator was recently used to assess the value of a three dimensional laparoscopic optics system. In this presentation we present an overview of advances in minimal access surgery, concentrating on procedures that have most recently become established in everyday surgical practice.