Abstract
Endoscopic surgery is a rapidly defusing treatment approach subject to continual technological advance. It offers great potential for economic benefits as well as health gains, but as shown in the article in this issue by Kesteloot and Penninckx, the relative cost of open versus endoscopic surgery is a quite complex issue. The main factors influencing the costs and effectiveness of endoscopic surgery are reviewed and the need for more and better evaluation studies highlighted.

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