Minimally invasive surgery is instrumental in the diagnosis of cancer, cancer staging, and the removal and repair of disease states with small incisions and decreased psychological trauma. The ability to perform conventional operations through small (keyhole) incisions is desirable to many patients so that they undergo surgery earlier in the course of their disease when an operation is potentially easier and more effective. The list of minimally invasive surgical procedures is increasing on a daily basis. Some of the more common procedures include cholecystectomy (gallbladder removal), appendectomies, anti-reflux procedures, hernia repairs, splenectomies, adrenalectomies, colon and small bowel resections, staging and diagnosis of cancers, and treatment for ulcer disease. Topics addressed in this issue include endoscopic submucosal dissection, endoscopic suturing, endoscopic transluminal surgery, and endosurgical instrumentation.