[New technologies in laparoscopic surgery].

The technology associated with endoscopic surgery continues to evolve as a result of industrial R & D and research within academic surgical departments with interest in surgical endoscopic and remote handling technology. Some of the developments in the last ten years are reviewed. The problem concerning health technology assessment (HTA) in relation to new devices/instrumentation and procedures is discussed. Randomised controlled clinical trials are unsuited for the initial HTA of technology-dependent interventions, and for this reason, an alternative system, controlled stepwise evaluation (CSE) is proposed.