The ability to do laparoscopic suturing or stapling techniques effectively greatly adds to the level of comfort and performance of the endoscopic surgeon. Each of us is driven by the desire to do a given procedure at laparoscopy just as well as we could at laparotomy. If we cannot, we question whether or not it should be done endoscopically by us. By being able to perform the techniques just described, surgeons can deal effectively with many situations which might otherwise keep them from providing an endoscopic service to their patients. Finally, we must weigh carefully the pros and cons of placing any sutures at all in a given situation.