The tremendous increase in medical knowledge over the last decades and technical progress in medicine have caused further professional specialization. Numerous medical fields have evolved through the process of separation from the parent specialization and the traditional distinction between surgical and medical disciplines has been blurred. As a result of this development organ-specific interdisciplinary units have been formed and new partners have united, such as surgeons and gastroenterologists in the field of interventional endoscopy. The fading boundaries brought with them resistance and even resentment and called for a mutual regulation by the professional associations which took place 10 years ago. Nowadays, surgeons and gastroenterologists in Germany are trained in interventional endoscopy and are the foundation of endoscopic interdisciplinary teamwork in emergency care, diagnostics, therapy, complication management and palliative treatment. Technical innovations striving for a minimization of operative trauma like NOTES depend on the cooperation of both fields of expertise. The driving force behind these efforts should be the shared interest in further improvement of patient care at the highest level of individual expertise, patient-oriented process optimization and adequate use of resources.