Laparoscopic surgery is open surgery carried out through small incisions with enhanced magnification of the operative field. The advantages of a laparoscopic (or key hole) approach to the abdomen and pelvis have been well documented and include: a significant reduction in postoperative pain, length of stay, recovery time and adhesion formation. In children or adolescents this will result in a faster return to school and normal activities. Laparoscopic incisions are much smaller than a transverse incision and indeed a midline laparotomy. This reduction in wound visibility is especially important in children and adolescents who otherwise may be asked by contemporaries or a new partner about the reasons behind the scar. This will be especially distressing while coming to terms with the psychological impact of the diagnosis of an XY karyotype or an absent uterus.