Gynaecological operative laparoscopy has progressed significantly over the past two decades. The process of laparoscopic surgery should be based on an appropriate risk management system that allows for improved quality of care. Regarding women with severe endometriosis, specialist referral centres should be developed. Units performing laparoscopic surgery should adopt recommendations and guidelines from scientific bodies (RCOG, NICE, BSGE) and should benchmark their audited activity against the national standards. The main components for consideration when developing models of service in laparoscopic surgery include: gynaecology outpatients, pre-operative preparation, operative and post-operative. Laparoscopic training can be developed and augmented with the use of simulators or laparoscopic trainers. Laparoscopic surgery necessitates a team approach between surgical, nursing and technical support staff. Audit of length of stay, analgesia requirement, complication rate and re-admission rate help to redesign and configure the service.