Topic: The advent of gynecological endoscopic surgery at a tertiary care hospital in Sikkim, a remote north- eastern state of India. Gynecological surgeries are being increasingly performed worldwide and have gained popularity because of shorter duration of surgery, decreased blood loss and faster recovery after surgery which decreases the cost of hospitalization. This has generated a keen interest in a large number of gynecologists who are getting trained in laparoscopic procedures and in turn are facilitating the establishment and smooth running of laparoscopy units in their own working area. The laparoscopic unit in our hospital was also started with the idea of imparting quality health care to the patients. The difficulties encountered in setting up the unit, monetary issues , training of surgeons and then counselling the patients about the advantages of undergoing laparoscopic surgery and their dilemma in accepting laparoscopic surgery in place of open surgeries are will be discussed