1. Rigid endoscopes provide excellent optics and are durable, but are not as versatile as flexible scopes. Flexible endoscopes provide accessibility to otherwise inaccessible areas, but have poorer optics. 2. There are several issues to consider when making the decision to use disposable or reusable items. This decision must be made jointly by the OR manager and the surgeon. The most important issue is patient outcome. 3. It is certain that the trend towards noninvasive procedures will continue as surgeons from additional surgical specialties adopt endoscopic techniques. The perioperative nurse must be ready to expand practice to facilitate the growing technology of endoscopic procedures.