Modern telecommunication allowing the transmission of digitalized voice and images through telephone lines has expanded to medicine. The Integrated Digital Network System (ISDN) can be used to transmit 128 kbit/sec (ISDN-2) to 2 Mbit/sec (ISDN-30). Together with smart compression techniques a teleconferencing system can be implemented to transmit images of an endoscopic operation. In this paper 2 such experiments are described. In the first experiment a laparoscopic cholecystectomy performed in the Netherlands is followed at the same time by surgeons in Hawaii through ISDN-2 lines. In the second experiment a laparoscopic hernia repair was followed in Orlando during a congress using ISDN-6 lines. The images sent over the ISDN-2 lines are rather blurry with rapid movement. The images over the ISDN-6 lines were more acceptable. Data compression and decompression results in a time delay of approximately 1 second, which seems not disturbing during the connection. The cost of communication is comparable to telephone communication, which makes this form of telecommunication feasible in surgical practice.