Minimal-access surgery including laparoscopy has been widely integrated into the practice of both adult and pediatric surgery during the last 10 to 15 years. Although there is substantial institutional and individual variation in contemporary practice, many complex gastrointestinal operations and virtually all of the simpler intra-abdominal procedures have been performed successfully using laparoscopic techniques. Appendicitis in its several clinical forms is the most common childhood abdominal surgical problem, so it is no surprise that laparoscopic appendectomy has emerged as one approach in the care of both complex and simple appendicitis in pediatric patients. At present, data examining either administrative processes or clinical end points that directly reflect patient outcomes have failed to establish an evidence-based preference between laparoscopic and open appendectomy. In this issue of the ARCHIVES, the article by Lintula et al1 examines 1 important administrative aspect of this issue: relative costs.