Laparoscopic surgery (surgery by minimal access, internal view by video camera and miniaturised instruments) is a new surgical technique, which offers major benefits for the patient. Video-imaging is intrinsic to the technique. Teaching and training are thus facilitated, as ' the student sees what the surgeon is seeing during the procedure'. The TESUS project is to federate European University Hospitals (Belgium, Germany, France, and Switzerland) in a network for on-line transmissions of surgical procedure imaging and counsel in day-to-day practice. European staff organized weekly transmission, for teaching purposes, of live surgical procedures will allow for an approach to standardization of practice across the continent. TESUS permitted the creation of an active network for surgical staff. Beyond the technical specification which was necessary to create the links, TESUS was a real challenge for the surgeons to call into question their practices. The TESUS network now attracts surgeons throughout Europe and all over the world. Surgical staff can suggest investments to their hospital management. Via the TESUS network system these investments can be economically assessed and for example, information can be gained on surgeon availability to resolve problems in delicate cases (expert or another surgeon on the network).