Advances in minimally invasive surgery (MIS) have dramatically changed the approach to many gynecologic diseases. Three MIS innovations that have recently been introduced or reintroduced are robotic surgery, natural orifice transluminal surgery (NOTES), and single-incision laparoscopic surgery (SILS). All three offer both advantages and disadvantages, compared to traditional laparoscopy. Of these three developing technologies, robotic surgery is likely to have the largest impact on clinical care. Despite a long history of MIS in gynecology, technologic advances are finding more clinical applications in the fields of general surgery and urology. Gynecologists should continue to be engaged in the development and application of advances in MIS. (J GYNECOL SURG 25:67). © 2009, Mary Ann Liebert, Inc. All rights reserved.