Multimedia tools are effective for the acquisition of cognitive skills in colorectal surgery and are well accepted as an educational resource.

Dear Sir, We read with interest the article by Stechman et al.[1] regarding the current application of diagnostic laparoscopy in suspected appendicitis and laparoscopic appendicectomy (LA) in the United Kingdom.We were surprised by their findings, that only 68% of respondents used diagnostic laparoscopy and of those, 69% only used it selectively in female patients of reproductive age as there is well documented advantages of laparoscopy such as improved diagnostic ability [2], reduction of negative appendicectomy rate [3], smaller incisions, lower rate of wound sepsis [3], less pain and quicker patient return to normal activity [3]. Furthermore, this finding was thought to be an overestimate of the current use of laparoscopy as 2007 UK data from Hospital Episodes Statistics data showed only 22.5% of appendicectomies were performed laparoscopically in the UK.We reviewed our local data at Christchurch Hospital, New Zealand by reviewing hospital discharge coding data and found 74% (110 ⁄ 461) of all coded appendicectomies were performed laparoscopically in 2007 and 78% were performed laparoscopically in the five years period from 2003-2008. Over 95% of LA were performed by registrars at our institution.The authors discuss the costs of LA as being a potential drawback to the procedure with reference to a recent American paper [4]. We perform LA without the routine use of disposable equipment such as staplers, catch bags and disposable ports to minimise the costs of the procedure.At our institution diagnostic laparoscopy and LA is the procedure of choice for suspected appendicitis and this is supported by the findings of a systematic review of the current clinical evidence [3].

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