Surgeons have always prided themselves on their self-reliance, individual achievements, and independence of thought and action. However, in some instances, the current evolution of surgery appears to be most affected by socioeconomic and political factors, as opposed to unique clinical accomplishments. To a certain extent the vast social transformation of American medicine now controls the fate of the individual practitioner to a greater degree than clinicians, as a collective force, are able to direct their own profession. Nowhere are these changing forces more evident than in the drive to foster the use of a laparoscopic approach to inguinal herniorrhaphy. Through public relations and massive advertising campaigns, corporate America is attempting to convince surgeons and the public of the necessity to perform hernia repairs via laparoscopy. This focus was especially apparent at the 1991 and 1992 Clinical Congresses of the American College of Surgeons. Twelve-foot-high video screens along with ample opportunities