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In recent years, the concept of minimally invasive surgery has become accepted by the surgical community, though there are limitations in locating small gastrointestinal tumors when laparoscopy is used alone. Meanwhile, endoscopy is an excellent tool for locating these small tumors, though one must take extreme care to avoid hollow viscus perforation. Combination of laparoscopy and gastroduodenoscopy has extensive application in the resection of gastrointestinal stromal tumors, sessile gastric polyps and early gastrointestinal carcinoma. During laparoscopic operation, the endoscopist can help to locate the tumor or polyp. Endoscopy can also help to determine whether or not the tumor or polyp has been resected completely. In performing traditional laparoscopic colectomy for left-sided colonic tumors, specimen retrieval necessitates a mini-incision which is often the cause of postoperative pain, wound infection, and other pain-related complications. The combination of laparoscopy with transanal endoscopic microsurgery is feasible for selected patients with left-sided colonic tumors, and complications related to mini-incision can be avoided completely. Combination of laparoscopy and gastrointestinal endoscopy also benefits patients with acute bowel obstruction prior surgical operation. With the help of perineum-bowel tube, sigmoidoscopic technique can relieve acute bowel obstruction, so that these patients may have chance for laparoscopic operation. In summary, this hybrid approach can not only decrease surgical incisions, but also avoid some of the surgical risks of emergent operations.