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Survey of mission hospitals in North and Northeast India revealed that even the hospitals that had donated laparoscopic surgical equipment were unable to offer laparoscopic surgeries because of the high cost of the disposables involved. Although there are several studies comparing the disposable versus re-usable instruments (especially the ports) especially with respect to the costs, there is hardly any study looking at the re-use of disposable instruments. Although many might not admit it officially, it is a common practice in India to re-use disposable instruments. We present our findings with re-use of disposable laparoscopic items at the various mission and rural hospitals where our team has operated, and other issues related to laparoscopic surgeries in rural hospitals.