We quantified and compared the advantages and disadvantages of disposable and reusable laparoscopic instruments in a prospective, randomised study of 158 cholecystectomies. The patients were randomly divided into two groups: 80 underwent surgery with reusable instruments, 78 with disposable instruments. The following parameters were recorded in both groups: duration of surgery, number of complications, technical problems during surgery, rate of conversion to open surgery, subjective postoperative pain, postoperative hospitalisation time, length of inability to work, and postoperative evaluation by the operating room personnel. No overall differences were found in subjective pain, postoperative complications, postoperative hospitalisation time, or time before returning to work. Surgery with disposable instruments was on the whole faster, with fewer conversions to open surgery, but this was statistically non-significant. Reusable instruments were associated with a statistically significant increase in the rate of intraoperative, instrument-related difficulties. In spite of longer operation times and higher personnel costs with reusable instruments, we found that cholecystectomy with reusable instruments costs an average of 1,015 DM less per procedure.