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Background: Performing laparoscopic procedures requires different skill sets and team dynamics compared with open procedures. We evaluated team composition and procedure time between these two surgical approaches using data collected from hospitals in the United State and Canada. Methods: A total of 1,260 general surgical cases were reviewed retrospectively, recording the number of operation personnel, procedure complexity, and the procedure time. Results: Laparoscopic procedures ( n = 930), on average, had a higher procedure difficulty coding which led to a longer procedure time and involved more people in the surgical team than open procedures ( n = 330). When we selected cases with matched procedure difficulty coding, laparoscopic procedures ( n = 450) still required longer procedure times and involved more operative personnel than open procedures ( n = 92). Discussion: Increased laparoscopic team size and procedure time must be influenced by factors other than case difficulty. The factors may derive from inherent complexity of the surgical setting and team dynamics unique to laparoscopic procedures. [ABSTRACT FROM AUTHOR]