The first complete surgery performed by doctors on one continent controlling robotic instruments on another has gone off without a hitch. Surgeons in New York removed a 68-year-old woman¿s gall-bladder as she lay across the ocean in Strasbourg, France¿more than 7,000 kilometers away. Remotely-controlled robots had assisted in some trans-atlantic operations before now and doctors had consulted on procedures from a distance, but the time lag imposed by existing telecommunications technology was considered too great to make full telesurgery feasible over long ranges.

As will be described in an upcoming issue of Nature, surgeons from the European Institute of Telesurgery in Strasbourg working here in the U.S. manipulated the distant machine via a high-speed fiberoptic connection, observing its responses to their hand motions just 155 milliseconds later on a video screen. Practice operations on pigs had determined that any delay longer than 330 milliseconds would prove too risky. The operation took just under an hour, and surgeons in France stood ready to take over at the first sign of trouble. The patient went home two days later with no complications.

This kind of robot is best suited to perform minimally invasive procedures, in which a thin tube equipped with a camera and surgical instruments is inserted into a patient, giving surgeons increased control in addition to the ability to operate from afar. This success opens the door for skilled doctors to lay mechanical hands on patients in places that are hard to reach or lack personnel with the right expertise. But limitations remain; someone has to be able to set up the equipment, and the robot itself remains rather pricey.

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