Surgeons using robotic systems at Mount Sinai Medical Center in New York have performed a lapa-roscopic gallbladder operation on a patient 4000 miles away in Strasbourg, France. Reporting in the Sept. 27 issue of Nature, the medical team, which also included researchers from Louis Pasteur University of Strasbourg and the University of California in Santa Barbara, cited the development of asynchronous transfer mode multiplexing for telecommunications as the enabling technology. The setup comprised two Zeus robotic systems from Computer Motion of Santa Barbara, one in New York and one in Strasbourg, linked by a 10-Mb/s dedicated fiber optic connection. The mean total delay time -- including round-trip packet transport and video coding and decoding -- was 155 ms. The procedure took 54 minutes, and the 68-year-old patient was discharged after 48 hours without complications.