[Code name: "Lindbergh operation"].

"The madman forces doors, the wise follow " Persian proverb In 1927, Charles Lindbergh flew non-stop across the Atlantic for the first time in history, aboard the " Spirit of St. Louis ". This pioneering feat took place from Paris to New York. It was in the same spirit of innovation and daring that the IRCAD/EITS (Institut de Recherche contre les Cancers de l'Appareil Digestif/European Institute of TeleSurgery) team realized the first transatlantic surgical procedure between New York and Strasbourg, appropriately dubbed the Lindbergh operation. Since 1993, the experts at IRCAD/EITS had been preparing for the impossible. The notion of long-distance surgery took shape within the EUREKA Master (minimal access surgery by telecommunication and robotics) project. It was felt that enhancing the quality, reliability and safety of the data transmission by digitizing and robotizing the surgical act could eliminate all space and time constraints. Robotization of the surgical act was first developed with the support of the Karlsruhe Research Center. This led to an effective, yet heavy, non-ergonomic system that was not suited for introduction in the operating room. Wiser for the experience, the IRCAD/EITS team geared itself towards partnership with an industrial company. This involved working with ZEUS TM , a robot comprised of three arms. Two arms manipulate the instruments in response to the movement of the surgeon's hands. The third arm manipulates the voice-controlled endoscope. A console enables the surgeon to handle the joysticks that command the two instruments held by the robotic arms. Each articulated arm has a double security system. Signals are checked more than a thousand times per second. Manual information originating from the surgeon is analyzed by the master-slave interface and rendered safe. Demultiplication also enables the tele-effector to carry out extremely precise movements. After two years of experimental work, a laparoscopic robotic cholecystectomy was performed on a patient in September 1999. Subsequently, a prospective evaluation was conducted on 25 patients. This proved the feasibility, reproducibility and safety of the technique as well as its acceptability by the medical and paramedical teams (1). Further, computer-assisted surgery allowed some distancing between the surgeon and patient as the command console was connected to the operating table by a cable system a few meters in length. The team was only one step from the realization of a complete surgical procedure over a long distance. Data from the literature and reports by surgeons of the US army …