Dr. Volkmar Falk performs robotic surgery on a patient from controls in the next room at the Herzzentrum Heart Center in Leipzig, Germany. (Visiting doctors watch surgeon Volkmar Falk perform a coronary artery bypass graft on a patient lying in the adjoining room, using a tele-manipulated surgical system (called a robotic system by some) designed by Intuitive Surgical Corporation of Mountainview, California, at the Herzzentrum, Leipzig, Germany. The assistant surgeon has incised small holes into the patient's chest wall through which the instruments-attached to sterile plastic covered manipulating arms-will pass and be telemanipulated by the surgeon in the next room. The room in which the surgeon is working is a less sterile work environment than that of the operating room where the patient lies. It is much like an office; phones are ringing, there is heavy foot traffic and personal conversation-at times at crescendo level.