The transmission of medical image information by electronic means (in the beginning not necessarily in a digital format) is about 40 years old.3 However, digital data formats are a prerequisite for image communication meeting medical quality requirements. As of today, most preoperative information about a given pathology is primarily digital (magnetic resonance imaging, computed tomographic scans, and sonographic imaging). To print this information onto plastic films constitutes a reduction of the informational content and availability. Only standards,4 time, and financial resources are necessary to use this information in its original format. It is then obvious that we need to develop tools of enhanced data viewing, ie, 3-dimensional reconstruction,5,6 volume rendering,7,8 virtual endoluminal views,9,10 and image fusion,11,12 to enable the best possible preoperative assessment of the available information. An improvement of surgical planning is evident, even if patient benefit can not be proven by proper clinical trial techniques. More difficulties may arise if the surgeon, during an operative procedure, wants to review the data or even wishes to superimpose digital information on his or her conventional view of the surgical site. The first problem may be solved by the development of surgery-adapted interfaces based on voice or motion control. The second would involve the construction of a virtual reality environment fusing real-time optical stereoscopic images with stored 3-dimensional data. For open-access general surgery, a multitude of problems arise from such a scenario, some of them purely technical, some of them rather human. Technologically, the first major difficulty arises from the structural and positional mobility of the involved soft tissues, which prevents a precise fusion of preoperative with intraoperative information. The immediate problem, however, lies in the quality of our eyes, their dynamic range, their high-resolution, large weighted field, and spatial optical data acquisition that is so far not equaled by any technical solution. However, the obvious benefits of minimal access surgery, at least for a limited number of diseases, have made surgeons all over the world accept a clearly inferior video image of their work field, even loss of the third dimension, when technological solutions for 3-dimensional viewing were available. Thus, if the benefit from virtual reality surgery is large enough, there is no fundamental obstacle to it. A good example for such benefit comes from cardiac surgery, where considerable progress has been made toward a virtual heart arrest that may enable the surgeon to work on a motionless image of the heart13 while the motion of the beating heart is removed electronically from the video image. Far more difficult, of course, is the then necessary addition of the cyclic spatial reconfiguration of the beating heart to a robotic interface between the surgeon working on the motionless image on the screen and the real moving surgical site.