This paper discusses the use of the Long Elements Method – LEM in soft tissue modeling and surgery simulation. The LEM is a new method for real time, physically based, dynamic simulation of deformable objects, based on a new meshing strategy, using long elements. The method uses a combination of static (state-less) and dynamic approaches to simulate deformations and dynamics, obtaining a higher degree of compliance per time step. Global deformations that conserve volume and are convincingly compliant are obtained. Models are defined using bulk material properties. Elastic and plastic deformations can be simulated. The real time performance of the method and its intrinsic properties of volume conservation, modeling based in material properties and simpler meshing make it particularly attractive for soft tissue modeling and surgery simulation.