Gursky’s images have always been created with large format view cameras, which he continues to use. He was however, a pioneer in the usage of digital manipulation - a technological advancement which allowed him to create images with unrealistic patterns, and viewpoints.
The most famous example of this is his photograph Rhine II which was taken on a 10x8 camera and digitally manipulated, removing extraneous power cables and telephone poles. Whats left is a photograph of a landscape turned abstract and surreal.
This image holds the record for most valuable photograph to this day.