Successful Surgery in Space #NASA #Space

Today more than ever, the prospect of not only traveling, but colonizing, another planet seems less like fantasy and more like reality.  While many of the barriers that still exist are technological or logistical, like how to fuel such a voyage or communicate back to Earth, perhaps the most important barrier is how to treat health conditions that are bound to arise in space, especially if they require operative interventions.  While there are multiple environmental hazards in space, perhaps the most apparent is the gravity, or rather lack-there-of.

 An Example: The effect produced by microgravity exemplifies the potential for a single (albeit significant) environmental change to cause major multi-systemic consequences on the human body. On Earth, gravity pulls fluids to the lower extremities. In space, absence of gravity causes fluids to redistribute evenly throughout the body. The heart receives an increased volume of fluid returning to it, and compensates by increasing stroke volume. In microgravity conditions, increases in stroke volume are usually accompanied by increases in heart rate to boost total cardiac output. Via the parasympathetic effect, this will actually cause a drop in heart rate, which can be problematic in such an environment.

 In situations of internal bleeding when simple tourniquets or other topical treatment are inappropriate, more drastic surgery may be necessary. Relative to Earth, surgery in space may carry greater risks. For example, the intestines are essentially free floating within the abdomen, tethered only to the posterior abdominal wall. Consequent to microgravity, bowel may therefore freely float out of an abdominal incision, creating a risk of contamination or damage. In cases of bleeding in space, blood does not collect or pool in the same way it des on Earth, but instead forms miniature droplets on surfaces.

 If these droplets are disrupted, blood may float off the surface, potentially creating a biohazard. As surgery is a fine-motor task, vestibular may make performing even simple surgical tasks incredibly difficult and time-consuming. Inclusion of a surgical robot may address onboard surgical needs. Surgical robots have become widely used in certain surgical subspecialties. They use arm-like actuators that actually have a greater range of motion and are not susceptible to fatigue compared to the human hand. Commonly they are situated a short distance from the patient, with the operating surgeon controlling it in real time using controllers. The distance between the surgeon and robot can potentially be expanded, and robotic surgery has been conducted underwater and even across the Atlantic Ocean. Though this would effectively permit a surgeon on Earth to perform surgery in space, as distance between the surgeon and robot increases, the time taken for radio signals to travel in between operator and robot also increase.

 For example, Mars is several million miles from earth. Radio signals can take more than 20 minutes to travel from Earth to Mars. Obviously, if a patient were critically ill or actively bleeding, this time delay creates a greater risk to the patient and could lead to catastrophic results. Due to this, it seems like a medically trained crew member is essential personnel with the current state of technology. However recently, fully autonomous robotic surgery in an animal was demonstrated for the first time. If this technology is developed into a feasible solution for human surgery, an autonomous surgical robot could address the issue of needing an onboard surgeon and also allow independence from Earth-based surgical solutions.