FROM THE 16TH SLS ANNUAL MEETING AND ENDO EXPO 2007, SAN FRANCISCO, CALIFORNIA, SEPTEMBER 5–8, 2007
SURGERY IN SPACE: NEEMO MISSION
PRESENTED BY TIMOTHY BRODERICK, MD
Astronaut-physicians are being trained for space travel by performing surgery in extreme environments. The more extreme environment increases the risk and severity of injury. Small animal surgeries are already being performed during space flight to validate whether surgery is possible in flight. Computer-based surgical simulation is being used also in micro-gravity surgery, which actually improves visualization, and robotic surgery in micro-gravity can be more stable than robotic surgery in earth’s gravity.
The Aquarius, the only underwater sea lab in the world, was developed to simulate the environment on the moon so that NASA extreme environment mission operations (NEEMO) could be undertaken. On one NEEMO mission, a physician in Canadian, directed surgery being performed on the underwater Aquarius.
NEEMO 7 tested how by using telehealth, a nonsurgeon or nonphysician can do surgery with a telementor far away. A laparoscopic cholecystectomy was performed as well as if a physician had done it; however, vascular surgery was not. Telementoring facilitates expert care at distances. A problem is secondary latency, which can be overcome via technique and technology. NEEMO 7 demonstrated that surgeons perform surgery better than nonsurgeons do, and therefore, surgeons should be taken on missions into space.
NEEMO 9 looked at telemedicine and telesurgery. Simulated knee ultrasound and arthroscopy were successfully performed despite the lunar latency. Telementor, telementee, and communication protocols can overcome latency. Another NEEMO finding is that in vivo robots could improve care in extreme environments. Robotic telesurgery was demonstrated in the Aquarius with a physician in Canadian operating the robot underwater.
NEEMO XII used 2 robots to perform telesurgical ultrasound under the guidance of a Veress needle with the physician in Tennessee.