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Review Article

우주에서의 외과수술

Surgery in Space

이용웅

항공우주의료원 항공우주의학과

Yongwoong Lee

Department of Aerospace Medicine, Aerospace Medical Center, Cheongju, Korea

Correspondence to:
Yongwoong Lee
Department of Aerospace Medicine, 80 Hyochonsongam 1-gil, Namil-myeon, Sangdang-gu, Cheongju 28187, Korea
Tel: +82-43-290-6881
Fax: +82-43-294-8951
E-mail: saint2leeyw@hanmail.net

This article was announced at 2022 Aerospace Medical Association of Korea Spring Conference.
Received: July 1, 2022; Accepted: July 11, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Korean J Aerosp Environ Med 2022; 32(2): 39-43

Published August 31, 2022 https://doi.org/10.46246/KJAsEM.220010

Copyright © Aerospace Medical Association of Korea.

Abstract

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For Mars exploration, spaceflight is advancing with the goal of sending manned spacecraft to Mars. Mars is 54.6 million kilometers away when it is closest to Earth. If a surgical emergency occurs during Mars exploration, it could take months or years to transport patients. Research estimates that an average of one surgical emergency will occur every 2.4 years during the Mars expedition for a crew of seven. Considering the astronomical cost of space travel and astronaut training, surgical treatment needs to be considered. There are various problems in performing surgery in space, but typically, physiological changes in the body due to microgravity, difficulty in performing surgery due to an unfamiliar environment, and difficulty in maintaining sterility can be considered. Also, since an experienced surgeon cannot ride on all spaceships, tele-surgery is required. As an alternative to overcome these problems, robot assisted minimal invasive surgery has been proposed. However, it is necessary to solve the signal delay caused by the longer distance. Other alternatives, such as the development of Robot technology, rapid transport due to trauma pod, and performing surgery while notifying the crew medical officer, have been suggested.

Keywords

Surgery in space, Robotic surgery in space, Telerobotic surgical system, Signal latency, Microgravity effects

References

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  1. Blue RS, Bridge LM, Chough NG, Cushman J, Khpal M, Watkins S. Identification of medical training methods for exploration missions. Washington, D.C.: NASA; 2014. pp. 1-19.
  2. Purvis N. From floating guts to ‘sticky’ blood - here’s how to do surgery in space [Internet]. Carlton: The Conversation; 2020 [cited 2022 May 24]. Available from: https://theconversation.com/from-floating-guts-to-sticky-bloodheres-how-to-do-surgery-in-space-141837.
  3. Demontis GC, Germani MM, Caiani EG, Barravecchia I, Passino C, Angeloni D. Human pathophysiological adaptations to the space environment. Front Physiol 2017;8:547. https://doi.org/10.3389/fphys.2017.00547
    Pubmed PMC CrossRef
  4. Martin A, Sullivan P, Beaudry C, Kuyumjian R, Comtois JM. Space medicine innovation and telehealth concept implementation for medical care during explorationclass missions. Acta Astronaut 2012;81:30-33. https://doi.org/10.1016/j.actaastro.2012.06.021
    CrossRef
  5. Campbell MR, Billica RD. Surgical capabilities. In: Barratt M, Baker E, Pool S, editors. Principles of clinical medicine for space flight. New York (NY): Springer; 2019. p. 233-252.
    CrossRef
  6. Convertino VA, Doerr DF, Ludwig DA, Vernikos J. Effect of simulated microgravity on cardiopulmonary baroreflex control of forearm vascular resistance. Am J Physiol 1994;266(6 Pt 2):R1962-R1969. https://doi.org/10.1152/ajpregu.1994.266.6.R1962
    Pubmed CrossRef
  7. Guell A. Lower body negative pressure (LBNP) as a countermeasure for long term spaceflight. Acta Astronaut 1995;35:271-280. https://doi.org/10.1016/0094-5765(95)98732-o
    CrossRef
  8. Keyak JH, Koyama AK, LeBlanc A, Lu Y, Lang TF. Reduction in proximal femoral strength due to long-duration spaceflight. Bone 2009;44:449-453. https://doi.org/10.1016/j.bone.2008.11.014
    Pubmed CrossRef
  9. Cialdai F, Colciago A, Pantalone D, Rizzo AM, Zava S, Morbidelli L, et al. Effect of unloading condition on the healing process and effectiveness of platelet rich plasma as a countermeasure: study on in vivo and in vitro wound healing models. Int J Mol Sci 2020;21:407. https://doi.org/10.3390/ijms21020407
    Pubmed PMC CrossRef
  10. Riwaldt S, Monici M, Graver Petersen A, Birk Jensen U, Evert K, Pantalone D, et al. Preparation of a spaceflight: apoptosis search in sutured wound healing models. Int J Mol Sci 2017;18:2604. https://doi.org/10.3390/ijms18122604
    Pubmed PMC CrossRef
  11. Baker ES, Barratt MR, Sams CF, Wear ML. Human response to space flight. In: Barratt M, Baker E, Pool S, editors. Principles of clinical medicine for space flight. New York (NY): Springer; 2019. p. 367-411.
    Pubmed CrossRef
  12. Campbell MR. A review of surgical care in space. J Am Coll Surg 2002;194:802-812. https://doi.org/10.1016/s1072-7515(02)01145-6
    CrossRef
  13. Kimura Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, et al. TG13 current terminology, etiology, and epidemiology of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013;20:8-23. https://doi.org/10.1007/s00534-012-0564-0
    Pubmed CrossRef
  14. Buckius MT, McGrath B, Monk J, Grim R, Bell T, Ahuja V. Changing epidemiology of acute appendicitis in the United States: study period 1993-2008. J Surg Res 2012;175:185-190. https://doi.org/10.1016/j.jss.2011.07.017
    Pubmed CrossRef
  15. Campbell MR, Johnston SL 3rd, Marshburn T, Kane J, Lugg D. Nonoperative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. J Am Coll Surg 2004;198:822-830. https://doi.org/10.1016/j.jamcollsurg.2004.01.009
    Pubmed CrossRef
  16. Cucinotta FA, Schimmerling W, Wilson JW, Peterson LE, Badhwar GD, Saganti PB, et al. Space radiation cancer risks and uncertainties for Mars missions. Radiat Res 2001;156(5 Pt 2):682-688. https://doi.org/10.1667/0033-7587(2001)156[0682:srcrau]2.0.co;2
    CrossRef
  17. Sargsyan AE, Hamilton DR, Jones JA, Melton S, Whitson PA, Kirkpatrick AW, et al. FAST at MACH 20: clinical ultrasound aboard the International Space Station. J Trauma 2005;58:35-39. https://doi.org/10.1097/01.ta.0000145083.47032.78
    Pubmed CrossRef
  18. Leach N. 3D printing in space. Archit Des 2014;84:108-113. https://doi.org/10.1002/ad.1840
    CrossRef
  19. Takács Á, Jordán S, Nagy DÁ, Tar JK, Rudas IJ, Haidegger T. Surgical robotics — born in space. Paper presented at: 2015 IEEE 10th Jubilee International Symposium on Applied Computational Intelligence and Informatics; 2015 May 21-23; Timisoara, Romania. Piscataway (NJ): IEEE, 2015. p. 547-551.
    CrossRef
  20. Takács Á, Rudas IJ, Haidegger T. The other end of human-robot interaction: models for safe and efficient tool-tissue interactions. In: Barattini P, Federico V, Virk GS, Haidegger T, editors. Human-robot interaction: safety, standardization, and benchmarking. Boca Raton (FL): Chapman and Hall/CRC; 2019. p. 137-170.
    CrossRef
  21. Haidegger T, Sándor J, Benyó Z. Surgery in space: the future of robotic telesurgery. Surg Endosc 2011;25:681-690. https://doi.org/10.1007/s00464-010-1243-3
    Pubmed CrossRef
  22. Garner R. Goddard Space Flight Center [Internet]. Washington, D.C.: NASA; 2021 [updated 2022 Jul 13; cited 2021 Aug 23]. Available from: https://www.nasa.gov/goddard.
  23. Doarn CR, Anvari M, Low T, Broderick TJ. Evaluation of teleoperated surgical robots in an enclosed undersea environment. Telemed J E Health 2009;15:325-335. https://doi.org/10.1089/tmj.2008.0123
    Pubmed CrossRef
  24. Loff S. About NEEMO (NASA extreme environment mission operations) [Internet]. Washington, D.C.: NASA; 2017 [cited 2022 May 24]. Available from: https://www.nasa.gov/mission_pages/NEEMO/about_neemo.html.
  25. Thirsk R, Williams D, Anvari M. NEEMO 7 undersea mission. Acta Astronaut 2007;60:512-517. https://doi.org/10.1016/j.actaastro.2006.09.015
    CrossRef
  26. Hoeckelmann M, Rudas IJ, Fiorini P, Kirchner F, Haidegger T. Current capabilities and development potential in surgical robotics. Int J Adv Robot Syst 2015;12. https://doi.org/10.5772/60133
    CrossRef
  27. Hannaford B, Friedman D, King H, Lum M, Rosen J, Sankaranarayanan G. Evaluation of RAVEN surgical telerobot during the NASA extreme environment mission operations (NEEMO) 12 mission. Seattle (WA): University of Washington; 2009 Feb. Report No.: UWEETR-2009-0002.
  28. European Space Agency. Augmented reality promises astronauts instant medical knowhow [Internet]. Paris: European Space Agency; 2012 [cited 2022 May 24]. Available from: http://www.esa.int/Enabling_Support/Space_Engineering_Technology/Augmented_reality_promises_astronauts_instant_medical_knowhow.

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