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Surgery In Space: I Foresee Problems

Mon, 07/14/2014 - 10:27am
Skeptical Scalpel

The astronauts are halfway to Mars when suddenly one of them develops abdominal pain and requires surgery. What will they do? 

According to NASA, a miniature robot capable of assisting in surgery has been developed, tested in pigs and is soon to be trialed in a weightless environment. The robot, which weighs less than 1 pound, can be inserted into the abdomen via the umbilicus and controlled remotely. 

The press release from NASA said types of operations that the robot would be capable of performing were "emergency appendectomies, emergency cholecystectomies, emergency perforation of gastric ulcers [sic], and intra-abdominal bleeding due to trauma." NASA meant to say "repair of perforated gastric ulcers." Not surprisingly, many science reporters for media outlets, for example, SFGate and WiredUK, did not notice the error. New Scientist also missed it, but at least published a later correction. 

However, even the famous da Vinci robot is incapable of performing surgery on its own. 

The original idea was that a surgeon on the ground would direct the robot's movements, but that will not be possible for two reasons. In deep space, the time lag between the earthbound surgeon's actions and the robot's response would be too long, and a recent article about remote-controlled drone crashes highlighted the problems that can occur when links are lost or computers malfunction. 

The plan is to train the astronauts to perform minimally invasive robotic surgery on each other. What could go wrong? 

A lot.

If they are only going to train on simulators and then have to do real surgery in space, they will be completely lost, robot or not. I know of no simulator that can re-create the degree of inflammation accompanying some cases of acute appendicitis or cholecystitis. My experience in performing and supervising thousands of these procedures is that at times, these organs are so adherent to the omentum and other structures that dissection is very difficult. 

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