Could Medical Surgery Be Performed in Space?

JAKARTA - Space missions require lengthy planning. In fact, it is said more in-depth preparations may be needed on missions to Mars, compared to the International Space Station (ISS) and the Moon.

What if there is an accident or something on the way to outer space that must be carried out by a medical operation? Could it be done?

Reported by Universe Today, on a space mission that was carried out at ISS, it was reported that an astronaut had experienced a blood clotting condition. This was discovered as part of a study assessing the effects of microgravity on the jugular vein.

Astronauts can conduct an ultrasound with the help of a specialist doctor and are instructed to take injections of drugs that are already available at ISS.

Over time, blood clots were reported to shrink and when astronauts returned to Earth, the condition disappeared in just 24 hours.

In other cases, a Russian cosmonaut must return to Earth immediately when it appears they are suffering from appendicitis. Although surgery is a relatively common action on Earth, this is not the case in space.

A study that was released in 2018 examined several problems surrounding operations in space. The research title is ' Surgery in Space ' written by Sandip Panesar from Stanford University and K. Ashkan, professor of Neurosurgery at King's College Hospital, published in the British Journal of Surgery. Even though the paper is two years old, it is still considered relevant.

It's very difficult to operate in zero gravity

Some time ago, Nina Louise Purvis also wrote about the problem of space operations in The Conversation . Purvis holds a master's degree in Astrophysics, as well as a PhD in Medical Physics and is currently conducting research in Space Physiology at King's College.

This operation or space surgery appears in response to a renewed interest in space exploration. The first thing to consider is distance.

A medical emergency at ISS means stabilizing the patient with real-time assistance from specialists in the field, so that the patient can return to Earth. On the Moon, if there is a kind of residence module, patients can be stabilized, with real-time assistance from specialists on Earth. Returning to Earth will be more complicated, but there will be contingency plans.

Then on Mars, the minimum distance between this Red Planet and Earth is about 54.6 million km (31 million miles) away. The maximum distance is about 401 million km (249 million miles).

Meanwhile, the average distance is around 225 million km (140 million miles). When a spaceship is launched, it takes about six months to travel between Mars and Earth. In the event of a medical emergency, assistance from specialists on Earth can experience communication latency of up to 20 minutes.

Apart from distance problems, constant radiation exposure is also dangerous. Another problem may lie in the microgravity.

The human body responds to micro gravity by redistributing blood. Blood is concentrated in the head, and other body parts must compensate.

Plans for medical emergencies in outer space must take into account the possibility of severe injuries that require surgery. Research shows that seven crew members will have an emergency that requires operations every 2.4 years during the Mars mission.

Researchers have also found the most likely scenarios: appendicitis, injury, inflammation of the gallbladder, and cancer. Even with intense health screening carried out by astronaut candidates, this problem can arise.

Astronauts have performed several operations on ISS in mice. It was an important experiment that produced some fundamental improvements. But, imagine opening a human body in zero gravity.

"One problem is that, during open surgery, the intestine will float, covering the view of the surgical field. A possible solution for that is keyhole surgery, where only small incisions are made. Small instruments and cameras will be deployed. But the blood still wants to float, and needs to be addressed, "explained Pervis.

Robot help

Robotic surgery is a potential partial solution for space surgery. Robot surgeons are used in several heart, thoracic, gastrointestinal, and other operations.

But this system is not an artificial intelligence surgeon. They are controlled remotely by a surgeon, which is impossible when it takes 20 minutes for a signal to get to Mars.

Another problem with operations and medical care in space is supply. Space is always limited to spacecraft and decisions must be made carefully. Like how much medical equipment can you carry?

ISS has a pharmacy on board, and contains things like blood thinners, and syringes. But that cannot bring everything to all possibilities.

Maybe everything does not need to be carried, if a 3D printer can help bridge the gap between what is needed and what is at hand. 3D printers may be used to produce at least some types of medical supplies.

Several studies have seen that, including one carried out during a 4-month Earth-analog simulation of a Mars mission. In that scenario, the crew-members who have no surgical experience succeeded in completing 16 sets of timed preparation, draping, incision, and stitching tasks to evaluate the relative speed using four thermoplastic instruments printed on Earth compared to conventional instruments.

While the findings were limited, they at least showed some potential for 3D printing of surgical equipment on demand. In fact, maybe some equipment can be printed 3D with in-situ resources on Mars, even though it's still far away.

"There is a lot of research and preparation for possible surgical emergencies during the Mars mission. However, not a few are unknown, especially when it comes to diagnosis and anesthesia."

While waiting for a better solution to this problem, Purvis points to prevention as the main tool. He said in the end, prevention was better than surgery.