Surgery in the Next Space Missions

Abstract

In the coming years, missions to the Moon and Mars shall be the new goals of space flight. The complexity of these missions due to the great distance from Earth and the unforeseen obstacles to settle on another planet have given rise to great concerns for crew health and survival. The need for advanced crew autonomy and a different approach to surgical emergency require new protocols and devices to help future crew medical officers and other crew members in a task of unprecedented difficulty. Hence, the increasing variety of schedules, devices, and protocols being developed. A serious health problem, such as an emerging surgical disease or severe trauma, can jeopardize the mission and survival of the entire crew. Many other difficulties are present in deep-space missions or settlements on other planets, such as communication and supply, also medical, delays, and shortage, and the presence of radiation. Progress in advanced technologies as well as the evolution of robotic surgery and the use of artificial intelligence are other topics of this review. In this particular area of research, even if we are still very far from an “intelligent robot”, this evolution must be evaluated in the light of legislative and ethical considerations. This topic was presented at the annual meeting of the American College of Surgeons—Italy Chapter in 2021.

SY-MIS Project: Biomedical Design of Endo-Robotic and Laparoscopic Training System for Surgery on the Earth and Space

“…Starting with the requirements, the main medical considerations (Figure 11) that address our proposal lie in the fact that the body suffers morpho-physiological changes [36,37] caused by: "trauma" such as hemopneumothorax, airway obstruction, and bone fractures; also, by: "non-trauma" such as gallstone cholecystitis and urolithiasis. Those health conditions sometimes have to be treated using a surgical procedure, where, due to microgravity it is crucial to perform the best management procedures for bleeding control [38], for this reason, it is expected to be used for 2 types of surgeries in order to be the less invasive [39]: i) Natural Orifice Transluminal Endoscopic Surgery (NOTES), which is an operation that uses a computer system to help guide the surgical tools, which are passed through the mouth to access the mouth and throat; and ii) Single Port Surgery (SPS), which is an operation using one single entry point. Therefore, the SETY© Platform is able to be used for training future medical astronauts with endoscopic tools and robotic arms.…”