Surgery in space

[SpinDrift]

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I recently listened to a podcast about space travel to Mars and beyond which sparked my curiosity into just how surgery in space might be performed. I researched a little bit and didn't really find too much about the subject other than it would probably be a horrible experience for not only the patient but the surgeon as well. But with long distance space exploration at our doorstep I feel like this might be a good subject to educate myself with. Anybody have any insights they want to offer or forums to point me towards? NASA has a 4th year med student rotation that looked promising and I know NASA has some sort of surgical training for doctors but other than aerospace residencies what else is there?

 

[IlDestriero]

There has been some research on anesthesia in a zeroG environment.

 

[deleted87051]

I don’t believe most NASA Flight Surgeons are actually surgeons. Don’t know how much if any surgical training they actually get.


Then there was this guy.....

Leonid Rogozov - Wikipedia

en.m.wikipedia.org

 

[SpinDrift]

I don’t believe most NASA Flight Surgeons are actually surgeons. Don’t know how much if any surgical training they actually get.


Then there was this guy.....

Leonid Rogozov - Wikipedia

en.m.wikipedia.org

That guy is a certifiable bamf. From what I've read there are some surgeons at NASA that do get training for space surgery. They utilize the pools to simulate zero G but that was about as much detail as the read went but most docs are the aerospace type. Really this is just a segue way for me to get into orbit, that or join space force.

 

[SpinDrift]

There has been some research on anesthesia in a zeroG environment.

Yeah there is definitely a lot more literature on anesthesia than surgery. I suppose its far easier to explore anesthesia in space rather than surgery. Makes me wonder how this surgical niche will move forward.

 

[bornhuman]

Would like to read more about this topic. If any references/studies available, kindly send link.

MD class of 81'
GS

There has been some research on anesthesia in a zeroG environment.

 

[clinicallabguy]

Scrub tech opens the basic tray:

**All of the instruments float away***

 

[deleted1001426]

Yeah there is definitely a lot more literature on anesthesia than surgery. I suppose its far easier to explore anesthesia in space rather than surgery. Makes me wonder how this surgical niche will move forward.

My guess is a lot of poor monkeys will be losing their organs on the iss for the sake of scientific advancement in the near future

 

[Sephirakra]

My guess is a lot of poor monkeys will be losing their organs on the iss for the sake of scientific advancement in the near future

All historical evidence points to a different animal...

 

[kraskadva]

Scrub tech opens the basic tray:

**All of the instruments float away***

That's an easy fix ... magnets.
But what do you do about the blood? Open abdominal surgeries, never mind vascular anything, whould be *A**MESS*

 

[dpmd]

That's an easy fix ... magnets.
But what do you do about the blood? Open abdominal surgeries, never mind vascular anything, whould be *A**MESS*

Then there is all the issue with exposure that we use gravity for at present. I figure they can work out some sort of vent hood to collect all the liquid droplets but when you can go head up or head down to move the bowel out of your damn way now you will need an extra few retractors. I can't begin to figure out what laparoscopy would look like. Does insufflation actually give room to work or do the bowels float within the co2 up to the limits of the mesentery?

 

[kraskadva]

Then there is all the issue with exposure that we use gravity for at present. I figure they can work out some sort of vent hood to collect all the liquid droplets but when you can go head up or head down to move the bowel out of your damn way now you will need an extra few retractors. I can't begin to figure out what laparoscopy would look like. Does insufflation actually give room to work or do the bowels float within the co2 up to the limits of the mesentery?

Ugh, yeah, they probably would float around. There was something in the news recently about astronouts getting JV clots that had everybody super worried because apparently even the venous blood backflows due to lack of gravity.
Surgery in space wil probably have to wait for artificial gravity because by the time you get another instrument/ retractor/ hood/ etc in to fix all the issues,t here won't be room for the surgeon to stand at the table.

 

[SpinDrift]

I think you're right but will artificial gravity be here by the time we start venturing to Mars? It would be pretty cool to help pioneer surgery in space......probably has a pretty steep learning curve unfortunately.

 

[LoGo]

There’s a pretty good textbook on space medicine if you’re interested (Fundamentals of Space Medicine, Clément).

Most space medicine will not be physically done by a doctor - meaning, the MD (Flight Surgeon) will be on Earth and telemedicine technology will be used to discern diagnostic information and provide intervention. Surgery mid space flight is realistically not going to happen for many, many years, so just as we do now on airplanes, surgery will wait until landing somewhere where there will then be gravity, sterile capability etc.

If we ignore sterility, the typical lack of a surgeon on board, and the chaos that would be emergency surgery mid-space flight, potentially laparoscopic procedures would allow for some degree of blood containment. For open and realistically laparoscopic as well you’d need to simulate gravity somehow. Maybe doing surgery in a centrifuge but then of course you’d need (1) a giant centrifuge, (2) some way to “activate” or provide propulsion to the centrifuge and (3) some way to address the reaction torque produced by the centrifuge on the rest of the space craft.

 

[SpinDrift]

I'm working on a podcast right now called "The Space Surgeon" I've lined up a few people in the field to interview but I'm definitely open for suggestions. I plan on launching it in late July 2020. If you know anyone or have any ideas please send them my way. The ultimate goal is to interview Jonny Kim! If you don't know who that is do yourself a favor and look him up.

 

[BobbyKoch]

I'm working on a podcast right now called "The Space Surgeon" I've lined up a few people in the field to interview but I'm definitely open for suggestions. I plan on launching it in late July 2020. If you know anyone or have any ideas please send them my way. The ultimate goal is to interview Jonny Kim! If you don't know who that is do yourself a favor and look him up.

Kevin Fong might make a good guest. Good luck with your project!

 

[SpinDrift]

Kevin Fong might make a good guest. Good luck with your project!

Thank you for the recommend, I'll look more into Kevin Fong. He seems like a pretty interesting guy!

 

[BobbyKoch]

Extreme medicine is a great book and 13 minutes to the moon—fantastic pod!

 

[spacegun]

Claude Piantadosi is a pulmonary and critical care physician at Duke. He wrote the book Mankind Beyond Earth: The History, Science, and Future of Human Space Exploration.

Amazon product ASIN 0231162421

 

[SpinDrift]

Claude Piantadosi is a pulmonary and critical care physician at Duke. He wrote the book Mankind Beyond Earth: The History, Science, and Future of Human Space Exploration.

Amazon product ASIN 0231162421

I'll definitely check this out and send him an email. I'm interviewing Dr. Mark Campbell and Dr. George Pantalos for upcoming episodes, both are pioneers in space surgery! Very exciting stuff