It’s 2025 and you’re serving as medical officer on a crew traveling on the first manned spaceflight to Mars. You’ve trained for this mission for years, and NASA’s doctors gave you a clean bill of health before you left on the 6-month trip to the Red Planet. You wake up on day 121 of the mission with a dull pain in your stomach that over several hours becomes sharper upon palpation in the right lower quadrant. You have no appetite and are feeling nauseated. You shrug it off as being the result of the freeze-dried chili you had for dinner the night before. But later in the day, you begin vomiting and are now running a fever of 101°F.
As you enter the medical lab, you desperately hope that it’s the chili and not something more serious. Unfortunately, blood work, urinalysis, and ultrasound results eventually point to only one diagnosis: acute appendicitis. Your appendix has to be removed immediately, but you’re about 40 million kilometers away from the nearest emergency room. Fortunately, NASA began considering this possibility many years earlier.
Flash back to the present, when tests are scheduled to begin in a few months on a fist-sized robotic surgeon. The robot, produced by Virtual Incision of Lincoln, NE, weighs 0.4 kg, has 2 arms fitted with tools that can grab, cut, cauterize, and suture tissue, and is equipped with a video camera. It is designed to enter the body through a small incision in the umbilicus into an insufflated abdominal cavity. Once inside, the robot can be remotely operated via a control station on Earth to perform various surgical procedures. The upcoming experiments, to be conducted in an airplane flying parabolic arcs, will attempt to determine whether the little robot can perform basic tests of agility, such as manipulating small objects like rubber bands, in zero-gravity conditions.
Traditional surgery in space would be a perilous exercise. Besides the difficulty of performing delicate procedures using multiple tools floating around in zero gravity, the possibility that bodily fluids could escape, float away, and contaminate equipment would be disastrous. The use of a small robot that could perform procedures in vivo would lessen these dangers. This robotic device is designed to enter the body all at once through a specialized port that would avoid loss of insufflation and reduce complexity. It would be programmed to facilitate multiple minimally invasive surgical procedures, including appendectomies, cholecystectomies, and the repair of gastric ulcer perforations and intra-abdominal bleeding due to trauma. Upon completion of the procedure, the robot can be removed easily, along with any retrieved specimens.
Currently, the device is designed to be controlled remotely by a surgeon on Earth, who would manipulate the robot inside a patient in low-Earth orbit, such as on the International Space Station. However, in the far reaches of interplanetary space, the time delay for the signals to reach your spacecraft would make this infeasible, and therefore crew members would need to be trained to operate the device.
Fortunately, one of your crewmates has completed multiple simulations using the robot back in Houston. She completes the appendectomy without complications. After waking up later that day, you’re groggy but extremely grateful that this little robotic surgeon is part of your crew.
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- Markvicka EJ, Frederick TP, Lackas KM, et al. Miniature in vivo surgical robot for space applications. NASA Human Research Program Investigators’ Workshop. 2014.http://www.hou.usra.edu/meetings/hrp2014/pdf/3231.pdf.
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