DRAINING an infected abscess on Earth is a straightforward procedure. On a spaceship travelling to the moon or Mars, it could kill everyone on board.
Blood and bodily fluids cannot be contained in zero gravity, which means there is currently no way to perform surgery in space without contaminating the cabin. This makes an extended stay problematic, says James Antaki at Carnegie Mellon University in Pittsburgh, Pennsylvania.
"Based on statistical probability, there is a high likelihood of trauma or a medical emergency on a deep space mission," he says.
Antaki is part of a team of US researchers developing an astro-surgical tool that could help.
The Aqueous Immersion Surgical System, or AISS, is a transparent box that creates a watertight seal when it is placed over a wound and pumped full of sterile saline solution, says George Pantalos at the University of Louisville in Kentucky.
The saline solution is held under pressure inside the AISS to prevent blood from seeping out of the wound. Airtight holes allow surgeons to access the submerged wound using handheld and orthoscopic instruments.
By varying the pressure within the AISS, the device could also be used to siphon up and recycle blood.
"You won't have a blood bank in space, so if there is bleeding you want to save as much blood as you can," says James Burgess, also at Carnegie Mellon, who came up with the concept.
Researchers will put the system to the test aboard NASA's zero-gravity C-9 aircraft next week in the first of several experiments planned. They will perform surgery on an artificial coronary system filled with synthetic blood to test its ability to keep blood inside the body and out of the surgeon's field of view. Other experiments are likely to include a sub-orbital flight test, says Pantalos.
Tam?s Haidegger, a bioengineer at Budapest University of Technology and Economics in Hungary, says the AISS or a similar device will be an essential tool on future space flights to an asteroid, Mars or even aboard the International Space Station. ISS astronauts could soon be increasing their stay from six months to a year.
In the event of a medical emergency on board the space station, the only current option is to evacuate the astronaut back to Earth. This is not only dangerous for the patient but it is also extremely expensive, says Haidegger. Fortunately, however, no such emergency has yet occurred.
According to Haidegger, it will not always be necessary to have a doctor on board the spacecraft - a surgeon on Earth could assist with invasive surgical procedures via a teleoperated robot, making a hasty return to Earth unnecessary (Acta Astronautica, doi.org/jdx). The new device could play a part in such space surgery.
In the short term, Pantalos says the AISS may be useful in operating theatres back on Earth - for example, for brain and spine surgery, where bleeding presents serious complications.
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