Introduction: Previous simulation and porcine experiments aboard the reduced gravity program
KC-135 turbojet have demonstrated that microgravity surgery is feasible. Ideally, surgical care in
spaceflight will incorporate recent advances in care while remaining easy enough for a crew medical
officer (CMO) lacking surgical proficiency or extensive surgical experience to perform. As a
minimally invasive surgical technique, hand-assisted laparoscopic surgery (HALS) benefits the patient
via smaller incisions, less pain, and faster recovery than traditional open surgery. HALS also
helps less experienced laparoscopic surgeons perform laparoscopic surgery.
Methods: An inexpensive inanimate surgical simulator was constructed to evaluate the usefulness
of HALS in microgravity. This simulator was utilized during brief periods of microgravity provided
by parabolic flight on the KC-135. The simulator was successfully used by both a physician-astronaut
and an experienced laparoscopic surgeon. Task completion included simulated surgery with
exploration of the intestines and ligation of the appendix.
Results: Simulated HALS was successfully performed in microgravity. HALS effectively contained
operative equipment and small amounts of introduced fluids within the simulated abdominal cavity.
Astronaut and surgeon experience suggest that HALS could facilitate minimally invasive surgery
(MIS) in microgravity.
Discussion: HALS holds promise as a surgical approach in microgravity, particularly as space
travel extends beyond low earth orbit. HALS provides the benefits of MIS, facilitates MIS surgery
by less surgically proficient or experienced CMOs, and contains equipment and fluid within the operative
field. Simulation provides an easy, cost-effective platform to evaluate medical technology for
space flight as well as a method to train CMOs on-orbit.
