Floating Guts, 'Sticky' Blood: Challenges of Surgery in Space

On a Mars mission with seven astronauts, emergency surgeries are likely every 2.4 years.
Brad Bergan
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In early 2020, an astronaut in space developed a possibly life-threatening blood clot in the neck. While they were successfully treated with medication by Earth-bound doctors, it raised the question of how space agencies and private spaceflight companies planning to land humans on Mars might perform serious medical treatment beyond Earth's atmosphere, according to a think-piece from The Conversation.


Surgeries, medicine in space

Surgical emergencies are one of the most challenging issues of space travel. But in the last several years, researchers of space medicine have developed ideas that might help — including 3D printers and surgical robots.

Mars is roughly 54.6 million kilometers (33.9 million miles) away. Comparatively, the International Space Station (ISS) orbits only 400 kilometers (248.5 miles) above our heads.

When a surgical emergency strikes on the ISS, the procedure involves stabilizing the patient, and then transporting them back to Earth as fast as possible — while taking heed of telecommunicated medical advice in real-time.

Of course, this wouldn't work on Mars, since evacuation would take months or even years — far too late to reverse a medical emergency on Earth. Even if the problem is minor, communications with Earth are delayed for more than 20 minutes — which might leave a patient astronaut helpless in critical condition for too long.

Not to mention the extreme environment one faces during transit to and on Mars -- where astronauts face high radiation levels, microgravity, and an enclosed and pressurized cabin or suit. These conditions are taxing for astronauts' bodies, and often take time to acclimate.

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We know that space travel manipulates human cells, heart performance, and blood pressure regulation. However, it also affects the fluid distribution of bodies and weakens bones and muscles.

In a crew of just seven people during a mission to Mars, researchers estimated an average of one surgical emergency every 2.4 years. Primary causes are expected to be cancer, appendicitis, gallbladder inflammation, or simple injury.

This is part of why astronauts are thoroughly screened, but surgical emergencies also happen in healthy subjects — and are likely exacerbated in extreme environments like space.

Inventing surgeries for space travel

This has led researchers to push forward innovation and improve surgical methods like magnetizing surgical tools so they stick to surfaces in zero-g.

However, during open surgery, the intestines would float around the site of operation, obscuring the crucial view of the surgical fields. To circumvent this problem, space travelers will likely opt for minimally-invasive surgical techniques like keyhole surgery — ideally within patients' internal cavities via minute incisions with a camera and instruments.


NASA Chris Hadfield Cardio Lab ISS
Astronaut Chris Hadfield works out in his cardio lab. Source: Life Sciences Data Archive / NASA

Bodily fluids, blood in space, on Mars

Bodily fluids, too, behave in different ways on Mars, and in space. Blood in our veins could stick to instruments because of surface tension. Additionally, droplets of body fluids could form streams — restricting surgeons' view.

Moreover, circulating air in the enclosed cabin or habitat could put astronauts at risk of infection. Blood-repelling surgical tools and surgical bubbles might solve this problem.

As of writing, researchers have already created and tested numerous surgical enclosures in microgravity environments. NASA, for example, analyzed a closed system consisting of a surgical clear plastic overhead canopy with integrated arm ports — to eschew the risk of contamination.

The list of new inventions, unique approaches, and technological advances that could capably transform how surgery is done on Mars and in space is practically endless. Suffice to say the medical field has no shortage of room for forward-thinking scientists and astronauts of tomorrow.

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