Health in space: surgery in the context of manned space exploration
Epublication WebSurg.com, Sep 2014;14(09). URL: http://websurg.com/doi/lt03enrunge001
The European Space Agency (ESA) foresees the exploration of the solar system, which implies as a long-term objective the prospect of Mars’s exploration by human beings. Ensuring the crew’s well-being and operational performance will not only depend on the ability to prevent health issues, but also to make a fast and accurate diagnosis and therefore to quickly provide reliable and adequate treatment. Building the required knowledge and understanding the aspects specifically related to crewed exploration will be performed on a long timescale. It is therefore of high interest to also develop short-term and medium-term technologies, especially by resorting to the use of analog environments such as the Concordia station to validate these technological concepts for future space activities. While the ESA has carried out several activities in the field of prevention and countermeasures, monitoring, and diagnosis, only a very limited number of projects have been dealing with treatment techniques. Consequently, the ESA recently decided to explore this rather untapped field and has started working on assisted surgery as a potential treatment possibility for future space exploration missions. During a manned Lunar or Martian mission, emergency surgical care for life-threatening pathologies (e.g. major trauma) may have to be carried out inside the spacecraft or habitat since an evacuation to a specialized surgical facility may not be immediately possible. The crew would therefore need some support, in order 1) to overcome the lack of surgical expertise and sufficiently skilled staff on the site where the patient is located (e.g. spacecraft, geographically isolated place), 2) to overcome the lack of training (no daily practice) and preserve medical skills (including surgical procedures) of the crew’s medical officer, if any. The presentation given in November 2013 at the 3rd RAMSES symposium aims at providing a first overview about surgery-related activities at the European Space Agency, including achievements and future perspectives.