Measurement of laparoscopic skills in microgravity anticipates the space surgeon.

BACKGROUND There clearly must be a surgical capability to support the exploration of the solar system by humans. We hypothesized that microgravity would impair surgical task performance and sought to measure degree and criticality of task erosion. METHODS Twenty subjects performed basic laparoscopic exercises (grasping, cutting, clipping, and suturing) in an inanimate trainer on the ground and during the microgravity phase of a parabolic flight. Skill assessment involved time, accuracy, and force transfer. RESULTS A decrease in the total number of on-target task completions was observed in microgravity compared with the ground performance for all tasks. The ratio between the total number of attempts and the number of completions was higher in microgravity. The amount of force introduced into the system was not significantly higher in microgravity. CONCLUSIONS We conclude that although tasks are performed with much greater deliberation and work in microgravity, there is no barrier to accurate and effective laparoscopic surgery.

[1]  Blake Hannaford,et al.  The BlueDRAGON - a system for measuring the kinematics and dynamics of minimally invasive surgical tools in-vivo , 2002, Proceedings 2002 IEEE International Conference on Robotics and Automation (Cat. No.02CH37292).

[2]  R. D. Billica,et al.  Endoscopic surgery in weightlessness , 2001, Surgical Endoscopy.

[3]  R. D. Billica,et al.  Laparoscopic surgery in weightlessness , 1996, Surgical Endoscopy.

[4]  M R Campbell,et al.  Surgical bleeding in microgravity. , 1993, Surgery, gynecology & obstetrics.

[5]  B. Hannaford,et al.  Skills evaluation in minimally invasive surgery using force/torque signatures , 2000, Surgical Endoscopy.

[6]  R M Satava.  Surgery in space. Phase I: Basic surgical principles in a simulated space environment. , 1988, Surgery.

[7]  B. Miles,et al.  Endoscopic surgery and telemedicine in microgravity: developing contingency procedures for exploratory class spaceflight. , 1999, Urology.

[8]  David R. Williams,et al.  The biomedical challenges of space flight. , 2003, Annual review of medicine.

[9]  Mark R Campbell,et al.  Performance of advanced trauma life support procedures in microgravity. , 2002, Aviation, space, and environmental medicine.

[10]  G. Fried,et al.  Development of a model for training and evaluation of laparoscopic skills. , 1998, American journal of surgery.

[11]  Arnauld Nicogossian.  Medicine and space exploration , 2003, The Lancet.

[12]  A. Derossis,et al.  Housestaff performance is improved by participation in a laparoscopic skills curriculum. , 2002, American journal of surgery.

[13]  Iaroshenko Gl,et al.  Peculiarities of surgical intervention under conditions of weightlessness , 1967 .

[14]  I. Howard,et al.  Accuracy of aimed arm movements in changed gravity. , 1992, Aviation, space, and environmental medicine.

[15]  G. Fried,et al.  Comparison of laparoscopic performance in vivo with performance measured in a laparoscopic simulator , 1999, Surgical Endoscopy.

[16]  B Fowler,et al.  Human sensorimotor coordination during spaceflight: an analysis of pointing and tracking responses during the "Neurolab" Space Shuttle mission. , 2001, Aviation, space, and environmental medicine.

[17]  J. Rosser,et al.  Skill acquisition and assessment for laparoscopic surgery. , 1997, Archives of surgery.

[18]  J. Rosser,et al.  Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. , 1998, Archives of surgery.

[19]  M R Campbell,et al.  Ultrasound-guided Percutaneous Aspiration of Fluid for Management of Peritonitis in Space , 2006 .