Key Takeaways

Robotic assistants are revolutionizing remote surgery in space.
SpaceMIRA utilizes high-definition cameras.
Remote surgery is necessary with the rise of space tourism.

Two hundred and twenty miles above Earth, the surgeons were cutting. Through layers of tightly stretched rubber bands mimicking human tissue, their sharpened shears sliced. Meanwhile, tiny grabbers mounted on the arm of their robotic assistant held the bands in place.

What made this precision surgery more challenging and exciting than the usual practice procedure is that the doctors weren't in the house. This remote operation was performed in a box the size of a microwave mounted to a wall in the International Space Station (ISS). The team of six surgeons operating spaceMIRA — a miniaturized in-vivo robotic assistant — were visible only through a screen.

Making the Cut: The Future of Surgical Operations

NASA has been looking into how to perform robotic surgery in space for a long time. The first remote-guided operation event finally took place in orbit on Feb 10, 2024, a few weeks after spaceMIRA arrived at the ISS onboard a Northrop Grumman cargo ship. Like virtual precision procedures on Earth, the challenges and benefits of practicing medicine via a robotic assistant were immediately apparent.

On the upside, the images hovering before MIRA's remote operators stationed in Lincoln, Nebraska, and Houston, Texas, were huge. SpaceMIRA's high-definition cameras made the gator clips and rubber bands wielded by the robotic assistant appear orders of magnitude larger than life.

Less ideal was the time lag. When surgeons on Earth use precision surgery devices, like the DaVinci, the robotic digits move nearly as quickly as their own. By contrast, because of the time it takes for spaceMIRA to receive its directives from Earth, MIRA moves an average of 0.85 seconds after the surgeons on Earth.

Against the Odds

In the case of a medical emergency, a slightly slower surgery is strongly preferable to no surgery at all. Though there's yet to be a medical emergency on the ISS requiring surgery, it's not a matter of if such an emergency will take place but when.

According to the University of California San Francisco, in terms of events per person per year, the risks of a surgical emergency happening in microgravity may be higher than they are on Earth. As of today, less than 600 people have ever been to the altitude of the ISS. Yet, there have been two suspected cases of appendicitis, according to the British Journal of Surgery. One of these cases, a cosmonaut, was returned to Earth for treatment in 1982 — the only option unless a surgeon is onboard with all the tools and time they need to conduct an operation.

More than 40 years later, the risk of loss of crew life due to acute appendicitis or cholecystitis — an infection of the gallbladder — raises enough concern that conversations about removing these organs before spaceflight are ongoing, as noted by npj Microgravity. After all, on a trip to Mars, there's no fast way home. Even the moon might be too far to evacuate a space explorer with a kidney stone they can't pass on their own.

With the rapid rise of space tourism, more humans with more medical conditions than ever before will be pushing further into the cosmos. Even if there were a doctor onboard, given the mass and volume limitations during space missions, would they have the necessary tools on hand to make the tiniest cut possible before the blood started to float away from the wound? If the mission had a robotic surgical suite packed away in the corner, the onboard doctor could deploy it as needed to maximize precision and vision in the cramped confines of the ship.

In the absence of a crew doctor, a device like spaceMIRA might stand in for the ship's surgeon, extending the reach of the nearest medical provider to the moon, Mars and beyond.

Almost Within Reach: Virtual Precision Procedures

Precision surgery via robotic assistant systems was invented to help medical practitioners make the smallest and best cuts possible in the least amount of time. Teleoperation devices, like spaceMIRA, have been doing just that on Earth whether or not the surgeon was in the room: Years before its debut in microgravity, MIRA was used to remove part of a patient's large intestine remotely. Students at the University of Nebraska are training on it now.

Mastering surgery in space would not only vastly increase a space mission's medical capability — how well a medical need within the mission matches the resources available — but also solve a critical and ongoing problem faced by the people of Earth every day: The countries with the fastest-growing populations have less than 1 surgeon per 100,000 people, as reported in The Lancet Global Health. Virtual precision procedures conducted via robotic assistant are the future of surgical operations wherever the need for surgeons is unmet. A teleoperation device like MIRA delivered to developing countries, remote regions and low-resource healthcare facilities would effectively bring world-class surgeons into the room without the aid of transportation of any kind.

With spaceMIRA, the ultimate robotic assistant and teleoperation device, the doctor doesn't need to be in the house to perform precision surgery in space — or anywhere.

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