NASA NEEMO Topside Report — Mission Days 7 & 8 – April 9 and 10, 2006

We had some amazing accomplishments on Sunday while (hopefully) most of you were enjoying your weekends. We started a new Center for Minimal Access Surgery (CMAS) experiment to evaluate telerobotic technologies in extreme and lunar environments. The robot in question is an experimental new two-armed robot which is much more compact and portable than previous systems. It has “stereo” cameras, which allows the remote surgeon to see in three dimensions, rather than the standard two-dimensional image on a flat screen. It gets digitally linked to the robotic arms aboard Aquarius via a combination of land-based and wireless telecommunications networks. The task was to perform vascular suturing (stitching up a vein) on a medical model aboard Aquarius, with one of the aquanauts assisting the surgeon by changing instruments on the robotic arms and passing sutures.

This marks the first time in human history an entire robotic surgical platform was transported to an extreme environment (in this case Aquarius) and was manipulated successfully from afar. From the control console at CMAS in Hamilton, Ontario, Dr. Mehran Anvari was able to perform a complex surgical task (vascular suturing, or stitching up a vein). Imagine turning your crowded bedroom into an operating room, assembling and hanging an incredibly sophisticated robot between two bunks, and enabling a surgeon thousands of kilometers away to perform a surgical procedure with it! That’s what occurred onboard Aquarius Sunday. But there’s more: previous research has shown that surgeons can adapt to latencies of 200 to 500 milliseconds, but “common knowledge” said that time delays greater than 500 milliseconds, or half a second, would make such a task impossible. On Sunday it was done successfully even with a 2-second time delay — equivalent to the time it would take for the signal to travel to the moon! This truly was a noteworthy scientific achievement.

Image above: NEEMO-9 astronaut/aquanaut Ron Garan works with a Center for Minimal Access Surgery experiment in the Aquarius Underwater Laboratory. Credit: NASA

The other major new CMAS experiment that was performed was a validation of digital radiology. One of the possible medical emergencies that might arise in an extreme environment, such as a space exploration mission, is an orthopedic injury. A bone fracture would require diagnosis and medical treatment as soon as possible.

Since x-rays are very important tools in both diagnosing orthopedic injuries and in determining appropriate treatment, we wish to demonstrate that digital x-ray images can be transmitted from an extreme environment over a telecommunications network for evaluation by an expert radiologist. Transmission of medical images such as x-rays over a telecommunications network results in both a time delay (latency) and in some loss of image quality.

The ability to transmit digital x-ray images from an extreme environment requires the compression of the x-ray data to enable fast delivery of the images. However, higher compression rates cause image degradation which could hinder the ability to make a clinical diagnosis. Our goal is to send a series of compressed x-ray images to evaluate which compression algorithms provide both the image quality to make a clinical diagnosis and a timely data transfer. Once the images are uploaded, a physicist and a radiologist will evaluate each image without knowing whether it was sent from Aquarius over the simulated lunar network or an uncompressed x-ray image sent from within the hospital.

Thanks for staying with us!

– NEEMO 9 Topside Team