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Endoscopic surgery in weightlessness: the investigation of basic principles for surgery in space.

BACKGROUND: Performing a surgical procedure in weightlessness, also called 0-gravity (0-g), has been shown to be no more difficult than in a 1-g environment if the requirements for the restraint of the patient, operator, surgical hardware, are observed. The performance of laparoscopic and thorascopic procedures in weightlessness, if feasible, would offer several advantages over the performance of an open operation. Concerns about the feasibility of performing minimally invasive procedures in weightlessness have included impaired visualization from the absence of gravitational retraction of the bowel (laparoscopy) or thoracic organs (thoracoscopy) as well as obstruction and interference from floating debris such as blood, pus, and irrigation fluid. The purpose of this study was to determine the feasibility of performing laparoscopic and thorascopic procedures and the degree of impaired surgical endoscopic visualization in weightlessness. METHODS: From 1993 to 2000, laparoscopic and thorascopic procedures were performed on 10 anesthetized adult pigs weighing approximately 50 kg in the National Aeronautics and Space Administration (NASA) Microgravity Program using a modified KC-135 airplane. The parabolic simulation system for advanced life support was used in this project, and 20 to 40 parabolas were used for laparoscopic or thorascopic investigation, each containing approximately 30 s of 0-g alternating with 2-g pullouts. The animal model was restrained in the supine position on a floor-level Crew Medical Restraint System, and the abdominal cavity was insufflated with carbon dioxide. The intraabdominal and intrathoracic anatomy was visualized in the 1-g, 0-g, and 2-g periods of parabolic flight. Bleeding was created in the animals, and the behavior of the blood in the abdominal and thoracic cavities was observed. In the thoracic cavity, gas insufflation and mechanical retraction was used at times unilaterally to decrease pulmonary ventilation enough to increase the thoracic domain. RESULTS: Visualization was improved in laparoscopy, from tethering of the bowel by the elastic mesentery, and from the strong tendency for debris and blood to adhere to the abdominal wall because of surface tension forces. The lack of adequate thoracic domain made thorascopy more difficult. Fluid in the thoracic cavity did not impair visualization because the fluid at 0-g does not loculate posteriorly, but disperses along the thoracic wall and mediastinal reflections. CONCLUSIONS: Performing minimally invasive procedures instead of open surgical procedures in a weightless environment has theoretical advantages, especially in the ability to prevent cabin atmosphere contamination from surgical fluids (blood, pus, irrigation). Visualization will become more important and practical as the endoscopic hardware is miniaturized from its current form, as endoscopic technology becomes more advanced, and as more surgically capable medical crew officers are present in future long-duration space exploration missions.

Animals↗

Recent advances in technologies required for a "Salad Machine".

Future long duration, manned space flight missions will require life support systems that minimize resupply requirements and ultimately approach self-sufficiency in space. Bioregenerative life support systems are a promising approach, but they are far from mature. Early in the development of the NASA Controlled Ecological Life Support System Program, the idea of onboard cultivation of salad-type vegetables for crew consumption was proposed as a first step away from the total reliance on resupply for food in space. Since that time, significant advances in space-based plant growth hardware have occurred, and considerable flight experience has been gained. This paper revisits the "Salad Machine" concept and describes recent developments in subsystem technologies for both plant root and shoot environments that are directly relevant to the development of such a facility.

Air Conditioning↗

The NASA OCEAN project--an ocean-space analog

An advanced life support system (ALS) with bioregenerative components may one day be required for long-term, deep space exploration, in extended missions to Mars or in establishing long-term bases on the moon. Intensive research programs on such ALS systems have been ongoing throughout the National Aeronautics and Space Administration (NASA) since 1988. Notably, projects have been initiated at the John F. Kennedy Space Center (KSC), Ames Research Center (ARC), and the Lyndon B. Johnson Space Center (JSC). The KSC ALS work has been named the "Breadboard Project" because of its approach developing the components and combining them into a breadboard to understanding the bioregenerative ALS picture [also called a Controlled Ecological Life Support System (CELSS)] in smaller pieces, similar to an electronic "breadboard." The Breadboard Project has been involved for 7 years in the study of higher crops grown in a 113 m3 chamber--the longest operating and largest such closed, controlled growth chamber in the world. This chamber has proven itself to be very successful in growing a wide variety of crops from seedlings to harvest and in helping researchers understand the complex biological cycle of such edible plants in closed, environmentally controlled environments. Because the system's ultimate use will be a more challenging environment, moving a specially designed piece of the system into extreme conditions was an important test. Engineers at KSC developed a compact, portable, functional plant module for testing in the world's only fixed seafloor laboratory at Key Largo, FL. The laboratory, called MarineLab, is operated out of the facilities of the Marine Resources Development Foundation in a lagoon of some 10 m depth. The project was called the OCEAN project (Ocean CELSS Experimental Analog NASA).

Ecological Systems, Closed↗

Life sciences issues affecting space exploration.

The U.S. space program is undertaking a serious examination of new initiatives in human space exploration involving permanent colonies on the Moon and an outpost on Mars. Life scientists have major responsibilities to the crew, to assure their health, productivity, and safety throughout the mission and the postflight rehabilitation period; to the mission, to provide a productive working environment; and to the scientific community, to advance knowledge and understanding of human adaptation to the space environment. Critical areas essential to the support of human exploration include protection from the radiation hazards of the space environment, reduced gravity countermeasures, artificial gravity, medical care, life support systems, and behavior, performance, and human factors in an extraterrestrial environment. Developing solutions to these concerns is at the heart of the NASA Life Sciences ground-based and flight research programs. Facilities analogous to planetary outposts are being considered in Antarctica and other remote settings. Closed ecological life support systems will be tested on Earth and Space Station. For short-duration simulations and tests, the Space Shuttle and Spacelab will be used. Space Station Freedom will provide the essential scientific and technological research in areas that require long exposures to reduced gravity conditions. In preparation for Mars missions, research on the Moon will be vital. As the challenges of sustaining humans on space are resolved, advances in fundamental science, medicine and technology will follow.

Adaptation, Physiological↗

[Effects of noise generated by life support systems on the human hearing function].

The review is devoted to the effects on the human hearing function of noise generated by the life support systems (LSS). Based on the analysis of literature on testing the experimental and operational LSS of the Russian and NASA space vehicles and stations the authors conclude that the negative effects of LSS generated noise have been kept in the focal point of the medical community of the International Space Station program consolidating efforts of IPs toward the development of advanced methods of protection and control of the crewmembers' acoustic organs.

Ecological Systems, Closed↗

Analysis and modeling of information flow and distributed expertise in space-related operations.

Evolving space operations requirements and mission planning for long-duration expeditions require detailed examinations and evaluations of information flow dynamics, knowledge-sharing processes, and information technology use in distributed expert networks. This paper describes the work conducted with flight controllers in the Mission Control Center (MCC) of NASA's Johnson Space Center. This MCC work describes the behavior of experts in a distributed supervisory coordination framework, which extends supervisory control/command and control models of human task performance. Findings from this work are helping to develop analysis techniques, information architectures, and system simulation capabilities for knowledge sharing in an expert community. These findings are being applied to improve knowledge-sharing processes applied to a research program in advanced life support for long-duration space flight. Additional simulation work is being developed to create interoperating modules of information flow and novice/expert behavior patterns.

Communication↗

Future opportunities for life science programs in space.

Most space-related life science programs are expensive and time-consuming, requiring international cooperation and resources with trans-disciplinary expertise. A comprehensive future program in "life sciences in space" needs, therefore, well-defined research goals and strategies as well as a sound ground-based program. The first half of this review will describe four key aspects such as the environment in space, previous accomplishments in space (primarily focusing on amphibian embryogenesis), available resources, and recent advances in bioinformatics and biotechnology, whose clear understanding is imperative for defining future directions. The second half of this review will focus on a broad range of interdisciplinary research opportunities currently supported by the National Aeronautics and Space Administration (NASA), National Institute of Health (NIH), and National Science Foundation (NSF). By listing numerous research topics such as alterations in a diffusion-limited metabolic process, bone loss and skeletal muscle weakness of astronauts, behavioral and cognitive ability in space, life in extreme environment, etc., we will attempt to suggest future opportunities.

Animals↗

The Chameleon Suit--a liberated future for space explorers.

Mankind's spacefaring future demands the ability to work freely and frequently in space. Traditional spacesuit systems burden both the spacefarer and the mission, limiting the extent to which this is possible. The spacefarer is burdened by a pressure suit designed for isolation from the environment and a life support system designed to replace everything our environment normally provides. The space mission is burdened by this equipment and the expendable materials to operate and maintain it. We aren't free to work in space as frequently, as long, or in all of the locations envisioned. The NASA Institute for Advanced Concepts (NIAC) has sponsored research on an alternative concept, the "Chameleon Suit", that seeks to liberate future explorers and missions from these limitations. The Chameleon Suit system works with the environment in an adaptive fashion to minimize hardware and expendable materials. To achieve this, functions of the life support system are integrated with the pressure suit using emerging materials and design technology. Technologies under study include shape change polymers and electroemissive materials to modify heat transfer characteristics of the spacesuit "skin" achieving thermoregulation analogous to that in natural biological systems. This approach was shown to be feasible for many space missions during the Phase 1 study program. The current Phase 2 program is investigating more aggressive concepts aimed at eliminating most of the hardware currently included in the spacesuit's life support backpack. This paper describes the concept, study results to date, and possible impacts on future human space exploration.

Biomimetic Materials↗

Morphological responses of wheat to changes in phytochrome photoequilibrium.

Wheat plants (Triticum aestivum L.) were grown at the same photosynthetic photon flux (PPF), 200 micromoles per square meter per second, but with phytochrome photoequilibrium (phi) values of 0.81, 0.55, and 0.33. Plants grown at phi values of 0.55 and 0.33 tillered 43 and 56%, less compared with plants grown at phi of 0.81. Main culm development (Haun stage) was slightly more advanced at lower values of phi, and leaf sheaths, but not leaf lamina, were longer at lower phi. Dry-mass accumulation was not affected by different levels of phi. Three levels of PPF (100, 200, and 400 micromoles per square meter per second) and two lamp types, metal halide and high pressure sodium, were also tested. Higher levels of PPF resulted in more dry mass, more tillering, and a more advanced Haun stage. There was no difference in plant dry mass or development under metal halide versus high pressure sodium lamps, except for total leaf length, which was greater under high pressure sodium lamps (49.5 versus 44.9 centimeters, P < 0.01).

Agriculture↗

Testing a Mars science outpost in the Antarctic dry valleys.

Field research conducted in the Antarctic has been providing insights about the nature of Mars in the science disciplines of exobiology and geology. Located in the McMurdo Dry Valleys of southern Victoria Land (160 degrees and 164 degrees E longitude and 76 degrees 30' and 78 degrees 30' S latitude), research outposts are inhabited by teams of 4-6 scientists. We propose that the design of these outposts be expanded to enable meaningful tests of many of the systems that will be needed for the successful conduct of exploration activities on Mars. Although there are some important differences between the environment in the Antarctic dry valleys and on Mars, the many similarities and particularly the field science activities, make the dry valleys a useful terrestrial analog to conditions on Mars. Three areas have been identified for testing at a small science outpost in the dry valleys; 1) studying human factors and physiology in an isolated environment; 2) testing emerging technologies (e.g., innovative power management systems, advanced life support facilities including partial bioregenerative life support systems for water recycling and food growth, telerobotics, etc.); and 3) conducting basic scientific research that will enhance our understanding of Mars while contributing to the planning for human exploration. We suggest that an important early result of a Mars habitat program will be the experience gained by interfacing humans and their supporting technology in a remote and stressful environment.

Antarctic Regions↗

Advanced Crew Escape Suit.

Design of the S1032 Launch Entry Suit (LES) began following the Challenger loss and NASA's decision to incorporate a Shuttle crew escape system. The LES (see Figure 1) has successfully supported Shuttle missions since NASA's Return to Flight with STS-26 in September 1988. In 1990, engineers began developing the S1035 Advanced Crew Escape Suit (ACES) to serve as a replacement for the LES. The ACES was designed to be a simplified, lightweight, low-bulk pressure suit which aided self donning/doffing, provided improved comfort, and enhanced overall performance to reduce crew member stress and fatigue. Favorable crew member evaluations of a prototype led to full-scale development and qualification of the S1035 ACES between 1990 and 1992. Production of the S1035 ACES began in February 1993, with the first unit delivered to NASA in May 1994. The S1035 ACES first flew aboard STS-68 in August 1994 and will become the primary crew escape suit when the S1032 LES ends its service life in late 1995. The primary goal of the S1035 development program was to provide improved performance over that of the S1032 to minimize the stress and fatigue typically experienced by crew members. To achieve this, five fundamental design objectives were established, resulting in various material/configuration changes.

Astronauts↗

Workshop on future directions for plant research at NASA: a report.

NASA's Fundamental Space Biology Division and the Advanced Human Support Technology Program convened a workshop in December 2003 [correction of 2004] at Kennedy Space Center, Florida, to chart future directions for plant research at NASA. The purpose of the workshop was to bring together key managers and principal investigators in NASA's plant research community as well as non-NASA funded researchers to formulate a strategy to guide future plant research for the Office of Biological and Physical Research (OBPR). Subsequent to the workshop, on Wednesday, January 14, 2004, President George W. Bush announced a proposal for NASA to go back to the moon and later send a manned mission to Mars. The following is a summary of workshop recommendations provided by the plant research community within the framework of the new exploration vision as set for by NASA.

Ecological Systems, Closed↗

The space elevator: a new tool for space studies.

The objective has been to develop a viable scenario for the construction, deployment and operation of a space elevator using current or near future technology. This effort has been primarily a paper study with several experimental tests of specific systems. Computer simulations, engineering designs, literature studies and inclusion of existing programs have been utilized to produce a design for the first space elevator. The results from this effort illustrate a viable design using current and near-term technology for the construction of the first space elevator. The timeline for possible construction is within the coming decades and estimated costs are less than $10 B. The initial elevator would have a 5 ton/day capacity and operating costs near $100/lb for payloads going to any Earth orbit or traveling to the Moon, Mars, Venus or the asteroids. An operational space elevator would allow for larger and much longer-term biological space studies at selectable gravity levels. The high-capacity and low operational cost of this system would also allow for inexpensive searches for life throughout our solar system and the first tests of environmental engineering. This work is supported by a grant from the NASA Institute for Advanced Concepts (NIAC).

Acceleration↗

In-flight medical incidents in the NASA-Mir program.

This paper summarizes medical experience during the six NASA-Mir flights from March 14, 1995, to June 4, 1998. There were 7 U.S. astronauts who were part of 6 Mir space crews and worked jointly with 12 Russian cosmonauts. Advances in space medicine have created a safer environment; however, experience shows that crewmembers experience traumatic injuries and illnesses of diverse etiologies during spaceflight. During these joint flights both Russian and U.S. medical kits were available to crewmembers who could access either medical kit as appropriate. The Russian medical team had primary responsibility for monitoring and care of all crewmembers and analyzing medical results. When medical incidents occurred, the appropriate Russian or U.S. medical team determined the plan for diagnosis and treatment. Each team kept the other informed regarding medical situations during the flights and strictly observed the principles of medical confidentiality. A summary of medical incidents by programmatic element is described as experienced by the crewmembers and the ground support medical teams. The most frequent medical cases were small traumatic injuries to the skin and mucous membranes and fluctuations in the cardiovascular system, manifesting primarily in the form of cardiac dysrhythmias. The ability to use both the Russian medical aids and the U.S. medical kit significantly increased the effectiveness and reliability of therapeutic and prophylactic care. The degree of medical care and cooperation established precedents for integrating these systems for the medical support of expeditions on the International Space Station.

Aerospace Medicine↗

An Antarctic research outpost as a model for planetary exploration.

During the next 50 years, human civilization may well begin expanding into the solar system. This colonization of extraterrestrial bodies will most likely begin with the establishment of small research outposts on the Moon and/or Mars. In all probability these facilities, designed primarily for conducting exploration and basic science, will have international participation in their crews, logistical support and funding. High fidelity Earth-based simulations of planetary exploration could help prepare for these expensive and complex operations. Antarctica provides one possible venue for such a simulation. The hostile and remote dry valleys of southern Victoria Land offer a valid analog to the Martian environment but are sufficiently accessible to allow routine logistical support and to assure the relative safety of their inhabitants. An Antarctic research outpost designed as a planetary exploration simulation facility would have great potential as a testbed and training site for the operation of future Mars bases and represents a near-term, relatively low-cost alternative to other precursor activities. Antarctica already enjoys an international dimension, an aspect that is more than symbolically appropriate to an international endeavor of unprecedented scientific and social significance--planetary exploration by humans. Potential uses of such a facility include: 1) studying human factors in an isolated environment (including long-term interactions among an international crew); 2) testing emerging technologies (e.g., advanced life support facilities such as a partial bioregenerative life support system, advanced analytical and sample acquisition instrumentation and equipment, etc.); and 3) conducting basic scientific research similar to the research that will be conducted on Mars, while contributing to the planning for human exploration. (Research of this type is already ongoing in Antarctica).

Antarctic Regions↗

A management information system to study space diets.

A management information system (MIS), including a database management system (DBMS) and a decision support system (DSS), was developed to dynamically analyze the variable nutritional content of foods grown and prepared in an Advanced Life Support System (ALSS) such as required for long-duration space missions. The DBMS was designed around the known nutritional content of a list of candidate crops and their prepared foods. The DSS was designed to determine the composition of the daily crew diet based on crop and nutritional information stored in the DBMS. Each of the selected food items was assumed to be harvested from a yet-to-be designed ALSS biomass production subsystem and further prepared in accompanying food preparation subsystems. The developed DBMS allows for the analysis of the nutrient composition of a sample 20-day diet for future Advanced Life Support missions and is able to determine the required quantities of food needed to satisfy the crew's daily consumption. In addition, based on published crop growth rates, the DBMS was able to calculate the required size of the biomass production area needed to satisfy the daily food requirements for the crew. Results from this study can be used to help design future ALSS for which the integration of various subsystems (e.g., biomass production, food preparation and consumption, and waste processing) is paramount for the success of the mission.

Biomass↗