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There are many dangers involved in space exploration, as we all know, there are always chances that an astronaut would be seriously injured or fall ill. This would be especially true for continued space exploration, particularly on long duration journeys.

I would imagine that there are considerable challenges of surgery in low or zero-gravity environments. Should an astronaut have an accident or suffer a life threatening ailment, what is the procedure to perform surgery in near zero-gravity?

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    $\begingroup$ Leonid Rogozov had to perform an appendectomy on himself in 1961 at a Soviet base in Antarctica (he was the only doctor at the base). At least he had full gravity. $\endgroup$ Nov 6, 2014 at 2:40

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The Med.Ops section of the ISS User's Guide is apparently available online. It is generally split into the following sections

I'm far from being a medic, or even para-medic so my take may be wrong. A quick gander at the sections on Nosebleeds, and Penetration of the Eye by a foreign object, and Collapsed Lung revealed nothing beyond algorithms.

My concerns on the subject of surgery in microgravity

  • containment of bodily fluids,
  • organ relocation upon ingress
  • post-op

remained unaddressed in the Med.Ops manual itself.

However a further search brought up this article specifically on the subject of surgery in space was published in Acta Astronaut. 2012; 79: pp.61–66

Thus far, no surgical procedure has ever been performed on a human during spaceflight. Despite that, surgery involving anaesthesia, interventions, and survival was successfully performed in rodents for the first time on the STS-90 Neurolab Shuttle mission demonstrating that minor surgical procedures may be feasible in humans

(https://web.archive.org/web/20061205192016/http://neurolab.jsc.nasa.gov/)

Specific to the topic of containment of bodily fluids is this article (paywalled methinks) - at-least relevant to bleeding in microgravity

Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

As a layman, the general impression I receive is that

  • Surgery may be done in micro-gravity
  • Minimally invasive aka laparoscopy may be the way to proceed
  • Closing & post-op might require specialized techniques, and tools.

For instance

  • getting collected fluids back into the body reducing/breaking surface-tension
  • bodily organs apparently expand, and relocate themselves around the thoracic cavity

Finally, having spouted all that (+:, research on micro-gravity parabolic flights, and simulations may have a long way to go before a procedure may be planned/executed on board the ISS, or in space. Until then, let's hope no emergency arises.

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