From April 3 to 20, 2006

If you have dreamed of travelling to the Moon or Mars in the future, stay tuned! The next step toward the future of space exploration is the 9th NASA Extreme Environment Mission Operation, or NEEMO 9, April 3 to 20, 2006. This research mission will assess new ways to deliver medical care to a remote location. In one test, doctors in Hamilton, Ontario, use a prototype robot to perform surgery on a simulated patient some 2,000 kilometres away off the Florida coast in the Aquarius undersea laboratory.

Image of the Aquarius underwater habitat and laboratory

The Aquarius underwater habitat and laboratory (Credit: NOAA's Undersea Research Center at the University of North Carolina Wilmington)

NEEMO 9 is an exciting mission for Canada to take part in. You are invited to read the mission journal of commander and Canadian Space Agency (CSA) astronaut Dr. Dave Williams. Watch as crew test state-of-the-art medical care technologies developed by Canadian researchers for diagnosis and treatment of a patient who is thousands of kilometres away.

The NEEMO 9 mission team includes medical practitioners and astronauts, but all become "aquanauts" for the undersea mission. Remote medical care testing is part of the main objective, which is to prepare for exploration and navigation on the Moon. The habitat environment offers a chance to try out exploration techniques, such as remotely operated vehicles (ROVs) and technologies for gathering and sorting rock samples.

NEEMO 9 is a joint project involving McMaster University's Centre for Minimal Access Surgery (CMAS), the U.S. Army Telemedicine and Advanced Technology Research Center (TATRC), the National Space Biomedical Research Institute, the CSA, and NASA.

Remote care in space and on Earth

Telemedicine, the delivery of remote medical care over a telecommunications link, has evolved tremendously with high-speed telecommunications technology, which has increased both the amount of information that can be transmitted and the speed of transmission. Physicians can now remotely diagnose and treat a wide range of health problems. 

One of the experiments on NEEMO 9 will demonstrate the capability of sending digital radiographs from an extreme isolated environment to a teaching hospital for interpretation. In many rural areas of Canada, the high cost of sending patients to larger hospitals for medical procedures could be reduced with new telehealth technologies. 

These technologies challenge the traditional concept whereby a hospital provides service to a specific geographic region, and offers a new vision of virtual hospitals or "hospitals without walls" that deliver regional care while also providing advanced medical support to rural facilities through new telemedicine technologies.

The future of surgery and health care

Telerobotic surgery is a new surgical approach that uses leading-edge technology to allow a surgeon to operate on a patient in another location. Three elements are required to support telerobotic surgery: high-speed telecommunications, advanced robotics technology, and surgeons skilled in performing minimally invasive surgery through tiny keyhole incisions. Canada is a world leader in all three areas. 

Throughout Canada, high-speed, state-of-the-art terrestrial and satellite telecommunications are widely used. Advanced Canadian robotics technologies, similar in concept to the robotic arm used on the Space Shuttle and the International Space Station, have been used in developing the next generation of surgical robot, and Canadian surgeons are amongst the best in the world at pursuing innovative research on minimally invasive surgery. With its unique expertise in the three enabling technologies, Canada can take a leading role in shaping the future of remote health care and telerobotic surgery.

These new telehealth technologies will change the future of rural health care. They are also important enabling technologies for missions to send humans to the Moon or Mars. Missions like NEEMO 9 are research and technology accelerators that drive the development of smaller, portable, more capable devices for delivering advanced medical care in remote locations. Space exploration thus has a dual role: extending the capability to send humans farther into space while benefiting people on Earth.

About Hamilton's Centre for Minimal Access Surgery (CMAS)

CMAS, a McMaster University Centre located at St. Joseph's Healthcare in Hamilton, Ontario, develops telemedicine technologies to help Canadian physicians in isolated communities gain better access to the latest medical knowledge, techniques and specialists.

There are three primary science objectives for CMAS on the NEEMO 9 mission:

  • Telementoring – An experienced surgeon in an advanced treatment facility in Hamilton will use pre-established two-way telecommunications link to guide either a physician or a non-physician in the Aquarius underwater habitat through a complex medical procedure. Telementoring procedures will include the assessment and diagnosis of extremity injuries and surgical management of fractures.

  • Telerobotics – Using a prototype next generation surgical robot, surgeons in Hamilton will perform real-time abdominal surgery on a patient simulator in the Aquarius habitat. By varying the signal transmission delays from less than a second to up to 3 seconds, the mission can evaluate the capability of performing telerobotic surgery in a wide range of remote settings, both on Earth and on future missions to the Moon. Miniature robotic surgical cameras within the abdomen will be used to enhance the surgeon’s view.

  • Human Performance – The effects of fatigue and a number of stressors on the capabilities of a crew to perform complex experiments both inside and outside the undersea habitat will be evaluated. This information is of significant interest to health-care professionals on Earth, but also in preparation for exploration missions to the Moon.

Dr. Mehran Anvari, who is taking part in the NEEMO 9 medical experiments, spearheaded CMAS in 1999. On February 28, 2003, the internationally respected leader in his field successfully performed the world’s first hospital-to-hospital telerobotics-assisted surgery from his lab at St. Joseph’s in Hamilton on a patient in North Bay, Ontario, nearly 400 kilometres away.