Astronauts test the waters of telemedicine’s limits

Canadian astronauts will trade the heights of outer space for the depths of the sea in a telemedicine experiment that could see non-physicians one day take part in life-saving medical procedures.

Representatives from NASA, the Canadian

Space Agency and a number of Canadian surgeons gathered in Hamilton Monday to discuss NASA’s Extreme Environment Mission Operations 7 (NEEMO). The joint project also involves McMaster University’s Centre for Minimal Access Surgery (CMAS) at St. Joseph’s Healthcare.

The 10-day mission will use the harsh environment of an underwater habitat called Aquarius located 19 metres below the surface of the sea about 5.6 km off Key Largo in the Florida Keys National Marine Sanctuary. The group hopes to develop and evaluate surgical robotic technologies and see how they can be used to further space exploration and change the future of health care on Earth. The mission will take place Oct. 11 to 21.

Canadian vendors like March Networks and the NORTH Network have used two-way videoconferencing tools to allow health-care workers to make remote diagnosis, check up on patients and assist with surgical procedures, but NEEMO aims to further develop telesurgery, where robot limbs and distance technology allow surgeons to actually perform procedures remotely.

As part of NEEMO’s mission, team members will use a dummy called abdominal surgical simulator to test how well surgeries could be performed underwater. It could also explore whether untrained individuals could assist in surgeries with the help of health-care professionals thousands of miles away.

McMaster’s Center for Minimally Invasive Surgery will supply the robotics, while a virtual private network (VPN) will be based on Multi-Protocol Label Switching (MPLS) technology from Cisco Systems and managed by Bell Canada.

Dr. Craig McKinley, who has worked on a similar network with Bell and Cisco in the past, said in a teleconference call that the infrastructure provided was “”flawless in terms of allowing us to actually bring a doctor into my operating room.””

Cisco Systems of Canada‘s national manager of enterprise marketing, Brantz Myers, said NEEMO 7’s mission is an extension of what it’s calling a medical-grade network architecture.

“”It’s very much a proof point,”” he said. “”If you can work in the extreme environments and make a network perform to support a life-critical procedure, we feel quite confident in working on some of these Earth-based procedures.””

Most of those networks traditionally involved in telemedicine have used transmissions of radiological pictures or other data, where latency is not a crucial issue, said NEEMO’s chief scientist, Mehran Anvari. “”For our work, latency is important, so we’ll be using software to reduce the impact of latency in the network,”” he said.

CSA astronaut Dave Williams, who will be part of the Aquarius’s crew, said NASA and the CSA are interested because space missions face a geographical disparity in terms of health care that’s similar to remote parts of Canada.

“”What we’re hoping to do is look at this technology, and see whether or not we can adapt it, miniaturize it, make it more sophisticated to help us further the exploration of space,”” he said.

Anvari said the artificial models of cadavers that will be used in the experiment will provide a good idea of how strong the infrastructure for advanced telesurgery will have to be.

“”They bleed, they have right organs, very similar to the real thing,”” he said. This is what we use day-to-day to train our surgeons at the moment.””

NEEMO 7 will also test satellite in addition to fibre-optic network equipment because LAN equipment is not available everywhere, Anvari added. The team is already talking with government agencies about how it could apply the results of its research. In Ontario, meanwhile, the provincial government on Monday announced an investment of $5.7 million in telemedicine technology to deliver health services in Northern Communities.

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