title: Evaluation of surgical skills in microgravity using force sensing.
abstract: BACKGROUND
  Force measurements can be used to characterize surgical maneuvers in microgravity.
  
  
  METHODS
  : A series of surgical tasks was performed by a group of 20 participants (n=20) both in 1g on the ground and in 0 g aboard NASA's KC-135 aircraft in parabolic flight. The group included astronauts, a flight surgeon, surgeons, physicians, Ph.D.-scientists, and technical personnel. The interaction forces between the surgical instruments and the mock tissue were measured for a clip-applying, suturing, grasping, and cutting. Seven evaluations in 1g and a single evaluation in 0 g were performed by each of the participants.
  
  
  RESULTS
  The data from a single participant are examined in detail. Statistical results for the group of 20 participants do not show significant differences in the average or peak forces during clip-applying or in the average forces applied during suturing in 0 g versus in 1g. However, the results do show statistically greater (43% higher) peak forces during suturing in microgravity.
  
  
  CONCLUSIONS
  These data show the usefulness of analyzing force information to assess surgical task performance in microgravity. Although peak suturing forces were statistically higher in microgravity, their clinical relevance is unknown, but likely would not result in a change in clinical outcome. Overall, the data suggest that forces exerted during surgical tasks will not pose a significant barrier to effective surgery in microgravity.
authors.affiliation: Department of Mechanical Engineering, Virginia Commonwealth University, 601 West Main Street, Room 310, P.O. Box 843015, Richmond, VA 23284-3015, USA. jespeich@vcu.edu
authors.forename: John E
authors.initials: JE
authors.lastname: Speich
authors.forename: Yvonne D
authors.initials: YD
authors.lastname: Cagle
authors.forename: Azhar
authors.initials: A
authors.lastname: Rafiq
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Merrell
authors.forename: Charles R
authors.initials: CR
authors.lastname: Doarn
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Broderick
mesh_terms: D000337:Aerospace Medicine / Q000379:methods*; D005069:Evaluation Studies as Topic; D018737:Hand Strength; D006801:Humans; D013026:Space Flight; D013314:Stress, Mechanical; D013525:Surgical Instruments; D013537:Sutures; D013997:Time Factors; D014893:Weightlessness; D018474:Weightlessness Simulation