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Neemo 7 Mission

Aquarius Underwater Habitat
Key Largo, Florida
October 11 to 21, 2004

The NEEMO 7 mission (NASA's Extreme Environment Mission Operations 7) involved the Centre for Minimal Access Surgery (CMAS) at McMaster University, the Canadian Space Agency (CSA) and NASA. The mission aimed to demonstrate and evaluate new medical diagnostic and therapeutic technologies to enhance the delivery of state-of-the-art medical care in remote and harsh environments. Recent breakthroughs in Canadian telecommunication and biomedical technologies have significantly improved the capability to provide remote medical care. These technologies could someday contribute to the human exploration of space, particularly for long-term expeditions to the Moon and Mars.

The Centre for Minimal Access Surgery (CMAS)

CMAS, a McMaster University centre 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. Dr. Mehran Anvari spearheaded CMAS in 1999. On February 28, 2003, at St. Joseph's Healthcare Dr. Anvari successfully performed the world's first hospital-to-hospital, telerobotic-assisted surgery on a patient in North Bay, Ontario, nearly 400 kilometres away.

The primary CMAS science objectives of the NEEMO 7 mission were:

• Telementoring, in which an experienced surgeon (in an advanced treatment facility) used pre-established, two-way telecommunications links to guide the remote surgeon through an operation in the remote Aquarius habitat. Telementoring procedures included intubation, local anesthetic block, trocar insertion, arterial suturing, ultrasound evaluation of the abdomen, ultrasound evaluation of the chest (pneumothorax) and chest tube insertion.

• Telerobotics, where leading-edge, virtual-reality technology were used to translate a surgeon's natural movements (fingers, hands and wrists) into the movements of a robot, located in the Aquarius habitat, with the goal of determining the potential use of telerobotics in space missions. Telerobotic surgery procedures included suture of a nerve or artery, ultrasound guiding of a drain and laparoscopic appendectomy or nephroscopy.

These procedures were performed on a surgical simulator with physician-trained and non-physician-trained astronauts in order to understand the limitations of these procedures in a space-analogue environment. Procedures were performed several times in order to obtain a level of confidence in the results.

CSA and NASA objectives

In addition to the telementoring and telerobotic surgery objectives, this space-analogue mission incorporated other science and operational objectives from CMAS, CSA and NASA. Additional science and operational objectives included other telehealth, physiological monitoring, human behaviour and performance and marine science objectives.

The Aquarius Habitat

Deployed 19 metres underwater, 5.6 km off Key Largo, in the Florida Keys National Marine Sanctuary, the Aquarius undersea laboratory supports research in coastal and ocean resource science and management. The habitat itself, a 3-by-14-metre steel cylinder, provides 11 cubic metres of living and laboratory space for a six-person crew. The lab is equipped with computers linked to shore, as well as Internet, telephones, radios, and video-conferencing equipment.

Aquarius is an ambient pressure habitat-its interior atmospheric pressure is equal to the surrounding water pressure. At this depth and pressure, divers normally have only about 80 minutes before they must return to the surface, or they risk experiencing decompression illness. However, the mission crew, known as "aquanauts," can stay indefinitely. They also have nearly unlimited bottom time during their scuba dives out of the habitat, as long as they stay at the same depth. However, there is a price to pay for such long stays at this pressure; at the end of a mission, aquanauts must undergo 17 hours of decompression in a chamber within Aquarius itself in order to minimize the risk of decompression sickness. At the end of the decompression period, aquanauts leave Aquarius in scuba gear and rise to the surface.

Aquarius missions typically last 10 days and are usually conducted from April to November. This extreme hostile environment is analogous to human space flight and has been used by NASA in the training of space station astronauts and as a platform for research and technology development since 2001.