Some day Craig McKinley might find himself at the NASA Johnson Space Center giving instructions to a Mars-bound astronaut on how to extract a kidney stone.
Or he might be hanging out his professional shingle as a mission specialist aboard the International Space Station.
The 40-year-old North Bay surgeon and recreational diver stands on the cutting edge of what he calls a “renaissance” in medical and telehealth technology.
Specializing in laparoscopic surgery, McKinley, who holds a degree in electrical engineering and a Masters in biomedical engineering, has become one of Canada’s foremost authorities in telerobotic surgery.
“In the next century, it will be routine to have physicality at a distance, to be able to manipulate objects at a distance and also the ability to have sensory perception,” says McKinley.
Last October, McKinley was part of a crew who entered an underwater laboratory off the Florida Keys dubbed Aquarius on an 11-day mission called NEEMO 7.
Headed by Canadian astronaut Robert Thirsk, its mandate was to test diagnostic and surgical care procedures for astronauts in space and possibly patients in remote areas.
The mission was a joint venture involving NASA, the Canadian Space Agency (CSA) and McMaster University’s Centre for Minimal Access Surgery (CMAS) where much of the technology was developed.
Resting in 19 metres of water, an underwater operating room was created in a three-by-14-metre chamber where various techniques of tele-mentoring (allowing a doctor to watch and advise) and telerobotics (allowing a doctor to clinically intervene in operations) were tested.
Aquarius replicates an isolated environment similar to a space shuttle. Through the use of computers, telephones, videoconferencing and the Internet, the team simulated procedures to see if astronauts could perform rudimentary surgical procedures.
The crew participated in mock procedures including ultrasound diagnosis, drainage of an abscess, suturing of vessels and nerves and performing a kidney stone extraction.
McKinley, who runs a private practice with his wife in North Bay, has performed 22 laparoscopic surgeries using telementoring procedures, has no doubt this type of health-care delivery is the shape of things to come.
His mentor, Dr. Mehran Anvari of CMAS, became the first surgeon in the world to carry out telerobotics-assisted surgery in 2003.
In space, non-invasive techniques such as laparoscopic surgery are preferred because of the limitations in a zero gravity environment and the fact blood and other bodily fluids can be easily confined.
“Whether you’re an astronaut on a deep sea space exploration mission, whether you’re a scientist in Antarctica or whether you’re a Canadian in a remote, rural area, these types of technologies should enable people to deliver to you state-of-the art surgical care,” he asserts.
Minimally invasive surgery is maturing and is slowly being accepted as a standard of care in the surgical community, he says.
McKinley says the space program provides a research and development accelerator. He adds Canada can be a global leader in these technologies with its a strong broadband telecommunications infrastructure and robust robotics industry.
“We can create a system of telesurgical supports throughout Canada where larger centres provide support for smaller, remote communities.”
