Intraperitoneal Gas Insufflation Will Be Required for Laparoscopic Visualization in Space: A Comparison of Laparoscopic Techniques in Weightlessness
Bibliographic record
Abstract
BACKGROUND: Laparoscopic surgery (LS) is contemplated during long duration space flight, but it typically necessitates intraabdominal hypertension (IAH) from insufflation to create a surgical domain. Because there are spontaneous changes in abdominal wall behavior in weightlessness (0g) that have been previously suggested to increase LS visualization, we studied the comparative laparoscopic visualization between gasless (noGAS), abdominal wall retraction (AWR), and standard 15 mmHg gas insufflation (GAS) during weightlessness. STUDY DESIGN: In-flight LS was performed on four anesthetized pigs during weightlessness obtained through parabolic flight in a research aircraft. GAS was studied during 27 parabolas and compared with 20 parabolas using AWR-LS and 12 with noGAS. Pelvic visualization was scored in real time during flight by 2 or 3 surgeons per parabola and postflight through review of compiled digital video disk (DVD) images by 29 independent reviewers. Physical measurements of the sagittal (anterior-posterior) and transverse dimensions of anesthetized pigs were recorded during 39 parabolas. RESULTS: Despite consistent increases in the sagittal abdominal dimension in weightlessness (GAS and noGAS), on-board scored visualization in 0g was unchanged for noGAS (p=0.78) and decreased during AWR (p=0.09), compared with 1g. Although AWR was considered feasible in 1g, spontaneous visceral movements reduced the surgical domain in 0g. Neither AWR nor noGAS was believed safe. But visualization during GAS in 0g was increased over that in 1g (p < 0.001). CONCLUSIONS: Both noGAS and AWR are impractical in weightlessness. Gas insufflation will be required. With insufflation, visualization and perceived ability to perform LS was improved by weightlessness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".