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Updated: Oct 11, 2025

Emergency Undocking in Robotic Surgery: A Simulation Curriculum

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Published on: May 20, 2018

Hierarchical Task Analysis Reimagined as a Planning Tool for Surgery During Exploration Space Flight.

Karen Hughes Miller¹, Erica Sutton², George Pantalos³

¹School of Medicine, 5170University of Louisville, Louisville, KY, USA.

Surgical Innovation

|December 6, 2021

Summary

This study adapted a laparoscopic appendectomy procedure for spaceflight by deconstructing surgical tasks. The developed hierarchical task analysis (HTA) model identified key skills and supplies for non-surgeons in microgravity.

Keywords:

extreme medical environment job aid surgical planning surgical team training task analysis

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Area of Science:

Space Medicine
Surgical Simulation

Background:

Space exploration necessitates planning for in-flight medical emergencies, including acute surgical care.
Laparoscopic appendectomy, a routine Earth procedure, presents unique challenges in microgravity due to altered physics and limited resources.

Approach:

Developed an expanded Hierarchical Task Analysis (HTA) model to deconstruct laparoscopic appendectomy for non-surgeons.
Iterative content development involved literature review, expert feedback, video analysis, and cadaveric simulation.
Integrated instructional designers, medical experts, and media production for a comprehensive approach.

Key Points:

The expanded HTA model detailed 178 actions, 13 columns, and included video links for training.
Identified 13 areas needing further research for microgravity adaptation.
Successfully simulated a laparoscopic appendectomy on a cadaver using 30 items and a simplified crew role.
Highlighted 8 generalizable skills and 27 multipurpose supply/equipment items.

Conclusions:

An expanded HTA effectively deconstructs surgical procedures for extreme environments.
This methodology facilitates integrated crew training, supply review, and adaptation strategies for spaceflight surgery.
The approach proved valuable in identifying necessary modifications for performing surgery in microgravity.