Harnessed to the walls, their surgical tools moored down with magnets, a team of French doctors are to attempt the world's first human operation in zero-gravity on Wednesday. It will serve as a test for performing surgery in space.
The aircraft enabling the pioneering operation is Zero-G, a plane designed and built by Europe to simulate gravity-free conditions, providing a priceless laboratory-in-the-sky to test out new technologies.
Working inside a custom-made operating block, three surgeons, backed by two anaesthetists and a team of army parachutists, will remove a fatty tumour from the forearm of an intrepid volunteer over the course of a three-hour flight.
Miniature surgical tools, held in place with magnets placed around the patient's stretcher, will be used to adapt to the reduced size of the operating theatre, which was designed by a French elevator manufacturer.
Though there are no current plans for doctors to fly on spacecraft, the operation is part of a project to develop surgical robots in space that are guided via satellite by Earth-based doctors. The project is on course for completion in 2007 with backing from the European Space Agency (ESA).
"Since February, we have been rehearsing this operation on the ground and in the plane. It is all crystal-clear in our heads," says surgeon Dominique Martin at Bordeaux University Hospital in southwestern France.
Martin's team laid the groundwork for Wednesday's operation in October 2003, with an operation on a 0.5 millimetre-wide rat tail's artery.
The European space plane, a specially-adapted Airbus A300 operated out of Bordeaux, flies in a series of roller-coaster like parabolas, creating between 20 and 22 seconds of weightlessness at the top of the curve, a process repeated around 30 times for a 3-hour flight.
As well as the challenge of working in zero gravity, the surgical team will have to halt their work each time the plane pulls out and gravity resumes.
Anaesthetist Laurent de Coninck believes that zero-gravity surgery offers huge promise for space exploration, though it would at first be limited to treating simple, accidental injuries.
"Today more than 400 people have already travelled into space. The chances of injuries occurring during missions will become ever greater – and to bring a wounded person back to Earth for treatment is both risky for them and expensive," he explains.
His colleague Martin hopes one day to work with the ESA to develop an operating block for a future Moon base.
World space agencies hope that by 2020 a permanently inhabited base can be established on the Moon, to conduct research, exploit lunar resources, learn to live off the lunar land and test technologies for voyages to Mars.
In the shorter term, pre-built robotic surgical blocks could also have valuable uses here on Earth, for instance inside caves or difficult-to-access location, such as after an earthquake.
"Long-distance flights to Mars will not be happening in the immediate future," points out Guy Laslandes, head of the Ariane V programme at France's National Centre for Space Studies (CNES). "But the experiment will allow the development of working methods and miniaturised tools that can be used in extreme conditions on Earth, such as during missions to the North Pole."
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