How surgeries are performed on military and hospital ships?

Question

I am intersted in papers or reports on how the operations are conducted in the presence of permanent pitching.

Is it even possible to perform, for example, heart transplant in such conditions?

What operations are known to be possible to perform?

How military ships are expected to surgically treat wounded crew in case of a storm?

Are there any special pieces of equipment that increase the probability of success for a range operations?

Please note that I do not have any medical background.

P.S. I would really appreciate links and references

Previous research

Here I found that it is indeed possible to perform somewhat complex surgeries while afloat.

Then I found the paper which reviews some aspects of surgery on military ships. But it lacks details and focuses on differences between training and real practice instead of methods used by "Ship's Surgeons".

There is another report that I liked, but again it lacks details. Ideally, I want to know the difference between operating on a ship and on a shore.

This paywalled research states that there is no significant difference while operation afloat. I was not able to steal the article, so I don't know the methodology and can't judge if it is valid research.

Answer 1

Medical operations are always a question of risks versus benefits.

And of course, likelihood of said risks and benefits. I think the sources you have found are fairly good, but I might encourage you to look into surgical risk assessments in militaries generally (e.g., Austere Resuscitative and Surgical Care (ARSC)).

Generally the scene or theater safety is just one of the many factors that a care team would take into consideration, and that would include any predictable or expected motion of the surgical location (truck, helicopter, plane, ship, etc.). Obviously the more complex a surgery procedure is, the more inherent risk it may hold, so additional scene/theater risk might dissuade you from proceeding without sufficient concern over the risk of inaction or alternate treatment.

Moving specifically to ships (rather than boats), as pointed out by others, they are often conducting the majority of their work in port. Such general descriptions and quantifications of the work actually being done isn’t hard to come by.

Further, when actually in transit, it should be understood that all of the modern ships come with significant stabilizing systems that greatly reduce any such “pitching” (roll) effects you might be concerned with.

But, for the sake of argument, if you’re in an unstable OR, with a pressing need, that you can’t conceivably wait or Ruck or Truck your way to better conditions in time, with all the materials you need for the procedure, then you are going to choose to do the least amount of work you can reasonably do—-that which is necessary—-until the scene is “safe” or at least more favorable. I do not know of many who are arrogant enough to be cutting on important bits (e.g., arteries) when they know their hands/equipment cannot be expected to be stable.

The solution becomes attempting to stabilize the situation (pt, MD, equipment, etc.) so you can isolate generally, or at minimum hold in a sympathetic relative position, rather than trying to develop some Herculean skills of surgery with a vibrosword.