Once upon a time, space travel, let alone colonizing planets, was just a dream. But as that dream becomes a reality there are some aspects of crewed missions we need to consider that perhaps haven’t been given due attention before now.

Colonizing planets means long journeys cooped up in spacecraft. Currently, it will take around nine months to get Mars, and nine years to get to Pluto, which takes long-haul travel to a new dimension, so you better hope on your rocket there's a doctor onboard.

In fact, a new meta-analysis has looked at six decades’ worth of scientific literature to gather information on an aspect of long-haul space travel that will have to be addressed by future space travelers; medical treatments that will have to be carried out onboard, specifically, surgery in space.

According to the study, published in the British Journal of Surgery, there are many complications, and we are seriously unprepared for it.

"Future astronauts or colonists will inevitably encounter a range of common pathologies during long?haul space travel," the authors write. "Novel pathologies may [also] arise from prolonged weightlessness, exposure to cosmic radiation, and trauma."

Plus, of course, the extreme environment of space affects the body in many unique physiological ways – bone and muscle atrophy, cardiovascular changes, and fluid redistribution for example, which need to be taken into consideration as they will affect the way surgery will be performed.

There is another aspect of space surgery that needs to be considered too, though it is rather unpleasant. The matter of weightlessness… and bodily fluids during surgery.

Experimental surgery has been carried out in simulated microgravity before and they learned quite quickly that both the patient and surgeon will need to be strapped down. This means everything will need to be within reach, so the concept of “traumapods” is recommended. This also addresses the issue of preventing any contaminated specimens – blood, fecal matter etc – from escaping about the ship.

“Because of the surface tension of blood, it tends to pool and form domes that can fragment on disruption by instruments,” according to the study. “These fragments may float off the surface and disperse throughout the cabin, potentially creating a biohazard.”

It gets worse.

“The tendency of organs to eviscerate has also been reported.” 

The lack of gravity means that bowels do not stay where they should, and in moving around and bumping up against other organs, the risk of accidentally perforating them is higher than normal, which means we’re also on board with the idea of "hermetically sealed enclosures" for patient and doctor. 

Other logistical problems include actually having the space inside a spacecraft to house a medical center that has all the equipment and supplies one might need. One way of getting around this is having a 3D-printer on board to print tools as and when you need them. Scientists have even invented a way of making printable plastic from astronaut poop. 

There's also the idea of Earth-to-space telesurgery, though communication delays between Earth and Mars right now are between 4 and 22 minutes, which may prove life-threatening.

So yes, there are many logistical complications still to work through, and though we may not be quite there yet, at the rate private space exploration is going, this is one aspect of space travel we do not want to be up there going "Oh yeah, I didn't think of that...".