HEALTHCARE INNOVATIONS of the past and future coincided last week as Glasgow played host to the first triennial conference of the Royal College of Physicians and Surgeons.

Delegates attending the two-day event at the SECC were treated to a comprehensive range of lectures and forums covering the history of developments in medicine, surgery and dentistry, culminating in a black-tie ball at the city's Kelvingrove Art Gallery and Museum on Friday.

Among the programme's highlights was a talk given by one of the pioneers of ultrasound, Professor John MacVicar, on Thursday, and the opening presentation on the interrelationship of space travel, robotics and "telementored" surgery given by Canada-based surgeon, Professor Mehran Anvari at the Royal College on Wednesday.

The two technologies, developed half a century apart, are linked in their ability to revolutionise medicine. Anvari, a professor of surgery at McMaster University in Ontario, established the world's first telerobotic surgical service in 2003 to cope with the demands of delivering healthcare across a remote environment. He has since performed 22 "remote" surgeries - cross-country satellite link-ups that enable him to observe, instruct and now, thanks to innovations in robotics, perform procedures from hundreds of miles away. Just as ultrasound was one of the groundbreaking developments of 20th-century medicine, Anvari forecasts that these latest advances will transform surgery not only across the world, but across the galaxy.

"At the moment, space missions rely on our ability to bring people back if they fall ill," said Anvari. "But the space station has changed all that, because now we have to start thinking about how do we provide healthcare to people in space. The plan to extend that human presence to a moon base by the year 2022 in order to accelerate the mining of lunar resources - and this is really now becoming a reality - has put the pressure on. The Chinese have also said they will have a moon base by 2025, so there is a new space race on with them but also, perhaps, now with India. Then there is the fact that a moon base is essentially a platform to launch missions to Mars, which in turn raises a whole new set of problems in terms of radiation exposure and the effects of prolonged lack of gravity."

One of the most common side-effects of relatively short trips to space is kidney stones, either during or after expeditions, but there are also problems with organs changing shape and shifts in fluid which cause an astronaut's face to swell while their legs become skinny. To date, these physiological factors have been the focus of scientific attention. However, the prospect of extended stays on moon bases or travel to Mars have encouraged Nasa to turn its attention to dealing with trauma injuries and disease, without having to abort missions and returning entire crews to earth.

It was Anvari's pioneering work in telesurgery which first attracted the attention of the Canadian Space Agency and Nasa, seeking ways to resolve the dilemma of bold ambitions held back by such minor physical defects as kidney stones and appendicitis.

While video links have already been used successfully to allow space agency engineers to instruct astronauts in carrying out space-station repairs, the dexterity and precision required for surgical procedures is obviously hampered by zero-gravity - as Anvari sampled for himself on a commercial "spaceflight". Comparable conditions have been simulated using an underwater station off Florida, where "aquanauts" have received telementoring in surgical procedures from Anvari at his base in Canada.

Although he reports that their training makes astronauts more co-operative and less squeamish pupils that the average junior doctor, the future of space surgery lies in robotics - which can be installed on space stations, but operated remotely by qualified surgeons. And, suggesting Stanley Kubrick was more than a little prescient, the next step could be intuitive machines.

Anvari said: "Surgeons are still the brains behind the operation - a robot is simply going to be the modern-day equivalent to the scalpel a hundred years ago. Artificial intelligence may be the next stage, but the human surgeon will never be obsolete. Technology's job is to facilitate, not to replace, the patient-doctor relationship."

Like the telecoms industry, surgery is set to benefit from our obsession with space travel. "Telementoring will become as much a norm within the next two decades as email is today", claimed Anvari. "And yet, when it was introduced 15 years ago, many doubted it would ever catch on. Remote surgery reduces the need to move patients, it will enable us to provide better care and access to experts regardless of location, and, as a result, potentially decrease waiting times."

For Professor John MacVicar, there are clear parallels between remote and robotic surgery today and the potential he and his fellow Glasgow-based researchers - led by the late Professor Ian Donald - unleashed 50 years ago this year when they turned ultrasound theories to practical use. "It took an awful long time to catch on. I left in 1974 and by that time I thought it was well established, but when I took the chair at Leicester - no ultrasound."

Despite early doubters, ultrasound has found applications throughout medicine, both therapeutic and diagnostic.

Besides sonograms in pregnancy, it can be used to detect cancerous growths, for teeth-cleaning and even sports therapy.

MacVicar believes the scepticism actually served ultrasound well, as it will again in the seemingly far-fetched realms of telerobotics. "It's good to be sceptical. It make you work harder."