The use of new technology combining optical navigation, computer processing, and special positioning sensors used airplanes for space orientation recently entered the operating room at Rambam Health Care Campus in Haifa. The surgical procedure, which has been carried out to date approximately 50 times globally, was first performed in Israel during hip replacement surgery with the help of Swiss development which, according to specialists, can significantly improve surgical accuracy and results.
Izolda Shuster, a 66-year-old woman from the northern Israeli city of Carmiel, suffered in recent years from erosion of the hip joint, a common medical problem among the elderly. She recently underwent hip replacement surgery in her left leg and became the first person in Israel who was operated on with the help of groundbreaking Swiss technology, which uses a small navigation system that allows the surgeon to perform surgical procedures with greater precision. One day after surgery, Shuster was walking, and two days later, was released from the hospital feeling good. Until today, approximately 50 of these operations have been performed around the world, in a small number of facilities in Switzerland, Germany, Australia, and now Israel.
The operation, which was conducted in the orthopedic service at Rambam HCC under the direction of Professor Doron Norman, was performed by Dr. Daniel Levin – the head of Rambam’s Hip Surgery Service and an expert in hip replacement surgery – who adopted the technology for hip replacement surgery using a minimally invasive frontal approach (AMIS). Use of the navigation system, developed by the Swiss company Naviswiss, allows the surgeon to be assisted by a unique, optical computerized system that helps to place the implants in the most accurate and suitable location for each individual patient with regard to the complexity of the position, the movement and the position of the pelvis. The system can accurately reconstruct the length of the limb, the center of rotation, and the range of angles that are important to the placement of the implants in a way that can ensure survival for many years, maximal joint stability and minimization of joint erosion in the long term.
“Hip replacement operations are considered one of the most successful modern surgeries, and possibly even the most successful,” explains Dr. Levin, adding, “The surgery promises significant improvement of the pain and quality of life for the patient suffering from irreversible damage to the hip. Today, recovery from this surgery is extremely quick, and average modern survival of implants is more than 95% for 10 years."
According to Dr. Levin, one of the technical challenges that surgeons face today is the optimal placement of implants, which can be different from person to person. The positioning is of great importance for ensuring joint stability, the success of the operation and the optimal functioning thereafter.
During the course of the surgery, at the press of a button, the computerized optical navigation system enables the exact angles in which the surgeons work to be seen on a screen, thereby restoring the optimal and desirable position for each and every patient. Use of the optical navigation system effectively eliminates the need for imaging, which is now considered a useful and frequently used surgical tool. At the end of the surgery, the navigation system produces a printed report precisely documenting the angles of the implants, the length of the limb, and more. This report is important documentation for the surgeon and the patient in order to know the accurate, objective outcome of the surgery.
“We believe that new technologies whose cost of utility is high have a real place and need,” sums up Dr. Levin. "There is no doubt that such technology can be suitable for surgery in the modern age in which we live today. The first surgery that was performed at Rambam was successful and the navigation system helped us achieve optimal accuracy and an equal length of limbs. We expect the patient to recover quickly.”
This is how navigation is done in orthopedic surgery: