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Time is on the patient’s side

Digitally controlled interventions, minimally invasive surgical procedures and a consistently followed treatment pathway: cutting-edge methods have made hip replacement and spinal surgery not only safer, but also more efficient.
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Spinal surgery .mp4

Adrian Tschannen and Reinhild Werlen-Walpen don’t know each other, but they have something in common: both had successful orthopedic surgery. During the operation, both benefited from the most up-to-date medical instruments and materials. And in both cases, the surgery was controlled by a digital system: the Surgical Procedure Manager. As a result, the overall process – including optimal preparation and follow-up – was completed without any problems. Both patients are satisfied with the outcome.

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Reinhild Werlen-Walpen from the Valais region, previously a passionate athlete and a member of a local volleyball team, realized at the age of 45 that her back was longer up to the task. Considerable pain forced her to give up the sport. The diagnosis, a herniated disc in the lower lumbar region and spondylolisthesis, made her life a living hell.

When he was in his mid-50s, business IT specialist and outdoor sports enthusiast Adrian Tschannen from Biel felt a sharp pain in his hip. At first, he thought he had pulled a muscle, but a visit to the orthopedist shed light on the situation: the X-ray image clearly showed that he was suffering from arthritis of the hip. At their doctors’ advice, both Werlen-Walpen and Tschannen initially tried conventional treatments, but after some time, surgery was unavoidable in both cases.

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“I was unable to lift my legs after hiking,” Reinhild Werlen-Walpen recalls. “I needed crutches to walk and was afraid that I would eventually end up in a wheelchair.” Her physician, Samuel Schmid, Chief Senior Physician at Upper Valais Hospital Center in Brig, helped her make a decision. “He explained in detail what would happen and I trusted him.” An everyday occurrence for the spinal specialist: “Usually I see the patients over a certain period of time and at some point the only option that is left is surgery.”

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Ultimately, Adrian Tschannen also reached the point where he didn’t want to wait any longer and discussed with his physician, Daniel de Menezes, a senior orthopedic physician at Biel Hospital Center, what he could expect from an operation, a common experience for de Menezes: “Choosing the right time for a hip replacement is entirely up to the patient.” Just like Reinhild Werlen-Walpen, Tschannen also attended a preparatory course prior to surgery. He met the entire team and found out what he could expect before and after the operation.

Both operations were completed without any problems, a routine job for the doctors, and due, in part, to improved materials, state-of-the-art minimally invasive surgical techniques and instruments. Additional safety for the patient during surgery is provided by the digital support of a modern navigation system, the “Surgical Procedure Manager” (SPM). The audiovisual system uses sound and on-screen images and leads through every step of the operation, which cannot be continued until the preceding process has been correctly completed. “The system increases safety during surgery,” according to de Menezes, “every team member takes the right step at the right time and in the right place.” This also saves time, as Samuel Schmid confirms: “An SPM-controlled operation takes 20 minutes less than it used to.”

For the patient, this means more safety during and fewer complications after surgery, because the less time it takes, the fewer anesthesia-related problems occur and the healing process is faster. The experiences made with each patient are digitally collected and subsequently analyzed to eliminate errors. The cost factor is another plus. Costs were reduced at Biel Hospital Center with the use of this standardized procedure.

Both Reinhild Werle-Walpen and Adrian Tschannen received intensive support before and after surgery. The so-called clinical pathway, where the entire team works closely together and treatments are aligned, is standardized at the hospitals in Biel and Brig and based on the collected experience. This establishes security. “I felt that I was in good hands, right from the outset,” says Adrian Tschannen. Both he and Reinhild Werlen-Walpen are enjoying their new lease on life: “It is simply marvelous to be able to move normally again.”

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The Hip’s Enemies: Arthritis and Other Diseases

There are many reasons why a hip can cause pain. Most of the time it is arthritis, the age-related wear of the protective cartilage in the femoral head and acetabulum that is responsible. Advanced cartilage wear leads to the two bones rubbing against each other with no protection. Walking will then cause pain. Other causes of hip destruction include rheumatic and metabolic diseases, inflammations, congenital deformities and injuries from accidents such as fractures. Permanent damage to the hip can be remedied by implanting an artificial hip joint.

This is How an Artificial Hip Works

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An artificial hip is implanted when conservative methods to treat hip joint disease are no longer effective. On the femur side, an artificial hip consists of a shaft with a ceramic or metal head at its end. This is inserted into the previously prepared bone. A hip socket is implanted on the side of the pelvis. An inlay is pressed into this socket, enclosing the head and providing a surface for it to slide on. The materials used are ceramic and highly cross-linked polyethylene, a plastic that exhibits very low wear compared to the materials used in the past. Nowadays, implanting an artificial hip is a minimally invasive procedure that typically takes one to one and a half hours.

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Surgical Procedure Manager: Digitally Controlled Workflow in the Operating Theater

The Surgical Procedure Manager (SPM) is a digitally controlled workflow that helps surgeons and the surgical team to establish optimal medical standards. This platform allows the development, digitalization and performance of medical procedures. Every step taken during the operation is illustrated and documented on a chronological basis. This guided procedure ensures that human error is avoided and guarantees the highest quality standards. Another benefit is that medical staff new to the team can use the SPM for information and guidance and to quickly familiarize themselves with the work routine. Recorded data makes it possible to measure the quality of treatment, allowing continuous optimization that shortens the processes. All of this makes the surgical interventions more cost-effective and safer at the same time – for both the patients and the hospital.

What is a Herniated Disc?

Pain in the lower lumbar region is the most common back pain. Very often it occurs due to degenerated discs. These cartilaginous “shock absorbers” between the vertebrae ensure that the latter do not rub against each other. Over time, it can lead to pain if they are worn or damaged by injury or disease. If the disc material then leaks out or if it tears, this is called a herniated disc. Damaged spinal discs can press against nerves or the spinal cord, which may lead to stabbing pain all the way down to the legs, or it can cause muscle cramps and numbness.
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This is how spinal surgery works

When conventional methods such as physical therapy and pain medication no longer alleviate the pain, spinal surgery may be the answer.
A range of options is available, depending on the diagnosis:
  • In spinal fusion a material, known as bone graft, is inserted between the vertebrae. It is intended to stimulate the body to grow new bone and fuse the vertebrae. Other devices, such as small screws, plates, bars and a space holder – referred to as a cage in medical terminology – support the spine, while the bones are fusing. Most of the time, the procedure is minimally invasive and lateral, i.e., it is performed through a small cut on the side.
  • A discectomy means removing the entire disc or a part of it to relieve the pressure on the nerves.
  • Disc replacement means implanting an artificial disc to replace a degenerated one.
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Digitally controlled interventions, minimally invasive operating methods and a consistently implemented treatment regimen: cutting-edge methods have made hip replacement operations both safer and more efficient.