Text written in Basque and translated automatically by Elia without any subsequent editing. SEE ORIGINAL

[Guided surgery]

Similar to the GPS used to know where to go on the roads, there are also navigation systems for operations in medicine. The mode of operation using this technology is called navigational surgery, a device that guides all the steps and movements of the surgeon.

We'll be in the operating room in a few minutes. We'll be in a traumatology operation to see how navigational surgery works. A hip prosthesis will be installed with the help of this technology. In any case, we want to warn you that some of the images you will see are raw.

IÑAKI MINGUEZ, Traumatology XXI: We need to place a hip prosthesis with the help of a navigation system. This system will tell us what steps we need to take.

As a GPS does, the system will tell the surgeon where to proceed. To do that, you need these elements, these balls. They are devices or sensors that operate by infrared rays and measure position and distance.

IÑAKI MINGUEZ, Traumatology XXI: These are the devices and this is the stylus again, we have placed other devices in the pelvis and also in the femur. We've covered them to protect them.

Taking precautions is the first step to start navigating. Anatomical parameters are collected with the pointer pen. Here, the volume of the pelvic orifice is being measured.

IÑAKI MINGUEZ, Traumatology XXI: The browser identifies the problem or defect of the patient and the system will tell you how to correct it.

IÑAKI MINGUEZ, Traumatology XXI: We have information about the pelvis and how the hole should be. Come on, let's go.

IÑAKI MINGUEZ, Traumatology XXI: The devices are placed in different places; in this case, in the pelvis and femur. If it was a knee operation, we'd put it in the vertebral bone. What they do is interpret the shape of the bone. The device is also incorporated in all the instruments that we use during the operation, for example in the pencil for taking measurements.

The human eye could cause a five- to six-millimeter error in the placement of a prosthesis. Following the instructions of the browser, the error will be limited to a maximum of one millimeter. Apparently it is not a big difference, but the consequences of this small difference can be very important: the fluctuation of a few millimeters could cause the prosthesis to move and have to be repositioned after a few years.

IÑAKI MINGUEZ, Traumatology XXI: As with a car part, if a screw is not tightened properly, it can be loosened over the years.

In the past, years of experience guaranteed such a level of precision. However, the human factor remains valid.

IÑAKI MINGUEZ, Traumatology XXI: It's expressing inclination and anteversion or retroversion, and it's right. It matches the human eye, which is what I see.

Now we need to place the first part of the prosthesis. The test is always done before... yes, it will suit you well. We'll put the final piece in the pelvis.

A dome-shaped element made of alloys of various metals is placed in the pelvis. The white material carried on it is hydroxyapatite. Hydroxyapatite is a biological adhesive that binds to the patient's bone and fixes the piece completely to the hip.

IÑAKI MINGUEZ, Traumatology XXI: Well, we've put it on. We'll see it in the femur now. He's given us the green light, so we'll move on.

The femur is like a tube into which we must insert the thigh part of the prosthesis. So we're going to make a hole.

He's telling us how we're doing. We're going well. The 4 you see up there means we've stretched his leg four millimeters. As a result of arthrosis, the patient had dysmetria, one leg was shorter than the other.

The connecting element between the pelvis and the femur is made of polyethylene. Now it is necessary to place the prosthetic element that runs on the femur.

IÑAKI MINGUEZ, Traumatology XXI: This is the difference in the femur. We've made a gap of the right size... it'll fit right in. There he goes. That's it. That's it. It's in its place. We’ll fix it a little.

Give it to OKeia..., yes... it is correct; the navigator has told us so. Now we're going to complete the prosthesis.

Navigational surgery began during brain operations. In traumatology, it is used for the placement of prostheses, mostly of the hip and knees, and, looking forward, it is also being extended to other fields.

IÑAKI MINGUEZ, Traumatology XXI: Soon we are going to use cruciate ligament clamps and also in certain bone fractures, for example for the placement of a screw.

IÑAKI MINGUEZ, Traumatology XXI: With the final piece on the femur, it is necessary to place the part that carries it at the end, this ceramic ball that comes in contact with the polyethylene inside the dome. All right, let's go! The system says that the prosthesis will not come out of place and is stable. This has been everything. Disassemble, close and you’re done.