Seattle Startup Aims to Change Surgery Using AI, Computer Vision, and Augmented Reality – GeekWire

Seattle Startup Aims to Change Surgery Using AI, Computer Vision, and Augmented Reality – GeekWire

Proprio’s medical director and co-founding surgeon Sam Browd using the Paradigm system. The screen shows an image of a vertebra. (Own image)

At a former Boeing manufacturing plant near the Seattle waterfront, a six-year-old startup is preparing a system that it says will change surgery.

Proprio’s technology allows surgeons to view key structures on a three-dimensional screen in real time. The system helps doctors make incisions and guide the placement of hardware, such as devices that can help straighten the spine.

The name “Proprio” is a pun on the word “proprioception,” the body’s ability to sense its own position in space, CEO and co-founder Gabriel Jones said during a recent tour of the company’s headquarters.

“For surgeons, that’s incredibly important,” he said. “They need to understand how anatomy and biology react, how they can treat it.”

The company, Jones said, “is all about improving what clinicians can do.”

Proprio has submitted its marketing application to the US Food and Drug Administration and expects approval of the system, called Paradigm, in early 2023. Multiple clinical sites at medical institutions are ready to start using the product if the FDA gives it the green light. and commercial launch is expected to follow, Jones said.

The system has been tested primarily for spinal and cranial surgery, some of the largest sources of revenue for hospital systems and a target market for Proprio.

Paradigm captures high-definition images of the operative field from above and fuses them with images from preoperative 3D scans. The system is based on advances in light field imaging, computer vision, machine learning, robotics, and augmented reality.

The surgeon can view the relevant anatomy in three dimensions on one screen, including parts that are difficult or impossible to see with the naked eye. The generated images can also adapt to changes in position in the anatomy, changing in real time.

The company, a spin-out from the University of Washington, has not released its data, making it difficult for outside researchers to evaluate the product. And established competitors like medical device giant Medtronic have some similar capabilities.

But other systems don’t offer the full range of features that Proprio promises, said Matthew Scott-Young, a surgeon at Gold Coast Spine in Queensland, Australia, and past president of the Spine Society of Australia.

Artificial intelligence, combined with augmented reality and virtual reality systems, can enable integration with advanced imaging methods such as CT scans, MRIs, ultrasounds and X-rays, said Scott-Young, who is not affiliated with the startup.

“Other companies just bundle some of these features into a single platform, so Proprio is possibly a game changer,” Scott-Young said. Proprio, he said, “combines all the good things together.”

The CEO of Propio, Gabriel Jones, at the company’s headquarters in Seattle. (Photo GeekWire/Charlotte Schubert)

Other Proprio co-founders include Samuel Browd, a neurosurgeon at Seattle Children’s who co-founded the high-tech sports helmet maker Vicis; University of Washington professor Joshua Smith, who directs the UW Sensor Systems Laboratory; technology executive and investor Kenneth Denman; and machine vision expert James Youngquist, who leads the startup’s R&D.

Proprio’s technology partners include Intel, HTC, NVIDIA, Samsung, and the Paul G. Allen School of Computer Science at the University of Washington.

David Fiorella, the team’s product manager, showed GeekWire how changes in the position of a vertebra in a model are recorded as a three-dimensional image. The system’s 3D sensing capability enables precise placement of surgical implants, including screws for spinal fusion surgery.

Paradigm also allows for the visualization of multiple vertebrae and measures their position relative to one another, functionality that should help surgeons with the difficult task of accurately placing spinal rods while aligning multiple vertebrae. The system also helps to minimize the repeat X-rays that such surgeries often require.

“The doctor is expected to squeeze and manipulate the spine to achieve healthy alignment,” Jones said. “That’s not an A to B type of stage. It’s curved in space.”

These types of complex surgeries today often use systems, including one made by Medtronic, that require the temporary use of an external device placed on the body to help guide correct positioning during procedures. The systems are slow, static, expensive and expose the surgeon and patient to ionizing radiation, Jones said.

Paradigm has the potential to supplant such systems, which are sold to hospitals and healthcare systems and are used in about 30% of surgeries, Jones said. Ultimately, Paradigm may be useful for an even broader swath of surgery.

Christopher Shaffrey, chief of spine surgery at Duke University and a member of Proprio’s medical advisory board, told GeekWire that the Paradigm could take over the role of several other devices in the operating room, adding that it would make their work more efficient. . He anticipates that the Proprio Paradigm will be widely adopted by surgeons.

The Paradigm system. (Own Photo)

Proprio collects data through its healthcare partners and surgeons at UW Medicine, Seattle Children’s and elsewhere, who have compared how Paradigm visualizes operations compared to existing systems. Paradigm has also been tested on cadavers and other surgical models.

The company’s on-site operating room includes audio recording devices and cameras built into the entire ceiling to capture a complete view of the procedure. Jones calls it a “batcave for surgery.”

“Data drives everything,” Jones said. “We collected everything from the surgery.”

Proprio’s studies, which have not yet been made public, focus on usability, accuracy, and precision, such as the ability to guide hardware like a screw to the proper location. Jones said the data shows the technology has the potential to increase precision, decrease complications and revisions, reduce radiation exposure and reduce operating room time.

“Better, faster, safer is what we tend to focus on,” Jones said.

Like many in the medical field, a personal experience drew Jones to the area. When he was young, his best friend passed away from a brain tumor and the boy’s neurosurgeon father couldn’t save him.

Jones co-founded Proprio in 2016, leaving his previous position at consultancy Intentional Futures, where he helped clients like Bill Gates assess emerging technologies.

The company has raised $42.1 million and employs 51 medical device and software engineers, machine learning experts, and marketing professionals.

The company’s engineering leadership includes Neeraj Mainkar, formerly vice president of software engineering at robotics company Vicarious Surgical, and Shannon Eubanks, an alumnus of SonoSite, Bayer HealthCare and Seattle startup Magnolia Medical Technologies.

A circuit board sports the Proprio logo in the custom-designed company font. (Photo GeekWire/Charlotte Schubert)

Jones is meticulous about the product, and his team members are strict about design and detail. The Proprio logo uses the same colors as a well-known surgery textbook, and the angles of curvature of the Paradigm components mirror each other. Even the Proprio font is custom designed.

“The details really matter in the system, its features, design and execution, for our team and our client,” Jones said.

The team is also developing its ability to review surgical procedures from visual and audio data, such as a surgeon’s command to provide a screw and noting it. Such an automated review system can also support medical coding of procedures to facilitate reimbursement, adding value to the client.

“The quality, depth and richness of the data is likely to drive better surgical performance,” Jones said.

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