Seattle startup aims to transform surgery with AI, computer vision, and augmented reality – GeekWire

Proprio Chief Medical Officer and co-founding surgeon Sam Browd using the Paradigm System. The screen shows a paragraph image. (photo fitting)

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

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

CEO and co-founder Gabriel Jones said the name “Proprio” is a play on the word “proprioception,” meaning the body’s ability to sense its position in space.

“For surgeons, this is very important,” he said. “They need to understand how anatomy and biology interact, and how they can address it.”

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

Proprio has submitted its marketing application to the FDA and expects to receive authorization for the system, called Paradigm, in early 2023. Multiple clinical sites at medical institutions are preparing to begin use of the product if the FDA gives it the green light, and a commercial launch is expected, he said. Jones.

The system has been tested primarily for spine and craniofacial surgery, which are two of the biggest revenue streams for hospital systems and a target market for Proprio.

A model that takes high-resolution images of the operating field from above and combines them with preoperative 3D scans. The system builds on advances in light field imaging, computer vision, machine learning, robotics, and augmented reality.

The surgeon can see the relevant anatomy in three dimensions on the screen, including parts that are difficult or impossible to see with the eye alone. The images created can also adapt to location changes in the anatomy, and change in real time.

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

Matthew Scott Young, a surgeon at Gold Coast Spine in Queensland, Australia, and former president of the Spine Society of Australia, said other systems don’t deliver the full range of functionality Proprio promises.

Scott Young, who is not affiliated with the startup, said AI, along with augmented reality and virtual reality systems, could allow integration with advanced imaging modalities such as CT scans, MRI scans, ultrasounds and X-rays.

“Other companies are bundling some of these features into just one platform, which is why Proprio could be a game-changer,” said Scott Young. “It brings all the good things together,” Proprio said.

Propio CEO Gabriel Jones at the company’s Seattle headquarters. (Photo by GeekWire/Charlotte Schubert)

Other Proprio founders include Samuel Braude, a Seattle pediatric neurosurgeon who co-founded high-tech sports helmet maker Vicis. University of Washington Professor Joshua Smith, who leads the Sensor Systems Laboratory at the University of Washington. CEO and technology investor Kenneth Denman; and computer vision expert James Youngquist, who heads research and development for the startup.

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

David Fiorella, product manager on the team, showed GeekWire how to change the position of a paragraph in a model recorded as a 3D image. The system’s 3D sensing capability enables precise placement of surgical implants, including spinal fusion surgery screws.

The model also enables visualization of multiple vertebrae and measures their position relative to one another – a function that should aid surgeons in the difficult task of precisely positioning the spinal rods while aligning multiple vertebrae. The system also helps reduce the repeated x-rays that such surgeries often require.

“The doctor is expected to twist and manipulate the spine into a healthy alignment,” Jones said. “This is not an A-to-B scenario. It’s curved in space.”

Such complex surgeries currently often use systems, including those made by Medtronic, that require the temporary use of an external device placed in the body to help guide the correct position during procedures. Jones said the systems are slow, static, expensive, and expose the surgeon and patient to ionizing radiation.

Jones said Paradigm has the potential to replace such systems, which are sold to hospitals and health systems and are used in about 30% of surgeries. Ultimately, the model may be useful in a broader range of surgery.

Christopher Chaffery, 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 many other devices in the operating room, adding that it would make his job more efficient. He expects the Proprio model to be widely adopted by surgeons.

form system. (photo proprio)

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

The company’s on-site operating room includes audio recorders and cameras built throughout the ceiling to capture a full view of the procedure. Jones calls it the “surgery bat cave.”

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

Proprio’s ratings center around usability, accuracy, and accuracy, such as the ability to drive hardware like a screw into the appropriate location. Jones said the unpublished data shows the technology has the potential to increase accuracy, reduce complications and revisions, reduce radiation exposure, and reduce operating room time.

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

Like many in the medical field, Jones was drawn to the area by personal experience. When he was young, his best friend died of a brain tumor, and the child’s neurosurgeon father was powerless to save him.

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

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

The company’s engineering leadership includes Neeraj Menkar, former vice president of software engineering at robotics company Vicarious Surgical, and Shannon Eubanks, a SonoSite, Bayer HealthCare and Magnolia Medical Technologies company in Seattle.

Circuit board with Proprio logo in specially designed company font. (Photo by GeekWire/Charlotte Schubert)

Jones is meticulous about the product, and his team members stick with design and detail. The Proprio logo uses the same colors as the well-known surgery textbook, and the angles of curvature of the model’s components mirror each other. Even the Proprio font is tailor-made.

“The details are really important in a system—its functionality, its design, and its implementation—for our team and our customer,” said Jones.

The team is also building its ability to review surgical procedures from visual and audio data, such as the surgeon’s command to provide and hold the screw. This 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 lead to better surgical performance,” Jones said.

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