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Best and Brightest of Augmented Reality in Surgery - November 2023

While augmented reality for consumer adoption might be a decade or so away (for hardware cost and capability reasons) the XR industry points to enterprise and training as one of the early places where this technology will justify its development and hardware price tag. Augmented reality in healthcare - specifically, for use during surgery inside operating rooms - is one of the most exciting frontiers of AR and AI innovation. Below, we will discuss some of the most impactful companies and products in augmented reality and surgery.

1.) Augmedics: AR Surgical Assistance

Augmedics is a medical technology company that was founded in Israel and is on the cutting-edge of AR headset-based surgical assistance. The company originally used its AR headset products for training on cadavers. However, Augmedics recently earned U.S. FDA clearance in 2019 for their xvision spine system. Augmedics xvision spine system makes use of a custom proprietary headset (see picture 1) and optical markers to achieve a “99.1% overall percutaneous screw placement accuracy, eliminates the attention shift of referring to a separate screen and adds these features to potentially decreasing the radiation exposure demonstrated through traditional fluoroscopy-based procedures.“ In 2023, Augmedics raised $82.5 million in funding through a Series D round led by CPMG. H.I.G. Capital, Revival Healthcare Capital, and Almeda Ventures also participated in this funding round.

2.) Neo Medical: Swiss-based AR/AI Platform

Neo Medical, Swiss-based AR/AI Platform for Surgery

Neo Medical is a global medical technology company that primarily focuses on creating products that improve spinal surgery. The company is based in Switzerland. Neo Medical has developed a virtual platform called ADVISE that is designed to provide surgeons with real-time intraoperative augmented visibility. ADVISE stands for “Advanced Dynamic Visualization of Intraoperative Spinal Equilibrium.” The ADVISE platform is supported by augmented reality and enables personalized spine surgical treatments for each patient operated on with the system. ADVISE will complement NEO Medical’s earlier platform of optimized instruments and implants. The company’s goal is to create an integrated ecosystem that dramatically improves spinal surgery. In 2022, Neo Medical closed a $20.6 million funding round. Swisscomm Ventures was the lead investor in this funding round.

3.) eXpanded eXistence: Reducing Errors during Surgery with Augmented Reality

eXpanded eXistence is a U.S.-based medical technology company that has created a highly innovative AI surgical platform. This surgical platform uses artificial intelligence, mixed reality headsets, and tablets.

The goal of eXpanded eXistence’s surgical platform is to significantly reduce errors and minimize waste in operating rooms around the world. eXpanded eXistence’s surgical platform has already been used in over 250 surgeries with extremely impressive results.

There are two main modes for the eXpanded eXistence platform. The first is Viewer X, which allows users to view surgical preference card data from outside the sterile field. The second is Experience X in which the surgeon accesses the procedural data from the AI via the mixed reality headset using hand-tracking, allowing it to be used even in the sterile field during a procedure.

4.) Medivis: SurgicalAR

Medivis is based in New York City in the United States. It was founded by engineers and physicians in 2016. This augmented reality development company has several AR-based medical technology products. One is called SurgicalAR, which is a surgical imaging platform. Medivis’s SurgicalAR PRO workstation has integrated hardware that enables holographic rendering of all patient-specific data. SurgicalAR has been deployed at over 40 hospitals and medical schools. SurgicalAR is helping surgeons to visualize and perform complex procedures. Medivis’s SurgicalAR platform is FDA-cleared.

Spatial Computing to Power Anatomy Education

In addition to SurgicalAR, Medivis also offers AnatomyX. AnatomyX is an augmented reality and spatial computing software designed to help students, instructors, and administrators to study anatomy, physiology, and pathology. AnatomyX has over 5,000 anatomic models and over 2,000 active users. It has also been deployed at over 40 institutions. In 2023, Medivis completed a Series A funding round which raised $20 million. This funding round was led by Thrive Capital. A number of other institutions and individuals participated in this funding round including Initialized Capital, the Mayo Clinic, Kevin Durant, Bob Iger, Dr. Robert Spetzler, Hugo Berra, and Coalition Operators.

5.) Surgical Theater: Immersive 360-Degree Views of Patient Data

Surgical Theater is a U.S.-based company that offers powerful AR-based visualization products that enable surgeons to view 360-degree 3-dimensional views of patient data. The company’s two primary products are SyncAR Spine, and SyncAR Cranial. SyncAR Spine gives surgeons an immersive view of the spine via Surgical Theater 360-degree 3D XR models. Surgeons wear AR headsets to see the images. SyncAR Cranial also provides immersive 360-degree 3D views of patient data. However, the images are integrated with Medtronic StealthStation S8 and optics to deliver an AR overlay that directs microscope oculars. SyncAR Cranial allows surgeons to see around, behind, and even through anatomy. It allows surgeons to see highly detailed 360-degree images of critical structures in real-time. In 2015, Surgical Theater completed a $9 million Series A funding round. Smartphone maker HTC was the lead investor in this funding round. HTC also collaborated with Surgical Theater on the development of its products. Surgical Theater has received FDA clearance for some of its earlier products such as its Surgical Navigation Advanced Platform (SNAP) product in 2013.

6.) Novarad: VisAR to Empower Safer, More Effective Surgeries

Novarad is an American medical technology company that is helping to make surgeries safer and more effective through its advanced augmented reality (AR) products. The company’s primary AR product is VisAR, which is an augmented-reality surgical navigation tool. VisAR is a headset that is worn by the surgeon during surgery. The headset display superimposes 2 or 3D images over the patient’s body during the operation. The headset also has precise instrument tracking that is +/- 1mm in accuracy. VisAR only requires a 2-minute setup in the operating room, and it provides a dramatically increased level of precision for surgeons. It provides navigational views and an integrated targeting system. The VisAR is FDA-cleared.

7.) Surglasses Taiwan “Caduceus S” AR Spine Navigation System

Surglasses is a Taiwan-based biotechnology company that also goes by the name Taiwan Main Orthopedic Biotechnology Company. Surglasses has several augmented reality products aimed to help with surgery including Caduceus S. Caduceus S is an augmented reality spine navigation system. This product is a headset that the surgeon wears during surgery. During the operation, the device projects the real-time augmented reality of the surgical navigation screen in front of the surgeon’s eyes. The device is capable of locating the distance, direction, and angle of the lesion with an accuracy level of 2mm. The Caduceus S has 510(k) FDA clearance. It is Taiwan’s first AR spine surgery navigation system to obtain a TFDA Class II medical device license.

This device can be set up and ready for use in about ten minutes. It also only requires about 2-4 x-ray images to be taken which allows for an extremely low exposure to radiation. Surglasses also has another AR product called Foresee-X. Foresee-X is a smart augmented reality surgical glasses display system. This device can connect to various X-ray machines, 2D and 3D laparoscopes, and specialized endoscopes. These glasses project medical imaging in real-time to assist surgeons and allow them to focus directly on the surgical area. Surglasses is in the process of obtaining EU and CE Certification and Taiwan TFDA Class II Medical Device Market Clearance.

8.) Cydar Medical: Create a 3D Soft Tissue Map with Cydar EV Maps

Cydar Medical creates 3D soft tissue map

Cydar Medical is a developer of augmented reality (AR) medical products that is based in Cambridge, UK. The company was founded in 2012, and its flagship product is Cydar EV Maps. This product creates a patient-specific three-dimensional map of soft tissue. This map updates in real time which allows for the optimization of procedure planning and intraoperative navigation in addition to the assessment of outcomes. The goal of this product is to make minimally invasive, endovascular surgeries easier, faster, and smarter.

In 2023, Cydar Medical completed an $11.5 million Series A funding round that was led by Pembroke VCT who made an investment of $3.7 million. Downing Healthcare Ventures also made a significant contribution to this funding round. Cydar has also successfully established partnerships with Medtronic and Brainlab. Cydar EV Maps has been installed in 50 medical centers across the US, UK, and EU. The first patients have also already been enrolled in clinical studies to evaluate Cydar’s EV Maps product. Cydar is also planning to expand the product so that it can be used for a variety of minimally invasive surgical procedures instead of just endovascular procedures. Cydar Maps has FDA 510(k) clearance as software as a medical device.

9.) Proprio Vision: Surgical Navigation to Boost Patient Outcomes

Proprio Vision, augmented reality surgical navigation

Proprio is a six-year-old medical technology startup that is located in a former Boeing manufacturing facility near Seattle’s waterfront in Washington, USA. Proprio’s main product is a surgical navigation system called Paradigm. Paradigm uses Volumetric Intelligence™ technology to create a 3D view of the patient’s anatomy and the surgical space. Proprio uses a PRISM™ array to capture high-definition, multi-modal images with “light-field technology.” This system does not expose the patient or the doctor to harmful radiation and the information is shown on a mixed-reality display on a computer screen. The Paradigm system provides critical information through preoperative imaging and planning and intraoperative performance data.

The goal of this computer-assisted navigation product for spine surgery is to increase implant accuracy, decrease the likelihood of revisions, decrease complications, decrease OR time, and decrease radiation exposure for patients, surgeons, and OR staff. The Paradigm system has received 510(k) FDA clearance. This product is the first to use light-field technology in a spine surgery navigation system. Proprio has a number of technology partners including HTC, Intel, NVIDIA, Samsung, and the Paul G. Allen School of Computer Science at the University of Washington. Proprio completed a Series B funding round in 2023 that saw the company raise $43 million.

10.) Brainlab - Mixed Reality Viewer Empowers Physician Collaboration

Brainlab is a health technology company headquartered in Munich, Germany. This company has a product called “Mixed Reality Viewer.” This product uses a combination of Mixed Reality Viewer software and dedicated viewing hardware. This product allows images to be transported from Elements Viewer software onscreen into the room in front of doctors with the assistance of the Magic Leap spatial computing platform. With this technology, patient data can be displayed in 3D in the room - it is not limited to the size of a screen. Once the data is displayed, doctors can walk around the images and even resize and move them to view the anatomical data from all angles. Multiple doctors can view the same data to analyze the case and create a treatment or surgery plan. In 2023, Brainlab received a €50 million loan from the European Investment Bank (EIB).

11.) DeGen Medical - DeGen XR Supports Provider Training and Patient Education

DeGen Medical Inc. is a medical device company that is based in South Carolina in the United States. This company has a product called DeGen XR, which is a proprietary augmented reality platform for healthcare provider training and patient education. This system displays data to users in a 4-dimensional space. It does this by incorporating surgical animations, pathology models, and neurological sensory models. This product is not intended for diagnostic use.

Anatomical data is viewed through a mixed reality headset. DeGen XR will enable surgeons to give their patients a much more comprehensive understanding of their pathologies. Patients will not be limited to looking at 2 dimensional images or resin spine models to understand key information about their anatomy. The DeGen XR product allows physicians to show skeletal anatomy and nerve elements to patients, family members, and other healthcare providers in a much more detailed way. This is beneficial for helping all parties involved to fully understand the pathology and the medical interventions that will take place .

12.) Medacta - NextAR Platform Provides Surgeons with Real-Time Instrument Guidance

Medacta is a company that specializes in the design, production, and distribution of orthopedic products and accompanying surgical techniques. The company was founded in 1999 and is based in Castel San Pietro, Switzerland. Medacta has a highly innovative product called NextAR. This product is a next-generation augmented reality surgical platform. The NextAR platform uses advanced 3D planning tools, an integrated single-use tracking system, a revolutionary compact, and augmented reality to enable data-driven decision-making. This gives the surgeon the power to make personalized adjustments during surgery based on the patient’s specific anatomy. To use the product, the surgeon wears the NextAR Smart Glasses. Then, images are superimposed on the operative field of view. The NextAR Tracking System provides real-time instrument guidance and accurate implant positioning. The NextAR platform has received FDA clearance in the United States.

13.) OnPoint Surgical - Improving Surgical Accuracy

Onpoint Surgical is a medical technology company that is based in Bedford, Massachusetts in the United States. The company has a revolutionary AR platform that is designed to help with orthopedic and neurosurgical spinal procedures. With the Onpoint Surgical platform, virtual surgical guides and virtual spinal implants are superimposed onto the surgeon’s visual field. See-through optical head-mounted displays are used to accomplish this. The Onpoint Surgical AR platform was created to improve hand-eye coordination and surgical accuracy in order to create better operative outcomes. OnPoint Surgical has received 510(k) FDA clearance for its Augmented Reality Spine System.

14.) Orcana - MARS, Multi-User Augmented Reality System

Orcana is a San-Francisco-based company that builds AR products to assist with surgery to make operations more efficient and safe. The company’s main product is called Orcana MARS. MARS stands for “Multi-User Augmented Reality System.” This product allows surgeons to view imaging without looking away from the platform. It also ensures optimal hand-eye coordination which gives surgeons the power to guide surgical instruments with an extremely high level of accuracy during operation. Further, MARS also allows for real-time shared vision, multi-angle situational awareness, and live surgical collaboration. Orcana received $100,000 in pre-seed funding from Softeq Development in 2021.

15.) Surgalign Purchased by Augmedics

Surgalign is a medical technology company that was based in the United States. Recently, Surgalign went bankrupt. However, in 2023, its assets were purchased by Augmedics for $900,000 in cash. Among these assets was Surgalign’s HOLO Portal. HOLO Portal is an AI-driven augmented reality surgical navigation system. HOLO Portal allows for image-guided navigation of a patient’s spine. This patented technology allows the surgeon to see a 3D overlay of the patient’s anatomy. Additionally, the trajectory and 3D targeting are superimposed on surgical instruments in real-time. Now that Augmedics has purchased this technology, it will add it to its suite of AR medical products. Augmedics’ purchase of Surgalign’s technology makes the company even more of a force to be reckoned with in the augmented reality medical device industry. Augmedics is currently based in Chicago despite being founded in Israel.

What’s Next for Augmented Reality in Surgery?

We’re seeing brilliant innovation in the medical technology field every month, coming from the clients we work with and AR development companies in the field. We have a passion for helping healthcare professionals improve both their lives and the lives of their patients with the power of augmented reality. If you have a project that you’d like to discuss, we’d love to hear from you.


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