Annual Meeting Innovator of the Year

The Vivistim device is implanted in stroke survivors by neurosurgeons, enabling therapists to use a wireless remote that communicates with the device to pair vagus nerve stimulation (VNS) with high-repetition, goal-oriented functional activities to increase neuroplasticity. This in-clinic Paired VNS Therapy is complemented by self-initiated Vivistim Therapy, which allows stroke survivors to swipe a magnet across the implant to activate vagus nerve stimulation while doing daily activities at home or in the community. MicroTransponder is changing the status quo in the stroke continuum of care, helping neurologists address stroke recovery beyond the acute crisis.

NousNav: an open-source low-cost navigation system for low and middle income countries

Contemporary intracranial surgery in advanced medical systems benefits significantly from the widespread adoption of neuronavigation technology. However, for many patients globally, this technology remains inaccessible due to the high cost and complexity of commercial neuronavigation systems. Dr. Alexandra Golby has developed an innovative low-cost, open-source neuro-navigation system–NousNav– designed specifically for use in lower resource settings in order to democratize access to advanced medical technology. NousNav addresses this disparity by providing neurosurgeons worldwide with an affordable, fully functional neuro-navigation system. NousNav also incorporates an integrated training program. The system is entirely open-source and utilizes low-cost, off-the-shelf components, making it easy to reproduce and deploy in any region. Key components include a 3D motion capture camera and a moderately specified laptop running custom software. Custom pointer and reference array components were designed to be easy and inexpensive to manufacture, while other hardware components are sourced from low-cost consumer photographic equipment. The total cost for all hardware components is less than $5000. NousNav’s software is built on 3DSlicer, an open-source widely-used image analysis platform. It features a user-friendly interface designed to guide clinicians through the pre-operative and intra-operative steps necessary for planning and executing a surgical approach. The clean and simple user interface allows for intuitive intra-operative use by either the practicing clinician or support personnel in the operating room, eliminating the need for a dedicated technician. NousNav prototypes have been built and distributed by Dr. Golby to collaborators in Rwanda, Senegal, Ethiopia, and more.

Surgical technical skills are critical, particularly in high-stakes interventions like neurosurgery, where errors can have detrimental effects on patient outcomes and lead to significant cost burdens on healthcare systems. Surgical simulations record vast amounts of data which allows a granular and accurate assessment of surgical skills. Our innovation involves a real-time artificial intelligence application that utilizes surgical performance data obtained from virtual reality simulations. Six parallel algorithms make decisions five times per second, enabling not only the evaluation of surgical performance but also assistance with instrument utilization and the identification of risks related to bleeding and tissue injury. This system learned expert-level performance from 14 neurosurgeons who performed brain tumor resections 83 times. The validation of this innovative system was provided on neurosurgical trainee performance. It successfully differentiated trainees based on their bimanual skills on a brain tumor resection task and determined their year in their program (published in npj digital medicine, Yilmaz et. al., 2022). Furthermore, a randomized controlled trial has shown that students taught by this system learn brain tumor resection faster compared to those instructed by human instructors (manuscript is in preparation). This innovation enables a comprehensive application to assist expert surgeons or teach trainees. As the data recording methodologies are being developed, the future of our system will involve integration into real surgical operating rooms to assist the surgeon to enhance safety. A related patent application was made with collaboration with McGill University, Canada, patent application number: WO2022077109A1.

In a collaboration between mechanical engineering and the department of neurosurgery at the University of Utah, we have developed a motorized cervical traction device to overcome limitations inherent to weight and pulley closed cervical traction which incorporates load sensing and recording, 1 lb weight accuracy, low unit profile, multiple degrees of freedom, and locking non-backdrivable actuators.

Based in Seattle, Proprio is developing a new type of surgical imaging and navigation system that extends the surgeon’s vision using real-time three-dimensional rendering of anatomical data. The Proprio system integrates recent advancements in robotics, computer vision, and graphics processing to enable surgeons to see and interact with patients as never before, reduce the complexity of surgical procedures, and create a valuable new visual data set to enhance medical training and drive healthcare innovation. Proprio is an interdisciplinary team of top surgeons, computer vision and robotics engineers, medical device leaders, and video game designers. Designed for use before, during, and after surgical procedures, the Proprio system is the first to use computational imaging to help surgeons visualize and navigate the most critical and high-risk moments of a case. Proprio generates a 360-degree, 3D immersive image of the surgical field. Surgeons can use a head-mounted display to extend their visual field, enabling them to zoom through tissue and around corners, navigating freely and fluidly while they operate. Most importantly, in the extended reality display surgeons can perform without ever taking their eyes off their patients. Beyond the operating room, Proprio’s vision is to enable world-class surgeons to impart their lifetimes of accumulated expertise to the next generation of practitioners in a way that has never been possible before. Imagine stepping into the shoes of a surgical luminary and experiencing an immersive replay of their expertise from any angle. The team developed Proprio’s core technology and immersive interface working side-by-side with surgeons to understand how they work, the obstacles they face in the operating room, and the tools they need to be more successful. The team’s user-led approach gave them new insights into operating room workflow and inspired them to create a completely new model for surgical visualization. One of the biggest challenges for AI in surgery, including orthopedics, is that the companies that currently build equipment and devices are not built to fully take advantage of the technology. Throwing AI at an existing database of healthcare data can only succeed to a very limited extent. Data systems also must be designed, just like a great product. To build a truly AI-driven company in medicine, you must build the company as a hybrid of the very best technical talent and the best medical device talent. We think that is a core difference in what is being done at Proprio compared to the rest of the industry. This technology will be the future of healthcare – leveraging both the minds of humans and computers to perform surgery and enhance the capabilities of the surgeons themselves. Proprio wants to put the focus back on the patient and eliminate any nuances that come with outdated surgical processes. In life-or-death moments, this technology can remove previous limitations and shift patient outcomes for the better. Surgical navigation using the Proprio system promises greater accuracy and efficiency compared to currently available systems, while capturing a unique dataset that will enhance surgical training and quality of care metrics. https://vimeo.com/570110147