This Startup Wants to Use the Apple Vision Pro for the Most Boring Part of Surgery

This story is part of our Chief Innovation Officer Forecast series with Quartz, a business report from the front lines of the future.

Earlier this month, a British hospital made headlines with the first surgery ever carried out with the assistance of an Apple Vision Pro, a $3,500 mixed reality headset. The nurses wearing Apple’s fancy goggles in the operating room were running software built by a company called eXeX. When you hear about a VR headset in surgery, it probably brings to mind floating 3D body parts or a display that tells doctors exactly where to place the scalpel. That’s not eXeX’s business. Instead, the company’s building tools for something that seems much more boring, at least at first: helping surgeons stay organized.

“People assume that surgical healthcare has got to be sophisticated and modern. The reality is the way we organize it is probably the most archaic of all the major industries on the planet,” said Robert Masson, MD, a practicing neurosurgeon and CEO of eXeX. “It’s all memorization and guesswork with scribbles on pieces of paper. It’s total chaos theory.”

According to Masson, surgical care is stuck in the distant past, with all of the work going towards groundbreaking treatments, but almost no focus on the most basic foundational standards that keep the process moving. It’s the little things: eXeX is setting up the surgery room, helping nurses keep track of which tools the doctor needs and when, and keeping documents organized. Streamlining these processes could amount to a revolution in healthcare, a revolution that is going to make someone a lot of money if they can develop a widely adopted platform.

Outside of the surgical process, eXeX’s main product runs on a table. But when the scrubs go on, a headset could be the ideal tool. We talked to Masson about how tools like the Apple Vision Pro could be the next big thing in healthcare.

(This interview has been edited for clarity and consistency.)

Gizmodo: Can you explain why the surgical environment is so behind when it comes to the presentation and organization of information? Healthcare is almost a trillion-dollar industry, how can it be this bad?

Robert Masson: If you look at how IT healthcare developed, it’s very retrospective; the patient came, we saw them, and this is what happened. That’s electronic health records. It doesn’t get a lot more sophisticated than that. To me, the future is about predictive analytics that can help you figure out what needs to happen next and the best way to execute it. We focus on putting a coil in an aneurysm in the brain, putting in a hip prosthesis, that’s the end result of surgery. But nobody’s really stopped to look at the very boring foundational part of it.

Gizmodo: So what exactly does your software do?

RM: I’ll give you an example at the equipment level. There are tens of thousands of pieces and tools and consumables. Some poor surgical technician has to walk in to figure out which piece of the puzzle we need to put together. The surgeon asks for the drill, and the technician says “What drill?” Well, it’s the drill I use every time at this moment. But there’s no uniform process to keep track of these details. Now someone has to run down in the elevator to get it.

So, for example, our software can provide a reference guide in a holographic forward for what stage we’re at. Surgery runs downhill if you know what’s coming, but if you don’t know what the sequence is as a team, it’s inherently disorganized. We’re working on the fine details, but this is the stuff that increases anxiety, and stress, and a lack of orientation.

Gizmodo: That’s not what you think of when you think about cutting-edge healthcare technology.

RM: We’re talking about the least glamorous part of the process.

Gizmodo: But why do you need a headset for this?

RM: Well you certainly don’t need it for every aspect of what we’re doing. It’s just a software environment for your organization. But with a touch-free system, you can penetrate the sacred bubble of the sterile field. The ability to interact with digital screens and holograms and lists and maps and products unlocks all kinds of possibilities. Suddenly, you’ve got an interactive digital tool that you can use without violating the sanctity of sterility.

Now, do I want the circulating nurse behind the field to have a fancy headset? Hell no. That person uses an iPad, or computer, or even a phone. Our core product is tablet-based. But what we’re really focused on is the portability and application these different types of environments require.

Gizmodo: So as I understand it, the surgeons themselves aren’t wearing the headset here. Is that the next step?

RM: Honestly, as a surgeon, I wouldn’t even consider it, at least for now. There’s always a tendency to say “look at this amazing tech, let’s put a screw in with it.” Well, we’re already putting screws in without the headset, so it doesn’t really solve a problem. People tend to think of floating spines, floating heights, you know, an overlay that tells you where to put a catheter in the liver. Honestly, it’s all unnecessary because we already do that pretty well. What we don’t do really well is stay organized.

Gizmodo: I imagine some people are going to react to this as a gimmick, or maybe even see it as a threat. What are the hurdles you need to get past?

RM: Well the first thing you always hear is it’s going to cause infections. Yeah. So do eyeglasses. So does hair. So do beards. But at the end of the day, it’s new technology, and the question is, does it work and does it solve problems? If it’s the best application for the job, there’s your answer.

Gizmodo: I’m kind of coming back to the very beginning of the conversation, but it just strikes me that we’re dealing with some of the most advanced technology on the market. This is Star Trek stuff, but we’re solving the least sexy problems in the world with it.

RM: Look I don’t want to imply that healthcare is bad. It’s just that nobody’s focused on the basics. And it’s a little shocking that we’re so behind the eight ball when you compare it to automotive, or defense, or aviation, or manufacturing, or heaven forbid Amazon, it’s all so well organized. Yet healthcare is just garbage. This isn’t what gets people excited, it’s hard for a super-specialist to go backward to the origin of surgery. But sometimes you do have to go backward to go forward. Healthcare is finally doing that.

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