The success of that surgery encouraged Hachach-Haram to turn his research project into a proper venture. He raised money, hired a team to develop the technology, and spent the next two years relentlessly proselytizing at conferences about the digital operating room. “I would fly 10 hours just to give a 10-minute talk,” he says. In 2019 Proximie was ready for commercial launch.
When the Covid-19 pandemic hit the UK a year later, Proximie had already been used in 1,200 surgeries in more than 30 countries. “Like all companies in the first weeks of the pandemic, we announced to our shareholders that we were going to prioritize our mental well-being and just try to survive,” says Hachach-Haram. A week later, she changed her mind. “I realized, wait a minute, this is exactly when people are going to need our technology,” she says. She called another shareholder meeting and announced: “Delete the old plan. Let’s speed up.” In six months, the number of users multiplied by ten and the number of surgical sessions increased to 5,500. Today, more than 20 per cent of NHS hospitals have access to the software. “Before, we were just a science fiction concept with some potential,” she says. “Suddenly, we were the only way to do things.”
Due to the suspension of routine operations during the pandemic, Hachach-Haram went many months without performing a single operation. “When we went back into business, our confidence was shaken,” says Hachach-Haram. “We needed to get back at it, so we would get together and ask a colleague to help us through it, because we needed that support.”
When it was not possible to have another consultant physically present, many used Proximie for remote support. If the loss of skill and confidence during the pandemic was a concern for experienced surgeons, the problem was even more pronounced for their younger colleagues: NHS trainees saw a 50 per cent reduction in training opportunities, according to official data. to operate. “Many trainees in the prime of their education missed 18 months of practice,” she says. “We cannot afford to take 10 years to train people. We had to think about how Proximie could speed that up.”
The American Society of Gastrointestinal and Endoscopic Surgeons, for example, sent anatomically realistic porcine tissue models to trainees working from home so they could practice abdominal wall hernia repairs while receiving remote expert help. The Hip Preservation Society, on the other hand, established a regular virtual education program that included live surgery; a labral reconstruction procedure, for example, has been passed on to more than 500 people worldwide. “Historically, only a couple of trainees had access to a procedure,” she says. “Now hundreds could have access to the few cases that were occurring.”
Today, more than 95 percent of surgical sessions using Proximie are also recorded in its online library, allowing surgeons to edit and tag images that can later be used for training or reporting. This library currently stores more than 20,000 surgical videos, making it the largest database of its kind. “When we started, we only had the live surgery feature in mind,” she says. “But then we thought, what if people want to get feedback after the operation or review their performance? That’s why we built the library.” When she first saw footage of her own surgeries, Harach-Haram knew, for example, that her behavior was, as she describes it, “a bit aggressive.” “I found that I liked doing the operations myself, even when there were trainees in the room,” she says. Now, in similar situations, she forces herself to hand over the surgical instruments, she purposely clasps her hands close to her chest, and walks away from the operating table. “I learned not to be in her space,” she says. “I just give them the room.”
This article appears in the July/August 2023 issue of WIRED UK magazine.
