"You can do it," he said. "Come give brain surgery a shot. Anyone can do it."
So along I went, elated by the invitation extended by Jose Maria Amich, to the Harvard i-lab to play neurosurgeon for a hot second and try my hand at one of the most common neurosurgeries: Ventriculostomy. It is a neurosurgical procedure that involves creating a hole within a cerebral ventricle to drain excess cerebrospinal fluid from the head.
Amich is the co-founder and CEO of Z Imaging, a startup being incubated at Harvard i-lab that develops augmented reality (AR) tools for surgery and other high-precision tasks. Having earned his undergraduate degree in molecular biology in 2018, Amich heads a team of four biomedical and software engineers who have either foregone or postponed an academic career for an entrepreneurial one.
Nestled in a bright corner of the Harvard i-lab space, the Z Imaging team is building a set of AR tools to improve accuracy, increase patient safety and make ventriculostomy minimally invasive.
Why ventriculostomy? It is one of the most common neurosurgical procedures performed globally and yet has room for error.
Today, most surgeons perform this procedure through a freehand pass technique with the help of surface anatomical landmarks and scans. A study published in the Journal of Neurosurgery assessing the accuracy of such a method in one instance found that it typically required two passes per successful placement, and 22.4 percent of the catheter tips were in nonventricular spaces.
"Our goal is to train practitioners to place a drain the ventricular of the brain in the first try," Amich said.
Amich deliberately avoided using the term "neurosurgeon" for a reason. One of the startup's goals is to make the software intuitive and the learning curve minimal.
"Today, medical centers who don’t have access to neurosurgeons cannot perform this procedure," Amich said. "We want to democratize access for safe surgeries by training physicians, nurse practitioners and advanced medical staff to be able to perform this."
To prove how simple the software is, Amich invited me to try it out myself. I performed a ventriculostomy using the AR toolkit and a model skull. Watch the full process in our video.
https://www.youtube.com/watch?v=AmU9rx_fmlc&feature=youtu.be
In an emergency setting, Z Imaging's system will help surgeons using image guidance or surgical navigation, to increase accuracy as well as reduce time.
The startup is currently running a pilot program at Brigham and Women's Hospital under the mentorship of Dr. William Gormley, director of neurosurgical critical care and performance improvement at the hospital. The pilot involves using Z Imaging's AR toolkit in high-volume emergency cases.
Another ongoing pilot at Brigham and Women's and Massachusetts General Hospital is to train nurses, students and surgeons to assess whether nurses and students can perform cases that typically only attendings and residents do.
Since the company's goal is to make access easy, all of its pilots are run in the emergency room, not the operating room.
So how does it work? A screen displays a 3D image of the skull overlaid with the patient's CT scans. These, Amich explained, are done automatically and dynamically. The software adjusts the alignment even if the patient moves. The catheter acts as a GPS to the map of the skull using the 3D image and scans. On the screen, two bright green dots pop up guiding the catheter to the targeted spots.
In the four years since its inception, Z Imaging has been part of revered incubator and entrepreneurship programs like MassChallenge, MassConnect, Harvard i-lab and Y Combinator.
Some of its investors include Y Combinator, Yleana Global and Plug and Play Ventures.
Backed by a sub-million dollar pre-seed round, Z Imaging is raising a bridge round to support its mission to make its device portable enough to fit in a briefcase.
