Proximie bridges the geographic gaps between surgical specialists and remote clinicians.

ACCORDING TO AN ARTICLE FROM THE NATIONAL INSTITUTES OF HEALTH, travel restrictions from covid curtailed opportunities for in-person surgical mentoring. A specialist in heart surgery, for example, couldn’t fly some distance to scrub in to assist with a new technique. Telementoring, notes the nih, can solve challenges like this by enabling guidance from a distance using online tools.

Barriers to close-proximity surgical collaboration predate the pandemic. It remains challenging to send geographically dispersed surgeons in time for an emergency or time-sensitive procedure.

Advanced telementoring enables remote surgical collaboration and for surgeons to move from one operation to another without these delays. A specialist can participate in one surgery in Lebanon andanother in Milan without going anywhere.

Breaking geographic barriers

In 2016, Nadine Hachach-Haram, m.d., founded Proximie to develop its eponymous surgical telementoring platform. The Proximie web app enables multiple health care practitioners to take part in live procedures globally in operating rooms and cath labs to supplement local care.

According to Charlie Wilhelm, Proximie’s general manager of the Americas, surgeons access the technology on devices compatible with the Google Chrome or Microsoft Edge, including mobile phones and tablets.

Expanding collaborative care

Proximie enables audio-video communication with video overlays from imaging and augmented reality (ar) tools. Two-way video allows clinicians to see each other during the procedure; collaborating surgeons can speak with the clinicians in the or via the platform. Remote practitioners can overlay patient scans and X-rays on top of the patient in the operating field while viewing the procedure.

With Proximie, clinicians can draw over images and video freehand, manipulate ar hands and pointers in the surgical field to illustrate and instruct surgeons inmanual and robotic techniques. They can point to specific surgical tools, circle and outline areas for incisions and sutures, and move overlaid medical images into view topoint and draw over those.

Using the Proximie web app, health care practitioners can interact in a procedure or assessment remotely and mentor a local clinician through a live operation, visually and intuitively, says Wilhelm.

The telementoring technology displays up to four concurrent live video feeds from medical devices, cameras and wearables using picture- in-picture technology. Compatible input technologies include room cameras, webcams, surgical robotics, scopes, ECG, ultrasound and other devices with video outputs.

The app integrates with existing and easily sourced hardware at low bandwidth, making it malleable to clinical settings worldwide.

The technology complies with HIPAA, GDPR, and local data security and privacy regulations.

Proximie in practice

James Porter, M.D., is the director of surgical robotics at Swedish Medical Center at Providence St. Joseph Health in Seattle. As a robotic urologic oncologist and robotic surgery specialist, Porter treats and resections prostate, kidney and other urologic cancers. He also teaches robotic surgical techniques internationally and locally.

Porter used to travel once a month to provide surgical instruction outside the U.S. and speak at symposia. COVID prevented Porter from continuing this routine.

“Surgical education needed to continue despite the travel restrictions. Since I spend most of my time in the OR, I have many opportunities to collaborate with surgeons and teach the latest techniques in urologic robotics. This is where Proximie benefits me the most,” says Porter.

Porter reaches out through the web app to guide and mentor geographically dispersed surgeons. He assists the clinicians in their first experiences with complex new procedures and invites them into his OR so they can watch him operate. “It’s very convenient for me and my colleagues who don’t want to travel,” says Porter.

The technology unites health care practitioners in R&D labs to test and develop surgical robotics technologies and products. “Proximie allows multiple surgeons into a lab for collaboration and troubleshooting robotic devices,” says Porter.

Patients benefit from the experience their clinicians gain through Proximie.

“It is easy to get siloed in surgery and do what you learned 20 years ago and never change or improve. Interaction with other surgeons provides the foundation for improvement,” says Porter. The Proximie web application supports the work/life balance that Porter prefers. “Less travel means less time on a plane and more time at home,” he says.

Porter appreciates the seamless two-way communication he can have with the technology. “There is very little to no latency, which means I never talk over the other surgeons,” he says. “The telestration is very robust, with many options and features to get the details of the surgery to the other participants. The ease of setup is also nice,” Porter says.

For more information

Proximie is a subscription- based software solution. Contact Proximie at or request a demo at •