The success of that operation encouraged Hachach-Haram to turn its research project into a real business. She raised money, hired a team to develop the technology, and spent the next several years proselytizing at digital operating room conferences. “I’d fly 10 hours to give a 10-minute speech,” she says. In 2019, Proximie was ready for its commercial launch.
When the Covid-19 pandemic reached the UK a year later, Proximie had already been used in 1,200 operations in more than 30 countries. “Like any company in the first few weeks of the pandemic, we announced to our shareholders that we would prioritize our mental wellbeing and simply 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 convened another shareholder meeting and announced, “Screw the previous plan. We are going to accelerate.” In six months, the number of users has increased tenfold and the number of surgical sessions has risen to 5,500. Today, more than 20 per cent of NHS hospitals have access to the software. “We used to be just a sci-fi concept with some potential,” she says. “Suddenly we were the only way to do things.”
Because of the Due to the interruption of routine operations during the pandemic, Hachach-Haram went many months without performing a single operation. “When we went back to work, our confidence was broken,” says Hachach-Haram. “We had to get back into it, so we would team up 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 to get remote support instead. If the loss of skill and confidence during the pandemic was a concern for veteran surgeons, the problem was even greater for their junior colleagues: NHS trainees saw a 50 per cent reduction in training opportunities to operate, according to official data. “Many interns in the prime of their education have missed 18 months of practice,” she says. “We don’t have the luxury of taking 10 years to train people. We had to think about how Proximie could accelerate that.”
For example, the Society of American Gastrointestinal and Endoscopic Surgeons sent anatomically realistic pig tissue models to interns working from home so they could practice abdominal wall hernia repairs while being remotely assisted by experts. The Hip Preservation Society, on the other hand, set up a regular virtual education program with live surgery — a labral reconstruction procedure, for example, was broadcast to more than 500 people around the world. “Historically, only a few interns would have access to a procedure,” she says. “Now hundreds had access to the few cases that happened.”
Currently, more than 95 percent of surgical sessions using Proximie are also recorded in the online library, allowing surgeons to edit and tag footage that can later be used for training or debriefing. This library currently contains more than 20,000 surgical videos, making it the largest database of its kind. “When we started, all we had in mind was the live surgery feature,” she says. “But then we thought, what if people want feedback or review their performance after surgery? That is why we built the library.” For example, when she first viewed footage of her own surgeries, Harach-Haram found that her behavior was, as she describes it, “a bit intrusive.” “I noticed that I liked to do the operations myself, even when there were interns in the room,” she says. Now, in similar situations, she forces herself to hand over the surgical instruments, purposefully clasps her hands at her chest, and steps away from the operating table. “I’ve learned not to be in their space,” she says. “I just give them space.”
This article appears in the July/August 2023 edition of WIRED UK magazine.