The operating room is the most expensive high-stakes room on Earth - and it ran on memory. A neurosurgeon decided to change that.
Everyone building for the operating room wants to be the robot that does the surgery. eXeX wanted to be the thing that gets the room ready for it - which turns out to be where a surprising amount of the time and money actually goes.
Here is a fact about surgery that does not make it into the brochure: a meaningful chunk of what happens in an operating room happens before anyone picks up a scalpel. The instruments have to be laid out in the right order. The team has to know which tray comes first, which implant, which step follows which. And that knowledge - the choreography of a specific surgeon doing a specific procedure - tends to live in exactly one place, which is the head of the person who has done it a thousand times. When that person retires, or is simply in a different room that day, the knowledge does not transfer cleanly. It gets approximated. Approximation, in an operating room, is expensive.
eXeX - short for "eXpanded eXistence," and yes, the capitalization is load-bearing - is a company built on the premise that this is a software problem, not a heroics problem. Founded in 2022 by Dr. Robert Masson, an internationally practicing micro-neurosurgeon, the company makes what it calls a Surgery Intelligence platform. The elevator version: it captures a surgeon's setup and workflow knowledge, turns it into a structured, approved playbook, and delivers that playbook to every member of the team, on whatever device they happen to be using. Not to tell the surgeon how to operate. To tell everyone else how to get ready.
That distinction is the whole company, and eXeX is unusually disciplined about it. The software does not touch clinical decision-making. It is not, by the company's own insistence, a medical device. It handles the parts of surgery that are logistical rather than clinical: room setup, instrument sequencing, staff onboarding, and tracking which phase of the workflow the team is actually in. This is, by design, the least cinematic part of the operating room. Gizmodo, covering the company, called it "the most boring part of surgery." eXeX did not object. Boring, in a room where mistakes are measured in human outcomes, is the entire value proposition.
"The OR is the most expensive high-stakes room on Earth, and it runs on memory. We changed that."
Masson's insight came from the position of someone who had spent a career on the sharp end of the problem. His framing, in interviews, is that mixed reality and AI are not tools for how the surgeon executes the surgery - they are tools for the team around the surgeon: the logistics, the flow, the waste, the sequence. The surgeon is not the bottleneck. The system feeding the surgeon is. Reframe the bottleneck and you get a different company - one that competes less with surgical robots and more with the clipboard, the whiteboard, and the tribal memory of a veteran scrub tech.
The company describes its founding group as "passionate futurists," which is the kind of phrase that usually means nothing, except that here the roster backs it up. Alongside the neurosurgeon sits a mixed-reality studio founder, an XR developer whose past work spans Apple, Amazon and Disney, and a CTO who previously founded a mixed-reality software lab. It is a strange and specific blend of talent - part hospital, part effects studio - and it explains why a surgical-logistics company keeps showing up in headlines about holograms.
Because the other thing eXeX did, the thing that got it written up everywhere, was put an Apple Vision Pro into a live operating room. In February 2024, during spine reconstruction surgeries, the company's software ran on the headset to give nurses and technicians holographic, touch-free access to the surgical setup and procedural guides - from within the sterile field, where you cannot exactly reach out and tap a screen. Masson described it as "a digital twin of the organization, setup, and workflow." It was, by the company's account, a world first. A month later, eXeX and Cromwell Hospital did the same in the UK. Then a joint-replacement surgery at an AdventHealth surgery center.
What makes this restrained rather than hype-y is the footnote eXeX keeps attaching: it does not intend to commercialize on the Vision Pro, and it is not positioning the headset as a medical device. The demonstrations proved the concept. The actual product runs on ordinary devices the whole team already owns. The hologram was the headline; the checklist is the business.
Lets teams build and standardize procedure playbooks across surgeons and facilities using structured "Surgical Profiles." This is where a surgeon's tacit setup knowledge becomes shared, editable data.
Gives OR staff access to surgeon-approved Surgical Profiles to organize room setup, coordinate workflow steps, and document operational tasks - across every device on the team.
The core layer tying it together: real-time workflow-phase tracking, live operational insights, and staff onboarding - all without altering clinical decision-making.
The mixed-reality layer, demonstrated on Apple Vision Pro, overlaying holographic setup maps and procedural guides onto the physical room with touch-free access inside the sterile field.
"With eXeX and Apple Vision Pro, surgical teams have the brilliance of visual holographic guidance and maps, improving visuospatial and temporal orientation."
The numbers eXeX cites come from an internal evaluation at a Global Microsurgical Center in January 2025, and they are worth reading with the appropriate grain of salt that any internal evaluation deserves: 3x improvement in setup accuracy, 6x faster staff onboarding, 4.5x more efficient surgical workflow. Whether those hold up under independent, peer-reviewed scrutiny is exactly the kind of question a commercial launch is supposed to answer. But the direction is the point - and the direction is at the staffing crunch and the setup delay, not at the surgeon's hands.
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The priced seed round arrived roughly two years after founding, alongside the CTO hire of Michael Dykier. The stated use of funds: accelerate the platform and support a commercial debut across select hospitals in the United States and United Kingdom. Masson's line on it was characteristically flat - gratitude to "our investment partners and alpha sites for their participation and insights." No moonshot rhetoric. Just the next room.
eXeX uses the phrase "building the Surgical Metaverse," which invites the obvious eye-roll. The honest read is more interesting. The surgical AR/VR space is crowded on the training and navigation side - names like Osso VR, Medivis, Proprio and ImmersiveTouch - and dominated on the procedure side by the Medtronics and Strykers of the world, whose systems focus on the cut itself. eXeX has planted a flag somewhere less contested: the operational, logistical, team-coordination layer. Whether that is a durable standalone market or a feature the incumbents eventually absorb is the real question hanging over the company.
What is genuinely distinctive is the discipline of the positioning. By refusing to be a medical device, eXeX sidesteps the years-long regulatory gauntlet that slows most surgical hardware. By refusing to touch clinical decisions, it sidesteps the liability that comes with them. It sells time and consistency to hospitals drowning in staffing shortages - a pitch aimed squarely at the CFO and the OR manager, not just the surgeon. That is either a very clever wedge or a ceiling. The commercial launch will tell.
"We are grateful for our investment partners and alpha sites for their participation and insights."
Figures and milestones are drawn from public sources including eXeX press releases, the company website, and third-party coverage as of mid-2026. Efficiency metrics (3x / 6x / 4.5x) reflect an internal company evaluation and are approximate. Funding, dates and staff titles reflect the most recent public information available.