Patient-specific surgical intelligence

Know the anatomy
before the first incision.

XENA turns pelvic MRI into a patient-specific 3D surgical map, revealing disease extent, organ involvement and critical anatomy so teams can plan the approach, procedure and specialists before the OR.

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Clinical evaluations underway with US programs  ·  Investigational  ·  510(k) in preparation

The surgical problem

Four questions shape the operation.

01
Where is the disease?
Dissection path
02
Which organs are involved?
Procedure and specialists
03
How much of it is there?
Extent of excision
04
Which critical structures are at risk?
Anatomy to protect

Today these answers are assembled from the radiology report and the 2D slices, one at a time. XENA holds all four at once.

MRI Pelvis · Impression

"…extending to the left uterosacral ligament, with tethering of the anterior rectal wall. Pouch of Douglas obliterated."

The report

Clinical interpretation

Findings described in words.

T2 sagittal pelvic MRI slice
The MRI

Source evidence

Reviewed slice by slice.

The XENA view of this patient’s anatomy and disease
The XENA model

Surgical context

Disease, organs and critical anatomy in one traceable view.

XENA Atlas

Map. Plan. Simulate. Reference.

One patient-specific model, carried from imaging into the OR.

Disease shown against the pelvic organs beside the source T2 slices Deep endometriosis with organ involvement measured against the uterus and bowel Laparoscopic view rendered from the patient's own anatomy from the selected port, with camera and instrument control The XENA view of the patient's anatomy on the OR display while the surgeon works at the console
Example case. Deep endometriosis.
  1. 01 Map

    See disease extent and organ involvement in one view.

    Findings from the pelvic MRI are mapped against the bowel, bladder, ureters, uterus and ovaries. Isolate structures, adjust opacity and return every mapped finding to its source image.

    3D modelOrgans and cavitiesPathologyMeasurementsCross sections
  2. 02 Plan

    Define the approach and procedure.

    Read complexity from the number of lesions, how deep each one runs and which organs it crosses. Decide the route and the extent of excision before the day of surgery.

    Disease isolatedDepth of invasionExtent of excision
  3. 03 Simulate

    Preview the surgical view.

    Choose a port of entry and preview the laparoscopic view from the patient’s own anatomy. Explore the intended approach before the case.

    Port selectionLaparoscopic cameraUterine manipulator
  4. 04 Reference

    Carry the plan into the OR.

    Open the model, source MRI and saved planning views on iPad during the procedure. No additional hardware.

    iPad in the ORSaved viewsSource MRI
  5. Explore an interactive case
Case routing

See the involvement.
Bring the right team.

Suspected bowel, bladder or ureter involvement changes the procedure and who needs to be in the room. XENA shows it while the schedule can still change.

General gynecology
Localized disease without suspected organ involvement.
MIGS
Extensive or technically complex pelvic disease.
MIGS with colorectal or urology
Suspected bowel, bladder or ureter involvement.
A multidisciplinary surgical team in a robotic operating room
Patient conversation

Show the patient
what is planned.

Before consent, walk the patient through her own anatomy, the proposed approach and the specialists who may be involved. The same model the surgical team planned from.

A clearer conversation, from the same source imaging.

The source T2 sagittal slice The same anatomy as a patient-specific model
Clinical evidence

The model changed
the surgical plan.

43%of surgical plans revised after the model was reviewed
91%
Concordance with operative findings
60%
Improvement in surgeons’ spatial understanding

Prospective observational pilot  ·  20 consecutive laparoscopic surgeries for suspected or confirmed moderate-to-severe endometriosis. Thott K, Godbole D. JMIG. 2025;32(11 Suppl):S48. doi:10.1016/j.jmig.2025.09.044.

Clinical workflow

From MRI to a prepared case
in 48 hours.

Works with the MRI the patient already has. Protocol agnostic, 1 to 5 mm slices.

Day 0

MRI transferred

PACS export, PowerShare or secure transfer.

Day 1 to 2

Model built and reviewed

Checked against the radiology read, then reviewed by a practicing surgeon.

Pre-op

Case planned

MRI and model reviewed side by side. Planning views saved.

Day of surgery

Model referenced on iPad

The model, source MRI and saved views remain available during the procedure.

MRI protocol agnostic, 1 to 5 mm  ·  Physician reviewed  ·  Traceable to source MRI  ·  De-identified and encrypted
Operative intelligence

Better records.
Defensible complexity.

Nothing is lost between plan and claim. XENA reads the operative video against the preoperative model and documents work beyond the standard procedure.

01 Analyze
02 Document
Operative video with recognized structures marked against the preoperative model

Illustrative example of XENA operative-video analysis. Coding decisions remain with the site and its compliance team.

Hospital value

Prepare complex cases
before they reach the OR.

Plan for safe, complete excision

See the mapped disease and its organ relations, and the structures to protect around it.

Route complex cases earlier

Flag cases that may require colorectal or urology support before scheduling.

Prepare the right team and resources

Anticipate staffing, room time and resource needs from the expected procedure.

Create a structured record of complexity

A preoperative record of disease extent and organ involvement.

Coding and reimbursement by setting
HCPCS C8001
Hospital outpatient facility

3D anatomical segmentation for preoperative planning under HOPPS. Use and payment depend on setting and workflow.

Operative coding context
Applies to the operation

Modifiers 22, 59 / XS and 62 / 66 apply to the operation, not to the model. XENA may support the preoperative record. The operative note must document the work performed.

Eligibility and payment depend on the setting, payer, documented work and applicable policy. Each site should confirm its pathway with its coding and compliance team. XENA is investigational and not yet cleared for clinical use.

Published disease-complexity data
211 vs 110 minMedian operative time in severe versus mild endometriosis.
6 vs 3 daysMedian length of stay in the same cohort.
3.6×Odds of severe postoperative complications in severe disease.

Thomassin-Naggara et al., JAMA Network Open 2023, n=605. Independent disease-complexity data, not XENA performance or a demonstrated XENA effect.

Request the ROI model

Indication pipeline

One anatomical foundation.
Built for each operation.

Endometriosis

Map extent and organ involvement.
Plan excision, approach and team.

Clinical validation

Adenomyosis

Map disease within the uterine wall.
Support treatment and uterine-sparing decisions.

Clinical evaluation

Fibroids

Map number, depth and position.
Plan route, incision, removal and repair.

Clinical evaluation

Pelvic oncology

Map tumor boundaries and critical anatomy.
Plan resection and multidisciplinary care.

Planned

The first surgery should be the best surgery.

Our vision

Make precision surgery
the standard.

XENA began with Czuee’s own endometriosis surgeries and one question: why was so much understood only after the operation had begun?

Surgery begins with rich imaging. But when the operation starts, much of that information stays behind. Tissue moves. Anatomy is obscured. The surgeon must decide where to cut and what to protect in real time.

We are building intelligence for the entire operation. Before it, inside it, after it.

Czuee Morey, CEO and co-founder of XENA
Czuee Morey  ·  CEO & Co-Founder  ·  Endometriosis patient

  1. Before the incision

    Know what the operation will demand. The patient’s MRI becomes a 3D view of the disease and everything it touches. The approach, the procedure and the team are decided before the incision, not after it.

  2. During the operation

    Keep the critical anatomy in view. The next frontier is guidance that holds the plan inside the changing surgical field. What must be removed. What must be protected. The safest path between them.

  3. After the operation

    Turn the operation into evidence. The video is compared with the plan. What was found and what was done become a record that closes this case and improves the next.

Executive team
No-cost pilot evaluation

Evaluate XENA on
10 of your own cases.

You choose the cases. We return clinically reviewed models the same week and review them with you.

01

Select the cases

Moderate-to-severe endometriosis and complex benign gynecology.

02

Receive the models

Send de-identified DICOM. Receive clinically reviewed models the same week.

03

Review them together

Compare each model with the MRI read and available operative findings.

Let’s plan your first case.

Leave your email and we will schedule a session around one of your cases.

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