Good surgical software isn't built behind a screen. It's built at the same table as the people who'll actually use it — with printed X-rays, a pencil, and a ruler, if that's what it takes to get the details right. That's a conviction we hold firmly at Presurgeo, and last week Dr. Ralph Sakkers gave us a clear example of why.
Going old-school on purpose
We sat down with Ralph to work through osteotomy planning from first principles. Instead of opening a laptop, he reached for printed X-rays, a pencil, a ruler, and a pair of scissors, and walked us through how he actually reasons about a correction: finding the mechanical axis, measuring the deformity, working out the angles and level of the cut by hand.
It would have been faster to jump straight to a digital tool. But we asked for this precisely because it wasn't fast. Planning it out on paper forces a level of precision and understanding that's easy to skip past when software does the measuring for you — you see every assumption, because you have to draw it yourself. If we don't understand the problem at that level of detail, we have no business encoding it in software. That's the whole reason we build this way: not with surgeons at arm's length, but with surgeons in the room, tracing the same lines they'd trace on a real case.
From plan to execution
Understanding the plan is only half of it. Ralph then showed us how that same plan gets translated into something a surgeon can actually execute in the OR: drilling K-wires into a 3D-printed bone model at exactly the angle and position the plan calls for.
This is the step that's easiest to get wrong from the outside. A plan that looks correct on paper, or on a screen, still has to be executable with a drill, in real anatomy, under real constraints. You only catch that gap by watching someone who's done it hundreds of times try to actually do it — which is exactly why we don't treat sessions like this as optional.
This is how we make sure our software is safe and effective
That's the point we want to be direct about: expert input like Ralph's isn't a nice-to-have we bring in to validate a decision we've already made. It's a requirement we design around from the start. Every assumption we get right — and every one we'd have gotten wrong without him — comes down to hours like this one, spent with someone who is generous enough to slow down and explain why, not just what. That is what stands between software that looks right and software that is actually safe and effective in a surgeon's hands. So: thank you, Ralph. For your time, your patience, and for caring enough about getting this right to spend an afternoon with pencils and scissors instead of just telling us what to do.
If you want to see how partnerships like this one shape what we're building, please get in touch to learn more about Presurgeo.
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