Surgical Theater Protects their Medical Applications with Dotfuscator

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Dotfuscator

Published on January 19, 2021 by Kayla Franczak

Reading Time: 3 minutes

Surgical Theater Protects their Medical Applications with Dotfuscator

How It All Started

How is flying a fighter plane similar to performing neurosurgery? They have more in common than you’d think. In 2005, Monty Avisar and Alon Geri, two Israeli fighter pilots were assigned to work with Lockheed Martin to build a $50 million F-16 Flight Simulator program for the Israeli Air Force to improve hand-eye coordination skills for their pilots during combat. Avisar took on the role of project manager and Geri served as senior engineer; the project was a success.

Four years later in 2009, the two finished their military service in Israel and moved to Cleveland, Ohio. Their experience working in virtual reality applications inspired them to wonder where this technology could also be applied. With several connections to surgeons, the two came to understand the ins and outs of operation procedures; in a similar way, surgeons were also working on a battlefield. What if surgeons could also train like fighter pilots and preview their surgical procedure, much like a fighter pilot could pre-fly their mission? The surgeons could pre-plan the operation from every angle and every approach to increase their situational awareness. And a year later, Surgical Theater was born.

The VR Medical Technology Construct

Using medical imaging, like an MRI, CT, or DTI, a 360-degree virtual reality construct is created based on the patient’s own anatomy and pathology; this gives the surgeon a true representation of the problem at hand for a more precise and safer surgery. Not only has this tool become valuable for surgeons, but it’s also revolutionized patient education and engagement, and delivered an immersive environment for residency medical students. Surgical Theater first began with neurosurgery VR simulations, and later expanded to cardiac surgery, spinal surgery, and plastic surgery.

Intellectual Property Protection

Evidently, Surgical Theater had a pretty impactful piece of technology on their hands. As Avisar and Geri continued to build it out, the algorithms grew more advanced and the user interface became more sophisticated. Their intellectual property was worth something and they didn’t want to risk any chance of replication through reverse engineering. They also wanted to ensure their devices would become FDA certified, which required them to pass an audit that all procedures are carried out properly. A pen test was the next logical step to discover software vulnerabilities and to help them on their way of becoming a true FDA medical technology company.

With the advice from an Israeli application hardening company, they made several changes to their C# code. The same company also suggested obfuscating their code with PreEmptive’s Dotfuscator protection. After doing research for themselves, Avisar and Geri found PreEmptive well established and reputable; it also didn’t hurt that they were located right next door to PreEmptive’s office.

Helpful Customer Service and Easy Integration

Soon after, Geri met with the PreEmptive team to learn more about Dotfuscator. Two onboarding conversations later, Surgical Theater was able to successfully integrate Dotfuscator into their build with a personalized protection plan. To this day, the Surgical Theater team follows the same techniques with every new release. This includes delivery on everything from laptops to portable devices, and any device sent outside the United States. And since integrating Dotfuscator into their code, Surgical Theater has had zero instances of tampering or reverse engineering.

Surgical Theater Today

Surgical Theater has been used for more than 10,000 surgical procedures with top hospitals including: University Hospitals, Mayo Clinic, and Mt. Sinai in New York City. Especially in light of the recent Covid-19 pandemic, Surgical Theater’s technology has become even more invaluable. Using the VR medical scans, doctors can better analyze Covid-19 patients’ lungs and the long-term implications of scaring and inflammation.

By protecting their technology with PreEmptive’s Dotfuscator, Surgical Theater is better equipped to fend off hackers from stealing their IP, especially during the rise of pandemic surges where these types of medical technology are highly sought after. As Geri put it best, “Your IP is your most valuable asset, so you must have this form of protection. You can work on creating upgrades or new features, but at the end of the day if you aren’t protected, you risk losing your product and everything you worked so hard for. It really does pay to be protected.”

For a full version of our Surgical Theater Case Study, including feedback from Surgical Theater’s Chief Software Engineer, please read the PDF.