GPS systems on mobile devices help with navigation, avoiding traffic jams, and confidently moving through unfamiliar roads by indicating the current location and direction of travel. A similar navigational mechanism can be imagined inside an operating room, where it assists the surgeon in navigating the delicate structures of the human brain or spine.
This is the idea behind easyNav™—a surgical navigation system developed by HRS Navigation, a company based in Bengaluru. This technology uses medical images to map the patient's anatomy and track surgical instruments in real time, allowing surgeons to understand their position, especially when working near sensitive nerves, blood vessels, and other critical structures.
HRS Navigation was founded in 2015 by Arpit Palival and Shweta Palival. They created an Indian alternative to imported surgical navigation platforms. According to the company, their systems are installed in over 200 hospitals and have supported more than 20,000 operations.
However, the driving force behind the startup was not simply creating complex medical technology, but solving a problem that Arpit often faced: why should access to advanced surgical care depend so heavily on the patient's place of residence or financial status?
Why Surgical Precision Must Go Beyond Metropolises
Arpit, an electronics engineer who also completed an executive management program at IIM Calcutta, spent about 11 years in an international position before deciding to found a medical technology company in India. His experience gave him an understanding of the principles of surgical navigation and the standards such systems must meet, and it helped him notice a gap in the market.
Although surgical navigation technology was already available internationally, its adoption in India was limited not only by the cost of acquiring equipment. Some imported systems required hospitals to regularly purchase consumables for every procedure or upgrade operating rooms to meet specific infrastructure requirements. For hospitals with limited budgets, these costs could make the technology difficult to maintain, especially when treating patients who could not afford expensive surgery.
Arpit recalls meetings with families struggling to pay for treatment. One such case involved a father who asked him to continue operating on his child, promising to sell his house to raise funds. He notes: 'I saw that reality,' describing the motives that led him to create something for India.
In his view, the problem was not a lack of medical knowledge, but that the tools necessary to support complex procedures were not always available to the hospitals and patients who needed them. Simply lowering the price of an imported system would not solve this problem; the technology also had to work within the context of Indian hospitals.
'The system needs to be adapted to the requirements of Indian infrastructure,' explains Arpit. This became the core principle for HRS Navigation. Starting from a small office and developing the technology from scratch, the founders set out to create a system that could function with existing hospital equipment without sacrificing accuracy.
It was a complex undertaking in a field requiring extensive research, engineering, testing, and regulatory compliance. Arpit says that developing the technology from the prototype stage took years of work, including studying scientific papers and building the team's technical expertise at a time when many modern artificial intelligence tools did not yet exist. These efforts ultimately led to the creation of easyNav™, designed with two priorities in mind: accuracy meeting high clinical requirements, and adaptability making the system practical for Indian hospitals.
How Does GPS Work for Surgeons?
To understand this technology, imagine a person driving through an unfamiliar city without a navigator. They have to rely on signs, landmarks, and their own judgment to choose a route. GPS adds an extra layer of information, showing the person's position relative to the route and helping to correct the direction of travel.
Surgical navigation applies a similar principle inside the operating room, using medical scans instead of road maps. Before surgery, CT scans provide detailed images of the patient's anatomy, which are used to create a reference base for the procedure. During the operation, the navigation system tracks the position of surgical instruments and displays their location relative to this anatomy.
This gives the surgeon an additional way to verify the instrument's position and trajectory, especially when the target is deep inside the body or close to structures that need to be preserved. For example, in neurosurgery, the system can help the surgeon plan a path to a tumor and understand its relationship with vital structures. In spinal surgeries, it helps determine the entry point and trajectory for screw placement.
Dr. Ranjit Deshmukh, a consultant neurosurgeon at Sahyadri Hospital, Pune, explains that traditionally, complex procedures relied on anatomical landmarks, surgical experience, and intraoperative visualization to determine orientation. He states: 'Navigation provides an additional level of anatomical guidance, helping the surgeon plan and perform these procedures with greater confidence.'
With easyNav™, Dr. Deshmukh can understand in real time where his instruments are relative to the patient's anatomy. He particularly values this in complex brain surgeries involving deeply located tumors, lesions near major blood vessels, and procedures around the skull base. The technology also supports planning when a tumor is close to functional areas of the brain. Information obtained through methods like functional MRI and tractography helps surgeons understand these connections and plan an approach aimed at the safest possible tumor removal while preserving critical functions.
It is important to note that navigation does not replace the surgeon's judgment or experience; rather, it provides supplementary information to support decisions at critical stages of the operation. Dr. Deshmukh, with 15 years of experience using international navigation platforms, finds easyNav™ comparable in usability and overall workflow. He adds: 'Once the surgical team gets used to the system, it integrates into the procedure without adding unnecessary complexity.'
He also noted a reduction in uncertainty in many complex cases, although he cautions that complications and reoperation rates depend on several factors and cannot be attributed to one technology. For Arpit, maintaining this accuracy while ensuring system accessibility required extensive research into components, performance, and design. The team worked to meet international quality and regulatory parameters while developing a system suitable for the infrastructure and needs of its intended users.
From Small Hospital to Mother's Second Chance
The value of this approach becomes evident when the technology reaches hospitals outside major urban centers. Arpit recalls a case with a surgeon in a small town in Maharashtra who used the system for an operation on a young child from a farming family. The family had limited financial resources, and the surgeon performed the operation for approximately 10,000 rupees. When the surgeon shared the result with colleagues, they were surprised that such a procedure was conducted in a small center.
For Arpit, this was precisely the change HRS Navigation hoped to bring about: helping qualified doctors gain access to tools supporting complex surgery, even outside the largest hospitals. Another example is a charitable hospital in Siddhagiri, Maharashtra, where the system has been in use for several years. According to Arpit, patients travel there from Maharashtra and neighboring Karnataka because the hospital offers treatment at affordable prices.
He remembers the case of a mother of three children with a brain tumor in a particularly difficult location. After consulting several larger hospitals, she eventually underwent surgery at this charitable hospital. The procedure was successful, and she survived with preserved neurological functions, according to Arpit. Such stories illustrate why surgical navigation is important not just in the operating room. When a hospital can offer complex procedures at an affordable price, patients have the opportunity to receive care closer to home instead of traveling to a large city.
The impact extends beyond patients. Surgeons gain confidence from the ability to verify the position of their instruments during difficult procedures. Arpit recalls how some senior surgeons initially questioned the system when its interface differed from their expectations. However, after repeated verification of its accuracy during operations, many began relying on it as an essential part of their workflow.
The company also cites a memorable procedure in Guntur, where a patient undergoing brain surgery remained conscious and watched the movie Baahubali. Unlike most brain surgeries performed under general anesthesia, awake craniotomy requires the patient to remain conscious so that doctors can monitor brain function in real time. In this case, the patient felt comfortable enough to watch the movie while the surgical team monitored his reaction using HRS Navigation technology. Arpit notes: 'This case attracted wide media attention.' For the team, this procedure became a vivid demonstration of how image-guided technology can support surgeons in carefully selected operations where monitoring vital patient functions is crucial.
HRS Navigation systems are now used in a wide range of hospitals, from small centers in places like Guntur and Gorakhpur to large institutions, including Apollo Hospitals and AIIMS facilities. Dr. Deshmukh believes that such technologies can help bridge the gap between medical institutions in metropolises and those outside them, provided that hospitals also possess the necessary clinical knowledge, training, and technical support for effective use of these systems. He emphasizes: 'Advanced surgical technologies should not be limited to a few tertiary centers in large cities.'
Creating Medical Technologies in India for the World
Ensuring the accessibility of precise technologies also means rethinking the business model behind them. Arpit argues that HRS Navigation avoided the expense of consumables for every procedure—a model he believes allows hospitals to use the system without weighing the cost of additional supplies against the patient's ability to pay. The company also designed easyNav™ to work with existing operating room infrastructure, reducing the need for hospitals to make massive changes before adopting the technology.
These decisions are part of broader ambitions: to demonstrate that complex medical devices can be designed and manufactured in India without compromising performance. Arpit says that HRS Navigation has received international recognition for its product design, including the iF Design Award from Germany and the A’ Design Award from Italy. The company was also selected by the Ministry of Science and Technology of India for recognition related to the country's 75th anniversary of independence. For him, these milestones are important because medical technologies made in India should be judged by what they achieve, not by assumptions about where they come from. He concludes: 'We have come a long way doing this from India,' describing the company's aspiration to become globally respected. This ambition is closely tied to the original reason he founded the company. The goal is not only to compete with established international manufacturers but also to
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