The startup that wants to give surgeons X-ray vision

Over Zoom, James Hu asks me this sincerely, standing in the middle of a large white room that reads between clinical and stylized. I consider the question, not because I have, but because it occurs to me: I’ve perhaps never thought much about it at all, and suspect many people haven’t. But it’s a medical phenomenon—and a surgical tightrope.  

Hu, a doctor and cofounder of surgical precision access and visualization platform Illuminant, breaks it down: The spine is a high-wire part of the human body, where even infinitesimal mistakes can be disastrous. He demonstrates for me on a dummy.

“If you go towards the middle, that’s the spinal cord, and if you hit that, the patient is paralyzed,” Hu gestures. “And if you drive the needles a little too deep here, this is your aorta, this is your vena cava, and you can bleed out on the table.”

A few millimeters are the difference between success and failure, life and death. In the U.S. each year, spine surgeons are performing about 1.2 million of these high-stakes procedures. And Hu and his former Stanford classmate Eldrick Millares are building tech that, in some sense, helps those surgeons see. Their startup Illuminant is building a smart surgical lamp called Skylight. 

“What Skylight does is display images directly on a patient’s skin to tell you exactly what’s underneath as you’re cutting,” Millares said. “You can basically get X-ray vision. It’s like a live tattoo that moves with the patient. It updates in real time, tells you exactly where you need to cut, the angle you need to go, and how deep you need to go.” 

Illuminant—founded in 2021—has raised an $8.4 million seed round, led by Wing 2 Wing Ventures, Fortune has exclusively learned. The Los Angeles-based startup has taken a unique approach to fundraising: The company has additional venture backers (like Elderberry Ventures and Soma Capital) but about half of that $8.4 million is grant funding from federal institutions like the National Science Foundation, the National Cancer Institute, and the National Institute on Aging. 

Millares and Hu have specifically chosen L.A., seeking to tap into the market of engineers who not only work in tech, but engineers who’ve come from entertainment. Their task is scientific, medical, and technical, but it’s also fundamentally visual. 

“Disney Imagineering has this project where they project clothes on performers while they’re onstage, and you can change the clothes out,” Millares said. “We now have one of those folks here working with us—we’re projecting anatomy on patients.”

It often makes sense to start with the hardest thing, and spinal surgery is impossibly hard: One in five spine surgeries needs a revision. 

“The future of spine surgery, and really any surgery that relies on navigation, is moving toward more precise and less invasive procedures,” said Dr. Jeffrey Wang, co-director of USC’s Spine Center and Illuminant’s clinical advisor, via email. “Over time, that also has the potential to expand where these kinds of procedures can be performed, not just in major centers.”

Spinal surgeries are the proof point (Hu also reckons it’s a sizable market, worth around $2 billion). Millares and Hu are looking at using Illuminant’s tech for lung cancer biopsies and other percutaneous access procedures (where tools like stents or catheters are inserted through a tiny, needle-made hole—the tech can also guide needle placement). Their eventual hope is grander: That most massive, open surgeries fade into medical history, like the surgical bone saws of the Victorian era. 

“I think open surgeries are going to become more and more of a rare procedure,” Hu said, “limited to extremely complex cases, and all your bread-and-butter cases will be done percutaneously, through the skin.”

See you tomorrow,

Allie Garfinkle
X: @agarfinks
Email: alexandra.garfinkle@fortune.com

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VENTURE CAPITAL

– Rogo, a New York City-based AI partner for financial institutions, raised $160 million in Series D funding. Kleiner Perkins led the round and was joined by Sequoia, Thrive Capital, Khosla Ventures, J.P. Morgan Growth Equity Partners, BoxGroup, Mantis VC, Jack Altman, Evantic, and Positive Sum.

– Hightouch, a San Francisco-based agentic marketing platform, raised $150 million in Series D funding. Growth Equity at Goldman Sachs Alternatives and Bain Capital Ventures led the round and were joined by Iconiq Capital, Sapphire Ventures, Amplify Partners, Y-Combinator, TD7, and others.

– Axoft, a Cambridge, Mass.-based developer of implantable neurotechnology, raised $55 million in Series A funding. C.P. Group Innovation led the round and was joined by Alumni Ventures, the Stanford President’s Venture Fund, Hillhouse Investment, and Gaorong Ventures.

– belo, a Buenos Aires, Argentina-based developer of financial products designed for travelers, raised $14 million in Series A funding. Tether led the round and was joined by Titan Fund, The Venture City, Mindset Ventures, G2, and others.

– Rocsys, a Rijswijk, The Netherlands-based developer of hands-free charging technology for autonomous electric vehicles, raised $13 million in a Series A extension. Capricorn Partners led the round and was joined by Scania Invest, Forward.One, SEB Greentech Venture Capital, and Graduate Ventures.

– definity, a Chicago-based agentic data engineering platform, raised $12 million in Series A funding. GreatPoint Ventures led the round and was joined by Dynatrace and existing investors StageOne Ventures and Hyde Park Venture Partners.

– General Analysis, a San Francisco-based security layer for AI agents, raised $10 million in seed funding. Altos Ventures led the round and was joined by 645 Ventures, Menlo Ventures, Y Combinator, and others.

– OpenObserve, a Menlo Park, Calif.-based observability platform, raised $10 million in Series A funding. Nexus Venture Partners and Dell Technologies Capital led the round.

– Shapes.inc, a San Francisco-based platform designed for users to talk to AI with their friends, raised $8 million in seed funding. Lightspeed led the round and was joined by AI Capital Partners, AI Grant, and others.

– Blomma, a San Francisco-based AI career coaching platform, raised $5 million in seed funding. Felicis Ventures led the round and was joined by angel investors.

– Mosaic SoC, a Zurich, Switzerland-based developer of semiconductors designed to bring spatial intelligence to devices that already exist, raised $3.8 million in pre-seed funding. Founderful led the round and was joined by Kick Foundation.

– Dreambase, an Austin, Texas-based AI-powered analytics platform designed for Supabase (a Postgres development platform), raised $3.7 million in seed funding. Felicis Ventures led the round and was joined by Active Capital, FirstMile Ventures, Darkmode Ventures, Angel Collective, Earl Grey Capital, Mercury Fund, and others.

PRIVATE EQUITY

– CC Capital and One Investment Management acquired Insignia Financial, a Melbourne, Australia-based wealth management group, for $3.9 billion AUD ($2.5 billion USD).

– Anaconda, backed by Insight Partners, acquired Outerbounds, an Austin, Texas-based AI building and deployment platform. Financial terms were not disclosed.

– ARCHIMED and La Caisse acquired Stago, an Asnières-sur-Seine, France-based blood coagulation analysis company. Financial terms were not disclosed.

– Bregal Milestone acquired a majority stake in CoreGo, a Helsinki, Finland-based developer of payments systems and technology for festivals, sports events, and venues. Financial terms were not disclosed.

– Catchment Capital acquired a majority stake in Vertech Industrial Systems, a Phoenix-based developer of automation technology for industrial plants. Financial terms were not disclosed.

– Engineering Resource Group, backed by Godspeed Capital, acquired Haltom Engineering, a Memphis-based MEP engineering consulting firm. Financial terms were not disclosed.

– I Squared Capital agreed to acquire Elea Data Centers, a Rio de Janeiro, Brazil-based data center platform. Financial terms were not disclosed.

– Urban Armor Gear, backed by HKW, acquired Nomad Goods, a Santa Barbara, Calif.-based smartphone and smartwatch accessory designer and manufacturer. Financial terms were not disclosed.

EXITS

– Arlington Capital Partners acquired ENERCON, a Kennesaw, Ga.-based architecture, engineering, environmental, and project management firm, from Oaktree Capital Management. Financial terms were not disclosed.

– OpenGate Capital agreed to acquire the Europe and Middle East division of Total Safety, a Pasadena, Texas-based safety and compliance solutions company for petrochemical and oil and gas customers, and a Littlejohn & Co. portfolio company. Financial terms were not disclosed.

IPOS

– Avalyn Pharma, a Boston-based developer of therapies for respiratory diseases, now plans to raise up to $300.6 million in an offering of 16.7 million shares priced between $16 and $18 on the Nasdaq. F-Prime Capital Partners, Eventide Fund, Norwest Venture Partners, Novo Holdings, Perceptive, SR One Capital, Vida Ventures, and Wellington Biomedical Fund back the company.

FUNDS + FUNDS OF FUNDS

– BMW i Ventures, a Mountain View, Calif.-based venture capital fund, raised $300 million for its third fund focused on AI, industrial technologies, and advanced materials companies.