Where UpSurgeOn's EIC Accelerator Brain Surgery Models Stand Today

Neurosurgery residents typically get into a cadaver lab only a few times a year, according to the EU's project summary, and learn much of the rest on real patients. UpSurgeOn, founded near Milan by the neurosurgeons Federico Nicolosi and Giannantonio Spena, sells a cheaper substitute: a plastic skull, the BrainBox, holding a synthetic brain that can be opened, dissected and clipped, paired with phone apps and augmented reality that overlay the anatomy. In June 2019 the European Commission selected the company in the last rounds of the EIC SME Instrument Phase 2, the Horizon 2020 forerunner of the EIC Accelerator, and granted it €1,208,256 towards a €1,726,080 project called UpSurgeOn Academy.

Seven years later the company is active, has raised two private rounds and says its simulators are used in more than 110 countries. Its filed accounts tell a more modest story: €1.94 million in revenue in 2024, and a loss in every year from 2021 to 2024.

What UpSurgeOn Does Now

UpSurgeOn is trading and growing. The Italian business register lists UpSurgeOn S.r.l. as active, with 2024 revenue of €1,936,669 and a net loss of €235,528, according to companyreports.it and visurissima, which both draw on the Registro Imprese. In March 2026 the company announced a €5 million round led by CDP Venture Capital through its Evoluzione fund, with Simest, Deep Blue Ventures, Azimut Libera Impresa and FBH, as reported by BeBeez and Startupbusiness. The money is meant for international expansion, new surgical specialties and research into measuring surgical skill.

The product range has moved beyond the six cranial boxes of the EU project. The company website now lists cranial, spine, skill, fluorescence and anatomy series, a "Lab-in-a-Box" for hospitals and companion apps, and covers plastic surgery, ear, nose and throat surgery and orthopaedics as well as neurosurgery. It claims 500+ scientific institutions, 300+ medical technology companies and 110+ countries as users; its About page gives lower figures of 300+ institutions and 200+ companies. Neither set can be checked independently.

In January 2025 UpSurgeOn and the British simulation company Inovus Medical announced a global strategic partnership: UpSurgeOn's models are to be integrated into Inovus's Totum platform for cranial, spine, ENT and plastic surgery, with Inovus selling them in "key international territories". Inovus's own site lists UpSurgeOn research among its resources, which supports the link. Sales figures for the partnership are not public.

The Technology: A Synthetic Brain in a Box

Surgeons have traditionally learned on cadavers and in the operating room. Cadaver labs are expensive, hard to run for legal and ethical reasons, and unavailable in some countries; the company's final EU project report reports unforeseen demand from Muslim countries where, it says, religious rules prohibit the use of cadavers even for training. Virtual reality simulators avoid those problems but give little sense of touch.

UpSurgeOn's approach combines the two. A BrainBox reproduces the skull, brain and vessels for one surgical approach, built from 3D anatomical models, and can be cut and reused for exercises such as opening the skull or clipping an aneurysm. An app teaches the anatomy and steps, and an augmented reality layer projects the hidden structures onto the physical model through a phone or tablet. According to CORDIS, project coordinator Paolo Raimondo said the company was "the first to develop, patent and offer" this mix; the company's About page says it had filed nine international patents by 2022. Specific patent numbers were not found in this research.

Independent tests are mixed but broadly positive. In the UCL study of the aneurysm model, 8 of 10 expert surgeons said the brain looked realistic but only 2 of 10 said it felt realistic; the model did separate experts from novices, with median skill scores of 27 against 14.5, and the authors called it "a promising adjunct to training". A 2023 course for 16 medical students run by Charité and other European centres, published in Medicina by authors who declared no conflict of interest, found that all participants said the app helped their anatomical orientation. An earlier evaluation of the augmented reality kit with 30 residents, in which more than 89% rated it very helpful, was published in Frontiers in Surgery in 2022; three of its authors are UpSurgeOn's founders and its lead bioengineer, as the paper discloses.

What the EIC Project Promised, and What CORDIS Shows

The European Commission's list of the 5 June 2019 winners names UpSurgeOn of Milan alone for UpSurgeOn Academy, and CORDIS shows no other beneficiary. It followed a Phase 1 feasibility grant of €50,000 from May to August 2018. The Phase 2 project started on 1 October 2019 and closed on 31 December 2021, so it ran almost entirely through the pandemic.

The application set out a platform of apps, physical BrainBoxes and augmented reality for medical students, residents and surgeons. It also promised €15.4 million in revenue, a cumulative EBITDA of €5.2 million and a return on investment of 3.3 in the five years after the project, and a Phase 1 summary on CORDIS added 15 new hires. The final report says the company built apps and six physical boxes for six cranial approaches, held 35 hands-on courses and 7 conferences in the second period despite travel bans, and by 2021 had more than 300 customers in more than 70 countries, half of them universities and neurosurgery schools. It also changed the business model: instead of selling mainly to individual trainees, it moved to selling to schools through medical device companies that sponsor training courses.

1. Apps plus physical BrainBoxesDeliveredSix cranial boxes and apps on sale from early 2021, per CORDIS and the company website.
2. Augmented reality trainingDeliveredTested with 30 residents in a 2022 study.
3. Scientific validationPartlySeveral published studies; the Harvard study CORDIS called "shortly to be published" was not found.
4. 15 new hiresDeliveredStaff rose from 8 in 2019 to at least 25 in 2024 in register data.
5. €15.4M revenue, 2022 to 2026Behind€3.68M in 2022 to 2024; 2025 and 2026 not yet filed.
6. €5.2M cumulative EBITDANot shownNet losses every year from 2021 to 2024.

On the product, the grant did what it was meant to do: the platform was built, launched within the project period and sold internationally. The financial plan has proved far too optimistic so far.

The Money

Register data show how slowly sales started. Revenue was €6,160 in 2019 and €3,918 in 2020, before rising to €311,811 in 2021, according to visurissima; those early figures appear in no second source. From 2022 the figures match on two services: €648,959 in 2022, €1,089,799 in 2023 and €1,936,669 in 2024, per visurissima and aziende.it. Atoka puts the 2024 growth at 77.6%, which matches those numbers; money.it gives 52.29%, which does not.

The losses were largest while the team grew: €856,400 in 2022 and €854,783 in 2023, narrowing to €235,528 in 2024, per visurissima, with aziende.it matching the last two. Together, 2021 to 2024 lost €2,152,108. Money.it reports a positive EBITDA of €332,650 for 2024, a figure no second source confirms.

Private investors have backed the company twice. A €3 million round in 2022 involved the Italian packaging group Guala Dispensing, according to Startupbusiness and the company's own March 2026 release. Together with the 2026 round, the company's institutional funding exceeds €8 million, according to Pulse 2.0. Valuations and stakes are not public. UpSurgeOn is not in the EIC Fund portfolio, which was checked in full on 8 October 2026; as an SME Instrument grant, the 2019 award did not include equity.

Other public money has followed. The Lombardy region granted €503,247.41 towards a €546,452.37 project, Avatar, for patient-specific surgical models built from medical imaging, under the EU's regional development fund, according to a funding notice on the company website; patient-specific models were a next step named in the EU project report. And UpSurgeOn is a partner, with €60,000, in PRISM, a European Research Council proof-of-concept project led by Tilburg University from August 2024 to July 2026 to build a realistic model for training researchers in surgery on non-human primates.

Why Europe Should Care

Europe is short of health workers, and the Commission has used its EU4Health programme to fund training, including digital skills for the health workforce, as in its September 2024 action on retaining nurses. UpSurgeOn's case for public money was that cheaper, portable training could produce more and better-trained surgeons, citing a shortfall of 23,000 neurosurgeons in low- and middle-income countries and rising malpractice claims. Its Global Training Project took simulators to 11 emerging countries during the EU project, according to CORDIS. The PRISM project adds a European research-ethics angle: replacing some live-animal surgical training with models.

The Verdict

UpSurgeOn has not been asked for comment for this article. It is based entirely on public records, company statements, scientific papers and EU project data, linked throughout.