No clinician should have to place a neuraxial needle by feel alone.
Rivanna Guidance Solutions (RGS) was formed in October 2026 as an operating company of Rivanna Medical, Inc. with a single job: bring real-time neuraxial guidance into the procedure, beginning in labor and delivery. We are headquartered in Charlottesville, Virginia, where the platform we build on was invented.
The standard a patient receives should not depend on the shift, the provider, or the body.
Neuraxial anesthesia is among the most commonly performed procedures in medicine, and for nearly a century the advance of the needle has been guided by feel, in a population where rising BMI makes the landmarks harder to find. Training takes years and resets every July, when new residents begin; the decision at the needle cannot wait. We hold a simple point of view: neuraxial guidance should not stop at the skin. It should continue while the needle advances. Our purpose follows from it: help clinicians guide the needle, care teams measure the case, and programs improve their practice.
Fifteen years of RIVANNA, focused on one procedure.
Rivanna Medical began in 2010, founded by University of Virginia graduate students who set out to address the high failure rates of epidural and spinal anesthesia placement. The first prototype was built with a toaster oven, a trailer hitch, and a deer-spine phantom. From that start, the platform has earned multiple FDA clearances, and its development has been accelerated by non-dilutive federal awards from NIH and other government programs: a first SBIR in 2012 through Accuro® 3S grants in 2023 and 2025.
Today RGS builds on that platform, manufactured in an FDA-registered, ISO 13485:2016-certified facility in Charlottesville. The intellectual property behind Accuro 3S spans 50+ patents and applications across 10+ families, licensed exclusively to RGS.
Accuro 3S is FDA 510(k) cleared with SpineNav-AI image-processing software. RGS engages the specialty directly, as a SOAP Diamond Sponsor and ASA Innovator Supporter, and through work with the Multicenter Perioperative Outcomes Group (MPOG).
A limited, evidence-led release is underway.
Accuro 3S is entering the field through five Pioneer sites in 2026, with the 2027 Trailblazer cohort now forming and a wait list ahead of broader availability. Site selection is deliberate; evidence leads availability.
Founder-led, with operators from across capital medtech.
Will Mauldin, PhD
Led RIVANNA from a University of Virginia lab to more than 1,300 systems in the field.
Jonathon Pons
More than twenty years launching and scaling capital medtech, from Covidien to sales leadership at HistoSonics and Echosens.
Mark Sylvester, JD
Previously Genome Medical.
Adam Dixon, PhD
Led RIVANNA’s technology from the first Accuro to the Accuro 3S clearances; each SBIR awarded has become a commercialized product or significant follow-on funding.
Board of Directors
Rich Fabian, CEO of Profound Medical and former CEO of SonoSite.
Beyond guidance: neuraxial procedure intelligence.
The blind procedure is a solvable problem. Real-time guidance is the beginning. Each guided procedure can be measured; measured procedures can teach a program. That destination is neuraxial procedure intelligence.
Our mission: bring intelligence to every neuraxial procedure by connecting real-time guidance for the clinician at the bedside, structured measurement of each case, and program-level insight for quality, training, and oversight.
Guidance is here today. The measurement and insight layers are in development, and they will enter our claims only as the evidence supports them.
Our vision: a future of safer neuraxial care for every patient.
Commercial figures are company data on file as of Q2 2026. Patents are held by Rivanna Medical and licensed exclusively to RGS.