In the world of healthcare innovation, breakthroughs rarely come from where we expect them. For UltraGreen.ai, the journey began not in an advanced lab or a futuristic AI model, but with an unassuming green dye first developed decades ago by Kodak.
Known as indocyanine green (ICG), the compound has long been used in ophthalmology to visualise blood flow in the eye. Today, UltraGreen has transformed this humble dye into the backbone of a surgical revolution – one powered by data, imaging and AI.
At its core, ICG binds to blood plasma and glows green under near-infrared light. Surgeons inject the dye during procedures to visualise blood flow in real time, allowing them to see where tissue is healthy, where it is dying, and where best to cut or stitch. What once relied on a surgeon’s “feel” can now be measured, quantified and optimised with data. This shift, according to CEO Ravi Sajwan, is not just about sharper images: it’s about precision, safety and outcomes.
A data-driven surgical ecosystem
When Sajwan acquired the dye business in 2015, it was originally to secure supply for a medical device company. But what began as a supply chain solution quickly evolved into a full-scale healthcare ecosystem. Today, UltraGreen owns the lion’s share of the U.S. and European ICG markets, while pushing into APAC with affordable imaging systems designed for diverse healthcare settings.
“Every bottle sold enables a surgery,” Sajwan explained. That simple equation underscores the company’s scale: from just US$20,000 in sales a decade ago to nearly one million vials shipped annually today. More importantly, each vial unlocks a data point. By combining dye, cameras and cloud-connected software, UltraGreen has created what Sajwan calls a “fluorescent-guided surgery ecosystem”- a platform that not only visualises blood flow but captures quantifiable data for AI-driven insights.
Applications are wide-ranging. In colon cancer surgery, ICG helps surgeons determine where to safely reconnect tissue. In gallbladder removals, a procedure prone to costly litigation, real-time visualisation reduces the risk of cutting into the liver. Plastic and breast reconstruction surgeons use it to preserve healthy tissue and minimise scarring. The technology even extends to sentinel lymph node detection in oncology, expanding precision beyond the operating room.
IMAGE: UltraGreen.ai
The shift from storage to real-time intelligence
Traditional surgical decisions often rely on storage-based data such as MRI scans performed weeks before surgery. UltraGreen’s approach replaces this static view with live information. “When a surgeon injects the dye, they see perfusion immediately,” Sajwan said. “That means nutrients and toxins in the blood are visible in real time, guiding the best surgical outcome.”
This leap from delayed to instantaneous intelligence is where AI enters the equation. By analysing video feeds from near-infrared cameras, UltraGreen’s software quantifies how “green is green”, turning shades of fluorescence into actionable perfusion metrics. Surgeons are no longer just relying on instinct; they’re working with a data-backed compass.
Horizontal AI meets healthcare reality
But Sajwan is quick to clarify: healthcare requires more than general-purpose AI. “Horizontal AI is great for Wikipedia or ChatGPT,” he said. “The more data you feed it, the better it gets. But in surgery, Ravi’s perfusion level today is not the same as anyone else’s, nor even mine tomorrow under different stress levels.”
Instead, UltraGreen champions vertical AI models built for specific clinical workflows. For example, perfusion data combined with cardiac inputs can help determine whether a patient with heart disease will heal properly after surgery. In diabetic foot ulcers, thermal imaging, wound photographs, ICG visualisation can be fused into a “wound language model” to predict whether an ulcer will heal or require amputation.
These models don’t generalise across populations. They are patient-specific, surgery-specific and deeply vertical in scope. “AI in healthcare should augment, not replace human intelligence,” Sajwan argued. “Our job is to give clinicians precise, real-time information so they can make better decisions.”
Preventing problems, not just treating them
Perhaps the most striking example of UltraGreen’s philosophy is in diabetic care. Globally, tens of millions of people face amputations each year due to untreated foot ulcers. Current pathways involve repeated doctor visits and delayed interventions. By integrating wound imaging, perfusion analysis and AI-driven predictions, UltraGreen’s system allows doctors to intervene earlier and sometimes avoid amputation altogether.
The economic and human impact is staggering. In the U.S., a single diabetic foot ulcer can cost US$50,000 annually in care. In countries with fewer MRI machines or specialists, delays can be fatal. By lowering costs through accessible cameras and subscription-based models, UltraGreen aims to democratise precision healthcare worldwide.
Building trust through ecosystems
Beyond the technology, UltraGreen’s success hinges on trust. The company has cultivated a global network of surgeons, key opinion leaders and camera manufacturers, bringing them together under the International Society for Fluorescent Guided Surgery. Word of mouth, Sajwan stressed, is more powerful than marketing. “When surgeons see peers using ICG and getting better outcomes, adoption follows naturally.”
The company has also learned a critical lesson: never disrupt clinical workflow. New tools must fit seamlessly into what nurses, anesthesiologists and surgeons already do. That principle has allowed UltraGreen to scale without resistance and offer new insights without demanding new habits.
Value-based AI in surgery
What does the future hold? Sajwan envisions AI models that don’t just enhance surgery but transform value-based care. Today, about 20 per cent of gallbladder surgeries in the U.S. use ICG. UltraGreen wants that number to be 100 per cent, arguing that reducing litigation, improving outcomes and lowering system costs make the case undeniable.
“Innovation is about making inventions useful,” Sajwan said. “AI can help us quantify perfusion, predict wound healing and guide surgeons, but only if it respects the human at the centre of healthcare.”
For a company that started with a green dye once used in film processing, UltraGreen has come a long way. Its story illustrates how deep tech, when paired with humility and precision, can rewrite the surgical playbook: not by chasing hype, but by solving real problems where they matter most.
