My 2 cents on $TRXC -> Road leading to Laparoscopy

Before you read on, please be aware that the analysis below is my opinion only and may include flawed assumptions and inaccuracy of logic; therefore, caveat emptor applies here.  Furthermore, all emphasis (color-coded, boldness, and underlined) on the excerpts are my own.

Since I’m neither a doctor nor a surgeon, I’m going to express my 2 cents using a 13 years old article written by a practicing general surgeon as my reference.  You can read the entire article by clicking the title to the article -> Laparoscopic Surgery – The Advantages and Disadvantages  (The article was written back on May 3rd, 2005)

Below is an excerpt from the beginning of the article:

TRXC_lapa_adv_vs_disadv

Below is an outline of the article that included the advantages and disadvantages:

  1. Over the past 15 years technology has radically changed the way many surgeries are performed.
  2. Laparoscopic or “minimally invasive” surgery is where the surgeon
    1. makes a very small incision
      1. often in the patient’s belly button
    2. uses this incision to insert a camera (called laparoscope) into the abdominal cavity
    3. Surgeon looks at a television screen to perform the operation
    4. Carbon dioxice, a nontoxic and odorless gas, is then used to create an air pocket withing the abdomen for the surgeon to operate
    5. Depending on the operation:
      1. one or more additional incisions, less than a half-inch in size, are made to insert surgical instruments into the abdomen to perform the procedure
    6. Incisions are usually closed with stitches that dissolve
  3. THE ADVANTAGES
    1. Patients have much less discomfort and require less pain medicine due to smaller incisions
    2. They are able to get up and walk around sooner and get back to their regular activities earlier
    3. Long incisions (from traditional surgery) restricted patient’s activities when they go home
      1. to prevent developing a hernia at the incision site
      2. Hernias RARELY occur at laparoscopic incision sites
        1. so patient can exercise and lift a lot earlier
    4. Patients are less likely to develop wound infections
      1. because the incisions are so small
    5. Patients are able to get out of bed sooner
      1. they are less likely to develop blood clots  or pneumonia than traditional surgery
    6. Patients undergoing bowel surgery are able to drink and eat earlier than in the past
    7. After incisions have healed the scars are almost invisible
  4. THE DISADVANTAGE
    1. Not many disadvantage
      1. Laproscopic surgery requires that patients
        1. undergo a general anesthetic (aka “put to sleep”)
        2. patients are hooked to a breathing machine during surgery
          1. this may cause sore throat after operation
      2. Patients may have nausea from the anesthesia medicines
      3. Occasionally, patients may get air pockets under the diaphragm
        1. the muscle between the chest and abdominal cavity
        2. these pockets of air may cause neck and shoulder pain
      4. Some patients complain of feeling bloated afterward

========

Below is my 2 cents on the above:

Since the article was written back in 2005, the author’s mentioned of “past 15 years” meant technology of laparoscopic surgeries began around the year 1990. And from 2005 to the current year of 2018, that’s another 13 years of technological progress in the field of laparoscopy that included an introduction of the robotically-assisted surgical device, Da Vinci, from Intuitivei Surgical Inc. 17 years ago and the Senhance from TransEnteris Inc.last October 2017.

As mentioned numerous time before, we must give thanks to Intuitive Surgical (ISRG) for leading the medical community into the world of robotic-assisted surgeries. Due to the nature of FDA’s stringent approval process, ISRG enjoyed the fruit of its technological moat for the last 17 years!  But this 17 years monopoly without a competitive peer has finally come to an end with the recent FDA’s clearance of the Senhance robotically-assisted surgical device in October 2017.  Senhance’s passing the FDA scrutiny after 17 years is a much-needed miracle because it offers a choice against the Da Vinci.

The advantages and disadvantages of the laparoscopy are self-explained from the outline above.  And it is obvious, per my 2 cents, that the advantages far more outweighed the disadvantages.  This risk of general anesthetic and air pockets paled in comparisons to the complications arose from long incisions which included the major suffering of pains and possible infections.

Sidebar: One of the benefits I received when posting my weekly blog is that sometimes my researches lead me to a better understanding of the subject I’m writing. Until today, I didn’t realize the disadvantages of laparoscopic surgery included issues such as general anesthetic (aka “put to sleep”) requirement and the complications from air pockets.  I also wasn’t aware of the risk of developing a hernia at the incision site from traditional long incision cut.

My previous blog posts on $TRXC repeatedly emphasized the importance of “choice” being made available.  It is also the focus I used to determine the prospect of success in my making a bet on $TRXC.  Please be forewarned that I will tirelessly repeat this “importance of choice” message from time to time.

Why do you need to repeat this from time to time?

I can summarize it in one word; it is the power of:

P R E F E R E N C E

EVERY human has his/her preference.  And preference can only occur if there is a choice.  Without a choice, the Da Vinci becomes the ONLY robotically-assisted surgical device regardless of the surgeons’ personal feeling about the Da Vinci.

What about those who don’t like the Da Vinci?

That will be tough luck because the surgeons either use the Da Vinci as a robotically-assisted surgical device or don’t use one at all. However, surgeons who don’t like the Da Vinci can wait for FDA to issue clearance for another competitive robotically-assisted surgical device.

After 17 years, the waiting is now over.

Don’t you think the 17 years monopoly might create hesitation in adopting a new version of robotically-assisted surgical device beside the Da Vinci?

It is my 2 cents that “preference” plays such a major role in the human decision-making process that Senhance, being a highly competitive product with all the bells and whistles already discussed from my previous blog posts, is a strong choice for surgeons who don’t like Da Vinci for whatever reasons.

Can you give an example of preference here?

Sure! Here is a simple example of preference:

Although most of us are not a surgeon, ask yourself which one of the visual platforms do you prefer below anyway:

This one here below?TRXC_DaVinci2

Or this one here below?

TRXC_Senhance2

Here you’ve one approach where you put your head into the box-like structure to see the surgery or the alternative approach where you sit back and watch the monitor like 99.9% of the computer users do.  When the computer graphic designers or the AutoCAD users have NO ISSUE with handling and managing details on the video screen, I don’t think surgeons will have any issue performing the surgery watching the monitor either, don’t you think?

The fact that NOT EVERYONE likes to put their head into a box-like structure to perform surgery, by itself, tells me that the “preference” I’m talking about is as valid as a choice between blue and red.  And that is why I believe Senhance has a better than 50/50 to be adopted.

Sidebar: notice on the first image, the other surgeon standing on the left had no clue what the surgeon was doing during the operation.  Meanwhile, the 2nd photo showed how easy it was for the other surgeon to watch the performance of operation live.  So from a training point-of-view, Senhance has a much better presentation when it comes to explaining the nuances of the surgery by the senior surgeon to the training surgeons during surgery.

After going through the advantages and disadvantages of laparoscopy above, I think it is safe to say that laparoscopic surgery is and always will be the preferred choice for the patients if the choice is available.  Now, it is high time for the surgeons to have a choice between the Da Vinci and the Senhance when it comes to choosing a robotically-assisted surgical device.  In the next few years, it is my 2 cents that both Da Vinci and Senhance will play a major role in transforming the surgical market into a robotically oriented phenomenon.  In other words, the road to laparoscopy is big enough for both Da Vinci and the Senhance.

Don’t forget; all the above are my opinions only!

Good Luck and may fortune blesses all TRXC investors.

My 2 cents.

From my camera:

IMG_0519



Categories: Daily trading Journal, trading journal

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  1. Weekly thought on $AEMD, $GRWG, $IBIO, $LRAD, $MARK, TRXC – Trading my two cents

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