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Sometimes you sound like a nitwit, other times a jerk, and yet others, a fairy,
You are a complicated guy. Get lost.
Let's hope Ximedica is not dropping the ball on the actual development side. The more reserves Titan can raise for itself, the more insurance against any slowdowns or setbacks in the Ximedica shop. I said insurance, not a guarantee.
Titan managemnent: I've given up on hearing anything from them. They apparently pay only lip service to loyal investors, or possibly no one real leader is in charge there and they just pass the buck around. No presence in that crew. It would be nice to know who is really running the show at Titan.
If Titan raises its public image and generates a little buzz, that pushes Ximedica too, to perform also to meet expectations. Wonder how that relationship factors into the silence issue.
I'd prefer this product to be the Ximedica SPORT anyway.
Exactly my sentiments.
Remarkably off the medical tech market radar screen. ISRG stole the show lock, stock, and barrel.
If Titan ever got anything but the most rare and obscure press, price would climb radically.
Excellent review and article.
Makes one wonder where all these "current" systems are, like the mentioned:
"TELELAP Alf-X® system[13], which has been developed by SOFAR (Milan, Italy) and received the CE mark in 2011"
They don't seem to be actually marketed. In any case, Titan, please don't waste time.
I think a lot of people are duped by the term "Robotic" being used to describe Surgibot. Gets them excited. It is NOT a robot any more than my steering wheel to tires linkage are robots. My ABS system is robotic.
Actually, SPORT and daVinci can at least claim a bit more that they are robotic in that they actively modulate the human's movements through software algorithms. True robots can make movements autonomously via stored programs and data, react to external events, and make decisions. Semi-automated suturing, or assisted debridement would be a likely first for true surgical robotics. Some of the orthopedic systems are the closest we have to true robotics.
No one is there yet. That is why the other more academically-driven platforms are no where near commercialization. They are pushing true robotics.
Surgibot is not a surgical robot. It is a MIS device. It is a joke to compare it to daVinci or hopefully, to SPORT.
Agreed. War-wound surgery is too complex, bloody, and dirty for SPORT anywhere in the near future.
Lives are saved by stabilization and transport to surgeons. Then it takes experience and guts to put things together for the next round in a proper hospital.
Titan will not be receiving any significant monies from the military anytime in the next many years.
Forget that. Not in the equation.
IMO
I wrote about this a couple weeks ago. Whether standing or seated, the Surgibot video shows that nost of its instrument control, except grasp and wrist rotate, come from the elbows and shoulders. It seems to waste most of the wrist motion available to the surgeon. Plus, the neck and eyes are angled up. Plus, glasses. Console has to be more ergomomic.
Yea, that's why daVinci was a dismal failure, and ISRG went bankrupt years ago. Yes, I remember well the surgeons kicking the console across the room and literally sitting perched on the daVinci arms trying to control them with their hands. One guys shoe fell into the sterile field once; I saw it myself.
We will never go back to remote control - never.
Great information from you both. Thank you.
Great information about potential competition. Are you affiliated with the SurgRob blog site?
These potential competitors illustrate why Titan needs to gain cash reserves by growing pps and getting warrants exercised. Better to have the cash in place to pay Ximedica whatever they need to move SPORT along. It needs to make a big splash, similar to daVinci in the way that it dominates the second (smaller) wave of successful commercial systems.
I trust that the three examples of international surgical robotics are not as far along on the development path, but the field could get crowded relatively fast. Titan has LUCKED OUT (and it has NOTHING to do with their planning)that so far, academic surgical robotics has trumped commercial development. I think maybe ISRG just took the wind out of everyone's sails early on. Really, their success is amazing, the Henry Ford of their time. But the window of opportunity won't last forever for Titan.
Positivity is one thing.
Making claims for new information that is neither described or verified is meaningless; it is better if you don't post anything in that case.
That's the only Korean company that has been mentioned in any context on this board over the past 2 years as I recall.
Samsung has the resources to undertake any type of project they want, including surgical robotics. However, I fail to see what advantage there could in any connection between ISRG and Samsung. Unless ISRG would license their arm technology. Anyway, Samsung and other Japanese robotics companies could develop something better now themselves than daVinci.
I'll tell you one thing, we are lucky Titan is Canadian, and working with Ximedica who offers strong regulatory navigation services. I'm hearing from more and more U.S. medical companies, new and existing, for whom the cost and complexity of FDA over-regulation is preventing new products from even being developed.
Thanks for elaborating. Sounds like he may not even know what reverse-engineering means. I agree with your "beats me".
Any future information will always be appreciated on this board.
Thank you for the post.
Could you elaborate on your reported statement, " He said that Intuitive has sold the rights to a Korean company and that they were reverse engineering it. When I asked him the name of the company he did not know. Has anyone heard of anything like this? ". I don't understand; who sold what rights? He wasn't going to say that ISRG is selling off to a Korean company.
Any info would be appreciated.
Dak, thanks.
How important are surgical clips in the procedures that SPORT is currently targeting?
If clips are unavailable, is ligation still the common method? Been a few decades since I did my large animal surgery class.
The previous post seems to be the level at which Titan's closest competition is operating. Took the text from the SurgRob site, which seems to keep pretty abreast of what is going on. I suggest all Titan longs read it from time to time.
Unbelievable that Titan is STILL OFF THE RADAR. Frankly, I don't care as long as Ximedica is busting butt. However, it's still hard to believe we are a buck-fifty stock with the development level SPORT is currently at.
Also, please look at my Post #20574. Have not heard from any of our good surgeons yet addressing my questions, which I feel are very pertinent to our current situation.
"This year at the Hamlyn Symposium, we will be launching the Surgical Robot Challenge supported by the dVRK (da Vinci Research Kit) community, RAVEN II Open Source Surgical Robot community, and the KUKA Light Weight Robot research community. The purpose of the Challenge is to foster collaboration, share resources and tackle some of the unmet technical/clinical challenges in robotic surgery. The Challenge is organised into three categories and the winner of each theme will receive a cash prize for the team, free registrations to the next Hamlyn Symposium, and a trophy. An overall winner will be selected by a panel of judges and presented with the Challenge Cup and an additional cash prize.
Challenge 1: MIS Essentials
Minimally Invasive Surgery (MIS) is an inherently demanding endeavour. Long instruments through predefined ports possess a limited range of movement, which can make surgical manipulation of delicate tissue technically challenging. Robotic platforms with 3-D endoscopy and articulated instruments may help overcome these barriers. In“MIS Essentials” we assess performance in a series of basic surgical skills with increasing difficulty. Both FLS (Fundamentals of Laparoscopic Surgery) and FRS (Fundamentals of Robotic Surgery) trainers will be used for this Challenge. The teams will be tested with basic robotic manoeuvres such as peg transfer, precision cutting and suturing to more difficult tasks involving deep suture with intracorporeal knot and anastomosis. The teams are encouraged to develop bespoke instruments with certain levels of automation.
Challenge 2: Working in Tight Spaces
MIS is increasingly performed in tight spaces. For example, paediatric laparoscopic surgery is limited by the inability of many surgeons to perform small anastomoses. Arguably the greatest potential role for robotic platforms in surgery is in such small working spaces. Pyeloplasty – an operation to remove a blockage in one or both ureters – is the highest volume example of robot-assisted MIS in children. In “working in tight spaces” we begin by assessing performance in different stages of the pyeloplasty procedure. Detailed guideline of the procedure will be provided and the teams are encouraged to develop novel robotic instruments to simplify the performance of certain surgical steps.
Challenge 3: Freestyle Competition
In this Challenge, you are encouraged to bring your own surgical robot platform or your instrument/programme that can be run on dVRK, RAVEN II or Kuka LWR to perform a specific surgical task/procedure. We particularly encourage seamless integration of human-robot integration, machine learning and collaborative control. This is a Challenge that is ideally suited for showcasing your latest technology from your existing research projects.
How to Enter
If you are interested in entering the Challenge, you will need to complete a registration form and submit via the symposium website before 30 March 2015. Detailed instructions and competition guidelines will be sent to you shortly afterwards. A dedicated team will assist you throughout the preparation of the competition as well as logistics during the Symposium."
Steering Committee
•Guang-Zhong Yang, Imperial College London, UK (Chair)
•Russ Taylor, Johns Hopkins University, USA
•Blake Hannaford, University of Washington, USA
•Simon DiMaio, Intuitive Surgical Inc, USA
•Cyrill von Tiesenhausen, Kuka Robotics, Germany
More information: at Hamlyn
Of course it can't be kept a secret. It's like telling the entire pharmaceutical investment community "hey, we'll talk about all the major classes of drugs EXCEPT antimicrobials". Not providing any info on that. It's all a big secret, hush, hush! Even though microbial resistance is the major problem we face around the world. Just sit back and use penicillin until you hear something.
The investment community WANTS to know WHAT to INVEST IN! That's why it is called an investment community.
How many times have you read that surgical robotics is a MAJOR GROWTH SECTOR in MEDICAL TECHNOLOGY!!?? ISRG is a monopoly who blew the f*cking roof off its initial pps.
Titan is the ONLY freakin', actually on-the-way-to-market, company, IN THE WORLD, that we all seem to know of that can realistically add to the surgical robotics field anytime in the near future.
How the hell can that be kept secret??!
Have a lttle mercy. Sounds like he lost his shirt with Spider/Surgibot.
For our surgeons out there, Surgibot mentions energy ligation forceps. Is that something that SPORT is likely to offer?
Also, any guesses as to what SPORT might be doing about surgical clips? This has always seemed a BIG question to me. It also probably requires partnership with a clip manufacturer.
Look at the 2013 daVinci instruments catalog link: http://www.intuitivesurgical.comproducts871145_Instrument_Accessory_%20Catalog.pdf
A quick read shows 42 instruments. Dozens of other trocar, port, caps, etc. of supplemental parts.
Roughly 11 are cardiac specific. Forget about those for now.
The rest cover General, Urologic, and Gynecologic surgery.
There are 3 clip applier sizes alone. 10 instruments are listed for nephrectomy which SPORT will do supposedly.
What will SPORT need as a minimum to get rolling for their indications? Seems to me the design and production of a suitable effector suite for SPORT (and auxiliary components) is a MAJOR TASK; some of these are cautery too, so require the additional engineering for effective and safe electrical operation.
Does anyone know what the minimum set was that daVinci had in its earliest commercial phase? They started with prostatectomy, I believe.
I'm sure that "you don't need them all". But, on the other hand there must be some minimum set, and anything extra means another port on the patient.
I can tell you that if you look closely at the Surgibot video, you can sense that the tactile feedback is minimal at best going through so much mechanism.
Also, when you watch the body language of the surgeon with the Surgibot, you realize that the control of motion is coming from the elbows and shoulders. The wrists seem only to be used to rotate the effector. Thumb/Finger motion is only used to grasp. The whole effect seems to be one in which the fine motion of the wrist and fingers that surgeons use is wasted.
Add to that the articulation knob that is somewhere in the middle, along with the camera control.
daVinci and SPORT (I think) allow full wrist motion use with the forearms at rest on a cushion. Surgibot just looks UNCOMFORTABLE, from the stance of the operator to the motion of the handles.
It may be built well, but it just doesn't look ergomonic. The video is a bit bizarre; I suggest they update it with an animal procedure.
In it's defense, it seems a lot of the Surgibot surgeons listed are doing bariatrics. Maybe that is its niche. I wish them luck since I'm sure a lot of people put their hearts into this device.
We can only hope that Titan management is seriously studying the continuing ISRG experience and developing a strategy for SPORT that will limit them from making the same 'mistakes' that ISRG has made.
Good article about ISRG. SeekingAlpha: Why ISRG is no longer a growth stock
http://seekingalpha.com/article/2906886-why-intuitive-surgical-is-no-longer-a-growth-stock?auth_param=12m5os:1adplqe:e770fae7451597cad8277b5e1525e281&uprof=45&dr=1
Yea, the excitement is overwhelming. Look at your pps and message board chatter.
Get lost; the Gooberbot is a dead end.
He uses a surgibot to pick up french fries that fell under the counter in the ISRG cafeteria. Says he hates the glasses though.
HaHaHa! I'd change that to no road ahead though for TRXC longs.
As I said in my last post, although long and hopeful, I have to admit I know NOTHING about the particulars of this machine. Neither does anyone in the the market, hence the ridiculous pps.
Of course I know it wasn't an ISRG add. I'm not a moran.
It is a great surgical video and I thank you for posting it. Yeah for surgical robotics!
My point was that it is an effective demonstration of daVinci capability only; it bears little or no relevance to SPORT for the Titan investor, or interested medical community. Why? There is extremely limited public information available about the SPORT platform.
As to the SPORT effectors current and planned: there is no information available demonstrating or claiming how they can be interchanged in situ. Besides a needle driver/forceps and a bovie/dissector, no other effector types have been named. Staples or clips suitable for use with SPORT have never been mentioned, let alone demonstrated. A retractor is very likely not part of the SPORT platform. Efficient suturing has not been demonstrated.
A telling patent (or patent application; I forget which) was the armature that was obviously intended to support multiple SPORT heads. What does this tell us?
The bottom line:
Long or not, we are for all intents and purposes in the dark at this time as regards anything but the most trivial elements of the SPORT platform. I simply don't know what to expect as to how it will stack up against daVinci. Without that information, educated investment will continue to be wary. The stellar cast behind Titan has told us nothing.
Looks like a nice advertisement for daVinci.
From your experience, and knowledge/expectations of SPORT and potential effectors, could SPORT do this job?
It looks like they use daVinci arms to control each port.
If SPORT can reduce the two effector ports and camera port to a single port, good. But note a liver retractor, controled by a person will still be needed with SPORT. Also, we don't know if switching effectors in SPORT will require full withdrawl of the SPORT arm (both effectors).
Also, the closely opposed effectors of SPORT don't have the range of separation that two separate daVinci arms can have. Are there situations where SPORT effectors, since they are "bundled together coming from the same direction" are a limitation.
I'm not trying to argue anything against SPORT, but for this operation, SPORT would seem to come up short.
I'm happy that ISRG is pushing the surgical robotic indications envelope.
Titan's advantage will be to get to the market first with it's "small, mobile" form factor first.
My point is that ISRG is NOT going to be designing and building larger systems than daVinci anytime in the near future. No one is. If they have any foresight at all, they are assessing the market experience and have come to the same conclusion as Titan; smaller is better. They have the resources to design in that direction.
Dak, true, but I think the important point here is that daVinci is a proven design. Maybe, ultimately, the SPORT-type effectors will prevail, but in the meantime if ISRG can reduce the overall size of daVinci, make it mobile, reduce arm number, etc., they can still stay ahead of Titan.
I am sure you are correct about ISRG. That is supported by their surgeon's survey.
Titan has no time to waste.
Warning: Advertisement for Gooberbot.
And why should the surgeon stand 4 feet away with a Gooberbot and repair a hernia? It doesn't have true tactile feedback either. I suspect (although I'm not a surgeon) that tissue tension during a hernia repair is best sensed with the fingers anyway.
Please, no GooberBot advertising on this board.
Thank you Sir.
MX77, I second your question. That would be a serious blow to many here holding this stock.
Agree that Titan appears the only player with a platform realistically possible to go to market in the next year or two, for general robotic surgery that is.
It's almost unbelievable. I hope they are working like hell to stay ahead.
Not worried about Surgibot. Still think it is a dead end.
I can only think insider info is circulating. This is day three of steady gains and volume w/ no fall-off. Granted, day trading is adding momentum and some false pps value, but the consistency goes against it being pure speculative plays.
Doesn't appear that TXRC got any sympathetic pop in pps or trading the past two days, to go along with TITXF.
That should rule out any mutually-favorable news or market chatter out there that might have occurred.
Any theories out there about what might be fueling this pop? Seems a bit too early to be based on anticipation of any next report, especially since the milestones were so extended for the new indications. Most on the board here were thinking that even with a good next announcement, interest in TITXF would continue to be lukewarm, as it has been for some time.
My guess is that there is some good news circulating among a select few people.
LTG, the more I read and think about all types of surical robotics, the less Surgibot even enters my thought process. It is not a robot; it doesn't have "haptic feedback"; and it does not look like it offers any significant ergometric advantage to the surgeon, short of stabilizing the instruments in relation to the MIS port.
Surgibot represents some sort of market-ready lowest-tier instrument holder; maybe there are some advantages in that for some surgeons, I don't know. But it will not go anywhere; I assure you.
Really though, you are not wanted on this board because you cheerlead like someone delusional while pretending to show some respect for Titan.
Too early and steady a pop, to be based on anticipation of any scheduled news.