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For trans rectal incision there are no incisions, the device is inserted via the anus and using air the rectum is distended to make space to see and excise the tumor. The limitation presently is the ability to see with regular surgery. The robot allows the surgeon to see better and with the robots arms you can dissect the tumor off of the wall of the rectum and suture it closed.
This also allows you to go higher up on the rectum to resect tumors that would require laparoscopic or open surgery.
A great leap forward for surgery.
Some news from contacts in NYC. After ACS meeting many of the surgeons are even more enthusiastic about SPORT because there was a presentation using Davinci robot for trans rectal excision of polyps and tumors. They think that the sport system will even be better than DaVinci because of the fact that the arms bend and will make it easier to remove the tumors. This is a great advantage to patients.
Also from the meeting, Head and Neck surgeons say that the sport system will also make surgery in the upper airway much easier than even Davinci which does a good job.
Other areas of interest was esophageal resections because the Davinci robots straight instruments have a harder time reaching up into the chest without compressing abdominal organs like the pancreas.
I would not worry about day to day stock price variation, in fact it is a great time for those with a high PPS average to bring that down if you have the funds.
Bought another 50000 shares on the drop today.
The surgeons use davinci and also perform laparoscopic cases. The person at the booth told my friends to buy more stock because they have verbal commitments for sales in USA and will announce soon. No sales person I have meet ever talks about future sales that have not been reported in sec filings?
A group of my fellow surgeons just got back from the ACS and transenterix had a large booth with the robot for trying. The surgeons said the product was unimpressive and did not offer anything over Intuitive and was just a robot controlling laparoscopic stick instruments.
Some of the surgeons own stock in both titan and transenterix and are selling their transenterix and buying more titan.
What does that say.
The stock will be a rocket for the next two months as new investors come in and old investors add shares.
If you wait you will continue to leave money behind.
Added more on Tuesday and rewarded in two days. Cant ask for more!
The price is supported by new investors coming into the market. I personally have brought 5 physicians into Titan shares. Each one purchasing over 100000 shares.
It is this kind of growth in support of the company that will support the price per share for sometime without news.
The fact that the price was over .50 cents when the new CEO was announced and now the company has a product and a time frame for FDA 510 filing the price is definitely undervalued by 25 percent in the short term.
Easy to convince fellow docs to come for the ride.
One thing that the management can start to develop that intuitive did a horrble job with is relationships with the surgical community. They would try to get surgeons to use their system by using fear of market loss. This really aggregated surgeons myself included. A marketing plan with surgeon's input early in the process will be an important tool to increase early sales. I would develop survey's using survey monkey and send them out to all disciplines very soon so that the company hits the road running.
It can take a week or more to get your stock from a warrant into your broker's trading account. Look at titan's web site there are instructions on how to obtain your stock. Have to send certified check to their managing stock broker.
That's why is you plan on actively trading your investment better to convert to stock especially once in the money. If negative news came out about a company by the time you can sell the profit could be gone.
I agree the warrant itself can be traded but this does not create any revenue for the company. Correct?
If you own warrants and you are in the money it is always worth converting into stock. You can not trade the warrant and the potential gains can by lost quickly if the stock starts to reverse and you don't have the stock issued to you.
Warrants are not stock and can not be traded on the exchange. Always purchase stock as soon as company seems to be moving up. Otherwise if market changes you lose your profit.
There is no risk to converting once in the money.
Titxf market cap is now 89 million.
Trxc market cap is 515 million after FDA approval and before news was 216 million.
If you use a conservative valuation for this time period for titan would be at 150 million. Have about another 60 to 70 percent rise in price share, or about 50 to 60 cents per share until fda news.
Not bad for a new investor with less risk than early investors.
At this time in the product development cycle you have least amount of risk to your investment than any other previous time with Titan.
There will be more positive news from New York which will again add investors with price advancement since at these price levels who would be a seller.
I am a bariatric surgeon in practice for 20 years. Whether the incision is 5mm or 3mm doesn't matter much. The main reason to use a robot is if it allows you to perform a task faster and better than you can laparoscopically with the same safety.
I use a lot of stapling devices which need a 12mm trocar Anyway.
The reason that general surgeons have not been overly excited about the robot over the last ten years is because of the following:
1. Most of our procedures take less than an hour to complete and the added time to set up the robot reduces income.
2. The added cost of the robot to procedures that pay the hospital an amount that barely covers the cost now.
3. No outcome difference to the patient for a procedure that adds cost.
4.Patients have not pressured surgeons to move to this technology and for the surgeon he does not get paid any more for using the robot to perform the case. The robot has to benefit both the patient and the surgeon.
5. Since intuitive's robot sits in one OR you have to change your schedule to the availability of that room.
6. No tactile feedback which is important for advanced cases. In fact may of the law suits against surgeons using the robot involves injury to tissues and organs because you can't sense pressure on these structures.
If sport can address some of these points will get access to surgeon's ears.
If you look at the evolution of robots in surgery, the main reason robots were bought was to help hospitals gain market share vs hospitals who could not afford them.
There are two main procedures where the robot aids surgeons in suturing prostatectomy and hysterectomy because of the 360 rotation of the tips. The robot has allowed average surgeons to perform procedures that their technical ability would not allow them to perform.
The advantage of sport is small foot print, able to go to multiple OR's and hopefully lower cost to acquire and maintain.
Some procedures that sport could make easier would be laparoscopic ventral hernia repairs, laparoscopic inguinal hernias and oral cavity surgery.
As to a reverse split, companies who have a viable product will have to have investment fund support before the split. The reason to reverse split is to get it listed on the nasdaq over $1.00 not to reduce outstanding shares. The value of the company doesn't change after splitting.
The stock value went up 150% after just placing one unit at a testing center. Think how much the value will rise after FDA submission. At this point selling your shares only makes sense if you need the money now for living. From this point on every good news dump will cause the shares to rise.
For division and sealing of vessels you need a bipolar device to grasp, seal and cut the tissue. If you look at devices like ligasure(covidien), enseal(ethicon), thunderbolt(Olympus), and others you can imagine that the robot needs a separate port and attached instrument that is actuated by the surgeon on the console. My vision of sport is not as an all inclusive robotic system but as another tool to use during my surgery with other small trocars. If sport can offer great optics and local suturing and dissection with the assistance of a few 5mm trocars that would be great.
My opinion of the TRXC system as a surgeon is that it is a step backwards in technology given that the aim of newer robotic systems is a smaller foot print in the OR. Also the erogonomics of the work station is poor.
The down side of the sport system is that there are only two working robot arms and many procedures require 3-4 instruments for exposure and operating. Also they need to have a bipolar tip cautery. I have not seen that tip on their website only unipolar. Having a strong energy device as part of your system is essential to moving into the market.
My opinion is still that they will be acquired by another company long before any sales for their IP
The quickest path to getting your investment back or a profit will be once fda approved having this stock on the nasdaq exchange where institutions can invest and can be part of etfs. This company will be bought long before it ever sells one unit.
The management has to align institutional investors so that when the company does a reverse split to get the stock on the nasdaq there is support for the price. All of the buying now is from people who are like myself and others on this message board. Institutions are not allowed to invest in pink sheet companies as part of their bylaws.
If there is success with the platform, the management will be able to align investors to support a reverse split. This will take at least 6 months after the company gets the platform submitted to the FDA.
This is a good time to invest for the new investor as well as lowering your average cost to the long term investor.
I have purchased 250,000 shares since the low of ten cents.
Still high risk but starting to see some light at the end of the tunnel.
The amount of warrants outstanding is 142,652,323 with a total value of approx. $87,000,000. The majority 59,000,000 are at 20 cents Canadian for a total of 12,000,000 Canadian dollars. Warrants are always diluting value but when exercised the hope is at that time the company's position can support the market price. Warrants are not counted as outstanding shares until exercised.
The only way for us to have long term success with this company is for the product to work well and add value to the operating room for the hospital system.
Only another 2 years to go.
I have invested in the stock since it was in the 2 dollar range and have bought on the way down to reduce the average stock price. The only reason to stay in the game is if you believe in the company. When the stock hit ten cents I bought another 100000 shares which brought my break even price to .285 per share. As is always the case start up companies always dilute the initial investors equity when they need money to pay for salaries and capital expenses.
Based on the number of outstanding shares and the value of competitors a fair market range for the stock with no sales but a viable working product without FDA approval is the 1.00 to 1.20 range. With FDA approval that would go to 3-4 dollars.
Thats why it is important for those invested at higher price to price average when the stock is low. Always investing just like gambling not over your head and with money that if your entire investment disappears it will not affect you significantly.
I am a surgeon working with the intuitive robot and would say that intuitive was not very customer friendly to surgeons and many surgeons would love to use another companies product.
Whether that will be titan's time will tell.
total volume at 1pm 3.3 million shares, remember that there is a seller for every buyer. No such thing as more buyers than sellers when speaking about volume. More bids puts pressure on the stock to rise to get people to sell their shares. The price goes up until sellers enter and accept their bid price. Same on the down side ask price declines until someone is willing to buy the stock.
The main objective of the company should be to create a cost effective system as compared to Intuitive that is easy to implement and allows for easy access to surgeons without extensive training. Intuitive is not well liked by the surgical community because of the type of sales practices it uses to pressure surgeons to perform procedures with the robot. The next company to enter the market will have many surgeons ready to jump off the intuitive platform and will be able to capture surgeons who have used the robot yet.
Ethicon staplers will be used through a separate 12mm port. Titan does need a bipolar energy device on one of the arms of the robot to have any chance for market introduction. All of the procedures require division of vessels and a proven bipolar device is essential. Ethicon wants to be linked to a robotic device so the sales team can discount their products at the surgicenters and increase the sales growth of their staple line. Titan needs to pick a growing procedure and become the niche robotic company to get exposure and market acceptance.
Titan's robot platform will enter a bariatric weight loss market that is in an exponential growth phase. Laparoscopic gastric sleeve procedures are growing at high double digit rates and the Sport system will be able to be used on these cases with a much lower cost than the Intuitive Surgical robot. The sport system could be supported at outpatient surgical centers where the majority of growth will be over the next ten yrs. Especially with the advent of more 23 hr stay outpatient centers being built Sport if marketed correctly could dominate this area with minimal competition from intuitive. Ethicon understands the link between its stapler growth and being linked to a robotic system that will dominate the ambulatory surgery center market. This is the most important area that titan medical can focus on over the next two years to become quickly profitable.