Wrote this... hadn't seen that I was replying to a message that was deleted before I finished!
Room for many players in this marketplace. Market expected to be almost 8 times current revenue levels in 3 to 4 years.
As for Senahance, it received a CE mark in December 2011 as the ALF-X Telelap system. Since then, the "technology" was bought by Transenterix and they have sold a total of eight systems worldwide, with a total of 21 surgeons using these systems. Oh, one of those eight in not in an approved market (Japan) so commercial use of the instrument may be limited or non-existent until is gets their approval. They are not yet deriving any substantial revenue from this product line. They do have haptic feedback which da Vinci does not, and they do move the camera based on surgeon's eyeball movements - not sure if that is a feature or a major distraction. The system also supports up to four separate arms entering the patient through four separate ports, and... is there a fifth port for the camera? Each of the four arms is mounted to a separate gigantic pod, each requiring something on the order of maybe 6 to 8 (or more) square feet of valuable floor space around the patient, preventing access to the patient by personnel, and making anesthesiology folk run through an obstacle course to get anything done.
As the only real player in the game, Intuitive's da Vinci line has a captive market. One big pod next to the patient (like SPORT) but up to four arms entering the patient through as many ports. They have recently introduced a single port option (like SPORT) but were holding off on sales for some unknown reason. da Vinci is that much better than anything else out there because for most of these general surgery indications, the only competition is Senhance.
If analysts are correct in their growth predictions for the market, either some viable players (grin and say Titan!) will enter the marketplace soon, or ISRG will have to nearly double their revenues EACH of the next three years to meet these analysts' predictions. Other viable players likely to include Verb, Medtronic, Ethicon, etc. But if the growth is as predicted, that means there is room in the marketplace for 7 or 8 companies, each as large as Intuitive is today - or assuming some substatial growth for ISRG, they can quadruple in size and still leave room for four more companies at ISRG's current size.
