Let me take run at that question you directed at Vonpeasal. Some hospitals did not buy the Spy equipment outright. They entered into some form of per us rental agreement. Some of these hospitals found that they would be better off buying the equipment and paying a much lower cost per kit. In effect, the economics were indicating BUY was the increasingly better choice when the machine was being actively used.
Thanks for the reply. Your explanation fits with my understanding but Vonpessal seemed to be describing something different. Just wanted to make sure I wasn't missing something. There seems to be a trend towards more sales which they refer to as capital sales vs installations under the "placement" model which was lower risk for the hospital but more costly. The placement model meant that NVDQ had to pony up for the hardware. This shift should make expansion less costly for NVDQ. All in all it sounds like they are successfully building confidence in their product and technology. The salesforce build out seems to be fairly aggressive which the market opportunities would seem to support. Now we just need to see if their new sales team can execute. Sounds like they are following ISRG's model of using a separate class of clinical field reps whose job it is to drive procedure volume. Now lets see what they plan to do with all that cash. My guess is that they are going to try to lock up significant IP, probably thought acquisition but possibly through licensing. Then again maybe they just want some of that cash to fund placements under the placement model.