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Intuitive Surgical, Inc. Message Board

  • ps56k ps56k Mar 1, 2013 3:18 PM Flag

    where's The Fish

    where's The Fish guy with the overall medical insight and comments on ISRG ?

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    • Thanks for the kind comments. I'm around. Just been busy with other things and don't post as much as I used to. I don't think anything will come of the FDA survey other than volatility, which has been with us all along. I think that long term ISRG is still in very good shape. I have some concerns about cuts to medicare reimbursement and how that may impact non-medicare reimbursements. Also a significant change in the mix between medicare and non-medicare patients COULD impact hospitals ability to absorb the additional direct costs of robotic surgery. offsetting that is the fact that there will be more insured patients and presumably higher utilization to spread the costs over and that should help ISRG specifically and hospitals more generally.

      It is also true that direct surgical costs are not the only costs and when looked at comprehensively robotic surgery compares more favorably. The studies that say "no improved outcomes" for robotic surgery almost never include pain, scarring or speed returning to normal activities as "outcomes" which is absurd. Patients absolutely care about these "outcomes" even if the medical journals are tone deaf to them.

      Robotic will also probably progress significantly from where it is now so that in time the core "outcomes" should be superior. Firefly alone is capable of generating costs savings on a per procedure basis that could more than cover the additional cost of robotic surgery. Robotic surgery is here to stay and will continue to grow. It will continue to gain market share even for procedures that are easy to do laparoscopically and many of the procedures they are currently doing are not easy to do via standard lap.

      The inexorable move to single site will only make it harder for standard lap to remain relevant. One need look no further than ISRG's recent gains in gall bladder surgery to see this. This was considered so easy that the robot was not used, but single incision gall bladder surgery is another story

      • 2 Replies to fish_discover_water_last
      • andersongordon Mar 5, 2013 9:07 AM Flag

        Fish, there is a request to hear from you on the NVDQ MB. I concur. Your insights and questions are among the best on this MB and I know your interested in NVDQ. Also there is a shroud of opacity over CRDC's testing/launch/business plan for their new Stapler-Cutter. If you have any time and insight as to either your views would be appreciatied.

      • Glad to see your back. You stalker dropped in once while you were gone to say you were in jail. LOL. How long is that idiot going to keep stalking you? Even crazy girlfriends give up after 6 months or so, that clown is now going on 3 years of his crud. What a loser.

        I got out of my big position in ISRG the on the 4th and moved into Google, Chipotle, Gilead, and some other stocks. I figure I need to sit on the sidelines until this junk blows over and Google is moving.

    • yeah... he is indeed an insightful guy..

      • 1 Reply to davdddd
      • yeah - at least you learned a little, and got pointed to some actual facts in the med community to research or read about that would have some impact on the ISRG stock, or others in the same general arena...

        SO - haven't been here for a long time - what happened - is he no longer around and posting ???

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