Is TransEnterix Surgical Robotic System Doomed?

TransEnterix, Inc. [NYSE American: TRXC] is a medical device company that is focused on the use and development of robotics to improve minimally invasive surgery.

The Morrisville, NC company is at the forefront of development and commercialization of ALF-X Surgical Robotic System (the ALF-X System), and SurgiBot System.

The Company’s Senhance™ Surgical Robotic System is a multi-port robotic surgery system, which allows multiple robotic arms to control instruments and a camera. The system comes equipped with state of the art technology such as haptic feedback and the ability to move the camera through eye movement.

How TransEnterix Helps Surgeons

This device enables surgeons to visualize and use the haptics to “feel” if there is any conflict or contact with tissue outside their immediate field of view.

The system replicates laparoscopic motion and integrates three-dimensional high definition (3DHD) vision technology. The idea is to empower greater movement and vision while minimizing patient recovery times.

Digitizing the interface between the patients and the surgeon in laparoscopy while increasing control and reducing surgical variability for improved patient outcomes allows hospitals to reap economic benefits.

The company also developed the SPIDER device and the SurgiBot System, a single-port, robotically enhanced laparoscopic surgical platform designed as a single-incision, patient-side robotic-assisted surgery system.

TransEnterix also develops and manufactures laparoscopic surgical instruments required in abdominal surgery, such as scissors, graspers, clip appliers, and suction and irrigation instruments.

The Senhance Surgical Robotic System is available for sale in the US, the EU and select other countries.

TransEnterix has won the prestigious 2019 MedTech Breakthrough Award for Best New Surgical Technology Solution.

TransEnterix Revenues Are Concerning

In the quarter ended June 30, 2019, the robotic surgery company reported a revenue of $3.6 million as compared to revenue of $6.4 million in the same period last year.

Revenue in the second quarter of 2019 included $2.7 million in system sales, $560 thousand in instruments and accessories, and $342 thousand in services. The $2.7 million in system sales included a revenue of $1.3 million from a system sold in 2017 which the company received in the second quarter.

For the second quarter ending June 30, 2019, total net operating expenses were $22.2 million. It was $18.5 million in the three months ended June 30, 2018.

For the second quarter ending June 30, 2019, net loss amounted to $20.2 million, or $0.09 per basic share, as compared to a net loss of $34.2 million, or $0.17 per basic share, in the same period last year.

For the three months ended June 30, 2019, adjusted net loss was $19.2 million, or $0.09 per basic share, as compared to an adjusted net loss of $11.7 million, or $0.06 per basic share in the same period three months ended June 30, 2018.

TransEnterix Cash Boost From AutoLap

The Company had cash and cash equivalents, restricted cash and short term investments of approximately $34.0 million as of June 30, 2019. The Company believes that existing cash and short term investments and the expected proceeds from the AutoLap transaction are sufficient to support the business into mid-2020.

On May 28, 2019, the Company announced that it received Japanese regulatory approval for the Senhance Surgical System. The Senhance Surgical System was approved by the Ministry of Health, Labor and Welfare (MHLW) for use in laparoscopy for general surgery, gynecology, and urology.

On July 10, the Company announced that AutoLap® image-based laparoscope positioning system (AutoLap) asset sale and equity sale to Great Belief International Limited (GBIL) was originally expected to bring in a total of $47 million.

What Are The Risks of Buying TransEnterix?

Recent events have gone heavily against the company and the robotic surgery device developer is currently ailing.

The AutoLap Asset Sale agreement with GBIL has been revised.  The sale price of $17 million stays but the proposed equity investment of $30.0 million in TransEnterix common stock at $2.00 per share stands cancelled.

The situation is extremely fluid and the company is in the urgent need to raise capital, failing which, it runs the risk of liquidity running out at the end of Q1/2020. Preliminary Q3 revenues of $1.9-2.1 million fall well short of consensus expectations.

In addition, the core Senhance system business continues to disappoint consistently failing to live up to its billings.

Cash Burn Continues

Cash usage remains at elevated levels with the company burning cash to the tune of $20M per quarter.

TransEnterix is implementing a restructuring plan to lower cash burn and reduce operating expenses, but the company’s efforts to continue Senhance development and commercialization will again lead to hefty cash consumption.

To support its present expense rate, the company is projected to need to raise roughly $80M in cash to last through Q3 of 2020—a very tall order indeed given its robotic surgery system continues to draw lukewarm response from physicians.

Eight months ago its shares were trading at $5. Today they are trading at an abysmal $0.31.  This puts the robotic surgery maker in a much more vulnerable position than what it was eight months ago. The desire to expand globally coupled with falling sales is drastically depleting its cash reserves.

The company is currently paying about 10% interest per annum on its debt and to borrow additional money to finance its operation does not seem to a very appetizing prospect.

TransEnterix Stock Forecast Summary

TransEnterix’s Senhance robotic surgery system has failed to draw much enthusiasm from physicians.

It has constantly failed to meet sales targets, extending its dry run in the US to six months now. TransEnterix sold 15 Senhance robotic systems in 2018. Since then, as sold one system in Taiwan and another in Germany.

The company hoped for a turnaround in its fortune in the second quarter of 2019 but the forecast sales failed to materialize.

On a positive note, the Japanese Ministry of Health established Senhance reimbursement rates equal to existing laparoscopic rates paid for 98 procedures. This could the adoption of their technology and sales cycle in Asia.

Even with the share price at all-time lows, the company’s market capitalization appears to be on the high side, given the robotic surgery company’s substandard performance of the core business and the limited cash it currently has in its kitty.

By contrast, shares of Intuitive Surgical Inc. [NASDAQ: ISRG], the maker of the da Vinci surgical system, have been soaring as physicians adopt its technology hand over fist.

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The author has no position in any of the stocks mentioned. Financhill has a disclosure policy. This post may contain affiliate links or links from our sponsors.