Surgical Innovations Share Discussion Threads

[buywell3] 21/1/2021 21:03

================= The Effect of Obesity on Lung Function ====================

We have all read about people going into ICU's are having breathing difficulties and not getting enough oxygen into their blood

Many of these have to go on mechanical ventilators that breathe for them

To do this the patient is sedated

Mechanical Ventilation is best avoided as there are many Covid-19 articles now that links its use to Ventilator Acquired Pneumonia (VAP) which can occur as quick as 48 hours after a patient being put on a mechanical ventilator .

Death rate associated with VAP is 50% --- so it is best avoided by the use of CPAP ventilation which was what boris johnson had --- the patient is NOT sedated and breathes oxygen themselves



VAP is now a major issue with Covid-19 because many Obese patients end up on a mechanical ventilator and proning (turning over) needs to be carried out on a regular basis to give such a patient a chance of recovery and involves 7 people for one patient being proned

Proning in non ventilated patients/non mechanically ventilated patients is now also being recommended --- one wonders how nurses cope ??









So obese patients with BMI's of over 40 to over 50 are being turned over by a team of 7 nurses around 2 times each day and circa 75% of patients in ICU's are now overweight to morbidly obese

Clearly this situation cannot carry on going forwards as Covid-19 is now most likely to become a endemic disease

An obese persons lungs are already NOT functioning efficiently even before Covid-19 came onto the scene

Obesity causes substantial changes to the mechanics of the lungs and chest wall, and these mechanical changes cause asthma and asthma-like symptoms such as dyspnea, wheeze, and airway hyperresponsiveness. Excess adiposity is also associated with increased production of inflammatory cytokines and immune cells that may also lead to disease.

Covid-19 pneumonia has very recently been identified as lasting longer and being worse than other types of pneumonia



Conclusions:

Obese COVID‐19 patients show more severe pneumonia lesions on CT chest imaging

This is due to their already compromised lungs being more easily affected by the Covid-19 virus

The COVID‐19 epidemic will persist for the foreseeable future.
Given the significant toll the outbreak has taken on the healthcare system, identifying those patients with a greater need for medical attention is necessary.

Recent studies suggest that obesity is associated with worse severity of COVID‐19 pneumonia, increasing the need for hospitalization, critical care and mechanical ventilation.



Another reason for the number of Obese people to receive gastric band surgery to lesson the impact on the NHS ICU's and the Nurses that work there and other wards where Covid-19 obese patients reside

[buywell3] 20/1/2021 21:42

============= The NHS --- Weight Loss Surgery --- and Covid-19 ================


If readers have looked at the links in the last couple of buywell posts then they can be in NO DOUBT regarding the links between Obesity and Covid-19


buywell is therefore surprised to read that the NHS which reviewed its 'weight loss surgery' web page last April 2020 did not pick up on the obese ICU patient numbers that must have been obvious to nursing staff in ICU's and re-write their guidance as to when weight loss surgery can be performed on the NHS

What the NHS say is:

''Weight loss surgery, also called bariatric or metabolic surgery, is sometimes used as a treatment for people who are very obese.

It can lead to significant weight loss and help improve many obesity-related conditions, such as type 2 diabetes or high blood pressure.

But it's a major operation and in most cases should only be considered after trying to lose weight through a healthy diet and exercise.''

==== No mention of Cancer risks or Covid-19 or strokes or Heart attacks note ====






The NHS in the 'overview' section go on to say:


Weight loss surgery is available on the NHS if:

you have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and an obesity-related condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure)

you've tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off

you agree to long-term follow-up after surgery – such as making healthy lifestyle changes and attending regular check-ups

Speak to a GP if you think weight loss surgery may be an option for you.

If you qualify for NHS treatment, they can refer you for an assessment to check surgery is suitable.

You can also pay for surgery privately, although this can be expensive.



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But then the NHS under the 'availability' section say :

NHS criteria for weight loss surgery

The criteria for weight loss surgery on the NHS can vary across England. Check with a GP if you think surgery could be an option for you.

National Institute for Health and Care Excellence (NICE) guidelines on obesity recommend that surgery should be provided on the NHS if you meet all of the following criteria:

you have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and a serious condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure)

you've tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off

you agree to long-term follow-up after surgery – such as making healthy lifestyle changes and attending regular check-ups

you're fit and healthy enough to have surgery under general anaesthetic (where you're asleep)

you've been receiving or will receive treatment from a specialist obesity team




If your BMI is 50 or over, surgery may be considered without needing to try other weight loss methods first.

If you've been recently diagnosed with type 2 diabetes, particularly if you have a south Asian background, an assessment to see if surgery is suitable may be considered if your BMI is below 35.


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Now buywell knows that the NHS is under pressure and that Nures and Doctors are flogging themselves to death trying to keep pace with the surge of Covid-19 patients flooding into ICU's in most Hospitals --- many of which are now full and are sending patients hundreds of miles in an ambulance to another Hospital where hopefully a spare ICU bed ( just over 5,500 in England) will still be free on their arrival ---- BUT

Those NHS people that write these reviews are NOT flogging themselves to death and are NOT in the front line like the nurses

AND BUYWELL IS HORRIFIED to read that the next time that these recommendations are to be reviewed are not UNTIL APRIL 2023


3 years between review dates ----

'Page last reviewed: 14 April 2020
Next review due: 14 April 2023 '



This simply CRASS STUPIDITY and buywell urges anyone with any clout or NHS contacts to bring this to the attention of those that can get these recommendations put right to reflect obesity and Covid-19 ICU Hospitalization

There are now many medical articles citing this to draw from so there is NO EXCUSE

PLUS

The NHS needs to write their guidance in much more simple and friendly terms as monies do come from taxpayers :


NHS criteria for weight loss surgery


National Institute for Health and Care Excellence (NICE) guidelines on obesity recommend that surgery should be provided on the NHS if you meet the following criteria:


1. You have a body mass index (BMI) of 40 or more

2. You have a BMI between 31 and 39 together with another serious condition

3. If you have been recently diagnosed with type 2 diabetes an assessment to see if weight loss surgery is suitable may be considered if your BMI is below 35. Please contact your doctor ASAP.



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Likewise

''Weight loss surgery, also called bariatric or metabolic surgery, is sometimes used as a treatment for people who are obese.

It can lead to significant weight loss and help improve many obesity-related conditions, such as type 2 diabetes, high blood pressure, reduce the risk of several cancer types and also help improve Covid-19 morbidity and fatality outcomes.

Weight Loss Surgery can now be performed using Minimally Invasive Surgery (MIS also known as Keyhole Surgery or Laparoscopic Surgery. See


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2015 ---- Some UK Government facts:

It is estimated that obesity is responsible for more than 30,000 deaths each year. On average, obesity deprives an individual of an extra 9 years of life, preventing many individuals from reaching retirement age. In the future, obesity could overtake tobacco smoking as the biggest cause of preventable death.

Obesity increases the risk of developing a whole host of diseases. Obese people are:

At increased risk of certain cancers, including being 3 times more likely to develop colon cancer

More than 2.5 times more likely to develop high blood pressure - a risk factor for heart disease

5 times more likely to develop type 2 diabetes

The costs of obesity :

Failing to address the challenge posed by the obesity epidemic will place an even greater burden on NHS resources. It is estimated that the NHS spent £6.1 billion on overweight and obesity-related ill-health in 2014 to 2015.

Annual spend on the treatment of obesity and diabetes is greater than the amount spent on the police, the fire service and the judicial system combined.

And in 2020 from the UK National Audit Office

Absence from work due to obesity could be as much as £27 BILLIONS ANNUALLY .



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buywell ends

With ICU bed occupancy rates now running at circa 75% with overweight and obese patients suffering from Covid-19 and other health issues ( circa 35%) links can be supplied

The NHS with a finite number of ICU beds (5,500) overworked ICU Nurses and Doctors, need to get proactive in trying to reduce that 'type' of patient that occupies ICU's the most often and for the longest stays ie Obese patients



The cheapest and probably the preferred choice for many obese people would be the Gastric Band

A cost of circa 5K a patient

Or 1 Billion would treat 200,000 obese people --- buywell thinks it should be the 2021 Government Target

And a target for each year that follows ---- MIS using Dexter leased Robotics being the way forwards








See last few buywell posts for added info

[buywell3] 19/1/2021 22:10

A sobering article this



The USA CDC has just recently stated that in America the prevalence of obesity was 42.4% in 2017~2018

The expectation is for that to rise to 50% by 2030

ICU's in the UK currently are occupied by around 75% of overweight/obese patients

Such patients are nearly twice as likely to need mechanical ventilation

Those patients need proning more often needing around 7 Nurses to turn them over and also occupy ICU beds for twice as long as patients with a BMI of under 25

No wonder nurses are clapped out and crying and suffering mental issues

This is why the last post above was created as NOBODY is addressing the whale in the ICU room

[buywell3] 14/1/2021 08:18

To any newbe to SUN

A couple of points to think about from here on

1) Planned operations in the NHS have been getting cancelled for the last few years around the winter flu season when beds get full in hospitals. This has been made worse by Covid-19 and looks now imo to be an ongoing issue for the NHS and Government to sort out .

2) Cancellation of operations does NOT however mean that the work is lost unless of course the patient dies --- which regards to MIS the area of SUN operations is imo unlikely in the vast majority of cases so what it means is that the backlog of work stacks up


It is fairly obvious now that there is a bed shortage in ICU's and also a staff shortage

Ditto for nurses across other wards

Not enough doctors, surgeons or Hospitals to cope with what will be the Covid endemic as we all learn to live a vaccine existance getting what imo will be at least 2 Covid-19 jabs a year until a cure is found .

So the Government has to invest in technologies that can clear the backlog and keep pace with increase in work as more sick patients arrive at Hospitals

MIS reduces LOS in Hospitals so it frees up beds and allows more patients to receive treatment

MIS results in less complications after surgery so it saves money re claims and is better in patient outcomes a win/win

MIS Robotic surgery has the potential to increase the output of operations carried out as robots do not get tired or go sick or take annual leave







buywell expects to see a RNS from SUN very soon now to say that a certain Hospital/s with NHS Trust XXXX has leased yyy Dexters

buywell expects such an RNS to be accompanied by investors buying SUN as such news sinks in

buywell expects further RNS's to follow as other Hospitals and other NHS Trusts follow with a similar result

[xylemflow] 13/1/2021 12:49

The spread is so wide because there just isn't much in the market - sellers think its got a lot more life in it and buyers are after a bargain. It is the circular problem of AIM lack of liquidity. Big spreads make a share illiquid, and illiquid shares have a big spread. Catch 22. At the moment, all of the trades are small. It needs a big investor to take a view on the future of this share and to hoover-up a load regardless of price (to a point). Once that happens there will be a lot of smaller shareholders keen to sell, creating a more liquid market at a higher price.... at least that is what I learned at business school!!

[gbh2] 13/1/2021 12:35

Try checking the actual spread with test buy & sell.

[boonkoh] 13/1/2021 12:26

Despite the increase in trading volumes over the last 2 weeks, the spread is still ridiculously wide.

[gbh2] 13/1/2021 08:21

I was on holiday up in Newcastle during that 12p peak, I wasn't into web trading at the time and selling over the telephone cost me dearly, but left me with a profit which last until the final blow when the Directors were kicked out.

[buywell3] 13/1/2021 08:18

buywell is into making predictions as some know to their cost and some know to their gain


buywell predicts SUN will be sold within 3 years as of today

buywells understanding is that there are some nifty new MIS products soon to be added to the SUN range of MIS surgical instruments

Means more IP you see which is worth lots of lolly if it works as designed

3p next target for now

[boonkoh] 12/1/2021 20:25

Wow, amazed that there was actually a buy at the full 2.3p in the last few minutes of trade.Clearly lack of any stock and someone is intent in hoovering up any size, any ask price...

[buywell2] 12/1/2021 14:38

Distalmotion make the Dexter Surgical Robot which is going to save the NHS loads of lolly compared to others as each robot will be LEASED by SUN to separate NHS Hospitals/Trusts

SUN will then supply the consumables that the robot uses every operation




8th Jan 2021

Michael Friedrich, CEO, Distalmotion said:

"Distalmotion are looking forward to some early successes in the important UK market with our partner, Elemental Healthcare. The NHS is especially appropriate for the Dexter strategic model of selling and we already have hospitals that are some way into the process of product acquisition."

[buywell2] 12/1/2021 14:26

Up circa 50% since buywell3 posted his chart a week or so back and probably reflects the AMS update regarding LiquiBandFix8 USA progress and sales;

Not many new investors probably know this is made by SUN and SUN own the IP

10th position on the Leader Board

Long time since that was seen so perhaps Dexter News has also sunk in

There will be consumables that SUN sells to Dexter users per operation and one would expect uptake of the Robot to commence very soon as it is my understanding that a number of NHS surgeons have been trained in its use and are ready to rock

10 SUN Surgical Innovations 2.10 16.67% 0.30

[xylemflow] 12/1/2021 14:07

It’s all happening today. Seems like a large seller has cleared out. With all the recent good news it’s no suprise the shares are rising. Once Covid is under control this may fly - today will be people getting in early.

[boonkoh] 12/1/2021 12:43

Looking at the sale trades today and yesterday, looks like big seller overhang is gone. All small trades vs large trades.

[jmf69] 11/1/2021 07:21

I never understand why a company would wait a week and a half to release a positive rns and then do it on a Friday.

[jmf69] 09/1/2021 10:15

Don't blame the NHS. Blame this useless shower of a government

[xylemflow] 09/1/2021 09:22

Buywell - I wish the NHS would employ you! They do not appear to be able to roll out a vaccine let alone a robot. Having said that, I agree with your thoughts and better late than never sums it up. It’s more good news for SUN.

[jmf69] 08/1/2021 07:18

So they decided to finally issue an RNS for the Dexter CE approval.

[xylemflow] 07/1/2021 09:01

Looks like the worlds longest retirement! 12 months then 12 months.

[jmf69] 07/1/2021 07:48

Adam Power retiring at the end of the Year.

[boonkoh] 06/1/2021 14:54

I reckon it is because we still have a seller overhang - at around 1.70-1.75p. Hence why the bid is so low.There's no shares offered below 1.85p for sale at the moment.I reckon the true spread is probably 1.75-1.9p without the overhang, or maybe even 1.8p to 1.9p. Which I expect to get to shortly - might be today, or next few days.

[jmf69] 06/1/2021 14:18

Uk elective surgery pretty much at a stand still but if the vaccine rollout progresses then we could be in for a much improved year.GLA

[xylemflow] 06/1/2021 14:10

Why would there be such a massive spread? SI normally trades in a reasonably tight band for an illiquid stock yet when it gets a bit of liquidity the spread stretches out. A lesson in this reaction would be appreciated!

It does look like things are heading in the right direction for the company.