I have a TM240A. I almost certainly wouldn't have purchased it, but it kind of came as a bonus along with a manual stencil printer, when I moved into new business premises. Long story...
I had been considering getting a Neoden 4 or something around that price range, but I really don't do enough volume to justify it. I would often hand assemble small batches of boards for my clients - never more than 10 at a time. Many of these are quite small and tightly packed PCBs (0603, 0402, but no BGA), and the small ones are often a double sided load.
After acquiring the TM240A it sat in a corner for 6 months, until I had a job worth running - five panels of 6 PCBs. It took a long day to get familiar with the machine, mostly finding the right way to load tapes and formatting the data file, but also making sense of the controls, and correct setting of part rotation. Training a staff member on the basics took a few hours, including him generating the data file for his design.
I had no one to show me anything, other than some YT videos, but I do have many years of experience with CNC equipment and manual assembly. Surprisingly I found handling a 3x2 panel was easy, but the instructions were lacking on how to restart at a particular component on a PCB in the panel other than the first. That was the one time I reached out for support from Neoden.
I do have the usual issues, like too few "feeders", and mispicks with components getting dropped around the tape handling area. Most issues I've found to be due to tapes getting jammed due to leader tape splices, or poor handling of the cut tape from the supplier. Cut tape is one of those things you just have to deal with when using "expensive" parts in low volume manufacture. I now buy as many parts that I can in full reels.
I certainly don't try to place every part with the machine, just the majority of small & cheap parts. It isn't much hassle to hand place a large capacitor or inductor during inspection before reflow. Usually a few of the placed parts need a bit of a nudge into position, but the reflow is the bottleneck in the process anyway.
I think I've only run about 6 different designs on it in the last 8 months, and I don't imagine using it more than one day a month on average, if that. For that first design in a panel of 6, I've run about 30 panels, and the only real issue was reworking the first couple of panels where I had a DC/DC converter chip rotated 180. Didn't show up in my initial low voltage tests, but blew most of the components when powered from 24V! That was a pain to rework, as it was a TSSOP-8 package and up tight against a large diode and inductor.
I definitely haven't got the process streamlined to the point where it is economical compared to my local assembly house, but it makes a lot of sense for the small runs of prototypes or low-volume designs.
My local assembler requires me to kit parts for any runs, but at least he is pretty flexible about cut tape and using my 300x400 stencils. Most other assemblers I've dealt with require large unframed stencils and charge $600+ each for them.