Conmed Corp (CNMD) 2023 Q2 法說會逐字稿

Before the conference call begins, let me remind you that during this call, management will be making comments and statements regarding its financial outlook, its plans and objectives. These statements represent the forward-looking statements that involve risks and uncertainties as those terms are defined under the federal securities laws. Investors are cautioned that any such forward-looking statements are not guarantees of future events, performance or results. The company's actual results may differ materially from its current expectations.

在電話會議開始之前，請允許我提醒您，在這次電話會議期間，管理層將就其財務前景、計劃和目標發表評論和聲明。這些陳述代表前瞻性陳述，涉及風險和不確定性，這些術語是根據聯邦證券法定義的。投資者請注意，任何此類前瞻性陳述均不能保證未來事件、績效或結果。本公司的實際業績可能與其目前預期有重大差異。

Please refer to the risks and other uncertainties disclosed under the forward-looking information in today's press release as well as the company's SEC filings for more detail on the risks and uncertainties that may cause actual results to differ materially. The company disclaims any obligation to update any forward-looking statements that may be discussed during this call, except as may be required by applicable law. You will also hear management refer to non-GAAP or adjusted measurements during this discussion. While these figures are not a suitable substitute for GAAP measurements, management uses these figures to aid in monitoring the company's ongoing financial performance from quarter-to-quarter and year-to-year on a regular basis and for benchmarking against other medical technology companies.

請參閱今天新聞稿中前瞻性資訊中揭露的風險和其他不確定性以及公司向 SEC 提交的文件，以了解可能導致實際結果出現重大差異的風險和不確定性的更多詳細資訊。除適用法律要求外，本公司不承擔更新本次電話會議期間可能討論的任何前瞻性陳述的義務。在這次討論中，您還將聽到管理階層提到非公認會計準則或調整後的衡量標準。雖然這些數字不能取代 GAAP 衡量標準，但管理層使用這些數字來幫助定期監控公司每季和每年的持續財務業績，並與其他醫療技術公司進行基準比較。

Adjusted net income and adjusted earnings per share measure the income of the company, excluding credit or charges that are considered by the company to be special or outside of its normal ongoing operation. These adjusting items are specified in the reconciliation supporting the company's earnings releases posted to the company's website. With these required announcements completed, I will now turn the call over to Curt Hartman, CONMEDs, Chair of the Board, President and Chief Executive Officer, for opening remarks. Mr. Hartman?

調整後淨利和調整後每股盈餘衡量公司的收入，不包括公司認為特殊或正常持續營運以外的信貸或費用。這些調整項目在公司網站上發布的支援公司收益發布的調節表中指定。完成這些必要的公告後，我現在將會議轉交給 CONMED 董事會主席、總裁兼首席執行官科特·哈特曼 (Curt Hartman) 致開幕詞。哈特曼先生？

Thank you, Jonathan. Good afternoon and thank you for joining us for CONMED's Second Quarter 2023 Earnings Call. With me on the call is Todd Garner, Executive Vice President and Chief Financial Officer. Our plan is to share with you our second quarter results and then open the call to your questions. I will start by saying we are incredibly pleased with our team's performance in the second quarter. After setting a new quarterly sales record in Q1, we handily beat that with our Q2 performance. Total sales for the quarter were $317.7 million, representing a year-over-year increase of 14.6% as reported and an increase of 16.6% in constant currency. On an organic constant currency basis, sales growth finished at 12.6%. Our commercial teams were outstanding in the first half and the results in Orthopedics and General Surgery indicate we delivered balanced growth across our product offering on a global basis.

謝謝你，喬納森。下午好，感謝您參加 CONMED 2023 年第二季財報電話會議。與我一起參加電話會議的是執行副總裁兼財務長 Todd Garner。我們的計劃是與您分享我們第二季的業績，然後開始電話詢問您的問題。首先我要說的是，我們對球隊第二季的表現非常滿意。在第一季創下新的季度銷售記錄後，我們在第二季度的業績輕鬆打破了這一紀錄。該季度總銷售額為 3.177 億美元，年增 14.6%，以固定匯率計算成長 16.6%。以有機固定匯率計算，銷售額成長 12.6%。我們的商業團隊在上半年表現出色，骨科和一般外科的表現顯示我們在全球範圍內實現了產品供應的均衡成長。

I'd remind everyone that in mid-June, the In2Bones business reached its one-year anniversary. We remain pleased with this business and look forward to continued growth in this exciting market as part of our organic base. Additionally, the BioBrace offering continues to build momentum through growing market acceptance, which is being driven by positive clinical experiences. From an earnings perspective, during the second quarter, our GAAP net income totaled $13.7 million. This compares to a net loss of $168.3 million in the second quarter of 2022 due primarily to the extinguishment of most of the 2024 convertible notes. Excluding special items that affected comparability, our adjusted net income of $26.1 million increased 5.3% year-over-year and our adjusted diluted net earnings per share of $0.83 increased 9.2% year-over-year.

我想提醒大家的是，六月中旬，In2Bones 業務迎來了一周年紀念日。我們對這項業務仍然感到滿意，並期待作為我們有機基礎的一部分，在這個令人興奮的市場中持續成長。此外，BioBrace 產品在積極的臨床經驗的推動下，不斷提高市場接受度，並繼續保持勢頭。從獲利角度來看，第二季我們的 GAAP 淨利潤總計 1,370 萬美元。相較之下，2022 年第二季的淨虧損為 1.683 億美元，這主要是由於大部分 2024 年可轉換票據的註銷。排除影響可比性的特殊項目，我們的調整後淨利潤為 2,610 萬美元，年增 5.3%，調整後攤薄每股淨利潤為 0.83 美元，年增 9.2%。

At a macro level and consistent with my first quarter comments, the underlying surgical markets that we serve are healthy and health care staffing levels continue to improve. Conversely, inflationary pressure on the material side has been slower to dissipate and supply chains are not yet fully recovered. Overall, we see all these dynamics as stable to improving in the second half of 2023. In summary, I'm very pleased with the focus and results delivered in the quarter, and I'm confident we will build on our success in the second half.

從宏觀層面來看，與我第一季的評論一致，我們服務的潛在外科市場是健康的，醫療保健人員配備水準持續改善。相反，物質方面的通膨壓力消散較慢，供應鏈尚未完全恢復。總體而言，我們認為所有這些動態將在 2023 年下半年穩定改善。總之，我對本季度的重點和成果感到非常滿意，我相信我們將在第二季度的成功基礎上再接再厲一半。

Before I turn the call over to Todd, I'd like to provide important context about the standard insufflation market and our competitive position with AirSeal. Let me start by saying that AirSeal is an only-in-class technology. From Day 1, it has been replacing standard insufflation from all marketplace competitors in both robotic and laparoscopic procedures given its unmatched clinical benefit delivered through low pressure. The introduction of another standard insufflation device into the market will not change our clinical or sales algorithm, whether it is it a stand-alone device or attached to a robot. The only parties that will feel the pressure from the introduction of another standard inflation device are the existing standard insufflation companies that we have been replacing for the past seven years. I will again remind you that none of these companies can deliver consistent pneumo at low pressure nor the related clinical benefits which are significant and are included in the investor presentation that we posted this afternoon.

在將電話轉給 Todd 之前，我想提供有關標準吹氣市場以及我們在 AirSeal 方面的競爭地位的重要背景資訊。首先我要說的是，AirSeal 是一項獨一無二的技術。從第一天起，它就在機器人和腹腔鏡手術中取代了所有市場競爭對手的標準吹氣，因為它透過低壓提供了無與倫比的臨床效益。將另一種標準吹氣設備引入市場不會改變我們的臨床或銷售演算法，無論它是獨立設備還是連接到機器人。唯一會感受到引入另一種標準充氣裝置的壓力的是我們在過去七年中一直在更換的現有標準充氣公司。我要再次提醒您，這些公司都無法在低壓下提供一致的氣動，也無法提供重要的相關臨床效益，這些效益已包含在我們今天下午發布的投資者介紹中。

Our position has always been that AirSeal delivers better patient outcomes and competitive devices, driven principally through lower pressure. To support that position, we have 33 peer-reviewed studies with over 6,000 enrolled patients across five surgical specialties that demonstrate reduced postoperative pain, reduced length of stay, reduced 30-day visits, reduced ER visits and improved ventilation metrics. Standard insulation has zero clinical studies that demonstrate any of these important clinical benefits. In fact, I think I can make a compelling argument that we are, through our clinical capabilities, growing the number of available surgeries that can be done laparoscopically in certain patient populations to include elevated risk and high body mass index patients.

我們的立場始終是，AirSeal 主要透過降低壓力來提供更好的患者治療效果和具有競爭力的設備。為了支持這一立場，我們進行了33 項同儕審查研究，涉及5 個外科專業的6,000 多名入組患者，這些研究顯示術後疼痛減輕、住院時間縮短、30 天就診次數減少、急診就診次數減少並改善了通氣指標。標準絕緣材料的臨床研究為零，證明了這些重要的臨床益處。事實上，我認為我可以提出一個令人信服的論點，即透過我們的臨床能力，我們正在增加可在某些患者群體中進行腹腔鏡手術的數量，以包括高風險和高體重指數患者。

Competitively, since 2018, six new insufflation devices have been introduced to the market and AirSeal continues to win surgeons globally. While the concept of integration of advice with a robot may enhance ease of use, it will do nothing to change the clinical paradigm on which we have been taking market share, and we'll continue to take market share. I will also remind you that in 2018, two strong competitors introduced their AirSeal equivalents, and I think our results would suggest we navigated that period just fine. From a technology and sustainability standpoint, we own 187 issued patents and have another 124 pending. They extend our patent position through the end of the 2030s, and we continue to add to this position.

從競爭角度來看，自 2018 年以來，已有六種新的吹氣設備被引入市場，AirSeal 繼續贏得全球外科醫生的青睞。雖然建議與機器人整合的概念可能會提高易用性，但它不會改變我們一直佔據市場份額的臨床模式，而且我們將繼續佔據市場份額。我還要提醒您，2018 年，兩個強大的競爭對手推出了他們的 AirSeal 同類產品，我認為我們的結果表明我們在這段時期表現得很好。從技術和永續發展的角度來看，我們擁有 187 項已頒發專利，另有 124 項正在申請中。他們將我們的專利地位延長到 2030 年代末，我們將繼續擴大這一地位。

Further, our AirSeal IP crosses the system and is integrated in such a way that is not one seminal patent that protects us, but rather the integration of the patents across all aspects of the system to include the IFS box, tube set and access ports. This is what makes AirSeal function in a manner that delivers clinical benefit. Each of these components is manufactured separately in a unique facility with the critical parts being in-sourced here at CONMED. We're not currently aware of any patent work that will allow another device to function in a low-pressure mode.

此外，我們的 AirSeal IP 跨越系統並以這樣一種方式集成，這不是保護我們的一項開創性專利，而是跨系統各個方面的專利集成，包括 IFS 盒、管組和接入端口。這就是 AirSeal 能夠以提供臨床益處的方式發揮作用的原因。每個組件均在獨特的工廠中單獨製造，關鍵零件則在 CONMED 內購。目前我們還沒有發現任何專利工作可以允許其他設備在低壓模式下運作。

Finally, based on the June 2023 best hospitals in the U.S. teaching hospital category, AirSeal is present in 92% of the top 25 teaching institutions with MIS procedural utilization rates ranging from just getting started to over 75%. This is a statistically significant fact given that physicians utilize what they are trained on when they depart to surgical practice. We will never be dismissive of competitive entrants, but I think it's misinformed to assume that same old technology created by the same partner to the rest of the insufflation market will somehow materially impact our results. Never mind that the market knows minimal details about this device. From my chair, if it's not obvious that it can provide consistent pneumoperitoneum at low pressure as proven through clinical studies like AirSeal has shown, it is just another standard insufflation device.

最後，根據 2023 年 6 月美國教學醫院類別中的最佳醫院，AirSeal 出現在前 25 名教學機構中的 92% 中，MIS 程序使用率從剛起步到超過 75% 不等。這是一個具有統計意義的事實，因為醫生在進行外科手術時會利用他們所接受的訓練。我們永遠不會輕視競爭者，但我認為，假設由同一合作夥伴為其他注氣市場創造的相同舊技術將以某種方式對我們的結果產生重大影響是錯誤的。不要介意市場對這款設備的了解很少。從我的椅子上看，如果它不能像 AirSeal 等臨床研究所證明的那樣，在低壓下提供一致的氣腹，那麼它只是另一個標準的吹氣裝置。

The only in-class AirSeal technology supported by extensive clinical benefits derived through low pressure has clearly been moving the market to embrace our solution. We do not see anything in a standard insufflation offering that would slow that progression, and we remain extremely optimistic about our future with AirSeal. More importantly, and if you really digest the quarter we just delivered, the overall prospects for CONMED, given the surgical diversity of and balanced growth our portfolio is demonstrating look the best they have ever looked in my tenure.

唯一一流的 AirSeal 技術透過低壓獲得廣泛的臨床效益，顯然已經推動市場接受我們的解決方案。我們認為標準吹氣產品中沒有任何東西會減緩這一進程，我們對 AirSeal 的未來仍然非常樂觀。更重要的是，如果你真正了解我們剛剛發布的季度，考慮到我們的投資組合的手術多樣性和平衡增長，CONMED 的整體前景看起來是我任期內最好的。

I'll now turn the call over to Todd, who will provide further details on our financial performance and discuss our updated outlook. Todd?

我現在將把電話轉給托德，他將提供有關我們財務業績的更多詳細資訊並討論我們最新的前景。托德？

Thank you, Curt. All sales growth numbers I reference today will be given in constant currency. The reconciliation to GAAP numbers is included in our press release. As usual, we've included an investor deck on our website that summarizes the results of the quarter and our updated guidance. And this time, it includes some supplemental information on the moat around our AirSeal product line, consistent with Curt's comments.

謝謝你，柯特。我今天引用的所有銷售成長數字都將以固定匯率給出。我們的新聞稿中包含了與 GAAP 數據的對帳。像往常一樣，我們在網站上提供了投資者資料，總結了本季度的業績和更新的指導。這次，它包含了一些關於我們的 AirSeal 產品線護城河的補充信息，與 Curt 的評論一致。

For the second quarter of 2023, our total sales increased 16.6%. On an organic basis, revenue grew 12.6%. We anniversary the In2Bones acquisition on June 13, and Biorez will turn organic on August 9. For Q2, our sales in the U.S. increased 17.1% versus the prior year quarter, and our international sales grew 16.0%. Worldwide Orthopedics revenue grew 19.8% in the second quarter. In the U.S., Orthopedic sales grew 29.4% and internationally, Orthopedic sales increased 14.8%. The Total worldwide General Surgery revenue increased 14.1% in the quarter. U.S. General Surgery revenue grew 12.5%, while internationally General Surgery revenue increased 17.9%.

2023 年第二季度，我們的總銷售額成長了 16.6%。在有機基礎上，收入成長了 12.6%。 6 月 13 日是我們收購 In2Bones 的周年紀念日，Biorez 將於 8 月 9 日實現有機轉型。第二季度，我們在美國的銷售額比去年同期增長了 17.1%，國際銷售額增長了 16.0%。第二季全球骨科營收成長 19.8%。在美國，骨科銷售額成長了 29.4%，在國際上，骨科銷售額成長了 14.8%。本季全球普外科總收入成長 14.1%。美國一般外科收入成長 12.5%，而國際一般外科收入成長 17.9%。

Now let's move to the expense side of the income statement. We will discuss expenses and profitability in the second quarter, excluding special items, which include charges for acquisitions and contingent consideration, termination of distributor agreements, legal matters, debt refinancing costs, restructuring and software implementation costs, amortization of intangible assets and amortization of deferred financing fees net of tax. Adjusted gross margin for the second quarter was 54.4%, a decrease of 50 basis points from the prior year quarter. This was consistent with our guidance of mid-54 for Q2. Similar to Q1, we saw exceptionally strong growth in some of our lower-margin geographies, which has skewed the margin to the lower end of our guidance so far. We remain excited about the improving margins ahead. For Q3, we expect gross margins to improve sequentially over Q2 by approximately 150 basis points. And then again, sequential improvement from Q3 to Q4 between 100 and 150 basis points.

現在讓我們轉到損益表的費用部分。我們將討論第二季度的費用和盈利能力，不包括特殊項目，其中包括收購費用和或有對價、終止分銷商協議、法律事務、債務再融資成本、重組和軟體實施成本、無形資產攤銷和遞延資產攤提融資費用（稅後淨額）。第二季調整後毛利率為54.4%，較去年同期下降50個基點。這與我們 54 年中第二季的指導一致。與第一季類似，我們在一些利潤率較低的地區看到了異常強勁的成長，這使得利潤率偏向我們迄今為止指導的下限。我們對未來利潤率的提高仍然感到興奮。對於第三季度，我們預計毛利率將比第二季度環比提高約 150 個基點。然後，從第三季度到第四季度，環比改善了 100 到 150 個基點。

Research and development expense for the second quarter was 4.3% of sales, 20 basis points higher than the prior year quarter. Second quarter adjusted SG&A expenses were 37.4% of sales. Leverage gained on the higher sales drove the 70 basis points improvement over the prior year quarter. On an adjusted basis, interest expense was $8.5 million in the second quarter. We expect a similar level of interest expense in Q3, and that does incorporate the rise from today.

第二季研發費用佔銷售額的4.3%，比去年同期高出20個基點。第二季調整後的銷售、管理及行政費用佔銷售額的 37.4%。銷售額增加所帶來的槓桿作用推動了比去年同期成長 70 個基點的成長。經調整後，第二季利息支出為 850 萬美元。我們預計第三季的利息支出將達到類似水平，並且這確實包含了從今天開始的上漲。

The adjusted effective tax rate in Q2 was 21.9%. Taxes came in lower than expected, principally due to the excess tax benefit from stock plans. This is difficult to predict, but we don't expect the same benefit in future quarters. We still expect the tax rate to be around 25% going forward. Second quarter GAAP net income was $13.7 million. This compares to GAAP net loss of $168.3 million in Q2 of 2022. GAAP earnings per diluted share were $0.43 this quarter compared to a loss of $5.65 per share a year ago. Excluding the impact of special items discussed earlier, in the second quarter, we reported adjusted net income of $26.1 million, an increase of 5.3% compared to the second quarter of 2022. Our Q2 adjusted diluted net earnings per share were $0.83, an increase of 9.2% compared to the prior year quarter.

第二季調整後的有效稅率為21.9%。稅收低於預期，主要是由於股票計劃帶來的超額稅收優惠。這很難預測，但我們預計未來幾季不會有同樣的好處。我們仍預計未來稅率為 25% 左右。第二季 GAAP 淨利為 1,370 萬美元。相比之下，2022 年第二季 GAAP 淨虧損為 1.683 億美元。本季 GAAP 攤薄後每股收益為 0.43 美元，而一年前每股虧損 5.65 美元。排除先前討論的特殊項目的影響，第二季度調整後淨利潤為 2610 萬美元，較 2022 年第二季度增長 5.3%。第二季度調整後攤薄每股淨利潤為 0.83 美元，增長與去年同期相比增長9.2%。

Turning to the balance sheet. Our cash balance at the end of the quarter was $27.8 million compared to $26.5 million as of March 31. Accounts receivable days as of June 30 were 65 days, flat compared to the end of Q1. Inventory days at quarter end were 200 compared to 215 at March 31. Long-term debt at the end of the quarter was $971.5 million versus $995.3 million as of March 31. Our leverage ratio on June 30, 2023, was 5.1x. We continue to expect our leverage ratio to be below 4.25x by the end of the year. Cash flow provided from operations in the quarter was $26.7 million compared to cash flow from operations of $18.7 million in the second quarter of 2022. Capital expenditures in the second quarter were $4.5 million compared to $5.7 million a year ago.

轉向資產負債表。截至 3 月 31 日，我們的現金餘額為 2,780 萬美元，而截至 6 月 30 日的應收帳款天數為 65 天，與第一季末持平。季度末的庫存天數為200 天，而3 月31 日為215 天。季末的長期債務為9.715 億美元，截至3 月31 日為9.953 億美元。截至2023 年6 月30 日，我們的槓桿率為5.1 倍。我們仍然預計到年底我們的槓桿率將低於 4.25 倍。本季營運產生的現金流為 2,670 萬美元，而 2022 年第二季營運產生的現金流為 1,870 萬美元。第二季的資本支出為 450 萬美元，而去年同期為 570 萬美元。

Now let's turn to financial guidance. We now expect reported revenue for the full year to be between $1.230 billion and $1.260 billion compared to our previous guidance range of between $1.205 billion and $1.250 billion with no material change to the expected currency impact on the year. We now expect full year adjusted EPS in 2023 to be between $3.40 and $3.55 compared to our previous range of $3.30 and $3.50.

現在讓我們轉向財務指引。我們現在預計全年報告收入將在 12.30 億美元至 12.60 億美元之間，而我們先前的指導範圍為 12.05 億美元至 12.50 億美元，預計全年的貨幣影響不會發生重大變化。我們現在預計 2023 年全年調整後每股收益將在 3.40 美元至 3.55 美元之間，而之前的區間為 3.30 美元至 3.50 美元。

As discussed previously, the full year 2023 will have one less selling day compared to 2022. The way our calendar falls, Q1 had one extra day and Q3 will have two fewer sales days. As we look at the third quarter, we expect reported revenue between $295 million and $305 million. That includes approximately 100 basis points of FX headwind. We expect adjusted EPS in Q3 to be between $0.80 and $0.85.

如前所述，與 2022 年相比，2023 年全年的銷售天數將減少 1 天。根據我們的日曆，第一季的銷售天數將增加一天，第三季的銷售天數將減少兩天。展望第三季度，我們預計報告營收在 2.95 億美元至 3.05 億美元之間。其中包括約 100 個基點的外匯逆風。我們預計第三季調整後每股收益將在 0.80 美元至 0.85 美元之間。

As Curt said, we are pleased with the Q2 performance and our focus on executing and continuing to build on our strong first half as we move through the rest of 2023. We remain confident in our ability to deliver innovation to our customers while driving above-market growth and profitability over the long term. With that, we'd like to open the call up to your questions, and I'll turn it back to Jonathan.

正如Curt 所說，我們對第二季度的業績感到滿意，並在2023 年剩餘時間專注於執行和繼續鞏固我們強勁的上半年業績。我們仍然對我們為客戶提供創新的能力充滿信心，同時推動上述目標市場的長期成長和獲利能力。至此，我們想開始回答您的問題，然後我會將其轉回喬納森。

Certainly. (Operator Instructions.] Our first question comes from the line of Robert Marcus from JPMorgan.

當然。 （操作員說明。）我們的第一個問題來自摩根大通的羅伯特·馬庫斯。

Congrats on a good quarter. Two questions. Maybe first, I could start out with underlying trends. It looks like you're participating in a lot of the strong ortho and surgery trends we're hearing from other peers. But would love to get a sense -- I know you touched on it a bit in the script, but I would love to get a sense of specifically U.S. and how the revamped sales force is doing in ortho and how surgery [X] air filtration and smoke evacuation did in the quarter?

恭喜季度表現良好。兩個問題。也許首先，我可以從潛在趨勢開始。看起來您正在參與我們從其他同行那裡聽到的許多強大的矯形和手術趨勢。但我很想了解一下——我知道你在劇本中提到了一點，但我很想了解一下美國的情況，以及改造後的銷售隊伍在骨科領域的表現，以及手術[X]空氣過濾的情況該季度的排煙工作做了嗎？

I would just say, overall, we're very excited about the performance broadly speaking. Our U.S. Orthopedics business has been undergoing a bit of a renovation. Pat Beyer, that was tucked in under him in October of 2020. He's brought in a new leadership team. We're really starting to see the fruits of that labor. The second quarter was our best U.S. Orthopedics organic performance that we've had in a number of quarters. And I think that bodes well for the second half that is supported by better sales, better marketing, better overall support, but also the underlying markets to the point of the question are seeing higher procedure levels. But you put all that together, and it helps for delivering good results.

我只想說，總的來說，我們對整體表現感到非常興奮。我們的美國骨科業務正在進行一些改造。 2020 年 10 月，帕特·拜爾 (Pat Beyer) 接任了他的職位。他帶來了一個新的領導團隊。我們確實開始看到這種勞動的成果。第二季度是我們幾個季度以來最好的美國骨科有機表現。我認為這對下半年來說是個好兆頭，這將得到更好的銷售、更好的營銷、更好的整體支持的支持，而且就問題而言，基礎市場正在看到更高的程序水平。但你把所有這些放在一起，就有助於取得良好的結果。

On the General Surgery side, absent AirSeal and Buffalo Filter, we delivered growth. I mean people on this call probably don't understand the amount of business that we have in our advanced endoscopic technology category, and that was just shy of a double-digit grower in the quarter. We don't usually talk about that, but it was a great performance by that business on a global basis. And then if I take a different angle on it and look globally, we had really strong global performance -- market except one that had some unique challenges in that market with our portfolio, but really a strong performance across the core of the company and in each of our business categories.

在普通外科方面，在沒有 AirSeal 和 Buffalo Filter 的情況下，我們實現了成長。我的意思是，參加這次電話會議的人可能不了解我們在先進內視鏡技術類別中擁有的業務量，而本季的業務量僅略低於兩位數的成長。我們通常不會談論這一點，但該業務在全球範圍內的表現非常出色。然後，如果我從不同的角度看全球，我們在全球市場上的表現非常強勁，除了我們的投資組合在該市場中面臨一些獨特挑戰的市場，但在公司的核心和業務領域確實表現強勁。我們的每個業務類別。

Great. And I know you talked a lot about it in the script. So not to pound on it too much, but there's a lot of newfound worry in the market that AirSeal is a great product and delivers a lot of incremental growth for you, that a lot of the placements and use are in conjunction with intuitive surgical robotic procedures and reports that a third-party OEM might be making an insufflator to integrate with it. And again, I know you talked in the script, but I think it'd be helpful maybe just to review what percentage of AirSeal is from robotic procedures. What's currently in the market today beyond AirSeal and maybe some of the reasons that even if the robotic platform comes with an insufflator that Arco will still be used and still be used in a good amount of procedures and forward growth?

偉大的。我知道你在劇本中談了很多。因此，不要過分強調它，但市場上有很多新發現的擔憂，認為 AirSeal 是一款出色的產品，可以為您帶來大量增量增長，很多放置和使用都與直觀的手術機器人相結合程序和報告指出第三方OEM 可能正在製造與其整合的吹氣機。再說一次，我知道您在腳本中談到過，但我認為回顧一下 AirSeal 來自機器人程式的百分比可能會有所幫助。目前市場上除了 AirSeal 之外還有什麼？即使機器人平台配備了吹氣機，Arco 仍然會被使用，並且仍然會被用於大量的手術和未來的增長，這可能是一些原因嗎？

Thanks, Ravi. Yes, I mean, look, the power of AirSeal is in the clinical differentiation that it brings. And we shared some of those studies and data that Curt shared verbally, that's in the deck, it's in the back of the deck that we provided today, and you can see this has proven over millions of patients and over many years. As Curt said, many times in the last several years, our competition has said, okay, we finally found the answer to AirSeal. This is -- you're going to like this just as much as you like AirSeal. And everything has been found wanting so far because it does not do all three things at once. You put gas into the abdomen, remove smoke and measure. And AirSeal, because of our key feature with no valves and because everything is done simultaneously, it doesn't turn on and off. Everything is simultaneous that we're allowed to operate at much lower pressures consistently over a myriad of procedures and lots and lots of patients.

謝謝，拉維。是的，我的意思是，看，AirSeal 的力量在於它帶來的臨床差異化。我們分享了科特口頭分享的一些研究和數據，這些研究和數據在我們今天提供的幻燈片的後面，你可以看到這已經在數百萬患者和多年來得到證明。正如 Curt 所說，在過去的幾年裡，我們的競爭對手多次表示，好吧，我們終於找到了 AirSeal 的答案。這是——您會喜歡它，就像您喜歡 AirSeal 一樣。到目前為止，一切都被發現是有缺陷的，因為它不能同時完成所有三件事。您將氣體注入腹部，除去煙霧並進行測量。而 AirSeal，由於我們的關鍵特點是沒有閥門，而且所有事情都是同時完成的，因此它不會打開和關閉。一切都是同時進行的，我們可以在無數的手術和大量的患者中一致地在低得多的壓力下進行操作。

Doing that in practice is very difficult. And in our opinion, nothing that comes with valves or turns on and off -- now I'm removing smoke, now I'm not. Now I'm inserting gas, now I'm not. Now I'm measuring, now I'm not. Anything that starts and stops with those functions and has a valve that is constantly trying to fight the escape of gas is not going to be capable of operating anywhere close to the clinical outcomes that you see AirSeal do. And that is why everything that has entered the market so far, even with all the promotions about saying they figured out how to match AirSeal, nothing has come close.

在實踐中做到這一點是非常困難的。在我們看來，沒有任何閥門或開關——現在我在除煙，現在我不是。現在我正在註入氣體，現在我不注入氣體。現在我在測量，現在我不會測量。任何以這些功能啟動和停止並且具有不斷嘗試阻止氣體逸出的閥門的東西都無法達到您所看到的 AirSeal 所達到的臨床效果。這就是為什麼迄今為止進入市場的所有產品，儘管所有的促銷活動都聲稱他們找到瞭如何匹配 AirSeal 的方法，但沒有任何產品能與之相媲美。

And as you can -- we're coming up on eight years -- we're 7.5 years post-acquisition. This product line is growing north of 20% every quarter because of how differentiated it is in the space. People -- doctors are not going to go backwards in clinical outcomes because another company sells it that they like -- they really like something else that company sells. That's just not how our space works.

正如你所知道的——我們即將迎來收購後的 8 年——我們已經 7.5 年了。由於該產品線在該領域的差異化程度，該產品線每季都會成長 20% 以上。人們——醫生不會因為另一家公司出售他們喜歡的產品而導致臨床結果倒退——他們真的很喜歡該公司出售的其他東西。我們的空間不是這樣運作的。

To specifically answer your question about the attachment to the robotic procedures, it is high in the U.S. because that business was built in the wake of robotic procedures, and it sells very nicely. And it's -- and all of the features of the product are relevant to all MIS procedures, but especially robotic procedures, where there's the added risk of the working space collapsing on the arms, there's that added risk and then the added time of having to reset if that were to happen. So, there is a high attachment in the U.S. There's a low attachment to robotic procedures outside the U.S. because frankly, there weren't as many robotic procedures outside the U.S. years ago. And so that -- our sales force outside the U.S. sells it very effectively into non-robotic MIS procedures. Our U.S. sales force has not been forced to develop those muscles. And so, they've lived a very good life in the wake of robotic procedures. But there's still enormous -- if for any reason, that opportunity behind robotic procedures were to someday slow, AirSeal could still grow just as fast as we have been by shifting focus into the non-robotic.

具體回答你關於機器人程式附件的問題，它在美國很高，因為該業務是在機器人程式之後建立的，而且賣得很好。該產品的所有功能都與所有 MIS 程序相關，尤其是機器人程序，其中工作空間倒塌到手臂上的風險增加，風險增加，而且必須花費更多時間如果發生這種情況，請重置。因此，在美國人們對機器人手術的依戀度很高。而在美國以外的地方，人們對機器人手術的依戀度很低，因為坦白說，幾年前在美國以外的地方並沒有那麼多機器人手術。因此，我們在美國以外的銷售團隊非常有效地將其銷售到非機器人 MIS 計畫中。我們的美國銷售團隊並沒有被迫發展這些肌肉。因此，在機器人手術之後，他們過著了非常美好的生活。但仍然存在巨大的潛力 - 如果出於某種原因，機器人程式背後的機會有一天會變慢，AirSeal 仍然可以透過將重點轉移到非機器人程式來像我們一樣快速成長。

So, we feel very strong about our competitive position about the differentiation. We see nothing in the market, nothing in any filings, nothing in any discussions that would challenge that. And it's been a terrific product, now almost eight years post-acquisition, and we expect -- we don't see anything slowing it down.

因此，我們對自己在差異化方面的競爭地位非常有信心。我們在市場上、任何文件中、任何討論中都沒有看到任何可以挑戰這一點的內容。這是一個非常棒的產品，現在已經是收購近八年後的事了，我們預期——我們沒有看到任何因素會阻礙它的發展。

And Robbie, from a competitive standpoint, any company in the marketplace who provides a video platform for MIS surgery is going to have an insufflation device. And the insufflation category has traditionally been provided by an OEM. Suspect it's the same OEM that's providing this device. And that is considered standard insufflation technology. When you look at attachment to a robot, it's like a video stack. You're putting the platform on there. There may be some integrated ease-of-use features. But again, consistent pressure, stable pneumoperitoneum at low pressure that can handle the removal of smoke without movement in the working space that can handle doing that at low pressure. That's the clinical benefit and differentiation of the technology and the intellectual property across the three elements provided. So hopefully, that helps people understand a little bit different the clinical aspects and value that AirSeal brings to the marketplace, the clinical marketplace.

Robbie 表示，從競爭的角度來看，市場上任何為 MIS 手術提供視訊平台的公司都將擁有吹氣裝置。充氣類別傳統上由 OEM 提供。懷疑是提供此設備的相同 OEM。這被認為是標準的吹氣技術。當你觀察機器人的配件時，它就像一個視訊堆疊。你把平台放在那裡。可能有一些整合的易用功能。但同樣，壓力一致、低壓下穩定的氣腹可以處理煙霧的去除，而無需在可以處理低壓下的工作空間中移動。這就是所提供的三個要素的技術和智慧財產權的臨床效益和差異化。因此，希望這可以幫助人們了解 AirSeal 為臨床市場帶來的臨床方面和價值。

One moment for our next question. And our next question comes from the line of Rick Wise from Stifel.

請稍等一下我們的下一個問題。我們的下一個問題來自 Stifel 的 Rick Wise。

The warehouse related issues and customer recapture, maybe you can help us understand or get a little more color on where things stand. Obviously, the software implementation was done, completed, and you were last quarter back up and running. I think if I'm remembering correctly, you said that greater than 50% of customers who had been disrupted or in some way, had returned. Where are you now -- how much benefit did we see in the quarter? And when do we get back to where you were or where you would aspire to be?

與倉庫相關的問題和重新吸引客戶，也許您可以幫助我們理解或進一步了解情況。顯然，軟體實施已經完成，並且您在上個季度恢復並運行。我想如果我沒記錯的話，您說過超過 50% 的受到干擾或以某種方式受到干擾的客戶已經返回。您現在在哪裡—我們在本季看到了多少收益？我們什麼時候才能回到您原來的位置或您渴望達到的位置？

I think we're on the path that we've talked about really probably going back to fourth quarter. We had good return in the first quarter. supported by an uptick in overall procedure volumes, generally speaking, and I feel like we've -- we're pretty far back to recovery on the majority of our customers. There will always be some stragglers may have signed up with a competitive entrant and had to make some commitments. But I think the best way I can frame it, Rick, we're not walking around worried about how soon are these people are going to come back. We feel like we've done a good job recapturing any customers that may have departed us for some period of time. And I think the underlying strength in the markets and our overall innovation and portfolio, and sales teams have done a really nice job reassuring those customers that we're back and we're in front of it again. And we've said on the last call, we're still working on all the opportunity that the warehouse implementation software brings us, and we'll continue to work on that. Any time you have a state-of-the-art software platform, you're going to try to optimize it day in, day out, month in, month out, and that journey will continue.

我認為我們正走在我們討論過的道路上，很可能會回到第四季。第一季我們獲得了良好的回報。一般來說，整體手術量的增加支持了這一點，我覺得我們已經——我們的大多數客戶已經恢復了相當長的一段時間。總是會有一些落後者可能已經與競爭者簽約並必須做出一些承諾。但我認為最好的方式是，瑞克，我們不會四處走動，擔心這些人多久會回來。我們覺得我們在重新吸引可能離開我們一段時間的客戶方面做得很好。我認為市場的潛在實力、我們的整體創新和產品組合以及銷售團隊做得非常好，讓這些客戶放心，我們回來了，我們再次處於領先地位。我們在上次電話會議上說過，我們仍在努力利用倉庫實施軟體帶給我們的所有機會，並且我們將繼續努力。每當您擁有最先進的軟體平台時，您都會嘗試日復一日、月復一月地對其進行最佳化，並且這個過程將繼續下去。

Okay. And I know how important innovation is in your mind and to the CONMED strategy. Can you give us any color about what we might see or any way to characterize the kind of impact that new product launches are having or about to have in a broader portfolio sense? And maybe roll into that, just a little more detailed update on In2Bones and Biorez. It seems like they're doing well. Maybe just help us understand where they are in terms of growth and acceptance and how we think about the contribution. Just those two alone might make two or four second-half top line growth?

好的。我知道創新在您的心目中以及 CONMED 策略中的重要性。您能否給我們一些關於我們可能看到的情況的顏色，或者以任何方式來描述新產品發佈在更廣泛的投資組合意義上正在或即將產生的影響？也許還會涉及 In2Bones 和 Biorez 的一些更詳細的更新。看起來他們做得很好。也許只是幫助我們了解他們在成長和接受方面的狀況以及我們如何看待他們的貢獻。僅憑這兩點就可能使下半年的收入成長兩到四個？

Yes. So, we're encouraged by the contribution from new product introductions. And I would probably say leading that right now across the company is our Orthopedics business. If you were at Academy, you saw a lot of products at Orthopedics, not just Biorez, that was a focus, obviously, but we had a lot of new products. And when I look at our new product revenue in the quarter, based on the way we measure it, globally, our Orthopedics business, new product contribution has been very helpful. And again, that's credit to revamp, the new team, leadership and how they're approaching innovation with the commercial team and integrating that with our manufacturing group. And I think I mentioned on the last call, in our interventional endoscopy business, we introduced a product called AVEO, which we think is an only-in-class product and market reception on that has been very favorable. Obviously, it's capital components so it's going through a little longer purchasing cycles. But boy, the marketplace feedback has been really, really strong.

是的。因此，我們對新產品推出的貢獻感到鼓舞。我可能會說，目前整個公司的領導者是我們的骨科業務。如果您在學院，您會在骨科中看到很多產品，而不僅僅是 Biorez，這顯然是一個焦點，但我們有很多新產品。當我查看本季的新產品收入時，根據我們在全球範圍內衡量的方式，我們的骨科業務、新產品的貢獻非常有幫助。再說一次，這要歸功於改造、新團隊、領導力以及他們如何與商業團隊進行創新並將其與我們的製造團隊整合。我想我在上次電話會議中提到，在我們的介入內視鏡業務中，我們推出了一款名為AVEO 的產品，我們認為這是同類產品中唯一的產品，並且市場對此非常受歡迎。顯然，它是資本組成部分，因此它的採購週期要長一些。但是天哪，市場的回饋真的非常非常強烈。

So, we continue to push on new product innovation. It's part of what we brought to the company, and it will always be part of our fabric and our teams are doing a really nice job of it right now. Biorez and In2Bones, as I commented, we feel very good about both of those. In2Bones comprehensive business, comprehensive portfolio, rolling out PCR plating kind of the next iteration on the ankle, doing really good work. And we sunsetted the one-year mark. It's part of the organic business now, and we'll look forward to that contribution in the second half and going forward, and Biorez becomes organic in August. But boy, we're super excited by the market reaction. It's good clinical outcomes drive this and good surgeon experiences drive this, and we're seeing that, and it's about educating surgeons so they understand the technology and how we approach it, how they approach it. But the market enthusiasm is very strong. And again, we feel very good about that acquisition. I don't think we've commented about specific contribution in the second half. So, I'm probably not going to break that out here.

因此，我們持續推動新產品創新。這是我們為公司帶來的一部分，也將永遠是我們結構的一部分，我們的團隊現在在這方面做得非常好。 Biorez 和 In2Bones，正如我所評論的，我們對這兩者都感覺非常好。 In2Bones 業務全面，產品組合全面，在腳踝上推出了下一代 PCR 電鍍技術，做得非常好。我們結束了一周年的紀念。現在它是有機業務的一部分，我們期待下半年和未來的貢獻，Biorez 將在八月成為有機業務。但是天哪，我們對市場反應感到非常興奮。良好的臨床結果推動了這一點，良好的外科醫生經驗推動了這一點，我們看到了這一點，這是關於教育外科醫生，讓他們了解這項技術以及我們如何處理它，他們如何處理它。但市場熱情卻非常旺盛。再說一次，我們對這次收購感覺非常好。我認為我們沒有評論過下半年的具體貢獻。所以，我可能不會在這裡透露這一點。

One moment for our next question. And our next question comes from the line of Matthew O'Brien from Piper.

請稍等一下我們的下一個問題。我們的下一個問題來自 Piper 的 Matthew O'Brien。

Todd, can you just flesh out a little bit more on the smoke side? I think you said AirSeal has been growing 20%. I want to make sure, did it grow 20% this quarter? Is Buffalo growing 20% as well. And what I'm getting at is if those two still grow about 20%, it looks like the rest of the General Surgery business was a little bit lighter than maybe I would have expected, especially with the comp being a little bit easier here in Q2 versus Q1. Are you just not getting all that halo effect yet from those two differentiated products? Or is there something else going on there?

托德，你能在煙霧方面再充實一點嗎？我記得您說過 AirSeal 成長了 20%。我想確定一下，本季成長了 20% 嗎？水牛城也成長了 20% 嗎？我的意思是，如果這兩家公司仍然增長約 20%，那麼普通外科業務的其餘部分似乎比我預期的要輕一些，尤其是這裡的補償要容易一些。Q2 與 Q1。您是否還沒有從這兩種差異化產品中獲得光環效應？或者有其他事情發生嗎？

Yes. So, they definitely did grow north of 20% in the second quarter. And I don't know that I'd grant your easy comp comment on Q2. But look, we're pleased with how the business is going. We grew 12.6% organic across the company. We've got these new acquisitions, which are just turning -- they're just anniversarying, they're obviously growing nicely strong. So, we feel very good about the organic growth profile of the company. That's incorporated in the guidance we just gave. I will remind you that Q3, our range does include the double-digit organic growth despite having two fewer sales days, right? So, remember that as you judge the Q3 number. But look, the business is going well. Obviously, there's some legacy products that grow slower. We all know that. But we have many parts of the business growing really well right now.

是的。因此，他們在第二季度確實增長了 20% 以上。我不知道我是否會同意您對第二季的簡單補償評論。但看，我們對業務的進展感到滿意。我們整個公司的有機成長率為 12.6%。我們已經有了這些新的收購，這些收購剛剛發生，它們剛剛週年紀念，它們顯然正在變得非常強大。因此，我們對公司的有機成長狀況感到非常滿意。這已納入我們剛剛提供的指南中。我要提醒您的是，第三季度，儘管銷售天數減少了兩天，但我們的產品系列確實實現了兩位數的有機增長，對嗎？所以，當你判斷第三季的數字時，請記住這一點。但你看，生意進展順利。顯然，有些遺留產品的成長速度較慢。我們都知道。但我們的許多業務目前都成長得非常好。

Okay. Appreciate that. And then I don't want specifics on BioBrace or In2Bones, but are those two still largely on deal plan as far as what you were expecting or ahead of expectations? And then this volume growth that we're seeing, everybody is seeing, and I am in no way, Todd, asking about 2024 numbers, but do you think this is something on the volume side that can continue through not only the back half of this year, which it sounds like it already is, but even into next year as well, just the strength in volumes because everybody in the space is going to have a tough comp next year as a result of the strength this year.

好的。感謝。然後我不想了解 BioBrace 或 In2Bones 的具體信息，但是就您的預期或超出預期而言，這兩家公司是否仍在很大程度上處於交易計劃中？然後我們看到的銷量成長，每個人都看到了，托德，我絕不會詢問 2024 年的數字，但你認為銷量方面的增長不僅會持續到下半年嗎？今年，聽起來已經是這樣了，但即使到明年，也只是數量上的實力，因為由於今年的實力，該領域的每個人明年都會有一個艱難的競爭。

Yes. Thanks, Matt. Yes, on the deals, yes, they're both performing at least to plan. We talked about on the Q1 call that Biorez, we kind of raised the expectations from mid-single-digit millions to high single-digit millions for 2023. So that obviously was out of the gates a little better than we thought. And yes, look, I think halfway through 2023, I don't think we would be alone in saying the environment feels good. It feels like pre-pandemic, where med tech is back, and procedures are back and the growth rates in our spaces are getting back to where they used to be. You're right, it's too early to talk about 2024, but it does -- barring -- I'm knocking on wood here, but it does feel like maybe we've finally gotten through all the pandemic disruptions and that we probably do have some tailwind from people that didn't get care when they should have and there's some pent-up demand maybe. I think it's really tough to quantify. But I think that probably is a tailwind out there for all of us. And yes, I think we're feeling good about the future as we sit here today.

是的。謝謝，馬特。是的，在交易方面，是的，他們至少都在按計劃進行。我們在第一季電話會議上談到 Biorez，我們將 2023 年的預期從中個位數提高到了高個位數。所以這顯然比我們想像的要好一些。是的，我認為到 2023 年過半，我認為我們不會是唯一一個說環境感覺良好的人。感覺就像是疫情大流行前，醫療技術又回來了，手術也回來了，我們空間的成長率也回到了以前的水平。你是對的，現在談論 2024 年還為時過早，但它確實——除非——我在這裡敲木頭，但確實感覺也許我們終於度過了所有大流行的干擾，而且我們可能會做到有些人在他們應該得到照顧的時候卻沒有得到照顧，也許還有一些被壓抑的需求。我認為這確實很難量化。但我認為這對我們所有人來說可能都是順風順水。是的，我認為當我們今天坐在這裡時，我們對未來感覺良好。

Thank you. One moment for our next question. And our next question comes from the line of Vik Chopra from Wells Fargo.

謝謝。請稍等一下我們的下一個問題。我們的下一個問題來自富國銀行的 Vik Chopra。

Congrats on a great quarter. Two questions to me. So maybe the first one is on your international business. You put up pretty strong numbers on tough year-over-year comps. I'm just wondering what trends you're seeing in your various geographies? And then on my follow-up question, in your guidance, you've sort of raised the top line by about $100 billion at the midpoint. And maybe just talk about what gets you towards the low end versus the high end of your guidance.

恭喜您度過了一個出色的季度。有兩個問題問我。所以也許第一個是關於你的國際業務。你們在艱難的逐年比較中取得了相當強勁的數據。我只是想知道您在不同地區看到了什麼趨勢？關於我的後續問題，在您的指導下，您將中點的收入提高了約 1000 億美元。也許只是談談是什麼讓你走向指導的低端和高端。

So, let me -- I'll take the easy one, Vik, and I'll leave Todd the second one. Our international business has been a very steady performer and this year is no exception. They're doing really a nice job across both Orthopedics and General Surgery. And I think Todd commented some of our export markets have had really strong performance with the Asian markets, Japan, China, Asia, broadly speaking, really probably growing a little faster than we had even assumed. But Europe is doing a nice job. Latin American market is doing a very nice job. So, it's been a very balanced international performance across both General Surgery and Orthopedics. And that's a testament to the infrastructure, the stability of the leadership team and the evolution of the channel and the country market focus that they've put in place over a number of years. So, hopefully, that answers your question on international, and I'll let Todd take the guidance question.

所以，讓我——維克，我選擇簡單的一個，而我將把第二個留給托德。我們的國際業務表現非常穩定，今年也不例外。他們在骨科和普通外科方面都做得非常出色。我認為托德評論說，我們的一些出口市場在亞洲市場、日本、中國、亞洲的表現非常強勁，從廣義上講，成長速度可能比我們想像的要快一些。但歐洲做得很好。拉丁美洲市場做得非常好。因此，一般外科和骨科的國際表現非常均衡。這證明了他們多年來所建立的基礎設施、領導團隊的穩定性以及通路的演變和國家市場重點。所以，希望這能回答你關於國際的問題，我會讓托德回答指導問題。

Yes. Just to make sure we're all level set. Our current revenue guidance is $1.23 billion to $1.26 billion. When we started the year, we guided $1.17 billion to $1.22 billion. So, it's been a $60 million increase.

是的。只是為了確保我們都已做好準備。我們目前的收入指引為 12.3 億至 12.6 億美元。年初時，我們指引了 11.7 億美元至 12.2 億美元。因此，增加了 6000 萬美元。

Million.

百萬。

Sorry, $1 million. I'm doing the same thing. A $60 million increase on the low end from the start of the year and a $40 million increase on the high end from the start of the year. And really that's just reflected in our performance, right? Things have gone better than we said. And we always had high expectations for the back half of this year. We continue to have high expectations for the back half of this year, and we're executing, and we're going to continue to focus on executing.

抱歉，100萬美元。我也在做同樣的事情。低端較年初增加 6,000 萬美元，高端較年初增加 4,000 萬美元。這確實反映在我們的表現中，對吧？事情比我們說的還要好。我們一直對今年下半年抱有很高的期望。我們對今年下半年仍然抱有很高的期望，我們正在執行，我們將繼續專注於執行。

Thank you. One will go for our next question. And our next question comes from the line of Matthew Mishan from KeyBanc.

謝謝。我們將討論下一個問題。我們的下一個問題來自 KeyBanc 的 Matthew Mishan。

Last three quarters, you guys have been around the low 54s from a gross margin perspective. It seems like this is the beginning of the ramp you've been expecting over the next, like, two years or just closer towards about 60%. What's clicking as you get into the second half that's enabling this change?

過去三個季度，從毛利率的角度來看，你們一直在 54 左右。這似乎是您所期待的未來兩年或更接近 60% 左右的成長的開始。當你進入下半場時，是什麼促成了這項改變？

Yes. Thank you, Matt. And you're right. This has -- we have been waiting to get through the first half of 2023. Things do get better from here. What's really clicking, has been clicking, is the mix of the business, right? These high-growth, highly differentiated product lines that continue to do well, all also come with elevated gross margins. And so that mix tailwind is actually picking up speed. It's not waning. It's picking up speed as those things grow faster than the rest of the portfolio. And so that is finally being allowed to show through because we've had some stability on the cost side, right? And we still think there's a lot of improvements that we can do on the cost side, but digesting the increased prices from 2022, which, as you know, takes a while to flow through our inventory and therefore, our financials, we knew that that would be a weight on the first half of 2023. And as we get -- as we've seen stabilization in the cost side, now that mix tailwind is starting to show through. And so, we are excited to now start ramping gross margins, as you've pointed out. And we feel very good and confident about the disclosure we made about six months ago when we said we expect gross margins to be to 60% by the end of 2025, and we feel very confident that we can get there. So, thanks for noticing, and I hope I answered your question.

是的。謝謝你，馬特。你是對的。我們一直在等待 2023 年上半年的到來。從現在開始，情況確實會變得更好。真正點擊的，一直點擊的，是業務的組合，對嗎？這些高成長、高度差異化的產品線持續表現良好，同時毛利率也有所提高。因此，混合順風實際上正在加速。它並沒有減弱。隨著這些產品的成長速度快於投資組合的其他產品，它的速度正在加快。所以這最終被允許表現出來，因為我們在成本方面已經有了一定的穩定性，對嗎？我們仍然認為在成本方面我們可以做很多改進，但消化從 2022 年開始上漲的價格，正如你所知，這需要一段時間才能流過我們的庫存，因此，我們的財務狀況，我們知道這將是2023 年上半年的一個壓力。正如我們所看到的，正如我們看到成本方面的穩定，現在混合順風開始顯現出來。因此，正如您所指出的，我們很高興現在開始提高毛利率。我們對六個月前的揭露感到非常滿意和充滿信心，當時我們表示預計到 2025 年底毛利率將達到 60%，我們對實現這一目標非常有信心。所以，感謝您的關注，我希望我回答了您的問題。

Yes, you did. And then I just wanted to switch over to nonrobotic U.S. laparoscopic procedures in the U.S. It just seems like such a big opportunity over the long term that your sales force hasn't really hit on as aggressively, I think, as -- or built the muscles to hit on as aggressively as probably you would like. When were you planning to kind of -- as you kind of think long term, when were you kind of planning to kind of make that shift or incentivize that shift in the sales force? And does it require something like an R&D update or a modestly different solution in the U.S.

是的，你做到了。然後我只是想在美國轉向非機器人美國腹腔鏡手術。從長遠來看，這似乎是一個巨大的機會，但我認為，你的銷售人員並沒有真正積極地採取行動，或者建立了您可以盡情地攻擊肌肉。你打算什麼時候——從長遠來看，你打算什麼時候做出這種轉變或激勵銷售團隊的這種轉變？它是否需要在美國進行研發更新或略有不同的解決方案？

Matt, it's a good question. And I'm sure right now, our commercial leadership team for that business is squirming in their seat. But I think Todd and I are probably being a little harsh. We have several examples of very nice wins on the general laparoscopic side that the team has delivered on earlier this year, which was a total system-wide swap-out. The single biggest point of resistance is you're asking that extensive surgical volume, which is like a 10:1 ratio relative to robotics to move to a much more expensive procedure. So, in a period the last couple of years where volumes have been up and down and pricing pressure and inflationary pressures, convincing health systems to change and incur additional cost, even though they recognize the clinical benefits has been more of an uphill climb. We hope that as the markets are stabilizing as procedure volumes are coming back, broadly speaking, and pricing and everything is normalized and material costs, etc., that customers are more willing to step into that realm.

馬特，這是個好問題。我確信現在，我們該業務的商業領導團隊正在他們的座位上蠕動。但我認為托德和我可能有點嚴厲。今年早些時候，我們的團隊在普通腹腔鏡方面取得了一些非常好的勝利，這是整個系統範圍內的替換。最大的阻力點是您要求進行大量的手術，與機器人技術的比例為 10:1，轉向更昂貴的手術。因此，在過去幾年的時間裡，數量不斷上升和下降，價格壓力和通貨膨脹壓力不斷增加，說服衛生系統進行改變並承擔額外成本，儘管他們認識到臨床益處更像是一個艱難的攀登。我們希望，隨著市場趨於穩定，整體而言，程序量正在回升，定價和一切都正常化，材料成本等也都正常化，客戶更願意進入這一領域。

And again, it takes a few big ones to tip over, and we've done that early this year and late last year. We had a couple of really nice wins and that's contagious for a sales force when they see things like that. Todd and I talked to our businesses frequently. And they know the story and the journey and the path that they're going on. And part of it is continuing to expand sales forces annually. Part of it is making sure we've got the right product cost structure for those customers, but we will get there. We're not going to change incentive plans to force people there that have been in this industry 30 years, it just doesn't work. It doesn't work the way it's designed, just keep it simple and let people go sell to the customers that are ready to be buyers and show them all the clinical value that we have, especially with a product like AirSeal.

再說一遍，需要一些大的東西才能翻倒，我們在今年年初和去年年底就做到了這一點。我們取得了一些非常好的勝利，當銷售人員看到這樣的事情時，這對他們來說是有感染力的。托德和我經常與我們的企業交談。他們知道這個故事、他們正在經歷的旅程和道路。其中一部分是每年持續擴大銷售團隊。其中一部分是確保我們為這些客戶提供正確的產品成本結構，但我們將實現這一目標。我們不會改變激勵計劃來強迫那些已經在這個行業工作了 30 年的人，這根本行不通。它並不像設計的那樣工作，只需保持簡單，讓人們向準備成為買家的客戶銷售並向他們展示我們擁有的所有臨床價值，尤其是像 AirSeal 這樣的產品。

Yes, I think that's an important part that I would just add, Matt. And I think that's kind of wisdom and focus that Curt brings here. He's funny, Curt's talking about the commercial team squirming. Whenever you talk about, well, let's drive the compensation plan to make them sell this much of this and this much of that and this much of the third thing, and Curt's always like, look, let's make it really clear how they make money and let's let them go make money and make sure they know they work for the customer. Yes, the check is signed by CONMED, but they work for the customer and give the customer what they want.

是的，我認為這是我要添加的重要部分，馬特。我認為這就是柯特帶來的智慧和專注。他很有趣，柯特正在談論商業團隊的蠕動。每當你談論，好吧，讓我們推動補償計劃，讓他們賣掉這麼多這個，這麼多那個，還有這麼多第三件事，柯特總是喜歡，聽著，讓我們真正弄清楚他們是如何賺錢的，讓我們讓他們去賺錢，並確保他們知道自己為客戶工作。是的，支票是由 CONMED 簽署的，但他們為客戶工作並為客戶提供他們想要的東西。

And so, I think it is important, as you asked that question, which is a good question, where some places do try and push behavior that way. Here, we say go make your number however you want to make it, right? It serves the customer. Well, if you think about -- if you're one of those sales reps in that space, you can walk in behind a $2 million robot and say, hey, why don't you buy this $30,000 box that makes every procedure safer, faster, better. And that's just an easier starting jumping off point than walking into a place without that $2 million block creating the hole for you there, right? So, you're walking in saying, hey, you should double the expense to get these benefits.

因此，我認為這很重要，正如您提出的問題一樣，這是一個很好的問題，有些地方確實嘗試以這種方式推動行為。在這裡，我們說你想怎麼做就怎麼做吧？它為客戶服務。好吧，如果你想一想，如果你是那個領域的銷售代表之一，你可以走進一個價值200 萬美元的機器人後面說，嘿，為什麼你不買這個價值30,000 美元的盒子，它可以使每個程序更安全，更快，更好。這只是一個比走進一個沒有 200 萬美元塊為你創造洞的地方更容易的起點，對嗎？所以，你走進來說，嘿，你應該加倍費用才能獲得這些好處。

It works. Doing it in the laparoscopic nonrobotic space works are, like Curt said, our U.S. team has proven that it works, our OUS team -- we grow just as fast in AirSeal outside the United States as we do inside the United States. And they don't have the wake of the robot. So, they have -- we already have -- we know that we can successfully go into nonrobotic procedures and convert those accounts. But we have not micromanaged the sales force to make them go there. They will go there when they need to go there. They will go there. And that opportunity is still there.

有用。正如Curt 所說，在腹腔鏡非機器人太空工作中做到這一點，我們的美國團隊已經證明它是有效的，我們的OUS 團隊——我們在美國境外的AirSeal 發展速度與在美國境內的發展速度一樣快。而且他們沒有機器人的尾流。所以，他們——我們已經——我們知道我們可以成功地進入非機器人程式並轉換這些帳戶。但我們並沒有對銷售人員進行微觀管理，讓他們去那裡。當他們需要去那裡時，他們就會去那裡。他們會去那裡。而這個機會仍然存在。

Thank you. One moment for our next question. And our next question comes from the line of Young Li from Jefferies.

謝謝。請稍等一下我們的下一個問題。我們的下一個問題來自 Jefferies 的 Young Li。

All right. Great. Maybe one more on AirSeal. Just to follow up on your earlier comments on the top 25 hospitals that uses it, I think it's a 92%, some as high as 75% penetrated. I guess I'm wondering what's the average penetration rate in that cohort if you have it, why or how did the top hospital get to 75%? Is it due to their procedure mix or more surgeon champions or more the longer length of time that AirSeal has been in their hospital?

好的。偉大的。也許還有一個關於 AirSeal 的內容。跟進您之前對使用該技術的前 25 家醫院的評論，我認為滲透率達到 92%，有些甚至高達 75%。我想我想知道該隊列的平均滲透率是多少（如果有的話），為何頂級醫院為何或如何達到 75%？是因為他們的手術組合還是更多的外科醫生冠軍，或者是 AirSeal 在他們醫院的時間更長？

There's a lot to unpack there. Teaching hospitals are notoriously hard to crack into. The surgeon champions are thought leaders. They are very clinically astute. They are absolutely in the prove it to me category. So, where we have the higher utilization rates, we've probably found a surgeon champion sooner, and they were able to help proliferate the technology across all the users in that account, where we have lower utilization rates. It may have been harder to crack into that hospital. They may have an allegiance to other technology, and they were waiting to see more clinical outcomes. But that's why you keep chipping away. And to be in 92% of them is really good after seven years.

那裡有很多東西需要解壓。眾所周知，教學醫院很難闖入。外科醫生冠軍是思想領袖。他們在臨床上非常敏銳。他們絕對屬於向我證明這一點的類別。因此，在我們利用率較高的地方，我們可能會更快地找到外科醫生冠軍，他們能夠幫助在該帳戶中的所有用戶中推廣該技術，而在我們的利用率較低的地方。闖入那家醫院可能更困難。他們可能熱衷於其他技術，並且正在等待看到更多的臨床結果。但這就是為什麼你不斷地削減。七年後能進入其中 92% 真是太好了。

And because we're in them, we keep showing up, we keep demonstrating the value, and we'll get more of those key opinion leaders on board across those facilities and the penetration rate will go up. Off the top of my head, I don't have the exact mean median average. But it ranges from just starting to north of 75% and probably everything in between. So, it is a journey when you're talking about teaching institutions. They don't just turn over overnight. It takes time, and our sales teams and our marketing teams spend an awful lot of time to get them on board, and we're proud of that work. And when people leave the teaching institutions, what they were trained on and who they trained by is very important to how they set up practice. And that's why it's such an important statistic for us.

因為我們在其中，所以我們不斷出現，不斷展示價值，我們將在這些設施中吸引更多關鍵意見領袖，滲透率將會上升。在我的腦海中，我沒有確切的平均中位數。但其範圍從剛開始到 75% 以上，也可能介於兩者之間。所以，當你談論教學機構時，這是一個旅程。他們不是一夕之間翻身的。這需要時間，我們的銷售團隊和行銷團隊花了大量時間讓他們參與進來，我們為這項工作感到自豪。當人們離開教學機構時，他們接受的培訓內容以及培訓對象對於他們如何進行實踐非常重要。這就是為什麼它對我們來說是一個如此重要的統計數據。

All right, great. That's very helpful color. I guess, a follow-up question. I was wondering, within your general surgery business, can you maybe comment on some of the key categories or indications that's driving growth, we're hearing things like bariatric surgery slowing down. It's a small part of your business. But are you seeing that as well? Maybe you can highlight some of the categories that's performing a little bit better and some that's a little bit slower.

好吧，太好了。這是非常有用的顏色。我想，這是一個後續問題。我想知道，在您的普通外科業務中，您能否對推動成長的一些關鍵類別或適應症發表評論，我們聽到減肥手術等放緩的消息。這只是您業務的一小部分。但你也看到了嗎？也許您可以突出顯示一些表現較好的類別和一些表現較慢的類別。

Yes. I don't think we would say we've seen any slowdown in bariatric surgery at this point in time. Again, it's a small part of our pie that we participate in. And I also think that that patient cohort probably has a broader mortality index that has to be dealt with. And so, when they get to the surgical side of things, I'm sure there's gastric bypass that is more of a weight reduction that could be impacted by a pharmaceutical solution. But there's just a lot of other bariatric surgery types and indications that are still going to be maintained out there because of the comorbidity of that patient cohort.

是的。我認為目前我們不會說減肥手術有任何放緩。再說一遍，這只是我們參與的一小部分。我還認為，該患者群體可能有更廣泛的死亡率指數需要處理。因此，當他們談到手術方面時，我確信胃繞道手術更多的是減輕體重，這可能會受到藥物解決方案的影響。但由於該患者族群的合併症，仍有許多其他減重手術類型和適應症仍將保留。

Generally speaking, across our General Surgery businesses we're seeing good procedure volume independent of specialty. I mean it's urological, it's general surgery straight up procedures. It's GYN procedures, there's strength across the board. I don't think I would call out any that are driving the ship, so to speak. And I think that as important on the interventional endoscopy side, really good volumes in that market space right now and our teams are super excited. And they've got a very, very exciting new product there. So, we feel good generally about that entire category of our business right now.

一般來說，在我們的一般外科業務中，我們看到了與專業無關的良好手術量。我的意思是，這是泌尿科的，是一般外科手術的直接程序。這是婦科手術，具有全面的優勢。可以這麼說，我認為我不會喊出任何駕駛這艘船的人。我認為，對於介入內視鏡檢查而言，同樣重要的是，目前該市場空間的銷售量非常好，我們的團隊非常興奮。他們在那裡推出了一款非常非常令人興奮的新產品。因此，我們目前對整個業務類別總體感覺良好。

Thank you. One moment for our next question. And our next question comes from the line of Kristen Stewart from CL King.

謝謝。請稍等一下我們的下一個問題。我們的下一個問題來自 CL King 的 Kristen Stewart。

Congrats on the results. I was wondering if you could just share a little bit more details on Buffalo Filter, -- if there's any passage of legislation since we last spoke. And just in general, the competitive environment there, too.

祝賀結果。我想知道您是否可以分享一些有關 Buffalo Filter 的更多細節——自我們上次談話以來是否有任何立法通過。總的來說，那裡的競爭環境也是如此。

There is. Ohio and Missouri got approved most recently. So, the cascade continues, and we expect that it will continue to build, and it continues to go well. That's -- there's a lot of runway there. We have the best device in the market, we believe, and we expect big things out of that business going forward.

有。俄亥俄州和密蘇裡州最近獲得批准。因此，級聯仍在繼續，我們預計它將繼續發展，並且繼續進展順利。那是——那裡有很多跑道。我們相信，我們擁有市場上最好的設備，我們期望該業務在未來取得更大的成就。

Okay. And maybe you could expand further just on a general capital environment. It looks like capital grew nicely this quarter. Just any additional color there you could share?

好的。也許你可以在一般資本環境上進一步擴張。看起來本季資本成長良好。您可以分享其他顏色嗎？

Sure. It's interesting. It was in -- it was solid performance both in General Surgery and in Orthopedics. And it was interesting. We had -- one of our better performances on power tools. We had really strong performance on video. And on the General Surgery side, we have an extensive platform of energy platforms, Argon and just basic energy. And all of those did very well in the quarter. And I think the teams feel pretty good about both of those categories as we look into the second half of the year. Obviously, AirSeal Capital, Buffalo Filter Capital, the boxes fall into that category as well. So those are helpful items as well on the general surgery side.

當然。這真有趣。它在普通外科和骨科領域都有出色的表現。這很有趣。我們在電動工具方面取得了更好的表現之一。我們在影片方面的表現非常出色。在一般外科方面，我們擁有廣泛的能源平台、氬氣和基本能源。所有這些在本季度都表現出色。我認為，當我們展望今年下半年時，球隊對這兩個類別都感覺非常好。顯然，AirSeal Capital、Buffalo Filter Capital 等盒子也屬於這一類。因此，這些對於普通外科來說也是有用的。

Thank you. One moment for our next question. And our next question comes from the line of Mike Matson from Needham & Company.

謝謝。請稍等一下我們的下一個問題。我們的下一個問題來自 Needham & Company 的 Mike Matson。

I guess, first, just wanted to ask one on BioBrace. Maybe talk about sort of the early feedback you're hearing there, what type of procedures you're seeing it used in? And to what degree do you think it's sort of taking share for some of the competing products versus just being picked up by surgeons that hadn't been using that type of product before?

我想，首先，我只是想問一下 BioBrace 上的一個問題。也許可以談談您在那裡聽到的早期回饋，您看到它用於什麼類型的程式？您認為這在多大程度上是搶佔一些競爭產品的份額，而不是被以前沒有使用過此類產品的外科醫生所採用？

Yes. It's a great question. We -- we're seeing it deployed in a host of other surgical procedures. We obviously have a product that's specific to rotator cuff. We have a product that's specific to ACL augmentation. But the one for rotator cuff is more like a patch construct. So, surgeons are modifying that and using it in other indications, whether it's Achilles tendon repair or glute repair. And I think if I try to remember from the slide at Academy, I think one of the surgeons put up 23 different surgical applications where BioBrace had been used. And there's a lot of new users new to the collagen A market that we're finding. But there are some competitive users from the first-generation product in the market who are interested in this product because candidly, the strength of [Time 0] is a massive selling feature that is a super important point when you talk about retear.

是的。這是一個很好的問題。我們——我們看到它被部署在許多其他外科手術中。顯然我們有一款專門針對肩袖的產品。我們有一款專門針對 ACL 增強的產品。但肩袖的結構更像是一種補片結構。因此，外科醫生正在對其進行修改，並將其用於其他適應症，無論是跟腱修復還是臀肌修復。我想，如果我試著回憶學院的幻燈片，我想其中一位外科醫生展示了 23 種不同的使用 BioBrace 的手術應用。我們發現，A 型膠原蛋白市場有許多新用戶。但市場上有一些來自第一代產品的競爭用戶對此產品感興趣，因為坦白說，[Time 0] 的優勢是一個巨大的銷售功能，當您談論後置時，這是一個非常重要的點。

So, we're seeing some adoption out of that space as well, but it's a growing market. It's new technology for healing and there's a lot of new adoption. Again, clinical studies are super important in this space, just like they were in the early days of AirSeal. So, we're working on clinical studies. The market has some clinical studies from the first-generation technology that's out there, but they want to see clinical studies in our technology. But because there's experience with that first-gen product, they probably did some of the market development heavy lifting that is beneficial to us and it's probably why we're a little bit ahead of plan.

因此，我們也看到了該領域的一些採用，但這是一個不斷成長的市場。這是一種用於治療的新技術，並且有許多新的採用。同樣，臨床研究在這個領域非常重要，就像 AirSeal 早期一樣。因此，我們正在進行臨床研究。市場上有一些第一代技術的臨床研究，但他們希望看到我們技術的臨床研究。但由於擁有第一代產品的經驗，他們可能做了一些對我們有利的市場開發繁重工作，這可能是我們比計劃提前一點的原因。

Okay. And then just with In2Bones now being a year path to actual close, can you maybe just talk about the degree to which you sort of increased investment there, either sales force or number of sets, R&D, etc.?

好的。然後，隨著 In2Bones 現在距離實際關閉還有一年時間，您能否談談您在那裡增加投資的程度，無論是銷售人員還是設備數量、研發等？

Yes. We bought it as a stand-alone business, Mike, and we run it as a stand-alone business. And obviously, internationally, we're doing more integration because we have the sales channel there and In2Bones did not have a sales channel. So, investment outside the U.S. is about getting regulatory approvals. It's about building more sales channel, where we -- where there was no lower extremity sales channel. But we're able to do that because we have an orthopedics presence under which we can tuck this. So, you're not building the management piece, you're building more of the direct sales or the distributor agent sales channel.

是的。麥克，我們把它買下來當作一個獨立的企業，我們把它當作一個獨立的企業來經營。顯然，在國際上，我們正​​在做更多的整合，因為我們在那裡有銷售管道，而 In2Bones 沒有銷售管道。因此，在美國境外投資的關鍵在於獲得監管部門的批准。這是關於建立更多的銷售管道，我們在那裡沒有下肢銷售管道。但我們能夠做到這一點，因為我們有骨科人員，我們可以把它塞進去。因此，您不是在建立管理部分，而是在建立更多的直銷或經銷商代理銷售管道。

In the U.S., I think everybody in the lower extremity space would say it's a great market and more feet on the street matter, and we're under that same mindset where feet on the street matter and a great R&D engine, which came with In2Bones is essential to us moving forward. But as Todd and I have said before, we don't do a top-down, spend this much in R&D, the local marketing team, the local R&D team, the leadership, the general manager, this reports again into Pat Beyer under global Orthopedics. They run their business reviews. They take market feedback. They build their R&D portfolio. They know what the sales channel can consume at once or over a period of years and they build an R&D engine to support that. So I think if we're doing anything on the leverage side, because of our infrastructure on medical education through our straight-up sports medicine business, we're able to do more medical education that In2Bones probably couldn't do on their own as a standalone because we just have scale through our bigger sports medicine business, and that occurs both in the U.S. and outside the U.S. and then some of the back-office scale that we talked about, we can bring a lot of that back office shared services that they just couldn't scale up.

在美國，我認為下肢領域的每個人都會說這是一個巨大的市場，更多的腳在街上很重要，我們也有同樣的心態，腳在街上很重要，而且In2Bones 配備了一個偉大的研發引擎對我們前進至關重要。但正如托德和我之前說過的，我們不會自上而下，在研發、本地行銷團隊、本地研發團隊、領導層、總經理上花費這麼多，這再次向帕特·拜爾（Pat Beyer）報告全球情況骨科。他們進行業務審查。他們聽取市場回饋。他們建立自己的研發組合。他們知道銷售管道可以一次性或幾年內消耗什麼，並建立一個研發引擎來支持這一點。因此，我認為，如果我們在槓桿方面做任何事情，由於我們透過直接的運動醫學業務建立了醫學教育基礎設施，我們能夠提供更多 In2Bones 可能無法單獨完成的醫學教育，因為是獨立的，因為我們只是透過更大的運動醫學業務實現了規模，這發生在美國和美國以外的地區，然後是我們談到的一些後台規模，我們可以帶來很多後台共享服務他們就是無法擴大規模。

Thank you. This does conclude the question-and-answer session of today's program. I'd like to hand the program back to Curt Hartman for any further remarks.

謝謝。今天節目的問答環節到此結束。我想將程序交還給科特·哈特曼以供進一步評論。

Thank you, Jonathan. I want to thank everybody. Today we went a little longer than normal, but I appreciate your time, and we look forward to speaking with you on our next earnings call. Thank you and have a good evening.

謝謝你，喬納森。我要感謝大家。今天我們的討論時間比平常要長一些，但我感謝您的寶貴時間，我們期待在下一次財報電話會議上與您交談。謝謝您，祝您晚上愉快。

Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.

女士們、先生們，感謝你們參加今天的會議。這確實結束了該程式。您現在可以斷開連線。再會。