直覺手術 (ISRG) 2012 Q1 法說會逐字稿

Ladies and gentlemen, thank you for standing by. Welcome to the Intuitive Surgical First Quarter Earnings Release Call. At this time all participants are in a listen-only mode. Later we will conduct a question and answer session. (Operator Instructions). I would now like to turn the conference over to our host, Mr. Calvin Darling, Senior Director of Finance for Intuitive Surgical. Please go ahead.

女士們，先生們，謝謝你們的支持。歡迎來到 Intuitive Surgical 第一季度收益發布電話會議。此時所有參與者都處於只聽模式。稍後我們將進行問答環節。 （操作員說明）。我現在想將會議轉交給我們的主持人，Intuitive Surgical 財務高級總監 Calvin Darling 先生。請繼續。

Thank you, good afternoon and welcome to Intuitive Surgical's first-quarter conference call. With me today we have Gary Guthart, our President and CEO; Marshall Mohr, our Chief Financial Officer; and Aleks Cukic, our Vice President of Strategic Planning.

謝謝大家，下午好，歡迎參加 Intuitive Surgical 的第一季度電話會議。今天和我在一起的是我們的總裁兼首席執行官 Gary Guthart；我們的首席財務官 Marshall Mohr；和我們的戰略規劃副總裁 Aleks Cukic。

Before we begin, I would like to inform you that comments mentioned on today's call may be deemed to contain forward-looking statements. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. These risks and uncertainties are described in detail in the Company's Securities and Exchange Commission filings. Prospective investors are cautioned not to place undue reliance on such forward-looking statements.

在開始之前，我想通知您，今天電話會議中提到的評論可能被視為包含前瞻性陳述。由於某些風險和不確定性，實際結果可能與明示或暗示的結果大不相同。這些風險和不確定性在公司提交給證券交易委員會的文件中有詳細描述。警告潛在投資者不要過分依賴此類前瞻性陳述。

Please note that this conference call will be available for audio replay on our website at IntuitiveSurgical.com on the audio archive section under our investor relations page. In addition, today's press release has been posted to our website.

請注意，本次電話會議將在我們的網站 IntuitiveSurgical.com 上的投資者關係頁面下的音頻存檔部分提供音頻重播。此外，今天的新聞稿已發佈到我們的網站。

Today's format will consist of providing you with highlights of our first quarter's results, as described in our press release announced earlier today, followed by a question and answer session.

今天的形式將包括為您提供我們第一季度業績的亮點，如我們今天早些時候宣布的新聞稿中所述，然後是問答環節。

Gary will present the quarter's business and operational highlights, Marshall will provide a review of our first-quarter financial results, Aleks will discuss marketing and clinical highlights, then I'll provide an update to our financial forecast for 2012. And finally, we will host a question-and-answer session.

Gary 將介紹本季度的業務和運營亮點，Marshall 將回顧我們的第一季度財務業績，Aleks 將討論營銷和臨床亮點，然後我將提供我們對 2012 年財務預測的更新。最後，我們將主持問答環節。

With that, I will turn it over to Gary.

有了這個，我會把它交給加里。

Thank you for joining us today. In this first quarter our team has executed well and we have experienced strong performance in procedures, encouraging acceptance of our new products and the financial results that follow.

感謝您今天加入我們。在第一季度，我們的團隊表現良好，我們在程序方面表現出色，鼓勵人們接受我們的新產品和隨後的財務業績。

For 2012, Intuitive is focused on the following. First, continuing our growth in gynecology and urology worldwide through outstanding execution in the field. Second, disciplined execution of our Single-Site and vessel sealing launches, focused on outstanding early customer experiences. Third, building robust clinical programs with leading customers in emerging procedures and general surgery, thoracic surgery and trans-oral surgery, and finally, strengthening our capabilities in international markets, particularly Europe, Japan and Korea.

2012 年，Intuitive 專注於以下方面。首先，通過在該領域的出色執行，繼續我們在全球婦科和泌尿科領域的發展。其次，嚴格執行我們的單站點和船舶密封發射，專注於出色的早期客戶體驗。第三，與新興手術和普外科、胸外科和經口外科的領先客戶建立強大的臨床項目，最後，加強我們在國際市場，特別是歐洲、日本和韓國的能力。

With regard to procedures, we experienced strong growth in general surgery and gynecology, leading to year-over-year procedure growth of approximately 29%. With uptake in colorectal procedures and the introduction of Single-Site in the United States, the category of general surgery grew at the highest rate this quarter. Worldwide urology procedures grew year-over-year as well, led by growth in European dVP, while US urology was flat. Aleks will provide additional procedure commentary later in the call.

在手術方面，我們在普外科和婦科方面經歷了強勁增長，導致手術同比增長約 29%。隨著結直腸手術的普及和單點手術在美國的引入，本季度普通外科手術的增長率最高。在歐洲 dVP 增長的帶動下，全球泌尿外科手術也同比增長，而美國泌尿外科則持平。 Aleks 將在稍後的電話會議中提供額外的程序評論。

As we have mentioned on previous calls, we have been investing in improving our structural capabilities in Japan. Our team has worked with Japan's MHLW on reimbursement for da Vinci prostatectomy, receiving reimbursement approval on April 1.

正如我們在之前的電話會議中提到的，我們一直在投資提高我們在日本的結構能力。我們的團隊與日本厚生勞動省就達芬奇前列腺切除術的報銷進行了合作，於 4 月 1 日獲得報銷批准。

Intuitive Surgical Japan has also successfully transitioned the import license for da Vinci S from Johnson & Johnson Japan to Intuitive Surgical Japan this month. We are encouraged by our progress in Japan and we will continue to invest to clear the path for increased da Vinci use.

本月，Intuitive Surgical Japan 還成功地將 da Vinci S 的進口許可證從 Johnson & Johnson Japan 轉移到 Intuitive Surgical Japan。我們對我們在日本取得的進展感到鼓舞，我們將繼續投資，為增加達芬奇的使用掃清道路。

Overall, international system sales were encouraging. However, our first-quarter system sales in Europe are somewhat disappointing. This is likely a combination of both economic pressures in Europe as well as organizational capability.

總體而言，國際系統銷售令人鼓舞。然而，我們在歐洲的第一季度系統銷售有些令人失望。這可能是歐洲經濟壓力和組織能力的結合。

Turning to operational highlights for the first quarter, procedures grew 29% over the first quarter of 2011. We sold 140 da Vinci Surgical Systems, up from 120 during the first quarter of last year. Total revenue was $495 million, up 28% over last year.

談到第一季度的運營亮點，手術比 2011 年第一季度增長了 29%。我們售出了 140 台達芬奇手術系統，高於去年第一季度的 120 台。總收入為 4.95 億美元，比去年增長 28%。

Instrument and accessory revenue increased to $208 million, up 32% over Q1 of 2011. Total recurring revenue grew to $289 million, up 31% from prior year and comprising 58% of total revenue.

儀器和配件收入增至 2.08 億美元，比 2011 年第一季度增長 32%。總經常性收入增至 2.89 億美元，比上年增長 31%，佔總收入的 58%。

Net income was $144 million, up 38% over last year. We generated an operating profit of $228 million before non-cash stock option expense, up 26% from the first quarter of last year and representing 46% of Q1 revenue.

淨收入為 1.44 億美元，比去年增長 38%。在扣除非現金股票期權費用之前，我們的營業利潤為 2.28 億美元，比去年第一季度增長 26%，佔第一季度收入的 46%。

We ended the quarter with $2.371 billion in cash and investments, up $199 million from last quarter. Significant cash outlays during the quarter included $50 million invested in the acquisition of our Korean distributor, fixed assets and intellectual property. Excluding the impact of these outlays, as well as $83 million from stock proceeds and $30 million used for working capital, we generated $211 million in gross cash flow from operations, which is 147% of our reported GAAP net income in the first quarter.

我們在本季度末擁有 23.71 億美元的現金和投資，比上一季度增加了 1.99 億美元。本季度的重大現金支出包括投資 5000 萬美元收購我們的韓國經銷商、固定資產和知識產權。排除這些支出的影響，以及來自股票收益的 8300 萬美元和用於營運資金的 3000 萬美元，我們從運營中產生了 2.11 億美元的總現金流，這是我們第一季度報告的 GAAP 淨收入的 147%。

The first quarter has been an active one for our product development, marketing and operations teams. In the quarter, we completed our first phase of rollout for Single-Site instruments and accessories for da Vinci SI in the United States.

第一季度對我們的產品開發、營銷和運營團隊來說是一個活躍的季度。在本季度，我們完成了在美國為 da Vinci SI 推出單點儀器和配件的第一階段。

Recall Single-Site is a platform for increasing patient value by reducing the number of incisions required by traditional multiport minimally invasive surgery. Instead of the multiple incisions of traditional laparoscopy, the body is entered through a single incision at the umbilicus.

Recall Single-Site 是一個通過減少傳統多端口微創手術所需的切口數量來提高患者價值的平台。代替傳統腹腔鏡的多個切口，身體通過臍部的單個切口進入。

Currently, Single-Site is cleared for single-incision cholecystectomy in the US and for broader educations indications in Europe. Experiences by our Single-Site customers in the US indicate that cholecystectomy procedure is safe, repeatable and teachable. Market response to date has been very encouraging.

目前，Single-Site 在美國被批准用於單切口膽囊切除術，在歐洲被批准用於更廣泛的教育適應症。我們在美國的 Single-Site 客戶的經驗表明，膽囊切除術是安全、可重複和可教的。迄今為止，市場反應非常令人鼓舞。

We are working with our customers in Europe to identify procedures in which Single-Site can bring additional patient value beyond cholecystectomy.

我們正在與歐洲的客戶合作，以確定單點手術可以為膽囊切除術帶來額外患者價值的手術。

We continue to focus on developing products that enable surgeons to convert traditionally open surgeries to minimally invasive surgery using da Vinci. In the quarter we completed our first customer access work on our EndoWrist vessel sealer, and are pleased with its performance in surgery.

我們繼續專注於開發產品，使外科醫生能夠使用達芬奇將傳統的開放式手術轉變為微創手術。在本季度，我們完成了對 EndoWrist 血管封閉器的首次客戶訪問工作，並對它在手術中的表現感到滿意。

Our vessel sealer brings to da Vinci surgeries surgeons full articulation and precise control. We think this instrument will facilitate robotic general surgery.

我們的血管密封劑為達芬奇外科醫生帶來了完整的關節和精確的控制。我們認為該儀器將促進機器人普外科手術。

We are communicating with the FDA regarding our da Vinci stapler, and we're making progress in answer answering their questions.

我們正在與 FDA 就我們的達芬奇訂書機進行溝通，我們在回答他們的問題方面取得了進展。

In imaging our Firefly Fluorescence Imaging System is now being used regularly to image kidney vasculature during da Vinci partial nephrectomy. Surgeons are also exploring the use of Firefly in visualizing blood flow in da Vinci colorectal procedures.

在成像方面，我們的螢火蟲熒光成像系統現在被定期用於在達芬奇部分腎切除術期間對腎臟血管系統進行成像。外科醫生還在探索使用螢火蟲來可視化達芬奇結直腸手術中的血流。

As we enter new markets and drive into new product arenas, we continue to invest in building our team and expanding partnerships, and in acquiring those technologies that can make a difference to robotic surgery.

隨著我們進入新市場並進入新產品領域，我們將繼續投資於建立我們的團隊和擴大合作夥伴關係，並收購那些可以對機器人手術產生影響的技術。

This quarter we added 94 people to our team, predominantly in sales, manufacturing and R&D, bringing our total team to 2018 employees. I will now pass the time over to Marshall, our Chief Financial Officer.

本季度，我們的團隊增加了 94 人，主要從事銷售、製造和研發，使我們的團隊總數達到 2018 人。我現在將把時間轉給我們的首席財務官 Marshall。

Thank you, Gary. Our first-quarter revenue was $495 million, up 28% compared with $388 million for the first quarter of 2011, and $2 million less than the $497 million reported for the fourth quarter of 2011.

謝謝你，加里。我們第一季度的收入為 4.95 億美元，與 2011 年第一季度的 3.88 億美元相比增長了 28%，比 2011 年第四季度報告的 4.97 億美元減少了 200 萬美元。

First-quarter revenues by product category were as follows. First-quarter instrument and accessory revenue was $208 million, up 32% compared with $157 million for the first quarter of 2011, and up 6% compared with $196 million in the fourth quarter of 2011.

第一季度按產品類別劃分的收入如下。第一季度儀器和配件收入為 2.08 億美元，與 2011 年第一季度的 1.57 億美元相比增長 32%，與 2011 年第四季度的 1.96 億美元相比增長 6%。

Year-over-year instrument and accessory growth was driven by procedure growth of 29% and initial purchases of recently launched products, including Single-Site starter kits and our Firefly product.

儀器和配件的同比增長是由 29% 的程序增長和對最近推出的產品的首次購買推動的，包括單站點入門套件和我們的 Firefly 產品。

Note that the first quarter of 2012 included one more surgical day than the first quarter of 2011 due to leap year.

請注意，由於閏年，2012 年第一季度的手術天數比 2011 年第一季度多一個。

Instrument and accessory growth relative to the first quarter of 2011 was primarily driven by procedure growth in sales for our Single-Site starter kits, partially offset by lower first-quarter stocking orders associated with seasonally lower first-quarter system sales.

與 2011 年第一季度相比，儀器和附件的增長主要是由我們的單站點入門套件的程序銷售增長推動的，但與第一季度系統銷售季節性下降相關的第一季度庫存訂單減少部分抵消了這一增長。

Instrument and accessory revenue realized per procedure, including initial stocking orders of $1985 per procedure was higher than the first quarter of 2011 by $50, and $10 higher than the fourth quarter of 2011.

每個程序實現的儀器和附件收入，包括每個程序 1985 美元的初始庫存訂單，比 2011 年第一季度高出 50 美元，比 2011 年第四季度高出 10 美元。

Over time we expect instruments and accessories per procedure to decline slowly, given the initial stocking orders have a lower impact on a larger install base. This natural decline has been more than offset in recent quarters by the positive impact of our new instrument and accessory products, specifically Single-Site, Firefly, and thoracic lung kit. Instrument and accessory revenue per procedure will fluctuate based on the rate of adoption of newer products as well as product and procedure mix.

隨著時間的推移，我們預計每個程序的儀器和配件將緩慢下降，因為初始庫存訂單對更大的安裝基礎的影響較小。這種自然下降在最近幾個季度被我們的新儀器和附件產品的積極影響所抵消，特別是 Single-Site、Firefly 和胸肺套件。每個程序的儀器和附件收入將根據新產品的採用率以及產品和程序組合而波動。

First-quarter 2012 systems revenue of $207 million increased 24% compared with $167 million of systems revenue for the first quarter of 2011, and decreased 8% compared with $225 million of systems revenue for the fourth quarter of 2011.

與 2011 年第一季度的 1.67 億美元系統收入相比，2012 年第一季度的系統收入為 2.07 億美元，增長了 24%，與 2011 年第四季度的系統收入的 2.25 億美元相比，下降了 8%。

We sold 140 systems in the fourth quarter(Sic-see press release) of 2012 compared with 120 systems in the first quarter 2011 and 152 systems in the fourth quarter of 2011. The first quarter of 2011 system count included systems involving trade-ins of older units comprised of 19 standard systems and 27 da Vinci S's. The first quarter of 2011 system count included 13 standard trade-ins and 19 da Vinci S trade-ins, while the fourth quarter of 2011 included 23 standard trade-ins and 27 da Vinci S trade-ins.

我們在 2012 年第四季度售出了 140 個系統（參見新聞稿），而 2011 年第一季度和 2011 年第四季度分別售出了 120 個和 152 個系統。2011 年第一季度的系統數量包括涉及以舊換新的系統較舊的單元由 19 個標準系統和 27 個 da Vinci S 組成。 2011 年第一季度的系統計數包括 13 個標準以舊換新和 19 個達芬奇 S 以舊換新，而 2011 年第四季度包括 23 個標準以舊換新和 27 個達芬奇 S 以舊換新。

Our first quarter average selling price per system, including all da Vinci models, was $1.47 million, an increase from the $1.38 million realized in the fourth quarter of 2011 and the same as the fourth quarter. ASPs include simulators and systems configured with Firefly, but exclude upgrades. The increase in average sales price relative to the first-quarter of 2011 reflects a higher proportion of dual consoles, a higher number of systems shipped with surgical simulators and Firefly, partially offset by an increased proportion of trade-in.

我們第一季度每個系統（包括所有達芬奇型號）的平均售價為 147 萬美元，高於 2011 年第四季度實現的 138 萬美元，與第四季度持平。 ASP 包括配置了 Firefly 的模擬器和系統，但不包括升級。與 2011 年第一季度相比，平均銷售價格的上漲反映了更高比例的雙控制台、更多配備手術模擬器和 Firefly 的系統，部分被以舊換新比例的增加所抵消。

We sold 25 dual console systems in the first quarter of 2012 compared to 16 in the first quarter of 2011 and 29 in the fourth quarter of 2011. ASP's will fluctuate quarter to quarter based on product, customer, and trade index as well as foreign exchange rates on direct sales to foreign customers.

我們在 2012 年第一季度售出了 25 台雙控制台系統，而 2011 年第一季度和 2011 年第四季度分別售出了 16 台和 29 台。ASP 將根據產品、客戶和貿易指數以及外匯進行季度波動直接向外國客戶銷售的稅率。

Service revenue of $81 million increased 27% compared with $64 million last year, and increased 7% compared with $75 million last quarter. The growth in service revenue was primarily driven by a larger system installed base.

服務收入為 8100 萬美元，比去年的 6400 萬美元增長 27%，比上一季度的 7500 萬美元增長 7%。服務收入的增長主要是由更大的系統安裝基礎推動的。

Total first-quarter recurring revenue comprised of instrument, accessory and service revenue of $289 million increased 31% compared with the first quarter of 2011, and increased 6% compared with the fourth quarter of 2011. Recurring revenue represented 58% of total first-quarter revenue compared with 57% in the first quarter last year and 55% last quarter.

包括儀器、配件和服務在內的第一季度總收入為 2.89 億美元，比 2011 年第一季度增長 31%，比 2011 年第四季度增長 6%。經常性收入佔第一季度總收入的 58%收入與去年第一季度的 57% 和上一季度的 55% 相比。

International results were as follows. Procedures outside of the US grew approximately 31% on a year-to-year basis, led by growth in Europe particularly the dVP. We also experienced growth in our other targeted procedures, including dVH in Europe.

國際結果如下。美國以外的程序同比增長約 31%，主要得益於歐洲的增長，尤其是 dVP。我們還經歷了其他目標程序的增長，包括歐洲的 dVH。

First-quarter revenue outside of the US at $105 million increased 15%, compared with revenue of $91 million in the first quarter of 2011, and decreased 2% compared with seasonally strong fourth quarter revenue of $107 million.

美國以外的第一季度收入為 1.05 億美元，與 2011 年第一季度的收入 9100 萬美元相比增長了 15%，與季節性強勁的第四季度收入 1.07 億美元相比下降了 2%。

Instrument and accessory revenue outside of the US grew 24% year-over-year and 22% sequentially.

美國以外的儀器和配件收入同比增長 24%，環比增長 22%。

We sold 35 systems outside of the US, compared with 31 in the first quarter of 2011 and 39 last quarter. We sold 14 systems in Europe in the first quarter, compared with 15 in the first quarter of 2011 and 23 in the fourth quarter of 2011.

我們在美國以外銷售了 35 台系統，而 2011 年第一季度為 31 台，上一季度為 39 台。我們第一季度在歐洲售出了 14 台系統，而 2011 年第一季度為 15 台，2011 年第四季度為 23 台。

European system sales reflect the challenging economic environment. However, we're also taking steps to improve our execution.

歐洲系統銷售反映了充滿挑戰的經濟環境。但是，我們也在採取措施改進我們的執行。

Capital sales in rest of world markets increased to 21 systems in the first quarter, compared to 16 in each of the first and fourth quarters of 2011. Aleks will provide additional details of overseas system sales.

第一季度世界其他市場的資本銷售增加到 21 個系統，而 2011 年第一季度和第四季度各為 16 個。Aleks 將提供海外系統銷售的更多詳細信息。

Moving on to the remainder of the P&L, gross margin in the first-quarter of 72% was the same as the first quarter of 2011 and lower than the 73% last quarter. The lower gross margin compared to the fourth quarter primarily reflected lower margins on our newly introduced products.

繼續看損益表的其餘部分，第一季度的毛利率為 72%，與 2011 年第一季度相同，低於上一季度的 73%。與第四季度相比，較低的毛利率主要反映了我們新推出的產品的較低利潤率。

Margins on newly launched products like Single-Site will typically be lower than our mature products, reflecting vendor pricing on low volume, temporary tooling costs and other startup costs. However, over time, as volumes increase we refine the manufacturing process in the product, we would expect to see improvement in the margins of these newer products.

Single-Site 等新推出產品的利潤率通常低於我們的成熟產品，這反映了供應商對小批量、臨時工具成本和其他啟動成本的定價。然而，隨著時間的推移，隨著產量的增加，我們改進了產品的製造工藝，我們預計這些新產品的利潤率會有所提高。

First-quarter 2012 operating expenses of $163 million were 25% compared -- up 25% compared with the first quarter of 2011, and were approximately the same as those for the fourth quarter of 2011. Relative to the fourth-quarter operating expenses, the first-quarter expenses included costs associated with employees added during the quarter and payroll taxes on a higher level of employee stock option exercises, offset by lower engineering project costs which fluctuate with prototype spending.

2012 年第一季度的運營費用為 1.63 億美元，比 2011 年第一季度增長 25%，為 25%，與 2011 年第四季度大致相同。相對於第四季度的運營費用，第一季度支出包括與本季度增加的員工相關的成本以及更高水平的員工股票期權行使的工資稅，被較低的工程項目成本所抵消，該成本隨原型支出而波動。

We added 94 employees in the quarter, including 41 employees in commercial operations and 44 employees in product operations.

本季度新增員工 94 人，其中商業運營 41 人，產品運營 44 人。

First-quarter 2012 operating income was $193 million or 39% of sales compared with $148 million or 38% of sales for the first quarter of 2011, and $200 million or 40% of sales for the fourth quarter of 2011.

2012 年第一季度營業收入為 1.93 億美元，佔銷售額的 39%，而 2011 年第一季度為 1.48 億美元，佔銷售額的 38%，2011 年第四季度為 2 億美元，佔銷售額的 40%。

First-quarter 2012 operating income reflected $34 million of non-cash stock compensation expense compared with $32 million for the first quarter of 2011 and $35 million last quarter. We have changed our annual stock option grant process such that one-half of the employees' annual grants were issued in February 15 and the other half will be issued on August 15. The first-quarter impact of the February 15 grant was more than offset by the full vesting of options granted in 2008.

2012 年第一季度的營業收入反映了 3400 萬美元的非現金股票補償費用，而 2011 年第一季度為 3200 萬美元，上一季度為 3500 萬美元。我們改變了我們的年度股票期權授予流程，員工年度授予的一半在 2 月 15 日發放，另一半將在 8 月 15 日發放。2 月 15 日授予的第一季度影響被抵消了以上2008 年授予的期權全部歸屬。

We would expect non-cash compensation expense to increase in the second quarter, reflecting the full quarter impact of the February 15 grant, and to increase further in the third quarter with the August 15 grant.

我們預計第二季度非現金補償費用將增加，以反映 2 月 15 日贈款對整個季度的影響，並隨著 8 月 15 日贈款在第三季度進一步增加。

Our effective tax rate for the first quarter of 27% was lower than our rate for 2011 of 30%. The decrease reflects a one-time benefit associated with a change in the way the IRS interprets the rules associated with Section 199 domestic manufacturing tax credit.

我們第一季度 27% 的有效稅率低於 2011 年 30% 的稅率。減少反映了與 IRS 解釋與第 199 條國內製造業稅收抵免相關規則的方式發生變化相關的一次性收益。

We expect the rate for the remainder of the year to be approximately 31%. The increase relative to 2011 reflects no research and development credit, a lower mix of foreign earnings, partially offset by ongoing Section 199 tax credit.

我們預計今年剩餘時間的利率約為 31%。相對於 2011 年的增長反映了沒有研發信貸、較低的外國收入組合，部分被正在進行的第 199 節稅收抵免所抵消。

Our net income was $144 million or $3.50 per share, compared with $104 million or $2.59 per share for the first quarter of 2011, and $151 million or $3.75 per share for the fourth quarter of 2011.

我們的淨收入為 1.44 億美元或每股 3.50 美元，而 2011 年第一季度為 1.04 億美元或每股 2.59 美元，2011 年第四季度為 1.51 億美元或每股 3.75 美元。

Now moving to the balance sheet. We ended the first quarter with cash and investments of $2.4 billion, up $199 million compared with December 31, 2011. The increase reflects $167 million of cash flow from operations, $83 million from the exercise of stock options, partially offset by $50 million associated with the purchase of our Korean distributor, purchase of capital, and IP.

現在轉到資產負債表。我們在第一季度結束時的現金和投資為 24 億美元，與 2011 年 12 月 31 日相比增加了 1.99 億美元。這一增長反映了 1.67 億美元的運營現金流，8300 萬美元的股票期權行使，部分被與相關的 5000 萬美元抵消購買我們的韓國經銷商，購買資本和IP。

During the fourth quarter we did not repurchase any of our common stock. However, we retained the option to exercise the remaining Board-authorized buybacks of $568 million.

在第四季度，我們沒有回購任何普通股。但是，我們保留了行使剩餘的董事會授權回購 5.68 億美元的選擇權。

Our accounts receivable balance increased to $300 million at March 31 from $298 million at December 31. Our net inventory increased $119 million at March 31 from $112 million at December 31.

我們的應收賬款餘額從 12 月 31 日的 2.98 億美元增加到 3 月 31 日的 3 億美元。我們的淨庫存從 12 月 31 日的 1.12 億美元增加到 3 月 31 日的 1.19 億美元。

And with that I would like to turn it over to Aleks, who will go over our sales, marketing and clinical highlights.

有了這個，我想把它交給 Aleks，他將審查我們的銷售、營銷和臨床亮點。

Thank you, Marshall. During the first quarter we sold 140 da Vinci systems -- 105 in United States, 14 into Europe and 21 into rest of world markets. As part of the 140 systems sales, 19 standard da Vinci systems and 27 da Vinci S systems were traded in for credit against sales for new da Vinci Si systems.

謝謝你，馬歇爾。在第一季度，我們售出了 140 台達芬奇系統——美國 105 台，歐洲 14 台，世界其他市場 21 台。作為 140 套系統銷售的一部分，19 套標準達芬奇系統和 27 套達芬奇 S 系統被用於抵扣新達芬奇 Si 系統的銷售額。

We had a net 94 system additions to the installed base during the quarter, which brings to 2226 the cumulative number of da Vinci systems worldwide -- 1615 in the United States, 379 in Europe and 232 in rest of world markets. 80 of the 140 systems installed during the quarter represented repeat system sales to existing customers.

在本季度，我們的安裝基礎淨增加了 94 個系統，這使全球達芬奇系統的累計數量達到 2226 個——美國 1615 個，歐洲 379 個，世界其他市場 232 個。本季度安裝的 140 個系統中有 80 個代表了對現有客戶的重複系統銷售。

In total, 132 of the 140 systems sold represented da Vinci Si systems, which included 25 dual console systems. The 35 system sales internationally included 7 into Japan, 4 into India and 3 into the countries of Italy, the UK and Australia. While our overall international system sales were strong, our Q1 EU system sales were somewhat disappointing and below historical trends.

總共售出的 140 個系統中有 132 個代表達芬奇系統，其中包括 25 個雙控制台系統。 35個系統的國際銷售包括7個進入日本，4個進入印度，3個進入意大利、英國和澳大利亞。雖然我們的整體國際系統銷售強勁，但我們第一季度的歐盟系統銷售有些令人失望，低於歷史趨勢。

Clinically we had a strong quarter, achieving an overall year-over-year procedure growth rate of approximately 29%. Gynecology, international dVP, along with the emerging categories of general surgery and thoracic surgery accounted for a large part of this growth. Cholecystectomy, colon and rectal resections, lobectomy, dVH and endometriosis resections, myomectomy and partial nephrectomy all exhibited strong year-over-year growth.

在臨床上，我們有一個強勁的季度，實現了約 29% 的整體同比手術增長率。婦科、國際 dVP 以及新興的普通外科和胸外科佔這一增長的很大一部分。膽囊切除術、結腸和直腸切除術、肺葉切除術、dVH 和子宮內膜異位症切除術、子宮肌瘤切除術和部分腎切除術都表現出強勁的同比增長。

International dVP growth remained strong both in Europe and rest of the world. However, in the US, dVP has felt some recent pressure from nonsurgical disease management -- namely active surveillance. With the international market playing an ever-increasing role in the worldwide procedure numbers, overall worldwide dVP growth remains positive.

歐洲和世界其他地區的國際 dVP 增長依然強勁。然而，在美國，dVP 最近感受到了來自非手術疾病管理的一些壓力——即主動監測。隨著國際市場在全球程序數量中扮演著越來越重要的角色，全球整體 dVP 增長仍然是積極的。

Recent new product launches are all proceeding well. The attachment rate for both the da Vinci Simulator and our Firefly product remained high, which is helping to buoy da Vinci system ASPs. The initial customer response to our da Vinci Single-Site product line has been very positive, with many centers up and running and several more scheduled for training.

最近的新產品發布進展順利。達芬奇模擬器和我們的螢火蟲產品的附著率仍然很高，這有助於提振達芬奇系統的 ASP。客戶對我們的 da Vinci Single-Site 產品線的最初反應非常積極，許多中心已經啟動並運行，還有幾個中心計劃進行培訓。

We initiated a phased rollout of the Vessel Sealer product in the second half of the quarter, and early customers are beginning to perform their initial cases. The product is performing well, and early customer feedback has been positive. But as with all new product launches, customer feedback processes and operational scaling will remain central themes.

我們在本季度下半年開始分階段推出 Vessel Sealer 產品，早期客戶開始執行他們的初始案例。該產品表現良好，早期的客戶反饋是積極的。但與所有新產品發布一樣，客戶反饋流程和運營規模仍將是核心主題。

Throughout this period, the focus of our operations team will be to optimize manufacturing while reducing costs. During the quarter, over 350 abstracts and papers representing a variety of surgical specialties were published within various peer-reviewed journals, while the clinical conferences were abundant with live da Vinci procedure transmissions, postgraduate robotic courses, podium presentations and clinical poster sessions.

在此期間，我們運營團隊的重點將是在降低成本的同時優化製造。在本季度，代表各種外科專業的 350 多篇摘要和論文發表在各種同行評審期刊上，而臨床會議則充斥著現場達芬奇程序傳輸、研究生機器人課程、講台演示和臨床海報會議。

As we discussed, da Vinci colon and rectal surgery is an emerging category and is receiving a lot of clinical interest, and for good reason. While clinical experiences for laparoscopic colon and rectal surgery date back to 1991, the adoption has been lagging.

正如我們所討論的，達芬奇結腸和直腸手術是一個新興類別，並且受到很多臨床關注，這是有充分理由的。雖然腹腔鏡結腸和直腸手術的臨床經驗可以追溯到 1991 年，但採用一直滯後。

In a recent edition of The American Surgeon, Dr. Joseph Carmichael and his colleagues from the University of California Irvine published a comprehensive review on the utilization of laparoscopy in colorectal surgery for cancer in academic medical centers. In it, they segment various colorectal surgical procedures as they relate to laparoscopic adoption.

在最近一期的《美國外科醫生》中，加州大學歐文分校的 Joseph Carmichael 博士和他的同事發表了一篇關於腹腔鏡在學術醫療中心結直腸癌手術中的應用的綜合綜述。在其中，他們細分了與腹腔鏡採用相關的各種結直腸外科手術。

University Hospital Consortium, or UHC, is a large organization consisting of 112 academic medical centers and their affiliates, representing approximately 90% of the nation's nonprofit academic medical centers. The study, based off data from the UHC database, included records from 22,780 patients who had undergone open or laparoscopic colon and rectal surgery for cancer between 2007 and 2009.

大學醫院聯盟 (UHC) 是一個大型組織，由 112 個學術醫療中心及其附屬機構組成，約佔全國非營利性學術醫療中心的 90%。該研究基於 UHC 數據庫的數據，包括 22,780 名在 2007 年至 2009 年間接受過開腹或腹腔鏡結腸和直腸手術的癌症患者的記錄。

Interestingly, 19,408 or over 85% of these patients received an open surgery as compared to 3372, or 14.8%, who had received a laparoscopic procedure. The study reports that as a percentage, the most commonly performed laparoscopic colon resection was a total colectomy at 22.6%, followed by a sigmoid resection of 17.3%. The least common were abdominoperineal resections at 8%, transverse colon resections at 10%.

有趣的是，這些患者中有 19,408 名或超過 85% 接受了開腹手術，而接受腹腔鏡手術的患者為 3372 名或 14.8%。該研究報告說，按百分比計算，最常進行的腹腔鏡結腸切除術是全結腸切除術，佔 22.6%，其次是乙狀結腸切除術，佔 17.3%。最不常見的是腹會陰切除術（8%），橫結腸切除術（10%）。

When subcategories were consolidated and analyzed, it was reported that laparoscopic surgery was incorporated in less than 20% of colon cancer resection and less than 10% of rectal cancer resections.

當合併和分析子類別時，據報導，腹腔鏡手術被納入不到 20% 的結腸癌切除術和不到 10% 的直腸癌切除術。

Historically, both patient value and da Vinci's procedure adoption have been strongest where traditional lab and MIS adoption has been limited. This is often the case within procedure categories where MIS is deemed clinically challenging.

從歷史上看，在傳統實驗室和 MIS 的採用受到限制的情況下，患者價值和達芬奇的程序採用都最強。在 MIS 被認為具有臨床挑戰性的程序類別中，通常會出現這種情況。

While every procedure has its own set of variables, prostatectomy, complex hysterectomy, partial nephrectomy, myomectomy, sacrocolpopexy and lobectomy have shared at least one common bond, which is that each of them, despite years of clinical effort, was limited to a relatively small number of centers, resulting in limited MIS penetration. We believe that MIS colorectal surgery is consistent with this theme.

雖然每個手術都有自己的一組變量，但前列腺切除術、複雜子宮切除術、腎部分切除術、子宮肌瘤切除術、骶骨固定術和肺葉切除術至少有一個共同點，即儘管經過多年的臨床努力，它們中的每一個都被限制在一個相對較小的範圍內。中心的數量，導致 MIS 的滲透有限。我們認為 MIS 結直腸手術符合這一主題。

While laparoscopic colorectal surgery is limited in the US, lab colon initiatives throughout Korean and Japanese universities have been more ambitious, which has led to some academic analysis of da Vinci's role versus laparoscopy.

雖然腹腔鏡結直腸手術在美國受到限制，但整個韓國和日本大學的實驗室結腸倡議更加雄心勃勃，這導致了一些學術分析達芬奇與腹腔鏡相比的作用。

A comparative study of urinary voiding and sexual function following a total mesorectal excision or TME for rectal cancer was recently published in the annals of Surgical Oncology. The study, authored by Dr. Sang Yoon Kim and his colleagues from Yangtze University, compared laparoscopic and robotic TME as it relates to complications in urinary continence and sexual function, which are both common complications in rectal cancer surgery.

最近在《外科腫瘤學年鑑》上發表了一項關於直腸癌全直腸系膜切除或 TME 後排尿和性功能的比較研究。該研究由長江大學的 Sang Yoon Kim 博士和他的同事撰寫，比較了腹腔鏡和機器人 TME，因為它與尿失禁和性功能的並發症有關，這都是直腸癌手術的常見並發症。

69 patients who underwent a lap or robotic procedure were prospectively enrolled. Their urogenital function was evaluated by uroflowmetry, standard questionnaires to establish an international prostate symptom score, and international index of erectile function score were given before surgery and at one, three, six and 12 months post-surgery. Their initial findings were not surprising, in that bladder function within both cohorts significantly decreased one month post-surgery.

前瞻性招募了 69 名接受膝上或機器人手術的患者。他們的泌尿生殖功能通過尿流計進行評估，標準問卷建立國際前列腺症狀評分，並在手術前和手術後 1、3、6 和 12 個月給出勃起功能評分的國際指數。他們的初步發現並不令人驚訝，因為兩個隊列中的膀胱功能在術後一個月顯著下降。

In the lap TME group, urinary dysfunction gradually improved over a six-month period, which is consistent with previously reported open-surgery TME studies. In other words, both lap and open TME required six months for ISP scores to decrease. However, interestingly, patients who underwent robotic TME showed significantly earlier recovery at a period of less than three months.

在膝上 TME 組中，泌尿功能障礙在六個月內逐漸改善，這與之前報導的開放手術 TME 研究一致。換句話說，單圈和公開 TME 都需要六個月的時間才能降低 ISP 分數。然而，有趣的是，接受機器人 TME 的患者在不到三個月的時間內恢復得明顯更早。

They also analyzed the urinary flow, where the most objective urinary function results were obtained. The robotic TME showed no decrease in mean voiding volume. The robotic TME urinary data analysis revealed superior outcomes compared to laparoscopic TME data, not only an ISP score but also in urinary flow.

他們還分析了尿流，從中獲得了最客觀的泌尿功能結果。機器人 TME 顯示平均排尿量沒有減少。與腹腔鏡 TME 數據相比，機器人 TME 尿液數據分析顯示出更好的結果，不僅是 ISP 評分，而且在尿流方面也有。

With respect to erectile function, the robotic TME group showed earlier recovery as compared to the laparoscopic TME group, six months versus 12 months. They stated that during pelvic dissection, avulsion or direct injury of the nerve plexus can easily happen, which is tied to postoperative sexual and urinary dysfunction. Enhanced 3-D HD magnified views along with 7 degrees of instrument freedom were found to be of high value during delicate dissection.

在勃起功能方面，與腹腔鏡 TME 組相比，機器人 TME 組恢復得更早，分別為 6 個月和 12 個月。他們表示，在盆腔解剖過程中，很容易發生神經叢的撕脫或直接損傷，這與術後性功能和泌尿功能障礙有關。增強的 3-D 高清放大視圖以及 7 個器械自由度被發現在精細解剖過程中具有很高的價值。

In their conclusions, the author stated, and I quote, we conclude that the use of da Vinci's surgical robotic TME system allowed for an earlier recovery in voiding and sexual function because it enabled meticulous dissection and maintenance of adequate counter traction strength as a result of enhanced dexterity. Close quote.

在他們的結論中，作者說，我引用，我們的結論是，使用達芬奇的手術機器人 TME 系統可以更早地恢復排尿和性功能，因為它能夠進行細緻的解剖和維持足夠的反牽引強度，因為增強的靈巧性。關閉報價。

As stated earlier, our GYN franchise remains robust. While most of our previous growth has been US-centric, we are beginning to experience dVH expansion in non-US markets. As was the case in the United States, complex dVH for malignant conditions appears to be the catalyst.

如前所述，我們的 GYN 專營權仍然強勁。雖然我們之前的大部分增長都以美國為中心，但我們開始在非美國市場體驗 dVH 擴張。與美國的情況一樣，惡性疾病的複雜 dVH 似乎是催化劑。

In this month's edition of Obstetrics and Gynecology, a group made up of both surgeons and epidemiologists from Jewish General Hospital and McGill University in Montreal published their two-year findings on both patient outcomes and economics associated with their robotic GYN cancer program. A total of 303 endometrial cancer patients were involved in the study.

在本月的婦產科雜誌上，一個由猶太綜合醫院和蒙特利爾麥吉爾大學的外科醫生和流行病學家組成的小組發表了他們關於與他們的機器人 GYN 癌症計劃相關的患者結果和經濟學的兩年研究結果。共有 303 名子宮內膜癌患者參與了該研究。

Following the initial -- the initiation of their robotics program, 143 consecutive dVH patients were compared to 160 consecutive patients who underwent surgery prior to the robotic program commencement. These 160 patients made up the historical cohort.

在最初的機器人項目啟動之後，將 143 名連續 dVH 患者與在機器人項目開始前接受手術的 160 名連續患者進行了比較。這 160 名患者構成了歷史隊列。

Within the historical cohort, the rate of minimally invasive surgery performed with traditional laparoscopy was 17%. During the following two post da Vinci years, the MIS rate had grown to 98%.

在歷史隊列中，使用傳統腹腔鏡進行微創手術的率為 17%。在達芬奇之後的兩年裡，MIS 率增長到 98%。

The patient characteristics were comparable in both areas except areas except for an even higher body mass index in the robotics era. Robotics patients had longer operating times but fewer adverse events, 13% compared to 42%; lower estimated median blood loss, lower by approximately 70%; and shorter median hospital stay, 2.2 days compared with 5.5 days.

除了機器人時代更高的體重指數之外，這兩個區域的患者特徵都具有可比性。機器人患者的手術時間更長，但不良事件更少，分別為 13% 和 42%；降低估計的中位失血量，降低約 70%；中位住院時間為 2.2 天，而中位住院時間為 5.5 天。

The overall hospital cost for the robotic group was significantly lower as compared with the historical group -- CAD7644 compared with CAD10,368.

與歷史組相比，機器人組的總體住院費用顯著降低 - CAD7644 與 CAD10,368 相比。

The gains with robotic surgery are even more pronounced in a multi-variable analysis where they consider both the full cohorts and matched subcohorts. The reduction in grade 2 or higher complications resulting in far less hospitalization drove significant dVH related hospital savings.

機器人手術的收益在多變量分析中更為明顯，他們同時考慮了完整的隊列和匹配的子隊列。 2 級或更高級別並發症的減少導致住院次數大大減少，從而顯著節省了與 dVH 相關的醫院費用。

However, the key factor in evaluating any cancer treatment is oncologic outcome. At present, the two-year post-dVH follow-up indicates a lower recurrence rate as compared with the historical cohort.

然而，評估任何癌症治療的關鍵因素是腫瘤學結果。目前，與歷史隊列相比，dVH 後兩年的隨訪表明復發率較低。

Improving procedure efficacy while reducing hospital cost is a powerful combination, and one that aligns us closely to the needs of our patients, providers and payers.

在降低醫院成本的同時提高程序效率是一種強大的組合，它使我們與患者、提供者和付款人的需求緊密結合。

This concludes my remarks and I'll now turn the time over to Calvin.

我的發言到此結束，我現在將時間交給 Calvin。

Thank you, Aleks. I will be providing you with an update to our financial forecast for 2012 including procedures, revenues and other elements of the income statement on a GAAP basis. I will also provide estimates of significant non-cash expenses to provide you with visibility into our expected future cash flows.

謝謝你，亞歷克斯。我將向您提供我們對 2012 年財務預測的更新，包括程序、收入和基於公認會計原則的損益表的其他要素。我還將提供對重大非現金支出的估計，讓您了解我們預期的未來現金流。

Starting with procedures, during the first quarter we saw continued strength in US gynecology procedures and Europe dVPs. We also saw strong global general surgery growth and positive US early market reactions to our Single-Site cholecystectomy offering.

從程序開始，在第一季度，我們看到美國婦科程序和歐洲 dVP 的持續增長。我們還看到了強勁的全球普外科增長和美國早期市場對我們的單部位膽囊切除術產品的積極反應。

We are now increasing our 2012 procedure guidance. On our last call we forecast procedures to grow approximately 24% to 26% from a base of approximately 360,000 procedures performed in 2011. We now forecast full year 2012 da Vinci procedure volume to grow approximately 25% to 27% above our 2011 total.

我們現在正在增加我們的 2012 年程序指南。在我們上次的電話會議上，我們預測程序將在 2011 年執行的約 360,000 例程序的基礎上增長約 24% 至 26%。我們現在預測 2012 年全年達芬奇程序量將比我們 2011 年的總量增長約 25% 至 27%。

Moving on to revenues, we are also increasing our 2012 revenue guidance. Based upon our higher procedure expectations and revenue contributions from new products, we now expect 2012 revenue to grow between 19% and 21% above total 2011 revenue of $1.76 billion. This is up from 17% to 19% revenue growth forecast on our previous call.

在收入方面，我們還增加了 2012 年的收入指導。基於我們更高的程序預期和新產品的收入貢獻，我們現在預計 2012 年收入將比 2011 年 17.6 億美元的總收入增長 19% 至 21%。這比我們之前電話會議的收入增長預測從 17% 提高到 19%。

Now turning to operating income, consistent with our previous forecast we continue to expect operating income to fall within a range of between 39% and 40% of net revenue. We will likely trend toward the lower end of this range as result of lower gross profit percentages realized on recently launched instrument products.

現在轉向營業收入，與我們之前的預測一致，我們繼續預計營業收入將在淨收入的 39% 至 40% 之間。由於最近推出的儀器產品實現的毛利潤百分比較低，我們可能會趨向該範圍的低端。

Now turning to non-cash expenses. We now expect non-cash stock compensation to fall within a range of between $152 million to $156 million for the year, compared to our previous forecast of $144 million to $150 million with the increase driven by higher option valuations associated with our higher stock price.

現在轉向非現金費用。我們現在預計今年非現金股票薪酬將在 1.52 億美元至 1.56 億美元之間，而我們之前的預測為 1.44 億美元至 1.5 億美元，這是由於與我們更高的股價相關的更高的期權估值推動的。

As Marshall described earlier, we would expect non-cash stock compensation expense to increase in the second quarter, reflecting the full quarter impact of the February 15 grant and to increase further in the third quarter with the August 15 grant. Amortization of purchased intellectual property, which is mostly recorded as R&D expense, is still expected to fall within a range of between $20 million and $24 million in 2012.

正如馬歇爾之前所述，我們預計第二季度非現金股票補償費用將增加，這反映了 2 月 15 日贈款對整個季度的影響，並隨著 8 月 15 日贈款在第三季度進一步增加。購買的知識產權的攤銷，主要記錄為研發費用，預計 2012 年仍將在 2000 萬美元至 2400 萬美元之間。

We expect other income, which is mainly comprised of interest income, to total between $15 million and $17 million for the year.

我們預計今年其他收入（主要包括利息收入）將在 1500 萬美元至 1700 萬美元之間。

With regard to income tax, our Q1 reported tax rate of 27.2% fell below our guidance range of between 29% and 31%, driven by the release of Section 199 reserves -- deductions for US manufacturing activities. Going forward, we expect our tax rates in quarters 2 through 4 to come in at the higher end of our range at around 31% of pretax income. While we will benefit from the ongoing manufacturing activities deduction, we project this benefit will be more than offset by the non-continuance of the US R&D tax credit and a slight shift in our projected geographic mix of pretax profit towards the US.

在所得稅方面，我們第一季度報告的 27.2% 的稅率低於我們 29% 至 31% 的指導範圍，這是由於第 199 條儲備金的釋放——美國製造業活動的扣除額。展望未來，我們預計第 2 至第 4 季度的稅率將達到我們範圍的高端，約為稅前收入的 31%。雖然我們將從正在進行的製造活動扣除中受益，但我們預計這一收益將被美國研發稅收抵免的不繼續以及我們預計的稅前利潤地理組合向美國的輕微轉變所抵消。

We expect that our share count for calculating EPS in Q2 2012 will be approximately 41.2 million shares. Our higher forecasted share count is driven by higher equivalent shares assigned to the diluted share calculation based on our higher stock price.

我們預計用於計算 2012 年第二季度每股收益的股票數量約為 4120 萬股。我們更高的預測股票數量是由基於我們更高的股票價格分配給稀釋股票計算的更高等值股票驅動的。

That concludes our prepared remarks. We will now open the call to your questions.

我們準備好的發言到此結束。我們現在將打開您的問題的電話。

(Operator Instructions) Spencer Nam, ThinkEquity.

（操作員說明）Spencer Nam，ThinkEquity。

Thanks for taking my questions. Just a couple of questions here. First of all, you know, you guys mentioned a lot about these new products and these different upgrades having impact on your procedure volume. And I'm curious whether the -- well, whether you guys could tell us how much your increase in procedure volume is driven by the upgrades and just new capability introduction versus -- you are actually well going out and just opening up the new procedure areas that you are currently working on.

感謝您提出我的問題。這裡只是幾個問題。首先，你知道，你們提到了很多關於這些新產品和這些不同的升級對你的手術量有影響的事情。我很好奇——好吧，你們能否告訴我們你的程序量增加多少是由升級和新功能引入驅動的，而不是——你們實際上很好地走出去，只是打開了新程序您目前正在從事的領域。

Well, I will answer that the best I can as I understand it. First off, I don't know that we had necessarily indicated that the new products, i.e. Single-Site and/or the Vessel Sealer, are the reason for the additional procedure growth, although they did add and contribute to it. The categories of general surgery, which include colorectal surgery, the categories of thoracic surgery, lobectomy, etc. in addition to the strong GYN growth and international dVP growth were really the reason that drove the added procedure for the quarter.

好吧，我會盡我所能回答。首先，我不知道我們是否一定表明新產品，即單點和/或血管密封器，是額外程序增長的原因，儘管它們確實增加並促成了它。除了強勁的 GYN 增長和國際 dVP 增長之外，包括結直腸手術、胸外科、肺葉切除術等在內的普外科類別確實是推動本季度增加手術的原因。

As far as differentiating between new procedures and/or new products, I don't know that we can do that calculation for you. I think in general there is good procedure strength that's happening across the core business, specifically dVP outside of the United States. dVP in the United States was actually down a little bit, but it was more than made up for in the addition of the other procedures that we talked about.

至於區分新程序和/或新產品，我不知道我們可以為您計算。我認為總的來說，整個核心業務都具有良好的程序實力，特別是美國以外的 dVP。美國的 dVP 實際上下降了一點，但在我們談到的其他程序的添加中已經彌補了這一點。

Tycho Peterson, JPMorgan.

第谷彼得森，摩根大通。

Hey, maybe I'll comment on that last point. You know, you talked about active surveillance and the dynamic there in the US. Can you just talk about -- I mean are you expecting dVP to remain flat here? And just talk about watchful waiting and how you think about that impacting this.

嘿，也許我會評論最後一點。你知道，你談到了美國的主動監視和動態。你能談談——我的意思是你希望dVP在這裡保持平穩嗎？只是談談觀察等待以及您如何看待影響這一點的問題。

Well, I think in general we have been talking about dVP being flattish for some time in the United States, for probably the last three or four quarters. And it is our expectation that as -- and I think you almost have to back away and look at it as dVP, and look at it in general as prostate cancer. And the treatment of the disease of prostate cancer, and what may happen on a macro level with -- if more people end up going into an active surveillance.

好吧，我認為總的來說，我們一直在談論美國的 dVP 持平一段時間，可能是過去三四個季度。我們的期望是——我認為你幾乎不得不退後一步，將其視為 dVP，並將其視為前列腺癌。以及前列腺癌疾病的治療，以及在宏觀層面上可能發生的事情——如果更多的人最終進入主動監測。

And history will tell you that at some point something as high as 60% of those men -- and it could be as high as two-thirds often wind up in some other therapy, either radiation or surgery, so some of this might be a lead/lag effect. We don't really know how to handicap that. I think there is a lot of information that is out there and I think we will probably move up and down with surgery in general.

歷史會告訴你，在某些時候，高達 60% 的男性——而且可能高達三分之二的人經常接受其他治療，無論是放射治療還是手術治療，所以其中一些可能是領先/滯後效應。我們真的不知道如何限制它。我認為那裡有很多信息，我認為我們可能會在手術中上下波動。

And outside of the United States, again, just to underscore, you're seeing the overall dVP number is growing. And that is really driven by both European strength as well as Asian and Latin American and other markets.

在美國以外，再次強調一下，您會看到整體 dVP 數量正在增長。這實際上是由歐洲實力以及亞洲和拉丁美洲及其他市場共同推動的。

Can you quantify what the revenues were from Single-Site stocking orders? We have had a few people ask on that.

您能否量化單站點庫存訂單的收入？我們有幾個人問過這個問題。

Single-Site stocking orders, quantify it?

單站備貨訂單，量化了嗎？

We are not going to quantify it, just tell you that -- like we said in the script, the attach rate for Single-Site was reasonable in the quarter. So we are still in the early stages. It's not -- I think if we gave out numbers now, it really wouldn't be an indication of much.

我們不會量化它，只是告訴你——就像我們在腳本中所說的那樣，單站點的附加率在本季度是合理的。所以我們還處於早期階段。不是 - 我認為如果我們現在給出數字，這真的不會表明太多。

Last one on service margins, I think they were at a record this quarter. You know, just talk about the sustainability of the service margins there and what's kind of driving this strength.

最後一個是服務利潤率，我認為本季度創紀錄。你知道，只要談談那裡服務利潤的可持續性，以及是什麼推動了這種力量。

Really improvements in product quality, reducing the amount of time that our field engineers have to spend servicing the equipment and leveraging more systems over the existing field service engineer force. It will fluctuate a little bit here and there, but I think that you've seen the margins over the last few quarters at a certain level, and it should continue at that level.

真正提高產品質量，減少我們的現場工程師必須花費在維修設備上的時間，並在現有的現場服務工程師隊伍中利用更多的系統。它會在這里和那裡有點波動，但我認為你已經看到過去幾個季度的利潤率處於某個水平，並且應該會繼續保持在這個水平。

Ben Andrew, William Blair.

本安德魯，威廉布萊爾。

Good afternoon, Aleks or Gary, maybe a question for you. If you think about the relative benefits of single-incision cholecystectomy versus lap, are you seeing enough kind of evidence of that benefit in the early days that convinces you the procedure trajectory is going to be very strong? Just talk a little bit about the selling process and what you are seeing in the initial rollout, if you would.

下午好，Aleks 或 Gary，也許是你的問題。如果您考慮單切口膽囊切除術與膝部的相對益處，您是否在早期看到了足夠多的證據證明這種益處使您相信手術軌跡將非常強大？如果願意的話，只需談談銷售過程以及您在最初推出時所看到的內容。

You know, I think on the first part of where the benefits are -- the early anecdotes we are hearing are a combination of benefits on pain and benefits on cosmesis. How these play out over time and what segment of the broader population is interested in those things, hard to forecast right now. So we'll see.

你知道，我認為第一部分的好處是——我們聽到的早期軼事是對疼痛的好處和對美容的好處的結合。這些隨著時間的推移如何發揮作用，以及更廣泛的人群中有哪些人對這些事情感興趣，現在很難預測。所以我們拭目以待。

Gary, are you hearing that that's patient-driven or physician-driven? Because we've heard some comments that a single-site through the umbilicus can actually be more painful in a way than the four ports of a typical lap chole.

加里，你聽說那是病人驅動還是醫生驅動？因為我們聽到一些評論說，通過臍部的單個部位實際上在某種程度上比典型的胯部膽汁的四個端口更痛苦。

Yes, mostly what we're hearing is a little bit of both. We hear both the surgeon commentary on it as well as some patient commentary on it. But it is early days, and I there'll be conflicting opinions for a while, until there is a large enough procedure base and evidence base for it to sort out. I will let Aleks speak to the selling process.

是的，我們聽到的主要是兩者兼而有之。我們聽到外科醫生對此的評論以及一些患者的評論。但現在還處於早期階段，我會有一段時間的意見分歧，直到有足夠大的程序庫和證據庫來梳理。我會讓 Aleks 談談銷售過程。

You know, again, if you look at the market before we entered into it, I think there were a fair amount of physicians and hospitals that were interested in single-incision surgery, as evidenced by the number of surgeons that were trained and some of the early successes that some of the other companies may have had in that area. So, the demand is there in terms -- let's say that the interest level is there.

你知道，再次，如果你在我們進入市場之前看一下市場，我認為有相當多的醫生和醫院對單切口手術感興趣，這可以從受過培訓的外科醫生的數量和一些其他一些公司可能在該領域取得的早期成功。所以，需求是存在的——假設利息水平是存在的。

And in terms of the sales process I think we are seeing a few things converge at the same time. You're seeing general surgeons who have garden-variety procedures like cholecystectomy. At same time you're seeing colorectal surgeons, who don't necessarily get involved in those types of surgeries, and you're seeing other areas.

在銷售流程方面，我認為我們看到一些事情同時發生。您會看到普通外科醫生進行膽囊切除術等各種手術。同時，您會看到結直腸外科醫生，他們不一定參與這些類型的手術，而您會看到其他領域。

We don't talk about it because they're not large markets. But if we look at procedures like adrenalectomies and some of the upper GI gastric surgeries, etc. they are all on small ends but nice trajectories.

我們不談論它，因為它們不是大市場。但是，如果我們看一下諸如腎上腺切除術和一些上消化道胃部手術等程序，它們都處於小範圍但很好的軌跡。

So there seems to be a lot of global awareness from the general surgeon that is making it let's say easier for our people to get in front of, and then consolidate the messaging of robotics programs to include general surgery. So there really isn't any sort of paint by numbers here that we can say is consistent, other than there is a lot of global awareness in this category right now.

因此，普通外科醫生似乎有很多全球意識，這讓我們可以說更容易讓我們的人走在前面，然後將機器人項目的信息整合到包括普通外科在內。所以這裡真的沒有任何類型的數字繪畫可以說是一致的，除了現在這個類別有很多全球意識。

And maybe two other quick questions. You talked about Europe placements being weak. What is your outlook for the year?

也許還有另外兩個簡單的問題。你談到歐洲的安置很弱。你對這一年的展望是什麼？

I know it's probably baked into your guidance, but do you think -- do you assume that it gets better? Or are you baking into it staying relatively tough even though procedure growth was pretty good? And what are you hearing about the magnitude of hospital budgets relative to procedure capability as we go through the year?

我知道它可能已經融入你的指導，但你認為 - 你認為它會變得更好嗎？或者即使程序增長非常好，您是否仍然堅持相對堅韌？在我們度過這一年的過程中，您對醫院預算相對於手術能力的規模有何看法？

A couple of questions in there. We think it will remain pressured for some time to come, so we're not forecasting that the pressure comes off capital budgets. As you said, the procedure side has been reasonably healthy to date. How expenditures reflect back into procedures is really hard for us to handicap. I think we're just going to have to wait and see where that goes.

裡面有幾個問題。我們認為它在未來一段時間內仍將面臨壓力，因此我們並不預測壓力會來自資本預算。正如你所說，迄今為止，程序方面一直相當健康。支出如何反映到程序中，這對我們來說確實是一個障礙。我認為我們將不得不等待，看看會發生什麼。

Then finally a quick one for Marshall. You talked about gross margin pressure early on with the rollout of seals and the new products. Is that something we could see resolving over the course of this year, or maybe takes a bit longer to get enough scale there? Thanks.

最後是馬歇爾的一個快速的。您很早就談到了推出密封件和新產品時的毛利率壓力。這是我們可以看到在今年解決的問題，還是可能需要更長的時間才能在那裡獲得足夠的規模？謝謝。

We're not going to put a timeframe on it. I would just say, like I said in the script, that over time we will -- we are working towards revising our production processes as well as the product itself in driving the cost down.

我們不會為此設定時間表。我只想說，就像我在劇本中所說的那樣，隨著時間的推移，我們會——我們正在努力修改我們的生產流程以及產品本身，以降低成本。

David Lewis, Morgan Stanley.

大衛劉易斯，摩根士丹利。

Good afternoon, a couple of quick questions. I want to try to maybe, Aleks or Gary, to rectify the revenue per procedure numbers. Obviously stronger than we would have thought, and you talked about general surgery being a contributor to incremental growth.

下午好，幾個簡單的問題。我想嘗試，Aleks 或 Gary，糾正每個程序數字的收入。顯然比我們想像的要強大，您談到普通外科手術是促進增長的一個因素。

So, I'm trying to figure out if general surgery comes on, revenue per procedure should trend down slightly, but in this quarter it trended up. And it did contribute to growth. So could you just give us more granularity on revenue per procedure going up, even though general surgery did contribute to positive growth acceleration?

因此，我試圖弄清楚普通手術是否會進行，每次手術的收入應該會略有下降，但在本季度呈上升趨勢。它確實促進了增長。那麼，即使普通外科手術確實促進了正增長加速，您能否給我們更多關於每次手術收入增長的粒度？

So when we are selling seal kits or our single-incision product (multiple speakers) Single-Site product, we are -- they are buying it as a kit. And they may not have done any surgeries yet, right?

因此，當我們銷售密封套件或我們的單切口產品（多揚聲器）單站點產品時，我們是 - 他們將其作為套件購買。他們可能還沒有做過任何手術，對吧？

So that is really what is helping increase the revenue per procedure. That as well as Firefly, as well as thoracic kits, so they're buying instruments and accessories in advance of doing the procedure. Now over time, they will be doing the procedures and then that will balance out.

因此，這確實有助於增加每個程序的收入。那還有螢火蟲，還有胸部套件，所以他們在做手術之前會購買儀器和配件。現在隨著時間的推移，他們將執行程序，然後平衡。

Long-term I think your question is, is the price they are paying for single-incision products less than what we are charging for our normal -- our multiple incision products, and the answer is yes.

從長遠來看，我認為您的問題是，他們為單切口產品支付的價格是否低於我們為我們的正常產品（我們的多切口產品）收取的價格，答案是肯定的。

Okay, so it sounds like even though the ancillary products like Firefly are doing obviously well, you still believe over time this trend is going to annualize down?

好吧，聽起來即使像 Firefly 這樣的輔助產品表現明顯不錯，你仍然相信隨著時間的推移這種趨勢會逐年下降嗎？

Over time, it is hard to exactly predict because the mix of new products and the mix of procedures is hard to forecast precisely. And so, some of them carry it up and some of them push it down, and so you have those two things working in opposition.

隨著時間的推移，很難準確預測，因為新產品的組合和程序的組合很難準確預測。所以，他們中的一些人把它舉起來，一些人把它推下來，所以這兩個東西是對立的。

And I know it's early, but is it safe to assume that in the earliest days of the initial general surgery traction that the majority of the success has been in chole versus other procedures?

而且我知道現在還為時過早，但是可以安全地假設在最初的普通手術牽引的早期，大部分成功都來自膽汁與其他手術嗎？

You are seeing really two different -- general surgery for us is a tale of two different activities. We have strength in colorectal, which is typically cancer procedures that would otherwise have been done open, and so that tends to be one set. There is a larger volume there.

你看到的是兩種不同的東西——對我們來說，普通外科手術是兩種不同活動的故事。我們在結直腸癌方面有實力，這通常是癌症手術，否則會在開放式手術中進行，因此往往是一組。那裡的體積更大。

And then we have Single-Site, which is right now approved for cholecystectomy. So you are seeing those two things kind of as a barbell.

然後我們有 Single-Site，現在被批准用於膽囊切除術。所以你把這兩件事看作是一個槓鈴。

As a total number of procedures, I think you're getting more from colorectal in terms of growth than you have in chole so far.

作為程序總數，我認為您從結直腸獲得的增長比迄今為止在膽汁中獲得的更多。

Okay, very helpful. One last quick one and I will jump back in queue. Just in terms of an O-US market dynamic question, if you think about your key markets, maybe Japan is less relevant right now. But in terms of Germany, France, Italy, in those key markets is prostatectomy still your single biggest growth contributor? So, not necessarily absolute, but on a growth perspective, is prostatectomy still the biggest driver in those three markets?

好的，很有幫助。最後一個快速的，我會跳回隊列。就 O-US 市場動態問題而言，如果您考慮一下您的主要市場，也許日本現在不太重要。但就德國、法國、意大利而言，在這些關鍵市場中，前列腺切除術仍然是您最大的增長貢獻者嗎？所以，不一定是絕對的，但從增長的角度來看，前列腺切除術仍然是這三個市場的最大推動力嗎？

The answer is mostly yes, although we are beginning -- you can see high growth off small bases in a couple of other procedures. So, off of a substantial base, the dVP is the highest grower.

答案大部分是肯定的，儘管我們正在開始——你可以在其他幾個程序中看到小基地的高增長。因此，在相當大的基礎上，dVP 是最高的增長者。

We are beginning to see hysterectomy for cancer conditions starting to come up. And there is some interest in general surgery in Italy, and that is starting to come up on a lower basis.

我們開始看到針對癌症的子宮切除術開始出現。意大利對普外科有一些興趣，而且興趣開始降低。

(Operator Instructions) Lennox Ketner, BofA Merrill Lynch.

（操作員說明）Lennox Ketner，美國銀行美林證券。

Hi, thanks so much for taking the question. Just to go back to the Single-Site product, our checks suggest you were in probably 20 to 30 hospitals this quarter. I'm just wondering if you're willing to comment on whether that is the right ballpark. And also just wondering, are you still in the -- at a point where you're hand-selecting the sites so that you can work with the early adopters? Or is that product available for broad distribution now?

您好，非常感謝您提出問題。回到 Single-Site 產品，我們的檢查表明您本季度可能在 20 到 30 家醫院。我只是想知道你是否願意評論這是否是正確的球場。並且只是想知道，您是否仍然處於手動選擇站點以便與早期採用者合作的地步？還是該產品現在可以廣泛分發？

First, with respect to the number of centers, we really aren't a position to disclose what those numbers are and will probably pass on trying to answer that question. But I would say that during the course of the quarter we have seen a lot of interest both in centers that have purchased and have begun doing cases, as well as the centers who are in the process of being trained.

首先，關於中心的數量，我們真的無法透露這些數字是多少，並且可能會繼續嘗試回答這個問題。但我想說，在本季度的過程中，我們看到了對已經購買並開始處理案例的中心以及正在接受培訓的中心的極大興趣。

So, comparing and contrasting Single-Site versus the Vessel Sealer, Single-Site from a market development standpoint is much further along than Vessel Sealer, which was a product that we started to phase into, roll out in the later half of the first quarter. So you should think of those two differently. Think of Single-Site being further along and think of Single-Site is a product now that customers can get their hands on.

因此，比較 Single-Site 與 Vessel Sealer，從市場發展的角度來看，Single-Site 比 Vessel Sealer 更進一步，這是我們在第一季度下半年開始逐步推出的產品.所以你應該以不同的方式看待這兩者。想想 Single-Site 會走得更遠，想想 Single-Site 是現在客戶可以使用的產品。

Okay, and then you mentioned that it's cleared for broader indications in Europe. Is it cleared for additional specific indications in Europe, or does it -- are you clear to use it in anything in Europe?

好的，然後你提到它已經清除了歐洲更廣泛的跡象。它是否可以在歐洲用於其他特定適應症，或者您是否清楚在歐洲的任何事物中使用它？

It's cleared in most things in the abdomen. It's not cleared in all parts of the body.

它在腹部的大多數東西中都被清除了。它沒有在身體的所有部位清除。

Okay. And then lastly on Japan, sorry if I missed that. But I was wondering if you said how many systems were sold into Japan, and then also if you could just talk about bit about what the process is for getting additional procedures approved in Japan. And I know you were kind of -- last quarter at least still debating which procedures to pursue there next, but if you could maybe just talk a little bit about the process there and whether you have made any decisions?

好的。最後是日本，如果我錯過了，請見諒。但是我想知道您是否說有多少系統銷往日本，然後您是否可以談談在日本獲得批准的額外程序的流程是什麼。而且我知道你有點 - 至少上個季度還在爭論接下來要執行哪些程序，但如果你可以談談那裡的流程以及你是否做出任何決定？

Sure, so the first question was how many went into Japan this quarter. It was seven. With regard to what happens next in terms of reimbursements, first, we're happy to have the first one in there.

當然，所以第一個問題是本季度有多少人進入了日本。那是七點。關於在報銷方面接下來會發生什麼，首先，我們很高興有第一個。

Going forward, the process changes a little bit. And the surgical societies are then the groups that lead the pursuit of a reimbursement beyond the first one, and so we will be in support of those societies as they look to see where they want to go.

展望未來，這個過程會發生一些變化。然後，外科協會是領導尋求補償的團體，超越了第一個，因此我們將支持這些協會，因為他們希望看到他們想去的地方。

It's a little bit early to figure out which one will be the next one in queue, but those societies are interested and they're starting to talk to us about it. As we know more, then we'll report more in future quarters.

現在確定哪一個將是下一個排隊的人還為時過早，但這些社團很感興趣，他們開始與我們討論這個問題。正如我們所了解的那樣，我們將在未來幾個季度報告更多。

Great, thanks so much. Congratulations.

太好了，非常感謝。恭喜。

Rick Wise, Leerink Swann.

瑞克·懷斯，李林克·斯旺。

Good afternoon everybody. Let me go back to the Europe issues again. Did I hear you correctly that part of the issues that you cited disappointing were the external factors, but some of them, if I understood you, were organizational? And you said you are taking steps to improve. Can you expand on that and give us a little more color on what you are doing and maybe how much of what was disappointing was related to internal versus external issues?

大家下午好。讓我再次回到歐洲問題。我沒聽錯，你提到的令人失望的部分問題是外部因素，但如果我理解你的話，其中一些是組織性的？你說你正在採取措施改進。您能否對此進行擴展，並就您正在做的事情給我們更多的色彩，也許令人失望的事情中有多少與內部和外部問題有關？

Yes, it's hard to quantify the differences. You did hear us right. I think there's some things we can do to strengthen our capabilities in Europe, and they tend to be around things like economics report, health technology assessments, marketing, those kinds of market access and structural issues more than they are sales process type. So we're working on those things, I think we're making some investments in them.

是的，很難量化差異。你沒聽錯。我認為我們可以做一些事情來加強我們在歐洲的能力，它們往往圍繞經濟報告、健康技術評估、營銷、這類市場准入和結構性問題，而不是銷售流程類型。所以我們正在做這些事情，我認為我們正在對它們進行一些投資。

How to distinguish how much is one and how much is the other is very tough to do. We don't know exactly how to do that.

如何區分一個是多少，另一個是多少是非常困難的。我們不知道該怎麼做。

Was sort of a minor factor really this quarter or this is something that really could make a significant difference as you address it in the second half, let's say?

本季度真的是一個次要因素，或者當你在下半年解決這個問題時，這真的可以產生重大影響，讓我們說？

It's clear there are economic pressures in Europe having nothing to do with us, and so I think -- and those things are going to exist. How quickly we can add some capabilities and make some changes, that's going to be hard-pressed to forecast. They are directionally correct and we will make those investments and progress.

很明顯，歐洲存在與我們無關的經濟壓力，所以我認為——這些事情將會存在。我們能以多快的速度添加一些功能並做出一些改變，這將是難以預測的。它們在方向上是正確的，我們將進行這些投資和進步。

Two other quick ones. You highlighted the transference of the da Vinci S license from J&J to you. Is there any economic impact that we should think about, or ability to sell or freedom of action that that helps with that we should understand?

另外兩個快速的。您強調了強生將達芬奇 S 許可證轉讓給您。是否有任何我們應該考慮的經濟影響，或者我們應該理解的銷售能力或行動自由？

There is not nothing material in terms of the commercial aspect of revenue or cost. What it does allow us to do is move on our timelines a little more quickly with regard to approvals of future products, and the ability to be more responsive to the marketplace. And so that is really the excitement of it for us.

就收入或成本的商業方面而言，並非沒有什麼重要的。它使我們能夠做的是在批准未來產品方面更快地推進我們的時間表，以及對市場做出更快響應的能力。所以這對我們來說真的很令人興奮。

Last quick one, you mentioned no stock buybacks in either the fourth quarter or the first quarter. I don't know how to ask about this, and rudely, why not? What are the factors that might drive that process? Thanks.

最後一個快速的，你提到在第四季度或第一季度都沒有股票回購。我不知道怎麼問這個，而且粗魯地問，為什麼不呢？可能推動這一進程的因素是什麼？謝謝。

Warren Buffett wrote in his shareholder letter something on this point that I thought was great, and I will just quote it for you. He says he looks for two conditions to be satisfied to buy back stock. And I will quote him, quote -- first, the company has ample funds to take care of the operational and liquidity needs of its business. Second, its stock is selling at a material discount to the company's intrinsic business value, conservatively calculated, unquote. I think he says it right. I think we are happy to emulate his behavior here and that is how we think about it.

沃倫·巴菲特 (Warren Buffett) 在他的股東信中就這一點寫了一些我認為很棒的東西，我會為你引用它。他說，他希望滿足兩個條件來回購股票。我會引用他的話，引用-首先，公司有充足的資金來滿足其業務的運營和流動性需求。其次，其股票的銷售價格低於公司的內在商業價值，保守計算，未報價。我認為他說得對。我認為我們很樂意在這裡效仿他的行為，這就是我們的想法。

And our last and final question comes from Michael Matson, Mizuho Securities.

我們的最後一個也是最後一個問題來自瑞穗證券的 Michael Matson。

Yes, just taking sort of -- standing back taking a bigger picture view of things, I guess first of all, you have got -- hysterectomy is obviously doing extremely well in the US. But by my math I think you are kind of getting upwards of in the 50% range now in terms of penetration. And I guess in another year or two, that is going to start to peak, I guess.

是的，只是有點——退後一步，從更大的角度看待事物，我想首先，你已經知道——子宮切除術在美國顯然做得非常好。但根據我的數學，我認為你現在的滲透率已經超過了 50%。我想再過一兩年，我想這將開始達到頂峰。

And so, where -- what do you really see beyond that to pick up the slack, if that is really starting to slow down as what we've seen with prostatectomy? Do you think it's really going to be Single-Site? Do you think it's the just the combination of the multitude of these other smaller procedures? Do you think it's general surgery? Just be interested in getting your thoughts there.

那麼，如果這真的開始像我們在前列腺切除術中看到的那樣開始放緩，那麼你真正看到了什麼來彌補這一點？你認為它真的會成為單站點嗎？你認為這只是眾多其他較小程序的組合嗎？你以為是普外科？只是有興趣在那裡表達你的想法。

Think about it this way, Michael. You have got -- if we went back in time in 2005 or so, where that question was asked as to what are you going to do when US prostatectomy reaches its height, we weren't talking about hysterectomy. We weren't talking about US hysterectomy, let alone international hysterectomy.

這樣想吧，邁克爾。你有 - 如果我們回到 2005 年左右的時間，那個問題被問到當美國前列腺切除術達到高度時你會做什麼，我們不是在談論子宮切除術。我們不是在談論美國的子宮切除術，更不用說國際子宮切除術了。

We weren't talking about lobectomy. We weren't talking about any of these procedures. Now -- or Single-Site and general surgery in general.

我們不是在談論肺葉切除術。我們不是在談論任何這些程序。現在 - 或單站點和一般手術。

So, when I sort of fast-forward the tape to where we are today, so recognize that dVP US has been flat for some time, you know, let's call it a year. And yet we are growing at a pretty significant rate. Why? Because there are other ways to sort of slice and look at it internationally. dVP internationally is growing at a very quick rate and it is a larger market than the US dVP market potentially.

因此，當我將磁帶快進到今天的位置時，請認識到 dVP US 已經有一段時間持平了，你知道，讓我們稱之為一年。然而，我們正在以相當顯著的速度增長。為什麼？因為還有其他方法可以在國際範圍內進行切片和查看。國際 dVP 正在以非常快的速度增長，它是一個比美國潛在的 dVP 市場更大的市場。

Now when you look at dVH, you are talking about the US dVH market, which we segmented down to a certain number, but it doesn't include non-US geographies. We are continuing to add procedures, and when you add general surgery, whether it be through single incision or other multiple incision procedures, and you continue to add thoracic, etc. there is plenty for us to do. We don't feel as if we are running out of steam or running out of procedures. But by all means, we feel completely the opposite.

現在，當您查看 dVH 時，您指的是美國 dVH 市場，我們將其細分為一定數量，但不包括非美國地區。我們還在繼續增加手術，當你增加普外科，無論是單切口還是其他多切口手術，你繼續增加胸外科等等，我們有很多事情要做。我們並不覺得自己沒有動力或沒有程序。但無論如何，我們的感覺完全相反。

So at this stage it is -- there is plenty on their plate and we think that over time we will be adding more things to our plate.

所以在這個階段——他們的盤子裡有很多東西，我們認為隨著時間的推移，我們會在我們的盤子裡添加更多的東西。

Okay. And just as sort of a follow on to that, just wondering what your thoughts are in terms of hysterectomy in Europe and outside the US. I mean, you kind of commented on it a little bit earlier in the Q&A. But is there any reason to believe that it might not sort of follow what happened in the US?

好的。就像對此的跟進一樣，只是想知道您對歐洲和美國以外的子宮切除術有何想法。我的意思是，您在問答環節早些時候對此發表了評論。但是有什麼理由相信它可能不會跟上美國發生的事情嗎？

I mean I realize these procedures probably aren't' as common, at least on a per capita basis outside the US. But is there any reason to believe, at least for the proportion that are done, that we wouldn't see similar adoption curves with time?

我的意思是我意識到這些程序可能並不常見，至少在美國以外的人均基礎上。但是，是否有任何理由相信，至少就完成的比例而言，我們不會隨著時間的推移看到類似的採用曲線？

You know, if you look at it from a couple perspectives, one is that dVH is done for multitude of reasons. It could be endometrial or cervical cancer, ovarian cancer. You move into the benign side and you've got fibroids, multiple fibroids, large fibroids, endometriosis, a combination of all the above and abnormal uterine bleeding, etc.

你知道，如果你從幾個角度來看，一個是 dVH 的完成有多種原因。它可能是子宮內膜癌或宮頸癌、卵巢癌。你進入良性的一側，你有肌瘤、多發性肌瘤、大肌瘤、子宮內膜異位症、上述所有情況的組合和異常子宮出血等。

So when you try to draw connections between women's healthcare is performed in the United States or delivered in the United States, and try to compare it to other markets, it's a little bit different, whereas prostatectomy is done for the same reason. They're all done for cancer.

因此，當您嘗試將在美國進行或在美國提供的女性醫療保健之間建立聯繫，並嘗試將其與其他市場進行比較時，它會有點不同，而前列腺切除術是出於相同的原因。他們都是為癌症做的。

Cancer tends to have consistency in a lot of countries, US and O-US. So, what are thoughts are at this stage is that, not unlike the United States, we would expect the dVH for malignant conditions to probably be the beachhead, if you will, into most of these countries. And what happens after that, we will have to wait and see.

癌症在許多國家（美國和 O-US）中往往具有一致性。因此，現階段的想法是，與美國不同，我們預計惡性疾病的 dVH 可能會成為大多數這些國家的灘頭陣地。之後會發生什麼，我們將不得不拭目以待。

But thus far, the strength that we've seen is consistent with that explanation. So, overall, I think you can just take away that women's healthcare in general, especially for benign conditions, is different in a lot of countries than it is in the United States.

但到目前為止，我們所看到的力量與這種解釋是一致的。所以，總的來說，我認為你可以忽略女性的醫療保健，特別是對於良性疾病，在很多國家都與在美國不同。

All right. That's all I had. Thank you.

好的。這就是我所擁有的。謝謝你。

Thank you. That was our last question. As we have said previously, while we focus on financial metrics such as revenues, profits and cash flow during these conference calls, our organizational focus remains on increasing patient value by improving surgical outcomes and reducing surgical trauma.

謝謝你。那是我們的最後一個問題。正如我們之前所說，雖然我們在這些電話會議期間關注收入、利潤和現金流等財務指標，但我們的組織重點仍然是通過改善手術結果和減少手術創傷來增加患者價值。

I hope the following experience from Kimberley in Florida gives you some sense of what this means in the lives of our patients. Quote, I was diagnosed with vaginal prolapse in November of 2011. I had a hysterectomy two years prior in November of 2009. This is an unfortunate condition caused by several factors such as heredity, number of children -- I have four -- and a previous hysterectomy.

我希望佛羅里達州金伯利的以下經歷能讓您了解這對我們患者的生活意味著什麼。引用，我在 2011 年 11 月被診斷出患有陰道脫垂。兩年前的 2009 年 11 月，我進行了子宮切除術。這是由遺傳、孩子數量（我有四個）和一個以前的子宮切除術。

My gynecologist referred me to Dr. Coyle for the da Vinci procedure due to its minimally invasive nature, and most of all, its highest success rate. I researched the procedure, met with Dr. Coyle, discussed it with my family, prayed, and decided to schedule the surgery. After years of back pain and discomfort, I was looking forward to some relief.

我的婦科醫生將我推薦給 Coyle 醫生進行達芬奇手術，因為它具有微創性，最重要的是，它的成功率最高。我研究了手術程序，會見了 Coyle 醫生，與家人討論過，祈禱，並決定安排手術時間。經過多年的背部疼痛和不適，我期待著一些緩解。

Never did I expect to feel as good as I do today just four weeks post-surgery. The first couple of days after the surgery were the hardest, and that was it. After that, the most difficult thing was adhering to the post-surgery instructions of what I couldn't do because I felt so good.

我從沒想過在手術後僅僅四個星期就會感覺像今天這樣好。手術後的前幾天是最艱難的，僅此而已。在那之後，最困難的事情是遵守術後指示，因為我感覺很好，所以我不能做。

I never realized how much the nagging pain I lived with prior to the procedure was affecting my life. Now I feel so renewed, refreshed and easily 10 years younger. I would like to say thank you to Dr. Coyle and his team for their continued pursuit of technological advances in the medical field, their commitment to medical excellence and true compassion for their patients' well-being.

我從來沒有意識到我在手術前忍受的痛苦折磨對我的生活產生了多大的影響。現在我感覺如此煥然一新，精神煥發，輕鬆年輕了 10 歲。我要感謝 Coyle 博士和他的團隊，感謝他們不斷追求醫學領域的技術進步，他們對卓越醫療的承諾以及對患者福祉的真正同情。

I would also like to thank those who created the da Vinci robot for their commitment to these types of advancements in medical technology that makes such a positive difference in people's lives. If you are considering this procedure, do yourself a favor and say yes. The outcome is truly worth passing on to others. End quote.

我還要感謝那些創造達芬奇機器人的人，他們對醫療技術的這些進步做出了承諾，這些進步對人們的生活產生瞭如此積極的影響。如果您正在考慮此程序，請幫自己一個忙並同意。結果確實值得傳遞給其他人。結束報價。

Patients like Kimberly are the strongest advocates for da Vinci surgery and form the very foundation of our operating performance. We have built our Company to take surgery beyond the limits of the human hand, and I assure you that we remain committed to driving the vital few things truly make a difference.

像金佰利這樣的患者是達芬奇手術的堅定擁護者，是我們運營業績的基礎。我們已經建立了我們的公司，以超越人手的限制進行手術，我向您保證，我們將繼續致力於推動真正發揮作用的重要少數事情。

This concludes today's call. We thank you for your participation and support on this extraordinary journey to improve surgery, and we look forward to talking to you again in three months.

今天的電話會議到此結束。我們感謝您在這個改善手術的非凡旅程中的參與和支持，我們期待在三個月後再次與您交談。

Ladies and gentlemen, that does conclude our conference for today. Thank you for your participation and using AT&T's Executive Teleconference Service. You may now disconnect.

女士們先生們，今天的會議到此結束。感謝您的參與和使用 AT&T 的行政電話會議服務。您現在可以斷開連接。