直覺手術 (ISRG) 2013 Q1 法說會逐字稿

Ladies and gentlemen, good afternoon.

女士們先生們，下午好。

Thank you for standing by, and welcome to the Intuitive Surgical quarter one 2013 earnings release conference call.

感謝您的支持，歡迎參加 Intuitive Surgical 2013 年第一季度收益發布電話會議。

At this time, all lines are in a listen only mode.

此時，所有線路都處於只聽模式。

Later there will be an opportunity for your questions, and instructions will be given at that time.

稍後將有機會提出您的問題，屆時將給出說明。

(Operator instructions).

（操作員說明）。

As a reminder, today's conference is being recorded.

提醒一下，今天的會議正在錄製中。

I would now like to turn the conference over to our host, Senior Director of Finance, Mr. Calvin Darling.

我現在想將會議轉交給我們的主持人，財務高級總監 Calvin Darling 先生。

Please go ahead.

請繼續。

Good afternoon and welcome to Intuitive Surgical's first-quarter earnings conference call.

下午好，歡迎參加 Intuitive Surgical 的第一季度收益電話會議。

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.

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.

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。

Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties.

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。

These risks and uncertainties are described in detail in the Company's Securities and Exchange Commission filings.

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。

Prospective investors are cautioned not to place undue reliance on such forward-looking statements.

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.

請注意，本次電話會議將在我們的網站上進行音頻重播，網址為：intuitivesurgical.com，位於我們投資者關係頁面下的音頻存檔部分。

In addition, today's press release has been posted to our website.

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 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今天早些時候宣布的新聞稿中描述的第一季度業績的亮點，然後是問答環節。

Gary will present the quarter's business and operational highlights.

Gary 將介紹本季度的業務和運營亮點。

Marshall will provide a review of our first-quarter financial results.

Marshall 將對我們的第一季度財務業績進行審查。

Aleks will discuss marketing and clinical highlights.

Aleks 將討論營銷和臨床亮點。

Then I will provide an update to our financial forecast for 2013.

然後我將更新我們對 2013 年的財務預測。

Finally, we will host a question and answer session.

最後，我們將舉辦問答環節。

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.

感謝您今天加入我們。

Before we get started describing our quarterly performance, I would like to make a few comments regarding current events.

在我們開始描述我們的季度業績之前，我想就當前事件發表一些評論。

As you know, we are in the midst of a concerted effort by critics of robotic surgery to challenge the benefit it brings to patients, the value it brings to the medical community and the quality of our organization.

如您所知，我們正處於機器人手術批評者的共同努力之中，以挑戰它給患者帶來的好處、它給醫學界帶來的價值以及我們組織的質量。

While taking these allegations very seriously, we remain deeply committed to developing and providing products that in a surgeon's hands ease the burden of surgery for patients who can benefit from them.

在非常認真地對待這些指控的同時，我們仍然堅定地致力於開發和提供外科醫生手中的產品，以減輕可以從中受益的患者的手術負擔。

We take pride in the benefits provided by our systems, demonstrated in numerous large-scale population studies comparing da Vinci surgery to open surgery for several different procedures.

我們為我們的系統所提供的好處感到自豪，這在許多將達芬奇手術與幾種不同手術的開腹手術進行比較的大規模人群研究中得到了證明。

We are confident that those who invest their time in a serious review of the clinical literature on da Vinci will find ample evidence of the benefit it brings to patients, surgeons, hospitals and the medical community at large.

我們相信，那些花時間認真回顧達芬奇臨床文獻的人會發現充分的證據證明它給患者、外科醫生、醫院和整個醫學界帶來的好處。

To date, over 1 million patients have chosen da Vinci minimally invasive surgery, surgery that would have otherwise been performed through an open incision.

迄今為止，已有超過 100 萬患者選擇了達芬奇微創手術，這種手術本來可以通過開放切口進行。

Turning to our performance in the quarter, we experienced strong growth in general surgery, slower growth in gynecology and a return to stability in urology.

談到我們在本季度的表現，我們經歷了普外科的強勁增長，婦科增長放緩以及泌尿科恢復穩定。

This resulted in an 18% procedure growth over 2012.

與 2012 年相比，這導致了 18% 的程序增長。

The first quarter of 2013 had one fewer surgery day than 2012.

2013 年第一季度的手術天數比 2012 年少一個。

Taking this into account, normalized procedure growth improves to approximately 20%.

考慮到這一點，標準化程序增長提高到大約 20%。

General surgery growth was led by single-site cholecystectomy and colon and rectal procedures.

單點膽囊切除術以及結腸和直腸手術引領了普通外科手術的增長。

Gynecologic procedures for benign indications are typically seasonally slower in the first quarter.

良性適應症的婦科手術在第一季度通常會因季節而變慢。

However, we experienced slower than expected growth in benign hysterectomies in this first quarter of 2013.

然而，我們在 2013 年第一季度經歷了低於預期的良性子宮切除術增長。

Worldwide urology procedures experienced solid growth, aided by the stabilizing of prostatectomy procedures in the United States.

得益於美國前列腺切除術的穩定，全球泌尿外科手術經歷了穩健的增長。

Considering the above, procedure growth for the quarter came in at the lower range of our expectations.

考慮到上述情況，本季度的程序增長處於我們預期的較低範圍內。

Alex will provide additional procedure commentary later in the call.

Alex 將在稍後的電話會議中提供額外的程序評論。

Turning to markets outside of the United States, our first quarter of SI system sales to Japan went well with encouraging early customer demand for the system.

轉向美國以外的市場，我們第一季度對日本的 SI 系統銷售進展順利，鼓勵了早期客戶對該系統的需求。

We are supporting surgical societies in Japan in their efforts to obtain national reimbursement for procedures beyond prostatectomy.

我們正在支持日本的外科協會努力為前列腺切除術以外的手術獲得國家報銷。

In Europe, procedures and system sales followed seasonal trends and showed modest growth.

在歐洲，程序和系統銷售跟隨季節性趨勢並呈現適度增長。

We continue to build our team in Europe, and I am pleased with our organizational development over the past few quarters.

我們繼續在歐洲建立我們的團隊，我對過去幾個季度的組織發展感到滿意。

Overall, operating highlights for the first quarter are as follows.

總體而言，第一季度的經營亮點如下。

Procedures grew 18% over the first quarter of 2012.

與 2012 年第一季度相比，程序增長了 18%。

Adjusting for the number of procedure days in the quarter, normalized growth was approximately 20%.

調整本季度的手術天數後，正常化增長率約為 20%。

We sold 164 da Vinci Surgical Systems, up from 140 during the first quarter of last year.

我們售出了 164 台達芬奇手術系統，高於去年第一季度的 140 台。

Total revenue was $611 million, up 23% over last year.

總收入為 6.11 億美元，比去年增長 23%。

Instruments and accessories revenue increased to $261 million, up 26% over Q1 of 2012.

儀器和配件收入增至 2.61 億美元，比 2012 年第一季度增長 26%。

Total recurring revenue grew to $356 million, up 23% from prior year and comprising 58% of total revenue.

總經常性收入增長至 3.56 億美元，比上年增長 23%，佔總收入的 58%。

We generated an operating profit of $285 million before non-cash stock option expense, up 27% from the first quarter of last year.

在扣除非現金股票期權費用之前，我們的營業利潤為 2.85 億美元，比去年第一季度增長 27%。

Net income was $189 million, up 32% over last year.

淨收入為 1.89 億美元，比去年增長 32%。

Earnings per share for the quarter were $4.56 compared to $3.50 in the first quarter of 2012.

本季度每股收益為 4.56 美元，而 2012 年第一季度為 3.50 美元。

We ended the quarter with $3,116,000,000 in cash and investments, up $196 million from last quarter.

我們以 3,116,000,000 美元的現金和投資結束本季度，比上一季度增加 1.96 億美元。

Significant cash outlays in the quarter included $17 million investment in fixed assets and intellectual property.

本季度的重大現金支出包括 1700 萬美元的固定資產和知識產權投資。

We repurchased $146 million worth of our shares in the quarter.

我們在本季度回購了價值 1.46 億美元的股票。

Our product development teams continued to make good progress.

我們的產品開發團隊繼續取得良好進展。

This quarter we initiated our controlled rollout for single-site hysterectomy and [uferectomy].

本季度，我們開始了單點子宮切除術和 [子宮切除術] 的可控推廣。

Leading surgeons are optimizing their procedure choreography, and we plan to expand our installations at a measured pace through the year.

領先的外科醫生正在優化他們的手術編排，我們計劃在一年中以有節制的速度擴大我們的設施。

Early surgeon and patient interest in Single-Site for hysterectomy is high.

早期外科醫生和患者對單點子宮切除術的興趣很高。

We have also initiated our first clinical cases with our da Vinci stapler.

我們還使用我們的達芬奇吻合器啟動了我們的第一個臨床病例。

As we have mentioned previously, our first stapling product is focused on colorectal surgery.

正如我們之前提到的，我們的第一個吻合器產品專注於結直腸手術。

Early clinical results and surgeon feedback on use of the stapler are very encouraging.

早期臨床結果和外科醫生對吻合器使用的反饋非常令人鼓舞。

Given the subtleties involved in the use and manufacture of surgical staplers, a rollout plan for the stapler will be conservative for the year.

鑑於外科縫合器的使用和製造涉及的微妙之處，縫合器的推出計劃在今年將是保守的。

Turning to system and imaging developments, we continue to invest in expanding indications for Firefly Fluorescence Imaging and in deepening our product offerings in support of system training.

轉向系統和成像發展，我們繼續投資擴大螢火蟲熒光成像的適應症，並深化我們的產品供應以支持系統培訓。

We are currently answering FDA questions regarding expanding Firefly indications to include biliary imaging.

我們目前正在回答 FDA 關於擴大螢火蟲適應症以包括膽道成像的問題。

The intent of this indication is to allow surgeons to image the common bile duct in real-time during cholecystectomy.

該適應症的目的是允許外科醫生在膽囊切除術期間實時成像膽總管。

On the simulation front, we have added new surgical skill modules to our simulator through our development partnerships.

在模擬方面，我們通過我們的開發合作夥伴為我們的模擬器添加了新的手術技能模塊。

Our medical research team is working with academic centers worldwide on face, content and construct validity studies of the da Vinci Skills Simulator.

我們的醫學研究團隊正在與世界各地的學術中心合作，對達芬奇技能模擬器的面部、內容和結構有效性進行研究。

Early publications of these validations are positive.

這些驗證的早期出版物是積極的。

Lastly, we are initiating our first clinical sites configured with da Vinci Connect over the next few months.

最後，我們將在接下來的幾個月中啟動我們的第一個臨床站點，其中配置了 da Vinci Connect。

Da Vinci Connect is our system for remote proctoring.

Da Vinci Connect 是我們的遠程監考系統。

Remote proctoring uses Internet-based conferencing technology to allow a distant surgeon to participate in the da Vinci case with a surgeon on an SI console through video, voice and illustration.

遠程監考使用基於 Internet 的會議技術，允許遠程外科醫生通過視頻、語音和插圖在 SI 控制台上與外科醫生一起參與達芬奇病例。

It is intended to augment surgical proctoring by lowering the time, distance and cost barriers to expert participation during a surgeon's learning period.

它旨在通過降低外科醫生學習期間專家參與的時間、距離和成本障礙來增強手術監考。

We are also investing in the construction of two new training centers that are expected to become operational this year, one increasing the capacity of our training center at our California headquarters and a second new facility in Atlanta to serve our customers in the East.

我們還投資建設了兩個預計將於今年投入運營的新培訓中心，其中一個增加了我們位於加利福尼亞總部的培訓中心的容量，第二個位於亞特蘭大的新設施為我們在東部的客戶提供服務。

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

隨著我們進入新的外科市場並進入新的產品領域，我們將繼續投資於建立我們的團隊並擴大合作夥伴關係，並獲取那些可以對機器人手術產生影響的技術。

This quarter we added 118 people to our team, predominantly in sales, manufacturing and R&D, bringing our total team to 2480 employees.

本季度，我們的團隊增加了 118 人，主要從事銷售、製造和研發，使我們的團隊總數達到 2480 人。

I will now pass the time over to Marshall, our Chief Financial Officer.

我現在將把時間轉給我們的首席財務官 Marshall。

Thank you, Gary.

謝謝你，加里。

Our first-quarter revenue was $611 million, up 23% compared with $495 million for the first quarter of 2012 and roughly equal to the $609 million last quarter.

我們第一季度的收入為 6.11 億美元，與 2012 年第一季度的 4.95 億美元相比增長了 23%，大致相當於上一季度的 6.09 億美元。

First-quarter revenues by product category were as follows.

第一季度按產品類別劃分的收入如下。

First-quarter instrument and accessory revenue was $261 million, up 26% compared to $208 million for the first quarter of 2012 and up 3% compared with $254 million in the fourth quarter of 2012.

第一季度儀器和配件收入為 2.61 億美元，與 2012 年第一季度的 2.08 億美元相比增長 26%，與 2012 年第四季度的 2.54 億美元相比增長 3%。

The year-over-year increase in instrument and accessory revenue was driven by procedure growth of 18%, sales of new products including Single-Site Vessel Sealer and Firefly and higher stocking orders associated with higher system unit sales.

儀器和配件收入的同比增長是由 18% 的程序增長、包括單點封口機和螢火蟲在內的新產品的銷售以及與更高的系統單元銷售相關的更高的庫存訂單推動的。

The 18% procedure growth was impacted by one additional operating day in the first quarter of 2012, reflecting Leap Year.

18% 的程序增長受到 2012 年第一季度增加一個營業日的影響，這反映了閏年。

Excluding the impact of Leap Year, procedure growth would have been approximately 20%.

排除閏年的影響，程序增長約為 20%。

Procedure growth also reflects seasonality associated with benign hysterectomies, which was more pronounced in 2013 compared with 2012 as we achieve deeper penetration in this market.

手術增長還反映了與良性子宮切除術相關的季節性，與 2012 年相比，2013 年的情況更為明顯，因為我們在該市場實現了更深入的滲透。

The year-over-year procedure growth was led by US general surgery and oncology procedures, partially offset by lower US dVPs of approximately 11%.

美國普通外科和腫瘤手術引領了手術同比增長，部分被美國 dVP 下降約 11% 所抵消。

US dVP procedures are approximately 4% higher than the fourth quarter of 2012.

美國的 dVP 程序比 2012 年第四季度高出約 4%。

The sequential increase in instrument and accessory revenue compared with the last quarter was driven by the timing of customer orders and new product revenue associated with the increased usage of Firefly, Vessel Sealer and Single-Site.

與上一季度相比，儀器和配件收入的連續增長是由客戶訂單時間和與 Firefly、Vessel Sealer 和 Single-Site 使用增加相關的新產品收入推動的。

Instrument and accessory revenue realized per procedure, including initial stocking orders, was approximately $2110 per procedure, which is higher than the $1990 realized in the first quarter of last year and the $2050 realized in the fourth quarter.

每個程序實現的儀器和附件收入，包括初始庫存訂單，約為每個程序 2110 美元，高於去年第一季度實現的 1990 美元和第四季度實現的 2050 美元。

The sequential increase from the fourth quarter of 2012 to the first quarter of 2013 was driven primarily by the timing of customer orders.

從 2012 年第四季度到 2013 年第一季度的環比增長主要受客戶訂單時間的推動。

First-quarter 2013 systems revenue of $256 million increased 24% compared with $207 million for the first quarter of 2012 and decreased 3% compared with $265 million for the fourth quarter of 2012.

2013 年第一季度系統收入為 2.56 億美元，與 2012 年第一季度的 2.07 億美元相比增長了 24%，與 2012 年第四季度的 2.65 億美元相比下降了 3%。

Our higher systems revenue compared to the first quarter of last year was driven by higher unit sales and a higher average selling price.

與去年第一季度相比，我們更高的系統收入是由更高的單位銷售額和更高的平均售價推動的。

We sold 164 systems in the first quarter of 2013 compared with 140 systems in the first quarter of last year and 175 systems in the seasonally stronger fourth quarter of 2012.

我們在 2013 年第一季度售出了 164 個系統，而去年第一季度售出了 140 個系統，而在季節性較強的 2012 年第四季度售出了 175 個系統。

Our first-quarter 2013 system sales included 25 systems into Japan where we launched the da Vinci SI at the start of this year.

我們在 2013 年第一季度的系統銷售額包括進入日本的 25 個系統，我們在今年年初推出了 da Vinci SI。

We sold seven systems into Japan during the first quarter of 2012 and 10 last quarter.

我們在 2012 年第一季度向日本銷售了 7 個系統，在上個季度向日本銷售了 10 個。

Our first-quarter average selling price per system was $1.55 million compared with $1.47 million realized in the first quarter of 2012 and the $1.49 million realized last quarter.

我們第一季度每個系統的平均售價為 155 萬美元，而 2012 年第一季度實現了 147 萬美元，上一季度實現了 149 萬美元。

ASPs include all da Vinci models, all simulators and Firefly when configured with the system and exclude upgrades.

ASP 包括所有 da Vinci 模型、所有模擬器和 Firefly（當與系統一起配置時），不包括升級。

Our higher first-quarter 2013 ASP was driven by a higher proportion of dual-console configurations and a favorable geographic mix.

我們較高的 2013 年第一季度 ASP 是由較高比例的雙控制台配置和有利的地理組合推動的。

48 of the 164 first-quarter sales were dual-console models compared with 25 of 140 last year and 32 of 175 last quarter.

第一季度銷售的 164 款中有 48 款是雙控制台機型，而去年同期為 140 款中的 25 款和上季度 175 款中的 32 款。

15 of the 25 units sold in Japan during the first quarter were dual-console models.

第一季度在日本銷售的 25 台中有 15 台是雙控制台機型。

We sold 97 simulators during the quarter, mostly in conjunction with new system sales, compared with 102 last year and 115 last quarter.

我們在本季度售出了 97 台模擬器，主要是與新系統銷售一起銷售，而去年為 102 台，上一季度為 115 台。

39 of our first-quarter 2013 system sales involve trade-ins comprised of 30 da Vinci Ss and nine standard models.

我們 2013 年第一季度的系統銷售中有 39 個涉及以舊換新，包括 30 個達芬奇 Ss 和 9 個標準型號。

46 of our first-quarter 2012 sales involved trade-ins, and 52 of our fourth-quarter 2012 sales involve trade-ins.

我們 2012 年第一季度的銷售額中有 46 項涉及以舊換新，我們 2012 年第四季度的銷售額中有 52 項涉及以舊換新。

Service revenue increased to $94 million, up 17% compared with $81 million last year and up 4% compared with $91 million last quarter.

服務收入增至 9400 萬美元，比去年的 8100 萬美元增長 17%，比上一季度的 9100 萬美元增長 4%。

The growth in service revenue was primarily driven by a larger system installed base.

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 instruments, accessories and service revenue, increased to $356 million, up 23% compared with the first quarter of last year and up 3% compared with the fourth quarter of 2012.

第一季度總經常性收入（包括儀器、配件和服務收入）增加到 3.56 億美元，比去年第一季度增長 23%，比 2012 年第四季度增長 3%。

Recurring revenue represented 58% of total first-quarter revenue compared with 58% in the first quarter of last year and 57% last quarter.

經常性收入佔第一季度總收入的 58%，而去年第一季度為 58%，上季度為 57%。

International results were as follows.

國際結果如下。

First-quarter revenue outside of the United States was $453 million, up 47% compared with revenue of $105 million in the first quarter of last year and up 17% compared with revenue of $131 million in the fourth quarter of 2012.

美國以外的第一季度收入為 4.53 億美元，與去年第一季度的收入 1.05 億美元相比增長 47%，與 2012 年第四季度的收入 1.31 億美元相比增長 17%。

Our year-over-year and quarter-over-quarter international revenue growth was driven by higher da Vinci system sales into the Japanese market.

我們的同比和環比國際收入增長受到日本市場達芬奇系統銷量增加的推動。

First-quarter 2013 international procedure volume was approximately 14% higher than the first quarter of 2012 and 10% higher than the fourth quarter of 2012.

2013 年第一季度的國際手術量比 2012 年第一季度高出約 14%，比 2012 年第四季度高出 10%。

During the first quarter of 2013, we sold 49 systems outside of the US compared with 35 in the first quarter of 2012 and 42 last quarter.

2013 年第一季度，我們在美國以外銷售了 49 台系統，而 2012 年第一季度為 35 台，上一季度為 42 台。

We sold 16 systems in Europe this quarter compared with 14 in the first quarter of 2012 and 24 last quarter.

本季度我們在歐洲銷售了 16 台系統，而 2012 年第一季度為 14 台，上一季度為 24 台。

Moving on to the remainder of the P&L, gross margin in the first quarter of 2013 was 71% compared with 71.9% during both the first and fourth quarters of 2012.

繼續看損益表的其餘部分，2013 年第一季度的毛利率為 71%，而 2012 年第一季度和第四季度的毛利率均為 71.9%。

Our lower first-quarter 2013 gross margin percentage resulted primarily from the impact of the medical device excise tax, partially offset by the favorable impact of higher system ASPs and higher service margins.

我們較低的 2013 年第一季度毛利率百分比主要是由於醫療器械消費稅的影響，部分被較高的系統 ASP 和較高的服務利潤率的有利影響所抵消。

Our first-quarter 2013 cost of sales included $6.5 million related to the medical device excise tax.

我們 2013 年第一季度的銷售成本包括與醫療器械消費稅相關的 650 萬美元。

First-quarter 2013 operating expenses of $183 million were up 13% compared with the first quarter of 2012 and down 4% compared with the fourth quarter of 2012.

2013 年第一季度運營費用為 1.83 億美元，與 2012 年第一季度相比增長 13%，與 2012 年第四季度相比下降 4%。

Our higher year-over-year operating expenses were primarily driven by headcount additions.

我們較高的同比運營費用主要是由於員工人數增加所致。

The sequential decrease in operating expenses was driven by lower variable compensation expense and the timing of engineering projects and other expenses.

運營費用的連續下降是由於可變補償費用減少以及工程項目和其他費用的時間安排。

First-quarter 2013 operating income was $251 million or 41% of sales compared with $193 million or 39% of sales last year and $248 million or 41% of sales for the fourth quarter of 2012.

2013 年第一季度營業收入為 2.51 億美元，佔銷售額的 41%，而去年同期為 1.93 億美元，佔銷售額的 39%，2012 年第四季度為 2.48 億美元，佔銷售額的 41%。

First-quarter 2013 operating income reflected $38 million of non-cash stock compensation expense compared with $34 million last year and $30 million last quarter.

2013 年第一季度的營業收入反映了 3800 萬美元的非現金股票補償費用，而去年同期為 3400 萬美元，上一季度為 3000 萬美元。

Our effective tax rate for the first quarter was 26% compared with 27% for the first quarter of 2012 and 31% last quarter.

我們第一季度的有效稅率為 26%，而 2012 年第一季度為 27%，上一季度為 31%。

As anticipated, our first-quarter 2013 income tax expense included a discrete benefit of approximately $7.5 million for the reinstatement of the 2012 R&D tax credit, which became effective January 1 of this year.

正如預期的那樣，我們 2013 年第一季度的所得稅費用包括約 750 萬美元的離散收益，用於恢復今年 1 月 1 日生效的 2012 年研發稅收抵免。

Otherwise, our tax rate would have been 29%.

否則，我們的稅率將是 29%。

Our tax provision for the first quarter of 2012 included a one-time benefit associated with domestic manufacturing tax credits, and otherwise, our tax rate in the quarter would have been 32%.

我們在 2012 年第一季度的稅收撥備包括與國內製造業稅收抵免相關的一次性福利，否則，我們在該季度的稅率將為 32%。

Our net income was $189 million or $4.56 per share compared with $144 million or $3.50 per share last year and $175 million or $4.25 per share for the fourth quarter of 2012.

我們的淨收入為 1.89 億美元或每股 4.56 美元，而去年為 1.44 億美元或每股 3.50 美元，2012 年第四季度為 1.75 億美元或每股 4.25 美元。

Now moving to cash flow, we ended the first quarter with cash and investments of $3.1 billion, up $196 million compared with December 31, 2012.

現在轉向現金流，我們在第一季度結束時擁有 31 億美元的現金和投資，與 2012 年 12 月 31 日相比增加了 1.96 億美元。

The increase was driven by $258 million of cash flows from operations, plus $89 million from the exercise of stock options, partially offset by $146 million in stock buy backs and $17 million of capital and IP purchases.

這一增長是由 2.58 億美元的運營現金流推動的，加上 8900 萬美元的股票期權行使，部分被 1.46 億美元的股票回購和 1700 萬美元的資本和知識產權購買所抵消。

During the first quarter, we bought back 299,000 shares at an average price of $487 per share.

第一季度，我們以每股 487 美元的平均價格回購了 299,000 股。

As recently announced, our Board of Directors has increased our share buyback authorization by $1 billion.

正如最近宣布的那樣，我們的董事會已將我們的股票回購授權增加了 10 億美元。

Including this latest authorization, we ended the quarter with approximately $1.2 billion of authorized share buybacks.

包括這項最新授權，我們在本季度結束時進行了約 12 億美元的授權股票回購。

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

有了這個，我想把它交給亞歷克斯，他將審查我們的銷售、營銷和臨床亮點。

Thank you, Marshall.

謝謝你，馬歇爾。

During the first quarter, we sold 164 da Vinci systems -- 115 in the United States, 16 into Europe and 33 into rest of world markets.

在第一季度，我們售出了 164 台達芬奇系統——115 台在美國，16 台銷往歐洲，33 台銷往世界其他市場。

As part of the 164 system sales, nine standard da Vinci systems and 30 da Vinci S systems were traded in for credit against sales for new da Vinci SI systems.

作為 164 套系統銷售的一部分，9 套標準達芬奇系統和 30 套達芬奇 S 系統用於抵扣新達芬奇 SI 系統的銷售額。

We finished the quarter with a net 125 system additions to the installed base, bringing to 2710 the cumulative number of da Vinci systems worldwide, 1957 in the United States, 430 in Europe and 323 in rest of world markets.

在本季度末，我們在安裝基礎上淨增加了 125 個系統，使全球達芬奇系統的累計數量達到 2710 個，美國為 1957 個，歐洲為 430 個，世界其他市場為 323 個。

75 of the 164 systems installed during the quarter represented repeat system sales to existing customers.

本季度安裝的 164 個系統中有 75 個代表對現有客戶的重複系統銷售。

In total, 162 of the 164 systems sold represented da Vinci SI or SIE systems, which included 48 dual-console systems.

總共售出的 164 個系統中有 162 個代表達芬奇 SI 或 SIE 系統，其中包括 48 個雙控制台系統。

The 49 system sales internationally included 25 into Japan, four into France and three into Turkey.

49 個系統在國際上銷售，其中 25 個銷往日本，4 個銷往法國，3 個銷往土耳其。

Clinically, Q1 year-over-year procedure growth was approximately 18%, led by the category of general surgery followed by GYN.

在臨床上，第一季度的手術同比增長約為 18%，其中普外科領先，其次是婦科。

General surgery growth was paced by cholecystectomy followed by colon and rectal resections.

通過膽囊切除術和結腸和直腸切除術來促進普通手術的生長。

As Gary stated, procedure growth reflected seasonality, the reduction of selling days and a slower quarter for benign dVH.

正如 Gary 所說，程序增長反映了季節性、銷售天數的減少以及良性 dVH 的季度放緩。

dVP, more specifically the rate of decline for US dVP, a topic extensively discussed, appears to be flattening out.

dVP，更具體地說是美國 dVP 的下降速度，一個被廣泛討論的話題，似乎正在趨於平緩。

US dVP was once again up on a sequential basis with a reduced rate of decline as compared to last year.

與去年相比，美國 dVP 再次環比上升，下降速度有所放緩。

Overall, other urology, as well as international dVP, showed solid growth both on a sequential and on a year-over-year basis.

總體而言，其他泌尿外科以及國際 dVP 在連續和同比基礎上均顯示出穩健的增長。

Recently released new products continue to perform well, notably Single-Site, where customer feedback has been positive and sales have remained strong.

最近發布的新產品繼續表現良好，尤其是 Single-Site，客戶反饋積極，銷售保持強勁。

Through Q1 2013, we have sold Single-Site instrument and accessory kits to approximately 630 US customers.

截至 2013 年第一季度，我們已向大約 630 名美國客戶銷售單點儀器和附件套件。

Our recently launched Vessel Sealer product has picked up clinical momentum with most of the interest coming from the specialties of colorectal, advanced general surgery and GYN.

我們最近推出的 Vessel Sealer 產品在臨床上獲得了發展勢頭，大部分興趣來自結直腸、高級普通外科和婦科專業。

The customer adoption for both da Vinci Simulator and Firefly continues to expand with 97 customers purchasing a da Vinci Simulator and 69 customers purchasing Firefly systems as part of their initial system purchase this quarter.

達芬奇模擬器和 Firefly 的客戶採用率繼續擴大，本季度有 97 名客戶購買了達芬奇模擬器，69 名客戶購買了 Firefly 系統，作為其初始系統購買的一部分。

In addition, we have begun a phased rollout of the da Vinci surgical stapling system, as well as our Single-Site hysterectomy products.

此外，我們已經開始分階段推出達芬奇手術吻合系統，以及我們的單點子宮切除術產品。

These rollouts will be expanded in a measured fashion, so we do not expect them to contribute materially to 2013 revenue.

這些部署將以有節制的方式擴大，因此我們預計它們不會對 2013 年的收入做出重大貢獻。

During the quarter, several hundred robotic abstracts and papers representing a variety of surgical specialties were published within various peer-reviewed journals, while quarterly clinical conferences produced several live da Vinci procedure transmissions, postgraduate robotic courses, podium presentations and clinical poster sessions.

在本季度，數百篇代表各種外科專業的機器人摘要和論文發表在各種同行評審期刊上，而季度臨床會議產生了幾個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 many of you know, we are currently participating at the annual SAGES conference, which is taking place in Baltimore.

眾所周知，我們目前正在參加在巴爾的摩舉行的 SAGES 年度會議。

The surgeon support we received at this conference thus far has been positive.

迄今為止，我們在本次會議上獲得的外科醫生支持是積極的。

Much of the critical press we received has been directed toward the cost efficacy of da Vinci within the specialty of GYN and, more specifically, within its use to treat benign conditions.

我們收到的許多批評性媒體都針對達芬奇在婦科專科範圍內的成本效益，更具體地說，是在其用於治療良性疾病方面。

To be clear, we believe strongly that one of our greatest growth opportunities consists of converting open hysterectomy to dVH.

需要明確的是，我們堅信我們最大的增長機會之一就是將開放式子宮切除術轉換為 dVH。

da Vinci has shown itself as a very capable and cost effective tool in expanding minimally invasive surgery to a far greater number of patients who would otherwise have undergone an open surgical procedure.

達芬奇已經證明自己是一種非常有能力且具有成本效益的工具，可以將微創手術擴展到更多原本會接受開放式手術的患者。

Open hysterectomy is where we focus.

開放式子宮切除術是我們關注的重點。

Open hysterectomy represents the largest component of our target market growth.

開放式子宮切除術是我們目標市場增長的最大組成部分。

Open hysterectomy conversions is where we deliver high patient value.

開放式子宮切除術轉換是我們提供高患者價值的地方。

Unfortunately, most of the media, as well as the ACOG commentary, were focused on da Vinci's economic profile versus either vaginal surgery or simple laparoscopy.

不幸的是，大多數媒體以及 ACOG 的評論都集中在達芬奇的經濟狀況上，而不是陰道手術或簡單的腹腔鏡檢查。

For decades, the popularity of vaginal and laparoscopy approaches to hysterectomy paled in comparison to the number of open hysterectomies being performed within the United States, which clearly explains the motivation driving our dVH opportunity.

幾十年來，與在美國進行的開放式子宮切除術的數量相比，陰道和腹腔鏡子宮切除術的普及程度相形見絀，這清楚地解釋了推動我們 dVH 機會的動機。

In a recent edition of the Journal, Gynecologic Surgery, a European study discussed this very issue.

在最近一期的《婦科手術》雜誌上，一項歐洲研究討論了這個問題。

The study emanated out of Cork University maternity hospital in Cork, Ireland, an extremely cost-sensitive market with national austerity measures in place.

該研究來自愛爾蘭科克的科克大學婦產醫院，這是一個對成本極為敏感的市場，國家採取了緊縮措施。

In the analysis, Cork U computed and compared hysterectomy-specific hospitalization costs between their hospital and a similarly sized reference hospital with a similar hysterectomy treatment mix.

在分析中，Cork U 計算並比較了他們的醫院與具有相似子宮切除術治療組合的類似規模的參考醫院之間的子宮切除術特定住院費用。

The hysterectomy treatment mix in these hospitals included open, midline incision, lower transverse incision, LAVH and vaginal hysterectomy.

這些醫院的子宮切除術治療組合包括開放、中線切口、下橫切口、LAVH 和陰道子宮切除術。

They determined that on average an open hysterectomy performed through a midline incision required an eight-day hospitalization, six days for a hysterectomy performed through a lower transverse incision, three days for an LAVH and three days for a vaginal hysterectomy.

他們確定，通過中線切口進行的開放式子宮切除術平均需要住院 8 天，通過下橫切口進行的子宮切除術需要 6 天，LAVH 需要 3 天，陰道子宮切除術需要 3 天。

They computed costs for a day of hospitalization to be approximately EUR534.

他們計算出住院一天的費用約為 534 歐元。

Cork University acquired their da Vinci system in 2008, whereas the reference hospital did not.

科克大學在 2008 年獲得了他們的達芬奇系統，而參考醫院沒有。

Following the inclusion of da Vinci, Cork University discovered that their dVH patients were spending only two days in the hospital, and GYN beds were being consumed for fewer days.

在納入達芬奇之後，科克大學發現他們的 dVH 患者在醫院只待了兩天，而 GYN 病床的使用時間也減少了。

They also reported that the rate of open surgery has been reducing by 10% per year at Cork following the introduction of dVH and is projected to represent only 5% of the total hysterectomies performed during the final year of the study, as compared to 35% open hysterectomy rate in the non-da Vinci reference hospital.

他們還報告說，在引入 dVH 後，科克的開放手術率每年減少 10%，預計僅佔研究最後一年進行的子宮切除術總數的 5%，而這一比例為 35%非達芬奇參考醫院的開放式子宮切除率。

When comparing the current mix and extrapolating over an annual basis, 280 hysterectomies, the bed-day rate is reduced from 1134 days to 756 days when incorporating da Vinci, which represents a potential annual savings of over EUR200,000.

在比較當前的組合併推斷每年 280 例子宮切除術時，如果加入達芬奇，就寢日費率從 1134 天減少到 756 天，這意味著每年可節省超過 200,000 歐元。

In the author's comments they stated, and I quote, In 2009 the American Congress of Obstetricians and Gynecologists released a statement recommending vaginal hysterectomy as the approach of choice for benign hysterectomies due to reduced operating times when compared to the laparoscopic approach.

在作者的評論中，我引用了他們所說的，2009 年美國婦產科醫師大會發表了一份聲明，建議將陰道子宮切除術作為良性子宮切除術的首選方法，因為與腹腔鏡手術相比，手術時間減少。

However, they note that laparoscopic surgery is an alternative to vaginal hysterectomy, is not -- when vaginal hysterectomy is not feasible or indicated.

然而，他們指出，腹腔鏡手術是陰道子宮切除術的替代方法，不是——當陰道子宮切除術不可行或沒有指徵時。

Increasing the rate of vaginal surgery decreases the cost of the surgery compared to the open approach due to reduced length of stay.

由於住院時間減少，與開放式手術相比，增加陰道手術率會降低手術成本。

Consideration must be given to the fact that not all surgeries are amendable to the vaginal approach, close quote.

必須考慮到並非所有手術都可以修改為陰道方法這一事實，密切引用。

One could argue that the same commentary would pertain to the laparoscopic approach in that it, too, has remained in the minority due to clinical and/or technical challenges.

有人可能會爭辯說，同樣的評論也適用於腹腔鏡方法，因為由於臨床和/或技術挑戰，它也仍然是少數。

The authors concluded their paper by stating, and I quote, robotic surgery is associated with reduced hospital stay compared with open surgery.

作者總結了他們的論文，我引用了，與開放手術相比，機器人手術與縮短住院時間有關。

While the initial outlay is expensive, the increased number of patients amendable to this minimally access approach compared with conventional keyhole surgery has the potential for financial savings, close quote.

雖然最初的費用很昂貴，但與傳統的鎖孔手術相比，這種最小訪問方法的患者數量增加，有可能節省資金，接近報價。

da Vinci colorectal resections have been expanding rapidly over the past several quarters.

達芬奇結直腸切除術在過去幾個季度迅速擴大。

The uptake has been driven by surgeons seeking to offer patients a less invasive alternative to open colorectal surgery.

外科醫生尋求為患者提供一種侵入性較小的替代開放式結直腸手術的方法，推動了這一趨勢。

While laparoscopic colorectal surgery has been proven to be safe and effective and has for years been available within several leading institutions throughout the world, it has nonetheless remained largely under penetrated within the United States.

雖然腹腔鏡結直腸手術已被證明是安全有效的，並且多年來已在全球多家領先機構中使用，但它在美國的普及率仍然很低。

In a recent edition of the Journal, Surgical Endoscopy, a study entitled Total Mesorectal Excision - a Comparison of Oncologic and Functional Results Between Robotic and Laparoscopic Rectal Surgery was published.

在最近一期的《外科內窺鏡》雜誌上，發表了一項題為“全直腸系膜切除術——機器人和腹腔鏡直腸手術之間腫瘤學和功能結果的比較”的研究。

The study, conducted in Rome, was based on 100 patients who had undergone minimally invasive anterior rectal resections with total mesorectal incisions or TME, 50 consecutive robotic rectal anterior resections with TME were compared to the first 50 consecutive laparoscopic rectal resections with TME.

這項在羅馬進行的研究基於 100 名接受了全直腸系膜切口或 TME 的微創直腸前部切除術的患者，將 50 次連續的機器人直腸前部切除術與 TME 進行了比較，與前 50 次連續的腹腔鏡直腸切除術與 TME 進行了比較。

The authors made several comparisons, which included operating time, conversion rate, lymph node yields, circumferential margins, length of stay and sexual function scores.

作者進行了幾項比較，包括手術時間、轉化率、淋巴結產量、周緣、住院時間和性功能評分。

They reported that the operative times were similar between the two groups with da Vinci holding only a slight advantage.

他們報告說，兩組的手術時間相似，達芬奇僅佔微弱優勢。

Lymph node yields were greater using da Vinci, 16.5 versus 13.8.

使用達芬奇的淋巴結產量更高，分別為 16.5 和 13.8。

Conversions to open surgery were 0% within the da Vinci cohort as compared to 12% for the laparoscopic cohort.

在達芬奇隊列中，開腹手術的轉化率為 0%，而腹腔鏡隊列為 12%。

The circumferential margins, less than 2 millimeters, were zero using da Vinci as compared to 12% for the lap group.

使用達芬奇時，小於 2 毫米的圓周邊緣為零，而膝部組為 12%。

In the author's conclusion, they wrote and I quote, robotic TME is oncologically safe and adequate for rectal cancer treatment, showing better results than laparoscopic TME in terms of circumferential margins, conversions and hospital length of stay, better recovery in voiding and sexual function is achieved with the robotic technique, close quote.

在作者的結論中，他們寫道，我引用，機器人 TME 在腫瘤學上是安全的，並且足以治療直腸癌，在圓周邊緣、轉換和住院時間方面顯示出比腹腔鏡 TME 更好的結果，更好地恢復排尿和性功能是用機器人技術實現，關閉報價。

In the early days of an emerging procedure, single center comparative analysis with strong findings lays the foundation for larger and more comprehensive comparative studies.

在新興程序的早期，具有強大發現的單中心比較分析為更大規模和更全面的比較研究奠定了基礎。

We would expect this trend to continue within the field of colon and rectal surgery.

我們預計這種趨勢將在結腸和直腸手術領域繼續存在。

This concludes my remarks, and I will now turn the time over to Calvin.

我的發言到此結束，現在我將把時間交給 Calvin。

Thank you, Alex.

謝謝你，亞歷克斯。

I will be providing you with updated to our financial forecast for 2013, including procedures, revenues and other elements of the income statement on a GAAP basis.

我將向您提供我們 2013 年財務預測的最新信息，包括程序、收入和基於公認會計原則的損益表的其他要素。

I will also provide estimates of significant non-cash expenses to provide you with visibility into our expected future cash flows.

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, on our last call, we projected our full-year 2013 procedures to grow approximately 20% to 23% from the base of approximately 450,000 procedures performed in 2012.

從程序開始，在我們上次的電話會議上，我們預計 2013 年全年的程序將在 2012 年執行的約 450,000 個程序的基礎上增長約 20% 至 23%。

Now, based upon first-quarter procedure trends, we expect our full-year 2013 procedure growth to be in the lower end of that range.

現在，根據第一季度的程序趨勢，我們預計 2013 年全年的程序增長將處於該範圍的低端。

Moving on to revenues, last quarter we forecasted full-year 2013 revenue growth of between 16% and 19%.

轉向收入，上個季度我們預測 2013 年全年收入增長在 16% 到 19% 之間。

Based upon favorable new instrument and accessory product sales and utilization, we now expect full-year 2013 revenue growth at the higher end of that range.

基於有利的新儀器和配件產品銷售和利用率，我們現在預計 2013 年全年收入增長在該範圍的較高端。

Our first-quarter system ASP of $1.55 million was higher than we expected, reflecting a high proportion of dual-console configurations in the system mix.

我們第一季度的系統 ASP 為 155 萬美元，高於我們的預期，反映出系統組合中雙控制台配置的比例很高。

Going forward in 2013, we would expect our systems product mix and overall systems ASP to return towards historical 2012 levels.

展望 2013 年，我們預計我們的系統產品組合和整體系統 ASP 將回到 2012 年的歷史水平。

Now turning to operating income, we continue to expect full-year operating income to fall within a range of between 38% and 39% of net revenue.

現在轉向營業收入，我們繼續預計全年營業收入將在淨收入的 38% 至 39% 之間。

Our first-quarter operating margin of 41% reflected favorable system pricing and timing of operating expenses.

我們第一季度 41% 的營業利潤率反映了有利的系統定價和運營費用的時間安排。

In Q2 we would expect operating expenses to increase at least $15 million, reflecting higher variable compensation, prototype, headcount, stock compensation and legal expenses.

在第二季度，我們預計運營費用將至少增加 1500 萬美元，這反映了更高的可變薪酬、原型、員工人數、股票薪酬和法律費用。

We continue to expect 2013 stock compensation to total between $184 million and $192 million for the year.

我們繼續預計 2013 年的股票薪酬總額將在 1.84 億美元至 1.92 億美元之間。

Timing of recognition should follow a quarterly pattern similar to 2012.

識別時間應遵循類似於 2012 年的季度模式。

Amortization of purchased intellectual property, which is mostly recorded as R&D expense, is still expected to come in between $28 million and $30 million in 2013.

購買的知識產權的攤銷，主要記錄為研發費用，預計在 2013 年仍將在 2800 萬美元至 3000 萬美元之間。

We continue to expect other income to total between $18 million and $22 million in 2013.

我們繼續預計 2013 年其他收入總額將在 1800 萬美元至 2200 萬美元之間。

With regard to income tax, as Marshall described, our Q1 tax rate reflected the benefit related to the reinstatement of the 2012 R&D tax credit.

關於所得稅，正如馬歇爾所描述的，我們的第一季度稅率反映了與恢復 2012 年研發稅收抵免相關的好處。

For the rest of this year, we continue to anticipate our tax rate to fall within a range of between 28% and 30% of pretax income.

在今年餘下的時間裡，我們繼續預計我們的稅率將在稅前收入的 28% 至 30% 之間。

Our share count for calculating EPS in Q1 2013 was approximately 41.4 million shares.

我們計算 2013 年第一季度每股收益的股票數量約為 4140 萬股。

Going forward, our share count will depend upon the magnitude and timing of share buybacks.

展望未來，我們的股票數量將取決於股票回購的規模和時間。

We will continue to be thoughtful in our execution of the $1.2 billion authorized by the Board for that purpose.

在執行董事會為此目的授權的 12 億美元時，我們將繼續深思熟慮。

That concludes our prepared remarks.

我們準備好的發言到此結束。

We will now open the call to your questions.

我們現在將打開您的問題的電話。

Operator?

操作員？

(Operator instructions) Tycho Peterson, JPMorgan.

（操作員說明）Tycho Peterson，摩根大通。

It's [Evan Lodesen] for Tycho.

第谷是[埃文·洛德森]。

I guess the first question was for Gary.

我猜第一個問題是問加里的。

Can you disaggregate the slowdown in benign dVH between the seasonal effects that you mentioned such as deductibles and then also the more coordinated efforts that you talked with regards to the robot, specifically?

您能否將良性 dVH 的放緩分解為您提到的諸如免賠額之類的季節性影響以及您談到的關於機器人的更協調的努力？

I think I heard the question, although there's a little bit of background noise on the phone.

我想我聽到了這個問題，雖然電話裡有一點背景噪音。

I think the question was, can we disaggregate the benign hysterectomy slowdown?

我認為問題是，我們可以分解良性子宮切除術的放緩嗎？

I think there's a few things going on there.

我認為那裡發生了一些事情。

As we look at multiport benign hysterectomy in total, we think our market opportunity is really the open surgical market share.

當我們全面研究多端口良性子宮切除術時，我們認為我們的市場機會實際上是開放的手術市場份額。

There's still more than 100,000 open benign hysterectomies being done in the US.

美國仍有超過 100,000 例開放式良性子宮切除術正在進行中。

We see three issues impacting benign hysterectomy.

我們看到了影響良性子宮切除術的三個問題。

First, as we become a larger part of the market, the impact of seasonality plays an proportionally bigger role in our performance.

首先，隨著我們成為市場的更大一部分，季節性的影響在我們的表現中發揮著更大的作用。

Said simply, when a new technique just a small part of the market, the number of unserved patients is sufficiently large that changes in the total number of patient admissions do not materially impact growth.

簡單地說，當一項新技術只是市場的一小部分時，未得到服務的患者數量足夠多，以至於患者入院總數的變化不會對增長產生實質性影響。

However, as penetration increases, the sensitivity to total admissions increases with it.

然而，隨著滲透率的增加，對總入學率的敏感性也隨之增加。

Second, several large healthcare organizations are reporting a greater than expected decline in patient admissions in the first quarter.

其次，幾家大型醫療機構報告第一季度患者入院人數下降幅度大於預期。

Given that benign hysterectomy is a large part of our procedure base, that will impact us as well.

鑑於良性子宮切除術是我們手術基礎的很大一部分，這也會影響我們。

Third, negative press has some hard-to-measure impact on benign hysterectomy, although it doesn't appear to be large.

第三，負面新聞對良性子宮切除術有一些難以衡量的影響，儘管它似乎並不大。

It's also probably not zero.

它也可能不為零。

And then, the second question -- you mentioned international procedure growth was about 14%.

然後，第二個問題——你提到國際程序增長約為 14%。

Could you help us think about what the growth is in Europe and trends there that you have seen recently?

您能否幫助我們思考一下歐洲的增長情況以及您最近看到的趨勢？

Just numerically, the 14% would be higher on the Asia and rest of world markets and a bit lower on the European side.

僅從數字上看，亞洲和世界其他市場的 14% 會更高，而歐洲市場會更低。

Benjamin Andrew with William Blair.

本傑明安德魯與威廉布萊爾。

Gary, talk a little bit about the guidance of 20% to 23% and targeting the low end of that range.

加里，談談 20% 到 23% 的指導，並針對該範圍的低端。

What does it take for you to hit that 20%?

你需要什麼才能達到那 20%？

Does it require a stabilization in benign dVH and, again, continued stabilization of prostatectomy?

是否需要穩定良性 dVH 並再次穩定前列腺切除術？

And just maybe walk through how you get to that 20% because we're struggling a little bit as we try to plug in the number for Q1 to get there.

或許你可以了解一下你是如何達到那 20% 的，因為我們在嘗試插入 Q1 的數字以達到那裡時有點掙扎。

A couple of things, and then Calvin may help you a little bit with that as well.

有幾件事，然後 Calvin 也可以幫助你。

But as we look out, we have seen three quarters in a row with prostatectomy where it's finding its footing with regard to [aduwes] so we are assuming that that trend stays about the same as we go through.

但正如我們所看到的，我們已經連續四分之三看到前列腺切除術在 [aduwes] 方面找到了立足點，因此我們假設這種趨勢與我們經歷的情況大致相同。

General surgery has shown real strength.

普外科顯示出了真正的實力。

On benign gynecology, I want to make sure we are separating out gynecologic procedures from just hysterectomy.

關於良性婦科，我想確保我們將婦科手術與子宮切除術分開。

There's more in benign gynecology than just hysterectomy; there's myomectomy and sacrocolpopexy, both of which were meeting our expectations in this quarter.

良性婦科不僅僅是子宮切除術。有肌瘤切除術和骶骨固定術，這兩者都符合我們本季度的預期。

The quarter is a little bit hard to interpret just because of the number of operating days, and there's a little bit of ambiguity as to how many there were in terms of how the holiday played.

僅僅因為營業天數，這個季度有點難以解釋，而且就假期的運作方式而言，有多少天有點模糊。

And we will have to see a little bit.

我們將不得不看到一點。

Impossible to predict the future perfectly.

不可能完美地預測未來。

We look out and think that our guidance at the low end makes sense, given those three factors together.

考慮到這三個因素，我們期待並認為我們在低端的指導是有道理的。

As we look at our guidance, there are a lot of moving parts, more and more, as you realize.

當我們查看我們的指導時，正如您所意識到的，有很多活動部分，越來越多。

But the key areas of growth are the same as they were entering the year, specifically the number of new procedures coming from US general surgery, US gynecology and international PPP are going to be still the largest areas of growth.

但增長的關鍵領域與今年一樣，特別是來自美國普外科、美國婦科和國際 PPP 的新手術數量仍將是最大的增長領域。

As Gary said, based upon customer insurgent feedback we have not seen a major impact on the benign dVH procedure demand, although we cannot really predict where that may hit in the future.

正如 Gary 所說，根據客戶反叛的反饋，我們沒有看到對良性 dVH 程序需求的重大影響，儘管我們無法真正預測未來可能會在哪裡受到影響。

We expect seasonality to play through and we will benefit later in the year on some of these things as well.

我們預計季節性因素會發揮作用，我們也將在今年晚些時候受益於其中一些事情。

And we do forecast that dVP has bottomed out.

我們確實預測 dVP 已經觸底。

So I think that's --

所以我認為那是——

Having said that, nobody has a crystal ball.

話雖如此，沒有人有水晶球。

And we will take it one quarter at a time.

我們將一次接受四分之一。

Two more quick questions, Gary.

加里，還有兩個快速的問題。

Are you hearing additional chatter or disturbing chatter from either surgeons or hospitals questioning the safety and perhaps the efficacy of the system?

您是否從外科醫生或醫院聽到額外的喋喋不休或令人不安的喋喋不休，質疑該系統的安全性和有效性？

I know that's really hard to quantify, but does it feel different now than it did a month ago?

我知道這真的很難量化，但現在感覺和一個月前有什麼不同嗎？

And were the trends in the quarter something that got your attention?

本季度的趨勢是否引起了您的注意？

It's interesting.

這真有趣。

With regard to surgeon feedback on use of our device, the safety and stability of it, surgeons are the ones who are absolutely closest to it.

關於外科醫生對我們設備使用的反饋，它的安全性和穩定性，外科醫生是絕對最接近它的人。

They work with it every day.

他們每天都在使用它。

We have seen very little change in their viewpoint in terms of people who actually know the device.

就實際了解該設備的人而言，我們看到他們的觀點幾乎沒有變化。

And likewise, that's true with hospitals who are our customers.

同樣，作為我們客戶的醫院也是如此。

These kinds of questions do come up in conversations.

這類問題確實會在對話中出現。

They come up in conversation with sales teams.

他們與銷售團隊進行對話。

But we have not seen a substantial change in the nature of that conversation, say, over the last few weeks of the quarter as we go through it.

但我們並沒有看到這種對話的性質發生重大變化，比如在本季度的最後幾週，我們正在經歷它。

Okay, and then, finally, you mentioned something intriguing about SG&A spending popping up in the second quarter.

好的，然後，最後，您提到了第二季度出現的 SG&A 支出的一些有趣的事情。

I thought I heard prototyping in the middle of that list.

我以為我在該列表的中間聽到了原型設計。

Can you describe that at all?

你能描述一下嗎？

Yes.

是的。

We have always said prototypes are going to be lumpy.

我們一直說原型會很粗糙。

Right?

正確的？

And I think if you look sequentially at operating expenses, they decline from Q4 to Q1 and it was relatively light in the areas that Marshall mentioned in his script.

而且我認為，如果您按順序查看運營費用，它們從第四季度到第一季度有所下降，而且馬歇爾在他的劇本中提到的領域相對較輕。

And I think you are going to see a pickup in the items that I mentioned including prototypes.

而且我認為您會看到我提到的包括原型在內的項目的回升。

Then, you had asked the question, just to follow up, on surgeon's view and surgeon's commentary on it.

然後，你問了這個問題，只是為了跟進外科醫生的觀點和外科醫生的評論。

I will tell you one surgeon's comments to me with regard to some of the criticism that has been up there.

我會告訴你一位外科醫生對我的評論關於那裡的一些批評。

He came back and said, hey, open surgery hasn't gotten any better for patients and laparoscopy hasn't gotten any easier for surgeons.

他回來說，嘿，開放手術對患者來說並沒有變得更好，腹腔鏡對外科醫生來說也沒有變得更容易。

And I think that's true.

我認為這是真的。

We have definitely heard the same thing.

我們肯定聽說過同樣的事情。

Thank you.

謝謝你。

Lennox Ketner, Bank of America.

美國銀行的倫諾克斯·凱特納。

Just a few questions -- first, I'm sorry if I missed it.

只是幾個問題——首先，如果我錯過了，我很抱歉。

I think you said that dVP was down about 11% year-over-year.

我認為您說 dVP 同比下降了約 11%。

But last quarter you had provided, I think, the overall growth rates for both general surgery and gynecology as well.

但我認為，上個季度您還提供了普通外科和婦科的總體增長率。

Is that something you would be willing to break out this time?

這一次你願意突破嗎？

We do that on an annual basis and not quarterly.

我們每年都這樣做，而不是每季度一次。

Okay, had to try.

好吧，不得不試試。

And then on the stapler, I was a little surprised to hear you say that people shouldn't be expecting any meaningful contribution from that product this year, just given that it's been on the market for six months or so now or, sorry, been approved, at least, for six months now.

然後在訂書機上，聽到你說人們不應該期待今年該產品有任何有意義的貢獻，我有點驚訝，因為它已經上市六個月左右，或者，對不起，已經現在至少批准了六個月。

Could you maybe just give us a little more color in terms of why the launch of that product is expected to be so measured?

您能否就為什麼預計該產品的發佈如此謹慎，給我們更多的色彩？

Are there additional features that need to be added to the stapler to make it more effective?

訂書機是否需要添加其他功能以使其更有效？

Or is it really just wanted to make sure that the initial customer experiences are good?

還是真的只是想確保最初的客戶體驗是好的？

If you could maybe just give people a little bit more of an explanation as to why that launch is expected to take so long or why it's expected to take so long assuming meaningful contribution?

如果您可以給人們更多的解釋，說明為什麼該發布預計需要這麼長時間，或者假設有意義的貢獻為什麼預計需要這麼長時間？

For starters, while we had the approval last year, the first clinical cases are -- happened in this quarter.

首先，雖然我們去年獲得了批准，但第一批臨床病例發生在本季度。

And really, the reason for it is twofold.

事實上，它的原因是雙重的。

One is we want to have outstanding first customer experiences with it.

一是我們希望通過它獲得出色的首次客戶體驗。

So far, we have.

到目前為止，我們有。

The second thing is the supply chain for the surgical stapler is a long one.

第二件事是外科縫合器的供應鏈很長。

It's a full system.

這是一個完整的系統。

It has electronics in it, software in it, motor packs and single-use sterilizable products.

它裡面有電子設備、軟件、電機組和一次性可消毒產品。

So, we want to make sure that that supply chain is exceptionally stable and ready.

因此，我們希望確保該供應鏈異常穩定和準備就緒。

Coming as we move to scale.

隨著我們擴大規模，即將到來。

And it's really working those two things in parallel to make sure we get a great result.

它實際上是在並行工作這兩個方面，以確保我們得到一個很好的結果。

Stapling is a subtle product.

裝訂是一種微妙的產品。

There are a lot of things about it in terms of both its manufacture and its use that you want to make sure you get right.

就其製造和使用而言，您要確保自己做對了很多事情。

And so we will be doing that.

所以我們將這樣做。

And as we start to see that stability, then we will start to ramp the release.

當我們開始看到這種穩定性時，我們將開始加速發布。

Okay.

好的。

But from a feature standpoint, you feel confident that the version that you have now has all the features that it needs to ultimately be successful?

但是從功能的角度來看，您是否確信您現在擁有的版本具有最終成功所需的所有功能？

It does.

確實如此。

Now, remember we have talked in the past that we are focusing this first stapler on the colorectal market.

現在，請記住我們過去曾說過，我們將第一台訂書機的重點放在結直腸市場上。

And so the size of the staple loads both in terms of their length and the size of the staples that go in these little cartridges are optimized for colorectal.

因此，就其長度而言，裝訂量的大小和裝在這些小盒中的訂書釘尺寸都針對結腸直腸進行了優化。

In time we will start to add different sized cartridges and different leg length staples to allow us to do other things.

隨著時間的推移，我們將開始添加不同尺寸的墨盒和不同腿長的訂書釘，以便我們做其他事情。

So this is really just the first step in a multistep process.

所以這實際上只是多步驟過程的第一步。

But it's not the lack of a particular feature for colorectal that has us moving at the pace we are moving.

但是，讓我們以我們正在移動的速度移動的並不是結腸直腸缺乏特定的功能。

Okay, that's helpful.

好的，這很有幫助。

And then last one, just on the buyback authorization -- I think it was obviously a much larger authorization that you guys have done in the past.

然後是最後一個，只是關於回購授權——我認為這顯然是你們過去所做的更大的授權。

I think people are happy to see, but how should we think about the timing of that going forward?

我認為人們很高興看到，但我們應該如何考慮未來的時機？

In the past, [US] has been pretty measured buybacks over time.

過去，[美國]隨著時間的推移進行了相當謹慎的回購。

Should we expect this one to occur any more quickly than the others or is it going to continue to be at the same pace as the others by being a larger overall authorization?

我們是否應該期望這個比其他的發生得更快，或者它是否會通過更大的整體授權繼續與其他人保持相同的速度？

I think you have somewhat characterized how we have approached it.

我認為您已經對我們的處理方式有所描述。

We have not been mechanical; we have been very thoughtful about what we have done and we will continue to be thoughtful.

我們不是機械的；我們對我們所做的事情非常深思熟慮，我們將繼續深思熟慮。

So you shouldn't look for any particular standard pattern, if you will.

因此，如果您願意，您不應該尋找任何特定的標準模式。

We will look for the right opportunities to buy back, over time.

隨著時間的推移，我們將尋找合適的回購機會。

David Roman, Goldman Sachs.

大衛羅曼，高盛。

I was hoping you could talk a little bit more about any efforts you are undertaking or look to undertake to address the weakness in dVH.

我希望您能多談談您正在或打算解決 dVH 弱點的任何努力。

Obviously, the seasonal piece in macro dynamics are what they are.

顯然，宏觀動態中的季節性部分就是如此。

But maybe any sort of impact you have had from the recent noise in the marketplace, what is your plan to start to stem that and then how long do you think it might take before we start to see some positive return from those efforts?

但也許你從最近的市場噪音中產生了任何影響，你有什麼計劃開始阻止這種影響，然後你認為在我們開始看到這些努力帶來一些積極的回報之前可能需要多長時間？

On the first comment of what do we think there is, in terms of opportunity in benign dVH, first of all we look out and say open procedures that are still being done through a laparotomy are great opportunities for us.

關於我們認為存在什麼的第一個評論，就良性 dVH 的機會而言，首先我們注意並說仍在通過剖腹手術完成的開放手術對我們來說是很好的機會。

We look around the country to see where those are and our ability to serve those patients.

我們環顧全國，看看它們在哪里以及我們為這些患者服務的能力。

That's our primary opportunity.

這是我們的首要機會。

You implied in your discussion that the negative press is having a fair impact in this.

您在討論中暗示負面新聞對此產生了公平的影響。

It's not clear that that's true.

目前尚不清楚這是否屬實。

Right now, separating out how much of this is seasonality, how much is just a total inpatient admission and how much is specific to intuitive is actually a hard thing to tease apart.

現在，要區分其中有多少是季節性的，有多少只是住院總入院，有多少是特定於直覺的，實際上是一件很難區分的事情。

Having said that, I think the strength of da Vinci surgery has been in its clinical outcomes.

話雖如此，我認為達芬奇手術的優勢在於其臨床結果。

And so that's where we start, relative to open surgery both in the publications and in the education of our sales team and the interaction with hospitals, it's that set of data.

所以這就是我們開始的地方，相對於出版物和我們銷售團隊的教育以及與醫院的互動中的開放手術，它就是那組數據。

And so we have done and we will continue to do that in terms of supplying them the data and resources they need to approach those patients.

所以我們已經做到了，我們將繼續這樣做，為他們提供接觸這些患者所需的數據和資源。

Over time, as we go through the year, we have Single-Site hysterectomy, which is really a little bit different marketplace.

隨著時間的推移，隨著時間的推移，我們進行了單點子宮切除術，這確實是一個有點不同的市場。

And that's, again, not looking so much at open procedures but looking at those patients who would rather have a single incision than multiport.

再說一次，不是過多地關注開放式手術，而是著眼於那些寧願單切口而不是多端口的患者。

And that, as we get to the close of the year, might just start to give us an opportunity to access a different group of patients.

而且，隨著我們接近今年年底，這可能剛剛開始給我們一個接觸不同患者群體的機會。

That's helpful.

這很有幫助。

And I know a lot of the questions on this call regarding market recent noise or marketplace concerns have been focused on gynecology.

我知道本次電話會議中關於市場近期噪音或市場擔憂的許多問題都集中在婦科。

But is it fair to say that hasn't trickled into the other parts of your business or the newer categories like general surgery that continues to be fairly robust, in your ability to attract new users, train new users?

但是，公平地說，在您吸引新用戶、培訓新用戶的能力方面，這並沒有滲透到您業務的其他部分或像普通外科這樣的新類別中嗎？

Any change in the size of your training classes, interest level?

你的培訓班的規模、興趣水平有什麼變化嗎？

Any other metrics that you could help us to gauge this looming question around noise versus reality?

您還有什麼其他指標可以幫助我們衡量這個關於噪音與現實的迫在眉睫的問題嗎？

We have not seen a change in the desire for people to be trained.

我們還沒有看到人們接受培訓的願望發生了變化。

We haven't seen anything that I can point to in the general surgery marketplace that would indicate a real impact.

在普通外科市場上，我們還沒有看到任何可以表明真正影響的東西。

Yes.

是的。

And again, I think evidence of that, that we have that helps us make that statement, are the actual procedure numbers, the number of people who are accessing proctors and training.

再一次，我認為可以幫助我們做出這一聲明的證據是實際的程序數量，訪問監考人員和培訓的人數。

And just as a level set, GYN, if you look at things like say, (inaudible) myomectomy and endometriosis resection, GYN is a -- and hysterectomy for malignant conditions, it is a very robust category.

就像一個水平集一樣，GYN，如果你看一下，（聽不清）子宮肌瘤切除術和子宮內膜異位切除術，GYN 是一個 - 並且針對惡性疾病的子宮切除術，它是一個非常強大的類別。

And while dVH benign is certainly the largest individual segment of that category, as we look out over all of GYN, we remain very encouraged.

雖然 dVH 良性肯定是該類別中最大的個體部分，但當我們縱觀整個 GYN 時，我們仍然非常鼓舞。

Okay.

好的。

And maybe last question, just to follow up on the share repurchase authorization -- in the past, I think you guys have used share repurchase to offset the impact of options being exercised and it has been not a top use of cash but something that you have done to manage options, dilution.

也許最後一個問題，只是為了跟進股票回購授權——過去，我認為你們已經使用股票回購來抵消被行使的期權的影響，這不是現金的最高用途，而是你已經做了管理選項，稀釋。

Is anything different or is there a prioritization to think about this $1 billion authorization, or it's just the cash balance has gotten to where it is, the stock price is where it is, so you need more to offset the impact of options exercised?

有什麼不同，或者是否有優先考慮這 10 億美元的授權，或者只是現金餘額已經到了它的位置，股票價格就是它的位置，所以你需要更多來抵消行使期權的影響？

I think, number one, is the authorization reflected confidence in the business.

我認為，第一，是授權反映了對業務的信心。

But I think that it's also intended to be a return to shareholders.

但我認為這也是為了回報股東。

We are talking about $1 billion.

我們談論的是 10 億美元。

That more than offsets any stock option dilution that we create through here.

這足以抵消我們在這裡創建的任何股票期權稀釋。

Lawrence Keusch.

勞倫斯·庫施。

Gary, there has been obviously a lot of discussion focused on procedures and the impact from the critics over the last several months.

加里，在過去的幾個月裡，顯然有很多討論集中在程序和批評者的影響上。

But I'm wondering if we can perhaps shift toward system sales, obviously quite strong this quarter.

但我想知道我們是否可以轉向系統銷售，本季度顯然相當強勁。

But I'm wondering if you are seeing anything change in the selling cycle or there have been some speculation that hospitals may hold back on purchasing while there is all this noise out there.

但我想知道您是否看到銷售週期有任何變化，或者有人猜測醫院可能會在所有這些噪音出現時停止採購。

So any color would be helpful.

所以任何顏色都會有幫助。

All I can speak to is the first quarter, and looking at the first quarter we haven't seen any meaningful impact of negative press on capital sales.

我只能說第一季度，從第一季度來看，我們沒有看到負面新聞對資本銷售產生任何有意義的影響。

In fact, the capital side was pretty strong, as we mentioned, not only in systems as a whole but in the attachment of some of the products we've added to SI.

事實上，正如我們所提到的，資本方面非常強大，不僅在整個系統中，而且在我們添加到 SI 的一些產品的附件中。

So console sales, simulator sales, Firefly demand have continued to be strong.

所以主機銷售、模擬器銷售、螢火蟲需求持續強勁。

Again, don't have a crystal ball as to what happens in the future.

再說一次，不要對未來會發生什麼有一個水晶球。

But so far the conversations have been pretty straightforward.

但到目前為止，對話非常簡單。

Okay, great.

好，太棒了。

And then this also has come up over the last several calls.

然後在過去的幾次電話會議中也出現了這種情況。

You have expressed some need to work on the European organization.

你已經表達了在歐洲組織工作的一些需要。

So I'm just curious, kind of take your temperature a little bit on where we are in that process.

所以我只是好奇，稍微了解一下我們在這個過程中所處的位置。

I think that we have been making good progress.

我認為我們已經取得了很好的進展。

I think that it's been measured but we have been adding resources in a few places.

我認為它已被衡量，但我們一直在一些地方添加資源。

Some of it has been leadership resources, some of it has been people in the sales force, experienced people in the sales force.

其中一些是領導資源，一些是銷售人員，銷售人員中經驗豐富的人員。

And some of it is in areas such as regulatory and reimbursement.

其中一些是在監管和報銷等領域。

We have made some great hires there.

我們在那裡做了一些很棒的招聘。

They are integrating well.

他們整合得很好。

And as we have said in the past, this is something that will happen over quarters, not over days.

正如我們過去所說，這將在幾個季度而不是幾天內發生。

But we are pleased with our progress.

但我們對我們的進步感到高興。

Okay, and then lastly just on the uses of cash, obviously share repurchase remains out there.

好的，最後只是關於現金的使用，顯然股票回購仍然存在。

But what are the latest thoughts around potentially using cash for some M&A opportunities?

但是，關於可能將現金用於某些併購機會的最新想法是什麼？

I think our eyes are always open for opportunities for a few things.

我認為我們總是睜大眼睛尋找一些事情的機會。

And some of it has been, as you know, in the past looking for technologies that we think fit really well with robotic surgery and advancing the ability of surgeons in the system to do more.

如您所知，其中一些過去一直在尋找我們認為非常適合機器人手術的技術，並提高系統中外科醫生的能力以做更多的事情。

We continue to be looking for and able to acquire those things that we think make a difference.

我們將繼續尋找並能夠獲得那些我們認為會有所作為的東西。

We also think that investments in markets not in the United States are really important.

我們還認為，在美國以外的市場進行投資非常重要。

You've seen us do that in the past and we continue to do so in terms of investing into existing organizational frameworks in Japan and in Korea and also positioning ourselves for success in other markets OUS.

您已經看到我們過去這樣做了，我們將繼續這樣做，以投資於日本和韓國的現有組織框架，並將自己定位為在其他市場取得成功。

And having cash helps us do that as well.

擁有現金也可以幫助我們做到這一點。

Okay, terrific, thank you.

好的，太好了，謝謝。

David Lewis, Morgan Stanley.

大衛劉易斯，摩根士丹利。

Hello, this is actually John in for David.

你好，這實際上是大衛的約翰。

So we had a few questions, one just while procedures were a little bit slower than expected, instrument revenue is still strong.

所以我們有幾個問題，一個只是程序比預期慢一點，儀器收入仍然強勁。

And I guess that was more related to the revenue per procedure being higher.

我想這與每個程序的收入更高有關。

And I was wondering if you could maybe break that out and how much of that was really the stocking versus how much of that was some more advanced tools?

我想知道你是否可以打破它，其中有多少是真正的長襪，而其中有多少是一些更高級的工具？

You mentioned thoughts on the system ASP as being normalized down a bit.

您提到對系統 ASP 的想法被規範化了一點。

Any thoughts to where revenue per procedure should go throughout the year?

對全年每個程序的收入應該去哪裡有任何想法嗎？

We have actually seen a bit of an uptick in what we call the base.

我們實際上已經看到我們所說的基礎有所上升。

So if you parse out stocking orders associated with new system purchases, we see a little uptick in the base.

因此，如果您分析與新系統採購相關的庫存訂單，我們會看到基數略有上升。

And that reflects the new products.

這反映了新產品。

So that reflects usage of Firefly, usage of vessel sealing.

所以這反映了螢火蟲的使用，容器密封的使用。

And I think it was also benefited -- the quarter was also benefited by the timing of purchases of INA through distributors and other customers, where they are entering their new fiscal year, so they may have bought more.

我認為它也受益了——本季度也受益於通過分銷商和其他客戶購買 INA 的時機，他們正在進入新的財政年度，因此他們可能購買了更多。

So I think it was a little bit higher than maybe we would expect going forward.

所以我認為它比我們未來預期的要高一點。

But it's definitely being benefited by the new product.

但它肯定會從新產品中受益。

Yes, and we have always talked is a lot of moving parts in this overall instrument accessory per procedure.

是的，我們一直在談論每個程序的整個儀器附件中有很多活動部件。

We have talked in the past about a national trend downward as the impact of stocking orders becomes less on a larger installed base and procedure mix, moving towards a simpler mix, may move it downwards.

我們過去曾談到全國性的下降趨勢，因為庫存訂單對更大的安裝基礎和程序組合的影響越來越小，向更簡單的組合移動，可能會向下移動。

But now that we are seeing the impact of the new products, even beyond the initial stocking of the new products as we have talked before, we are talking about utilization of products like the Vessel Sealer and the Firefly in procedures, which -- getting those procedures utilized and those products used in procedures it is allowing us really to capture a larger portion of the hospital's procedures spend through the da Vinci platform.

但是現在我們看到了新產品的影響，甚至超出了我們之前討論過的新產品的初始庫存，我們正在談論在程序中使用 Vessel Sealer 和 Firefly 等產品，獲得那些使用的程序和程序中使用的那些產品，它使我們能夠真正通過達芬奇平台獲得醫院程序支出的大部分。

And so directionally, we probably see that winning the day, at least for the balance of this year.

因此，在方向上，我們可能會看到這一天，至少在今年餘下的時間裡。

Thank you, very helpful.

謝謝，很有幫助。

And then a quick follow-up on Single-Site chole.

然後快速跟進 Single-Site chole。

First I was more curious, too, if you could break out how much Single-Site chole is out of all choles and then also just seeing kits increase each year on the Single-Site side and I was wondering if you could maybe discuss how much of those are repeat buyers, how much of those are new adopters and just what you've seen there.

首先，我也很好奇，如果你能找出所有 choles 中有多少 Single-Site chole，然後還看到 Single-Site 方面的套件每年都在增加，我想知道你是否可以討論一下其中是重複購買者，其中有多少是新的採用者，以及您在那裡看到的。

Yes.

是的。

At this point in time the Single-Site chole -- it is really moving from an initial introduction in some key element of our business here, a lot more mature status.

在這個時間點上，Single-Site chole - 它確實從最初引入我們業務的一些關鍵元素，變得更加成熟。

We have talked about the number of customers who have bought Single-Site products.

我們已經討論了購買 Single-Site 產品的客戶數量。

We may move away from that, I think, as it becomes part of the norm.

我認為，我們可能會遠離它，因為它已成為常態的一部分。

The portion that Single-Site versus multiport -- that's always transitioning.

單站點與多端口的部分——總是在轉換。

As most people are aware, the multiport side is generally part of the training pathway to move towards single port.

正如大多數人所知，多端口端通常是向單端口移動的訓練路徑的一部分。

But I think the multiport side is really just that; it's an avenue to move towards the ultimate destination of the single port.

但我認為多端口方面真的就是這樣。這是走向單一港口最終目的地的途徑。

So it's probably not as important at any point in time how many of those are.

因此，在任何時候，其中有多少可能都不那麼重要。

Just a qualitative remark on the reorder rate.

只是對重新訂購率的定性評論。

We have been watching it and we have been pleased so far.

我們一直在看它，到目前為止我們很高興。

Reorder rate has been positive for us.

重新訂購率對我們來說是積極的。

Amit Hazan, SunTrust.

阿米特哈贊，SunTrust。

I thought maybe I would first ask about Single-Site for dVH.

我想也許我會首先詢問 dVH 的單站點。

I think I was a little bit surprised in thinking back in your interaction with Single-Site for chole and what that did in 2012, essentially its first year.

回想一下您與 Single-Site for chole 的互動以及 2012 年（基本上是第一年）所做的事情，我想我有點驚訝。

In your comments that you thought it might not have much of an impact this year, so I thought maybe you could explain the differences between the rollout here versus the rollout for chole is and why it's going to take a little bit longer.

在您的評論中，您認為它今年可能不會產生太大影響，所以我想也許您可以解釋這裡的推出與 chole 的推出之間的區別，以及為什麼它需要更長的時間。

Well, again, as you know, we are pretty measured in our approach with all of these various procedures.

好吧，再一次，如您所知，我們在所有這些不同程序的方法中都非常謹慎。

And I think when you look at single incision hysterectomy, you are looking at products that are required to be made, which we are doing and we know how to do that.

而且我認為，當您查看單切口子宮切除術時，您正在查看需要製造的產品，我們正在這樣做並且我們知道如何做到這一點。

And then you are looking at really understanding -- the physicians are looking at really understanding procedure choreography.

然後你正在尋找真正的理解——醫生們正在尋找真正理解程序編排。

How do I do this?

我該怎麼做呢？

How do I do that?

我怎麼做？

How do I close the cuff?

如何關閉袖帶？

How do I take the adnexa, etc.?

我如何服用附件等？

And so, it's difficult to try to assign a reasonable timeline to how the choreography will go, in addition to the general issues of manufacturing new products, getting the supply chain down, etc.

因此，除了製造新產品、降低供應鍊等一般性問題外，很難為編排方式分配一個合理的時間表。

So we are being pretty cautious about that.

所以我們對此非常謹慎。

Now, if it turns out that that changes in time, we will certainly let you know.

現在，如果事實證明這種情況會隨著時間發生變化，我們一定會讓您知道。

But I think there are a number of surveys that people have done and we have done ourselves where there's a real excitement for it from a customer.

但我認為人們已經完成了許多調查，而我們自己也做了一些讓客戶真正感到興奮的調查。

And so, we just want to make sure you take this into consideration and not work that into your expectations because it's really too early to call.

因此，我們只想確保您考慮到這一點，而不是將其納入您的期望，因為現在打電話還為時過早。

Okay.

好的。

And then on the systems side, just the comment you made about system mix in ASPs maybe not holding through the whole year -- I'm just wondering if that's more product mix related, or is that geography related.

然後在系統方面，您對 ASP 中的系統組合所做的評論可能不會持續一整年——我只是想知道這是否與產品組合相關，或者與地理相關。

And if it's on the product side, just specifically what you are thinking in terms of the products that might not be there later in the year that you have been selling.

如果它是在產品方面，那麼具體來說，您在考慮的產品可能在您銷售的今年晚些時候可能不會出現。

Yes, it's primarily product mix.

是的，它主要是產品組合。

We had 48 of the 164 units were dual console systems in the first quarter.

在第一季度，我們有 164 台設備中的 48 台是雙控制台系統。

That's by far and away the highest proportion that we've had.

這是迄今為止我們擁有的最高比例。

We'd see that attach rate returning to more historical levels.

我們會看到附加率回到更多的歷史水平。

And as such, the ASP would be less than we saw here in the first quarter, maybe more in line with what we saw throughout 2012.

因此，平均售價將低於我們在第一季度看到的，可能更符合我們在整個 2012 年看到的情況。

Okay, and then last one for me -- I realize with regard to the FDA MedSun Survey, I guess it was only nine people.

好的，然後是我的最後一個——我意識到關於 FDA MedSun 調查，我猜只有九個人。

So maybe it's not even a survey or definitely not a government probe, as maybe some would call it.

所以也許這甚至不是一項調查，或者絕對不是政府調查，也許有些人會這樣稱呼它。

But have you guys talked to any of the doctors involved in that kind of in career?

但是你們有沒有和任何從事這種職業的醫生談過？

Do you know anything about the report that might be coming out with what you might be anticipating?

您是否知道可能會出現您所期待的報告的任何信息？

As far as we know, it was a confidentially run survey.

據我們所知，這是一項秘密進行的調查。

And so we have no -- nothing to share on that front.

所以我們沒有——在這方面沒有什麼可分享的。

We have time for one more question.

我們有時間再問一個問題。

Rick Wise, Stifel Nicolaus.

瑞克·懷斯，斯蒂菲爾·尼古拉斯。

Hi, it's actually [Mira Slava] for Rick today.

嗨，今天實際上是 Rick 的 [Mira Slava]。

Let me start with asking a question on Japan.

讓我先問一個關於日本的問題。

I could not help but notice a significant number of systems you have placed there this quarter.

我不禁注意到本季度您在那裡放置了大量系統。

It coincided with the SI approval in Japan.

它恰逢日本的SI批准。

Was the SI what you needed to help unlock this market to some extent?

SI 是您在某種程度上幫助打開這個市場所需要的嗎？

And related to that, should we expect this kind of rate to continue, or do you view this as an anomaly, as you launch the SI?

與此相關的是，我們是否應該期望這種速率會持續下去，或者當您推出 SI 時，您是否認為這是一種反常現象？

I think that they were happy to get SI approval and I think it has been well received.

我認為他們很高興獲得 SI 的批准，並且我認為這很受歡迎。

I think that there's some amount of early excitement having to do with SI.

我認為早期的興奮與 SI 有關。

Long-term, as you look at that market, procedure reimbursement is going to be the thing that is a long and sustained growth path.

從長遠來看，當您查看該市場時，程序報銷將是一條長期且持續增長的道路。

So I think system sales in Japan are going to be lumpy until additional procedures are reimbursed.

所以我認為日本的系統銷售將是不穩定的，直到額外的程序得到報銷。

And that's something that we are working with surgical societies on, on supporting them and helping them complete that activity.

這就是我們正在與外科學會合作，支持他們並幫助他們完成這項活動的事情。

One last question, please.

最後一個問題，請。

And going back to just that, quote, concerted effort by the critics of surgery, I was wondering if you have any plans to highlight some of your data on the outcomes and perhaps the economics of your procedures.

回到剛才，引用手術批評者的一致努力，我想知道您是否有任何計劃突出您的一些關於結果的數據，也許還有您的程序的經濟性。

And it goes back to what was asked earlier, but maybe if I could ask it a little bit differently, has your conversation with your customers changed in any way as a result of the negative press?

它可以追溯到之前提出的問題，但是如果我可以稍微不同地問一下，您與客戶的對話是否由於負面新聞而發生了任何變化？

There's two questions in there.

裡面有兩個問題。

On the first one, do we have plans to share our data, yes, we do.

在第一個方面，我們是否有計劃共享我們的數據，是的，我們有。

And we have been and we will continue to do so.

我們一直這樣做，我們將繼續這樣做。

And in terms of the kinds of conversations that occur with customers over this, and in a sense, the conversations with the customers are amongst the most straightforward because they understand the issues on all sides, the conversation has really come down to their own experiences and the data.

就這方面與客戶進行的對話而言，從某種意義上說，與客戶的對話是最直接的，因為他們了解各個方面的問題，對話實際上歸結為他們自己的經歷和數據。

And we are happy to and well-conditioned, well-positioned to have those conversations.

我們很高興並且有條件地進行這些對話。

We will continue to do so.

我們將繼續這樣做。

And as additional data comes out, we are happy to share it with you.

隨著更多數據的出現，我們很樂意與您分享。

That was our last question.

那是我們的最後一個問題。

In closing, da Vinci surgery has proven safety, efficacy, economic and ergonomic benefits when compared to the open surgical procedures it is replacing.

最後，與它所替代的開放式外科手術相比，達芬奇手術已證明其安全性、有效性、經濟性和人體工程學優勢。

We are steadfast in our conviction in the value that da Vinci has and will bring to the medicine, and we thank you for your support in helping Intuitive expand the benefits of minimally invasive surgery.

我們堅信達芬奇已經並將為醫學帶來的價值，我們感謝您在幫助 Intuitive 擴大微創手術的益處方面的支持。

We look forward to speaking to you again in three months.

我們期待在三個月內再次與您交談。

Ladies and gentlemen, that does conclude our conference for today.

女士們先生們，今天的會議到此結束。

Thank you for your participation and using the AT&T Executive Teleconference.

感謝您參與和使用 AT&T 高管電話會議。

You may now disconnect.

您現在可以斷開連接。