直覺手術 (ISRG) 2014 Q1 法說會逐字稿

完整原文

使用警語:中文譯文來源為 Google 翻譯,僅供參考,實際內容請以英文原文為主

  • Operator

    Operator

  • Ladies and gentlemen, thank you for standing by, and welcome to the Intuitive Surgical Q1 2014 earnings release call.

    女士們,先生們,感謝你們的支持,歡迎來到 Intuitive Surgical 2014 年第一季度財報電話會議。

  • (Operator Instructions).

    (操作員說明)。

  • As a reminder, this conference is being recorded.

    提醒一下,這次會議正在錄製中。

  • I would now like to turn the conference over to Calvin Darling, Senior Director of Intuitive Surgical.

    我現在想將會議轉交給 Intuitive Surgical 高級總監 Calvin Darling。

  • Please go ahead.

    請繼續。

  • Calvin Darling - Director, FP&A and IR

    Calvin Darling - Director, FP&A and IR

  • Thank you, and good afternoon.

    謝謝,下午好。

  • Welcome to Intuitive Surgical's first-quarter earnings conference call.

    歡迎來到 Intuitive Surgical 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 Patrick Clingan, Director of Finance.

    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;和財務總監 Patrick Clingan。

  • Before we begin, I would like to inform you that comments mentioned on today's call may be deemed to contain forward-looking statements.

    在我們開始之前,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存在重大差異。

  • These risks and uncertainties are described in detail in the Company's Securities and Exchange Commission filings, including our most recent Form 10-K filed on February 3, 2014.

    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,包括我們於 2014 年 2 月 3 日提交的最新 10-K 表格。

  • These filings can be found through our website or at the SEC's EDGAR database.

    這些文件可以通過我們的網站或 SEC 的 EDGAR 數據庫找到。

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

    告誡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,本次電話會議的音頻重播將在我們網站 IntuitiveSurgical.com 的投資者關係頁面下的音頻存檔部分提供。

  • In addition, today's press release and supplementary financial data tables have been posted to our website.

    此外,今天的新聞稿和補充財務數據表已發佈到我們的網站上。

  • 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發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; Marshall will provide a review of our first-quarter financial results; Patrick will discuss procedures and clinical highlights; then I will provide our updated financial outlook for 2014.

    Gary 將介紹本季度的業務和運營亮點; Marshall 將對我們的第一季度財務業績進行審查; Patrick 將討論程序和臨床亮點;然後我將提供我們對 2014 年的最新財務展望。

  • And 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。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Thank you for joining us today.

    感謝您今天加入我們。

  • The first quarter was a difficult one in the United States.

    第一季度在美國是艱難的。

  • Certain elected da Vinci procedures in the US have been under significant pressure, driven in part by changing surgical admissions, hospital financial uncertainty, and payer incentives favoring watchful waiting and conservative treatment.

    美國某些當選的達芬奇手術一直承受著巨大的壓力,部分原因是手術入院人數的變化、醫院財務的不確定性,以及支付方傾向於觀察等待和保守治療的激勵措施。

  • System sales in the quarter were down, largely as a result of slowing growth in our US procedures.

    本季度的系統銷售額有所下降,這主要是由於我們在美國的程序增長放緩。

  • Despite near-term challenges, we remain confident in the value our products bring to surgery and are pleased with the US launch and first sales of our newest system, the da Vinci Xi Surgical System, earlier this month.

    儘管近期面臨挑戰,但我們仍然對我們的產品為手術帶來的價值充滿信心,並對本月早些時候我們最新系統達芬奇 Xi 手術系統在美國的推出和首次銷售感到高興。

  • Turning to our procedure performance in the quarter, globally, we experienced continued growth in general surgery and urology and a small decline in gynecology.

    談到我們在本季度的手術表現,在全球範圍內,我們經歷了普外科和泌尿科的持續增長以及婦科的小幅下降。

  • This resulted in 7% procedure growth in the first quarter over the first quarter of 2013.

    這導致第一季度的程序比 2013 年第一季度增長了 7%。

  • General surgery growth was led by increases in colorectal surgery and single site cholecystectomy.

    普通外科手術的增長是由結直腸手術和單部位膽囊切除術的增加帶動的。

  • Worldwide urology procedures experience solid growth, particularly in prostatectomy in Europe and in Japan.

    全球泌尿外科手術穩步增長,尤其是歐洲和日本的前列腺切除術。

  • Gynecology procedures fell slightly year over year, driven by a contraction of procedures in the United States.

    受美國手術收縮的推動,婦科手術同比略有下降。

  • As a result, procedure growth for the United States in the quarter was below our expectations.

    因此,本季度美國的手術增長低於我們的預期。

  • Looking at procedures in the United States more deeply, general surgery led US procedure growth with strong uptake in colorectal surgery, as well as encouraging early growth in several other general surgery procedures.

    更深入地觀察美國的手術,普通外科通過結直腸手術的強勁增長引領美國手術的發展,並鼓勵其他幾種普通外科手術的早期發展。

  • Single-site cholecystectomy growth was solid in that quarter.

    該季度單點膽囊切除術增長穩健。

  • The growth rates slowed relative to prior quarters, in part due to exaggerated seasonality this quarter, as well as increasing economic pressures on hospitals.

    與前幾個季度相比,增長率有所放緩,部分原因是本季度季節性因素被誇大,以及醫院面臨的經濟壓力越來越大。

  • As announced in our pre-release, US gynecology declined in the low single digits year over year in the quarter, pressured by several factors, including increased Q1 seasonality; payer disincentives for benign surgery; and growing penetration of minimally invasive surgery for hysterectomy.

    正如我們在預發布中宣布的那樣,美國婦科在本季度同比下降了較低的個位數,受到多種因素的壓力,包括第一季度季節性增加;付款人對良性手術的抑制;以及子宮切除術微創手術的普及率不斷提高。

  • Going forward we expect US gynecology to pressure overall procedure growth rates through 2014.

    展望未來,我們預計美國婦科將在 2014 年對整體手術增長率施加壓力。

  • Patrick will provide additional procedure commentary later in the call.

    Patrick 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, procedure growth in Asia was strong off of a small base with urology, general surgery and gynecology segments contributing.

    轉向美國以外的市場,在泌尿科、普通外科和婦科領域貢獻較小的亞洲手術增長強勁。

  • We continue to expect lumpiness in capital sales in Asia due to limited reimbursement in Japan as well as anticipation of Xi approvals in the coming quarters.

    由於日本的報銷有限以及預計習近平將在未來幾個季度獲得批准,我們繼續預計亞洲的資本銷售將出現波動。

  • In Europe, procedure growth was solid with urology, gynecology, and general surgery contributing to growth.

    在歐洲,泌尿科、婦科和普通外科的手術增長穩健,為增長做出了貢獻。

  • We have filed for the CE Mark for our Xi system, and system sales for the next quarter or two may be lumpy as customers evaluate the new system.

    我們已經為我們的 Xi 系統申請了 CE 標誌,隨著客戶對新系統的評估,下一兩個季度的系統銷售可能會起伏不定。

  • Taken together, total system sales worldwide in the quarter were 87, down from 164 in Q1 of 2013.

    總的來說,本季度全球系統總銷量為 87,低於 2013 年第一季度的 164。

  • We launched our da Vinci Xi system in April at the SAGES conference.

    我們在 4 月份的 SAGES 會議上推出了 da Vinci Xi 系統。

  • The Xi system is optimized for multi-quadrant, multi-port procedures with smaller arms having greater reach and overhead architecture that allows multiple setup locations without repositioning the base of the system; a smaller, lighter endoscope, with improved imaging capability; and a host of other features that streamline setup and use.

    Xi 系統針對多像限、多端口程序進行了優化,較小的臂具有更大的範圍和開銷架構,允許多個設置位置,而無需重新定位系統底座;更小、更輕的內窺鏡,具有改進的成像能力;以及一系列簡化設置和使用的其他功能。

  • Early customer feedback has been enthusiastic, and we look forward to its continued adoption in surgery.

    早期的客戶反饋非常熱烈,我們期待它在手術中繼續得到採用。

  • The Xi system is not a direct replacement for our Si system, and we continue to sell, support and develop instruments for the Si.

    Xi 系統不能直接替代我們的 Si 系統,我們會繼續銷售、支持和開發 Si 儀器。

  • We have submitted 510(k) clearance applications for our advanced instruments for Xi, including the Xi Vessel Sealer and the Xi Stapler.

    我們已經為 Xi 先進儀器提交了 510(k) 許可申請,包括 Xi Vessel Sealer 和 Xi Stapler。

  • We plan to submit our Firefly 510(k) for Xi this month.

    我們計劃本月為 Xi 提交 Firefly 510(k)。

  • Da Vinci Xi currently does not have available single-site instruments and 5-millimeter instruments and it is not currently indicated for trans-oral procedures.

    Da Vinci Xi 目前沒有可用的單點儀器和 5 毫米儀器,目前不適用於經口手術。

  • As a result, we expect Xi adoption to proceed at a measured pace through 2014 as new instruments for Xi come to market and customers evaluate the differences between Si and Xi.

    因此,隨著用於 Xi 的新儀器上市以及客戶評估 Si 和 Xi 之間的差異,我們預計到 2014 年 Xi 的採用將有條不紊地進行。

  • This week we received FDA 510(k) clearance for the da Vinci Sp Surgical System, which is designed to expand our single-port product offerings.

    本週,我們收到了 da Vinci Sp 手術系統的 FDA 510(k) 許可,該系統旨在擴展我們的單端口產品供應。

  • The initial clearance is specific to urologic surgical procedures that are appropriate for a single-port approach.

    初始清除特定於適用於單端口方法的泌尿外科手術。

  • Da Vinci Sp is built around a dedicated, single-port, patient-side cart that delivers an articulating 3D, HD camera and three fully articulated instruments through a single 25-millimeter cannula.

    Da Vinci Sp 是圍繞一個專用的單端口患者側推車構建的,該推車通過一個 25 毫米插管提供一個鉸接式 3D、高清攝像機和三個完全鉸接的儀器。

  • The EndoWrist sp instruments have additional wrist joints inside the body compared to our current single-site instruments.

    與我們目前的單點器械相比,EndoWrist sp 器械在體內有額外的腕關節。

  • This is a sophisticated technology that we believe has long-term potential in several areas of surgery.

    這是一項複雜的技術,我們相信它在多個外科領域具有長期潛力。

  • We do not intend to commercialize da Vinci Sp until the current technology is engineered to be fully compatible with our newly released da Vinci Xi, currently projected for the second half of 2014.

    我們不打算將 da Vinci Sp 商業化,直到當前技術被設計為與我們新發布的 da Vinci Xi 完全兼容,目前預計在 2014 年下半年發布。

  • This will require product refinements, supply chain optimization, and additional regulatory clearances.

    這將需要產品改進、供應鏈優化和額外的監管許可。

  • Over the long term we believe a single-port cart will complement, not replace, multi-port and single-site technologies.

    從長遠來看,我們相信單端口推車將補充而不是取代多端口和單站點技術。

  • Turning to instruments, we have expanded launches of both our da Vinci stapler and da Vinci Single-Site for hysterectomy.

    在儀器方面,我們擴大了達芬奇吻合器和達芬奇單點子宮切除術的發布範圍。

  • Da Vinci Stapler adoption has been solid with strong reorder rates from early customers and increased utilization in colorectal surgery, our target market.

    達芬奇吻合器的採用一直很穩固,早期客戶的重新訂購率很高,並且在我們的目標市場結直腸手術中的利用率有所提高。

  • We are working on enhancements to da Vinci Stapling by developing a [white] new load, as well as pursuing indications in thoracic surgery.

    我們正致力於通過開發一種 [白色] 新負載來增強達芬奇吻合器,並尋求胸外科手術的適應症。

  • Our early launch of single-site hysterectomy is expanding at a measured pace with solid procedure growth from a small base and robust customer interest.

    我們早期推出的單點子宮切除術正以穩健的步伐從小基數和強烈的客戶興趣中穩步增長。

  • Development of our wristed, single-site needle driver for Si is progressing and we plan to submit our 510(k) for the wristed needle driver later this month.

    我們用於 Si 的腕式單點針頭驅動器的開發正在取得進展,我們計劃在本月晚些時候提交手腕式針頭驅動器的 510(k)。

  • We have been in regular contact with FDA while we work to resolve issues identified in prior audits and our Q4 warning letter.

    在我們努力解決之前審計和我們的第四季度警告信中發現的問題時,我們一直與 FDA 保持定期聯繫。

  • The FDA conducted a follow-up inspection of the Company in this first quarter, in which they reviewed actions and process that address prior findings as well as exploring other areas.

    FDA 在第一季度對公司進行了後續檢查,審查了解決先前發現的行動和流程,並探索了其他領域。

  • While we have made significant progress in addressing their concerns they have noted additional areas for improvement that will be published on a Form 483, which we will post on our website later this week.

    雖然我們在解決他們的擔憂方面取得了重大進展,但他們注意到了其他需要改進的地方,這些地方將在 483 表格中公佈,我們將在本週晚些時候將其發佈在我們的網站上。

  • We continue to strengthen our operations capabilities and compliance programs by further developing our team, engaging seasoned leadership, and improving our processes.

    我們通過進一步發展我們的團隊、聘請經驗豐富的領導和改進我們的流程來繼續加強我們的運營能力和合規計劃。

  • While our US business is undergoing change, it is worth stepping back and considering the long-term value of da Vinci in surgery.

    雖然我們的美國業務正在發生變化,但值得退後一步,考慮一下達芬奇在外科手術中的長期價值。

  • In neurology we see significant opportunity globally for prostatectomy and partially nephrectomy, procedures for which clinical and economic evidence supporting da Vinci use is well developed.

    在神經病學領域,我們在全球範圍內看到了前列腺切除術和部分腎切除術的重大機遇,支持達芬奇使用的臨床和經濟證據已得到充分發展。

  • Here we are focused on building our capability in Europe and Asia to support urologic growth.

    在這裡,我們專注於建立我們在歐洲和亞洲的能力,以支持泌尿外科的發展。

  • In gynecology, the economic value of da Vinci in hysterectomy for a broad population of patients is being demonstrated in papers like the ones Patrick will describe shortly.

    在婦科領域,達芬奇在廣泛患者子宮切除術中的經濟價值正在帕特里克即將描述的論文中得到證明。

  • We are supporting further clinical and economic evidence development for hysterectomy and other gynecologic procedures globally.

    我們支持在全球範圍內為子宮切除術和其他婦科手術進一步開發臨床和經濟證據。

  • Also, we are in the early days of our single-site launch for hysterectomy.

    此外,我們還處於子宮切除術單點發射的早期階段。

  • We believe additional instrumentation like our wristed single-site needle driver, will make a significant difference for single-site surgeons.

    我們相信額外的儀器,如我們的手腕單點針頭驅動器,將為單點外科醫生帶來顯著差異。

  • General surgery opportunity exists in several procedures globally, including colon and rectal resections, bariatric procedures, and other procedures within the abdomen.

    全球範圍內的多種手術中都存在普外科機會,包括結腸和直腸切除術、減肥手術以及腹部內的其他手術。

  • In general surgery, we are investing in products that optimize procedures, including stapling, vessel sealing, Firefly and our da Vinci Xi, as well as supporting evidence development and research.

    在普外科,我們正在投資優化程序的產品,包括縫合、血管密封、Firefly 和我們的達芬奇 Xi,以及支持證據開發和研究。

  • Thoracic surgery also holds long-term potential for ISI, but we are developing products including stapling and da Vinci Xi to address those thoracic procedures typically done through an open incision.

    胸外科也具有 ISI 的長期潛力,但我們正在開發包括吻合器和達芬奇 Xi 在內的產品,以解決通常通過開放切口完成的胸外科手術。

  • Lastly, we are still early in exploring the capabilities of single-port technologies like Single-Site and/or single port cart.

    最後,我們在探索單站點和/或單端口車等單端口技術的功能方面仍處於早期階段。

  • We will continue to pursue additional instrumentation and clearances for these new architectures as we work with surgeons to advance minimally invasive surgery.

    當我們與外科醫生合作推進微創手術時,我們將繼續為這些新架構尋求更多的儀器和許可。

  • As of today, we estimate that these opportunities represent millions of procedures annually for the countries in which we already operate.

    截至今天,我們估計這些機會每年代表我們已經開展業務的國家/地區進行數百萬次手術。

  • In future years we anticipate expanding our presence more deeply into Asia, India, and Latin America, further expanding the potential of da Vinci to positively impact surgery.

    在未來幾年,我們預計將業務更深入地擴展到亞洲、印度和拉丁美洲,進一步擴大達芬奇對外科手術產生積極影響的潛力。

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

    我現在將把時間交給我們的首席財務官馬歇爾。

  • Marshall Mohr - SVP and CFO

    Marshall Mohr - SVP and CFO

  • Thank you, Gary.

    謝謝你,加里。

  • Our first-quarter 2014 revenue and procedures were consistent with our press release issued on April 8. First-quarter revenues were $465 million, down 24% compared with $611 million for the first quarter of 2013; and down 19% from last quarter.

    我們 2014 年第一季度的收入和程序與我們在 4 月 8 日發布的新聞稿一致。第一季度收入為 4.65 億美元,與 2013 年第一季度的 6.11 億美元相比下降了 24%;比上一季度下降 19%。

  • Procedures for the first quarter grew approximately 7% compared with the first quarter of 2013 and were down approximately 5% compared with last quarter.

    第一季度的程序與 2013 年第一季度相比增長了約 7%,與上一季度相比下降了約 5%。

  • First-quarter 2014 revenue is net of approximately $26 million of revenue deferred in association with offers made to first-quarter US customers to trade in their recently purchased da Vinci Si surgical systems for our recently announced da Vinci Xi Surgical System.

    2014 年第一季度的收入已扣除約 2600 萬美元的遞延收入,這些收入與第一季度美國客戶提出的以他們最近購買的 da Vinci Si 手術系統換取我們最近發布的 da Vinci Xi 手術系統的提議相關。

  • The trade-in program also provides our customers the opportunity to exchange certain recently purchased da Vinci Si instruments and accessories for da Vinci Xi instruments and accessories.

    以舊換新計劃還為我們的客戶提供了將最近購買的某些達芬奇 Si 儀器和附件換成達芬奇 Xi 儀器和附件的機會。

  • The deferrals reduced first-quarter 2014 system revenue by approximately $24 million and instrument and accessory revenue by approximately $2 million.

    延期使 2014 年第一季度系統收入減少約 2400 萬美元,儀器和附件收入減少約 200 萬美元。

  • The $26 million deferral equates to $0.29 per share and is expected to be recognized within 2014.

    2600 萬美元的遞延相當於每股 0.29 美元,預計將在 2014 年內確認。

  • Procedure highlights will be covered by Patrick.

    Patrick 將介紹程序要點。

  • Revenue highlights are as follows.

    收入亮點如下。

  • Instrument and accessory revenue was down 2% compared with the first quarter of 2013, and was down 5% compared with the fourth quarter of 2013.

    儀器及配件收入較2013年第一季度下降2%,較2013年第四季度下降5%。

  • The decrease relative to the prior periods reflects lower instrument and accessory stocking orders associated with fewer system sales; the $2 million deferral associated with the trade-in program; the impact of changes in procedures, offset by increased sales of newer products.

    與前期相比的減少反映了與系統銷售減少相關的儀器和附件庫存訂單減少;與以舊換新計劃相關的 200 萬美元延期付款;程序變化的影響被新產品銷量的增加所抵消。

  • Instrument and accessory revenue realized per procedure, including initial stocking orders, was approximately $1,920 per procedure compared with $2,110 for the first quarter of 2013; and $1,930 last quarter.

    每次手術實現的儀器和配件收入(包括初始庫存訂單)約為每次手術 1,920 美元,而 2013 年第一季度為 2,110 美元;上個季度為 1,930 美元。

  • The decrease from the prior year reflects fewer stocking orders associated with fewer system sales, partially offset by new product sales.

    與上一年相比的減少反映了與系統銷售減少相關的庫存訂單減少,部分被新產品銷售所抵消。

  • The increase from the prior quarter primarily reflects new product sales and the timing of customer orders.

    較上一季度的增長主要反映了新產品銷售和客戶訂單的時間安排。

  • Systems revenue of $106 million decreased 59% compared with the first quarter of 2013 and decreased 48% compared with the fourth quarter of 2013.

    系統收入為 1.06 億美元,與 2013 年第一季度相比下降 59%,與 2013 年第四季度相比下降 48%。

  • The decline in systems revenue reflects fewer systems sales.

    系統收入的下降反映了系統銷售量的減少。

  • In the US we sold 45 systems in the first quarter compared with 115 systems in the first quarter of 2013 and 72 systems in the fourth quarter of 2013.

    在美國,我們第一季度售出 45 個系統,而 2013 年第一季度為 115 個系統,2013 年第四季度為 72 個系統。

  • The decline in US systems sales reflects the impact of lower procedure growth; spending uncertainties associated with the Affordable Care Act; customer anticipation of a new system being released; and relative to the fourth quarter, seasonality.

    美國系統銷售額的下降反映了較低程序增長的影響;與平價醫療法案相關的支出不確定性;客戶對發布新系統的預期;相對於第四季度,季節性。

  • We sold 13 Si-e's compared with 21 last quarter and five in the first quarter of 2013, at prices just below $1 million, depending on their configuration, reflecting continued demand for lower-cost systems for use in lower reimbursed procedures.

    我們售出了 13 台 Si-e,而上一季度為 21 台,2013 年第一季度為 5 台,價格略低於 100 萬美元,具體取決於它們的配置,反映了對用於較低報銷程序的低成本系統的持續需求。

  • Globally, our ASP of $1,476,000 increased relative to the fourth-quarter system ASP of $1,455,000.

    在全球範圍內,我們的平均售價為 1,476,000 美元,高於第四季度的系統平均售價 1,455,000 美元。

  • The increase reflects the favorable geographic and product mix.

    這一增長反映了有利的地理和產品組合。

  • In the first quarter we sold 23 dual console systems compared with 38 systems in the fourth quarter.

    在第一季度,我們售出了 23 個雙控制台系統,而第四季度為 38 個系統。

  • Outside the US we sold 42 systems in the first quarter, including 14 in Europe and 19 in Japan, compared with 49 systems into international markets in the first quarter of 2013, which included 16 into Europe and 25 into Japan; and 66 systems into international markets in the fourth quarter of 2013, which included 28 into Europe and 21 into Japan.

    在美國以外,我們在第一季度售出了 42 套系統,其中 14 套在歐洲,19 套在日本,而 2013 年第一季度我們在國際市場銷售了 49 套系統,其中 16 套在歐洲,25 套在日本; 2013 年第四季度有 66 個系統進入國際市場,其中 28 個進入歐洲,21 個進入日本。

  • First-quarter system sales also included three into each of France and Spain.

    第一季度的系統銷售額還包括法國和西班牙各三台。

  • Note that the first quarter is typically seasonally slower in most overseas markets except Japan.

    請注意,除日本外,大多數海外市場的第一季度通常季節性較慢。

  • Moving on to the remainder of the P&L, gross margin in the first quarter of 2014 was 67.9% compared with 71% for the first quarter of 2013 and 69.1% for the fourth quarter of 2013.

    轉到損益表的其餘部分,2014 年第一季度的毛利率為 67.9%,而 2013 年第一季度為 71%,2013 年第四季度為 69.1%。

  • Our lower margin percentage reflects a higher mix of new product sales and cost spread over lower production levels.

    我們較低的利潤率反映了新產品銷售和成本分攤到較低生產水平的較高組合。

  • Margins on newly launched products will typically be lower than our mature products, reflecting vendor pricing on low volumes, temporary tooling costs, and other startup costs.

    新推出產品的利潤率通常會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。

  • However, over time, as volumes increase, and we refine the manufacturing process and the product, we would expect to see improvement in the margins of these newer products, although they may not ultimately reach the level of our mature products.

    然而,隨著時間的推移,隨著產量的增加,以及我們改進製造工藝和產品,我們預計這些新產品的利潤率會有所提高,儘管它們最終可能不會達到我們成熟產品的水平。

  • Our margins on the Xi system will be lower than the margins for our Si products.

    我們在 Xi 系統上的利潤率將低於我們的 Si 產品的利潤率。

  • As described in our pre-earnings release dated April 8, the Company recorded a pretax charge of $67 million, equal to $1.25 per share to reflect the estimated costs of settling a number of product liability legal claims against the Company.

    正如我們在 4 月 8 日發布的財報前所述,公司記錄了 6700 萬美元的稅前費用,相當於每股 1.25 美元,以反映解決針對公司的一些產品責任法律索賠的估計成本。

  • These claims relate to alleged complications from surgeries performed with certain versions of monopolar cautery scissor, or MCS instruments, that included an MCS tip cover accessory that was the subject of a market withdrawal in 2012; and surgeries that were performed with MCS instruments that were subject of a recall in 2013.

    這些索賠涉及據稱使用某些版本的單極燒灼剪或 MCS 儀器進行手術的並發症,其中包括一個 MCS 尖端蓋配件,該配件已於 2012 年退出市場;以及在 2013 年召回的使用 MCS 儀器進行的手術。

  • The Company's estimate of the anticipated cost of settling these claims is based on negotiations with attorneys for patients who have participated in the mediation process that the Company established in conjunction with the polling agreement.

    公司對解決這些索賠的預期成本的估計是基於與參與公司根據投票協議建立的調解程序的患者的律師的談判。

  • To date, approximately 3,000 claims have been reviewed as part of the mediation process.

    迄今為止,作為調解過程的一部分,大約有 3,000 項索賠已得到審查。

  • Many of these claims gave rise to MDRs reported in the FDA's MAUDE database.

    其中許多聲明導致了 FDA 的 MAUDE 數據庫中報告的 MDR。

  • First-quarter 2014 operating expenses of $192 million, excluding the $67 million charge, were in line with our planned spending and reflect investments in overseas markets and new products.

    2014 年第一季度的運營支出為 1.92 億美元,不包括 6700 萬美元的費用,符合我們的計劃支出並反映了對海外市場和新產品的投資。

  • Our effective tax rate for the first quarter was 26.8% compared with 26.1% for the first quarter of 2013 and 22.5% last quarter.

    我們第一季度的有效稅率為 26.8%,而 2013 年第一季度為 26.1%,上一季度為 22.5%。

  • The first quarter of 2013 tax rate benefited from the retroactive reinstatement of the federal R&D credit for 2012, as well as the federal R&D credit for 2013.

    2013 年第一季度的稅率受益於追溯恢復 2012 年聯邦研發信貸以及 2013 年聯邦研發信貸。

  • The federal R&D credit has not been renewed for 2014 and, therefore, is not reflected in the first-quarter tax rate.

    2014 年聯邦研發信貸尚未更新,因此未反映在第一季度的稅率中。

  • Our net income was $44 million, or $1.13 per share, compared with $189 million, or $4.56 per share for the first quarter of 2013 and $166 million, or $4.28 per share for the fourth quarter of 2013.

    我們的淨收入為 4400 萬美元,即每股 1.13 美元,而 2013 年第一季度為 1.89 億美元,即每股 4.56 美元,2013 年第四季度為 1.66 億美元,即每股 4.28 美元。

  • An important measure of our performance is cash flow from operations.

    衡量我們業績的一個重要指標是運營產生的現金流量。

  • We define cash flow from operations as net income excluding after-tax non-cash compensation and amortization of intangible assets.

    我們將經營活動產生的現金流量定義為扣除稅後非現金補償和無形資產攤銷後的淨收入。

  • We will refer to this is non-GAAP net income.

    我們稱這是非 GAAP 淨收入。

  • For the first quarter of 2014, excluding the legal accrual of $67 million and the deferral of $26 million, we generated $135 million in non-GAAP net income, or $3.46 per share compared with $205 million or $4.99 per share for the fourth quarter of 2013.

    2014 年第一季度,扣除 6700 萬美元的法定應計費用和 2600 萬美元的遞延費用,我們產生了 1.35 億美元的非 GAAP 淨收入,即每股 3.46 美元,而 2013 年第四季度為 2.05 億美元或每股 4.99 美元.

  • We ended the year with cash and investments of $3 billion, up from $2.8 billion as of December 31, 2013.

    截至 2013 年 12 月 31 日,我們的現金和投資總額為 30 億美元,高於 28 億美元。

  • The increase was primarily driven by $166 million in net cash provided by operating activities.

    這一增長主要是由經營活動提供的 1.66 億美元淨現金推動的。

  • Keep in mind that the $67 million charge to income has not affected cash flow to date.

    請記住,迄今為止,6700 萬美元的收入支出並未影響現金流。

  • We have not repurchased shares in the first quarter.

    我們在第一季度沒有回購股票。

  • As of March 31, we still have $1 billion of share buybacks authorized.

    截至 3 月 31 日,我們仍有 10 億美元的股票回購授權。

  • And with that, I'd like to turn it over to Patrick who will go over procedure and clinical highlights.

    有了這個,我想把它交給帕特里克,他將檢查程序和臨床亮點。

  • Patrick Clingan - Director, Finance

    Patrick Clingan - Director, Finance

  • Thanks, Marshall.

    謝謝,馬歇爾。

  • Q1 year-over-year procedure growth was approximately 7% with US procedures growing 3% and international procedures growing 24%.

    第一季度手術同比增長約 7%,其中美國手術增長 3%,國際手術增長 24%。

  • On a macro basis, payer head winds combined with higher patient payments have impacted the number of benign hysterectomies in the US and in turn, the number of da Vinci hysterectomies performed with both declining during the first quarter.

    從宏觀上看,支付方的逆風加上患者支付的更高費用影響了美國良性子宮切除術的數量,進而影響了達芬奇子宮切除術的數量,兩者在第一季度均有所下降。

  • This minimally invasive surgery is currently a high proportion of benign hysterectomies, and there is wide dispersion of the remaining open procedures among hospitals and surgeons.

    這種微創手術目前在良性子宮切除術中所佔比例很高,其餘開放手術在醫院和外科醫生中分佈廣泛。

  • We expect da Vinci Hysterectomy to continue to decline roughly in line with declines in the market through 2014.

    我們預計達芬奇子宮切除術將繼續下降,大致與 2014 年市場的下降趨勢一致。

  • Other benign GYN procedures, including sacrocolpopexies, endometriosis resections, and myomectomies also experienced year-over-year declines in the first quarter.

    其他良性婦科手術,包括骶骨陰道固定術、子宮內膜異位症切除術和子宮肌瘤切除術,在第一季度也出現了同比下降。

  • We are in our early launch phase of single-site (inaudible) for hysterectomies.

    我們正處於子宮切除術單點(聽不清)的早期啟動階段。

  • The growth rate in the quarter was high off of a very small base.

    本季度的增長率很高,基數很小。

  • We plan to bring our single-site wristed Needle Driver into the market in order to further enable benign hysterectomy procedure adoption, but it is too early to predict whether this will drive overall growth in dVH.

    我們計劃將我們的單點腕式針驅動器推向市場,以進一步實現良性子宮切除術的採用,但現在預測這是否會推動 dVH 的整體增長還為時過早。

  • Before moving on, let me take a moment to discuss the recent FDA announcement discouraging the use of power morcellators and the surgical removal of assumed benign fibroids.

    在繼續之前,讓我花點時間討論一下最近 FDA 的聲明,該聲明不鼓勵使用電動粉碎器和手術切除假定的良性肌瘤。

  • Intuitive does not manufacture or sell power morcellation products.

    Intuitive 不製造或銷售動力粉碎產品。

  • Power morcellators do not attach to da Vinci Systems, and minimally invasive da Vinci surgeries are routinely performed without the use of power morcellators in both benign and malignant GYN surgeries.

    動力粉碎器不連接達芬奇系統,在良性和惡性婦科手術中,通常無需使用動力粉碎器即可進行微創達芬奇手術。

  • Said another way, for many patients, surgeons do not have to choose between minimally invasive surgery and morcellation.

    換句話說,對於許多患者來說,外科醫生不必在微創手術和粉碎術之間做出選擇。

  • Other alternatives for tissue extraction exist.

    存在用於組織提取的其他替代方案。

  • In the near term, this announcement may create uncertainty for surgeons and patients when choosing among minimally invasive surgical methods for removing fibroids.

    在短期內,這一公告可能會給外科醫生和患者在選擇用於去除肌瘤的微創手術方法時帶來不確定性。

  • Moving forward, we look to surgical societies as they set guidance for removal of assumed benign fibroids.

    展望未來,我們期待著外科學會為切除假定的良性肌瘤制定指南。

  • For da Vinci cholecystectomy, moderating growth appears to be attributable to both seasonality and physicians increasingly offering single-site to those patients that are cosmetically sensitive and not morbidly obese.

    對於達芬奇膽囊切除術,增長放緩似乎歸因於季節性和醫生越來越多地為那些對美容敏感且沒有病態肥胖的患者提供單點手術。

  • Looking more deeply, adoption is taking place primarily among commercially insured patients, seeking treatment from physicians at private hospitals with the ability to offer single-site benefits to patient, the hospital, and the surgeon.

    更深入地看,採用主要發生在有商業保險的患者中,他們向私立醫院的醫生尋求治療,能夠為患者、醫院和外科醫生提供單點福利。

  • If adoption remains limited to this segment, we would likely address a more narrow patient population than we previously expected.

    如果採用仍然僅限於這一細分市場,我們可能會解決比我們之前預期的更窄的患者群體。

  • We continue to believe that patients desire an improved cosmetic outcome compared to multi-port MIS.

    我們仍然相信,與多端口 MIS 相比,患者希望獲得更好的美容效果。

  • We have optimized the economics of our offering for our systems and instruments, and we believe material operating costs are currently at a small premium to multi-port laparoscopic material operating expenses.

    我們已經優化了我們為我們的系統和儀器提供的產品的經濟性,我們相信材料運營成本目前比多端口腹腔鏡材料運營費用略高。

  • Beyond cholecystectomy, broader growth in US general surgery is encouraging as we continue to see adoption across many sub specialties.

    除了膽囊切除術,美國普通外科的更廣泛增長令人鼓舞,因為我們繼續看到許多子專業的採用。

  • In particular, colon and rectal resections are a source of strength along with a variety of other surgeries for malignant and benign conditions.

    特別是,結腸和直腸切除術與其他各種針對惡性和良性病症的手術一樣,是力量的源泉。

  • While many of these procedures are too early to include in our addressable market opportunity, we are encouraged by the level of surgeon interest in these procedures as we continue to expand the breadth of our instrumentation for general surgeons.

    雖然其中許多手術還為時過早,無法納入我們可尋址的市場機會,但隨著我們繼續擴大普通外科醫生儀器的範圍,我們對外科醫生對這些手術的興趣水平感到鼓舞。

  • Investments in the colorectal market, including products and market development, are showing results.

    對結直腸市場的投資,包括產品和市場開發,正在取得成果。

  • International procedure growth of 24% remains strong.

    24% 的國際程序增長依然強勁。

  • Growth was led by urology, with meaningful contributions from GYN and general surgery.

    泌尿外科引領增長,婦科和普通外科做出了有意義的貢獻。

  • DDP uptake in Europe and Japan continues to be robust, sustaining the momentum we gained in the back half of 2013.

    DDP 在歐洲和日本的應用繼續保持強勁,維持了我們在 2013 年下半年獲得的勢頭。

  • Highlighting the growing interest in da Vinci's surgery education, in 2013 the European Association of Urology's Robotics section highlighted a da Vinci fellowship training program with 10 leading academic institutions across six countries.

    2013 年,歐洲泌尿外科協會的機器人部分強調了達芬奇外科教育日益增長的興趣,該項目與 6 個國家的 10 家領先學術機構合作開展了達芬奇獎學金培訓計劃。

  • The robotics section expanded the fellowship pilot in 2014 to 17 institutions as more country-level societies support the program.

    隨著越來越多的國家級學會支持該計劃,機器人部門在 2014 年將獎學金試點擴大到 17 個機構。

  • During the quarter we continued to see growth in peer-reviewed publications, highlighting da Vinci use in a number of journals.

    在本季度,我們繼續看到同行評審出版物的增長,突出了達芬奇在許多期刊中的使用。

  • I will take a moment to highlight just a few.

    我將花點時間強調幾個。

  • Total cost to treat a population of patients is of high importance as providers are increasingly focused on population health management.

    隨著提供者越來越關注人口健康管理,治療一群患者的總成本非常重要。

  • Two GYN studies published in this month's edition of Obstetrics and Gynecology show an interesting juxtaposition of how two cost effectiveness studies can look at the same subject and develop contrasting conclusions, with one using a population health perspective while the other evaluates a subset of the population.

    本月出版的婦產科雜誌上發表的兩項 GYN 研究有趣地並列顯示了兩項成本效益研究如何看待同一主題並得出截然不同的結論,其中一項使用人口健康觀點,而另一項評估人口的一個子集。

  • The first study from Dr. Leitao and team at Memorial Sloan-Kettering took a population health perspective on the impact robotic surgery could have to the overall cost of malignant hysterectomies in the US.

    Leitao 博士和 Memorial Sloan-Kettering 團隊的第一項研究從人口健康的角度研究了機器人手術可能對美國惡性子宮切除術的總成本產生的影響。

  • Looking at the adoption of robotic surgery within MSK for malignant hysterectomies from 2009 to 2010, the study showed that laparoscopic procedures were less expensive than robotic procedures and that robotic procedures were less expensive than open surgery.

    觀察 2009 年至 2010 年 MSK 斯隆採用機器人手術治療惡性子宮切除術的情況,該研究表明,腹腔鏡手術比機器人手術便宜,機器人手術比開腹手術便宜。

  • By extrapolating the MSK experience to a national experience, including the reduction in the rate of higher cost open surgery, the study concluded that the adoption of robotic surgery lowered the cost of malignant hysterectomies when evaluated for population health.

    通過將 MSK 斯隆的經驗外推到全國經驗,包括降低高成本開放手術的發生率,該研究得出結論,在評估人口健康時,機器人手術的採用降低了惡性子宮切除術的成本。

  • In contrast to these findings, Wright et al of Colombia wrote a follow-up to their 2013 publication.

    與這些發現形成對比的是,哥倫比亞的 Wright 等人在其 2013 年發表的文章中寫了一篇後續文章。

  • Using a similar methodology to the 2013 paper, this study also found that robotic surgery was more expensive than laparoscopic surgery, expanded to include both malignant and benign procedures.

    使用與 2013 年論文類似的方法,該研究還發現機器人手術比腹腔鏡手術更昂貴,並擴大到包括惡性和良性手術。

  • The study excluded the impact robotic surgery has brought to the broader population of patients who were historically treated through open surgery and the cost savings associated with the overall reduction in surgical morbidity.

    該研究排除了機器人手術給過去接受開放手術治療的更廣泛患者群體帶來的影響,以及與手術發病率總體降低相關的成本節約。

  • The contrasting outcomes of these papers illustrates the impact that population selection has in drawing an economic conclusion.

    這些論文的對比結果說明了人口選擇對得出經濟結論的影響。

  • As providers look to manage population health more directly under the Affordable Care Act, Dr. Leitao's study is more broadly applicable to a total population.

    由於提供者希望根據《平價醫療法案》更直接地管理人口健康,雷濤博士的研究更廣泛地適用於總人口。

  • We continue to work with customers to improve the understanding of the economic value da Vinci brings.

    我們繼續與客戶合作,以提高對達芬奇帶來的經濟價值的理解。

  • Next, the incidence rate and associated surgical procedures for early-stage lung cancer are likely to increase following the US PSTF recommendation to provide CT scanning to smokers at a high risk of developing cancer.

    接下來,隨著美國 PSTF 建議為患癌風險高的吸煙者提供 CT 掃描,早期肺癌的發病率和相關外科手術可能會增加。

  • Two recent studies have compared multi-center results of da Vinci lobectomies to over 10,000 lobectomies from the STS database gathered from 2010 to 2012.

    最近的兩項研究將達芬奇肺葉切除術的多中心結果與 2010 年至 2012 年收集的 STS 數據庫中的 10,000 多個肺葉切除術進行了比較。

  • The first study, published in Innovations, from Dr. Farivar and colleagues of Swedish Medical Center in Seattle, compare open lobectomy to video-assisted thoracic surgery, or VATS, and robotic lobectomies, and found that the use of robotic technology reduced the operative time, chest tube duration, post-operative blood transfusion and length of stay compared to both open and VATS lobectomies.

    西雅圖瑞典醫學中心的 Farivar 博士及其同事發表在 Innovations 上的第一項研究將開放式肺葉切除術與視頻輔助胸外科手術或 VATS 和機器人肺葉切除術進行了比較,發現機器人技術的使用減少了手術時間、胸管持續時間、術後輸血和住院時間與開放式和 VATS 肺葉切除術相比。

  • More importantly, the use of robotic technology also showed a reduction in 30-day mortality compared to both open and VATS.

    更重要的是,與開放手術和 VATS 相比,機器人技術的使用還顯示 30 天死亡率有所降低。

  • The second study, from Dr. Adams and team of Owensboro Medical Health System in Kentucky, published in the Annals of Thoracic Surgery, compared the initial 20 completely portable robotic lobectomies or CPRL, from six community surgeons to the STS database.

    第二項研究來自肯塔基州歐文斯伯勒醫療衛生系統的 Adams 博士和團隊,發表在《胸外科年鑑》上,比較了來自六名社區外科醫生的最初 20 個完全便攜式機器人肺葉切除術或 CPRL 與 STS 數據庫。

  • While reflecting the initial robotic case series from each of these surgeons, the authors concluded, quote, CPRL was superior in several measures compared with open, end quote.

    在反映這些外科醫生最初的機器人案例係列時,作者總結說,引用,CPRL 在幾個方面優於開放式、結束引用。

  • As well as, quote, outcomes were equivalent between CPRL and VATS, trending in favor of robotics, end quote.

    此外,引用,CPRL 和 VATS 之間的結果相同,傾向於支持機器人技術,結束引用。

  • I will conclude with two international publications on da Vinci use for rectal resections.

    我將以兩本關於達芬奇用於直腸切除術的國際出版物作為結尾。

  • Two papers focusing on robotic versus open or laparoscopic total mesorectal excision, or TME.

    兩篇論文側重於機器人與開放式或腹腔鏡全直腸系膜切除術或 TME。

  • The first paper, published in the European Journal of Surgical Oncology, is from a group of Italian and Brazilian surgeons based at leading academic institutions.

    第一篇論文發表在歐洲外科腫瘤學雜誌上,來自領先學術機構的一組意大利和巴西外科醫生。

  • The study included 174 patients and results showed that at five years post-operation, robotic TME has a lower rate of local cancer recurrence compared to open TME.

    該研究包括 174 名患者,結果表明,在術後五年,與開放式 TME 相比,機器人 TME 的局部癌症復發率較低。

  • The study also highlighted an increase in lymph nodes harvested, reduced blood loss, and lower length of stay at the cost of a longer OR time.

    該研究還強調以更長的 OR 時間為代價,收穫的淋巴結增加、失血減少和住院時間縮短。

  • The second paper, from China, published in the Journal of Surgical Research by Dr. [Shiang] and colleagues from the Chongqing Medical University, performed the meta analysis on robotic TME compared to laparoscopic TME.

    第二篇論文來自中國,由重慶醫科大學的 [Shiang] 博士及其同事發表在《外科研究雜誌》上,對機器人 TME 與腹腔鏡 TME 進行了薈萃分析。

  • The study identified over 1,200 patients and n showed that robotic TME was associated with a lower conversion rate from minimally invasive surgery to open surgery; a lower positive margin rate; and a lower rate of erectile dysfunction compared to laparoscopic TME.

    該研究確定了 1,200 多名患者,n 表明機器人 TME 與從微創手術到開放手術的較低轉化率相關;較低的正保證金率;與腹腔鏡 TME 相比,勃起功能障礙的發生率較低。

  • This concludes my remarks and I thank you for your time.

    我的發言到此結束,感謝大家抽出寶貴時間。

  • I will now turn the call over to Calvin.

    我現在將把電話轉給卡爾文。

  • Calvin Darling - Director, FP&A and IR

    Calvin Darling - Director, FP&A and IR

  • Thank you, Patrick.

    謝謝你,帕特里克。

  • I will be providing you with our updated financial outlook for 2014.

    我將為您提供 2014 年最新的財務展望。

  • Starting with procedures -- on our last call, we estimated full-year 2014 procedure growth of 9% to 12% above the approximately 523,000 procedures performed in 2013.

    從程序開始——在我們上次電話會議上,我們估計 2014 年全年程序增長 9% 至 12%,高於 2013 年執行的大約 523,000 例程序。

  • Now, based upon factors described earlier on the call, impacting US benign gynecology and other elective procedures, we are adjusting our 2014 procedure growth estimate to a range of between 2% and 8%.

    現在,根據電話會議之前描述的影響美國良性婦科和其他擇期手術的因素,我們將 2014 年的手術增長估計調整到 2% 到 8% 之間。

  • This is a wider range than we have previously communicated, giving consideration to increased volatility in elective procedures and the recent FDA statement discouraging the use of power morcellation techniques and the potential impact this may have on our procedure business.

    這比我們之前傳達的範圍更廣,考慮到選擇性程序的波動性增加以及最近 FDA 聲明不鼓勵使用動力粉碎技術以及這可能對我們的程序業務產生的潛在影響。

  • Moving to revenues, as has been discussed earlier, several factors are pressuring our business making it difficult in the near-term for us to predict systems sales volumes, and as a consequence, total revenue.

    轉向收入,如前所述,有幾個因素給我們的業務帶來壓力,使我們在短期內難以預測系統銷量,因此難以預測總收入。

  • Specifically, the breadth and evolving nature of our procedure growth.

    具體來說,我們程序增長的廣度和不斷發展的性質。

  • As a reminder, procedures are our primary driver of capital sales and the relationship between procedure growth rates and capital sales is highly sensitive.

    提醒一下,程序是我們資本銷售的主要驅動力,程序增長率與資本銷售之間的關係非常敏感。

  • Our recent introduction of the da Vinci Xi System and upcoming period of transition in advance of its release in international markets and ahead of the availability of Xi versions of certain advanced instruments; continued economic pressure and uncertainty at hospitals associated with the implementation of the Affordable Care Act; evolving utilization patterns and point-of-care dynamics; and likely variability in the timing of Japan's systems sales given the timeline for obtaining additional procedure reimbursement beyond dVP, anticipated no sooner than 2016.

    我們最近推出了達芬奇 Xi 系統,以及即將在國際市場發布之前和某些高級儀器的 Xi 版本上市之前的過渡期;與《平價醫療法案》的實施相關的醫院持續的經濟壓力和不確定性;不斷發展的利用模式和護理點動態;考慮到在 dVP 之後獲得額外程序報銷的時間表,預計不早於 2016 年,日本系統銷售的時間可能會發生變化。

  • Due to these factors affecting the capital side of our business, we will not be providing a revenue forecast at this time.

    由於這些影響我們業務資本方面的因素,我們目前不會提供收入預測。

  • As mentioned on last quarter's call, we expect to sell fewer systems in 2014 than the 546 systems sold in 2013.

    正如在上一季度的電話會議中提到的,我們預計 2014 年銷售的系統數量將少於 2013 年銷售的 546 個系統。

  • Our Q1 2014 gross profit percentage was roughly 68%.

    我們 2014 年第一季度的毛利率約為 68%。

  • As we move forward in 2014, we expect our gross profit percentage will shift directionally lower, given that our newly-launched da Vinci Xi System has lower gross profit margins at launch than the mature Si platform.

    隨著我們在 2014 年向前邁進,我們預計我們的毛利率將向下移動,因為我們新推出的達芬奇 Xi 系統在推出時的毛利率低於成熟的 Si 平台。

  • While we will look to cost reduce the product and improve margins over time, the da Vinci Xi will negatively impact gross margins in 2014.

    雖然我們希望隨著時間的推移降低產品成本並提高利潤率,但 da Vinci Xi 將對 2014 年的毛利率產生負面影響。

  • We also anticipate a growing proportion of sales of newer lower-margin instrument products throughout the year, including Stapler and Vessel Sealer.

    我們還預計全年新的低利潤儀器產品的銷售比例將增加,包括吻合器和容器密封器。

  • Our actual gross profit margin will vary, depending largely on product mix and systems production volume.

    我們的實際毛利率會有所不同,這在很大程度上取決於產品組合和系統生產量。

  • We believe deeply in our ability to fundamentally improve surgery and are continuing to pursue plans to increase the use of da Vinci-enabled MIS around the globe.

    我們深信我們有能力從根本上改進手術,並且正在繼續推行計劃,以增加全球範圍內啟用達芬奇的 MIS 的使用。

  • As stated previously, 2014 will be a year of increased investment for Intuitive Surgical, even during this period of capital sales uncertainty.

    如前所述,2014 年將是 Intuitive Surgical 增加投資的一年,即使在這個資本銷售不確定的時期也是如此。

  • We will be building our international capabilities, investing in new product developments and pursuing growth in multiple areas of our procedure business.

    我們將建立我們的國際能力,投資於新產品開發,並在我們的程序業務的多個領域尋求增長。

  • Now, excluding the impact of this quarter's $67 million charge for estimated legal settlements, we've continued to expect to grow our operating expenses roughly 12% to 15% above 2013 levels.

    現在,排除本季度 6700 萬美元的估計法律和解費用的影響,我們繼續預計我們的運營費用將比 2013 年水平增長約 12% 至 15%。

  • We expect our 2014 noncash stock compensation expense to be towards the lower end of the $180 million to $190 million range communicated on last quarter's call, compared to $169 million in 2013.

    我們預計我們 2014 年的非現金股票補償費用將接近上一季度電話會議上傳達的 1.8 億美元至 1.9 億美元範圍的下限,而 2013 年為 1.69 億美元。

  • We continue to expect other income, which is comprised mostly of interest income, to total between $15 million and $20 million in 2014, also towards the lower end of the range.

    我們繼續預計 2014 年主要由利息收入組成的其他收入總額將在 1500 萬美元至 2000 萬美元之間,也接近該範圍的低端。

  • With regard to income tax, we continue to expect our 2014 income tax rate to be between 25% and 28% of pretax income, depending primarily on the mix of US and international profits.

    關於所得稅,我們繼續預計 2014 年的所得稅稅率將在稅前收入的 25% 至 28% 之間,這主要取決於美國和國際利潤的組合。

  • This forecast does not assume the reinstatement of the R&D tax credit in 2014.

    該預測不假設 2014 年恢復研發稅收抵免。

  • Our share count for calculating diluted EPS in Q1 2014 was approximately 39.1 million shares.

    我們計算 2014 年第一季度稀釋後每股收益的股份數量約為 3910 萬股。

  • Our actual Q2 and fiscal year 2014 share count will depend on several factors, including the magnitude and timing of any additional share buybacks.

    我們實際的第二季度和 2014 財年股票數量將取決於幾個因素,包括任何額外股票回購的規模和時間。

  • That concludes our prepared comments.

    我們準備好的評論到此結束。

  • We will now open the call to your questions.

    我們現在將打開您的問題的電話。

  • Operator

    Operator

  • (Operator Instructions) Ben Andrew, William Blair.

    (操作員說明)本安德魯,威廉布萊爾。

  • Ben Andrew - Analyst

    Ben Andrew - Analyst

  • Gary, talk to us a little bit more about the 12% to 15% increase in OpEx with the revenue projection you just gave.

    加里,根據您剛剛給出的收入預測,與我們多談談運營支出增加 12% 到 15% 的情況。

  • Obviously, you run the business on a multi-year basis, and we don't believe or at least we believe there is a long-term opportunity.

    顯然,你經營的業務是多年的,我們不相信,或者至少我們相信有長期的機會。

  • But what are you seeing in 2015 and the needs of the Company today that justify that level of spending with this revenue forecast?

    但是,您在 2015 年看到了什麼以及公司今天的需求證明了這種收入預測的支出水平是合理的?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • I think as we have said in the past, the places we are investing I think really are points of our future growth.

    我認為正如我們過去所說的那樣,我們正在投資的地方我認為確實是我們未來增長的點。

  • And they are international markets, both in Europe, Japan, other places in Asia over time; as well as bringing to market products that we think help surgeons and, therefore, expand our opportunity, both deepening it in markets that we're already existing and the potential to open new markets.

    隨著時間的推移,它們是國際市場,包括歐洲、日本和亞洲其他地方;以及將我們認為可以幫助外科醫生的產品推向市場,從而擴大我們的機會,既深化我們已經存在的市場,也有可能開拓新市場。

  • I think that scaling back quickly as a result of near-term pressure is not in the long-term best interest of the Company.

    我認為,由於近期壓力而迅速縮減規模不符合公司的長期最佳利益。

  • Ben Andrew - Analyst

    Ben Andrew - Analyst

  • That's fair.

    這還算公平。

  • So should we think about a more, if you will, permanent lower domestic growth rate, given some of the pressures -- or maybe a multi-year lower domestic growth rate, because it does sound like the continued emphasis shift towards international is where the bulk of the growth would be coming from.

    因此,考慮到一些壓力,我們是否應該考慮更多(如果您願意)永久降低國內增長率 - 或者可能是多年較低的國內增長率,因為聽起來確實像是繼續將重點轉移到國際上大部分增長將來自。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • I think it is, from my point of view, too soon to make that comment.

    我認為,從我的角度來看,現在發表該評論還為時過早。

  • I look out and say, it's clear that there are some changing dynamics within the US marketplace, particularly around some of the procedures that are elective.

    我觀察並說,很明顯,美國市場中存在一些不斷變化的動態,特別是圍繞一些選擇性程序。

  • Some of those things are broader than intuitive.

    其中一些事情比直覺更廣泛。

  • And you look at the changes of surgical admissions that are changing and some of the payer behaviors around incentives or disincentives around surgery, we will have to see how those things wash out in time.

    你看看正在改變的手術入院的變化,以及圍繞手術的激勵或抑制因素的一些付款人行為,我們將不得不看看這些事情是如何及時消失的。

  • Some of them have to do with internal focus of the Company.

    其中一些與公司的內部焦點有關。

  • As we look at opportunities and have adjusted our sales force focus, that will pay off in time, but those things take a little time to wash through.

    當我們尋找機會並調整我們的銷售人員重點時,這將及時得到回報,但這些事情需要一點時間才能完成。

  • And so I think that is a good question to ask again and then again in future quarters.

    所以我認為這是一個很好的問題,可以在未來的幾個季度裡一次又一次地問。

  • And I would not call it right now.

    我現在不會稱呼它。

  • Ben Andrew - Analyst

    Ben Andrew - Analyst

  • Okay, last question for me, talking about, if you will, instrument pocket share in the evolving area of general surgery, if we go out 12 or maybe even 24 months, what percentage of the instruments that are not da Vinci today in a particular case for you all in a trained center do you think will still not be da Vinci at that point?

    好的,我的最後一個問題,如果你願意的話,談論儀器在不斷發展的普通外科領域的口袋份額,如果我們出去 12 個月甚至 24 個月,今天在特定領域中非達芬奇儀器的百分比是多少在訓練有素的中心為你們所有人提供的案例,您認為到那時仍不會是達芬奇嗎?

  • Can we get to 100% pocket share or is it going to be 50%, or whatever the number is, for some protracted period of time?

    我們能否在一段較長的時間內達到 100% 的口袋份額,或者它會是 50%,或者不管這個數字是多少?

  • Thank you.

    謝謝你。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Yes; so as you think about what kinds of things make sense for a customer on a da Vinci platform where we can really bring value, probably not 100%, but certainly higher than we are today.

    是的;所以當你思考什麼樣的事情對達芬奇平台上的客戶有意義,我們可以真正帶來價值,可能不是 100%,但肯定比我們今天高。

  • And I don't think we have called out, here is the endpoint.

    而且我認為我們還沒有喊出來,這是終點。

  • ABut a good example, Vessel Sealer has been really well received by our customer.

    但是一個很好的例子,Vessel Sealer 確實受到了我們客戶的好評。

  • The adoption has gone deeper in different places than we had anticipated when we started.

    不同地方的採用比我們開始時預期的要深入。

  • And as we look at stapling and its early adoption into colorectal, that has been pretty positive for us.

    當我們著眼於吻合術及其在結直腸癌中的早期應用時,這對我們來說是非常積極的。

  • Customer feedback on it has been strong.

    客戶對此的反饋很強烈。

  • And as we expand the Stapling offering to bring them articulation and stability and some of the things that we can bring, I think that is an opportunity for the Company as we go forward.

    隨著我們擴大 Stapling 產品,為他們帶來清晰度和穩定性以及我們可以帶來的一些東西,我認為這對公司來說是一個機會,因為我們向前邁進。

  • So I don't think we can peg an exact number for you, but I think it will move up, certainly in the multi-port, multi-quadrant procedures that we think we can make a big difference in, in the near term.

    所以我認為我們不能為你確定一個確切的數字,但我認為它會上升,當然是在我們認為我們可以在短期內產生重大影響的多端口、多像限程序中。

  • Go ahead, Calvin.

    去吧,卡爾文。

  • Calvin Darling - Director, FP&A and IR

    Calvin Darling - Director, FP&A and IR

  • Yes, and just a few thoughts on just the overall metric of instrument accessory revenue per procedure.

    是的,只是關於每個程序的儀器配件收入的總體指標的一些想法。

  • As was mentioned, we saw the positive contribution of the Stapler and the Vessel Sealer here in the first quarter, which really effectively offset the negative impact primarily from lower stocking orders with the lower system sales in the quarter.

    如前所述,我們在第一季度看到了 Stapler 和 Vessel Sealer 的積極貢獻,這確實有效地抵消了主要來自本季度系統銷售額較低的庫存訂單減少的負面影響。

  • So the overall metric was favorably in line first quarter of this year with fourth quarter of last year.

    因此,今年第一季度的總體指標與去年第四季度一致。

  • And so as you look forward, this higher proportion, you're going to have a higher proportion of single-site and less complex benign procedures in the overall mix and you have the positive impact of Vessel Sealer and Firefly.

    因此,當你向前看時,這個更高的比例,你將在整體組合中擁有更高比例的單點和不太複雜的良性程序,並且你會產生 Vessel Sealer 和 Firefly 的積極影響。

  • So as you look out into 2014, you've got factors moving in either direction, and it's really difficult to gauge the net direction of the metric moving forward in this year.

    因此,當您展望 2014 年時,您會看到兩個方向都在變化的因素,而且很難判斷今年該指標向前發展的淨方向。

  • Ben Andrew - Analyst

    Ben Andrew - Analyst

  • Thank you.

    謝謝你。

  • Operator

    Operator

  • Tycho Peterson, JPMorgan.

    摩根大通第谷彼得森。

  • Tycho Peterson - Analyst

    Tycho Peterson - Analyst

  • Just want to understand the guidance revision on procedures; specifically around the issue of morcellation, which as you called out does not sell power morcellation products but in the revised guidance you did call that out as a factor.

    只是想了解有關程序的指南修訂;特別是關於粉碎問題,正如你所說,它不銷售強力粉碎產品,但在修訂後的指南中,你確實將其作為一個因素。

  • So can you maybe just talk about how you see that impacting the market?

    那麼,您能否談談您如何看待這對市場的影響?

  • And do you need to step up marketing efforts around that to clarify (inaudible)?

    您是否需要圍繞此加強營銷工作以澄清(聽不清)?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • In the near-term, I think that the surgical societies are going to look and evaluate, and they are, what the implications are for minimally invasive surgery as a whole.

    在短期內,我認為外科學會將審視和評估對整個微創手術的影響,而且他們確實如此。

  • As we mentioned, power morcellation is not a part of many, many of the gynecologic procedures that we do.

    正如我們所提到的,強力粉碎並不是我們所做的許多婦科手術的一部分。

  • I think there will be some reassessment by the surgical societies and by surgeons themselves as they look at tissue extraction techniques and where they want to take guidance from there.

    我認為外科學會和外科醫生自己會重新評估組織提取技術以及他們希望從中獲得指導的地方。

  • So for us, it's pretty hard to forecast.

    所以對我們來說,很難預測。

  • I think at this point we're just going to have to wait and see.

    我認為在這一點上我們只能拭目以待。

  • Da Vinci offers a dexterity and the opportunity for alternative techniques to tissue extraction and so over time we will see where surgeons want to go with that.

    達芬奇提供了一種靈巧性,並為組織提取的替代技術提供了機會,因此隨著時間的推移,我們將看到外科醫生想要用它去哪裡。

  • Patrick, I don't know if you want to add.

    帕特里克,我不知道你是否想補充。

  • Patrick Clingan - Director, Finance

    Patrick Clingan - Director, Finance

  • I think, Tycho, the issue here really is about the unknown oncologic status of these fibroids.

    我認為,第谷,這裡的問題實際上是關於這些肌瘤的未知腫瘤學狀態。

  • If you step back and you think da Vinci is commonly used in procedures where cancer has been diagnosed, so while it is hard for us to get precise on it, we think until some of the treatment approaches are more settled, there might be some uncertainty in the marketplace here over the short run.

    如果你退後一步,你認為達芬奇通常用於診斷癌症的程序,那麼雖然我們很難準確地了解它,但我們認為在一些治療方法更加確定之前,可能會有一些不確定性短期內在這裡的市場。

  • Tycho Peterson - Analyst

    Tycho Peterson - Analyst

  • Okay.

    好的。

  • And then since this is the first call post the launch of the Xi, can you maybe just talk about some of the early momentum, understanding it's not necessarily an upgrade to the Si but have you seen any interest in existing Si customers upgrading?

    然後,由於這是 Xi 發布後的第一個電話,你能不能談談一些早期的勢頭,了解它不一定是對 Si 的升級,但你是否看到現有 Si 客戶有升級的興趣?

  • And then can you help us quantify the opportunity around multi-quadrant procedures in maybe areas like microsurgery, which I would think might be applicable as well.

    然後你能幫助我們量化多像限程序在顯微外科等領域的機會嗎,我認為這也可能適用。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Marshall, I will let you describe a little bit of the early pipeline as qualitatively as you see it.

    Marshall,我會讓你描述一些早期的管道,就像你看到的一樣定性。

  • Marshall Mohr - SVP and CFO

    Marshall Mohr - SVP and CFO

  • Sure.

    當然。

  • We're not going to talk about intra-quarter activity, but on the other hand, there was, as you know, there was a hospital in Texas that put out a press release on their first procedure.

    我們不會談論季度內活動,但另一方面,如您所知,德克薩斯州有一家醫院就他們的第一個程序發布了新聞稿。

  • And the excitement around it and the interaction that we've had with customers is positive.

    圍繞它的興奮以及我們與客戶的互動是積極的。

  • Not going to predict how it's going to roll out.

    不打算預測它將如何推出。

  • As Gary said in his part, there are certain instruments -- advanced instruments that are not yet available for it.

    正如加里在他的部分所說的那樣,有一些工具——高級工具尚不可用。

  • So it will probably be a rollout over time versus a bolus up front.

    因此,隨著時間的推移,它可能會逐漸推出,而不是預先推注。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • And when we think about multi-quadrant procedures and work that people are excited about, a lot of the features that have gone into the Xi are ones that surgeons have been interested in and asked us about and we have been in development with them for some time.

    當我們想到人們興奮的多像限程序和工作時,Xi 中的許多功能都是外科醫生感興趣並詢問我們的,我們已經與他們一起開發了一些時間。

  • So the idea of being able to in essence change setups without having to move the base around, the longer instruments help in larger patient populations; in general surgery, the narrower instruments get you into tighter spaces.

    因此,能夠在本質上改變設置而不必四處移動底座的想法,更長的儀器有助於更大的患者群體;在普通外科手術中,較窄的器械會讓您進入更狹窄的空間。

  • So as we look at general surgery, general surgery is indeed that, a lot of different procedures.

    所以當我們看普通外科時,普通外科確實是很多不同的程序。

  • And so we're excited about the flexibility that the setup of the platform brings as well as things like port hopping, the idea that the camera can move between different cannula to be able to get different views of the anatomy.

    因此,我們對平台設置帶來的靈活性以及諸如端口跳躍之類的東西感到興奮,相機可以在不同插管之間移動以獲得不同的解剖視圖。

  • So I think that has been strong for us.

    所以我認為這對我們來說很強大。

  • Microsurgery is not something we have talked about.

    顯微外科不是我們談論的東西。

  • I'm not quite sure where that came from.

    我不太確定那是從哪裡來的。

  • It's not an indication on the Xi, and so perhaps at another time we could talk about that in more detail.

    這不是對習近平的暗示,所以也許我們可以在另一個時間更詳細地討論這個問題。

  • Tycho Peterson - Analyst

    Tycho Peterson - Analyst

  • Last one, just quickly on the new Sp system announced today, I've had a few people asking about the 25-millimeter port size.

    最後一個,就在今天宣布的新 Sp 系統上,有幾個人問我 25 毫米的端口尺寸。

  • Does that get you around the risk of hernia?

    這會讓你遠離疝氣的風險嗎?

  • And maybe just talk to the discussions with FDA.

    也許只是談談與 FDA 的討論。

  • They have obviously gone after some of your competitors around port-site hernias.

    很明顯,他們已經針對端口部位疝氣追查了您的一些競爭對手。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Twenty-five is about the same size as the port that is going on -- that is used a little bit different kind of construction that is being used in single site.

    二十五與正在進行的端口的大小大致相同——它使用了一種與單一站點中使用的不同類型的結構。

  • I am not personally expert in the herniation issues, although understanding and listening to surgeons I understand that how you make the cut down, how you make the incision, and how you close it, closer technique has a large impact in what those things look like.

    我個人不是疝氣問題的專家,儘管我了解並聽取了外科醫生的意見,但我知道您如何進行切割,如何進行切口以及如何關閉它,更近距離的技術對這些東西的外觀有很大影響.

  • Conversations with regard to FDA have really centered around the technical performance aspects of the device and its application to urology in terms of the Sp itself, so really no additional color to provide you on that front.

    關於 FDA 的討論實際上圍繞著設備的技術性能方面及其在 Sp 本身方面在泌尿外科的應用,因此在這方面真的沒有額外的顏色可以為您提供。

  • Tycho Peterson - Analyst

    Tycho Peterson - Analyst

  • Okay, thank you.

    好的謝謝。

  • Operator

    Operator

  • Bob Hopkins, Bank of America.

    美國銀行的鮑勃·霍普金斯。

  • Bob Hopkins - Analyst

    Bob Hopkins - Analyst

  • Just wanted to clarify some things on the procedure volume guidance.

    只是想澄清一些關於程序卷指南的事情。

  • I just wanted to make sure I heard you right, to start out.

    我只是想確保我沒聽錯,開始。

  • So your guidance is -- for 2014 now for procedure volume growth is 2% to 8%.

    所以你的指導是——2014 年現在的手術量增長是 2% 到 8%。

  • That is a global number, correct?

    這是一個全球數字,對嗎?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • That is correct.

    那是正確的。

  • Bob Hopkins - Analyst

    Bob Hopkins - Analyst

  • So you started the year at 7%.

    所以你今年年初是 7%。

  • And so obviously what you are contemplating here is things potentially getting worse from here.

    很明顯,你在這裡考慮的是事情可能會從這裡變得更糟。

  • So I'd really like to just understand to the degree you are willing to talk about it, what are you contemplating getting worse from here?

    所以我真的很想了解你願意談論它的程度,你打算從這裡變得更糟嗎?

  • Is this GYN getting a little bit worse or is this GYN and chole getting a little bit worse?

    這個 GYN 變得更糟了還是這個 GYN 和 chole 變得更糟了?

  • And then just broadly speaking, what turns this around in your view?

    然後從廣義上講,在您看來是什麼扭轉了局面?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Yes, I think you look at it, and the things we are calling out are the increasing pressure that we are seeing in the US gynecology procedures, factors that we discussed on the call, including the payer disincentives for benign surgery, effects of the Affordable Care Act, and impacts on procedure potentially involving power morcellation, which is a rather recent event.

    是的,我想你看了一下,我們呼籲的是我們在美國婦科手術中看到的越來越大的壓力,我們在電話會議上討論的因素,包括付款人對良性手術的抑制因素,負擔得起的影響護理法,以及對可能涉及功率粉碎的程序的影響,這是最近發生的事件。

  • We have seen more volatility in these elective procedures and economic sensitivity, as well.

    我們也看到這些選舉程序和經濟敏感性的波動更大。

  • So that is on the gynecology side.

    所以這是在婦科方面。

  • And specific to cholecystectomy, and Patrick talked about what appears to be a tightening really of the types of patients that may be the target robotic candidates.

    具體到膽囊切除術,帕特里克談到了可能成為目標機器人候選人的患者類型似乎正在收緊。

  • And so these are early days in both these categories.

    因此,這兩個類別都處於早期階段。

  • But I think the range of the guidance is broader and lower in recognition of these factors.

    但我認為,考慮到這些因素,指導的範圍更廣、更低。

  • Patrick Clingan - Director, Finance

    Patrick Clingan - Director, Finance

  • Just to add a little light -- I think the big issue here is that you see some shifting winds in the US of benign surgery marketplace, broader than Intuitive and some that are specific to us.

    只是為了補充一點——我認為這裡的大問題是你看到美國良性手術市場的風向正在轉變,比 Intuitive 更廣泛,有些是我們特有的。

  • So I think the uncertainty is pretty high, especially around total hysterectomies in total -- the whole set, not just us -- over time.

    所以我認為不確定性非常高,尤其是隨著時間的推移,整個子宮切除術——整個集合,而不僅僅是我們。

  • And I think as hospitals start adjusting to some of the implications of Affordable Care Act And some of the swings and seasonality that we're seeing, the exaggerated swings, we will have to see how that plays out in the year.

    而且我認為,隨著醫院開始適應平價醫療法案的一些影響以及我們看到的一些波動和季節性,誇大的波動,我們將不得不看看它在今年會如何發揮作用。

  • And that is what accounts for this broad range.

    這就是這個廣泛範圍的原因。

  • Bob Hopkins - Analyst

    Bob Hopkins - Analyst

  • And so really as a follow-up to that, and Gary, this is a question for you, it's a question on buyback, but it's really a question about trying to understand your intended message regarding confidence in your long-term opportunities versus the near-term uncertainties.

    因此,作為後續行動,加里,這是一個問題,這是一個關於回購的問題,但它實際上是一個關於試圖理解你對長期機會與近期機會的信心的預期信息的問題- 期限的不確定性。

  • So as you noted, there's no buyback this quarter, and obviously there is a lot of uncertainty.

    所以正如你所指出的,本季度沒有回購,顯然存在很多不確定性。

  • But you are sitting on $3 billion in cash and you have a $1 billion buyback authorized.

    但是你坐擁 30 億美元的現金,並且你有 10 億美元的授權回購。

  • And my question is, why wouldn't now be a time for you guys to be more aggressive about the buyback if you are encouraged about the long term?

    我的問題是,如果你們受到長期鼓勵,為什麼現在不是你們更積極地回購的時候了?

  • And so again, I'm really just trying to gauge here long-term opportunities versus near-term uncertainty.

    因此,我真的只是想在這裡衡量長期機會與近期不確定性。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • I think that directionally we feel like buybacks are a good idea when we feel like there is a good opportunity for the market -- for the Company to be in the market.

    我認為,當我們覺得市場有一個很好的機會——讓公司進入市場時,我們覺得回購是一個好主意。

  • And that is something we speak about routinely with the board here.

    這是我們經常與董事會討論的話題。

  • And so we will see.

    所以我們會看到。

  • I think with the fair amount of volatility that has been evidenced in the US market and is likely to persist for some time given all the moving parts in the US market, when opportunities arise then I think the board will sit down and evaluate it.

    我認為,考慮到美國市場的所有變動因素,美國市場已經出現相當大的波動並且可能會持續一段時間,當機會出現時,我認為董事會將坐下來對其進行評估。

  • Bob Hopkins - Analyst

    Bob Hopkins - Analyst

  • And then just lastly really quickly on the Sp system, could you just talk a little bit more about that?

    然後最後真的很快在 Sp 系統上,你能多談談嗎?

  • What does that look like long term?

    從長遠來看,這看起來像什麼?

  • Really who is the customer for Sp?

    究竟誰是 Sp 的客戶?

  • Is that potentially a less expensive system that could be targeted to outpatient?

    這是否可能是一個可以針對門診病人的更便宜的系統?

  • I just want to understand who the real customer is for Sp as you see it, thinking long term when you have multiple approvals and just trying to understand where this is going.

    我只想了解您所看到的 Sp 的真正客戶是誰,當您獲得多項批准時從長遠考慮,只是想了解它的發展方向。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Right.

    正確的。

  • So the first thing is that we have not announced pricing.

    所以第一件事是我們還沒有公佈定價。

  • Likely the operating costs for the Sp system will slot in above Single-Site and at a slight premium to a da Vinci set.

    Sp 系統的運營成本可能會高於單站點,並且略高於達芬奇裝置。

  • It's not finalized, so it is not an operating cost, lower cost than Single-Site, which is actually quite good already.

    還沒有定型,所以不是運營成本,比Single-Site成本低,其實已經很不錯了。

  • Single-Site instrumentation from a material cost point of you are within, about $100 of multi-port laparoscopy costs.

    從您的材料成本點來看,單點儀器在多端口腹腔鏡檢查成本中約為 100 美元。

  • So the material cost comparisons are quite good on Single-Site already.

    因此,Single-Site 上的材料成本比較已經相當不錯了。

  • This has additional capability and will come into, from an operating point of view, at a small premium to that price point.

    這具有額外的功能,並且從操作的角度來看,將比該價格點有小幅溢價。

  • In terms of why we think it is interesting, the first indication to be entirely clear, is urology.

    就我們認為它有趣的原因而言,第一個完全清楚的跡像是泌尿科。

  • We think there are some interesting things that can be done, particularly in things like kidney cancer, where you have the removal of the specimen.

    我們認為可以做一些有趣的事情,特別是在腎癌等疾病中,您需要切除標本。

  • I think these are the kinds of procedures where full articulation and four arms make sense in a single-port context as we think about other places in the future that might have interesting indications; we think about places where you are going to be in confined spaces; head and neck is one of them; transanal procedures are another place that people have a real interest in.

    我認為這些是在我們考慮未來可能有有趣跡象的其他地方時,在單端口環境中完全清晰和四臂有意義的程序;我們考慮您將要進入密閉空間的地方;頭頸就是其中之一;經肛門手術是人們真正感興趣的另一個地方。

  • And one of the reasons that we are talking about this a little bit early relative to launch is to give us room to discuss it with surgeons; to develop it in terms of preclinical laboratory work over time, so we get a real chance to interact with customers about where this kind of architecture can take us.

    相對於發布,我們早一點討論這個問題的原因之一是給我們空間與外科醫生討論它;隨著時間的推移,根據臨床前實驗室工作來開發它,這樣我們就有機會與客戶互動,了解這種架構可以帶我們去哪裡。

  • I think early interest is quite high in terms of enthusiasm.

    我認為早期的興趣在熱情方面是相當高的。

  • I think there's real work to be done in terms of refining some of the elements that are present in terms of both the supply chain and the indications, and we will look forward to doing that over time.

    我認為在改進供應鍊和適應症方面存在的一些要素方面還有真正的工作要做,我們將期待隨著時間的推移這樣做。

  • Long term, I think there are some unique capabilities here technologically that may lead us to some interesting places.

    從長遠來看,我認為這裡有一些獨特的技術能力可能會把我們帶到一些有趣的地方。

  • Bob Hopkins - Analyst

    Bob Hopkins - Analyst

  • Thank you.

    謝謝你。

  • Operator

    Operator

  • David Roman, Goldman Sachs.

    大衛羅曼,高盛。

  • David Roman - Analyst

    David Roman - Analyst

  • I wanted to ask one strategic question and then one just specific question about the numbers.

    我想問一個戰略問題,然後是一個關於數字的具體問題。

  • And maybe starting with the strategic side, Gary, as I listen to your commentary in the prepared remarks where you've brought up international, I think you didn't specifically call it emerging markets, but you brought up Asia, India, Latin America, it sounds like there is sort of a shift a little bit in the strategy here as the US markets mature; and just the focus of the Company is moving to being more of a global medical device company with a little bit more of a broader focus and less of a pure-play technology company.

    也許從戰略方面開始,加里,當我在準備好的發言中聽到你的評論時,你提到了國際,我認為你沒有具體稱之為新興市場,但你提到了亞洲、印度、拉丁美洲,聽起來隨著美國市場的成熟,這裡的戰略有點轉變;只是公司的重心正在轉向成為一家全球性醫療設備公司,關注範圍更廣,而不是一家純粹的技術公司。

  • And as you look at the market valuations of those different types of businesses, I'm just wondering how you think about the evolution of the business as you start to look -- it sounds like more singles and doubles versus home-run opportunities coming from expansion of therapy versus new product launches?

    當你查看這些不同類型企業的市場估值時,我只是想知道你如何看待你開始關注的業務演變——聽起來更多的是單打和雙打,而不是本壘打的機會來自擴大治療還是推出新產品?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • Yes, I understand the question.

    是的,我明白這個問題。

  • I don't think certainly in the next few years -- I don't see that it is an either/or.

    我認為在接下來的幾年里肯定不會——我不認為這是一個非此即彼的選擇。

  • I think that we have made real investments and we will continue to invest.

    我認為我們已經進行了真正的投資,我們將繼續投資。

  • And those technologies we think can make a real difference in surgery.

    我們認為那些技術可以真正改變手術。

  • And I expect that to continue.

    我希望這種情況會繼續下去。

  • And the indications around thinking globally are not strongly this year, next year and the year following.

    今年、明年和後年圍繞全球思維的跡象並不強烈。

  • You know we have been investing in Europe and Japan longer term.

    你知道我們一直在歐洲和日本進行長期投資。

  • As you look multiple years out, I think there are real opportunities in other parts of Asia and Latin America, and I think it will be important for the Company to be there.

    展望未來多年,我認為亞洲和拉丁美洲其他地區存在真正的機會,我認為公司進駐那裡很重要。

  • It is not intended to signal a hard right turn away from innovation.

    它並不是要發出遠離創新的硬性右轉信號。

  • Innovation is in our DNA.

    創新是我們的 DNA。

  • You see it routinely in the products that we develop and bring to market, and I expect that to continue.

    你經常在我們開發和推向市場的產品中看到它,我希望這種情況會繼續下去。

  • David Roman - Analyst

    David Roman - Analyst

  • And then maybe just a second question on -- maybe this does relate a little bit to the slowing in choles, but one of the things that you have been talking about and this came up more on the fourth-quarter call, was on the R&D spending to collect more clinical data to support the adoption of therapies where you have stronger competition.

    然後也許只是第二個問題——也許這確實與膽汁的減緩有一點關係,但你一直在談論的其中一件事是在第四季度的電話會議上更多地提到的,是關於研發花錢收集更多臨床數據,以支持在競爭更激烈的情況下採用療法。

  • I am presuming that is sort of Ethicon and Covidien.

    我假設這是 Ethicon 和 Covidien 的一種。

  • But maybe you could talk about the type of data you're going to be collecting on choles in some of those procedures where you need to be more competitive.

    但也許你可以談談你將在一些你需要更具競爭力的程序中收集的關於 choles 的數據類型。

  • And then ultimately when that could drive a resumption in growth in those categories -- or sorry, a reacceleration of growth?

    然後最終什麼時候可以推動這些類別的增長恢復——或者抱歉,增長的重新加速?

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • So as you look out I think the type of data are pretty clear and routinely collected.

    所以當你看的時候,我認為數據的類型非常清晰並且是定期收集的。

  • I think first you collect clinical outcome data and that evolves sometimes from single institution studies, so multi-institution studies and so on, and then with that I think economics that follow.

    我認為首先你要收集臨床結果數據,這些數據有時會從單一機構研究、多機構研究等演變而來,然後我認為隨之而來的是經濟學。

  • So it really is a combination of how are your products used followed by what kind of outcomes are being obtained, followed by what are the economic consequences of those outcomes.

    因此,它實際上是您的產品如何使用、獲得什麼樣的結果以及這些結果的經濟後果的組合。

  • And that is really what we invest in.

    這就是我們真正投資的地方。

  • And where you have all three, you see's strong benefit.

    如果您擁有這三者,您就會看到巨大的好處。

  • Where you have products that is differentiated, where outcomes are differentiated, and the economics follow, that has been a strong predictor of growth.

    如果您擁有差異化的產品、差異化的結果以及隨之而來的經濟狀況,那麼這就是增長的有力預測指標。

  • So that is a routine part of what we do, both in the US and O-US.

    因此,這是我們在美國和 O-US 所做工作的常規部分。

  • Each health system calculates some of these things a little bit differently; disease states vary a little bit country to country, so it's not just a US-centric activity.

    每個衛生系統對其中一些事情的計算略有不同;疾病狀態因國家/地區而異,因此這不僅僅是以美國為中心的活動。

  • David Roman - Analyst

    David Roman - Analyst

  • Okay.

    好的。

  • And maybe just a quick last one here, I know Bob asked the question about buybacks an,d I understand the comments around volatility in the market.

    也許這裡只是最後一個,我知道鮑勃問了關於回購的問題,我理解關於市場波動的評論。

  • But maybe you just broadly help us think about capital allocation, if there are other priorities you might look at given some of the gyration in the top line here.

    但也許你只是廣泛地幫助我們考慮資本配置,如果還有其他優先事項,你可能會考慮考慮到這裡頂線的一些波動。

  • And you have spoken about M&A in the past as a potential; maybe how your thinking about broader use of cash in the context of everything that is going on here.

    您過去曾將併購視為一種潛力;也許你是如何考慮在這裡發生的一切的背景下更廣泛地使用現金的。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • The basic elements, as you have seen, has been A, organic growth funding, organic growth and development where we need to.

    如您所見,基本要素是 A、有機增長資金、有機增長和我們需要的發展。

  • We have invested O-US and sometimes those investments are organic and sometimes they are acquisitions of things that are important.

    我們投資了 O-US,有時這些投資是有機的,有時是對重要事物的收購。

  • I expect that to continue.

    我希望這種情況繼續下去。

  • We routinely look for technologies that will enhance our product lines and acquire them on an ongoing basis.

    我們經常尋找能夠增強我們產品線的技術並持續獲取它們。

  • Typically those have not been huge acquisitions, but in the future if there was an opportunity and a need, then those can grow.

    通常這些都不是大規模的收購,但在未來如果有機會和需要,那麼這些收購就會增長。

  • And so those are really the basic elements in the mix.

    因此,這些確實是組合中的基本元素。

  • They change a little bit in terms of how they are mixed together over time, but the three elements are all there.

    隨著時間的推移,它們在混合在一起的方式上發生了一點變化,但這三個元素都在那裡。

  • David Roman - Analyst

    David Roman - Analyst

  • Okay, thank you very much.

    好的,非常感謝。

  • Gary Guthart - President and CEO

    Gary Guthart - President and CEO

  • All right.

    好的。

  • We appear to have lost our operator.

    我們似乎失去了接線員。

  • If you are still on, I will go ahead and close.

    如果你還在,我會繼續並關閉。

  • While we discuss financial metrics on these calls, our organization remains focused on developing and delivering products that allow surgeons to deliver minimally invasive surgery to a broad base of patients.

    在我們討論這些電話會議的財務指標時,我們的組織仍然專注於開發和交付產品,使外科醫生能夠為廣泛的患者群提供微創手術。

  • I hope the following quote from Dr. Leitao and team from Memorial Sloan-Kettering in their recent paper on da Vinci use in hysterectomy gives you some sense of the value Intuitive brings to the surgical community.

    我希望 Leitao 博士和 Memorial Sloan-Kettering 團隊在他們最近關於達芬奇在子宮切除術中的應用的論文中引用了以下引述,讓您對 Intuitive 給外科界帶來的價值有所了解。

  • Quote, the key conclusion from our data in conjunction with other published data is that the cost of robotics must take into account how it affects the rate of laparotomy and not just compare successfully completed robotic to laparoscopic cases, because these are both minimally invasive approaches using different instrumentation.

    引用,我們的數據與其他已發布數據的關鍵結論是,機器人技術的成本必須考慮到它如何影響剖腹手術率,而不僅僅是將成功完成的機器人與腹腔鏡病例進行比較,因為這些都是微創方法,使用不同的儀器。

  • Also, it's important to take into account post-discharge cost outcomes.

    此外,重要的是要考慮出院後的成本結果。

  • Our data further validate and support the data from [Lao] and colleagues -- enhancement of laparoscopic programs with the introduction of the robotic platform and a (inaudible) decrease in laparotomy rates leads to cost neutralization of the robotic platform and potentially a cost savings overall.

    我們的數據進一步驗證和支持來自 [Lao] 及其同事的數據——隨著機器人平台的引入和剖腹手術率的(聽不清)下降導致腹腔鏡程序的增強導致機器人平台的成本中和並可能節省整體成本.

  • The authors continue, despite nearly 40 years of availability, laparoscopic hysterectomies still comprise only a small percentage of all hysterectomies in the United States and the world.

    作者繼續說,儘管腹腔鏡子宮切除術已有近 40 年的歷史,但在美國和世界範圍內,腹腔鏡子宮切除術仍然只佔所有子宮切除術的一小部分。

  • There are gynecologic surgeons who provide safe and efficient laparoscopic surgery.

    有婦科外科醫生提供安全高效的腹腔鏡手術。

  • It is important to continue to support their efforts.

    繼續支持他們的努力很重要。

  • Unfortunately, they only represent a minority of all gynecologic surgeons.

    不幸的是,她們只代表了所有婦科外科醫生中的一小部分。

  • The robotic platform is a device that overcomes some of the limitations of standard laparoscopic instrumentation and has increased minimally invasive approaches.

    機器人平台是一種克服了標準腹腔鏡器械的一些局限性並增加了微創方法的設備。

  • End quote.

    結束報價。

  • In closing, we are steadfast in our conviction and the value da Vinci has and can bring to medicine.

    最後,我們堅信我們的信念和達芬奇為醫學帶來的價值。

  • And we thank you for your support in helping Intuitive expand the benefits of minimally invasive surgery.

    我們感謝您的支持,幫助 Intuitive 擴大微創手術的優勢。

  • That concludes today's call, and I look forward to speaking with you again in three months.

    今天的電話會議到此結束,我期待三個月後再次與您交談。