直覺手術 (ISRG) 2014 Q4 法說會逐字稿

Ladies and gentlemen, thank you for standing by and welcome to the Intuitive Surgical Q4 2014 earnings release call. (Operator Instructions). As a reminder, today's conference call will be recorded.

女士們，先生們，感謝你們的支持，歡迎來到 Intuitive Surgical 2014 年第四季度財報電話會議。 （操作員說明）。提醒一下，今天的電話會議將被錄音。

Now I would like to turn the conference over to our first speaker, Senior Director of Finance with Intuitive Surgical, Mr. Calvin Darling. Please go ahead, sir.

現在我想把會議轉交給我們的第一位發言人，Intuitive Surgical 的高級財務總監 Calvin Darling 先生。請繼續，先生。

Thank you. Good afternoon and welcome to Intuitive Surgical's fourth-quarter earnings conference call. With me today, we have Gary Guthart, our President and CEO; Marshall Mohr, our Chief Financial Officer; and Patrick Clingan, Director of Finance.

謝謝你。下午好，歡迎來到 Intuitive Surgical 的第四季度收益電話會議。今天和我在一起的是我們的總裁兼首席執行官 Gary Guthart；我們的首席財務官 Marshall Mohr；和財務總監 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. Actual results may differ materially from those expressed or implied, as a result of certain risks and uncertainties. These risks and uncertainties are described in detail in the Company's Securities and Exchange Commission filings, including our most recent Form 10-K, filed on February 3, 2014, and our Form 10-Q, filed October 23, 2014.

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。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。這些風險和不確定性在公司向證券交易委員會提交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 表格和 2014 年 10 月 23 日提交的 10-Q 表格。

These filings can be found through our website or at the SEC's EDGAR database. Prospective investors are cautioned not to place undue reliance on such forward-looking statements.

這些文件可以通過我們的網站或 SEC 的 EDGAR 數據庫找到。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. In addition, today's press release and supplementary financial data tables have been posted to our website.

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。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 fourth-quarter results, as described in our press release announced earlier today, followed by a question-and-answer session. Gary will present the quarter's business and operational highlights. Marshall will provide a review of our fourth-quarter financial results. Patrick will discuss marketing and clinical highlights. Then I will provide our financial outlook for 2015. Finally, we will host a question-and-answer session.

正如我們今天早些時候發布的新聞稿中所述，今天的形式將包括向您提供我們第四季度業績的亮點，然後是問答環節。 Gary 將介紹本季度的業務和運營亮點。 Marshall 將對我們的第四季度財務業績進行審查。 Patrick 將討論營銷和臨床亮點。然後我將提供我們 2015 年的財務展望。最後，我們將舉行問答環節。

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 on the call today.

感謝您今天加入我們的電話會議。

2014 has been a year of transition for Intuitive, with macroeconomic uncertainty at the start of the year giving way to improving performance as the year progressed. At the outset, we focused on driving adoption of our platform in general surgery and launching key new products and in increasing our organizational capability and performance in international markets, particularly Europe and Japan.

2014 年對於 Intuitive 來說是過渡的一年，年初的宏觀經濟不確定性讓位於隨著時間的推移改善業績。一開始，我們專注於推動我們的平台在普外科領域的採用，推出關鍵的新產品，並提高我們在國際市場（尤其是歐洲和日本）的組織能力和績效。

The organization has responded well in the year, with solid procedure performance and a strong launch of our newest generation da Vinci platform. General surgery and international procedures have become the growth engine for the business.

該組織在這一年中反應良好，程序性能可靠，並大力推出了我們最新一代的達芬奇平台。普外科和國際手術已成為該業務的增長引擎。

Starting with a review of procedures, year-over-year growth was approximately 9%, led by growth in general surgery, growth in the use of da Vinci outside of the United States, and strength in urology, offset by flat annual performance in gynecology.

從程序審查開始，同比增長約為 9%，這主要是由於普通外科的增長、達芬奇在美國以外地區的使用增長以及泌尿科的實力，但被婦科年度表現平平所抵消.

General surgery growth was approximately 33% for the year, comprised of strong growth in da Vinci colorectal surgery, hernia repair, and in other general surgery procedures, offset by slowing da Vinci Single-Site use in cholecystectomy. While Single-Site cholecystectomy procedures were up in 2014, they were down in the fourth quarter.

普外科全年增長約 33%，其中達芬奇結直腸手術、疝修補術和其他普外科手術的強勁增長，被達芬奇單點手術在膽囊切除術中的使用放緩所抵消。雖然單點膽囊切除術在 2014 年有所上升，但在第四季度有所下降。

Outside of the United States, procedure growth remained robust, rising approximately 20% over procedures in 2013, based on strength in Europe and Asia. Patrick will review procedure trends in greater detail later in the call.

在美國以外，基於歐洲和亞洲的實力，手術增長依然強勁，比 2013 年的手術增長了約 20%。 Patrick 將在稍後的電話會議中更詳細地審查程序趨勢。

Looking at trends in capital sales for the year, capital placements increased in sequential quarters, helped by the launch of da Vinci Xi in the second quarter of 2014. Outside of the United States, our capital business was solid, with international system strength in Europe and Asia, outside of Japan. System sales weakened in Japan over 2013 as customers wait for both Xi clearance and additional reimbursement. Sales elsewhere, particularly China, grew over 2013.

從今年的資本銷售趨勢來看，在 2014 年第二季度推出 da Vinci Xi 的幫助下，資本配售連續幾個季度增加。在美國以外，我們的資本業務穩健，在歐洲擁有國際系統實力和亞洲，日本以外。由於客戶等待 Xi 清關和額外報銷，2013 年日本的系統銷售疲軟。 2013 年，其他地區（尤其是中國）的銷售額有所增長。

Our product launches were significant in 2014. In the second quarter, we launched our fourth-generation platform, the da Vinci Xi Surgical System. We launched Xi in the United States in April, followed by CE Mark in June; availability in France, Austria, and Switzerland in October; and Korea in December.

我們在 2014 年推出的產品意義重大。在第二季度，我們推出了第四代平台達芬奇 Xi 手術系統。我們於 4 月在美國發布了 Xi，隨後於 6 月發布了 CE 標誌； 10 月在法國、奧地利和瑞士上市；和韓國在 12 月。

The Xi system enhances our prior-generation systems by improving multi-quadrant access to the body, introducing the ability to move the endoscope between robotic arms, increasing range of motion and reach with slimmer arms, and enhancing ease of use and setup. Customer reception of the Xi has been strong, with interest in use by multiple specialties, including colorectal surgeons, urologists, thoracic surgeons, and gynecologic oncologists.

Xi 系統通過改進對身體的多像限訪問、引入在機械臂之間移動內窺鏡的能力、增加運動範圍和使用更細的手臂達到的範圍以及增強易用性和設置來增強我們的上一代系統。 Xi 的客戶接受度很高，包括結直腸外科醫生、泌尿科醫生、胸外科醫生和婦科腫瘤科醫生在內的多個專業人士對使用它很感興趣。

Our systems are optimized for different procedures by dozens of instruments and accessories. In 2014, we added to the initial set of instruments and accessories available for the Xi at launch by introducing the Xi Vessel Sealer in Q2, Xi Firefly in Q3, and Xi stapler in Q1 of 2015.

我們的系統通過數十種儀器和附件針對不同的程序進行了優化。 2014 年，我們在 Q2 推出了 Xi Vessel Sealer，在 Q3 推出了 Xi Firefly，在 2015 年第一季度推出了 Xi 吻合器，為 Xi 發佈時提供了一套初始儀器和配件。

In 2015, we plan to submit a 510(k) for software that allows for coordinated table motion with the Xi and a 510(k) for an Xi-compatible version of our Single-Site instruments. This filling out of the Xi product suite will increase the applicability of the platform to institutions interested in owning a single da Vinci system.

2015 年，我們計劃提交 510(k) 軟件，允許與 Xi 協調工作台運動，並提交 510(k) 軟件，用於我們的 Single-Site 儀器的 Xi 兼容版本。 Xi 產品套件的補充將增加該平台對有興趣擁有單一達芬奇系統的機構的適用性。

Turning to instruments, we launched our Wristed Needle Driver instrument for use with Single-Site surgery in Q4 of 2014. Surgeons performing single-incision hysterectomy with da Vinci Single-Site are particularly interested in the Wristed Needle Driver and initial uptake has been strong. Single-Site hysterectomy with Wristed Needle Driver is still in its early days and projecting its long-term impact on the hysterectomy market is premature.

談到儀器，我們在 2014 年第四季度推出了用於單點手術的腕針驅動器儀器。使用達芬奇單點進行單切口子宮切除術的外科醫生對腕針驅動器特別感興趣，並且最初的接受度很高。使用腕針驅動器的單點子宮切除術仍處於早期階段，預測其對子宮切除術市場的長期影響還為時過早。

In the fourth quarter of 2014, we issued a field action for our da Vinci Si stapler after we observed three intraoperative instrument failures. In each case, these procedures were completed successfully minimally invasively.

2014 年第四季度，我們在觀察到三個術中器械故障後，對我們的達芬奇 Si 吻合器發出了現場行動。在每種情況下，這些程序都以微創方式成功完成。

Our team has identified the root causes of failure and has requalified the stapler.

我們的團隊已經確定了失敗的根本原因，並對訂書機進行了重新鑑定。

As of this first quarter of 2015, the Si EndoWrist Stapler is back in production and first cases have been completed. Our Xi Stapler was also launched in the quarter, with first cases completed this month.

截至 2015 年第一季度，Si EndoWrist 吻合器已恢復生產，首批病例已完成。我們的 Xi Stapler 也在本季度推出，本月完成了第一批病例。

Looking back at the full year 2014, our operating performance was as follows. Worldwide procedures grew approximately 9%. We shipped 431 surgical systems in the year, down from 546 in 2013. Total revenue was $2.1 billion, down 6% from 2013. Recurring revenue grew to $1.57 billion, up 5% and comprising 70% of total revenue.

回顧2014年全年，我們的經營業績如下。全球程序增長了約 9%。我們全年出貨了 431 個手術系統，低於 2013 年的 546 個。總收入為 21 億美元，比 2013 年下降 6%。經常性收入增長至 15.7 億美元，增長 5%，佔總收入的 70%。

We generated $819 million in operating profit before non-cash stock option expense, down 21% from last year. Pro forma net income was $607 million, down 24% from 2013, and we reduced our shares outstanding by repurchasing 2.5 million shares at an average price of $398 per share during 2014.

扣除非現金股票期權費用之前，我們的營業利潤為 8.19 億美元，比去年下降 21%。預計淨收入為 6.07 億美元，比 2013 年下降 24%，我們在 2014 年以每股 398 美元的平均價格回購 250 萬股股票，減少了我們的流通股。

Turning to our operating performance in the fourth quarter, procedures grew approximately 10% over the fourth quarter of last year. We sold 137 da Vinci Surgical Systems, down from 138 in the fourth quarter of 2013.

談到我們在第四季度的經營業績，程序比去年第四季度增長了約 10%。我們售出了 137 台達芬奇手術系統，低於 2013 年第四季度的 138 台。

Total revenue for the quarter was $605 million, up 5% from prior year. Instrument and accessory revenue increased to $281 million, up 5%. We generated an operating profit of $237 million in the quarter before non-cash stock compensation expense, down 8% from the fourth quarter of last year, and pro forma net income was $184 million, down 5% from Q4 of 2013.

本季度總收入為 6.05 億美元，比去年同期增長 5%。儀器和附件收入增加到 2.81 億美元，增長 5%。我們在扣除非現金股票補償費用之前的季度實現營業利潤 2.37 億美元，比去年第四季度下降 8%，預計淨收入為 1.84 億美元，比 2013 年第四季度下降 5%。

In 2014, we made significant investments in our organization, including growing our direct to commercial organization in Japan. We anticipate growing our organization in specific areas through 2015, with particular emphasis on Asia, Europe, and in operations.

2014 年，我們對我們的組織進行了大量投資，包括在日本發展我們的直接商業組織。到 2015 年，我們預計在特定領域發展我們的組織，特別強調亞洲、歐洲和運營。

Looking to 2015, our priorities are as follows. First, we will focus on the expanded use of da Vinci in general surgery, particularly colorectal surgery and hernia repair. Second, we will work to complete our launch and new product introductions of da Vinci Xi in key markets globally.

展望 2015 年，我們的工作重點如下。首先，我們將專注於擴大達芬奇在普通外科手術中的應用，尤其是結直腸手術和疝修補術。其次，我們將努力完成da Vinci Xi在全球主要市場的發布和新產品介紹。

Third, we will develop our organizational capabilities in markets in Europe and Asia, and, finally, we plan to build Xi-compatible da Vinci Sp prototypes and initiate customer evaluations.

第三，我們將在歐洲和亞洲市場發展我們的組織能力，最後，我們計劃構建 Xi 兼容的達芬奇 Sp 原型並啟動客戶評估。

I will now turn the call over to Marshall, who will take you through our financial highlights.

我現在將電話轉給馬歇爾，他將帶您了解我們的財務亮點。

Thank you, Gary.

謝謝你，加里。

Our first-quarter 2014 revenue and procedures were consistent with our press release issued on January 13. Fourth-quarter revenues were $605 million, up 5% compared with $576 million for the fourth quarter of 2013 and up 10% from last quarter. Procedures for the fourth quarter grew approximately 10% compared with the fourth quarter of 2013 and approximately 9% compared with last quarter.

我們 2014 年第一季度的收入和程序與我們在 1 月 13 日發布的新聞稿一致。第四季度收入為 6.05 億美元，比 2013 年第四季度的 5.76 億美元增長 5%，比上一季度增長 10%。與 2013 年第四季度相比，第四季度的程序增長了約 10%，與上一季度相比增長了約 9%。

I will be describing our results on a non-GAAP or pro forma basis, which excludes the impact of our Xi trade-in programs, legal claim accruals, stock-based compensation, amortization of purchased IP, and investment impairments. We are providing pro forma information because we believe that business trends and operating results are easier to understand on a pro forma basis.

我將在非 GAAP 或備考基礎上描述我們的結果，其中不包括我們的 Xi 以舊換新計劃、法定索賠應計費用、基於股票的補償、購買的 IP 的攤銷和投資減值的影響。我們之所以提供備考信息，是因為我們相信在備考基礎上更容易理解業務趨勢和運營結果。

I will also summarize our GAAP results later in my script. We have posted reconciliations of our pro forma results to our GAAP results on our website so that there is no confusion.

我還將在稍後的腳本中總結我們的 GAAP 結果。我們已經在我們的網站上發布了備考結果與 GAAP 結果的對賬，以免造成混淆。

Procedure highlights will be covered by Patrick. Revenue highlights are as follows. Pro forma instrument and accessory revenue grew 4% compared with the fourth quarter of 2013 and 3% compared with the third quarter of 2014. The increases relative to prior quarters reflect procedure growth, partially offset by customer buying patterns and the impact of the field action for our da Vinci Si Stapler.

Patrick 將介紹程序要點。收入亮點如下。預計儀器和附件收入與 2013 年第四季度相比增長 4%，與 2014 年第三季度相比增長 3%。與前幾個季度相比的增長反映了程序增長，部分被客戶購買模式和現場行動的影響所抵消用於我們的達芬奇 Si 訂書機。

We have resolved the issue underlying the stapler and began shipping it again early in the first quarter of 2015. We also began shipment of our Xi Stapler early this quarter.

我們已經解決了訂書機的潛在問題，並於 2015 年第一季度初再次開始發貨。我們還於本季度初開始發貨 Xi 訂書機。

Instrument and accessory revenue realized per procedure, including initial stocking orders, was approximately $1,830 per procedure, compared with $1,930 for both the fourth quarter of 2013 and last quarter. The decrease from the prior year, as well as the prior quarter, reflects the timing of customer orders and the field action for our da Vinci Si Stapler.

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 1,830 美元，而 2013 年第四季度和上一季度均為 1,930 美元。與上一年和上一季度相比的下降反映了客戶訂單的時間安排和我們的達芬奇矽訂書機的現場行動。

Pro forma system revenue of $211 million increased 3% compared with the fourth quarter of 2013 and increased 37% compared with the third quarter of 2014. The increase in systems revenue compared with the third quarter primarily reflects higher system sales in Europe and the US.

預計系統收入為 2.11 億美元，與 2013 年第四季度相比增長 3%，與 2014 年第三季度相比增長 37%。與第三季度相比系統收入的增長主要反映了歐洲和美國較高的系統銷售額。

137 systems were placed in the third quarter, excluding two Xis traded for Sis under our trade-out program, compared with 138 systems in the fourth quarter of 2013 and 111 systems last quarter. 97 of the systems placed in the fourth quarter were Xis, compared with 59 in the third quarter and 50 in the second quarter.

第三季度放置了 137 個系統，不包括根據我們的折價計劃用 Xis 換取 Sis 的兩個系統，而 2013 年第四季度為 138 個系統，上季度為 111 個系統。第四季度放置的系統中有 97 個是 Xis，而第三季度和第二季度分別為 59 個和 50 個。

Globally, our system ASP of $1.550 million increased relative to the ASP for the fourth quarter of last year of $1.460 million and relative to the last quarter of $1.450 million. The increase in ASPs relative to last year reflects product mix, where the current quarter included a high mix of Xis and the fourth quarter of 2013 included a high mix of Si-es. The increase in ASPs relative to the last quarter reflects a higher proportion of Xi systems, a higher proportion of dual console systems, and a positive geographic mix.

在全球範圍內，我們的系統平均售價為 155 萬美元，高於去年第四季度的平均售價 146 萬美元和上一季度的 145 萬美元。 ASP 相對於去年的增長反映了產品組合，本季度包括大量 Xis，而 2013 年第四季度包括大量 Si-es。與上一季度相比，ASP 的增長反映出 Xi 系統比例更高、雙控制台系統比例更高以及積極的地域組合。

Hospitals financed approximately 15% of the systems placed in the fourth quarter, down from 27% last quarter. We directly financed 12 systems, of which five were structured as operating leases. Through the fourth quarter of 2014, we have entered into 14 operating leases.

醫院資助了第四季度約 15% 的系統，低於上一季度的 27%。我們直接為 12 個系統提供資金，其中五個採用經營租賃方式。截至 2014 年第四季度，我們簽訂了 14 項經營租賃。

In the US, we placed 71 systems in the fourth quarter, compared with 72 systems in the fourth quarter of 2013 and 61 systems in the third quarter of 2014. Outside the US, we sold 66 systems in the fourth quarter, compared with 66 in the fourth quarter of 2013 and 48 systems last quarter.

在美國，我們在第四季度部署了 71 個系統，而 2013 年第四季度為 72 個系統，2014 年第三季度為 61 個系統。在美國以外，我們在第四季度售出了 66 個系統，而在2013 年第四季度和上季度 48 個系統。

Year-over-year system placements reflect growth in Europe, 39 systems this quarter compared with 28 systems last year, and a reduction in Japan systems, six systems this quarter compared with 21 systems last year. Quarter-over-quarter system placement growth reflects higher system placements in Europe and other world markets. Fourth-quarter system sales included nine into Italy, seven into Turkey, and five into the Nordic countries.

同比系統佈置反映了歐洲的增長，本季度為 39 個系統，而去年為 28 個系統；日本系統的減少，本季度為 6 個系統，而去年為 21 個系統。系統佈局環比增長反映了歐洲和其他世界市場的系統佈局增加。第四季度系統銷售額包括 9 個進入意大利、7 個進入土耳其和 5 個進入北歐國家。

International revenue results were as follows. Fourth-quarter pro forma revenue outside the US was $197 million, or approximately the same as the fourth quarter of 2013 revenue of $195 million and up 29% compared with $153 million last quarter. Our higher sequential international revenue was driven by increased procedures and higher system sales in a seasonally stronger quarter.

國際收入結果如下。美國以外的第四季度預估收入為 1.97 億美元，與 2013 年第四季度的收入 1.95 億美元大致持平，較上一季度的 1.53 億美元增長 29%。我們較高的連續國際收入是由於在季節性較強的季度增加了程序和較高的系統銷售額。

Fourth-quarter 2014 OUS procedure volume was approximately 21% higher than the fourth quarter of 2013 and 14% higher than the third quarter of this year. Procedure volume was led -- growth was led by dVP, but also reflected strong growth in GYN and general surgery.

2014 年第四季度 OUS 手術量比 2013 年第四季度高出約 21%，比今年第三季度高出 14%。手術量領先——增長由 dVP 引領，但也反映了 GYN 和普通外科的強勁增長。

Moving on to the remainder of the P&L, pro forma gross margin in the fourth quarter of 2014 was 67.1%, compared with 70.7% for the fourth quarter of 2013 and 67.2% for the third quarter of 2014. Our lower margin percentage relative to prior quarters primarily reflects the high mix of Xi systems.

轉到損益表的其餘部分，2014 年第四季度的預計毛利率為 67.1%，而 2013 年第四季度和 2014 年第三季度分別為 70.7% 和 67.2%。我們的毛利率低於之前季度主要反映了 Xi 系統的高度混合。

In the first quarter, we recorded a pretax charge of $67 million to reflect the estimated costs of settling a number of product liability legal claims against the Company. During the second quarter and the fourth quarter, we recorded additional charges of $10 million and $5 million, reflecting additional claims. These claims relate to the 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 the subject of a recall in 2013.

第一季度，我們記錄了 6700 萬美元的稅前費用，以反映解決針對公司的多項產品責任法律索賠的估計成本。在第二季度和第四季度，我們記錄了 1000 萬美元和 500 萬美元的額外費用，反映了額外的索賠。這些索賠涉及使用某些版本的單極燒灼剪或 MCS 儀器進行的手術並發症，這些儀器包括 2012 年退出市場的 MCS 尖端蓋配件，以及使用 MCS 儀器進行的手術是2013 年召回的對象。

Our 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 a tolling agreement. We will continue to refine our estimates as we proceed through the negotiation process.

我們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收費協議建立的調解過程的患者的律師的談判。在談判過程中，我們將繼續完善我們的估計。

Pro forma operating expenses, which exclude the reserves for legal claims, stock compensation expense, and amortization of purchased IP, were up 9% compared with the fourth quarter of 2013 and were up 2% compared with last quarter. Our fourth-quarter 2014 pro forma operating expense, compared to the fourth quarter of 2013, reflects headcount additions and higher incentive compensation. The increase compared to last quarter was driven by higher incentive compensation and severance costs.

不包括法律索賠準備金、股票補償費用和所購知識產權攤銷的備考營業費用較 2013 年第四季度增長 9%，較上一季度增長 2%。與 2013 年第四季度相比，我們 2014 年第四季度的備考運營費用反映了員工人數的增加和更高的激勵薪酬。與上一季度相比的增長是由更高的激勵薪酬和遣散費推動的。

Our pro forma effective tax rate for the fourth quarter was 23.5%, compared with 25.8% for the fourth quarter of 2013 and 27.2% last quarter. The pro forma effective tax rate for 2014 benefited from the release of reserves specific to tax years where we have completed our IRS audit or jurisdictions where the statute of limitations have now expired.

我們第四季度的備考有效稅率為 23.5%，而 2013 年第四季度為 25.8%，上一季度為 27.2%。 2014 年的備考有效稅率受益於針對我們已完成美國國稅局審計的納稅年度或時效現已到期的司法管轄區的儲備金釋放。

In addition, the fourth quarter of 2014 rate benefited from the reinstatement of the federal research and development credit. We anticipate our pro forma effective rate for 2015 will reflect the more normal range of 28% to 30%. Our tax rate will fluctuate with changes in mix of US and OUS income and will not reflect a federal research and development credit unless such credit is reinstated.

此外，2014 年第四季度的利率得益於聯邦研發信貸的恢復。我們預計 2015 年的備考有效率將反映 28% 至 30% 的更正常範圍。我們的稅率將隨著美國和美國收入組合的變化而波動，並且不會反映聯邦研發信貸，除非此類信貸被恢復。

Our pro forma net income was $184 million or $4.92 per share, compared with $193 million or $4.98 per share for the fourth quarter of 2013 and $145 million or $3.91 per share for the third quarter of 2014. Excluding one-time tax benefits, our fourth-quarter 2014 pro forma net income would have been $159 million or $4.25 per share.

我們的預計淨收入為 1.84 億美元或每股 4.92 美元，而 2013 年第四季度為 1.93 億美元或每股 4.98 美元，2014 年第三季度為 1.45 億美元或每股 3.91 美元。不包括一次性稅收優惠，我們的第四季度-2014 年季度備考淨收入為 1.59 億美元或每股 4.25 美元。

As I indicated earlier, pro forma income provides an easier comparison of our financial results and business trends. I will now summarize our GAAP results. GAAP revenue was $605 million for the fourth quarter of 2014, compared with $576 million for the fourth quarter of 2013 and $550 million for the third quarter of 2014.

正如我之前指出的那樣，備考收入可以更輕鬆地比較我們的財務結果和業務趨勢。我現在將總結我們的 GAAP 結果。 2014 年第四季度 GAAP 收入為 6.05 億美元，而 2013 年第四季度和 2014 年第三季度分別為 5.76 億美元和 5.50 億美元。

GAAP net income was $147 million or $3.94 per share for the fourth quarter of 2014, compared with $166 million or $4.28 per share for the fourth quarter of 2013 and $124 million or $3.35 per share for the third quarter of 2014.

2014 年第四季度 GAAP 淨收入為 1.47 億美元或每股 3.94 美元，而 2013 年第四季度為 1.66 億美元或每股 4.28 美元，2014 年第三季度為 1.24 億美元或每股 3.35 美元。

We ended the quarter with cash and investments of $2.5 billion, up from $2.3 billion as of September 30, 2014. The increase was primarily driven by cash generated from operations. During the year, we repurchased 2.5 million shares for $1 billion at an average purchase price of $398 per share.

本季度結束時，我們的現金和投資為 25 億美元，高於 2014 年 9 月 30 日的 23 億美元。增長主要是由運營產生的現金推動的。年內，我們以每股 398 美元的平均購買價格，以 10 億美元的價格回購了 250 萬股股票。

With that, I would like to turn it over to Patrick, who will go over our sales, marketing, and clinical highlights.

有了這個，我想把它交給帕特里克，他將回顧我們的銷售、營銷和臨床亮點。

Thanks, Marshall.

謝謝，馬歇爾。

As mentioned earlier, total Q4 year-over-year procedures grew approximately 10%, with US procedures growing approximately 8% and international procedures growing approximately 21%.

如前所述，第四季度總手術量同比增長約 10%，其中美國手術量增長約 8%，國際手術量增長約 21%。

In US urology, the uptick in dVP procedures experienced in Q3 continued in Q4. Given our high rate of penetration in the US prostatectomy market, our dVP volumes are likely to track to overall US prostatectomy volumes. Coupled with continued growth in kidney procedures, our overall US urology procedures showed modest growth in 2014.

在美國泌尿外科，第 3 季度 dVP 手術的增長在第 4 季度繼續。鑑於我們在美國前列腺切除術市場的高滲透率，我們的 dVP 數量可能會追踪到美國前列腺切除術的整體數量。加上腎臟手術的持續增長，我們在美國的整體泌尿外科手術在 2014 年呈現適度增長。

In US gynecology, Q4 results were similar to prior quarters in 2014, with low single-digit procedure declines. dVHb volumes appear consistent with the expected total market benign hysterectomy procedure decline, partially offset by growth in cancer procedures. Single-Site hysterectomy continued to display rapid early growth, off a small base.

在美國婦科領域，第四季度的結果與 2014 年的前幾個季度相似，手術數量下降幅度很小。 dVHb 數量似乎與預期的良性子宮切除術市場總量下降一致，部分被癌症手術的增長所抵消。單點子宮切除術繼續顯示出快速的早期增長，但基數很小。

Moving on to US general surgery, adoption continues to be solid across a broad number of procedures. Colorectal and hernia adoption remains a source of strength, while cholecystectomies declined modestly in the quarter. Over the course of 2014, we have seen a shift in focus from cholecystectomy to hernia repair by our general surgeons and sales force.

轉向美國普通外科，在廣泛的程序中採用率繼續保持穩定。結直腸和疝氣的收養仍然是一個力量來源，而膽囊切除術在本季度略有下降。在 2014 年期間，我們看到我們的普通外科醫生和銷售人員的工作重點從膽囊切除術轉移到疝修補術。

Despite the decline in cholecystectomies this quarter, we continue to hear positive feedback from segments of the patient and surgeon populations that see value in the single-incision approach of our Single-Site technology or the real-time imaging of the biliary anatomy with our Firefly technology, among advantages associated with robotic surgery.

儘管本季度膽囊切除術有所減少，但我們繼續聽到部分患者和外科醫生的積極反饋，他們認為我們的 Single-Site 技術的單切口方法或我們的 Firefly 膽道解剖實時成像的價值技術，以及與機器人手術相關的優勢。

Looking more deeply at hernia repair, we are encouraged by robust procedure growth, coupled with positive feedback about the clinical outcomes being generated with da Vinci Surgery during these early stages of adoption. However, hernia repair is a broad term and the benefits associated with robotic and minimally invasive surgery varies across patient subsets.

更深入地觀察疝氣修復，我們對手術的強勁增長感到鼓舞，再加上在早期採用達芬奇手術所產生的臨床結果的積極反饋。然而，疝氣修復是一個廣義術語，與機器人和微創手術相關的好處因患者亞群而異。

For ventral hernias, surgeon feedback around the ease of suturing and enhanced vision associated with robotic surgery enables a minimally invasive closure of the primary defect that is similar to open surgery. Relative to laparoscopy, da Vinci surgeons have commented on increased intra-abdominal surgical dexterity for dissection and suturing, less postoperative pain, and similar or lower material operating costs.

對於腹疝，外科醫生對縫合的便利性和與機器人手術相關的視力增強的反饋使原發缺損的微創閉合類似於開放手術。相對於腹腔鏡檢查，達芬奇外科醫生評論說，腹腔鏡手術在解剖和縫合方面更加靈巧，術後疼痛更少，材料操作成本相似或更低。

For inguinal hernia, discussions continue among surgeons about the role of minimally invasive surgery for some procedures. However, da Vinci surgeons have reported to us that for certain inguinal hernias, there are advantages in transabdominal defect closure and a reduction in postoperative pain.

對於腹股溝疝，外科醫生繼續討論微創手術在某些手術中的作用。然而，達芬奇外科醫生向我們報告說，對於某些腹股溝疝，經腹閉合缺損和減少術後疼痛具有優勢。

Defining the subsets of hernia repair where robotic surgery is expected to thrive is difficult, particularly in these early days, though we are encouraged by our physician commentaries.

定義疝氣修復的子集，其中機器人手術有望蓬勃發展是困難的，特別是在這些早期階段，儘管我們的醫生評論讓我們感到鼓舞。

Looking abroad, international Q4 procedure growth of approximately 21% continued to be led by global adoption of dVP and other urologic procedures, with solid early contributions from gynecology and general surgery. In Japan, we have seen continued adoption of dVP. Clinical trials to support our reimbursement submissions for partial nephrectomy and gastrectomy have begun enrollment, and we continue discussions with key opinion leading surgeons and surgical society leadership on other procedures of interest.

放眼國外，全球採用 dVP 和其他泌尿外科手術繼續引領國際第四季度手術增長約 21%，婦科和普通外科的早期貢獻也很強勁。在日本，我們看到繼續採用 dVP。支持我們提交的部分腎切除術和胃切除術報銷申請的臨床試驗已經開始招募，我們將繼續與關鍵意見領先的外科醫生和外科學會領導就其他感興趣的程序進行討論。

Recently, a population-based study of the first year of dVP adoption in Japan was completed by researchers from the University of Tokyo and the Cleveland Clinic that included more than 10,000 patients. Published in Cancer Science, the study found that dVP, despite being within the first year of broad adoption, was associated with a lower complication rate, lower transfusion rate, shorter hospitalization, longer anesthesia time, and higher costs compared to open surgery and minimally invasive alternatives.

最近，東京大學和克利夫蘭診所的研究人員完成了一項關於日本採用 dVP 第一年的基於人群的研究，其中包括 10,000 多名患者。該研究發表在《癌症科學》雜誌上，研究發現，儘管 dVP 在被廣泛採用的第一年內，但與開放手術和微創手術相比，並發症發生率較低、輸血率較低、住院時間較短、麻醉時間較長以及費用較高備擇方案。

There is little detail around how costs were calculated in this study, though they appear correlated to anesthesia time. We know from prior studies that with experience, both cost and operating room time decline. The authors found the favorable clinical outcomes with robotic surgery noteworthy during these early phases of the introduction of our technology, offsetting the longer anesthesia time.

儘管成本似乎與麻醉時間相關，但在這項研究中幾乎沒有關於如何計算成本的細節。我們從之前的研究中知道，隨著經驗的積累，成本和手術室時間都會下降。作者發現，在引入我們技術的這些早期階段，機器人手術的有利臨床結果值得注意，抵消了較長的麻醉時間。

In Europe, in addition to strong capital sales, we are encouraged by continued clinical developments. While dVP adoption is driving the majority of procedure growth, initial developments in colorectal surgery may establish the foundation for future adoption.

在歐洲，除了強勁的資本銷售外，我們還對持續的臨床開發感到鼓舞。雖然 dVP 的採用推動了大部分手術的增長，但結直腸手術的初步發展可能為未來的採用奠定基礎。

Under the leadership of key opinion leading surgeons, the European Academy of Robotic Colorectal Surgeons was launched in December. Through a network of hospitals and surgeons, this group is providing standardized training and proctoring to support the introduction of robotic colorectal surgery across Europe.

在主要意見領先的外科醫生的領導下，歐洲機器人結直腸外科醫生學會於 12 月成立。通過醫院和外科醫生網絡，該小組正在提供標準化培訓和監督，以支持在歐洲引入機器人結直腸手術。

While there have been cost studies published that compare robotic surgery within patient and surgeon populations amenable to laparoscopy, additional cost studies with appropriate comparators were published this quarter. I will quickly review one from the University of Pittsburgh, published in the Journal of the Society of Laparoendoscopic Surgeons, that compared robotic to laparoscopic in open benign hysterectomies among surgeons who most commonly performed open surgery.

雖然已經發表了成本研究，比較了接受腹腔鏡檢查的患者和外科醫生人群的機器人手術，但本季度發表了帶有適當比較器的額外成本研究。我將快速回顧匹茲堡大學發表在《腹腔內鏡外科醫生協會雜誌》上的一篇文章，該文章將機器人與腹腔鏡在最常進行開放式手術的外科醫生的開放式良性子宮切除術中進行了比較。

The study reviewed nearly 5,000 benign hysterectomies performed by 237 surgeons across 10 hospitals from 2011 to 2013, including 119 surgeons that predominantly performed open hysterectomies. Using actual cost data during the hospital stay, the authors found that when open surgeons perform robotic and laparoscopic procedures, the costs were similar on an operating cost basis. Including an add-on cost for robotic maintenance and depreciation resulted in higher cost for robotic surgeries, but the authors noted a bias in this analysis, due to the exclusion of similar costs associated with the laparoscopic procedures.

該研究回顧了 2011 年至 2013 年 10 家醫院的 237 名外科醫生進行的近 5,000 例良性子宮切除術，其中包括 119 名主要進行開放式子宮切除術的外科醫生。使用住院期間的實際成本數據，作者發現，當開放式外科醫生執行機器人和腹腔鏡手術時，在手術成本基礎上的成本相似。包括機器人維護和折舊的附加成本導致機器人手術的成本更高，但作者指出該分析存在偏差，因為排除了與腹腔鏡手術相關的類似成本。

In conclusions, the authors stated, quote, although laparoscopic hysterectomy had the lowest costs overall, robotics may be no more costly than laparoscopic hysterectomy when performed by surgeons who predominantly perform open hysterectomy, close quote.

作者總結說，引述，雖然腹腔鏡子宮切除術的總體成本最低，但如果由主要進行開放式子宮切除術的外科醫生執行，機器人技術可能不會比腹腔鏡子宮切除術更昂貴，關閉引述。

This concludes my remarks and I thank you for your time. I will now turn the call over to Calvin.

我的發言到此結束，感謝大家抽出寶貴時間。我現在將把電話轉給卡爾文。

Thank you, Patrick.

謝謝你，帕特里克。

I will be providing you with our financial outlook for 2015, starting with procedures. As described in our announcement last week, 2014 total da Vinci procedures grew approximately 9% to roughly 570,000 procedures performed worldwide. During 2015, we anticipate full-year procedure growth within a range of 7% to 10%.

我將從程序開始為您提供我們 2015 年的財務展望。正如我們上週發布的公告所述，2014 年達芬奇手術總數增長了約 9%，在全球範圍內執行了約 570,000 例手術。 2015 年，我們預計全年手術增長率在 7% 到 10% 之間。

We expect similar seasonal timing of procedures in 2015 as we have experienced in previous years, with Q1 being the seasonally weakest quarter as patient deductibles are reset.

我們預計 2015 年手術的季節性時間與往年類似，第一季度是季節性最弱的季度，因為患者免賠額被重置。

With respect to revenue guidance, consistent with last year we will not be providing specific revenue guidance. We do expect 2015 capital sales to follow historical seasonal patterns, with Q1 being sequentially lower than the recently completed Q4. We will face foreign-exchange headwinds in 2015, based upon the impacts of the stronger US dollar.

關於收入指引，與去年一樣，我們不會提供具體的收入指引。我們確實預計 2015 年的資本銷售將遵循歷史季節性模式，第一季度將低於最近完成的第四季度。基於美元走強的影響，我們將在 2015 年面臨外匯逆風。

Turning to gross profit, we expect our 2015 pro forma gross profit margin to be fairly consistent with Q4 2014, based upon the anticipated proportion of Xi, stapler, and other new products with lower gross profit margins in our product mix and the foreign-exchange headwinds I mentioned earlier, partially offset by cost reductions realized during the year.

談到毛利，我們預計我們 2015 年的備考毛利率將與 2014 年第四季度相當一致，這是基於 Xi、訂書機和其他毛利率較低的新產品在我們的產品組合和外匯中的預期比例我之前提到的逆風，部分被年內實現的成本削減所抵消。

Our actual gross profit margin will vary quarter to quarter, depending largely upon product mix and systems production volume.

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

Turning to operating expenses, we expect to grow pro forma 2015 operating expenses between 7% and 10% above 2014 levels. As we have stated previously, we believe it is fundamentally early days for computer-assisted surgery and we will continue to make investments to pursue significant growth opportunities.

談到運營費用，我們預計 2015 年備考運營費用將比 2014 年增長 7% 至 10%。正如我們之前所說，我們認為計算機輔助手術基本上處於早期階段，我們將繼續進行投資以尋求重要的增長機會。

We expect our non-cash stock compensation expense to range between $180 million and $185 million in 2015, compared to $169 million in 2014. We expect other income, which is comprised mostly of interest income, to total between $14 million and $16 million in 2015.

我們預計 2015 年我們的非現金股票補償費用在 1.8 億美元至 1.85 億美元之間，而 2014 年為 1.69 億美元。我們預計 2015 年其他收入（主要包括利息收入）總計在 1,400 萬至 1,600 萬美元之間.

With regard to income tax, as Marshall described, we expect our 2015 pro forma income tax rate to be between 28% and 30% of pretax income, depending primarily on the mix of US and international profits. This forecast is consistent with our 2014 pro forma tax rate, excluding the impact of tax reserve releases in 2014, and does not assume the reinstatement of the R&D tax credit in 2015.

關於所得稅，正如 Marshall 所述，我們預計 2015 年預估所得稅稅率將在稅前收入的 28% 至 30% 之間，這主要取決於美國和國際利潤的組合。這一預測與我們 2014 年的備考稅率一致，不包括 2014 年稅收儲備釋放的影響，並且不假設 2015 年恢復研發稅收抵免。

Our share count for calculating diluted EPS in Q4 2014 was approximately 37.3 million shares. We estimate our Q1 2015 diluted share count to range between 37.4 million and 37.6 million shares.

我們計算 2014 年第四季度稀釋後每股收益的股份數量約為 3730 萬股。我們估計 2015 年第一季度攤薄後的股份數量在 3740 萬至 3760 萬股之間。

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

我們準備好的評論到此結束。我們現在將打開您的問題的電話。

(Operator Instructions). Ben Andrew, William Blair.

（操作員說明）。本安德魯，威廉布萊爾。

Thanks for taking the question. Gary, can you talk a little bit about the investment plans in terms of dollars, breaking down international versus US? Are you adding people in the field in the US in 2015, and if so, to what extent, and then maybe talk a little bit more about the specific investments overseas that you are making?

感謝您提出問題。加里，你能談談美元方面的投資計劃，分解國際與美國嗎？您是否在 2015 年在美國增加了該領域的人員，如果是，增加到什麼程度，然後可能會多談談您正在進行的海外具體投資？

Sure. With regard to sales headcount, in the US we will have -- I would anticipate modest growth in US headcount, not a ton. OUS, in terms of commercial organization, will be a greater source of investment. Some of it is in field headcount, some of it is in clinical trial effort and dollars, some in economics and economists, so a bit of a mix.

當然。關於銷售人數，在美國，我們將有——我預計美國員工人數將適度增長，而不是大量增長。 OUS，在商業組織方面，將是一個更大的投資來源。其中一些是現場人數，一些是臨床試驗工作和美元，一些是經濟學和經濟學家，所以有點混合。

Okay, and then, Marshall, on the gross margin side, you gave us some good thoughts there in terms of the guidance. How much is ForEx impacting that and when should you get to a volume on Xi and Xi instruments where we would start to see a normalization of gross margin?

好的，然後，馬歇爾，在毛利率方面，你在指導方面給了我們一些好的想法。 ForEx 對此有多大影響，什麼時候 Xi 和 Xi 工具的交易量會開始出現毛利率正常化？

We will have FX -- about -- a little over 20% of our revenues are FX based, and if you trickle that all the way down to what that impact is on the bottom line, because we do have costs that are also FX based, you get down to where the impact is less than 3%.

我們將擁有外匯——大約——我們收入的 20% 多一點是基於外彙的，如果你將其一直滲透到對底線的影響，因為我們確實有成本也是基於外彙的，你會下降到影響小於 3% 的地方。

As far as the gross margin goes, we are ramping Xi, obviously, production, given the volumes we did last quarter. We will continue to try to work down costs overall with Xi. That's typical with all new products, but I'm not sure that you should count on it getting on par with Si. It's a more advanced piece of equipment with higher complexity.

就毛利率而言，考慮到我們上個季度的產量，我們顯然正在提高 Xi 的產量。我們將繼續努力與習一起降低整體成本。這是所有新產品的典型特徵，但我不確定您是否應該指望它與 Si 相提並論。它是一種更先進的設備，具有更高的複雜性。

Okay, and then you talked about the revenue per case on instrumentation being down because of the product withdrawal. Should we see a bounce back in Q1 and could it overshoot a bit, even as you have obviously got lower volumes, but then that would flow through the year so we could see a more traditional stocking of instrumentation as you roll out stapler and roll these other products out?

好的，然後你談到了由於產品撤回而導致的每箱儀器收入下降。我們是否應該在第一季度看到反彈並且它會不會有點過頭，即使你的銷量明顯下降，但那會貫穿一年所以我們可以看到更傳統的儀器庫存，因為你推出訂書機並推出這些其他產品出了嗎？

I think the bigger impact in the quarter, frankly, wasn't the field stapler action. It was actually customer buying patterns. We saw fewer stocking orders being filled associated with system shipments, and then distributor buying patterns also are odd. If you remember last year, first quarter we had a higher amount sold through distributors than Q2, it was down, I believe, so anyway, the patterns really drove more of that change than did the field action.

坦率地說，我認為本季度更大的影響不是現場訂書機的行動。這實際上是客戶購買模式。我們看到與系統發貨相關的庫存訂單較少，分銷商購買模式也很奇怪。如果你還記得去年，第一季度我們通過分銷商的銷售額高於第二季度，我相信它是下降的，所以無論如何，模式確實比現場行動更能推動這種變化。

Having said that, we would think, just like we commented in Q2, that we would see a more normalization over time of the instrument success rates per procedure.

話雖如此，我們認為，就像我們在第二季度評論的那樣，隨著時間的推移，我們會看到每個程序的儀器成功率更加正常化。

Looking forward at the I&A revenue procedure, you look full year. 2014, it was $1,880 per procedure, and as we discussed earlier, the revenue -- the I&A revenue based in foreign currency is definitely going to be facing headwinds, based on the stronger US dollar will weigh on the overall metric. As you saw in 2014, the I&A revenue per procedure will vary from quarter to quarter, largely based on these timing kinds of factors.

展望 I&A 收入程序，您會看到全年。 2014 年，每個程序為 1,880 美元，正如我們之前討論的那樣，收入——基於外幣的 I&A 收入肯定會面臨逆風，因為美元走強將對整體指標產生壓力。正如您在 2014 年看到的那樣，每個程序的 I&A 收入將隨季度變化，主要取決於這些時間因素。

In regards to procedure mix, we don't necessarily see that moving the dial either up or down on that, although there are swing items in relation to the metric. One would be our relative success with the stapler and Vessel Sealer utilization and where are revenue procedures higher on where these advanced instruments are used, and conversely, a higher proportion of Single-Site cases would weigh on the metric.

關於程序組合，我們不一定會看到向上或向下移動撥盤，儘管有與指標相關的搖擺項目。一個是我們在訂書機和 Vessel Sealer 利用率方面的相對成功，在使用這些先進儀器的地方，收入程序在哪裡更高，相反，更高比例的單點案例會對指標產生影響。

Thank you.

謝謝你。

Bob Hopkins, Bank of America Merrill Lynch.

鮑勃霍普金斯，美銀美林。

Good afternoon and thanks for taking the questions. Gary, just to start out, I am sorry if I missed this, but could you walk through your assumptions for buyback in 2015? If you are not assuming a buyback, I am curious as to why and what the other priorities might be for your cash.

下午好，感謝您提出問題。加里，剛開始，如果我錯過了這一點，我很抱歉，但你能談談你對 2015 年回購的假設嗎？如果你不打算回購，我很好奇為什麼以及你的現金的其他優先事項是什麼。

We are not declaring anything at this time. When we think about uses of cash, we really think about a couple of things. One of them is used to invest in those things that we talked about, the ability to improve our presence in OUS markets, some investment in both operational efficiency and new innovations, and the ability to respond to opportunity as it comes up, technologically or otherwise.

我們目前沒有宣布任何事情。當我們考慮現金的使用時，我們確實會考慮幾件事。其中之一用於投資我們談到的那些事情，提高我們在 OUS 市場的存在的能力，對運營效率和新創新的一些投資，以及在技術或其他方面對出現的機會做出反應的能力.

Where we see opportunity to return cash to shareholders, we have demonstrated that we will, and we keep our eyes open on a routine basis for those opportunities.

在我們看到向股東返還現金的機會的地方，我們已經證明我們會這樣做，並且我們會定期關注這些機會。

Are there better M&A opportunities out there than you have seen in the past?

有沒有比您過去看到的更好的併購機會？

We have been thoughtful and persistent for years now, and so we -- I wouldn't comment strongly one way or another, only that we are thoughtful and engaged in those investigations all the time. Nothing has really changed in our rhythm or pattern the last eight quarters.

多年來，我們一直在深思熟慮和堅持不懈，所以我們——我不會以某種方式發表強烈評論，只是說我們一直在深思熟慮並一直參與這些調查。過去八個季度我們的節奏或模式沒有真正改變。

Then, lastly, I wanted to ask for a real update on Sp. I know the timelines have moved around there. Can you just highlight exactly what your expectations are for rollout and approval milestones as we think about the course of 2015 and into 2016?

然後，最後，我想要求對 Sp 進行真正的更新。我知道時間線已經在那裡移動了。在我們考慮 2015 年和 2016 年的過程中，您能否準確地強調您對推出和批准里程碑的期望？

Where we are, what we are trying to achieve on Standpoint -- Sp is our dedicated single port platform. As we talked about last year, our intent is to bring some of the functionality and features that we had brought forward in Xi and that have been well received by both our customers and by folks who review our products into the Sp. We are doing that now. That feels pretty good to me. I think it's the right set of decisions to make.

我們所處的位置，我們在 Standpoint 上努力實現的目標——Sp 是我們專用的單端口平台。正如我們去年談到的那樣，我們的目的是將我們在 Xi 中提出的一些功能和特性帶到 Sp 中，這些功能和特性受到我們的客戶和評論我們產品的人們的好評。我們現在正在這樣做。這對我來說感覺很好。我認為這是應該做出的正確決定。

We will develop those products and assemble them in the front half of the year and start getting customer feedback on them into the back half of the year. We're working with regulatory bodies about what submissions might look like. We don't have timelines to share with you on what our submissions will be, and as those firm up, we will communicate them with you.

我們將在上半年開發並組裝這些產品，並在下半年開始收集客戶對它們的反饋。我們正在與監管機構合作，了解提交的內容。我們沒有與您分享我們提交的內容的時間表，隨著這些確定，我們將與您溝通。

Okay, and then maybe just sneak one more in on Japan just really quickly. I am trying to gauge your confidence on the topic of Japan and whether or not you're confident at this point in suggesting that by the time we get to 2016, we will see increases that can drive better procedure volume growth at that time. It is really a question of gauging your confidence based on what you know today.

好吧，然後也許只是很快地再偷偷進入日本。我試圖評估您對日本話題的信心，以及您是否有信心建議到 2016 年時，我們將看到可以推動更好的手術量增長的增長。這實際上是一個根據你今天所知道的來衡量你的信心的問題。

We are actively involved. I can't give you a number or a binary decision on it.

我們積極參與。我不能給你一個數字或二元決定。

We have several conversations going on and real work in several different procedure categories. There are a lot of people who have high interest in Japan, in our products, a lot of our existing customers and future customers, and we are working on it diligently.

我們在幾個不同的程序類別中進行了幾次對話和實際工作。有很多人對日本、我們的產品、我們現有的客戶和未來的客戶有很高的興趣，我們正在為此努力。

There are several milestones that have to be met, both on the path we are on and some alternative pathways, that are real decisions on the part of government decision-makers as to where they want to go and how they want to proceed, and it would be premature to try to forecast for you what those decisions will be.

在我們所走的道路上和一些替代道路上，有幾個里程碑必須實現，這些都是政府決策者關於他們想去哪里以及他們想如何進行的真正決定，而且它嘗試為您預測這些決定是什麼為時過早。

Fair enough, thank you.

很公平，謝謝。

Tao Levy, Wedbush.

陶利維，韋德布什。

I wanted to ask a little bit if you can maybe expand on what you said in the prepared remarks regarding the early uptake in hysterectomy of the Wristed Single-Site instruments. Certainly, what type of procedures, what type of patients, which surgeons are starting to adopt it, and is it cannibalizing multi-arm hysterectomies? Anything like that would be helpful.

我想問一點，您是否可以擴展您在準備好的評論中所說的關於早期採用腕單點器械子宮切除術的內容。當然，什麼類型的程序，什麼類型的患者，哪些外科醫生開始採用它，它是否會蠶食多臂子宮切除術？任何類似的事情都會有所幫助。

Sure, the primary procedure that the Wristed Needle Driver -- Single-Site Wristed Needle Driver is being used for is benign hysterectomy. It is being pursued for patients who have an interest in a single incision.

當然，腕針驅動器——單點腕針驅動器用於的主要手術是良性子宮切除術。正在為對單個切口感興趣的患者進行研究。

We see a mixture of existing robotic surgeons and those who have not approached da Vinci Systems before, so it's both folks who are currently engaged with us as customers and those who have not prior engaged. We see a mixture of both of those.

我們看到現有的機器人外科醫生和以前沒有接觸過達芬奇系統的人的混合體，所以目前作為客戶與我們接觸的人和之前沒有接觸過的人。我們看到了這兩者的混合。

The product is performing well. Early demand has been really good. What we really want to watch and track is what happens on reorders and how people really experience it as they go forward.

該產品表現良好。早期的需求一直很好。我們真正想要觀察和跟踪的是重新訂購時發生的情況以及人們在前進過程中的真實體驗。

We see a little bit of both in the early stages, a little bit of switching multiport procedures into Single-Site and a little bit of approaching patients that otherwise would not have been done necessarily multiport robotically. So we are seeing both of those things, and it will take some quarters, I think, to shake out where people ultimately find that optimization.

我們在早期階段看到了一點點，一點點將多端口程序轉換為單點程序，一點點接近患者，否則這些患者不可能通過多端口機器人完成。所以我們看到了這兩種情況，我認為需要幾個季度才能確定人們最終找到優化的地方。

I am not too stressed about a little bit of the cannibalization here. I think that goes with the territory, and we will support surgeons taking the approach they think is most appropriate.

我對這裡的一點點蠶食並沒有太大壓力。我認為這與領土相符，我們將支持外科醫生採用他們認為最合適的方法。

Okay, that's helpful. The question on the price of the Si-e, I noticed in your latest presentation that's now -- has an ASP of around -- or at least last year -- of around $600,000, and the prior year, it was closer to $1 million.

好的，這很有幫助。關於 Si-e 價格的問題，我在你最近的演講中註意到現在 - 平均售價約為 - 或至少去年 - 約為 600,000 美元，而前一年接近 100 萬美元.

In terms of the pricing of that system, what is the objective? In the past, you have talked about outpatient surgery being a potential opportunity, if the pricing structure was correct for the hospitals. Is that part of that or there's just pricing pressure, you are trying to prevent competition from coming in at a lower price?

就該系統的定價而言，目標是什麼？過去，您曾談到門診手術是一個潛在的機會，前提是定價結構對醫院來說是正確的。那是其中的一部分還是只是定價壓力，你正試圖阻止競爭以更低的價格進入？

As you know, we have a range of options, so at the low end -- and I don't -- I would not read that chart as saying the ASP of Si-es is that number. It's just showing you where the low end is and that is looking at D featured Sis, the lower feature content Si-es, and including things like Firefly and so on, so you take those things out, that moves you lower in the range.

如你所知，我們有一系列選擇，所以在低端——我沒有——我不會讀那個圖表說 Si-es 的 ASP 就是那個數字。它只是告訴你低端在哪裡，那就是看 D 特色 Sis，較低的特徵內容 Si-es，包括 Firefly 等東西，所以你把那些東西去掉，這會讓你在範圍內變低。

With regard to do we think there is a possibility in other types of care, other sites of care? I think the answer to that is yes, so you think about both -- there is duration of care when you talk about things like outpatient, but there is both duration and location. How long are they in the hospital and where is it being performed?

關於我們認為其他類型的護理、其他護理地點是否有可能？我認為答案是肯定的，所以你要考慮兩者——當你談論門診等事情時，有護理持續時間，但有持續時間和地點。他們在醫院待了多長時間，在哪裡進行？

We see increases in both, increases in shorter duration stays and the increase in robotic surgery in different locations.

我們看到兩者都有增加，停留時間較短的增加以及不同位置的機器人手術的增加。

Si and Si-e, some of those lower-priced packages are designed to give an option to some of the customers who are interested in exploring that space. We have seen some interest, but I don't think it's been wild interest, unabashed interest, but we have seen some interest in it and we have seen some uptake. And you can see that reflected in the system sales numbers and placement numbers that we shared with you.

Si 和 Si-e，其中一些低價套餐旨在為一些有興趣探索該領域的客戶提供選擇。我們看到了一些興趣，但我不認為這是狂野的興趣，毫不掩飾的興趣，但我們看到了一些興趣，我們看到了一些吸收。您可以在我們與您共享的系統銷售數字和安置數字中看到這一點。

And just lastly, just a quick clarification, the Xi Single-Site instruments that you're talking about, that's different than the Sp (multiple speakers)

最後，快速澄清一下，您所說的 Xi Single-Site 樂器與 Sp（多揚聲器）不同

That is different, right. Exactly. The Single-Site instruments are the ones that go through curved cannulas. They work on the same patient side platform as an Xi, the ones that we are developing now, and they are an instrument and accessory kit, rather than a new patient side system.

那是不同的，正確的。確切地。單點儀器是通過彎曲插管的儀器。它們與我們現在正在開發的 Xi 在同一個患者端平台上工作，它們是一個儀器和附件套件，而不是一個新的患者端系統。

Sp is a dedicated single-port patient-side different mechanism, different robot system that delivers it, and those are at different price points and they have different capabilities.

Sp 是一種專用的單端口患者端不同機制，提供它的不同機器人系統，它們的價格不同，功能也不同。

As Sp progresses, we will share more of what that product looks like and some of those distinctions with our customers and with you as we go.

隨著 Sp 的進展，我們將與我們的客戶和您分享更多該產品的外觀以及其中的一些區別。

Okay, thank you.

好的謝謝。

Amit Hazan, SunTrust.

阿米特·哈贊，SunTrust。

Maybe let me just start with the chole side, and obviously the slowdown is quite pronounced if you think about it from 2013 to where we are in Q4 of 2014. I know there is not one driver there. I just maybe want to get some color on the different buckets of impact, and most importantly, the trend line now indicates really declines are going to be in the works for next year. Help us try to assess where the bottom might be to that category.

也許讓我從 chole 方面開始，如果你考慮一下從 2013 年到 2014 年第四季度的情況，顯然放緩是相當明顯的。我知道那裡沒有一個驅動程序。我可能只是想對不同的影響桶有一些了解，最重要的是，趨勢線現在表明明年確實會出現下降。幫助我們嘗試評估該類別的底部可能在哪裡。

Let me frame for you how we are thinking about it and I will let Patrick take you through a little bit more of the analytics so that -- .

讓我為您描繪一下我們是如何考慮它的，我會讓帕特里克帶您完成更多的分析，以便 - 。

We look out at Single-Site chole. We think there are three things that are important for a procedure long term, and that is that it is repeatable and teachable, safe and efficacious, and we think it is. There is a patient population that cares about it, and in Single-Site chole, we think that's true. Then the economics work, and we think the economics work for that patient population.

我們關注 Single-Site chole。我們認為對於一個長期的程序來說，有三件事很重要，那就是它是可重複和可教授的，安全和有效的，我們認為它是。有一群患者關心它，在 Single-Site chole 中，我們認為這是真的。然後經濟學起作用，我們認為經濟學對那個病人群體起作用。

Then the question becomes one of how big is that population and what's access like, and that's really what we are seeing here is hernia really grows. Patrick, I will let you take it from there.

然後問題就變成了人口有多大以及訪問情況如何，這就是我們在這裡看到的，疝氣真的在增長。帕特里克，我會讓你從那裡拿走它。

When we look at it where systems have, I guess, are pressured for access based upon their volumes and where we are seeing declines in -- the first procedure that tends to get squeezed is the cholecystectomy.

當我們看它時，我猜，系統的訪問壓力是基於它們的數量，而我們看到的是下降的地方——第一個容易受到擠壓的程序是膽囊切除術。

The surgeons for which we are seeing a combination of choles and hernias where choles are declining, we are seeing total growth in the volume of procedures that these surgeons are performing, which is encouraging because they are finding where it fits best in their practice.

我們看到外科醫生同時患有膽管炎和疝氣，而膽管炎正在減少，我們看到這些外科醫生正在執行的手術量總體增長，這是令人鼓舞的，因為他們正在尋找最適合他們實踐的地方。

But over time, based on the underlying advantage of the technologies, what we are hearing from surgeons, what we are hearing from patients who get a single incision outcome, and given some of the underlying patient demographics in the population who gets a cholecystectomy, we are encouraged there is something here that we'll be a part over the long run.

但隨著時間的推移，基於這些技術的潛在優勢，我們從外科醫生那裡聽到的，我們從獲得單切口結果的患者那裡聽到的，並考慮到接受膽囊切除術的人群中的一些潛在患者人口統計數據，我們受到鼓舞，從長遠來看，我們將參與其中。

All right, and then if I can shift over to revenue per procedure again, just I think at this point I want to try to better understand the patterns of stocking order, just given the volatility or variability we saw in 2014. I think specifically what I would like to understand better is the reason it has been more volatile in the last few quarters, maybe asking the impact beyond the simple math of how many systems you sell in a given quarter and the stocking associated with it, but why is that more volatile? Why are you not able to control that a little bit on a -- better on a quarter-to-quarter basis?

好吧，然後如果我可以再次轉向每個程序的收入，我想在這一點上我想嘗試更好地理解庫存訂單的模式，只是考慮到我們在 2014 年看到的波動或可變性。我認為具體是什麼我想更好地理解它在過去幾個季度波動更大的原因，也許會問影響超出了你在給定季度銷售了多少系統以及與之相關的庫存的簡單數學，但為什麼更多易揮發的？為什麼你不能在一個季度到一個季度的基礎上更好地控制一點？

We saw a similar thing in Q2 where the revenue per procedure was a bit lower than norms, and here in Q4, and you had a bounce back in Q3. What we are calling out and into the quarter really is this timing of customer orders.

我們在第二季度看到了類似的情況，每個程序的收入略低於規範，而在第四季度，您在第三季度出現了反彈。我們在本季度呼籲的實際上是客戶訂單的這個時間。

In this last quarter, it was timing of various types of orders, including stocking orders associated with new system sales, fewer of those coming through in the quarter than may have been according to historical norms. You have timing of orders with international distributors and just general timing of orders. As I mentioned earlier, not so much to do with things like procedure mix.

在最後一個季度，各種訂單的時間安排，包括與新系統銷售相關的庫存訂單，本季度通過的訂單數量可能少於歷史規範。您有與國際分銷商的訂單時間安排和一般的訂單時間安排。正如我之前提到的，與過程混合之類的事情關係不大。

Is there a pattern to this? I think your question, is there a pattern, I don't think there is. I think these things just tend to fluctuate quarter to quarter and balance out over longer periods of time.

這有模式嗎？我想你的問題是，有沒有模式，我認為沒有。我認為這些事情往往會逐季波動，並在較長時間內達到平衡。

Okay, thanks very much, guys.

好的，非常感謝，伙計們。

David Lewis, Morgan Stanley.

戴維劉易斯，摩根士丹利。

Gary, just two quick questions. Going back to chole for a second, earlier in the year you reduced the price of the chole instrumentation, which actually seemed to have a successful impact on driving incremental growth. Why do you think that strategy didn't have more staying power and would you consider further cuts in chole to drive adoption of that procedure?

加里，只有兩個簡單的問題。回到 chole，今年早些時候你降低了 chole 儀器的價格，這實際上似乎對推動增量增長產生了成功的影響。為什麼您認為該策略沒有更多的持久力，您是否會考慮進一步削減膽量以推動採用該程序？

Then kind of related, Gary, how do you think hernia and the market development around hernia is related and is there an opportunity to use a similar pricing strategy for hernia to drive adoption? And I had a quick follow-up.

那麼有點相關，加里，你認為疝氣和圍繞疝氣的市場發展有什麼關係，是否有機會使用類似的疝氣定價策略來推動採用？我有一個快速的跟進。

Sure, so on the chole side on pricing, we think that where we are right now on chole pricing with Single-Site is really appropriate. If you look at a system that's getting average utilization, the consumables cost of that procedure, and compare it to multi-port alternatives, we think we are right in there in terms of being competitive and appropriate value for what Single-Site can bring.

當然，所以在定價的 chole 方面，我們認為我們現在使用 Single-Site 進行 chole 定價是非常合適的。如果您查看一個獲得平均利用率的系統，該程序的耗材成本，並將其與多端口替代方案進行比較，我們認為我們在競爭力和 Single-Site 可以帶來的適當價值方面是正確的。

So I think we are in a good spot there. I think the biggest thing, and Patrick alluded to it, and the biggest thing we are hearing back from our customers is that as they look at the competition for time on the robot, they're making decisions about which cases get scheduled and which ones don't. That's a near-term problem. I think in the US, we saw an increase in procedures per system, so that turned around in the year where we were building capacity in the beginning part of 2014; the field has now been consuming capacity on the robots in the US. I think hernia is driving that.

所以我認為我們處在一個很好的位置。我認為最重要的事情，帕特里克提到了這一點，我們從客戶那裡聽到的最重要的事情是，當他們看到機器人時間的競爭時，他們正在決定哪些案件被安排，哪些案件被安排不。這是一個近期的問題。我認為在美國，我們看到每個系統的程序有所增加，因此在 2014 年初我們進行能力建設的那一年出現了轉機；該領域現在已經消耗了美國機器人的產能。我認為是疝氣導致的。

Part of that is this issue of which one does a surgeon and an institution find greater value in at the moment they have to make that decision. I think that has been a primary driver is that competition.

其中一部分是外科醫生和機構在必須做出決定的那一刻發現更大價值的問題。我認為主要的驅動力是競爭。

We will see over time if as capacity grows out and we have a broader set of options for them to choose from, whether that modulates. We will have to watch over the next few quarters and see how these two play together.

隨著時間的推移，我們將看到隨著容量的增長，我們是否有更廣泛的選擇供他們選擇，無論是調節。我們將不得不關注接下來的幾個季度，看看這兩者將如何一起發揮作用。

The economics of hernia are interesting and a little bit different. The laparoscopic hernia repairs use a different mix of instruments than choles do. It is a more expensive mix. Using one of our systems instead of laparoscopy allows for trade out of some more expensive laparoscopic instruments, and so our economic value there is well supported where we are currently. I think that looks really good.

疝氣的經濟學很有趣，而且有點不同。腹腔鏡疝氣修復術使用的器械組合與膽道手術不同。這是一個更昂貴的組合。使用我們的系統之一代替腹腔鏡可以換掉一些更昂貴的腹腔鏡儀器，因此我們目前的經濟價值得到了很好的支持。我覺得那看起來真的不錯。

The other thing is that not all hernias are an exchange between laparoscopy and da Vinci. A lot of them are still unopened -- a surprising number are still unopened and the economics also look good there. So hernia economics, the reports we're hearing back are pretty solid and we're feeling like we're in a pretty good position.

另一件事是，並非所有的疝氣都是腹腔鏡和達芬奇之間的交換。其中很多仍未開封——令人驚訝的數量仍未開封，而且那裡的經濟狀況看起來也不錯。所以疝氣經濟學，我們聽到的報告非常可靠，我們感覺我們處於一個非常好的位置。

Great, Gary, very helpful. Just one quick question on Sp timing. It was encouraging to hear your conviction that the delay, then, for the system is moving according to plan, at least that's what I heard.

太好了，加里，非常有幫助。只是一個關於 Sp 時間的快速問題。聽到您確信延遲是令人鼓舞的，因為系統正在按計劃運行，至少我是這麼聽說的。

Just trying to understand the timing here. You're going to lease this product to physicians in the first half. You're going to collect feedback from those physicians in the second half, so I am assuming that feedback is going to get incorporated into the device. Is it safe to assume there can't be a design lock, then, of the system until the end of 2015 or early 2016, or can you submit additional modules to the FDA before you have a design lock, or am I just thinking about this the wrong way?

只是想了解這裡的時間。您將在上半年將此產品出租給醫生。你將在下半年從那些醫生那裡收集反饋，所以我假設反饋將被整合到設備中。假設在 2015 年底或 2016 年初之前系統不會有設計鎖是否安全，或者您可以在設計鎖之前向 FDA 提交其他模塊，或者我只是在考慮這是錯誤的方式？

It's an interesting question. I think the answer is that you are always moving to a point at which you lock the design to allow for a submission, and then further feedback and iterations. A product design is fundamentally iterative, and when you make a decision to submit, it depends a lot on where you are, what you see, and what kind of performance you are seeing in the product.

這是一個有趣的問題。我認為答案是你總是移動到一個點，在這個點上你鎖定設計以允許提交，然後進一步的反饋和迭代。產品設計基本上是迭代的，當你決定提交時，這在很大程度上取決於你在哪裡，你看到了什麼，以及你在產品中看到什麼樣的表現。

So you ought to think about these as sequential locks, not a big one with a capital L. I think from a technology development point of view, I'm quite pleased. I think we have a fantastic team. I think that they are bringing technologies forward that we expect and that are going to make a difference.

因此，您應該將這些視為順序鎖，而不是大寫 L 的大鎖。我認為從技術發展的角度來看，我很高興。我認為我們擁有一支出色的團隊。我認為他們正在推進我們所期望的技術，這將有所作為。

Surgeon evaluation is part of the process, and so as those designs get to the point that it makes sense to get feedback, we will absolutely do it and we will do that through multiple forums, both in house and potentially out of house, and we will work through that.

外科醫生評估是流程的一部分，因此當這些設計達到獲得反饋有意義的地步時，我們絕對會這樣做，我們將通過內部和可能外部的多個論壇來做到這一點，我們將解決這個問題。

Okay, thank you very much.

好的，非常感謝。

David Roman, Goldman Sachs.

大衛羅曼，高盛。

Thank you for taking the questions. I wanted just to start with international, and if I look at the past two quarters, I think the third quarter you benefited from a pretty significant order in China. Then Q4 saw a nice step up in Europe.

感謝您提出問題。我只想從國際開始，如果我回顧過去兩個季度，我認為第三季度你從中國的一個相當大的訂單中受益。然後第四季度在歐洲取得了不錯的進步。

Can you maybe just talk about the sustainability of this uplift outside the United States, and to what extent this is tied to some of the discretionary spending investments you have made over the course of the year versus either macroeconomic factors or other things we need to consider?

你能不能談談美國以外這種增長的可持續性，以及這在多大程度上與你在這一年中進行的一些可自由支配的支出投資相關，而不是宏觀經濟因素或我們需要考慮的其他因素？

When we look out at -- just stepping back -- we look out at different opportunities outside of the United States, I think that there are interesting and durable long-term opportunities OUS.

當我們審視——只是退後一步——我們審視美國以外的不同機會時，我認為 OUS 存在有趣且持久的長期機會。

Having said that, they can be really lumpy, and one of the reasons that we have seen the kind of capital lumpiness that you just described is because there are different market access requirements in different countries. For example, what approvals look like in China is totally different than what they look like in Japan and different again from what they might look like in different parts of Europe.

話雖如此，它們可能真的很笨拙，我們看到你剛才描述的那種資本笨拙的原因之一是因為不同國家有不同的市場准入要求。例如，中國的審批方式與日本完全不同，也與歐洲不同地區的審批方式不同。

Long term, we are very positive and that is the motivation for the investments we make. Short term, expect lumpiness. It can require quotas or approvals or data submissions, and each country is a little bit different.

從長遠來看，我們非常積極，這是我們進行投資的動機。短期內，預計會有波動。它可能需要配額或批准或數據提交，每個國家都有點不同。

Okay, and maybe just a follow-up on the US and specifically the impact of the Xi system. Could you maybe give us some feedback now that we are three quarters into the launch on whether this type of -- this launch is playing out similarly to past ones, meaning that people really want to do colorectal, for example, and need the Xi to do it, or that people are getting the Xi and now they're building colorectal programs? How is the whole picture on some of those more advanced categories coming together, now that we are nine months into the introduction of the system?

好吧，也許只是對美國的跟進，特別是習體制的影響。你能不能給我們一些反饋，現在我們已經進行了四分之三的發布，關於這種類型的發布是否與過去類似，這意味著人們真的想做結直腸手術，例如，需要 Xi 來做它，或者人們正在接受 Xi，現在他們正在建立結直腸計劃？既然我們已經引入該系統九個月了，那麼一些更高級類別的整體情況如何？

I think -- first thing, the Xi launch has exceeded our expectations in terms of mix, just because in prior launches, we had fewer different instruments and accessories that had to be brought to the market concurrently with a system launch. Now we have things like Firefly and stapling and vessel sealing, a little more complex instruments, then. Those have been launched to the market in a staggered way, based on conversations with regulators and other pragmatic constraints.

我認為——首先，Xi 的發佈在組合方面超出了我們的預期，只是因為在之前的發布中，我們必須在系統發布的同時推向市場的不同儀器和配件更少。現在我們有了螢火蟲、縫合和血管密封，然後是更複雜的儀器。根據與監管機構的對話和其他務實的限制，這些產品以交錯的方式投放市場。

So it was unclear as to when different folks would step in to acquire that system, and we were pleased with the rate at which Xi has been adopted in the US and in Europe, for that matter. So that part has been really good.

因此，尚不清楚不同的人何時會介入以獲取該系統，就此而言，我們對 Xi 在美國和歐洲的採用率感到滿意。所以那部分真的很棒。

When you think about colorectal, just to go back to your assertion, colorectal was growing pretty nicely on the Si base already, so there had been interest in pursuit of colorectal. There is a group of surgeons who are both interested and skilled in moving forward, and Xi allows them to keep going.

當你想到結直腸癌時，回到你的斷言，結直腸癌已經在矽基上生長得很好，所以人們對追求結直腸癌很感興趣。有一群既有興趣又有技術的外科醫生在往前走，習讓他們繼續往前走。

In a sense, that's a virtuous cycle. You have some folks who have experience; Xi gives them a little greater capability. As they have stepped in and started to use that, they are starting to explore that greater capability and that drives further growth. We have seen that.

從某種意義上說，這是一個良性循環。你有一些有經驗的人；習近平給了他們更大的能力。隨著他們介入並開始使用它，他們開始探索更強大的功能並推動進一步增長。我們已經看到了。

We have been also pleasantly surprised by feedback from some more of our longer-term customers in urology and general oncology who have also found benefit in Xi that perhaps exceeded what we thought they might in the very beginning.

我們也對來自更多泌尿科和普通腫瘤學長期客戶的反饋感到驚喜，他們也發現 Xi 的益處可能超出了我們一開始的預期。

That's helpful. If I could just sneak one more in here, Gary, you began the call, I think, with describing 2014 as a year of transition and macroeconomic headwinds, uncertainty about the Affordable Care Act. How would you describe the environment as we exit 2014 and as you've talked to customers in 2015, either on the capital side or the procedure volume side on a 12-month basis?

這很有幫助。加里，如果我能再偷偷進來一次，我認為你開始打電話時將 2014 年描述為轉型和宏觀經濟逆風的一年，平價醫療法案的不確定性。您如何描述我們在 2014 年結束時以及您在 2015 年與客戶交談時的環境，無論是在資本方面還是在 12 個月的程序量方面？

I think at the C-suite level, we are seeing their ability to forecast their business start to improve. They still have to make priorities. It's not like it's a windfall on all fronts, but they are able to project a little bit better than they were before. They've got a year of the Affordable Care Act under their belt and that gives them some confidence to start making some decisions.

我認為在最高管理層層面，我們看到他們預測業務的能力開始提高。他們仍然必須確定優先事項。這不像是各方面的意外之財，但他們能夠比以前更好地預測。他們已經實施了一年的平價醫療法案，這讓他們有信心開始做出一些決定。

That said, there are still capital priority discussions and other things within these institutions and those kind of conversations continue.

也就是說，這些機構內部仍然存在資本優先權討論和其他問題，並且此類對話仍在繼續。

On the clinical side, I think the conversation is much the way it has been for the last couple years. I think folks are looking at outcomes and the cost or price they pay for those outcomes, and where they find value, then they are willing to invest and pursue. In that sense, we have been pleased with the growth of general surgery in the year. It has strengthened nicely as we have gone, and so that's how we have seen it.

在臨床方面，我認為對話與過去幾年的方式大致相同。我認為人們正在關注結果以及他們為這些結果付出的成本或價格，以及他們發現價值的地方，然後他們願意投資和追求。從這個意義上說，我們對今年普通外科的發展感到滿意。隨著我們的離開，它得到了很好的加強，這就是我們所看到的。

Okay, understood. I appreciate all the feedback.

好的，明白了。我感謝所有的反饋。

Rich Newitter, Leerink Partners.

里奇·紐特 (Rich Newitter)，Leerink Partners。

Thank you for taking the questions. Gary, I was wondering just with respect to your comments on chole regarding the time availability factor that might be contributing to the pullback, and it sounds like it's a little bit of cannibalization into hernia, but what are you seeing in accounts where maybe Xi has been placed for a few months now? What are you seeing with respect to the trend of chole utilization? Is that alleviating some of the time constraint issues?

感謝您提出問題。加里，我想知道你對 chole 關於可能導致回調的時間可用性因素的評論，這聽起來有點像疝氣，但你在 Xi 的賬戶中看到了什麼已經放置幾個月了？您對膽汁利用的趨勢有何看法？這是否緩解了一些時間限制問題？

With regard to Xi systems?

關於 Xi 系統？

Yes, so maybe where you had choles being done and an Xi was placed, which presumably, assuming it's not a first robotic placement, might alleviate some of the time availability issues.

是的，所以也許你已經完成了 choles 並放置了 Xi，假設這不是第一個機器人放置，這大概可以緩解一些時間可用性問題。

Right, yes, it's actually a good question. I don't have the answer at my fingertips.

是的，是的，這實際上是一個很好的問題。我手頭沒有答案。

Okay, fair enough. Then if I could, on the procedure volume guidance, maybe Calvin, 7% to 10%, that's your range. Is it fair to assume the various momentum factors behind your different procedure categories in the fourth quarter, those are essentially how we should be thinking about the composition of growth comprising that 7% to 10%, or is it just a continuation of the trends we saw in 4Q and carry those over to 2015 to model that growth rate?

好吧，很公平。然後，如果可以的話，關於程序量指導，也許 Calvin，7% 到 10%，這就是你的範圍。假設第四季度不同程序類別背後的各種動力因素是否公平，這些基本上就是我們應該如何考慮包括 7% 到 10% 的增長構成，或者它只是我們趨勢的延續在第 4 季度看到並將其延續到 2015 年以模擬該增長率？

Yes, just at a high-level view, assumptions going into the 7% to 10% guidance range, we are anticipating a similar US gynecology and urology macro trends that we saw in 2014 continuing on into 2015 and we absolutely expect that US general surgery and international will continue to drive procedure growth in 2015, as they did in 2014.

是的，從高層次的角度來看，假設進入 7% 到 10% 的指導範圍，我們預計我們在 2014 年看到的類似美國婦科和泌尿科宏觀趨勢將持續到 2015 年，我們絕對預計美國普通外科與 2014 年一樣，2015 年和國際將繼續推動手術增長。

Particular swing items that could move you towards the lower end or the higher end of the range would be changes in those macro trends in gynecology and urology. Those are large sets of procedures, and as we saw in this last couple of years, those things can definitely move the dial. Growth rates in early-stage US general surgery procedures, how they -- trajectory they follow is going to be important; the international growth side of things; and as was discussed a little earlier, just how successful we are with the Wristed Needle Driver contributions and how that may impact benign hysterectomy.

可以將您推向范圍的低端或高端的特定搖擺項目將是婦科和泌尿科宏觀趨勢的變化。這些是大量的程序，正如我們在過去幾年中看到的那樣，這些東西絕對可以改變錶盤。美國早期普通外科手術的增長率，它們如何——它們遵循的軌跡將很重要；事物的國際增長方面；正如之前討論的那樣，我們在 Wristed Needle Driver 方面的貢獻有多麼成功，以及這對良性子宮切除術有何影響。

Okay (multiple speakers)

好的（多個揚聲器）

We will just take one more question, please.

請再回答一個問題。

Thank you.

謝謝你。

Larry Keusch, Raymond James.

拉里·庫施，雷蒙德·詹姆斯。

Gary, can we circle back to Sp and help us think about the procedures that, again, you are targeting on that system and how we should think about that relative to the current Single-Site system that is out there?

Gary，我們能否回到 Sp 並幫助我們再次考慮您針對該系統的程序，以及我們應該如何考慮相對於當前單站點系統的程序？

Sure. Rather than thinking about procedures, I would guide you to what does it do differently? Because I think it's early and it has a lot of long-term possibility, but predicting exactly which one is when is going to be hard.

當然。我不會考慮程序，而是會引導您了解它有何不同之處？因為我認為現在還早，而且有很多長期的可能性，但很難準確預測是什麼時候。

What does it do differently? It delivers four computer-assisted or robotically-assisted instruments through a parallel access that can go fairly deep into the body through an entry point. When you think about that, you think about accessing the throat or the head and neck area transorally. You think about trans-umbilical things that might be able to be reached that are otherwise hard to reach with an architecture like Single-Site or trans-anal procedures or transvaginal procedures.

它有什麼不同之處？它通過並行訪問提供四個計算機輔助或機器人輔助儀器，該並行訪問可以通過入口點進入相當深的身體。當您想到這一點時，您會想到經口腔進入喉嚨或頭頸部區域。您考慮的是可能能夠達到的經臍帶事物，而這些事物可能無法通過單站點或經肛門程序或經陰道程序等架構實現。

Now you can think a lot about and we think about what are the disease states that surgeons can affect, positively impact with a technology like that or an opportunity like that, and they are fairly diverse and pretty interesting. Then you have to go all the way through some of the testing and evaluation that we are talking about doing this year, which is what can actually be done and at what kind of efficiency and what kind of price points. That's where the heavy lifting is.

現在你可以考慮很多，我們考慮外科醫生可以影響哪些疾病狀態，通過這樣的技術或這樣的機會產生積極影響，它們相當多樣化，也很有趣。然後你要一路走過去，我們今年講的一些測試和評估，就是實際可以做的，什麼樣的效率，什麼樣的價位。這就是繁重的工作所在。

Long term, I think it will open some interesting doors. Near term, we are not ready to call procedure sizes for you yet.

從長遠來看，我認為它會打開一些有趣的大門。近期，我們還沒有準備好為您調用程序大小。

Okay, and then just lastly, if you could maybe dissect a little bit about the procedures as you look through the year and talk a little bit about the seasonality that you saw actually in the benign procedures through the year. I am just curious if those -- if there are any observations that you can make relative to benign procedures (multiple speakers)

好的，最後，如果你可以在回顧一年的過程中稍微剖析一下這些程序，並談談你在全年的良性程序中實際看到的季節性。我只是好奇那些 - 如果有任何關於良性程序的觀察結果（多位發言者）

It's a good question. We will have Patrick jump in.

這是個好問題。我們會讓帕特里克加入進來。

I think if you just look at the way in which the year played out, the first quarter tended to be a little bit weaker relative to the rest of the year, so from an extent you could say that there was more seasonality in some of those benign procedures over the course of the year.

我認為，如果你只看今年的表現，第一季度相對於今年餘下時間來說往往有點疲軟，所以從某種程度上你可以說其中一些有更多的季節性一年中的良性程序。

That said, at the beginning of year there was also a lot of disruption with the implementation of the Affordable Care Act, so it's hard to necessarily pin it on seasonality. But to the extent that it was seasonality last year, just be aware because we still have a significant component of our business in those benign procedures.

也就是說，在年初，《平價醫療法案》的實施也受到了很多干擾，因此很難將其歸因於季節性因素。但就去年的季節性而言，請注意，因為在這些良性程序中，我們的業務仍有很大一部分。

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

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

I hope the following assessment of our latest system, the da Vinci Xi, by Dr. Harkins, a Texas general surgeon, gives you some sense of the impact our products have in surgery. Quote, despite my obvious interest in minimally invasive surgery, I had resisted adopting previous da Vinci platforms because of what I felt were limitations. The da Vinci Xi platform is a game changer for me. I now feel that this technology will not just equal my standard laparoscopic abilities, but actually allow me to reach new levels in providing surgical care to my patients, end quote.

我希望德克薩斯州普通外科醫生 Harkins 博士對我們最新系統 da Vinci Xi 的以下評估能讓您對我們的產品在手術中的影響有所了解。引用一下，儘管我對微創手術很感興趣，但我一直拒絕採用以前的達芬奇平台，因為我覺得它有局限性。 da Vinci Xi 平台改變了我的遊戲規則。我現在覺得這項技術不僅會等同於我的標準腹腔鏡檢查能力，而且實際上會讓我在為患者提供手術護理方面達到新的水平，引述結束。

We have built our Company to take surgery beyond the limits of human hand and I assure you that we remain committed to driving the vital few things that truly make a difference.

我們已經建立了我們的公司，以超越人手的極限進行手術，我向您保證，我們將繼續致力於推動真正有所作為的重要少數事情。

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

今天的電話會議到此結束。感謝您參與和支持這次改善手術的非凡旅程，我期待著三個月後再次與您交談。

Ladies and gentlemen, again, that does conclude our teleconference call for this afternoon. Again, thank you very much for your participation and you may now disconnect.

女士們，先生們，今天下午的電話會議到此結束。再次感謝您的參與，您現在可以斷開連接了。