直覺手術 (ISRG) 2016 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by and welcome to the Intuitive Surgical Q2 2016 earnings release call.

女士們、先生們，感謝各位的耐心等待，歡迎參加 Intuitive Surgical 2016 年第二季財報發布電話會議。

(Operator instructions)

（操作說明）

As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Calvin Darling, Senior Director of Finance, Investor Relations of Intuitive Surgical. Please go ahead, Sir.

再次提醒，本次會議正在錄影。現在，我謹將會議交給主持人，直覺外科公司財務與投資者關係高級總監卡爾文·達林。請便，先生。

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

謝謝。下午好，歡迎參加直覺外科公司第二季財報電話會議。今天和我在一起的有：我們的總裁兼執行長 Gary Guthart；我們的財務長 Marshall Mohr；以及財務與銷售營運副總裁 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 2, 2016, and 10-Q filed on April 19, 2016. 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.

在開始之前，我想告知各位，今天電話會議中提到的評論可能被視為包含前瞻性陳述。由於存在某些風險和不確定性，實際結果可能與明示或暗示的結果有重大差異。這些風險和不確定性在公司向美國證券交易委員會提交的文件中均有詳細描述，包括我們最近於 2016 年 2 月 2 日提交的 10-K 表格和於 2016 年 4 月 19 日提交的 10-Q 表格。這些文件可透過我們的網站或美國證券交易委員會的EDGAR資料庫找到。潛在投資者應注意，不要過度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，本次電話會議的音訊回放可在我們網站 Intuitivesurgical.com 的投資者關係頁面下的音訊存檔部分找到。此外，今天的新聞稿和補充財務數據表已發佈在我們的網站上。

Today's format will consist of providing you with highlights of our second-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 second-quarter financial results. Patrick will discuss marketing and clinical highlights. Then I will provide our updated financial outlook for 2016 and finally, we will host a question-and-answer session. With that, I will turn it over to Gary.

今天的會議形式將包括：首先向您介紹我們今天早些時候發布的新聞稿中描述的第二季度業績亮點，然後進行問答環節。Gary 將介紹本季的業務和營運亮點。馬歇爾將對我們第二季的財務表現進行回顧。Patrick 將討論行銷和臨床的亮點。然後我將提供我們最新的 2016 年財務展望，最後，我們將進行問答環節。接下來，我將把麥克風交給蓋瑞。

Good afternoon and thank you for joining us on the call today. In the second quarter, our Company performance was strong, highlighted by sustained procedure growth across multiple geographies, improved margins, and continued customer preference of our new products.

下午好，感謝各位今天參加我們的電話會議。第二季度，我們公司業績表現強勁，在多個地區實現了持續的業務成長，利潤率有所提高，客戶對我們的新產品持續青睞。

Turning first to procedures, global procedure growth for the quarter was nearly 16%, with prior-quarter trends continuing. Drivers of growth included US general surgery, growth in the use of da Vinci surgical systems outside the United States and modest growth in US urology and gynecology. Inguinal hernia repair and ventral hernia repair growth remains strong and growth in colorectal surgery was solid.

首先來看手術量，本季全球手術量成長近 16%，延續了上一季的趨勢。推動成長的因素包括美國普通外科手術的成長、美國以外地區達文西手術系統使用量的成長以及美國泌尿外科和婦科的適度成長。腹股溝疝氣修補術和腹壁疝氣修補術的成長動能依然強勁，結直腸手術的成長也十分穩健。

Procedure growth was variable by country in Europe, with accelerating growth in Germany. Both the Nordics and France experienced modest improvement relative to Q1 growth rates. In the UK, growth decelerated slightly from Q1.

歐洲各國手術量成長情況不一，其中德國成長速度加快。與第一季相比，北歐和法國的成長率均略有提高。英國經濟成長速度較第一季略有放緩。

In Asia, procedure growth in Japan was solid again in the quarter while growth in Korea was robust and accelerated over Q1 growth rate. Growth and procedures in China was also strong. Patrick will review procedure trends in greater detail later in the call.

在亞洲，日本的手術量成長在本季再次保持穩健，而韓國的成長勢頭強勁，並且比第一季的成長速度更快。中國的成長和流程也十分強勁。Patrick 將在稍後的通話中更詳細地回顧手術流程的發展趨勢。

We placed 130 da Vinci systems in the quarter, up from 118 in Q2 of 2015. Our most capable model, da Vinci Xi, represented roughly 3/4 of new capital placements. System placements orders included an increase in dual consoles and the addition of Integrated Table Motion, leading to higher feature content on average than Q1.

本季我們安裝了 130 台達文西手術系統，高於 2015 年第二季的 118 台。我們性能最強的機型達文西 Xi 約佔新增資本投入的 3/4。系統部署訂單包括增加雙控制台和增加整合式桌面運動，導致平均特色內容比第一季更多。

Placements in Europe and Asia increased over Q1 while US placements were slightly up relative to last quarter. Marshal will take you through our finances in more detail later in the call.

歐洲和亞洲的職缺數量較第一季有所增加，而美國的職缺數量較上一季略有成長。馬歇爾稍後會在通話中更詳細地向您介紹我們的財務狀況。

Our operations teams have performed well over the past several quarters and remain focused on optimizing our manufacturing design and supply chains. Q2 was another strong quarter of operations efficiency and cost reduction performance. We plan to continue these optimization efforts as they provide significant financial flexibility for us in coming years.

在過去的幾個季度裡，我們的營運團隊表現出色，並將繼續專注於優化我們的製造設計和供應鏈。第二季度營運效率和成本削減方面又取得了強勁的成績。我們計劃繼續推進這些優化工作，因為它們將在未來幾年為我們提供重要的財務靈活性。

Turning to highlights of our second-quarter operating results, procedures grew nearly 16% over the second quarter of last year. We shipped 130 da Vinci Surgical Systems, up from 118 in the second quarter of 2015. Revenue for the quarter was $670 million, up 14% from the prior year. Pro forma gross profit margin was 71.9% compared to 68% in the second quarter of last year. Instrument and accessory revenue increased to $339 million, up 14%. Total recurring revenue in the quarter was $467 million, representing 70% of total revenue.

再來看我們第二季經營業績的亮點，手術量比去年第二季成長了近 16%。我們交付了 130 台達文西手術系統，高於 2015 年第二季的 118 台。本季營收為 6.7 億美元，比上年同期成長 14%。經調整後的毛利率為 71.9%，去年第二季為 68%。儀器及配件收入增至 3.39 億美元，成長 14%。本季經常性收入總額為 4.67 億美元，佔總營收的 70%。

We generated a pro forma operating profit of $297 million in the quarter, up 30% from the second quarter of last year and pro forma net income was $220 million, up 28% from Q2 of 2015. Recent launches of Xi products, including Xi intraoperative Table Motion, have been well received, as has expansion of advanced instruments lines, including our stapling products. We're continuing to invest in these line extensions to increase the value and utility of our Xi offering. We have also increased investment in advanced imaging, including significant refinements in our intraoperative 3-D endoscopes, image processing for real-time and pre-operative images and near-infrared fluorescence imaging.

本季度，我們實現了 2.97 億美元的備考營業利潤，比去年第二季度增長了 30%；備考淨利潤為 2.2 億美元，比 2015 年第二季度增長了 28%。最近推出的 Xi 產品，包括 Xi 術中手術台運動系統，以及先進器械系列（包括我們的縫合器產品）的擴展，都受到了熱烈歡迎。我們將繼續投資這些產品線延伸，以提高我們 Xi 產品的價值和實用性。我們還加大了對先進成像技術的投入，包括對術中 3D 內視鏡、即時和術前影像的影像處理以及近紅外線螢光成像技術的重大改進。

Our single port, or SP, program is progressing to plan. As SP approaches clinical readiness, we are conducting in-house validations and initiating work with clinical trial sites in regulatory agencies. We expect first markets to include head and neck surgery, urology and colorectal surgery. Over time, I expect this list of applications to evolve.

我們的單一連接埠（SP）專案正按計劃進行。隨著 SP 接近臨床準備階段，我們正在進行內部驗證，並開始與監管機構的臨床試驗機構合作。我們預計首批市場將包括頭頸外科、泌尿外科和大腸直腸外科。隨著時間的推移，我預計這份應用程式清單會不斷更新。

As our businesses strengthened, we have increased our mid-and long-term investments in research and development. We have been increasing our investment in imaging, analytics and new product architectures based on our belief that a substantial opportunity exists to enable better outcomes and to expand access to our technologies globally. We expect quarter-to-quarter variation in spending and increased fixed expenses in the back half of this year. Calvin will take you through our projected spending later in the call.

隨著業務的增強，我們增加了對研發的中長期投資。我們一直在增加對成像、分析和新產品架構的投資，因為我們相信，這為實現更好的結果和在全球範圍內擴大我們技術的普及提供了巨大的機會。我們預計今年下半年支出將出現季度間波動，固定支出將增加。稍後，Calvin 將在電話會議中向大家詳細介紹我們的預計支出。

As we move forward in 2016, we remain focused on the following. First, expanding the use of da Vinci in general surgery and thoracic surgery, particularly colorectal surgery and hernia repair.

展望2016年，我們將繼續專注於以下方面。首先，擴大達文西手術系統在一般外科和胸腔外科的應用，特別是結直腸手術和疝氣修補術。

Second, advancing our ecosystem, including expanding our Xi line and taking our SP product into initial clinical use. Third, driving our organizational capabilities in markets in Europe and Asia and finally, assisting our customers in their efforts to maximize the comprehensive value of their programs. I will now turn the call over to Marshall, who will review financial highlights.

其次，推動我們的生態系統，包括擴大我們的 Xi 產品線，並將我們的 SP 產品投入初步臨床應用。第三，提升我們在歐洲和亞洲市場的組織能力；最後，協助我們的客戶最大限度地發揮其項目的綜合價值。現在我將把電話交給馬歇爾，他將回顧財務要點。

Thank you, Gary. I'll be describing our results on a non-GAAP, or pro forma basis, which exclude specified legal settlements and claim accruals, stock-based compensation, and amortization of purchased IP. We provide pro forma information because we believe that business trends and operating results are easier to understand on a pro forma basis. I will also understand 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.

謝謝你，加里。我將以非GAAP（非GAAP）或備考為基礎來描述我們的業績，其中不包括特定的法律和解和索賠提列、股票選擇權補償以及購買智慧財產權的攤銷。我們提供預測性訊息，因為我們相信，以預測性資訊為基礎，更容易理解業務趨勢和經營績效。我稍後會在腳本中解釋我們的GAAP結果。為了避免混淆，我們已在網站上公佈了備考業績與 GAAP 業績的調整表。

Second-quarter 2016 revenue was $670 million, an increase of 14% compared with $586 million for the second quarter of 2015 and an increase of 13% compared with first-quarter revenue of $595 million. Second-quarter 2016 procedures increased nearly 16% compared with the second quarter of 2015, and increased 7% compared with last quarter. Procedure growth has been driven by general surgery in the US and urology worldwide.

2016 年第二季營收為 6.7 億美元，比 2015 年第二季的 5.86 億美元成長了 14%，比第一季的 5.95 億美元成長了 13%。2016 年第二季手術量比 2015 年第二季成長了近 16%，比上一季成長了 7%。手術量的成長主要由美國的普通外科手術和全球的泌尿外科手術所推動。

Revenue highlights are as follows. Instrument and accessory revenue of $339 million increased 14% compared with last year and increased 5% compared with the first quarter of 2016. Growth in instruments and accessory revenue generally reflect procedure growth. Instrument and accessory revenue realized per procedure, including stocking orders, was approximately $1,810 per procedure. This metric has fluctuated in a tight range over the past couple of years.

以下是營收亮點。儀器及配件營收為 3.39 億美元，比去年同期成長 14%，比 2016 年第一季成長 5%。儀器和配件收入的成長通常反映了手術量的成長。每台手術的器械和配件收入（包括庫存訂單）約為每台手術 1,810 美元。過去幾年，該指標一直在一個較小的範圍內波動。

The slight decrease in the second quarter relative to the second quarter 2015 and the first quarter of 2016 primarily reflects the impact of customer buying patterns, partially offset by increased usage of our stapling and vessel sealer products. While instrument and accessory usage per procedure has been relatively constant, customer buying patterns fluctuate in the short-term.

與 2015 年第二季和 2016 年第一季相比，第二季略有下降，這主要反映了客戶購買模式的影響，但部分被訂書機和容器密封機產品的使用量增加所抵消。雖然每次手術中使用的儀器和配件數量相對穩定，但顧客的購買模式在短期內會有波動。

System revenue of $203 million increased 15% compared with the second quarter of 2015, and increased 37% compared with last quarter. These increases primarily reflect higher average system selling prices, higher system placements, and revenue associated with lease buyout transactions.

系統營收為 2.03 億美元，比 2015 年第二季成長 15%，比上一季成長 37%。這些成長主要反映了更高的系統平均售價、更高的系統部署量以及與租賃買斷交易相關的收入。

130 systems were placed in the second quarter compared with 118 systems in the second quarter of 2015 and 110 systems last quarter. 15 systems replaced under operating lease transactions in the current quarter compared with 19 last quarter and 5 systems in the second quarter of 2015.

第二季安裝了 130 套系統，而 2015 年第二季安裝了 118 套系統，上一季安裝了 110 套系統。本季透過經營租賃交易更換了 15 套系統，而上個季度更換了 19 套，2015 年第二季更換了 5 套。

As a reminder, revenue on operating lease transactions is recognized ratably over the life of the lease. As of the end of the second quarter, there were 66 systems out in the field under operating leases. We generated approximately $4 million of revenue associated with operating leases in the quarter compared with $1 million in the second quarter of 2015 and $4 million in last quarter.

再次提醒，經營租賃交易的收入應在租賃期間內按比例確認。截至第二季末，共有 66 套系統以經營租賃的方式投入使用。本季我們透過經營租賃獲得了約 400 萬美元的收入，而 2015 年第二季為 100 萬美元，上一季為 400 萬美元。

We also generated approximately $13 million of revenue during the quarter from lease buyouts compared with $6 million in the first quarter and $4 million in the second quarter of last year. We exclude the impact of operating leases and lease buyouts from our system ASP calculations.

本季度，我們也透過租賃買斷獲得了約 1,300 萬美元的收入，而去年第一季為 600 萬美元，去年第二季為 400 萬美元。我們在系統平均售價計算中排除了營業租賃和租賃買斷的影響。

Globally our average system selling price of $1.56 million was approximately $60,000 higher than both the second quarter of 2015 and last quarter. The increase compared with prior quarters reflects a higher mix of dual console systems and sales of Table Motion. We introduced intraoperative Table Motion in Europe in the third quarter of 2015, and early this year in the US.

全球範圍內，我們的平均係統售價為 156 萬美元，比 2015 年第二季和上一季均高出約 6 萬美元。與前幾季相比，成長反映了雙控台系統和桌上型運動系統銷售佔比的提高。我們在 2015 年第三季在歐洲推出了術中手術台運動系統，並於今年年初在美國推出了該系統。

During the first and second quarters we recognize $1 million and $6 million of Table Motion software, respectively. Both the mix of dual consoles and number of Table Motion placements will fluctuate quarter to quarter.

第一季和第二季度，我們分別確認了 100 萬美元和 600 萬美元的 Table Motion 軟體收入。雙控制台的組合和 Table Motion 的放置數量都會逐季度波動。

Service revenue of $128 million increased 13% year over year and increased approximately 3% compared with the first quarter of 2016. The year-over-year and quarter-over-quarter increases reflect growth in our installed base of da Vinci systems.

服務收入達 1.28 億美元，年增 13%，與 2016 年第一季相比成長約 3%。年比和環比增長反映了我們達文西手術系統安裝量的增長。

Outside of the US, results were as follows. Second-quarter revenue outside of the US of $185 million increased 10% compared with $168 million for the second quarter of 2015 and increased 13% compared with the first quarter of $164 million. The increase compared with the previous year is comprised of 16% growth in recurring revenue, which is driven by procedure growth of 25% and increased systems revenue of 2%. The increase compared to the first quarter reflects systems revenue growth of 30% and recurring revenue growth of 4%.

美國以外地區的結果如下。第二季美國以外的營收為 1.85 億美元，比 2015 年第二季的 1.68 億美元成長了 10%，比第一季的 1.64 億美元成長了 13%。與前一年相比，成長主要體現在經常性收入成長 16%，這主要得益於手術量成長 25% 和系統收入成長 2%。與第一季相比，成長反映了系統收入成長 30% 和經常性收入成長 4%。

Outside the US, we placed 51 systems in the second quarter compared with 46 in the second quarter of 2015, and 36 systems last quarter. Current-quarter system sales included 22 into Europe, 4 into China and 13 into Japan. System placements outside the US will continue to be lumpy as some of these markets are in the early stages of adoption. Some markets are highly seasonal, reflecting budget cycles or vacation patterns, and sales into some markets are constrained by government regulations.

在美國以外，我們第二季安裝了 51 套系統，而 2015 年第二季為 46 套，上一季為 36 套。本季系統銷售額包括歐洲 22 套、中國 4 套和日本 13 套。美國以外地區的系統部署仍將不均衡，因為其中一些市場仍處於早期採用階段。有些市場具有強烈的季節性，反映了預算週期或度假模式，而對某些市場的銷售則受到政府法規的限制。

Moving on to the remainder of the P&L, the pro forma gross margin for the second quarter of 2016 was 71.9% compared with 68% for the second quarter of 2015 and 70% for the first quarter of 2016. Compared with the first quarter of 2016, the higher gross margin reflects reduction in product costs, favorable costs associated with our scope exchange program, manufacturing efficiencies, and higher dual console mix, lease buyouts and Table Motion sales.

接下來來看損益表的其餘部分，2016 年第二季的備考毛利率為 71.9%，而 2015 年第二季為 68%，2016 年第一季為 70%。與 2016 年第一季相比，更高的毛利率反映了產品成本的降低、與我們的示波器交換計劃相關的有利成本、製造效率的提高以及雙控制台組合、租賃購買和 Table Motion 銷售的增加。

Future margins will fluctuate based on the mix of our newer products, the mix of systems and instrument accessory revenue, cost associated with our scope exchange program, our ability to further reduce product costs, improved manufacturing efficiency and in the long-term, the potential reinstatement of medical device tax.

未來的利潤率將根據我們新產品的組合、系統和儀器配件收入的組合、與我們的內視鏡更換計劃相關的成本、我們進一步降低產品成本的能力、提高生產效率以及從長遠來看，醫療器械稅的潛在恢復而波動。

Pro forma operating expenses increased 9% compared with the second quarter of 2015 and decreased nearly $2 million compared with last quarter. The increase over the second quarter of 2015 reflects increased investments in advanced imaging, advanced instrumentation and next-generation robotics, and increased headcount. The decrease compared with the prior quarter reflects lower payroll taxes, partially offset by increased headcounts, headcount costs, particularly in our product operations areas.

與 2015 年第二季相比，以備考計算的營運費用增加了 9%，與上一季相比減少了近 200 萬美元。與 2015 年第二季相比，成長反映了對先進影像、先進儀器和下一代機器人技術的投資增加，以及員工人數的增加。與上一季相比，下降反映了工資稅的減少，但部分被員工人數增加和員工成本增加所抵消，尤其是在我們的產品營運領域。

Our pro forma effective tax rate for the second quarter was 27.8% compared with an effective tax rate of 25.6% for the second quarter of 2015 and 27.4% last quarter. The increase in the tax rate compared with 2015 reflects one-time benefits reflected in 2015.

我們第二季的備考實際稅率為 27.8%，而 2015 年第二季的實際稅率為 25.6%，上一季為 27.4%。與 2015 年相比，稅率的提高反映了 2015 年的一次性收益。

Our second-quarter 2016 pro forma net income was $220 million, or $5.62 per share, compared with $173 million, or $4.57 per share, for the second quarter of 2015 and $170 million, or $4.42 per share, for the first quarter of 2016. As I indicated earlier, pro forma income provides an easier comparison of our financial results and business trends.

2016 年第二季度，我們的備考淨收入為 2.2 億美元，即每股 5.62 美元；而 2015 年第二季度為 1.73 億美元，即每股 4.57 美元；2016 年第一季為 1.7 億美元，即每股 4.42 美元。正如我之前提到的，預測收入可以更方便地比較我們的財務表現和業務趨勢。

I will now summarize our GAAP results. GAAP net income was $185 million, or $4.71 per share, for the second quarter of 2016 compared with $135 million, or $3.56 per share, for the second quarter of 2015 and $136 million, or $3.54 per share, for the first quarter 2016.

現在我將總結一下我們的GAAP業績。2016 年第二季 GAAP 淨收入為 1.85 億美元，即每股 4.71 美元，而 2015 年第二季為 1.35 億美元，即每股 3.56 美元，2016 年第一季為 1.36 億美元，即每股 3.54 美元。

We ended the quarter with cash and investments of $4.2 billion, up from $3.8 billion as of March 31, 2016. The increase was primarily driven by cash generated from operations and proceeds from stock option exercises. As our cash builds, we will continue to evaluate our approach to capital allocation. With that, I would like to turn it over to Patrick, who will go over our procedure and clinical highlights.

本季末，我們的現金和投資總額為 42 億美元，高於 2016 年 3 月 31 日的 38 億美元。成長主要由經營活動產生的現金流量和股票選擇權行使所得收益所推動。隨著現金流的增加，我們將繼續評估我們的資本配置方法。接下來，我將把發言權交給派崔克，他將介紹我們的流程和臨床要點。

Thanks, Marshall. Of our second-quarter procedure growth of nearly 16%, US procedures grew approximately 13% and total US procedures grew approximately 25%. During the first half of 2016, global procedure growth increased to approximately 16% compared to approximately 15% in the second half of 2015, and approximately 13% in the first half of 2015. We expect our procedure growth rate to moderate in the second half of 2016.

謝謝你，馬歇爾。第二季手術量成長近 16%，其中美國手術量成長約 13%，美國手術總量成長約 25%。2016 年上半年，全球手術量成長約 16%，而 2015 年下半年成長約 15%，2015 年上半年成長約 13%。我們預計2016年下半年手術量成長率將放緩。

In the United States, second-quarter procedure growth continued to outpace our expectations. Second-quarter growth in our mature procedures slowed modestly compared to the first quarter. General and thoracic procedure growth remained robust.

在美國，第二季度手術量成長持續超出我們的預期。與第一季相比，我們成熟手術計畫的第二季成長略有放緩。一般外科和胸腔外科手術量的成長依然強勁。

In US urology, second-quarter growth in da Vinci prostatectomy and kidney procedures slowed modestly compared to the first quarter of 2016. We continue to believe that our US prostatectomy volumes have been tracking to the broader prostate surgery market and we expect prostatectomy growth to return to levels similar to prostate cancer diagnoses over time.

在美國泌尿外科領域，與 2016 年第一季相比，第二季達文西前列腺切除術和腎臟手術的成長速度略有放緩。我們仍然相信，我們在美國進行的前列腺切除手術量與更廣泛的前列腺手術市場趨勢一致，我們預計隨著時間的推移，前列腺切除手術量的增長將恢復到與前列腺癌診斷量相似的水平。

In US gynecology, second-quarter procedures grew modestly year over year, growth led by malignant and complex benign hysterectomy. Continuing the recent trend, we estimate a larger proportion of da Vinci hysterectomy procedures were performed by gynecologic oncologists during the second quarter. Similar to the first quarter, US single-site gynecology procedures declined compared to the second quarter of 2015. In the US, procedures for benign gynecologic conditions slightly grew during the first half of 2016, exceeding our expectations.

在美國婦科領域，第二季度手術量年增幅度不大，其中惡性子宮切除術和複雜良性子宮切除術的增長最為顯著。延續近期的趨勢，我們估計在第二季度，由婦科腫瘤醫師實施的達文西子宮切除手術比例較高。與第一季類似，美國單中心婦科手術量較 2015 年第二季下降。2016 年上半年，美國良性婦科疾病的手術量略有成長，超出了我們的預期。

Second-quarter US general surgery procedure adoption remains strong, led by robust growth in hernia repair and continued adoption of colorectal procedures. Hernia repair continues to contribute the largest volume of new procedures in general surgery and surgeon retention and expansion remains encouraging. Cholecystectomy procedures slightly declined in the second quarter, with growth in multi-port procedures nearly offsetting declines in single-site procedures.

第二季度美國普通外科手術的普及率依然強勁，這主要得益於疝氣修補手術的強勁增長和結直腸手術的持續普及。疝氣修補術仍然是一般外科手術中新增手術量最大的手術，外科醫師的留任率和擴張速度仍然令人鼓舞。第二季膽囊切除手術量略有下降，其中多孔手術的成長幾乎抵消了單孔手術的下降。

Second quarter was another quarter with a large number of clinical publications and presentations evaluating da Vinci surgery. Of these, I have selected a few studies that you may find interesting. Intuitive is among the founding partners for the American Hernia Society Quality Collaborative Initiative, or the AHSQC, and in this quarter two preliminary analysis comparing da Vinci to open or laparoscopy complex ventral hernia repair were brought forward.

第二季度又有大量臨床出版物和報告對達文西手術進行了評估。其中，我挑選了一些你可能會感興趣的研究。Intuitive 是美國疝氣學會品質協作計畫 (AHSQC) 的創始合作夥伴之一，本季推出了兩項初步分析，比較了達文西手術與開放式或腹腔鏡複雜腹壁疝氣修補術。

The first was a podium presentation at the American Hernia Society Annual Meeting by Dr. Poulose from Vanderbilt comparing da Vinci to open retromuscular hernia repair. This patient matched analysis, involving data from multiple institutions, found that da Vinci reduced hospital length of stay by three days without significant differences in surgical site infections, readmissions or re-operations.

首先是范德比爾特大學的 Poulose 博士在美國疝氣學會年會上發表的演講，他將達文西手術與開放式肌後疝氣修補術進行了比較。這項涉及多家機構數據的病患配對分析發現，達文西手術系統可將住院時間縮短三天，且在手術部位感染、再入院或再次手術方面沒有顯著差異。

In addition, a paper was published in Surgical Endoscopy by Dr. Warren and colleagues from the University of South Carolina. The authors used their institution's submissions to AHSQC to compare da Vinci to laparoscopic retromuscular hernia repair. Their study found that with a longer operative time, da Vinci reduced the hospital length of stay by one day and also enabled a greater percentage of patients to receive facial closure and extra peritoneal placement of mesh, to which the authors attributed a reduced the likelihood of hernia recurrence or (inaudible) adhesions.

此外，沃倫博士及其來自南卡羅來納大學的同事在《外科內視鏡》雜誌上發表了一篇論文。作者利用其所在機構向 AHSQC 提交的數據，將達文西手術與腹腔鏡下腹膜後疝氣修補術進行了比較。他們的研究發現，雖然手術時間延長，但達文西手術可以減少一天的住院時間，也能讓更多比例的患者接受臉部縫合和腹膜外網片植入，作者認為這降低了疝氣復發或（聽不清楚）沾黏的可能性。

Next, as Marshall mentioned earlier, sales of our intraoperative Table Motion technology were strong in the quarter. During the quarter the first clinical publication reviewing this technology was published in the International Journal of Colorectal Disease by Dr. Morelli and colleagues from the University of Pisa. In a small case of series of colorectal resections, surgeons used Table Motion to reposition the patient an average of three to four times per procedure.

其次，正如馬歇爾先前提到的，本季我們的術中手術台運動技術銷售情況強勁。本季度，比薩大學的 Morelli 博士及其同事在《國際結直腸疾病雜誌》上發表了第一篇回顧該技術的臨床出版物。在一系列小規模的結直腸切除手術中，外科醫生使用手術台移動裝置，平均每次手術對患者進行三到四次重新定位。

The authors suggested that the technology may improve patient safety by reducing the amount of time in extreme patient positions and stated, quote, the da Vinci Xi plus the new operating table gives the potential to optimize gravity exposure and provide the quick access to different surgical objectives that is important in colorectal surgery, close quote.

作者認為，該技術可以透過減少患者處於極端體位的時間來提高患者安全性，並指出，“達文西 Xi 加上新的手術台有可能優化重力暴露，並提供快速進入不同手術目標的途徑，這在結直腸手術中非常重要。”

Turning abroad, procedure growth outside of the United States was approximately 25% in the second quarter, led by the global adoption of da Vinci prostatectomy, with solid contributions from kidney procedures and colorectal resections. Compared to the first quarter of 2016, second-quarter procedure growth improved in Europe and was similar to the first quarter in Asia.

從海外來看，第二季度美國以外的手術量增加了約 25%，這主要得益於達文西前列腺切除術在全球範圍內的普及，腎臟手術和結直腸切除術也做出了可觀的貢獻。與 2016 年第一季相比，第二季度歐洲的手術量成長有所改善，亞洲的手術量成長與第一季相似。

Outside of the US, second-quarter procedure performance varied by country, with strong growth in Germany, China and South Korea. In certain countries where our urology business has become more mature, such as the United Kingdom and Nordic countries, procedures continue to grow at a slower rate.

除美國以外，第二季度手術量因國家而異，德國、中國和韓國均實現了強勁成長。在某些泌尿科業務較成熟的國家，例如英國和北歐國家，手術量的成長速度仍然較慢。

Emerging procedures are in an early stage in these markets and we are engaged with a broad range of stakeholders working to enable procedure adoption in the gynecological and general surgery. In Japan, partial nephrectomy growth accelerated in the first-quarter following approval of national reimbursement.

在這些市場中，新興手術尚處於早期階段，我們正在與眾多利益相關者合作，努力推動婦科和普通外科手術中採用這些手術。在日本，國家健保報銷獲批後，第一季部分腎切除術的成長速度加快。

During the quarter a meta-analysis sponsored by the South Korean National Evidence-Based Healthcare Collaborating Agency, or NECA, was published in the annals of Surgical Treatment and Research that reviewed da Vinci in laparoscopic colon cancer resectioning. The meta analysis included nearly 700 patients and found that with a longer operative time, da Vinci surgery resulted in a more rapid return of normal diet and bowel functioning, lower blood loss and a shorter hospital stay. This government sponsored health technology assessment adds to the number of HTAs that have evaluated da Vinci surgery in a broad range of procedures over the years.

本季度，由韓國國家循證醫療合作機構（NECA）贊助的一項薈萃分析發表在《外科治療與研究年鑑》上，該分析回顧了達文西機器人腹腔鏡結腸癌切除術。這項統合分析納入了近 700 名患者，結果發現，雖然手術時間較長，但達文西手術能更快恢復正常飲食和腸道功能，減少出血量，並縮短住院時間。這項政府資助的衛生技術評估，進一步增加了多年來對達文西手術進行各種手術評估的衛生技術評估的數量。

I will conclude my remarks by highlighting one of the largest population-based studies on the impact of da Vinci prostatectomy published in the Journal of Urology by Dr. Pearson and colleagues from the University of Chicago. Using data from the National Cancer Database, this study includes nearly 100,000 prostatectomy patients treated with either da Vinci or open surgery.

最後，我將重點介紹芝加哥大學的皮爾森博士及其同事在《泌尿外科雜誌》上發表的一項關於達文西前列腺切除術影響的最大規模的基於人群的研究。本研究利用國家癌症資料庫的數據，納入了近 10 萬名接受達文西機器人輔助手術或開放手術治療的前列腺切除患者。

After matching the patient populations for risk factors, da Vinci surgery was shown to reduce positive surgical margins across low-, medium- and high-risk cohorts, as well as reduce the use of radiation therapy, 30-day readmissions and 30-day mortality compared to open surgery.

在對患者群體進行風險因素匹配後，達文西手術被證明可以降低低風險、中風險和高風險人群的陽性手術切緣，並且與開放手術相比，還可以減少放射治療的使用、30 天內再入院率和 30 天內死亡率。

Dr. Koch from Indiana University published a letter alongside the study titled Robotic Versus Open Prostatectomy: End of the Controversy, in which he stated that any debate over robotic prostatectomy should be put to rest. This concludes my remarks. I will now turn the call over to Calvin.

印第安納大學的科赫博士在題為《機器人前列腺切除術與開放式前列腺切除術：爭議的終結》的研究報告旁邊發表了一封信，他在信中表示，任何關於機器人前列腺切除術的爭論都應該就此結束。我的發言到此結束。現在我將把電話交給卡爾文。

Thank you, Patrick. I will be providing you with our updated financial outlook for 2016. Starting with procedures, on our last call we estimated full-year 2016 procedure growth of 12% to 14% above the approximately 652,000 procedures performed in 2015. We are increasing our estimate for 2016. We now anticipate full-year 2016 procedure growth within a range of 14% to 15%.

謝謝你，派崔克。我將向您提供我們最新的2016年財務展望。先從手術量說起，在我們上次的電話會議上，我們估計 2016 年全年手術量將比 2015 年進行的約 652,000 例手術增長 12% 至 14%。我們將提高2016年的預估。我們現在預計 2016 年全年手術量成長將在 14% 至 15% 之間。

In regards to certain forward-looking metrics, we have the following expectations. We anticipate fewer lease buyouts and lower upgrade and other systems revenue in Q3 and Q4 than we saw in Q2. Second-half 2016 system ASPs will likely be lower than Q2, driven by product and channel mix. We expect a directionally higher proportion of our system placements in Q3 and Q4 to come from operating leases than we saw in Q2.

對於某些前瞻性指標，我們有以下預期。我們預計第三季和第四季的租賃買斷數量將減少，升級和其他系統收入也將低於第二季。受產品和通路組合的影響，2016 年下半年系統平均售價可能會低於第二季。我們預計第三季和第四季系統部署中，經營租賃比例將比第二季更高。

Turning to gross profit, on our last call we forecast 2016 pro forma gross profit margin to be within a range of between 69% and 70% of net revenue. We are now increasing our estimate. We now expect full-year 2016 pro forma gross profit to be within a range of between 70% and 71% of net revenue.

再來看毛利潤，我們在上次電話會議上預測，2016 年的備考毛利率將佔淨收入的 69% 至 70%。我們現在提高了預估金額。我們現在預計 2016 年全年備考毛利潤將佔淨收入的 70% 至 71%。

Turning to operating expenses, based upon investments we are making in key areas of the business, we expect expense growth will accelerate in the second half of 2016. We continue to forecast pro forma 2016 operating expenses to grow between 12% and 15% above 2015 levels. Consistent with our last call, we expect our non-cash stock compensation expense to range between $170 million and $180 million in 2016 compared to $168 million in 2015.

就營運費用而言，根據我們對業務關鍵領域的投資，我們預計 2016 年下半年費用成長將加速。我們繼續預測 2016 年的備考營運費用將比 2015 年的水準成長 12% 至 15%。與上次電話會議一致，我們預計 2016 年的非現金股票補償支出將在 1.7 億美元至 1.8 億美元之間，而 2015 年為 1.68 億美元。

We expect other income to total approximately $30 million in 2016, higher than the $20 million to $25 million forecast on our last call, due primarily to higher interest income. With regard to income tax, we continue to expect our 2016 pro forma income tax rate to be between 26.5% and 28.5% of pretax income, depending primarily on the mix of US and international profits.

我們預計 2016 年其他收入總額約為 3,000 萬美元，高於上次電話會議預測的 2,000 萬至 2,500 萬美元，主要原因是利息收入增加。關於所得稅，我們仍然預計 2016 年的預計所得稅率將在稅前收入的 26.5% 至 28.5% 之間，主要取決於美國和國際利潤的組成。

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

我們的發言到此結束。現在開始回答各位的問題。

(Operator Instructions)

（操作說明）

Ben Andrew, William Blair & Company.

本安德魯，威廉布萊爾公司。

Good afternoon. Thanks for taking the question.

午安.感謝您回答這個問題。

Gary, maybe just start out by talking about the increased investments in OpEx in the back half. Obviously you guys have always been looking for opportunities there, but talk about, more granularly, about where those investments are coming and when we may see some payoffs. I recall it took about a year for the European investments to kick in.

加里，或許可以先談談下半年營運支出的增加投資。顯然，你們一直都在尋找這方面的機會，但請更具體地談談這些投資來自哪裡，以及我們何時才能看到一些回報。我記得歐洲的投資大約花了一年才開始產生效果。

Sure. As we've said before, I think the message here has been pretty consistent. Some of the investments are in technology, things like SP starting to move into field-based investment and scale, rather than just the upfront D, so you are seeing some growth in that.

當然。正如我們之前所說，我認為這裡傳達的訊息一直相當一致。部分投資集中在技術領域，例如 SP 開始轉向現場投資和規模化，而不僅僅是前期投入，因此你會看到這方面有所成長。

We have some other technology investments that are a little broader. We've talked about imaging and that is a multi-step process. Some of it is on the acquisition side, new kinds of endoscopes, some of it is on the software side and some of it is in the ability to enhance our florescence imaging portfolio.

我們還有一些其他領域的技術投資，範圍更廣一些。我們已經討論過成像，那是一個多步驟的過程。一部分在於採購方面，例如新型內視鏡；一部分在於軟體方面；還有一部分在於增強我們螢光成像產品組合的能力。

Some of those things will become commercial in future quarters. Some of them are a little longer, multi-year types of investments.

未來幾個季度，其中一些項目將會商業化。有些投資期間較長，屬於多年期投資。

With regard to investments outside of R&D, we've been growing our investments in regions around the world where we think there's real opportunity, from Japan to Germany and France and others. That will continue. I think that some of those investments are doing well for us. We have opportunity to perform better than we have thus far.

至於研發以外的投資，我們一直在世界各地我們認為有真正機會的地區加大投資，從日本到德國、法國等。這種情況還會持續下去。我認為其中一些投資為我們帶來了不錯的收益。我們有機會做得比目前為止更好。

The right kinds of investments there are sometimes for the clinical data and clinical trials, sometimes another market developing efforts, sometimes in our resources and headcount. Again, those things can be affective from a couple of quarters out to multi years out depending on what the activity is.

合適的投資有時用於臨床數據和臨床試驗，有時用於其他市場開發工作，有時用於我們的資源和人員配備。同樣，這些因素的影響可能持續數季甚至幾年，具體取決於活動內容。

Okay. Two more quick ones for me, please.

好的。請再幫我做兩道簡單的題。

In Europe you talked about some of the investments in emerging procedures. Is that a protracted multi-year process to move beyond urology and the initial GYN procedures that you've started to mature in certain geographies?

在歐洲，你們談到了一些新興技術的投資。是否要經過多年的漫長過程，才能超越泌尿科和您在某些地區已經開始成熟的初期婦科手術？

I think you can see early success sooner than years, but I think broad adoption in many of these places is a multi-year process. It starts with leading surgeons and key opinion leaders and surgical society endorsement and goes from there.

我認為可能在幾年內就能看到初步成功，但我認為在許多地方廣泛採用是一個多年的過程。它始於頂尖外科醫生、關鍵意見領袖和外科協會的認可，並以此為基礎發展。

In some cases, we need interactions with payers and reimbursement. I don't think you have to wait years to see the early indicators, but full penetration is often more than a year process.

在某些情況下，我們需要與付款方進行溝通並獲得報銷。我認為不必等待數年才能看到早期跡象，但全面滲透通常是一個超過一年的過程。

Great. Finally, the SP, you did say had a [knack].

偉大的。最後，SP，你確實說過他有[訣竅]。

Can you be more precise? Would that be sleep apnea or is this more thyroidectomy? Do you have some initial thoughts on where specifically, please? Thank you.

能說得更具體些嗎？那是睡眠呼吸中止症嗎？還是甲狀腺切除術後的症狀？請問您對具體地點有什麼初步想法嗎？謝謝。

Yes. I think in the beginning it's really starting into markets we are already participating in, so transoral, more than, for example, thyroidectomy. I think this is more around surgery in the throat.

是的。我認為，一開始它確實更多地進入了我們已經參與的市場，例如經口手術，而不是甲狀腺切除術。我認為這更多是關於咽喉手術的問題。

For sure, there's cancer indications for that. There may be benign indications.

當然，這其中肯定有癌症的跡象。可能存在良性症狀。

Part of what we are talking to regulatory bodies about are clinical requirements for them to make some of those assessments. It varies from what happens in Europe to what happens in the US to what happens in Asia. That will play out in time, but think of head and neck starting point as [towards].

我們正在與監管機構討論的部分內容是，他們需要滿足一些臨床要求才能進行某些評估。不同地區的情況各不相同，歐洲的情況、美國的情況以及亞洲的情況都不一樣。這會隨著時間的推移而發生，但可以把頭部和頸部的起點想像成[朝向]。

It may have other applications in neck surgery over time. I think SP is a pretty powerful platform, and where we start and where it evolves to will differ as surgeons get a chance to experience it for themselves.

隨著時間的推移，它可能在頸部手術中還有其他應用。我認為 SP 是一個非常強大的平台，隨著外科醫生有機會親身體驗，它的起點和發展方向將會有所不同。

Thank you. Tycho Peterson, JPMorgan.

謝謝。泰科·彼得森，摩根大通。

Thanks. First question, Gary, can you maybe just provide a little more clarity on SP timelines? Understand you're lining up initial sites now.

謝謝。Gary，首先請問您能否更詳細地說明SP的時間表？我知道你們現在正在籌備初期選址。

It sounds like from some of the recent discussions you are not expecting that to be much of a revenue contributor in 2017. So can you maybe talk a little bit about how we should think about the rollout next year?

從最近的一些討論來看，你似乎不指望它在 2017 年能帶來多少收入。那麼，您能否談談我們應該如何考慮明年的推廣計畫？

Sure. First step here is clearances and some clinical data to support to support that clearance. 2017 will be really focused on data generation. While I expect some revenue, I don't think it will be immaterial revenue contributor in 2017.

當然。第一步是獲得相關許可，並需要一些臨床數據來支持該許可。2017年將真正專注於數據生成。雖然我預計會有一些收入，但我認為它在 2017 年不會是微不足道的收入貢獻者。

A lot of that will be building the foundation, the evidence foundation, some of the clinical work. And then I think 2018 it starts to become more of a material contributor for us. As we get our clearances and start to solidify that timeline, we will call that out more for you.

其中許多工作是打基礎，建立證據基礎，以及進行一些臨床工作。然後我認為，從 2018 年開始，它對我們來說開始成為更重要的物質貢獻者。一旦我們獲得許可並開始確定時間表，我們將向您詳細說明。

Okay. Switching over to hernia, I think you've talked in the past about doing initial trial work. Can you talk a little bit about where that stands in terms of any patient enrollment and how we should think about timelines around the trail for 30-day, 1-year and 2-year follow-up?

好的。說到疝氣，我想你以前也談過進行初步試驗工作。您能否談談目前病患招募情況，以及我們應該如何考慮 30 天、1 年和 2 年追蹤的試驗時間表？

I will turn that to Patrick.

我會把這件事轉交給派崔克。

Yes, so we have a number of different initiatives ongoing as it relates to sponsoring evidence development in hernia repair. The two presentation publications that I mentioned on the call from the AHSQC is among the investments we've made in helping to support surgeons bring forward the outcomes that they are getting with da Vinci compared to the alternatives.

是的，我們目前有許多不同的措施正在進行中，旨在資助疝氣修復領域的證據開發。我在電話會議上提到的 AHSQC 的兩份簡報是我們為幫助外科醫生展示他們使用達文西手術系統所取得的成果（與替代方案相比）而進行的投資之一。

Okay. Last one, you had noted some delays in Europe around tenders from competitive [bake-offs]. Anything change from your perspective this quarter?

好的。最後，您提到歐洲在競爭性[烘焙大賽]的招標方面出現了一些延誤。從你的角度來看，這個季度有什麼變化嗎？

Nothing new to note. I think that tender offers and competitive interaction is the new normal.

沒有什麼新情況要注意。我認為，公開要約收購和競爭性互動是新的常態。

I think our teams are doing great. I think their performance has been effective. I think we're communicating well. We have a broad portfolio that allows us to engage the customer at different levels depending on what their needs are, so nothing new to report.

我認為我們的團隊表現非常出色。我認為他們的表現很有效。我認為我們溝通得很好。我們擁有廣泛的產品組合，可以根據客戶的需求在不同層面上與他們互動，所以沒有什麼新情況需要報告。

Okay, thanks.

好的，謝謝。

Thank you. David Lewis, Morgan Stanley.

謝謝。大衛路易斯，摩根士丹利。

Good afternoon. Just a couple of quick questions. Gary, one for you and then a clarifying financial question.

午安.幾個簡單的問題。加里，先問你一個問題，然後再問一個需要澄清的財務問題。

Gary, I appreciate the incrementally more detail you gave us in the pipeline this quarter. So two pieces, first is analytics. Can you give a broader sense of what the word analytics mean to you at Intuitive?

Gary，我很感謝你在本季逐步為我們提供了更多有關專案進度的細節。所以分為兩部分，第一部分是分析。您能否更廣泛地闡述一下「分析」一詞對您在 Intuitive 的意義？

And then on imaging, is the next disclosure we're likely to see an advanced imaging approval or simply an announcement of imaging clinical study? Then I had a quick financial follow-up.

那麼，在影像技術方面，我們接下來可能會看到的是高階影像技術的批准，還是只是影像臨床研究的公告？然後我快速地進行了一次財務跟進。

I think analytics has multiple components in it. As you may know, the majority of our systems are real-time connected to the Internet today. I think over 90% of systems are online.

我認為分析包含多個組成部分。如您所知，目前我們的大部分系統都與互聯網即時連接。我認為超過 90% 的系統都已上線。

They report back information to us mostly around the system performance itself, what itself is doing rather than patient information. That patient data can be turned into insights for the Company and for our customers and we have been doing that for some time now. So there's that type of analytics.

他們向我們回饋的資訊大多是關於系統本身的效能，也就是係統本身在做什麼，而不是關於病人的資訊。這些患者數據可以轉化為對公司和客戶有價值的見解，我們已經這樣做了一段時間了。所以，還有這種類型的分析。

Going forward, I think that as our computational structures get more powerful, we can bring some of that intelligence more real-time. So rather than off-line insights, you can start generating real-time insights. That's a multi-year pathway. I think it's interesting and challenging. I think there's long-term potential in it.

展望未來，我認為隨著我們的運算結構變得越來越強大，我們可以將其中一些智慧更即時地應用到實際應用中。因此，與其獲得離線洞察，不如開始產生即時洞察。這是一個需要多年才能完成的過程。我覺得這很有趣，也很有挑戰性。我認為它具有長遠的潛力。

We're moving down that pathway, making sure that we have good access and fast access and low-latency access to our devices in the field. And then bringing to bear information that can help surgeons as they are performing the procedure. You will see from us in future years a series of products that come out using that set of digital pipeline.

我們正在朝著這個方向努力，確保我們在現場能夠獲得良好的、快速的、低延遲的設備存取。然後，將這些資訊應用於外科醫生進行手術的過程中。未來幾年，你們將會看到我們推出一系列利用這套數位化流程的產品。

Turning to imaging, there are a couple different things. We are releasing endoscopes at a fairly regular clip and improving method of technologies. We made a technology change in the type of imaging we use when we switch to Xi that has allowed for a faster iteration for us in the kinds of imaging we do.

說到成像，這裡涉及幾個不同的面向。我們正以相當規律的速度推出內視鏡，並不斷改進技術方法。我們在切換到 Xi 時改變了成像類型，這使得我們在成像方面能夠更快地迭代。

So there's that kind of thing going on at kind of regular heart beat. Our customers are pretty well aware of where those things are.

所以，這類事情就像規律的心跳一樣，一直在發生。我們的客戶很清楚這些東西在哪裡。

There are other things we've talked about, other indications for fluorescence. We're more likely to talk to you about what's happening clinically there than to announce a launch, so you will have some warning prior to launch.

我們也討論過其他一些事情，其他螢光錶現。我們更傾向於與您討論臨床方面的情況，而不是宣布產品上市，因此在產品上市前您會收到一些通知。

Okay, that's helpful. Calvin or Marshall, thinking about the systems guidance in the back half of the year, a couple components. I note that this quarter that operating leases were down for the first time in several quarters, yet I think you said operating leases will pick back up in the back half of the year. What is the driver there?

好的，這很有幫助。卡爾文或馬歇爾，考慮到下半年的系統指導，有幾個組成部分。我注意到本季經營租賃金額幾季以來首次下降，但我認為您說過經營租賃金額將在下半年回升。那裡的司機是誰？

On mix, or ASP is going lower for systems in the back half, I am assuming that is tied to your view of different geographies, less Xis or less consoles, dual consoles. Just give us some flavor on those two dynamics, why are you so confident operating leases tick back up and ASPs tick down. Thank you.

關於混合，或者說後半段系統的平均售價降低，我假設這與你對不同地區的看法有關，例如 Xi 數量較少或控制台數量較少，雙控制台數量較少。請您詳細解釋這兩種動態變化的原因，為什麼您如此確信經營租賃價格會回升，而平均售價會下降？謝謝。

Philosophically, first of all, we provide our customers leases to provide some flexibility in how they get into robotics and it's proven out to be -- to work out pretty well for both them and us. This last quarter, we just saw a fewer number than the previous quarter. The previous quarter, if you recall, was [19]. We would expect it to be more like Q1 than it was Q2 so that's the increase that Calvin was referring to.

從理念上講，首先，我們為客戶提供租賃服務，以便讓他們在進入機器人領域時擁有一定的靈活性，事實證明，這對他們和我們來說都相當不錯。上個季度，我們看到的數字比上個季度少。如果你還記得的話，上一季是[19]。我們預計它會更像第一季而不是第二季度，這就是卡爾文所指的成長。

As far as ASPs go, seasonally, systems revenue is stronger in Q4. Systems drive a slightly lower gross margin than do instruments and accessories, so that mix alone will cause margins to go down.

就平均售價而言，從季節性來看，系統營收在第四季更為強勁。系統產品的毛利率略低於儀器和配件產品，因此僅此一項因素就會導致利潤率下降。

We also would expect a little bit better performance again due to seasonal factors in the non-US markets or outside of US so that mix also will drive revenues down a little. And then we expect to continue to see growth in stapling and vessel sealing in our newer technology products and those also drive slightly lower margin. A lot of mix will cause margins to go down in the next couple quarters.

由於美國以外市場或美國以外地區的季節性因素，我們預計業績會再次略有好轉，因此這一因素也會略微拉低收入。然後，我們預計在我們的新技術產品中，縫合和血管密封將繼續成長，但這些也會導致利潤率略微下降。未來幾個季度，產品組合的多樣化將導致利潤率下降。

Marshall, none of these things seem to me to be new dynamics. These seem to be ordinary operating dynamics for Intuitive. Is that sort of how you see it?

馬歇爾，在我看來，這些都不是什麼新現象。這些似乎是 Intuitive 的正常營運動態。你也是這麼看的嗎？

For the most part, the seasonal things are. I think the new thing is, is as we drive new product revenue, that increases over previous quarters.

大部分都是季節性的東西。我認為新的情況是，隨著我們推出新產品，收入會比前幾季有所成長。

David, if we're talking about margins, the one thing that was kind of different in the second quarter was on the service side. You saw a pretty market increase in the service gross profit in the second quarter and during the quarter we were able to utilize more refurbished scopes for our scope replacement program with customers. We're going to be expanding the program as the base builds out in the second half and that's going to require a much higher portion of the new scopes at higher cost and lower margin to replenish. That's something that will be a headwind in the second half.

大衛，如果我們談論的是利潤率，那麼第二季度與以往不同的是服務方面。第二季度服務毛利出現了相當大的市場成長，並且在本季度，我們能夠利用更多翻新的瞄準鏡來開展面向客戶的瞄準鏡更換計劃。隨著下半年基地的逐步建成，我們將擴大該計劃的規模，這將需要更高比例的新瞄準鏡以更高的成本和更低的利潤率進行補充。那將是下半季的一大不利因素。

Okay, thank you very much.

好的，非常感謝。

Bob Hopkins, Bank of America.

鮑伯霍普金斯，美國銀行。

Thanks, can you hear me okay?

謝謝，你能聽清楚我說話嗎？

We can.

我們可以。

Oh, great. Good afternoon. Marshall, just to continue on this conversation around margins.

哦，太好了。午安.馬歇爾，我們繼續討論一下邊際效應這個主題。

Last quarter, you commented on mix and how you didn't think you would be able to sustain 70% and now the guidance is going up on gross margin. I understand there's a lot of moving pieces here. So just from a top-down perspective, from where you sit today when you look forward at the business, should we be thinking about low 70%s gross margin as something that can be sustained over time? Just give us a sense of what you've been learning here in the first half of this year as it relates to a more sustainable outlook for gross margins longer term.

上個季度，您曾評論過產品組合，並表示您認為無法維持 70% 的毛利率，而現在毛利率預期卻上調了。我知道這裡面涉及很多方面。所以，從自上而下的角度來看，從你今天的位置展望公司未來時，我們是否應該認為 70% 左右的毛利率可以長期維持下去？請您簡要介紹一下，在今年上半年，您在如何更永續地提高毛利率長期前景方面學到了哪些知識。

Yes. I think we've given you the guidance for the remainder of the year. We think that is the best crystal ball we have at this point.

是的。我認為我們已經為你們提供了今年剩餘時間的指導。我們認為這是我們目前所能掌握的最好的預測資訊。

There are a lot of moving parts and it's hard to predict exactly where each one will come out. I will leave it at that. I don't want to get into where we think it will go long-term.

事情涉及很多環節，很難準確預測每個環節最終會如何發展。我就說到這裡吧。我不想深入探討我們認為它長期的發展方向。

Long-term, those same moving parts will cause us not to have high confidence in exactly where they will come out, although know that we will manage things very diligently. As you know, last year we put in programs to reduce the cost of Xi and Xi-related product and those been successful and that's part of what we're seeing here in the year-to-year improvement.

從長遠來看，這些不斷變化的因素會讓我們對最終結果沒有十足的把握，但請相信我們會非常認真地處理好一切。如您所知，去年我們實施了降低 Xi 及 Xi 相關產品成本的計劃，這些計劃取得了成功，這也是我們在這裡看到的逐年改進的部分原因。

But I mean in terms of thinking about the biggest moving pieces, one of the things that you have us focus on as we think a little bit longer term what we try to consider what a sustainable gross margin might look like for the Company.

但我的意思是，就考慮最大的變動因素而言，您讓我們關注的一點是，當我們從更長遠的角度來看待問題時，我們應該思考公司可持續的毛利率會是什麼樣子。

I don't think we've put a stake in the ground and I don't think I am prepared to do that right now.

我認為我們還沒有明確表態，而且我現在也不準備這樣做。

Okay. We can take it off-line, but thank you for that.

好的。我們可以離線處理，不過還是謝謝你。

Gary, one other thing I wanted to ask about, two quick things. One on just on the eye-popping number of $4.2 billion now in cash on the balance sheet and you get this question quite frequently. But I am just curious now with this almost 20% of the market cap in cash, are there sizable M&A targets out there that you are considering, and that's why there hasn't been anything incremental done with the cash? Just would love to get an updated view there.

蓋瑞，我還想問你一件事，兩個簡短的問題。僅憑資產負債表上高達 42 億美元的現金這一驚人數字，你就會經常被問到這個問題。但我現在很好奇，該公司目前擁有近 20% 的市值現金，是否有正在考慮的大型併購目標，所以才沒有動用這些現金進行任何新的投資？很想了解那裡的最新情況。

Then you mentioned on the topic of advanced imaging and timelines for new products, you said some of these new approvals could come in future quarters. When you made that comment, were you talking about advanced imaging specifically?

然後，您提到了先進成像技術和新產品的時間表，您說其中一些新的批准可能會在未來幾個季度獲得。當時你發表那番言論時，是指高階影像技術嗎？

Well let's speak to cash and then we'll go to the organic side.

好，我們先談現金交易，然後再談有機食品。

We look at the cash and think we are in an interesting point in the Company's evolution here. On the one hand, I think that the customer acceptance of our products has been really high. We are seeing, I think, great momentum on the clinical side in terms of clinical acceptance.

我們觀察了現金流，認為公司目前正處於發展的一個有趣階段。一方面，我認為我們產品的顧客接受度非常高。我認為，從臨床接受度來看，我們看到了臨床上的巨大發展動能。

We have a couple of things going on. We have some new platforms we want to bring to market that I think are outstanding, are very well done and well conceived. That will take some investment for us to do.

我們手頭上有兩件事要辦。我們有一些新的平台想要推向市場，我認為這些平台非常出色，製作精良，構思巧妙。這需要我們投入一些資金。

The other thing is that we see a proliferation of folks who want to enter the market with competitive offerings. That's both an opportunity for us and a requirement for some diligence. The opportunity is, some of those technologies are interesting and may be interesting to us. Other ones are things where we may want to speed up or adjust our strategy as the market evolves.

另一方面，我們看到越來越多的人想要帶著具有競爭力的產品或服務進入市場。這既是我們的機遇，也是我們進行盡職調查的要求。機會在於，其中一些技術很有趣，可能對我們有用。在其他一些方面，我們可能需要隨著市場的發展加快步伐或調整策略。

As we think about the cash broadly, our first thought is, can we use the cash productively to drive future growth organically? Our second thought is are there M&A opportunities that for the long-term that are good for the Company. The answer to both of those is are there opportunities.

當我們從宏觀角度考慮現金流時，首先想到的是，我們能否有效地利用現金流來推動未來的有機成長？我們的第二個想法是，是否存在對公司長期發展有利的併購機會。這兩個問題的答案都是：是否有機會。

The third are, are there other ways we can deploy capital with a long-term view for the benefit of shareholders and that might be in buybacks or dividends or other things. We're disciplined and thinking about capital allocation. I think this is a special time in the Company's history and we're walking through how we think about cash with a fair amount of discipline and diligence.

第三，我們是否可以以長期視角部署資本，以造福股東，例如股票回購、分紅或其他方式。我們做事嚴謹，會認真考慮資本配置。我認為這是公司歷史上一個特殊的時期，我們正在以相當的自律和謹慎的態度來審視我們對現金的看法。

You had asked the question on product releases. Why don't you ask it again to make sure I hit it.

你之前問過關於產品發布的問題。為什麼不再問一遍，確保我答對了？

Sure. You made a comment about the timing about new product releases. You said some will take many years and some of those approvals could come in future quarters. I was just curious as to whether that was a broad comment or whether you were specifically speaking to advanced imaging.

當然。你曾就新產品發佈時機發表評論。您說過有些審批需要很多年時間，有些審批可能會在未來幾季進行。我只是好奇，你這番話是泛泛而談，還是特指高階成像技術。

A broad comment. There are some imaging things that are nearer product things that look a lot like what we have today, and there are long-term imaging investments. So the submission pipeline and our regulatory interactions are pretty full pipeline.

一個廣泛的評論。有些成像技術更接近產品，與我們今天擁有的產品非常相似，而且還有一些長期的成像投資。因此，我們的申報流程和監管互動都非常忙碌。

Thank you very much.

非常感謝。

Thank you. Larry Keusch, Raymond James

謝謝。拉里·科伊施，雷蒙德·詹姆斯

Thank you. I just wanted to pick up on your last answer on the imaging.

謝謝。我只是想就您上次關於成像的回答補充一點。

If you were to sort of think about all the efforts in analytics and imaging that the Company is working on, and you were to take this out several years, what would be the benefits to the surgeon, at that time, with these technologies embedded versus what's available today in Xi?

如果把公司在分析和成像方面所做的所有努力都考慮進去，並且把時間推遲幾年，那麼屆時這些技術與如今 Xi 中提供的技術相比，對外科醫生來說會有哪些好處呢？

Yes, it's a good question. There's a couple of things that I think drive some of the variability that you see in surgery.

是的，這是個好問題。我認為造成手術結果差異的原因主要有兩個。

It's really interesting, if you ask the question in there's some research out there, surgery in general, not just Intuitive, how much better in terms of outcomes and lower complications is the top 10th percentile surgeon versus the average surgeon? The spread is quite big as you look at that. There's a lot of variability in surgical performance.

這個問題真的很有意思，如果你問一些研究，例如外科手術（不僅僅是直覺外科），排名前 10% 的外科醫生與普通外科醫生相比，在手術結果和併發症減少方面究竟能好多少，就會發現確實存在一些研究。你看，這個價差相當大。手術效果存在很大的差異。

You asked the question, what drives that variability. Why? Some of that, not all of it, but some of it is what you are looking at in visual images is subtle. Where are nerves, where are cancer boundaries, where are ureters, what's the right tissue to section plain. Those things are subtle and take a long time for people to internalize and the best do it better.

你問了這樣一個問題：是什麼導致了這種差異？為什麼？你在視覺圖像中看到的某些東西很微妙，但並非全部。神經在哪裡？腫瘤邊界在哪裡？輸尿管在哪裡？應該對哪部分組織進行平切？這些事情很微妙，需要很長時間才能被人們內化，而最優秀的人在這方面做得更好。

So what we're trying to do here is find technologies that make it easier for other surgeons to be as good as the best. We think that matters. Imaging will play a large role in that.

所以，我們現在努力的目標是找到一些技術，讓其他外科醫生也能像最優秀的外科醫生一樣出色。我們認為這很重要。成像技術將在其中發揮重要作用。

So play forward a decade, what you would really like to be able to do is mark tissues of interest in real time. Paint for the surgeon what the elements and boundaries are that allow for a good dissection or the popular resection or the best margin performance and that's what's really directing our investments.

設想十年後，你真正想做的是即時標記感興趣的組織。向外科醫生描繪出能夠實現良好解剖、常用切除或最佳切緣效果的要素和界限，這才是真正指導我們投資的方向。

Okay. That's really helpful. For Marshall, I guess, two quick ones.

好的。這真的很有幫助。我想，對馬歇爾來說，應該是兩個簡短的問題。

Per procedure revenue certainly was at a lower level than we've seen in some time. You've definitely mentioned some customer buying patterns in there, so if you could help us understand what that means.

單次手術收入確實比我們一段時間以來看到的水平要低。您確實提到了一些顧客的購買模式，所以如果您能幫助我們理解這些模式的含義，那就太好了。

Then on China, you did a number of systems in the quarter. Just wanted to figure out where we were with the quota and those kinds of one offs now in any given quarter?

然後，關於中國，你們在這個季度做了一些系統的工作。我只是想弄清楚目前每個季度我們在配額和這類一次性項目方面的情況如何？

As it relates to my comments on customer buying patterns, we are able to measure or look at what happens with instrument and accessory usage. And from that what we've determined is that the usage really hasn't changed a lot surgery by surgery. When we see fluctuations in what they are buying versus what they are using, there are times when they use more than they buy and times when they buy more than they use. It just happens -- and it's going to fluctuate quarter to quarter and that was my comment on the short term.

至於我對客戶購買模式的評論，我們可以衡量或觀察儀器和配件的使用。由此我們得出結論，手術的使用情況其實並沒有太大變化。當我們觀察他們的購買量與使用量之間的波動時，有時會發現他們使用的比購買的多，有時又會發現他們購買的多於使用的。這種情況就是這樣發生的——而且每個季度都會有波動，這就是我對短期情況的看法。

What we saw this quarter was, they used more than they purchased. I don't have a great explanation for it beyond that. That's just what we see.

本季我們看到的情況是，他們的使用量超過了購買量。除此之外，我沒有更好的解釋。這就是我們所看到的。

On the other hand, we do have distributors that buy in bulk because they are holding inventory to sell to their end customers, and we do see fluctuation in those numbers as well. The combination of the two direct hospitals that we sell to as well as distributors, we can actually measure or identify what is customer buying pattern. We don't see anything there that alarms us in one way or another.

另一方面，我們也看到一些分銷商批量進貨，因為他們需要持有庫存才能賣給最終客戶，而且這些數字也會出現波動。透過我們直接銷售的兩家醫院以及分銷商，我們實際上可以衡量或識別客戶的購買模式。我們沒有發現任何令我們感到擔憂的地方。

Okay. And China?

好的。那中國呢？

In China, we sold four systems this quarter. Those systems were sold to military hospitals. The quota that we were selling to in the couple of past years expired at the end of December.

本季我們在中國售出了四套系統。這些系統被賣給了軍醫院。過去幾年我們一直執行的銷售配額已於 12 月底到期。

We are waiting for the government to approve a new quota. We don't have great information as to when that will occur. Might describe the difference between military hospitals and non-military hospitals vis-a-vis quotas.

我們正在等待政府批准新的配額。我們目前還沒有確切的資訊表明這種情況何時會發生。可以描述軍醫院和非軍醫院在配額上的差異。

Yes. The quota system that we had was for public hospitals, and there is a process by which you were classified high-technology and there's a quota established by the government. It's in conjunction with their normal budget process. Their normal budget process this year has been delayed so that's why we're not sure exactly when they will approve that and then we will get a quota for it.

是的。我們實施的配額制度是針對公立醫院的，政府會根據一系列流程將醫院劃分為高科技醫院，並設定相應的配額。這是與他們正常的預算流程一起進行的。他們今年的正常預算流程被推遲了，所以我們不確定他們何時會批准，然後我們才能獲得相應的配額。

Military hospitals buy independent from those public hospitals, and we've been selling to military hospitals all along, frankly, and have a number of placements at them.

軍醫院的採購獨立於公立醫院，坦白說，我們一直在向軍醫院銷售產品，並且在軍醫院有很多訂單。

Okay, great. Very helpful, thank you.

好的，太好了。非常有用，謝謝。

Brandon Henry, RBC Capital Markets.

Brandon Henry，加拿大皇家銀行資本市場。

Yes, thanks for taking my question. Obviously, Intuitive has posted better than expected gross margins in the first half of the year and I think we're all trying to figure out how sustainable that is. Could you help us try to quantify or maybe bucket into several categories, what were the drivers of the year-over-year increase in gross margins in the first half of the year for 2016 versus the first half of the year in 2015?

是的，謝謝您回答我的問題。顯然，Intuitive 在今年上半年的毛利率高於預期，我想我們都在努力弄清楚這種情況是否可持續。您能否幫助我們量化或歸納出幾個類別，分析一下 2016 年上半年毛利率年增的驅動因素與 2015 年上半年相比有哪些？

Yes. I'm not sure we can list out item by item a specific contribution, but we have been focusing obviously on reducing costs for quite some time and managing our fixed costs and we are really pleased with the progress. We look at where we sit; six months into the year we're at 71% on a year-to-date basis and that coincides with the upper end of the 70% -- 70%, 71% guidance range.

是的。我不太確定我們能否逐項列出具體的貢獻，但我們顯然已經專注於降低成本和管理固定成本很長時間了，我們對所取得的進展非常滿意。讓我們來看看我們目前的狀況；今年前六個月，我們按年初至今的業績計算完成了 71%，這與 70% 到 71% 的指導範圍的上限相吻合。

But Q2 was an exceptionally strong quarter gross margin and I think we wanted to leave some specific comments there, specifically on the product side. We would expect a higher proportion of sales of newer products as was described and a lower proportion of dual consol sales and probably more sales through distributors at lower pricing and lower margins. I think I already mentioned previously on the service side, we had some real benefits on the scope exchange in the second quarter, which are unlikely to continue in the second half.

但第二季的毛利率異常強勁，我想就此發表一些具體評論，尤其是在產品方面。我們預期新產品的銷售比例會更高，正如之前所述，雙重通路銷售的比例會更低，而且透過經銷商的銷售可能會更多，價格和利潤也會更低。我想我之前在服務方面已經提到過，我們在第二季度透過範圍交換獲得了一些真正的好處，但這些好處不太可能在下半年繼續下去。

Okay. Separately, I think you guys mentioned some slight slowing in prostatectomy growth in Q2. Can you give us some more details on this comment and discuss what's implied for prostatectomy growth in the updated guidance range? Or are we now through the bolus of patients that previously deferred treatment? Thanks.

好的。另外，我想你們提到第二季前列腺切除術的成長略有放緩。您能否就此評論提供更多細節，並討論一下更新後的指導範圍對前列腺切除術後生長有何影響？或者我們現在已經度過了之前推遲治療的那批患者？謝謝。

It's tough to know where exactly you are with a patient population that may have differed treatment. What we saw in the quarter was just a slight slowing of growth from what we saw in the first quarter and second half of 2015 or frankly all throughout 2015.

對於接受過不同治療的患者群體，很難準確地了解你所處的位置。本季我們看到的成長速度只是比 2015 年第一季和下半年，或者坦白說，比 2015 年全年的成長速度略有放緩。

How much of that is associated with having worked through any potential bolus that may be out there is difficult to predict. Though I think as you've heard us say a few times in the past that over time we do expect that prostatectomy volumes are likely to return towards the rate of diagnosis. And our recent history and the recent growth rates we've seen in 2015 and the first half of 2016, we believe exceed that growth rate.

很難預測其中有多少與清除體內可能存在的任何潛在藥物劑量有關。雖然我認為，正如您過去多次聽到我們所說，隨著時間的推移，我們預計前列腺切除術的數量可能會恢復到診斷率的水平。我們相信，我們近期的歷史以及我們在 2015 年和 2016 年上半年所看到的成長率都超過了這一成長率。

Okay, thank you.

好的，謝謝。

Rick Wise, Stifel Nicholas.

Rick Wise，Stifel Nicholas。

Good afternoon, everybody. Let me start off with procedures again. I just wanted to make sure I understood the comment about the second-half procedure growth slowing.

大家下午好。讓我再從流程講起。我只是想確認一下我是否理解了關於下半年手術量成長放緩的評論。

Yes, I see that comps are modestly tougher. Is it something about OUS? Is it the urology recovery, if you will, slowing? Can you help us better understand your thinking there?

是的，我發現比賽難度確實略有增加。是不是跟美國境外組織（OUS）有關？是不是泌尿系統恢復速度變慢了？您能幫我們更能理解您當時的思路嗎？

You mentioned the growth rate comparisons get a little harder in the second half of the year. The mature procedure contributions that we saw in the first half of the year, we don't think will be as strong in the second half of the year. We continue to expect and will continue to drive growth in US general surgery and our overseas markets in urology and early-stage immersion procedures.

您提到下半年成長率的比較會變得有些困難。我們認為，上半年出現的成熟手術計畫帶來的效益，在下半年不會像上半年那麼強勁。我們將繼續推動美國普通外科業務以及海外泌尿外科和早期浸入式手術市場的成長，並將繼續推動這些業務的成長。

Okay. Back on gross margin. Clearly, it sounds from your comments that Table Motion adoption which has been, in your words, well received, has been one factor helping margins.

好的。回到毛利率上來。顯然，從你的評論來看，Table Motion 的採用（用你的話來說，受到了熱烈歡迎）是提高利潤率的一個因素。

Where are we in sort of the penetration of the installed base? 3% converted, 50%? Is this a tailwind now, leaving aside all the other moving factors, is this a positive tailwind now for a year or two or three?

目前我們的產品在已安裝用戶群的滲透率處於什麼水準？轉換率3%，50%？撇開其他所有影響因素不談，這是否會成為一股順風，並持續一兩年甚至三年？

I don't think I want to get into specific units on this. We are really pleased with the progress we're making and the strong market response from the customers.

我不想深入探討具體單位。我們對目前的進展以及客戶的積極市場反應感到非常滿意。

I think Marshall mentioned in his script we had $6 million of revenue attributable to Table Motion. It was roughly split 50-50 between new installations and systems in the field. Again, it was a strong quarter, but I think we will see how it heads.

我認為馬歇爾在他的劇本中提到，我們有 600 萬美元的收入歸功於 Table Motion。新安裝的系統和現場使用的系統大致各佔一半。這仍然是一個強勁的季度，但我想我們還要看看接下來的發展趨勢。

The history of selling back to the installed base rather than new installs is that you have a few quarters of strong performance and then it tends to tail off. Folks who are going to be interested in intend to move forward quickly and then mostly it will be a go forward. So you can look at history and that gives you a guide as to how much that is.

過去的經驗表明，向現有客戶群而非新客戶銷售產品，往往會經歷幾季的強勁銷售期，然後銷售業績就會逐漸下滑。那些對此感興趣的人打算迅速推進，然後大部分人都會順利推進。所以你可以查閱歷史，這可以讓你大致了解這個數字是多少。

Yes, and we do have around 750 or so da Vinci Xis out in the world at this point in time and we've made some progress on that. There's still some more out there.

是的，目前全世界大約有 750 台達文西 Xi 手術系統，我們在這方面取得了一些進展。還有一些在外面。

Got it. One last one for you, Gary, if I could. At stages this year, it was very clear this year that Intuitive's messaging around looking at total procedures costs in the hospital for robotics and how much economic sense it made -- robotics makes.

知道了。加里，如果可以的話，我想再給你最後一個問題。今年的一些階段，Intuitive 的訊息傳遞非常明確，即關注醫院機器人手術的總成本以及機器人手術的經濟意義。

When I listen to the looming competition from Medtronic at their Analyst Day and your friends at Berg, they are very focused on lowering per-procedure robotic costs too, it seems like in their words, laparoscopic levels. How do you react, how do you deal, how do you compete with that approach given their entrenched instrument capabilities? Will your new platforms address that per-procedure cost aspect of positioning you to better address some of these factors? Thanks so much.

當我聽到美敦力公司在分析師日上談論即將到來的競爭，以及你們在 Berg 公司的朋友們也非常關注降低每次手術的機器人成本時，似乎用他們的話說，就是降低到腹腔鏡手術的水平。面對他們根深蒂固的武器裝備，你該如何應對、如何處理、如何與他們競爭？你們的新平台能否解決每次手術的成本問題，以便更好地應對這些因素？非常感謝。

Sure. I think the first thing -- some of the messaging coming out around opportunities on price, on per-procedure price, I think there's a big challenge for new entrants there which is what benefit do you bring at which price points. I think you're going to have to show benefit over laparoscopy. What can be done that lap can't do?

當然。我認為首先，圍繞價格機會、每次手術價格的一些資訊表明，對於新進入者來說，這是一個很大的挑戰，那就是在哪些價格點上你能帶來什麼好處。我認為你需要證明這種方法比腹腔鏡手術更有優勢。有什麼是單輪車做不到的？

That's going to require some innovation and some technology and that technology is going to have to be paid for. I think over time, folks are going to have to come out and show what it is they plan to do to make that happen.

這需要一些創新和技術，而這些技術是需要資金支持的。我認為隨著時間的推移，人們終究要站出來，展示他們計劃採取哪些措施來實現這一目標。

As we look at it, I do think there are opportunities for Intuitive to manage different price points. We have already in terms of our capital line, and it's also true in our instrument line and we can continue to do that.

仔細分析一下，我認為 Intuitive 有機會管理不同的價格點。就我們的資本產品線而言，我們已經做到了這一點，就我們的金融產品線而言也是如此，而且我們可以繼續這樣做。

I think customers will have choice and the choice will be, at what point do they want to enter and what benefit and value do they find that price point. Intuitive will offer multiple price points. We will give them an opportunity. We have all ready and we will continue to. What value they find at what price point will be their decision.

我認為顧客會有選擇，而選擇的關鍵在於他們想在哪個價位進入市場，以及他們認為該價位能帶來什麼好處和價值。Intuitive 將提供多種價格選擇。我們會給他們一個機會。我們已經做好了一切準備，並將繼續這樣做。他們會根據自身需求和價格做出選擇。

There has so far been just one or two companies who have been out there having those conversations and driving it. I think we understand it reasonably well.

到目前為止，只有一兩家公司在進行這些對話並推動相關進程。我認為我們對此理解得相當透徹。

Interesting perspective, Gary.

蓋瑞，你的觀點很有意思。

Next question, please.

下一個問題。

Tao Levy, Wedbush Securities.

Tao Levy，Wedbush Securities。

Great, thanks. Good afternoon.

太好了，謝謝。午安.

Your utilization per system in the US keeps on hitting new highs. I'm just wondering, where is the increase in capacity that the hospitals are finding? Where is that coming from? Are they utilizing the workweek schedules a little bit more effectively versus in prior years?

您在美國的每個系統的使用率持續創下新高。我只是想知道，醫院所說的增加的收治能力究竟體現在哪裡？這是從哪裡來的？與往年相比，他們是否更有效地利用了工作週安排？

I think it's more than one thing for me. One is, we are seeing health systems integrated delivery networks optimizing the placement of their products and optimizing the flow of patients and surgeons around that product. That's kind of an operational efficiency of the hospital level or health system level that's been driving it.

我覺得對我來說，這不只一件事。一方面，我們看到醫療系統整合交付網路正在優化其產品的投放位置，並優化患者和外科醫生圍繞該產品的流動。這正是醫院層面或醫療體系層面的營運效率在推動這一趨勢的原因。

I think it's great. It's been great for our customers and we support it.

我覺得很棒。這對我們的客戶來說非常棒，我們支持這種做法。

I think the second thing is that some of the new procedure categories we are coming into allow for higher volume procedures out of single sites. So more repeatable shorter procedure durations give you higher utilization, just kind of the nature of the mix of product that's coming in.

我認為第二點是，我們即將進入的一些新的手術類別允許單一地點進行更大批量的手術。因此，更可重複的、更短的手術時間可以帶來更高的利用率，這大概就是產品組合的性質使然。

Lastly, I think in some of the markets, we are seeing referral consolidations. So low-volume surgeons are referring to higher volume surgeons essentially passing patients to those who do more and that also drives up utilization.

最後，我認為在某些市場，我們正在看到轉診整合的現象。因此，手術量低的醫生實際上是在指手術量高的醫生將病人轉診給手術量更大的醫生，這也推高了手術量的利用率。

There are kind of multiple factors there that have supported the growth. I don't know that it goes on forever. I don't think there's infinite growth in utilization possible, but so far so good.

有很多因素促成了這種成長。我不知道這種情況是否會永遠持續下去。我認為利用率的成長不可能無限，但目前為止一切順利。

Got you. Lastly, the percent of your applicable procedures that are currently using the robotic vessel sealer or stapler, do you give sort of a rough metric of where that stands today that you can share?

抓到你了。最後，您能否提供一個大致的指標，說明目前在適用的手術流程中，使用機器人血管密封器或縫合器的百分比是多少？

Hey, Tao. Certainly, we have seen growth in our sealer adoption each quarter over the past few years. And particularly in procedures where there's a high value associated with using those, whether it be in colorectal resection, even in some gynecologic procedures vessel sealers.

嘿，陶。當然，在過去幾年裡，我們每季的密封劑使用量都有所增加。尤其是在一些手術中，使用血管封閉器具有很高的價值，例如結直腸切除術，甚至在一些婦科手術中。

There's still a lot of runway left and in particular as you think about the white reloads that are only available on our Xi systems, as the Xi installed base becomes larger, opening up more opportunities for those to be used in thoracic procedures. There's going to be plenty of runway ahead as the installed base continues to move towards our newest technology.

還有很大的發展空間，特別是考慮到我們 Xi 系統獨有的白色彈匣，隨著 Xi 系統安裝基礎的擴大，這將為在胸腔外科手術中使用白色彈匣創造更多機會。隨著現有用戶群不斷向我們的最新技術遷移，未來仍有很大的發展空間。

But you don't have a procedure -- sorry, a percent that you can share just to get a sense of how long that runway is?

但您沒有具體的流程——抱歉，您沒有可以分享的百分比，讓我們了解一下這個緩衝期有多長？

Not at this time.

目前還沒有這個計劃。

Operator, we will take one more question from one more questioner.

操作員，我們再接受一位提問者的一個問題。

Richard Newitter, Leerink Partners.

Richard Newitter，Leerink Partners。

Thanks for squeezing me in. I just had a quick one, a follow-up on Table Motion.

謝謝你擠出時間陪我。我剛才快速地補充了一點，是關於桌子運動的後續問題。

It sounds like that product is certainly gaining traction and I was just curious to know, is this feature being used in the way that you would've expected it to? What I would really like to know is, do you think or can you tell us what procedures or new increment procedures does this potentially open up for you? Or could you begin to see it open up where you aren't already being used today? Thank you.

聽起來這款產品確實越來越受歡迎，我只是好奇，這個功能的使用方式是否符合你的預期？我真正想知道的是，您認為或您能否告訴我們，這可能會為您帶來哪些新的流程或增量流程？或者，你能否開始看到它在你目前尚未利用的領域中發揮作用？謝謝。

I think that early experience has been that it's well-received, particularly by multi-quadrant general surgeons, which is really where Xi was positioned and one of the big motivations for Table Motion. As frequently happens in this space, something that is a fundamental capability that's good in one place tends to have applications in others, and I suspect we will see that. As we get more data on it, we're happy to share it with you.

我認為早期經驗表明，它受到了很好的歡迎，尤其是多像限普通外科醫生，這正是 Xi 的目標群體，也是 Table Motion 的主要動力之一。在這個領域，經常會出現這樣的情況：一項在某個地方表現良好的基本能力，往往在其他地方也有應用，我懷疑我們會看到這種情況。一旦我們獲得更多相關數據，我們將很樂意與您分享。

That was our last question. As we've said previously, while we focus on financial metrics such as revenues, profits and cash flows during these conference calls, our organizational focus remains on increasing value by enabling surgeons to into improve surgical outcomes and reduce surgical trauma. We've built our Company to take surgery beyond the limits of the human hand and I assure you that we remain committed to driving the vital few things that truly make a difference.

這是我們最後一個問題。正如我們之前所說，雖然我們在這些電話會議中關注的是收入、利潤和現金流等財務指標，但我們組織的重點仍然是透過幫助外科醫生改善手術結果和減少手術創傷來增加價值。我們創立這家公司的目的是為了突破人手的極限，實現外科手術的目標。我向你們保證，我們將持續致力於推動那些真正能帶來改變的關鍵因素。

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

今天的電話會議到此結束。感謝您參與並支持我們這段非凡的外科手術改進之旅，我們期待三個月後再次與您交流。謝謝。

That concludes our conference for today. Thank you for your participation and for using AT&T executive teleconference service. You may now disconnect.

今天的會議到此結束。感謝您的參與以及使用AT&T高階主管電話會議服務。您現在可以斷開連線了。