直覺手術 (ISRG) 2017 Q1 法說會逐字稿

Thank you for standing by, and welcome to the Intuitive Surgical Q1 2017 Earnings Release Call.

感謝您的支持，歡迎來到 Intuitive Surgical 2017 年第一季度收益發布電話會議。

(Operator Instructions) And as a reminder, this conference is being recorded.

（操作員說明）作為提醒，正在錄製此會議。

I'll now turn the conference over to Senior Director of Finance and Investor Relations, Calvin Darling.

我現在將會議轉交給財務和投資者關係高級總監 Calvin Darling。

Please go ahead, sir.

請繼續，先生。

Thank you.

謝謝你。

Good afternoon, and welcome to Intuitive Surgical's First Quarter Earnings Conference Call.

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

With me today, we have Gary Guthart, our President and CEO; Marshall Mohr, our Chief Financial Officer; and Patrick Clingan, Vice President of Finance and Sales Operations.

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；以及財務和銷售運營副總裁 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.

在我們開始之前，我想通知您，今天電話會議中提到的評論可能被視為包含前瞻性陳述。

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

由於某些風險和不確定性，實際結果可能與明示或暗示的結果存在重大差異。

These risks and uncertainties are described in detail in the company's Securities and Exchange Commission filings, including our most recent Form 10-K filed on February 6, 2017.

這些風險和不確定性在公司提交給美國證券交易委員會的文件中有詳細描述，包括我們於 2017 年 2 月 6 日提交的最新 10-K 表格。

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

這些文件可以通過我們的網站或 SEC 的 EDGAR 數據庫找到。

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

告誡潛在投資者不要過分依賴此類前瞻性陳述。

Please note that this conference call will be available for audio replay on our website at intuitivesurgical.com on the Audio Archive section under our Investor Relations page.

請注意，本次電話會議的音頻重播將在我們網站 intuitivesurgical.com 的“投資者關係”頁面下的“音頻存檔”部分提供。

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

此外，今天的新聞稿和補充財務數據表已發佈到我們的網站上。

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

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一季度業績的亮點，然後是問答環節。

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

Gary 將介紹本季度的業務和運營亮點。

Marshall will provide a review of first quarter financial results.

Marshall 將對第一季度的財務業績進行審查。

Patrick is rejoining us to discuss procedure and clinical highlights, then I will provide our updated financial outlook for 2017.

Patrick 將重新加入我們討論程序和臨床重點，然後我將提供我們 2017 年的最新財務展望。

And finally, we will host a question-and-answer session.

最後，我們將舉辦問答環節。

With that, I'll turn it over to Gary.

有了這個，我會把它交給加里。

Good afternoon, and thank you for joining us on the call today.

下午好，感謝您今天加入我們的電話會議。

This first quarter of 2017 was a dynamic one for Intuitive, with strong performance in procedures and solid growth in system placements.

2017 年第一季度對於 Intuitive 來說是一個充滿活力的季度，程序表現強勁，系統安置穩步增長。

We are making good progress in developing deeper connections to our customers worldwide and advancing technologies and offerings that fundamentally improve surgery.

我們在與全球客戶建立更深層次的聯繫以及推進從根本上改善手術的技術和產品方面取得了良好進展。

Procedure growth accelerated in the quarter, rounding up to 18% over the first quarter of 2016.

本季度手術增長加速，與 2016 年第一季度相比增長了 18%。

The growth was broad-based by procedure category as well as global region.

這種增長在程序類別和全球地區都有廣泛的基礎。

Starting with the United States.

從美國開始。

Procedure growth in both the emerging category of general surgery and more mature categories in urology and gynecology exceeded our expectations.

新興的普通外科類別和泌尿外科和婦科的更成熟類別的手術增長超出了我們的預期。

General surgery growth continues to be encouraging with order of early clinical reports, surge in interest and utilization.

隨著早期臨床報告的訂購、興趣和利用率的激增，普通外科手術的增長繼續令人鼓舞。

Procedure growth in Europe, Korea and China were strong in the quarter.

本季度歐洲、韓國和中國的手術增長強勁。

While reasons for quarter-to-quarter fluctuations can be hard to assess, we estimate that Q1 benefited from some tailwinds that will balance out through the remainder of the year.

雖然很難評估季度間波動的原因，但我們估計第一季度受益於一些順風，這些順風將在今年餘下時間平衡。

Patrick will take you through these factors in more detail later in the call.

Patrick 將在稍後的電話會議中更詳細地介紹這些因素。

Our capital placement performance in Q1 2017 strengthened over Q1 of 2016, resulting in a growth in total placements from 110 to 133 this quarter.

我們在 2017 年第一季度的資本配售表現比 2016 年第一季度有所加強，導致本季度總配售數量從 110 筆增加到 133 筆。

As we mentioned on these calls, capital placements can be lumpy.

正如我們在這些電話會議上提到的那樣，資本配置可能是不穩定的。

And after a strong 2016, U.S. capital placements settled into moderate growth relative to Q1 of last year.

在經歷了強勁的 2016 年之後，美國的資本配置相對於去年第一季度穩定增長。

Outside the U.S. Placement growth in the quarter was a highlight with 56 systems sold in the quarter versus 36 in Q1 of 2016.

在美國以外地區，本季度的配售增長是一個亮點，本季度售出 56 個系統，而 2016 年第一季度為 36 個。

The lack of a new system quota in China and limited reimbursements in Japan constrained placement growth in these regions.

中國缺乏新的系統配額和日本有限的報銷限制了這些地區的安置增長。

Marshall will take you through system placement dynamics in greater detail.

Marshall 將帶您更詳細地了解系統佈局動態。

Turning to profitability for the quarter.

轉向本季度的盈利能力。

Strong procedure growth and solid system placements combined with favorable product mix and improvements in product costs to lead to gross margins at the top of our expected range and solid operating margin performance.

強勁的程序增長和穩固的系統佈局，加上有利的產品組合和產品成本的改善，使毛利率處於我們預期範圍的頂部，並實現穩健的營業利潤率表現。

Our fixed cost growth was as expected, with significant increases in R&D spending that reflect investments and bringing new products through clinical trials on the path to market.

我們的固定成本增長符合預期，研發支出顯著增加，這反映了投資和通過臨床試驗將新產品推向市場。

A summary of our first quarter pro forma operating results is as follows: Procedures grew approximately 18% over the first quarter of last year.

我們第一季度的備考經營業績摘要如下： 程序比去年第一季度增長了約 18%。

We shipped 133 da Vinci Surgical Systems, up from 110 in the first quarter of 2016.

我們出貨了 133 台達芬奇手術系統，高於 2016 年第一季度的 110 台。

Revenue for the quarter was $674 million, up 13% from the prior year.

本季度收入為 6.74 億美元，同比增長 13%。

Instrument and accessory revenue increased to $381 million, up 18%.

儀器和附件收入增加到 3.81 億美元，增長 18%。

Total recurring revenue in the quarter was $521 million, representing 77% of total revenue.

本季度經常性總收入為 5.21 億美元，佔總收入的 77%。

Gross profit margin was 72% compared to 70% in the first quarter of last year.

毛利率為 72%，而去年第一季度為 70%。

We generated a pro forma operating profit of $264 million in the quarter, up 15% from the first quarter of last year.

本季度我們的預估營業利潤為 2.64 億美元，比去年第一季度增長 15%。

And pro forma net income was $196 million, up 15% from Q1 of 2016.

預計淨收入為 1.96 億美元，比 2016 年第一季度增長 15%。

In the quarter, we also entered into a stock repurchase agreement in the amount of $2 billion.

本季度，我們還簽訂了 20 億美元的股票回購協議。

Marshall will take you through our finances in greater detail shortly.

Marshall 稍後將帶您更詳細地了解我們的財務狀況。

Turning to our product pipeline.

轉向我們的產品線。

As you know, we've increased our mid- and long-term investments in creating our next-generation of products and services based on our belief that substantial opportunity exists to enable more minimally invasive surgery, better outcomes and to expand access to our technologies globally.

如您所知，我們已經增加了對創造下一代產品和服務的中長期投資，因為我們相信存在大量機會來實現更多的微創手術、更好的結果並擴大對我們技術的訪問全球範圍內。

To bring these investments to market, we have developed a product pathway that responds to our customers' desire for choice in clinical capability and choice in total economics.

為了將這些投資推向市場，我們開發了一種產品途徑，可以滿足客戶對臨床能力和總體經濟選擇的需求。

Over the next several quarters, we plan to launch a new technology upgrade to Si, named da Vinci X, that enables a compelling entry point to our advanced technologies.

在接下來的幾個季度裡，我們計劃推出名為 da Vinci X 的 Si 新技術升級，為我們的先進技術提供一個引人注目的切入點。

Da Vinci Xi will remain our flagship, and we will provide customers with logical upgrade paths for more affordable, entry-level systems like Si and X to Si and Sp.

Da Vinci Xi 仍將是我們的旗艦產品，我們將為客戶提供更實惠的入門級系統（如 Si 和 X 到 Si 和 Sp）的合理升級路徑。

We have submitted our documents for CE Mark review for X and anticipate it will be available in Europe in the second quarter, with clearances in other regions following over time.

我們已經提交了 X 的 CE 標誌審查文件，預計它將在第二季度在歐洲上市，隨著時間的推移在其他地區獲得批准。

We'll provide you with additional information on X as it launches.

我們將在 X 發佈時為您提供更多信息。

The upcoming availability of da Vinci X has some accounting implications, which Marshall will describe in greater detail later in the call.

即將推出的達芬奇 X 具有一些會計影響，馬歇爾將在稍後的電話會議中更詳細地描述。

Our Sp program continues to progress in its clinical trial work and new site initiation.

我們的 Sp 計劃在其臨床試驗工作和新站點啟動方面繼續取得進展。

Cases at our active trial site in Asia have included transoral, urologic and colorectal surgery.

我們在亞洲的活躍試驗站點的案例包括經口、泌尿外科和結直腸手術。

We are also on track in initiating our U.S. IDE sites to gather clinical data in transoral surgery.

我們還在啟動我們的美國 IDE 網站以收集經口手術的臨床數據。

In reviewing feedback from surgeons in Asia and the latest standards for human factors validations, we have elected to pull forward a software release for Sp ahead of our urology 510(k).

在審查來自亞洲外科醫生的反饋和最新的人為因素驗證標準時，我們選擇在泌尿外科 510(k) 之前提前發布 Sp 軟件。

This will push back our urology 510(k) submission into the back half of 2017 and is likely to delay the launch of Sp in the U.S. by 1 or 2 quarters.

這會將我們的泌尿外科 510(k) 提交推遲到 2017 年下半年，並可能將 Sp 在美國的推出推遲 1 或 2 個季度。

While I'm disappointed by the delay, we believe it simplifies our submission and our ultimate path to market.

雖然我對延遲感到失望，但我們相信它簡化了我們的提交和我們最終進入市場的路徑。

In our flexible robotics program, we completed our first clinical experience in Australia in the quarter.

在我們的靈活機器人計劃中，我們在本季度完成了在澳大利亞的首次臨床體驗。

Surgeon commentary on its performance has been enthusiastic.

外科醫生對其性能的評論一直很熱情。

They are finishing patient follow-up and preparing their manuscript for publication.

他們正在完成患者隨訪並準備發表手稿。

The overall program is now in its design for pilot production phase.

整個項目目前處於試生產設計階段。

In closing, the first quarter of 2017 has been a busy one for Intuitive.

最後，2017 年第一季度對於 Intuitive 來說是忙碌的一年。

We remain focused on the following for the balance of the year: first, continued adoption of da Vinci in general surgery; second, continued development of European markets and access to customers in Asia; third, advancing our new platform, imaging, advanced instruments, da Vinci Sp and diagnostic platform progress; and finally, support for additional clinical and economic validation by global region.

在今年餘下的時間裡，我們仍將重點放在以下方面：首先，在普外科繼續採用達芬奇；二是繼續開拓歐洲市場，獲取亞洲客戶；第三，推進我們的新平台、影像、先進儀器、達芬奇 SP 和診斷平台的進展；最後，支持全球區域進行額外的臨床和經濟驗證。

I'll now turn the call over to Marshall, who'll review financial highlights.

我現在將電話轉給馬歇爾，他將審查財務亮點。

Thank you, Gary.

謝謝你，加里。

I will describe our results in a non-GAAP or pro forma basis, which excludes specified legal settlements and claim accruals, stock-based compensation, excess tax benefits related to employee stock awards and amortization of purchased IP.

我將在非 GAAP 或備考基礎上描述我們的結果，其中不包括特定的法律和解和應計索賠、基於股票的補償、與員工股票獎勵相關的超額稅收優惠和已購買知識產權的攤銷。

We provide pro forma information because we believe that business trends and operating results are easier to understand on a pro forma basis.

我們提供備考信息是因為我們相信業務趨勢和經營成果在備考基礎上更容易理解。

I will also summarize our GAAP results later in my script.

我還將在稍後的腳本中總結我們的 GAAP 結果。

We've posted reconciliations of our pro forma results to our GAAP results on our website so that there is no confusion.

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。

First quarter 2017 revenue was $674 million, an increase of 13% compared with $595 million for the first quarter of 2016 and a decrease of 11% compared with fourth quarter revenue of $757 million.

2017年第一季度營收為6.74億美元，較2016年第一季度的5.95億美元增長13%，較第四季度的7.57億美元營收下降11%。

As Gary outlined, we'll be launching the da Vinci X system in certain markets, pending appropriate regulatory clearances.

正如 Gary 概述的那樣，我們將在某些市場推出 da Vinci X 系統，等待適當的監管許可。

In conjunction with the launch, we will offer customers who purchased systems in the first quarter the opportunity to upgrade or trade out their systems for the X system.

結合此次發布，我們將為在第一季度購買系統的客戶提供升級或換購 X 系統的機會。

As a result, we deferred 23 million of first quarter revenue.

因此，我們推遲了第一季度收入的 2300 萬美元。

And consistent with prior deferrals, this revenue will be recognized when customers either trade out their systems or when the offers expire, whichever comes first.

並且與之前的延期一致，當客戶換出他們的系統或優惠到期時（以先到者為準），將確認該收入。

First quarter 2017 procedures increased nearly 18% compared with the first quarter of 2016 and increased 2% compared with last quarter.

2017 年第一季度的程序與 2016 年第一季度相比增長了近 18%，與上一季度相比增長了 2%。

Procedure growth relative to last year and the fourth quarter has been driven by general surgery in the U.S. and urology worldwide and reflects the benefit of the Easter holiday being in the second quarter of 2017 rather than the first quarter of 2016.

相對於去年和第四季度的手術增長受到美國普通外科和全球泌尿外科的推動，並反映了復活節假期在 2017 年第二季度而不是 2016 年第一季度的好處。

Patrick will provide more detail concerning procedure adoption.

Patrick 將提供有關程序採用的更多詳細信息。

Revenue highlights are as follows.

收入亮點如下。

Instrument and accessory revenue of $381 million increased 18% compared with last year and decreased 1% compared with the fourth quarter of 2016, which closely reflects procedure growth.

儀器及附件收入為 3.81 億美元，與去年同期相比增長 18%，與 2016 年第四季度相比下降 1%，這與程序增長密切相關。

Instrument and accessory revenue realized per procedure, including initial stocking orders, was approximately $1,840 per procedure compared with $1,830 last year and $1,900 last quarter.

每個程序實現的儀器和附件收入（包括初始庫存訂單）約為每個程序 1,840 美元，而去年為 1,830 美元，上季度為 1,900 美元。

The increase relative to the first quarter of 2016 primarily reflects increased sales of our stapling and vessel sealing products, mostly offset by customer buying patterns.

與 2016 年第一季度相比的增長主要反映了我們的吻合器和血管密封產品的銷售額增加，大部分被客戶購買模式所抵消。

The decrease compared with the fourth quarter of 2016 primarily reflects the impact of customer buying patterns.

與 2016 年第四季度相比的下降主要反映了客戶購買模式的影響。

System revenue of $153 million, which excludes the revenue deferred in conjunction with the customer trade-out program, increased 4% compared with the first quarter of 2016 and decreased 35% compared with last quarter.

系統收入為 1.53 億美元，不包括與客戶交易計劃相關的遞延收入，與 2016 年第一季度相比增長 4%，與上一季度相比下降 35%。

The year-over-year increase reflects higher system placements and higher lease buyout and operating lease revenue, partially offset by the revenue deferral and lower average selling prices.

同比增長反映了更高的系統配置和更高的租賃買斷和經營租賃收入，部分被收入遞延和較低的平均售價所抵消。

The quarter-over-quarter decrease reflects seasonally lower number of systems, the revenue deferral and lower average selling prices, partially offset by higher lease-related revenue.

環比下降反映了季節性系統數量減少、收入遞延和平均售價下降，部分被租賃相關收入增加所抵消。

133 systems were placed in the first quarter of 2017 compared with 110 systems in the first quarter of 2016 and 163 systems last quarter.

2017 年第一季度放置了 133 個系統，而 2016 年第一季度為 110 個系統，上一季度為 163 個系統。

21 systems were placed under operating lease transactions in the current quarter compared with 19 systems in the first quarter of 2016 and 13 last quarter.

本季度有 21 個系統被置於經營租賃交易之下，而 2016 年第一季度為 19 個系統，上一季度為 13 個。

As a reminder, revenue on an operating lease transaction is recognized ratably over the lease -- life of the lease.

提醒一下，經營租賃交易的收入在租賃期間按比例確認——租賃期限。

As of the end of the first quarter, there were 95 systems out in the field under operating leases.

截至第一季度末，現場有 95 個系統處於經營租賃狀態。

We generated approximately $5 million of revenue associated with operating leases in the quarter compared with $4 million in the first quarter of 2016 and approximately $5 million last quarter.

我們在本季度產生了約 500 萬美元與經營租賃相關的收入，而 2016 年第一季度為 400 萬美元，上一季度約為 500 萬美元。

We generated approximately $10 million of revenue during the quarter from lease buyouts compared with $6 million in the first quarter of 2016 and $7 million last quarter.

我們在本季度通過租賃收購產生了約 1000 萬美元的收入，而 2016 年第一季度為 600 萬美元，上一季度為 700 萬美元。

Globally, our average selling price, which excludes the impact of operating leases and lease buyouts and revenue deferrals, was $1.46 million compared with $1.5 million last year and $1.48 million last quarter.

在全球範圍內，我們的平均售價（不包括經營租賃和租賃收購以及收入遞延的影響）為 146 萬美元，而去年為 150 萬美元，上季度為 148 萬美元。

The decrease in ASP compared to the fourth quarter primarily reflects geographic mix.

與第四季度相比平均售價的下降主要反映了地域組合。

The decrease compared to last year primarily reflects a higher proportion of Si refurbished systems sold to cost-sensitive market segments.

與去年相比的減少主要反映了銷售給成本敏感的細分市場的矽翻新系統的比例更高。

We expect lower-priced systems to be -- to cost-sensitive market segments to represent an increasing proportion of our sales in the future.

我們預計價格較低的系統將在對成本敏感的細分市場中占我們未來銷售額的越來越大的比例。

Service revenue of $140 million increased 13% year-over-year and increased approximately 4% compared with the fourth quarter of 2016.

服務收入 1.4 億美元，同比增長 13%，與 2016 年第四季度相比增長約 4%。

The year-over-year and quarter-over-quarter increases reflect growth in our installed base of da Vinci systems.

同比和環比增長反映了我們達芬奇系統安裝基數的增長。

Outside of the U.S., results were as follows.

在美國以外，結果如下。

First quarter revenue outside of the U.S. of $183 million increased 12% compared with $164 million for the first quarter of 2016 and decreased 14% compared with $212 million for the fourth quarter.

美國以外的第一季度收入為 1.83 億美元，與 2016 年第一季度的 1.64 億美元相比增長 12%，與第四季度的 2.12 億美元相比下降 14%。

Recurring revenue increased 23% compared with the previous year and 5% compared with the fourth quarter, reflecting procedure growth, partially offset by customer buying patterns.

經常性收入與去年同期相比增長 23%，與第四季度相比增長 5%，反映了手術增長，部分被客戶購買模式所抵消。

Systems revenue decreased 9% compared with the first quarter of 2016 and decreased 39% compared with the previous quarter.

系統收入與 2016 年第一季度相比下降 9%，與上一季度相比下降 39%。

The decrease in OUS systems revenue relative to both the prior year and the prior quarter reflect lower system ASPs, reflecting sales of Si refurbished product to cost-sensitive market segments; revenue deferrals; operating leases, 6 in the current quarter, versus none in the prior year and 2 in the prior quarter; geographic mix; and changes in the number of systems placed.

OUS 系統收入相對於去年和上一季度的下降反映了較低的系統平均售價，反映了 Si 翻新產品向成本敏感的細分市場的銷售；收入遞延；經營租賃，本季度有 6 項，而去年和上一季度為 2 項；地理組合；以及放置的系統數量的變化。

Outside the U.S., we placed 56 systems in the quarter compared with 36 in the first quarter of 2016 and 63 systems last quarter.

在美國以外，我們在本季度部署了 56 個系統，而 2016 年第一季度為 36 個，上季度為 63 個。

The decrease in system placements relative to the prior quarter primarily reflects seasonality.

系統佈置相對於上一季度的減少主要反映了季節性。

The increase in system placements relative to the prior year reflects higher sales into Europe, Korea and India.

與上一年相比，系統佈局的增加反映了歐洲、韓國和印度的銷售額增加。

Current quarter system placements included 21 into Europe, 7 into Korea, 6 into India, 6 into Japan and 2 into China.

當前季度系統安置包括 21 個進入歐洲、7 個進入韓國、6 個進入印度、6 個進入日本和 2 個進入中國。

System placements outside of the U.S. will continue to be lumpy as some of the OUS markets are in the early stages of adoption.

由於一些 OUS 市場處於採用的早期階段，美國以外的系統佈局將繼續不穩定。

Some markets are highly seasonal, reflecting budget cycles or vacation patterns, and sales into some markets are constrained by government regulations.

一些市場具有很強的季節性，反映了預算週期或假期模式，並且某些市場的銷售受到政府法規的限制。

Moving on to the remainder of the P&L.

繼續討論損益表的其餘部分。

The pro forma gross margin for the first quarter of 2017 was 72% compared with 70% for the first quarter of 2016 and 71% for the fourth quarter of 2016.

2017 年第一季度的備考毛利率為 72%，而 2016 年第一季度為 70%，2016 年第四季度為 71%。

The increase compared to the prior year reflects reduced product costs and manufacturing efficiencies.

與上一年相比的增長反映了產品成本和製造效率的降低。

Compared with the fourth quarter of 2016, the higher gross margin reflects a higher mix of instrument and accessory revenue relative to systems revenue.

與 2016 年第四季度相比，較高的毛利率反映了儀器和配件收入相對於系統收入的更高組合。

Since we deferred costs associated with the $23 million revenue deferral, the trade-out program had little impact on our margins.

由於我們推遲了與 2300 萬美元收入延期相關的成本，因此折衷計劃對我們的利潤率幾乎沒有影響。

Future margins will fluctuate based on the mix of our newer products, the mix of systems and instrument and accessory revenue, our ability to further reduce product costs and improve manufacturing efficiency, and in the long term, the potential reinstatement of the medical device tax.

未來的利潤率將根據我們新產品的組合、系統和儀器及配件收入的組合、我們進一步降低產品成本和提高製造效率的能力以及從長遠來看可能恢復醫療器械稅而波動。

Pro forma operating expenses increased 19% compared with the first quarter of 2016 and increased 1% compared with last quarter.

預計營業費用較 2016 年第一季度增長 19%，較上一季度增長 1%。

The increases are consistent with our planned investments in product development, specifically da Vinci Sp, flexible robotics, imaging and advanced instrumentation and the expansion of our OUS markets.

這些增長與我們計劃在產品開發方面的投資是一致的，特別是達芬奇 Sp、柔性機器人、成像和先進儀器以及我們 OUS 市場的擴張。

Our pro forma effective tax rate for the first quarter was 28.1% compared with an effective tax rate of 27.4% for the first quarter of 2016 and 26.9% last quarter.

我們第一季度的備考有效稅率為 28.1%，而 2016 年第一季度的有效稅率為 27.4%，上一季度為 26.9%。

Our tax rate will fluctuate with changes in the mix of U.S. and OUS income and with the impact of onetime items.

我們的稅率將隨著美國和美國收入組合的變化以及一次性項目的影響而波動。

Our first quarter 2017 pro forma net income, which excludes income associated with the revenue deferral, was $196 million or $5.09 per share compared with $170 million or $4.42 per share for the first quarter of 2016 and $242 million or $6.09 per share for the fourth quarter of 2016.

我們 2017 年第一季度的備考淨收入（不包括與收入遞延相關的收入）為 1.96 億美元或每股 5.09 美元，而 2016 年第一季度為 1.7 億美元或每股 4.42 美元，第四季度為 2.42 億美元或每股 6.09 美元2016 年。

The $23 million revenue deferral, including the associated deferral of cost of sales and income tax effect, reduced GAAP and pro forma net income per diluted share by approximately $0.28 per share.

2300 萬美元的收入遞延，包括相關的銷售成本遞延和所得稅影響，使 GAAP 和預估每股攤薄淨收入減少了約 0.28 美元。

Earnings per share benefited from our $2 billion stock buyback as our average shares outstanding were reduced by 1.7 million shares as we retired 2.4 million shares on January 27, 2017.

每股收益受益於我們 20 億美元的股票回購，因為我們在 2017 年 1 月 27 日退市 240 萬股，平均流通股減少了 170 萬股。

A final delivery of shares under the ASR, if any, will be delivered at the end of the contract period.

ASR 下的最終股份交付（如果有）將在合同期結束時交付。

As I indicated earlier, pro forma income provides an easier comparison of our financial results and business trends.

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。

I will now summarize our GAAP results.

我現在將總結我們的 GAAP 結果。

GAAP net income was $180 million or $4.67 per share for the first quarter of 2017 compared with $136 million or $3.54 per share for the first quarter of 2016 and $204 million or $5.13 per share for the fourth quarter of 2016.

2017 年第一季度 GAAP 淨收入為 1.8 億美元或每股 4.67 美元，而 2016 年第一季度為 1.36 億美元或每股 3.54 美元，2016 年第四季度為 2.04 億美元或每股 5.13 美元。

GAAP net income for the first quarter included $21 million of litigation charges compared with $2 million in the first quarter of 2016 and $6 million last quarter.

第一季度的 GAAP 淨收入包括 2100 萬美元的訴訟費用，而 2016 年第一季度為 200 萬美元，上一季度為 600 萬美元。

The first quarter charges included approximately $14 million for the estimated cost of settling product liability claims covered by tolling agreements.

第一季度的費用包括約 1400 萬美元，用於解決收費協議涵蓋的產品責任索賠的估計費用。

We have made substantive progress, resolving over 90% of the tolled cases.

我們取得了實質性進展，解決了90%以上的收費案件。

The remainder of the first quarter charges is related to a settlement of the dispute over license and supply agreement.

第一季度的剩餘費用與許可和供應協議糾紛的解決有關。

Beginning in 2017, we are required under GAAP to report the excess tax benefits or deficiencies associated with employee stock awards in our tax provision rather than as an adjustment to paid-in capital in prior periods.

從 2017 年開始，根據美國通用會計準則，我們需要在稅收準備金中報告與員工股票獎勵相關的超額稅收優惠或不足，而不是作為對前期實收資本的調整。

The excess tax benefit included in our GAAP results for the first quarter was $33 million, contributing $0.85 per share.

我們第一季度的 GAAP 業績中包含的超額稅收優惠為 3300 萬美元，每股貢獻 0.85 美元。

We've excluded this benefit from our pro forma results.

我們已經從我們的備考結果中排除了這個好處。

This amount will fluctuate quarter-to-quarter based on the volume of employee stock option exercises and the number of RSUs vesting.

該金額將根據員工股票期權行使量和 RSU 歸屬數量按季度波動。

We ended the quarter with cash and investments of $3.1 billion, down from $4.8 billion as of December 31, 2016.

本季度末，我們的現金和投資為 31 億美元，低於 2016 年 12 月 31 日的 48 億美元。

The decrease reflects our $2 billion stock buyback, partially offset by cash generated from operations and proceeds from stock option exercises.

這一減少反映了我們 20 億美元的股票回購，部分被運營產生的現金和股票期權行使的收益所抵消。

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

有了這個，我想把它交給帕特里克，他將回顧我們的程序和臨床亮點。

Thanks, Marshall.

謝謝，馬歇爾。

Of our first quarter procedure growth of nearly 18%, U.S. procedures grew approximately 14%, and outside of the United States, procedures grew approximately 28%.

在我們第一季度近 18% 的程序增長中，美國程序增長了約 14%，美國以外的程序增長了約 28%。

Procedure growth benefited from tailwinds from the shift of the timing of the Easter holidays from Q1 into Q2, which had the greatest impact on our European business.

程序增長受益於復活節假期時間從第一季度轉移到第二季度的順風，這對我們的歐洲業務影響最大。

Excluding the benefit from these tailwinds, our procedure performance exceeded our expectations during the quarter.

排除這些順風帶來的好處，我們的程序性能在本季度超出了我們的預期。

In the United States, both mature and growth procedures such as general and thoracic surgery outperformed our plan.

在美國，普通手術和胸外科等成熟手術和成長手術的表現都優於我們的計劃。

Though difficult to assess, strength in the U.S. may have been due to a short-term uptick in patients seeking care ahead of any potential health care reform.

雖然難以評估，但美國的實力可能是由於在任何潛在的醫療改革之前尋求治療的患者的短期上升。

In U.S. urology, the first quarter growth rate for da Vinci Prostatectomy was similar to 2016.

在美國泌尿外科，達芬奇前列腺切除術第一季度的增長率與 2016 年相似。

We believe that our U.S. prostatectomy volumes have been tracking to the broader prostate surgery market.

我們相信我們在美國的前列腺切除術量一直在追踪更廣泛的前列腺手術市場。

Earlier this month, the United States Preventative Services Task Force, or USPSTF, proposed a change to its 2012 guidance around PSA screening from recommending against screening at any age to encouraging individual patients and physicians to consider PSA screening for men aged 55 to 69.

本月早些時候，美國預防服務工作組 (United States Preventative Services Task Force, USPSTF) 提議修改其 2012 年關於 PSA 篩查的指南，從建議反對在任何年齡進行篩查改為鼓勵個別患者和醫生考慮對 55 至 69 歲的男性進行 PSA 篩查。

We are pleased to see the USPSTF more close align its recommendation with guidelines from the American Urology Association (sic) [American Urological Association].

我們很高興看到 USPSTF 的建議更符合美國泌尿外科協會 (sic) [美國泌尿外科協會] 的指南。

In U.S. gynecology, first quarter procedure growth sustained trends observed during 2016.

在美國婦科，第一季度的程序增長維持了 2016 年觀察到的趨勢。

Procedure growth in U.S. GYN appears to be driven by consolidation of surgeries towards physicians that specialize in complex cancer surgery, who tend to be users of the da Vinci system.

美國 GYN 手術的增長似乎是由手術整合向專門從事複雜癌症手術的醫生推動的，他們往往是達芬奇系統的用戶。

First quarter U.S. general and thoracic surgery procedure adoption remains strong, led by solid growth in hernia repair and continued adoption of colorectal procedures.

第一季度美國普外科和胸外科手術的採用率仍然很高，這主要得益於疝修補術的穩步增長和結直腸手術的持續採用。

Hernia repair continues to contribute the largest volume of new procedures in the United States, and existing surgeon retention and utilization remain encouraging.

在美國，疝修補術繼續貢獻最大數量的新手術，現有外科醫生的保留和利用仍然令人鼓舞。

Trends in lobectomies and other thoracic procedures continue to show early-stage adoption.

肺葉切除術和其他胸部手術的趨勢繼續顯示早期採用。

Turning abroad.

轉向國外。

Procedures outside of the United States -- procedure growth outside of the United States was approximately 28% in the first quarter, led by the global adoption of da Vinci Prostatectomy, with solid contributions from kidney procedures, general surgery and gynecology.

美國以外的手術——在全球採用達芬奇前列腺切除術的帶動下，美國以外的手術在第一季度增長了約 28%，腎臟手術、普外科和婦科手術做出了巨大貢獻。

As I mentioned earlier, the shift of the timing of the Easter holidays from Q1 into Q2 served as a tailwind in the quarter, likely contributing an estimated 3% to our 28% procedure growth outside of the United States.

正如我之前提到的，復活節假期的時間從第一季度到第二季度的轉變在本季度起到了順風作用，估計可能為我們在美國以外的 28% 程序增長貢獻了 3%。

Procedure growth was led by Europe, China and South Korea.

手術增長由歐洲、中國和韓國引領。

In Europe, procedure growth benefited from the Q1 calendar tailwind but also showed strength on an organic basis.

在歐洲，程序增長受益於第一季度的順風，但也顯示出有機增長。

Procedure growth in China was driven by a strong expansion in system utilization, but system placements remain constrained pending the issuance of a new quota for civilian hospitals.

中國的手術增長是由系統利用率的強勁擴張推動的，但在民用醫院新的配額發放之前，系統安置仍然受到限制。

In South Korea, procedure growth was driven by a mix of specialties and procedures, in addition to a recent uptick in system placements over the past several quarters.

在韓國，除了最近幾個季度系統安置的增加外，程序增長還受到專業和程序組合的推動。

Recently, procedure growth in Japan has slowed as dVP penetration has grown above 80%.

最近，隨著 dVP 滲透率增長超過 80%，日本的手術增長放緩。

During the quarter, the clinical study being conducted to support a reimbursement submission for gastrectomy completed enrollment.

在本季度，為支持胃切除術報銷申請而進行的臨床研究完成了註冊。

Over the past several months, new clinical evidence has highlighted the role of da Vinci in treatment of gastric cancers in Asia.

在過去的幾個月裡，新的臨床證據凸顯了達芬奇在亞洲胃癌治療中的作用。

Case series comparing da Vinci to open or laparoscopic procedures have emerged from both South Korea and Japan.

韓國和日本都出現了將達芬奇手術與開腹手術或腹腔鏡手術進行比較的病例係列。

Dr. Yang and colleagues from Yonsei University Health System compared all 3 modalities of surgery across nearly 1,000 patients in an article published in the Annals of Surgical Oncology.

Yonsei University Health System 的 Yang 博士及其同事在 Annals of Surgical Oncology 上發表的一篇文章中比較了近 1,000 名患者的所有 3 種手術方式。

The authors found that the da Vinci patient cohort had the highest rate of surgical success compared to open or laparoscopic procedures while experiencing a reduction in major in-hospital complications, a reduction in positive resection margins and improved left node yield.

作者發現，與開腹或腹腔鏡手術相比，達芬奇患者隊列的手術成功率最高，同時主要院內並發症減少，陽性切除邊緣減少，左淋巴結產量提高。

Dr. Uyama and colleagues from Fujita Health University published a letter in the Annals of Laparoscopic and Endoscopic Surgery, highlighting prior work on over 500 radical gastrectomies for gastric cancer.

Uyama 博士及其來自藤田保健大學的同事在《腹腔鏡和內窺鏡手術年鑑》上發表了一封信，強調了之前對 500 多例胃癌根治性胃切除術的研究。

The authors found that in exchange for greater blood loss and operating time, da Vinci gastrectomy was associated with a reduction in complications and length of hospitalization compared to laparoscopic gastrectomy.

作者發現，與腹腔鏡胃切除術相比，達芬奇胃切除術以更大的失血量和手術時間作為交換，可減少並發症和縮短住院時間。

In addition, the authors found that the da Vinci patient cohort included a larger proportion of advanced gastric cancers, proposing that da Vinci technology was best for these patients.

此外，作者發現達芬奇患者隊列中晚期胃癌的比例較高，因此提出達芬奇技術最適合這些患者。

Looking forward, during the second quarter, we expect our procedure growth rate outside of the United States to slow as the calendar tailwind becomes a calendar headwind of similar magnitude during Q2.

展望未來，在第二季度，我們預計我們在美國以外的程序增長率將放緩，因為日曆順風在第二季度變成了類似幅度的日曆逆風。

As we move throughout the year, we also expect the contributions from China and Japan to moderate until we obtain a new quota and place new additional systems in China and obtain additional procedure reimbursements in Japan.

隨著我們全年的行動，我們還預計中國和日本的貢獻會減少，直到我們獲得新的配額並在中國放置新的額外系統並在日本獲得額外的程序報銷。

The first quarter was another quarter with a large number of clinical publications evaluating da Vinci surgery.

第一季度是另一個有大量臨床出版物評估達芬奇手術的季度。

Of these, I wanted to highlight 2 additional publications.

其中，我想強調 2 個額外的出版物。

[Dr.

[博士。

Luwan] from Baptist Hospital of Miami and colleagues published results from nearly 300 right colectomy patients in the Journal of Surgical Laparoscopy Endoscopy & Percutaneous Techniques.

來自邁阿密浸信會醫院的 Luwan] 及其同事在 Journal of Surgical Laparoscopy Endoscopy & Percutaneous Techniques 上發表了近 300 名右側結腸切除術患者的結果。

Comparing da Vinci surgery with intracorporeal anastomosis to laparoscopic surgery with extracorporeal anastomosis, the authors found that while patients in the da Vinci cohort have longer operating times, they experienced less blood loss, shorter incision lengths and longer specimen lengths.

將達芬奇手術與體內吻合術與腹腔鏡手術與體外吻合術進行比較，作者發現，雖然達芬奇隊列中的患者手術時間更長，但他們的失血量更少，切口長度更短，標本長度更長。

Other clinical endpoints that trended towards improvements in the da Vinci patient cohort include readmissions, postoperative complications, lymph node yield and 0 incisional hernia repairs compared to 7% in the laparoscopic cohort.

達芬奇患者隊列中有改善趨勢的其他臨床終點包括再入院率、術後並發症、淋巴結產量和 0 例切口疝修復，而腹腔鏡隊列中為 7%。

The next publication is from [Dr.

下一份出版物來自 [Dr.

León] and colleagues from the McGill University in Montréal, Canada, published an article in the Journal of Gynecology Oncology (sic) [Journal of Gynecologic Oncology] on the impact -- to their hospital adopting da Vinci surgery for gynecologic oncology.

León] 和加拿大蒙特利爾麥吉爾大學的同事在婦科腫瘤學雜誌 (sic) [婦科腫瘤學雜誌] 上發表了一篇文章，闡述了對他們醫院採用達芬奇手術治療婦科腫瘤的影響。

The authors reported that the introduction of da Vinci increased the use of minimally invasive surgery from 15% to 76%, increasing the volume of patients treated by 27% and decreasing in-patient board cost by approximately $5,000 per patient.

作者報告說，達芬奇的引入使微創手術的使用率從 15% 增加到 76%，接受治療的患者數量增加了 27%，每位患者的住院費用降低了約 5,000 美元。

Despite a higher proportion of patients with complex comorbidities, the authors concluded, "Organizations are beginning to recognize that the economic implications of introducing a robotics program extend beyond the operating room.

儘管患有復雜合併症的患者比例較高，作者總結道，“組織開始認識到引入機器人程序的經濟影響超出了手術室。

It is timely to evaluate the broader ripple effects robotics has on hospital departments outside of the operating room."

現在是時候評估機器人技術對手術室以外的醫院部門產生的更廣泛的連鎖反應了。”

This concludes my remarks.

我的發言到此結束。

I will now turn the call over to Calvin.

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 updated financial outlook for 2017.

我將為您提供 2017 年最新的財務展望。

Starting with procedures.

從程序開始。

On our last call, we estimated full year 2017 procedure growth of 9% to 12%, above the approximately 752,000 procedures performed in 2016.

在我們上次電話會議中，我們估計 2017 年全年手術量增長 9% 至 12%，高於 2016 年執行的約 752,000 次手術。

Now based upon favorable trends in key markets outside of the U.S., U.S. general surgery growth and solid results in mature U.S. procedure categories, we are increasing our estimate for 2017.

現在，基於美國以外主要市場的有利趨勢、美國普通外科手術的增長以及美國成熟手術類別的穩固結果，我們正在上調 2017 年的預期。

We now anticipate full year 2017 procedure growth within a range of 12% to 14%.

我們現在預計 2017 年全年手術增長率將在 12% 至 14% 之間。

We expect the Q2 procedure growth procedure rates -- procedure growth rates, particularly in Europe, will reflect fewer operating days than in the previous year.

我們預計第二季度的程序增長率——程序增長率，尤其是在歐洲，將反映出比上一年更少的手術天數。

In regards to system placements, 21 of our 133 first quarter system placements were structured as operating leases.

在系統安置方面，我們第一季度的 133 個系統安置中有 21 個是經營租賃。

Going forward in 2017, we expect an increasing proportion of system placements to be under operating leases.

展望 2017 年，我們預計越來越多的系統配售將採用經營租賃方式。

We have recently expanded our leasing programs in Germany and Korea.

我們最近擴大了在德國和韓國的租賃計劃。

And in the U.S., more customers are considering operating lease arrangements to acquire da Vinci capacity.

在美國，越來越多的客戶正在考慮通過經營租賃安排來獲得達芬奇產能。

The average selling price for systems sold outright will vary quarter-to-quarter based upon factors including product, regional and trade-in mix.

直接銷售系統的平均售價將根據產品、區域和以舊換新組合等因素逐季變化。

With the upcoming expansion of our value-oriented system offering and increasing placements in the cost-sensitive market segments, we expect that our average system selling price will trend gradually lower in 2017.

隨著我們即將擴大以價值為導向的系統產品和增加對成本敏感的細分市場的佈局，我們預計我們的平均係統售價將在 2017 年逐漸走低。

As we have described, approximately $23 million of product revenue was deferred in Q1 related to our da Vinci X trade-out program.

正如我們所描述的，與我們的達芬奇 X 交易計劃相關的第一季度，大約 2300 萬美元的產品收入被推遲。

In future quarters, we expect to defer additional revenue related to da Vinci X trade-out offers that we will make to customers in the U.S. and other markets ahead of the availability of the product.

在未來幾個季度，我們預計將推遲與達芬奇 X 交易優惠相關的額外收入，我們將在產品上市之前向美國和其他市場的客戶提供這些優惠。

We will recognize revenue at the point the trade-out offers are executed or when they expire.

我們將在交易報價執行或到期時確認收入。

Turning to gross profit.

轉向毛利。

On our last call, we forecast 2017 pro forma gross profit margin to be within a range of between 69% and 71% of net revenue.

在我們上次電話會議上，我們預測 2017 年備考毛利率將在淨收入的 69% 至 71% 之間。

We now expect our full year 2017 gross profit margin to be in the upper half of that range.

我們現在預計 2017 年全年毛利率將處於該範圍的上半部分。

Turning to operating expenses.

轉向運營費用。

As we have described previously, we have accelerated our investments in several strategic areas that will benefit the company over the long run.

正如我們之前所描述的，我們已經加快了對幾個戰略領域的投資，從長遠來看，這些領域將使公司受益。

Accordingly, we have ramped our operating expenses as we focus on execution.

因此，由於我們專注於執行，因此我們增加了運營費用。

On our last call, we forecast pro forma 2017 operating expenses to grow between 15% and 18% above 2016 levels.

在上次電話會議中，我們預計 2017 年備考運營費用將比 2016 年增長 15% 至 18%。

We now anticipate coming in at the higher end of that range.

我們現在預計進入該範圍的高端。

Consistent with our last call, we expect noncash stock compensation expense to range between $190 million and $200 million in 2017 compared to $178 million in 2016.

與我們上次的電話一致，我們預計 2017 年的非現金股票補償費用將在 1.9 億美元至 2 億美元之間，而 2016 年為 1.78 億美元。

We expect 2017 other income to be between $30 million and $35 million compared to the $25 million to $30 million range forecast on our last call.

我們預計 2017 年其他收入將在 3000 萬美元至 3500 萬美元之間，而我們上次電話會議預測的範圍為 2500 萬美元至 3000 萬美元。

With regard to income tax.

關於所得稅。

Consistent with previous guidance, we expect our 2017 pro forma income tax rate to be between 26.5% and 28.5% of pretax income, depending primarily on the mix of U.S. and international profits.

與之前的指引一致，我們預計 2017 年的預估所得稅稅率將在稅前收入的 26.5% 至 28.5% 之間，這主要取決於美國和國際利潤的組合。

During Q1, we had 38.5 million diluted shares outstanding for EPS calculations.

第一季度，我們有 3850 萬股稀釋後流通股用於每股收益計算。

As Marshall described, in connection with our accelerated share buyback program, on January 27, we took delivery and retired approximately 2.4 million shares, representing the initial delivery from Goldman Sachs.

正如馬歇爾所描述的，與我們加速的股票回購計劃有關，1 月 27 日，我們接收並退回了大約 240 萬股股票，這是高盛的首次交付。

Based upon the timing of this transaction during the quarter, about 1.7 million shares were reduced from our Q1 share count.

根據本季度交易的時間，我們第一季度的股票數量減少了約 170 萬股。

The remaining 700,000 of the 2.4 million share reduction will be realized in Q2, reflecting the full quarter impact.

240 萬股減持中剩餘的 70 萬股將在第二季度實現，反映了整個季度的影響。

A final delivery of shares under the program, if any, will be delivered at the end of the contract period in November.

該計劃下的最終股份交付（如果有的話）將在 11 月合同期結束時交付。

Beyond the accelerated buyback, our actual Q2 shares outstanding will also be affected by the impacts of employee option grants, share price and other diluted share calculation inputs as well as any other buybacks.

除了加速回購之外，我們實際的第二季度流通股還將受到員工期權授予、股價和其他稀釋後股票計算輸入以及任何其他回購的影響。

That concludes our prepared comments.

我們準備好的評論到此結束。

We will now open the call for your questions.

我們現在將開始徵集您的問題。

(Operator Instructions) And our first question will come from Bob Hopkins with Bank of America.

（操作員說明）我們的第一個問題將來自美國銀行的鮑勃霍普金斯。

Can you hear me okay?

你能聽到我說話嗎？

We can.

我們可以。

We can.

我們可以。

Great.

偉大的。

So I guess, the first thing I'd like to ask about is your announcement on da Vinci X, and it sounds like if you're deferring revenue now that the timing of this is fairly imminent.

所以我想，我想問的第一件事是你在達芬奇 X 上的公告，聽起來你是否正在推遲收入，因為這個時間已經迫在眉睫了。

So is it safe to assume that X will actually be launching this calendar year?

那麼可以安全地假設 X 實際上會在這個日曆年推出嗎？

We plan to launch in Europe first, and we are in the process of the CE mark review.

我們計劃首先在歐洲推出，我們正在進行 CE 標誌審查。

We expect that we'll pass through that review in the next quarter or so.

我們預計我們將在下個季度左右通過該審查。

And then there are a couple of other follow-ups.

然後還有其他一些後續行動。

In terms of U.S. timing -- and then, Gary, can you just describe this a little bit more?

就美國的時機而言——然後，加里，你能再描述一下嗎？

I think you said it was an add-on to Si.

我想你說過它是 Si 的附加組件。

I'm just curious.

我只是好奇。

Is this technology primarily a lower-priced offering?

這項技術主要是一種低價產品嗎？

Or is it going to be positioned as a tool for new settings or new surgical markets?

還是將其定位為新環境或新手術市場的工具？

I just wanted to try to get a better understanding of what the kind of new market opportunity that this is addressing.

我只是想嘗試更好地了解這正在解決什麼樣的新市場機會。

Sure.

當然。

So let me describe a little bit of what it is first.

所以讓我先描述一下它是什麼。

It really combines our latest instrument accessory, robotic and computing and imaging technology with an Si patient cart chassis.

它真正將我們最新的儀器配件、機器人、計算和成像技術與 Si 患者推車底盤結合在一起。

This brings to market advanced upgrade package for Si technology that's lost between the Si and the Xi in terms of its breadth of critical reach, and it creates an attractive entry point for either an upgrade or a new install.

這為市場帶來了先進的 Si 技術升級包，就關鍵範圍的廣度而言，它在 Si 和 Xi 之間丟失，並且它為升級或新安裝創造了一個有吸引力的切入點。

I think that it will do well in places that Si does well today and adds to it some of the Xi technologies at an attractive economic place.

我認為它會在 Si 今天做得很好的地方做得很好，並在一個有吸引力的經濟地點添加一些 Xi 技術。

Where that goes in terms of treatment locations, we'll see.

就治療地點而言，情況如何，我們拭目以待。

I think it will be well received.

我認為它會很受歡迎。

And then lastly, I guess, on da Vinci X. Can you just talk about what sort of difference in price point are we talking about here?

最後，我想，關於達芬奇 X。你能談談我們在這裡談論的價格點有什麼樣的差異嗎？

And what sort of difference in functionality, if it's primarily addressing similar kind of surgical opportunities?

如果它主要解決類似的手術機會，那麼在功能上有什麼樣的差異？

I'm just curious to any sense for what's the ASP difference and the functionality difference.

我只是對 ASP 差異和功能差異有什麼感覺感到好奇。

That will be very helpful.

這將非常有幫助。

Yes.

是的。

You'll have to wait on ASPs.

您將不得不等待 ASP。

We aren't announcing it at this time.

我們現在不宣布它。

Just directionally, it'll be between Sis and Xis.

就方向而言，它會在 Sis 和 Xis 之間。

And in terms of capability, again, we'll -- as we launch, we'll give you additional information in terms of future benefit.

就能力而言，我們將再次——在我們推出時，我們將為您提供有關未來利益的更多信息。

It isn't foundational in terms of the types of procedures it can do.

就它可以執行的程序類型而言，它不是基礎的。

It will make Sis more capable to more comfortably do more procedures.

這將使 Sis 更有能力更輕鬆地執行更多程序。

Xi will remain the top of the line.

習仍將是最高層。

Xi has intraoperative table motion.

Xi 有術中手術台運動。

It has automated help and setup and optimization and multi-quadrant functions that X will not have.

它具有 X 所沒有的自動幫助、設置和優化以及多像限功能。

And could it launch in the U.S. this year?

它今年能在美國推出嗎？

That's my last question.

這是我的最後一個問題。

It is possible, but we haven't yet called the end date in terms of launch timing.

這是可能的，但我們還沒有確定發佈時間的結束日期。

Our next question will come from Amit Hazan with Citi.

我們的下一個問題將來自花旗的 Amit Hazan。

Let me just start maybe with the da Vinci Sp delay and just ask for a little bit more color, just specifically what happened to get you to drive that delay.

讓我從 da Vinci Sp 延遲開始，只要求多一點顏色，特別是發生了什麼讓你驅動那個延遲。

And then also, other than the software upgrade, are you pretty much ready for the 510(k) filing in terms of the clinical results you wanted to have?

然後，除了軟件升級之外，您是否已經準備好根據您想要的臨床結果提交 510(k) 文件？

Yes.

是的。

The clinical side has been really good.

臨床方面真的很好。

We're feeling great about our clinical experience and overall product performance.

我們對我們的臨床經驗和整體產品性能感到滿意。

We do -- we did learn some things in our trial that we want to make a little easier.

我們確實 - 我們確實在試驗中學到了一些我們想讓它們變得更容易的東西。

It has to do with making it a little bit easier to set up and a little bit smoother and optimized workflow.

它與使設置更容易一些以及工作流程更順暢和優化有關。

We decided that, given the extensive HF, human factors validations, that are required by regulators these days that we would rather do that sooner ahead of the submission than later.

我們決定，考慮到如今監管機構要求進行廣泛的 HF、人為因素驗證，我們寧願在提交之前儘早進行，也不願稍後進行。

And so we made the decision to go ahead and pull that software release forward and do those validations on the newly released software, so I'm not foundationally upset about where we are with regard to Sp.

因此，我們決定繼續推進該軟件版本，並對新發布的軟件進行驗證，因此我從根本上不會對我們在 Sp 方面的進展感到不安。

You get out, and you learn.

你出去，你學習。

I'd like to take those learnings and put them back into the product and get on with it.

我想吸取這些經驗並將它們重新應用到產品中並繼續使用它。

And just 2 quick questions on guidance.

以及關於指導的 2 個快速問題。

First, on the gross margin side.

首先，在毛利率方面。

I think I want to try to understand you had another really good gross margin quarter, and your guidance is still kind of a little bit below where we were last year.

我想我想試著了解你有另一個非常好的毛利率季度，你的指導仍然有點低於我們去年的水平。

But it seems like the same drivers are in place, lower cost and new products, managing fixed costs well.

但似乎相同的驅動因素已經到位，降低成本和新產品，很好地管理固定成本。

So I'm just trying to understand if this is conservatism by you or if you're actually starting to think about some of the maybe da Vinci X product coming through and that's why the guidance is lower.

所以我只是想了解這是否是你的保守主義，或者你是否真的開始考慮一些可能是達芬奇 X 的產品，這就是指導較低的原因。

What else is the offset versus what you've been able to achieve over the last 5 quarters?

與您在過去 5 個季度中取得的成就相比，還有什麼抵消？

Yes, Amit, this is Calvin.

是的，阿米特，這是卡爾文。

And we're definitely pleased with our Q1 gross profit results and our continued progress to reduce cost and improve efficiency, as Marshall took you through.

我們對我們第一季度的毛利潤結果以及我們在降低成本和提高效率方面的持續進展感到非常滿意，正如馬歇爾帶領您完成的那樣。

And as such, we did take up our guidance to the upper half of the 69% to 71% range.

因此，我們確實接受了 69% 至 71% 範圍上半部分的指導。

But you look at -- specifically at Q1, the gross margin of 72% in the quarter benefited from product mixes.

但你看——特別是在第一季度，本季度 72% 的毛利率得益於產品組合。

77% of our revenue is from higher margin recurring revenue, and 23% came from lower margin capital.

我們 77% 的收入來自利潤率較高的經常性收入，23% 來自利潤率較低的資本。

Also during the quarter, again, we had very few charges associated with field actions, excess, obsolete inventory.

同樣在本季度，我們與現場行動、過剩、過時庫存相關的費用也很少。

So as we look forward into the balance of '17, we think the margin will be impacted by things, including, of course, capital sales comprising a higher proportion of the revenue and that mix factor.

因此，當我們展望 17 年的餘額時，我們認為利潤率將受到一些因素的影響，當然包括資本銷售佔收入的更高比例以及該混合因素。

There will be some costs start to build up that -- to support the manufacturers of some of the new products.

將會有一些成本開始增加——以支持一些新產品的製造商。

We are assuming a higher field action and charges more aligned with historic ratios, and then as I talked about in the prepared comments, some directionally lower system ASPs as we expand our value-oriented system offering and increased placements in the cost-sensitive market segments.

我們假設更高的現場行動和收費與歷史比率更一致，然後正如我在準備好的評論中談到的那樣，隨著我們擴大以價值為導向的系統產品並增加對成本敏感的細分市場的安置，一些定向降低的系統 ASP .

And of course, the margin will vary quarter-to-quarter.

當然，利潤率會因季度而異。

Okay.

好的。

And then just lastly for me on -- is on the procedure guidance.

最後對我來說是關於程序指南。

So if I'm kind of hearing you correctly, putting all the pieces together, you had some selling day impact that you're calling out for the first time really.

因此，如果我沒聽錯的話，將所有部分放在一起，您就會產生一些銷售日影響，這是您第一次真正提出的。

I'm assuming you kind of knew that ahead of time, so I don't know how much that has an impact on your new higher guidance, but maybe a comment on that.

我假設你提前知道了這一點，所以我不知道這對你的新更高指導有多大影響，但也許可以對此發表評論。

And then in addition to that, you talked about strong kind of legacy growth, but your legacy growth was right in line with where it's been more recently.

除此之外，你還談到了強勁的遺留增長，但你的遺留增長與最近的情況一致。

So I'm just wondering, is the net effect of this that the higher guidance for you comes really from general surgery in the U.S.?

所以我只是想知道，對您的更高指導是否真的來自美國的普通外科手術？

Is that what's driving the higher number?

這是推動更高數字的原因嗎？

Yes.

是的。

You know there's a lot of factors.

你知道有很多因素。

Again, overall, we're, again, very pleased with our Q1 procedure results and growth trends, and we do expect 2017 procedure growth to continue to be driven by U.S. general surgery and international procedures.

同樣，總體而言，我們再次對第一季度的手術結果和增長趨勢感到非常滿意，我們確實預計 2017 年的手術增長將繼續受到美國普通外科手術和國際手術的推動。

We're still very early stages of adoption in these categories.

在這些類別中，我們仍處於採用的早期階段。

And again, we've raised our guidance in the quarter from 9% to 12% to 12% to 14%, so it's reflecting our increased confidence overall.

再一次，我們將本季度的指導從 9% 提高到 12% 到 12% 到 14%，因此這反映了我們整體信心的增強。

But at the end, we feel like our Q1 results were exceptional in the quarter.

但最後，我們覺得我們的第一季度業績在本季度非常出色。

And going forward, we would expect some moderation in growth in Asia, as Patrick took your through, as we await additional da Vinci procedure reimbursement in Japan and sales quota in China.

展望未來，我們預計亞洲的增長會有所放緩，因為帕特里克已經完成了，我們正在等待日本額外的達芬奇手術報銷和中國的銷售配額。

We'd expect moderation in the European growth rates due to timing of Easter holiday, slight moderation in U.S. mature procedures, which have continued trends, as you mentioned.

我們預計，由於復活節假期的到來，歐洲增長率會有所放緩，美國成熟程序略有放緩，正如你提到的，這些趨勢一直在持續。

But dVP and GYN, we'd assume some moderation there, and then just the overriding uncertainty in policy direction in the United States and what impact that may have.

但是 dVP 和 GYN，我們假設那裡有一些緩和，然後只是美國政策方向的壓倒一切的不確定性以及可能產生的影響。

We'll go next to David Lewis with Morgan Stanley.

我們將與摩根士丹利一起去大衛劉易斯旁邊。

Just a few quick ones.

只是一些快速的。

Gary, just starting off with the da Vinci X for a second here.

加里，這裡剛開始使用達芬奇 X。

I wonder, with the upgrade electronics package in tower on da Vinci X, is it going to be possible to upgrade the X with Sp?

我想知道，隨著達芬奇 X 塔中的升級電子組件，是否有可能用 Sp 升級 X？

Meaning, will that tower work with Sp?

意思是，那座塔能和 Sp 一起工作嗎？

So potentially, you can bring Sp to a broader marketplace than we initially thought, which we thought maybe was limited to just Xi?

那麼有可能，你可以將 Sp 帶入比我們最初想像的更廣闊的市場，我們認為這可能僅限於 Xi？

Yes.

是的。

So it's a good point.

所以這是一個很好的觀點。

It's -- the answer to that is ultimately, yes.

答案最終是肯定的。

But the computational hardware platform and the basics are shared across all 3: X, Xi, and ultimately, Sp.

但是計算硬件平台和基礎知識在所有 3 個共享：X、Xi，最終是 Sp。

So in addition to giving people a lower entry point on advanced technologies, it gives them logical upgrade pathways to advance technologies.

因此，除了為人們提供先進技術的較低切入點外，它還為他們提供了推進技術的合理升級途徑。

Perfect.

完美的。

Very fair.

很公平。

And then, Gary, just 2 more quick ones.

然後，加里，還有 2 個快速的。

One on Sp.

一個在 Sp。

Does this software upgrade or software pull forward, I should say, does that impact the time of the second and third filings you were forecasting out ahead of that and others?

這個軟件升級或軟件是否向前推進，我應該說，這是否會影響您提前預測的第二次和第三次申請的時間？

It does not appear to.

它似乎沒有。

Okay.

好的。

And then, Gary, the one procedure -- we talk a lot about prostate, we talk about hernia lately, but this thoracic procedure or segment has really come into the dialogue the last 6 months.

然後，加里，一個手術——我們經常談論前列腺，我們最近談論疝氣，但這個胸部手術或胸段在過去 6 個月裡真正進入了對話。

Can you just talk more about what's happening in thoracic?

你能多談談胸部發生的事情嗎？

How much of it is lung resection?

其中有多少是肺切除術？

How much of it is this broad category of VATS surgery?

這種廣泛的 VATS 手術有多少？

And anything you could share with us in terms of market size, stage of inflection?

關於市場規模、拐點階段，您有什麼可以與我們分享的嗎？

Because it's sort of merged from a nice place to a definitive driver.

因為它有點從一個不錯的地方合併為一個確定的驅動程序。

It'd be helpful to get some clarity.

弄清楚一些會很有幫助。

Sure.

當然。

I think just painting it broad strokes, the opportunity for us in thoracic surgery over time is real.

我認為只是粗略地描繪一下，隨著時間的推移，我們在胸外科領域的機會是真實的。

There's a lot of open surgery in that space.

那個空間有很多開放手術。

These are complex procedures and delicate surgeries, and so we think that sets up well for a da Vinci kind of platform.

這些都是複雜的程序和精細的手術，因此我們認為這為達芬奇平台做好了準備。

As we've brought Xi to the market with its longer reach, its narrower arms and its set of Xi staplers, that has helped.

當我們將 Xi 以其更長的觸及範圍、更窄的臂和一套 Xi 訂書機推向市場時，這有所幫助。

So we're seeing what would amount to early interest and early growth in that category.

因此，我們看到了該類別的早期興趣和早期增長。

In terms of market sizes and rate of penetration, I'll let Patrick speak to that a little bit.

就市場規模和滲透率而言，我會讓帕特里克稍微談一談。

We still think we're early.

我們仍然認為我們還早。

I would also say that we've got our sales force and commercial team really focused primarily on general surgery.

我還要說的是，我們的銷售團隊和商業團隊真正主要專注於普通外科手術。

I think we want to support that market really well.

我認為我們想要很好地支持那個市場。

But Patrick, take it away.

但是帕特里克，把它拿走。

If you look at the United States market, there's probably around 100,000 patients who receive surgery in a day, split evenly between lobectomies and other types of thoracic procedures for which we think our products can bring value to patients and surgeons.

如果你看看美國市場，每天可能有大約 100,000 名患者接受手術，在肺葉切除術和我們認為我們的產品可以為患者和外科醫生帶來價值的其他類型的胸腔手術之間平均分配。

When you look outside of the United States, markets are much, much larger, particularly when you look to Asia and China in particular.

當你看向美國以外的市場時，市場會大得多，尤其是當你看向亞洲和中國時。

So we're optimistic about the future, but we're still in very early days, and you're seeing some of the early evidence sets come out comparing robotics to open and even VATS surgeries where there are improving outcomes.

因此，我們對未來持樂觀態度，但我們仍處於早期階段，您會看到一些早期證據集將機器人技術與開放手術甚至 VATS 手術進行比較，結果有所改善。

And if that evidence holds up over time, we think there's a runway for us here.

如果這些證據隨著時間的推移而成立，我們認為這裡有適合我們的跑道。

Our next question is from Tycho Peterson with JPMorgan.

我們的下一個問題來自摩根大通的第谷彼得森。

I'll start off with just a couple of clarifications on procedure expectations.

我將從對程序期望的一些澄清開始。

Are you factoring in any impact from USPSTF guidelines?

您是否考慮了 USPSTF 指南的任何影響？

And then can you comment on hernia ventral versus inguinal?

然後你能評論腹側疝和腹股溝疝嗎？

Are you still seeing relatively balanced growth rates between the 2?

您是否仍然看到兩者之間相對平衡的增長率？

Tycho, it's Patrick.

第谷，是帕特里克。

From a USPSTF perspective, in 2012, when the original announcement came out, you saw dVP falling into a decline over a couple of year period.

從 USPSTF 的角度來看，在 2012 年最初的公告發佈時，您看到 dVP 在幾年內下降。

However, since then, you've seen our volumes really returned to nearly the level they were in 2011, so I think a lot of it has played through.

然而，從那時起，您已經看到我們的銷量真正恢復到接近 2011 年的水平，所以我認為其中很多已經發揮作用。

Now we're pleased to see the statement become more aligned to what the AUA society guidelines are.

現在我們很高興看到該聲明更加符合 AUA 社會準則。

From a ventral and inguinal hernia perspective, we remain encouraged by the trends we're seeing.

從腹疝和腹股溝疝的角度來看，我們仍然對我們所看到的趨勢感到鼓舞。

You continue to see growth in our existing surgeon populations doing more and more procedures, new surgeons coming along, and there's a lot of positive energy coming out of society meetings like the American Hernia Society and the SAGES meeting.

你會繼續看到我們現有的外科醫生人數在增加，他們正在做越來越多的手術，新的外科醫生不斷湧現，並且從美國疝氣協會和 SAGES 會議等社會會議中散發出許多積極的能量。

So we continue to be pleased by the adoption that we're seeing.

因此，我們繼續對我們所看到的採用感到高興。

And then on Sp.

然後在 Sp。

I know you suggested the software release wouldn't necessarily impact the timing for follow-on procedures beyond urology.

我知道您建議軟件發布不一定會影響泌尿外科以外的後續程序的時間安排。

Can you maybe just help us think of when you may have those filings for the follow-on procedures?

你能不能幫我們想想你什麼時候可以為後續程序提交這些文件？

And also, when can we get a readout from the first clinical experience in Australia?

而且，我們什麼時候可以從澳大利亞的第一次臨床經驗中得到讀數？

Is that something that would be published?

那是要發表的東西嗎？

Okay.

好的。

So 2 other things there: one is Sp, and one is our flexible robotics program.

所以還有另外兩件事：一個是 Sp，一個是我們的靈活機器人程序。

Now just going to Sp to start.

現在只是去 Sp 開始。

We have not yet settled on submission time lines for the additional indications on Sp beyond urology.

我們尚未確定 Sp 在泌尿科以外的其他適應症的提交時間表。

We are imminently initiating the transoral surgery trials, and then we'll open colorectal trials thereafter, but we have not yet set dates publicly for when we expect those submissions.

我們即將啟動經口手術試驗，然後我們將開始結直腸試驗，但我們尚未公開確定提交這些試驗的日期。

That said, the software update we're doing vis-à-vis the urology filing should not disrupt the time line of those 2. With regard to the work that was in Australia, that was on the flexible robotics platform.

也就是說，我們針對泌尿外科歸檔進行的軟件更新不應該打亂這兩個的時間線。關於在澳大利亞的工作，那是在靈活的機器人平台上。

There are in patient follow-up now, so they're following patients after their treatment for the prescribed amount of time in their protocol.

現在有病人隨訪，所以他們在治療後按照他們的協議中規定的時間跟踪病人。

I'd expect them to be presenting publicly in the fall.

我希望他們能在秋天公開展示。

We now have a question from Tao Levy with Wedbush.

我們現在有一個來自 Tao Levy 和 Wedbush 的問題。

Great.

偉大的。

So a question on the X, on the da Vinci X. Are the instruments similar, too, to the Xi?

那麼關於 X，關於達芬奇 X 的問題。儀器是否也與 Xi 相似？

Or is it still going to be a different core set of instruments?

或者它仍然會是一套不同的核心工具？

Good question.

好問題。

The instruments on X are the same family as the Xi.

X 上的儀器與 Xi 屬於同一家族。

So there are generation 2 advanced instrument kit, so things like stapling and vessel sealing or Gen 2. They are the same exact instruments, same part numbers as the Xi, likewise with imaging system.

所以有第 2 代高級儀器套件，比如吻合和血管密封或第 2 代。它們是完全相同的儀器，與 Xi 相同的部件號，同樣帶有成像系統。

So if you're an account that has multiple systems, you have Xis and Sis, then moving to X can standardize your Si base and have one set of instruments and accessories.

所以如果你是一個擁有多個系統的賬戶，你有 Xis 和 Sis，那麼轉向 X 可以標準化你的 Si 基礎，並擁有一套儀器和配件。

Got you.

明白了

And the pricing pathway for an upgrade from an Si 2 and X outside of obviously the deferral?

除了明顯的延期之外，從 Si 2 和 X 升級的定價途徑是什麼？

So not -- we haven't published yet what the list price steps are going to be.

所以不是——我們還沒有公佈定價步驟是什麼。

Got you.

明白了

Okay And then just lastly.

好的 然後最後。

I asked this question the last quarter.

我上個季度問過這個問題。

Just wondering if there's any update on the quota from China?

只是想知道中國的配額是否有任何更新？

Is that still something you expect over the near term?

這仍然是你對近期的期望嗎？

There really isn't -- this is Marshall.

真的沒有——這是馬歇爾。

There really isn't much of an update.

真的沒有太多的更新。

As we previously communicated, we're still waiting for quota which would cover the civilian hospitals in China, and we'll keep you informed as we hear.

正如我們之前所說，我們仍在等待覆蓋中國民用醫院的配額，我們會及時通知您。

Our next question is from Brandon Henry with RBC Capital Markets.

我們的下一個問題來自 RBC 資本市場的 Brandon Henry。

First, can you talk about the dynamic -- you mentioned the patients coming in for surgery ahead of potential health care reform changes.

首先，你能談談動態嗎——你提到了在潛在的醫療改革變化之前接受手術的患者。

And what you heard from surgeons regarding that dynamic?

你從外科醫生那裡聽到了什麼關於這種動態的信息？

And then should we expect this, the more dynamic, to occur in the second quarter?

那麼我們是否應該期待這種更有活力的情況發生在第二季度？

And I have a couple of follow-ups.

我有幾個後續行動。

I -- this is Gary.

我——這是加里。

I don't think we have a deep insight there.

我不認為我們在那裡有深刻的洞察力。

There's been a little bit of speculation that there's been some pull forward.

有一些猜測認為有一些進展。

We have seen just in the numbers a little more buoyance kind of broadly across our procedure base, not just in a single category, but kind of across each category which leaves us to believe there's something environmental going on.

我們在我們的程序基礎上從數字中看到了更多的浮力，不僅僅是在一個類別中，而是在每個類別中，這讓我們相信有一些環境問題正在發生。

I would not say that we have special insight.

我不會說我們有特別的洞察力。

I think it's a little bit of speculation.

我認為這有點猜測。

We'll know on the future quarters.

我們將在未來幾個季度知道。

I cannot predict what will happen Q2, Q3 with regard to how ACA dynamics will occur.

關於 ACA 動態將如何發生，我無法預測 Q2、Q3 會發生什麼。

Okay.

好的。

And then separately, on the international side.

然後分別在國際方面。

I think the company breaks out international procedures by prostatectomy, hysterectomy in kind of other bucket.

我認為該公司通過前列腺切除術、子宮切除術等其他方式突破了國際程序。

The other bucket is the kind of larger portion of international procedures that we don't really have a lot of visibility into the underlying trends there.

另一個桶是國際程序的較大部分，我們對那裡的潛在趨勢並沒有太多的了解。

So can you just spend some time discussing what specific countries or procedures are driving that continued 30%-plus growth in the other bucket and your confidence of kind of that rate of growth continuing for the other category going forward?

那麼，您能否花一些時間討論哪些具體國家或程序正在推動另一個類別持續 30% 以上的增長，以及您對其他類別繼續保持這種增長率的信心？

Yes, sure, Brandon, it's Patrick.

是的，當然，布蘭登，是帕特里克。

We continue to see most of our -- outside of the United States procedure growth being driven by urology, mostly prostatectomy and dVP, but also in kidney repairs, mainly through partial nephrectomies to which the system tends to be an enabler for population of patients to access partial nephrectomy for kidney cancers.

我們繼續看到我們的大部分 - 在美國以外的程序增長是由泌尿科驅動的，主要是前列腺切除術和 dVP，但也包括腎臟修復，主要是通過部分腎切除術，該系統往往是患者群體的推動者對腎癌進行腎部分切除術。

We also do see encouraging signs in general surgery and gynecology, stronger in Asia and in certain markets in Europe where we've already deeply penetrated urology.

我們也確實在普通外科和婦科領域看到了令人鼓舞的跡象，這些跡像在亞洲和我們已經深入滲透泌尿科的歐洲某些市場更為強勁。

Our next question is from Larry Biegelsen with Wells Fargo.

我們的下一個問題來自富國銀行的 Larry Biegelsen。

First, if I focus on the pipeline, any updates on the new technologies that you're working on, the imaging agent and additional instruments?

首先，如果我關注管道，你正在研究的新技術、顯像劑和其他儀器的任何更新？

And I had one follow-up.

我有一個後續行動。

Imaging trial on the imaging agent is initiated.

開始對成像劑進行成像試驗。

So far, so good.

到目前為止，一切都很好。

We're still early in the trial, but we're pleased.

我們仍處於試驗初期，但我們很高興。

Otherwise, our imaging programs are progressing against our plan.

否則，我們的成像程序將違背我們的計劃。

Your second question was on -- I'm sorry, advanced?

你的第二個問題是——對不起，高級？

Additional instruments.

附加儀器。

Instrumentation.

儀表。

We have a portfolio of instruments we're working on.

我們有一系列正在研究的工具。

Nothing to really call out in terms of dates for you.

就日期而言，沒什麼好說的。

We are making progress on expanding our stapler line to be a full-line stapling system, but nothing I'd call out for you on this call.

我們在將訂書機生產線擴展為全線訂書機系統方面取得了進展，但我不會在這次電話會議上為您提出任何要求。

Gary, let me ask one on the competition.

加里，讓我問一個關於比賽的問題。

So Medtronic has talked about bundling their surgical portfolio to drive sales of their robot.

因此，美敦力 (Medtronic) 談到了捆綁他們的手術產品組合以推動他們機器人的銷售。

Assuming they have a competitive offering, can you talk about things you could do, such as partnering to negate that advantage that they could have?

假設他們提供有競爭力的產品，您能否談談您可以做的事情，例如合作以抵消他們可能擁有的優勢？

We think -- the way we think about it in terms of servicing our customer is to allow them to have a minimally invasive surgery program that get the outcomes they want across a broad population of patients and surgeons.

我們認為——我們在服務客戶方面的思考方式是讓他們有一個微創手術計劃，在廣大患者和外科醫生中獲得他們想要的結果。

We think that our technologies are outstanding, and we'll continue to be market-leading.

我們認為我們的技術非常出色，我們將繼續保持市場領先地位。

To the extent that they need to augment a robotics system with other products, there are a plethora of other companies that are happy to sell into surgical suites.

就他們需要用其他產品來增強機器人系統而言，還有許多其他公司很樂意將其出售給手術室。

And I think as long as those are at an economically attractive price point and the products are well accepted, I think we're going to be in good shape.

而且我認為只要這些產品的價格在經濟上具有吸引力並且產品被廣泛接受，我認為我們就會處於良好狀態。

And our next question will come from Richard Newitter with Leerink Partners.

我們的下一個問題將來自 Leerink Partners 的 Richard Newitter。

Just the first one.

只是第一個。

Coming out of SAGES, we noticed just a palpable kind of acceptance, increased acceptance of hernia procedures in general, multiple kind of podium sessions devoted to it.

從 SAGES 出來後，我們注意到一種明顯的接受度，即對疝氣手術的接受度普遍提高，以及專門針對它的多種講台會議。

So I'm just wondering, is there that acceptance that you're seeing -- that we saw, do you guys feel that kind of there's been a notable inflection in the acceptance of kind of hernia -- robotic hernia surgery?

所以我只是想知道，是否有你們看到的接受度——我們看到的，你們是否覺得在接受某種疝氣——機器人疝氣手術方面出現了顯著的變化？

And would you be willing to kind of give us an updated kind of sense of where we are on the market opportunities within ventral and hernia -- inguinal, how big they are and kind of where you think that could go from your addressable market?

您是否願意給我們提供一種最新的感覺，讓我們了解我們在腹側和疝氣市場機會中所處的位置——腹股溝，它們有多大，以及您認為可以從您的目標市場去哪裡？

I think in the first part of your question, where are we in acceptance, I think that you're seeing some early exploration and enthusiasm, and we're feeling that enthusiasm as well.

我認為在你問題的第一部分，我們在哪裡接受，我認為你看到了一些早期的探索和熱情，我們也感受到了這種熱情。

But as you well know, the surgical population is not of one mind.

但正如您所知，外科手術人群並非一心一意。

And I think that we're going to see pro-con debates in hernia for some time, and I would expect that.

而且我認為我們將在一段時間內看到關於疝氣的讚成反對辯論，我希望如此。

And I think it'll be challenged and debated and discussed, variance by patient population, variance by surgical technique and variance by total economics to treat.

我認為它會受到挑戰、辯論和討論，患者人數的差異，手術技術的差異和總經濟學的差異要治療。

That leads to your second question, which is, are we ready to make any changes to our thoughts on estimated market size?

這就引出了您的第二個問題，即我們是否準備好改變我們對估計市場規模的想法？

And I think it's really too early to try to redraw boundaries there.

而且我認為現在嘗試重新劃定界限還為時過早。

So the summary for us is, so far, so good.

所以到目前為止，我們的總結非常好。

I think surgeons are finding real value and pursuing that value.

我認為外科醫生正在尋找真正的價值並追求這種價值。

They're doing what I think they should in terms of assessing it carefully and publishing the results and debating which patient groups and subgroups make sense, and we will support them in that effort.

他們正在做我認為他們應該做的事情，包括仔細評估和公佈結果，以及討論哪些患者組和亞組是有意義的，我們將支持他們的努力。

That's helpful.

這很有幫助。

And then just a follow-up on the ACA kind of -- some of the dynamics that might be playing out in the market, but I'm just wondering on the capital side and on the decision-maker side of the equation at hospitals and institutions.

然後只是對 ACA 的後續行動——一些可能在市場上發揮作用的動態，但我只是想知道在資本方面和醫院等式的決策者方面和機構。

Any updates on what you're hearing from customers on kind of their willingness to invest in an innovation like robotics?

關於您從客戶那裡聽到的關於他們願意投資機器人技術等創新的任何最新消息？

I think on the one hand in a good way, a lot of people understand the basic value proposition of robotics, are familiar with the kinds of things it can do.

我認為，一方面，很多人都了解機器人技術的基本價值主張，熟悉它可以做的事情。

So that has led to, I think, meaningful conversations that are data-driven and effective.

因此，我認為這導致了有意義的對話，這些對話是數據驅動的和有效的。

I think on the margins right now, the ACA has injected some caution on the part of capital buyers.

我認為目前在利潤率上，ACA 已經對資本購買者提出了一些警告。

So on the positive side, I think robotics, the value it can bring is pretty well understood.

所以從積極的方面來說，我認為機器人技術可以帶來的價值是眾所周知的。

On the negative side, I think on the margin at the outside, it's been -- the ACA uncertainty has been a slight negative.

在消極方面，我認為在外部邊緣，它一直是 - ACA 的不確定性一直是輕微的負面影響。

Our next question is from Rick Wise with Stifel.

我們的下一個問題來自 Stifel 的 Rick Wise。

Just a big-picture question first.

首先只是一個大問題。

I mean, I would assume you'd think that the opportunity for robotics and surgery is underpenetrated.

我的意思是，我假設你會認為機器人技術和外科手術的機會沒有得到充分利用。

I'm just sort of fascinated with the -- several times you've mentioned -- you, Marshall, Calvin had mentioned that average selling prices will trend lower because of new products and mix here.

我只是有點著迷 - 你已經多次提到 - 你，馬歇爾，卡爾文曾提到平均售價會因為新產品和混合在這裡下降。

Just stepping back from both specifics, how do we think about the opportunity for a lower-priced system perhaps driving the increased penetration?

只是從這兩個細節退一步，我們如何看待可能推動滲透率提高的低價系統的機會？

I mean, is this the next leg in robotic market penetration?

我的意思是，這是機器人市場滲透的下一步嗎？

And does da Vinci X and Sp, should we think about that more specifically as one of the next big opportunities as opposed to just a procedure or a geography, if you see what I'm getting at?

達芬奇 X 和 Sp，我們是否應該更具體地將其視為下一個重大機遇之一，而不僅僅是一個程序或一個地理區域，如果你明白我的意思的話？

I'll answer a little simpler question that you asked.

我將回答您提出的一個更簡單的問題。

I think we have been in close contact with our customers, particularly those outside the United States, and have been listening carefully to what kind of procedures they want to do, what the reimbursement environments are in their countries and what kind of capabilities need to match that procedure set and reimbursement set.

我認為我們一直在與我們的客戶保持密切聯繫，尤其是美國以外的客戶，並一直在認真傾聽他們想要做什麼樣的程序，他們國家的報銷環境如何以及需要匹配什麼樣的能力該程序集和報銷集。

And we think X fits that bill.

我們認為 X 符合該要求。

And as a result, I think that it'll be well received.

因此，我認為它會受到歡迎。

I don't think it's limited to a single country.

我不認為它僅限於一個國家。

I do think that we believe, and I think our customers believe, that total cost to treat is the right economic measure.

我確實認為我們相信，我認為我們的客戶也相信，治療總成本是正確的經濟措施。

That better outcomes followed by economic analysis to look at total cost to treat and to the extent that your technology offering can match that so that you get both great outcomes and lower total cost to treat, that will drive adoption.

更好的結果之後是經濟分析，以查看治療的總成本，以及您的技術產品可以匹配的程度，以便您獲得更好的結果和更低的總治療成本，這將推動採用。

How big, how fast X goes?

X有多大，有多快？

We don't have a crystal ball, but we invested in it based on some conversations and research we think was right.

我們沒有水晶球，但我們根據一些我們認為正確的對話和研究對其進行了投資。

I think that it's going to hit the mark for them, and we will be delighted to report to you in future quarters how it's going.

我認為它會達到他們的目標，我們將很高興在未來幾個季度向您報告它的進展情況。

Yes.

是的。

And Gary, just to follow on to that.

加里，只是為了跟進。

So just to be very clear, I mean, this is not, "Just an upgrade for existing Xi install base." It is that, but it's definitely something much broader, potentially.

所以要非常清楚，我的意思是，這不是“只是對現有 Xi 安裝基礎的升級”。就是這樣，但它絕對是更廣泛的，潛在的。

You can -- if one has an Si, then you can upgrade your Si to an X. If you have no system and you want to get started, then you can buy an X to get started.

你可以——如果你有一個 Si，那麼你可以將你的 Si 升級到一個 X。如果你沒有系統並且你想開始，那麼你可以購買一個 X 來開始。

Yes.

是的。

And you didn't mention -- I know it's small table motion this quarter.

而且你沒有提到 - 我知道這是本季度的小桌面動議。

Just out of curiosity, where are we with adoption and the uptake there?

出於好奇，我們在哪裡採用和接受？

Is it going as you expect and planned?

是否按照您的預期和計劃進行？

Yes.

是的。

At the top level, attach rate of table motion has exceeded our initial expectations and kind of our original business plan for that product.

在頂層，桌面運動的附加率超出了我們最初的預期和我們對該產品的原始業務計劃。

I think with regard to the last quarter, I would imagine, Patrick, about...

我想關於最後一個季度，帕特里克，我想大約......

Very solid attach rates with new Xi system sales.

新 Xi 系統銷售的附加率非常穩固。

We've worked largely through the existing population of customers, so we aren't seeing as much on a year-over-year basis as we saw when the product launched.

我們主要通過現有客戶群開展工作，因此與產品推出時相比，我們看到的同比增長並不多。

Okay.

好的。

And just last for me, on Fosun.

最後對我來說，在復星。

Any milestones we should expect and, let's say, the next 12 months on the program?

我們應該期待的任何里程碑，比方說，未來 12 個月的計劃？

And maybe just more broadly, how do we think about this partnership's impact, if anything, now looking ahead on the broader high surge Chinese business, and especially given the complex geopolitical situation?

也許更廣泛地說，我們如何看待這種夥伴關係的影響，如果有的話，現在展望更廣泛的中國業務，特別是考慮到復雜的地緣政治局勢？

Okay.

好的。

With regard to Fosun, I think I'd focus the audience on really 2 things: one is the technical progress of the flexible robotics platform because we think that's a major component, and then the other one will be our activities in building that organization, hiring staff.

關於復星，我想我會讓聽眾真正關注兩件事：一是柔性機器人平台的技術進步，因為我們認為這是一個主要組成部分，另一個是我們在建立該組織方面的活動，招聘員工。

As the organization builds out, then we'll announce to you kind of where we are.

隨著組織的建立，我們將向您宣布我們的位置。

I gave you an update on where we are in the flex robotics program.

我向您介紹了我們在 flex 機器人計劃中的最新進展。

We are very bullish on the interest in and the value that robotic surgery can bring to China.

我們非常看好機器人手術能給中國帶來的興趣和價值。

We have the right partner in Fosun over time.

隨著時間的推移，我們在復星找到了合適的合作夥伴。

That partnership exists today in the form of our distribution relationship with one of their subsidiaries in Chindex.

這種夥伴關係今天以我們與他們在美中互利的子公司之一的分銷關係的形式存在。

That will grow into the relationship into a full JV, and we will navigate the international waters as need be.

這將發展成為一個完整的合資企業的關係，我們將根據需要在國際水域航行。

So thank you for the question.

謝謝你的提問。

That was our last one.

那是我們的最後一個。

As we've said previously, while we focus on financial metrics such as revenue, profits and cash flow during these conference calls, our organizational focus remains on increasing value by enabling surgeons to improve surgical outcomes and reduce surgical trauma.

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使外科醫生能夠改善手術結果和減少手術創傷來增加價值。

We have built our company to take surgery beyond the limits of the human hand, and I assure you that we remain committed to driving the vital few things which really 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.

今天的電話會議到此結束。

We thank you for your participation and support on this extraordinary journey to improve surgery and look forward to talking to you again in 3 months.

我們感謝您參與和支持這一改善手術的非凡旅程，並期待在 3 個月後再次與您交談。

Thank you, and ladies and gentlemen, that does conclude our conference for today.

謝謝你們，女士們，先生們，我們今天的會議到此結束。

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

感謝您的參與和使用 AT&T Executive Teleconference。

You may now disconnect.

您現在可以斷開連接。