直覺手術 (ISRG) 2017 Q2 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Intuitive Surgical Second Quarter 2017 Earnings Release Call.

女士們，先生們，感謝你們的支持，歡迎來到 Intuitive Surgical 2017 年第二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, Finance, Investor Relations, Calvin Darling.

我現在將會議轉交給財務、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 Second Quarter Earnings Conference Call.

下午好，歡迎來到 Intuitive Surgical 的第二季度收益電話會議。

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.

今天和我一起的有： Gary Guthart，我們的總裁兼首席執行官；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, and 10-Q filed on April 19, 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 表格和 2017 年 4 月 19 日提交的 10-Q 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 with highlights of our second quarter results as described in our press release announced earlier today, followed by a question-and-answer session.

今天的形式將包括提供我們今天早些時候發布的新聞稿中描述的第二季度業績的亮點，然後是問答環節。

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

Gary 將介紹本季度的業務和運營亮點。

Marshall will provide a review of our second quarter financial results.

Marshall 將對我們第二季度的財務業績進行審查。

Patrick will discuss procedure in clinical highlights, then I will provide our updated financial outlook for 2017.

Patrick 將在臨床亮點中討論程序，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 will 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。

As you know, Intuitive is focused on significantly improving surgery and enabling access to our products and services in pursuit of this mission globally.

如您所知，Intuitive 專注於顯著改善手術並使人們能夠獲得我們的產品和服務，以在全球範圍內實現這一使命。

The momentum built over the past several quarters continued into the second quarter of 2017, with solid performance in procedures and strong growth in system placements.

過去幾個季度建立的勢頭一直持續到 2017 年第二季度，程序表現穩健，系統安置強勁增長。

Growth in procedures for the quarter was 16% over the second quarter of 2016.

本季度的程序比 2016 年第二季度增長了 16%。

Overall trends in the first quarter remained stable into the second.

第一季度的總體趨勢在第二季度保持穩定。

Starting with the United States.

從美國開始。

Both the emerging category of general surgery and more mature categories in urology and gynecology performed well.

無論是新興的普外科門類，還是較為成熟的泌尿外科和婦科門類，都表現不俗。

Hernia repair continues to stand out in the general surgery category, with additional contributions coming from colon procedures.

疝修補術在普通外科類別中繼續脫穎而出，結腸手術也做出了額外貢獻。

As we mentioned last quarter, European performance in Q1 of 2017 benefited from calendar tailwinds that we expected to balance out in the second quarter.

正如我們上個季度提到的，2017 年第一季度歐洲的表現受益於我們預計將在第二季度平衡的日曆順風。

Indeed, this occurred with core growth staying roughly steady through the first half of 2017 and European second quarter growth moderating.

事實上，這發生在核心增長在 2017 年上半年基本保持穩定且歐洲第二季度增長放緩的情況下。

Procedure performance in Asia was solid, with growth in China being a highlight from a constrained installed base.

亞洲的程序表現穩健，中國的增長是受限安裝基礎的亮點。

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 Q2 of 2017 strengthened with a growth in total placements from 130 in Q2 of 2016 to 166 this quarter.

我們在 2017 年第二季度的資本配售表現有所增強，總配售量從 2016 年第二季度的 130 筆增加到本季度的 166 筆。

As we mentioned on these calls, capital placements can be lumpy as evidenced by our performance in the first half of the year.

正如我們在這些電話會議中提到的那樣，我們上半年的業績證明了資本配置可能會起伏不定。

In the United States, placements rebounded from a softer Q1 to a strong Q2, anchored in repeat purchases by existing customers and multisystem placements.

在美國，由於現有客戶的重複購買和多系統展示位置，展示位置從疲軟的第一季度反彈至強勁的第二季度。

System placements in Europe grew moderately, aided in part by the launch of da Vinci X. In Asia, the placements grew slightly over the prior year period and over last quarter, constrained for the time being by the lack of a new system quota in China and limited reimbursements in Japan.

歐洲的系統配額溫和增長，部分得益於達芬奇 X 的推出。在亞洲，配額比去年同期和上一季度略有增長，暫時受到中國缺乏新系統配額的限制日本的報銷有限。

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

Marshall 和 Patrick 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 system placements led to gross margins that are lower than last quarter.

強大的系統佈局導致毛利率低於上一季度。

These margins are at the top of our expected range because of the strength in procedures and improvements in our operating efficiencies.

由於程序的優勢和我們運營效率的提高，這些利潤率處於我們預期範圍的頂部。

Our fixed cost growth met our expectations with increases in R&D expenses, growth in staff in European and Asian markets, investments in clinical trials and growth in our corporate computational capabilities.

我們的固定成本增長符合我們的預期，包括研發費用的增加、歐洲和亞洲市場員工的增長、臨床試驗的投資以及我們公司計算能力的增長。

Our second quarter pro forma operating results are as follows: procedures grew approximately 16% over the second quarter of last year; we shipped 166 da Vinci Surgical Systems, up from 130 in the second quarter of 2016; revenue for the quarter was $756 million, up 13% from the prior year; instrument and accessory revenue increased to $398 million, up 17%; total recurring revenue in the quarter was $540 million, representing 71% of total revenue; pro forma gross profit margin was 71.3% compared to 71.9% in the second quarter last year; we generated a pro forma operating profit of $313 million in the quarter, up 5% from the second quarter of last year; and pro forma net income was $228 million, up 4% from Q2 of 2016.

我們第二季度的備考運營結果如下：程序比去年第二季度增長了約 16%；我們出貨了 166 台達芬奇手術系統，高於 2016 年第二季度的 130 台；本季度收入為 7.56 億美元，同比增長 13%；儀器及配件收入增至 3.98 億美元，增長 17%；本季度經常性總收入為 5.4 億美元，佔總收入的 71%；預計毛利率為 71.3%，而去年第二季度為 71.9%；我們本季度的預估營業利潤為 3.13 億美元，比去年第二季度增長 5%；預計淨收入為 2.28 億美元，比 2016 年第二季度增長 4%。

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, in the back half of 2016 and the first half of 2017, we increased our midterm and long-term investments in creating our next generation of products and services.

如您所知，在 2016 年下半年和 2017 年上半年，我們增加了中長期投資以打造我們的下一代產品和服務。

We anchored in our belief that substantial opportunity exists to enable a more minimally invasive surgery, better outcomes and to expand access to our technologies globally.

我們堅信，存在大量機會來實現更微創的手術、更好的結果並在全球範圍內擴大對我們技術的訪問。

Starting with our multiport portfolio.

從我們的多端口產品組合開始。

We developed a system pathway that responds to our customers' desire for choice in clinical capability and choice in total economics.

我們開發了一個系統途徑來響應我們的客戶對臨床能力選擇和整體經濟選擇的願望。

In the quarter, we've received our CE Mark and 510(k) clearance for da Vinci X, our system that brings core Xi technology into a highly capable, lower entry price surgical system.

在本季度，我們獲得了 da Vinci X 的 CE 標誌和 510(k) 許可，我們的系統將核心 Xi 技術帶入了一個功能強大、入門價格較低的手術系統。

We're pleased with the early reception of X by our customers and the choice it brings to those around the world who seek to build robotic-assisted surgery programs with logical upgrade pathways and affordable access to our leading robot-assisted surgery ecosystem.

我們很高興我們的客戶及早接受了 X，它為世界各地尋求建立機器人輔助手術項目的人們提供了選擇，這些項目具有合理的升級途徑和負擔得起的進入我們領先的機器人輔助手術生態系統的途徑。

Our SP program continues to progress in its human clinical trial work and pilot production capability.

我們的 SP 項目在人體臨床試驗工作和試生產能力方面繼續取得進展。

We now have 4 clinical trial sites active, 3 in the United States and 1 in Asia.

我們現在有 4 個活躍的臨床試驗站點，3 個在美國，1 個在亞洲。

Cases in Asia have included transoral, urologic and colorectal surgery, while those in the U.S. are focused on transoral robotic-assisted surgery.

亞洲的案例包括經口、泌尿外科和結直腸手術，而美國的案例則側重於經口機器人輔助手術。

As we mentioned in our last -- in our call last quarter, we anticipate filing our 510(k) for SP in urology in the back half of 2017.

正如我們在上一季度的電話會議中提到的那樣，我們預計在 2017 年下半年提交泌尿外科 SP 的 510(k)。

Surgeon feedback from our trial sites is very encouraging.

我們試用網站的外科醫生反饋非常令人鼓舞。

Our teams continue to work on product validations and manufacturing capability to support submission and launch.

我們的團隊繼續致力於產品驗證和製造能力，以支持提交和發布。

Lastly, our flexible robotics program is meeting our expectations and making good progress in its product design phases and definition of regulatory pathways.

最後，我們的柔性機器人項目符合我們的預期，並在其產品設計階段和監管路徑定義方面取得了良好進展。

In closing, the second quarter of 2017 has carried forward momentum built in prior quarters, and 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 platforms, imaging, advanced instruments, da Vinci Sp and flexible robotics progress; and finally, support for additional clinical and economic validation by region.

最後，2017 年第二季度延續了前幾個季度的勢頭，我們在今年餘下時間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、成像、先進儀器、達芬奇 Sp 和柔性機器人技術的進步；最後，支持按地區進行額外的臨床和經濟驗證。

I'll now turn the call over to Marshall, who will 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 on a non-GAAP or pro forma basis, which excludes specified legal settlements and claim accruals, excess tax benefits associated with employee stock awards and charges associated with stock-based compensation and 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、與員工股票獎勵相關的超額稅收優惠以及與基於股票的補償和購買的 IP 相關的費用。

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 have 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。

Second quarter 2017 revenue was $756 million, an increase of 13% compared with $670 million for the second quarter of 2016 and an increase of 12% compared with the first quarter revenue of $674 million.

2017年第二季度營收為7.56億美元，較2016年第二季度的6.7億美元增長13%，較第一季度的6.74億美元營收增長12%。

We launched the da Vinci X system during the second quarter in the U.S. and European countries covered by CE Mark.

我們在第二季度在 CE 標誌覆蓋的美國和歐洲國家推出了達芬奇 X 系統。

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

結合發布，我們為第一季度購買系統的某些客戶提供了升級或換購 X 系統的機會。

As a result, we deferred $23 million of first quarter revenue, which we recognize when customers either trade-out their systems or when the offers expire, whichever comes first.

因此，我們推遲了第一季度 2300 萬美元的收入，這是我們在客戶更換系統或優惠到期時確認的收入，以先到者為準。

None of the deferred revenue was recognized in the second quarter.

第二季度沒有確認任何遞延收入。

We expect substantially all of the deferred revenue to be recognized by year-end.

我們預計幾乎所有遞延收入都將在年底前確認。

Second quarter 2017 procedures increased approximately 16% compared with the second quarter of 2016.

與 2016 年第二季度相比，2017 年第二季度的程序增加了約 16%。

It increased 5% compared with last quarter.

與上一季度相比增長了 5%。

Procedure growth relative to last year and the first quarter has been driven by general surgery in the U.S. and urology worldwide.

與去年和第一季度相比，手術的增長受到美國普通外科和全球泌尿外科的推動。

Patrick will provide more detail concerning procedure adoptions.

Patrick 將提供有關程序採用的更多詳細信息。

Revenue highlights are as follows: Instrument and accessory revenue of $398 million increased 17% compared with last year and increased 4% compared with the first quarter of 2017, which closely reflects procedure growth.

收入亮點如下： 儀器及配件收入 3.98 億美元，與去年同期相比增長 17%，與 2017 年第一季度相比增長 4%，這與程序增長密切相關。

Instrument and accessory revenue realized per procedure was approximately $1,830 per procedure compared with $1,810 last year and $1,840 last quarter.

每個程序實現的儀器和配件收入約為每個程序 1,830 美元，而去年為 1,810 美元，上季度為 1,840 美元。

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

與 2016 年第二季度相比的增長主要反映了我們縫合和血管密封產品的銷售額增加，部分被客戶購買模式所抵消。

The decrease compared with the previous quarter primarily reflects customer-buying patterns.

與上一季度相比的下降主要反映了客戶的購買模式。

System revenue of $216 million increased 7% compared with the second quarter of 2016.

與 2016 年第二季度相比，系統收入為 2.16 億美元，增長 7%。

It increased 41% compared with last quarter.

與上一季度相比增長了 41%。

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

同比增長反映了較高的系統配置和經營租賃收入，部分被較低的平均售價和較低的租賃買斷收入所抵消。

System revenue for the first quarter of 2017 excluded the $23 million of deferred revenue.

2017 年第一季度的系統收入不包括 2300 萬美元的遞延收入。

Had the first quarter included that revenue, quarter-over-quarter increase would have been 23%, reflecting a higher number of system placements, partially offset by lower lease buyout revenue.

如果第一季度包括該收入，環比增長將達到 23%，反映出系統安置數量增加，部分被較低的租賃買斷收入所抵消。

166 systems were placed in the second quarter of 2017 compared with 130 systems in the second quarter 2016 and 133 systems last quarter.

2017 年第二季度放置了 166 個系統，而 2016 年第二季度為 130 個系統，上一季度為 133 個系統。

27 systems were placed under operating lease transactions in the current quarter compared with 15 systems in the second quarter of 2016 and 21 last quarter.

本季度有 27 個系統被置於經營租賃交易之下，而 2016 年第二季度為 15 個系統，上一季度為 21 個。

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

提醒一下，經營租賃交易的收入在租賃期內按比例確認。

Of the 166 second quarter systems, 11 were X systems.

在第二季度的 166 個系統中，有 11 個是 X 系統。

As of the end of the second quarter of 2017, there were 120 systems out in the field under operating leases.

截至 2017 年第二季度末，現場有 120 個系統處於經營租賃狀態。

We generated approximately $6 million of revenue associated with operating leases in the quarter compared with $4 million in the second quarter of 2016 and approximately $5 million last quarter.

我們在本季度產生了約 600 萬美元與經營租賃相關的收入，而 2016 年第二季度為 400 萬美元，上一季度約為 500 萬美元。

We generated approximately $5 million of revenue during the quarter from lease buyouts compared with $13 million the second quarter of 2016 and $10 million last quarter.

我們在本季度通過租賃收購產生了約 500 萬美元的收入，而 2016 年第二季度為 1300 萬美元，上一季度為 1000 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 $1.56 million last year and $1.46 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 156 萬美元，上季度為 146 萬美元。

The decrease in ASP compared to the second quarter of 2016 primarily reflects lower-priced systems sold to cost-sensitive market segments and lower pricing offered to customers purchasing multiple systems.

與 2016 年第二季度相比，ASP 的下降主要反映了向成本敏感的細分市場銷售的低價系統以及向購買多個系統的客戶提供的低價。

We believe that flexible financing programs, like operating leases, have positively impacted our ability to grow our installed base.

我們相信靈活的融資計劃，如經營租賃，對我們擴大安裝基礎的能力產生了積極影響。

We expect a proportion of these types of arrangements would increase over time.

我們預計這些類型的安排中的一部分會隨著時間的推移而增加。

Service revenue of $142 million increased 11% year-over-year, it increased approximately 1% compared with the first quarter of 2017.

服務收入 1.42 億美元，同比增長 11%，與 2017 年第一季度相比增長約 1%。

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

同比和環比增長反映了我們使用達芬奇系統的安裝基數的增長。

Outside of the U.S., results were as follows: Second quarter revenue outside of the U.S. of $205 million increased 11% compared with $185 million for the second quarter of 2016.

美國以外地區的業績如下：第二季度美國以外地區的收入為 2.05 億美元，與 2016 年第二季度的 1.85 億美元相比增長了 11%。

It increased 12% compared with $183 million for the first quarter.

與第一季度的 1.83 億美元相比增長了 12%。

The increase relative to the prior year primarily reflects increased system placements net of leases and increased instruments and accessories, reflecting procedure growth, partially offset by lower system ASPs.

與上一年相比的增長主要反映了扣除租賃和儀器及附件後系統安置的增加，反映了程序增長，部分被較低的系統平均售價所抵消。

Patrick will provide procedure growth information.

Patrick 將提供程序增長信息。

The year-over-year decline in system ASPs reflects increased sales of lower-cost systems to cost-sensitive markets.

系統 ASP 的同比下降反映了低成本系統向成本敏感市場的銷售增加。

The increase in revenue relative to the last quarter reflects increased system placements and increased instrument and accessory growth.

與上一季度相比收入的增加反映了系統佈局的增加以及儀器和附件增長的增加。

Outside of the U.S., we placed 63 systems in the second quarter compared with 51 in the second quarter of 2016 and 56 last quarter.

在美國以外，我們在第二季度部署了 63 個系統，而 2016 年第二季度為 51 個，上季度為 56 個。

5 of the system placements in the current quarter were operating leases compared with 2 last quarter -- last year and 6 last quarter.

本季度的系統佈置中有 5 個是經營租賃，而上個季度為 2 個——去年和上個季度為 6 個。

Current quarter system placements, including 29 into Europe, 14 into Japan, 5 into India, 5 into Australia and 3 into China.

當前季度系統佈局，包括 29 個進入歐洲、14 個進入日本、5 個進入印度、5 個進入澳大利亞和 3 個進入中國。

System placements outside of the U.S. will continue to be lumpy as some of the o-U.

美國以外的系統佈局將繼續像一些 o-U 一樣參差不齊。

S. markets are in early stages of adoption.

美國市場正處於採用的早期階段。

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 second quarter of 2017 was 71% compared with 72% for the second quarter of 2016 and 72% for the first quarter of 2017.

2017 年第二季度的備考毛利率為 71%，而 2016 年第二季度為 72%，2017 年第一季度為 72%。

The decrease compared with the second quarter of 2016 primarily reflects decreased service margin associated with higher scope repair costs.

與 2016 年第二季度相比的下降主要反映了與更高的範圍維修成本相關的服務利潤率下降。

The decrease compared with the first quarter reflects a higher proportion of system revenue relative to total revenue.

與第一季度相比的減少反映了系統收入相對於總收入的比例更高。

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 23% compared with the second quarter of 2016.

與 2016 年第二季度相比，預計營業費用增長了 23%。

It increased 2% compared with last quarter.

與上一季度相比增長了 2%。

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 o-U.

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 o-U 的擴展。

S. markets.

S. 市場。

The year-over-year growth rates will subside over the remainder of the year with total year growth still expected to be around 18%.

同比增長率將在今年餘下時間放緩，預計全年增長率仍將在 18% 左右。

Our pro forma effective tax rate for the second quarter was 29.2% compared with an effective tax rate of 27.8% for the second quarter of 2016 and 28.1% last quarter.

我們第二季度的備考有效稅率為 29.2%，而 2016 年第二季度的有效稅率為 27.8%，上一季度為 28.1%。

The increase in our tax rate reflects an increased proportion of U.S. income relative to total income.

我們稅率的提高反映了美國收入相對於總收入的比例增加。

Our tax rate will fluctuate with changes in the mix of U.S. and o-U.

我們的稅率將隨著美國和美國的組合變化而波動。

S. income and with the impact of onetime items.

S. 收入與一次性物品的影響。

Our second quarter 2017 pro forma net income was $228 million or $5.95 per share, compared with $220 million or $5.62 per share for the second quarter of 2016 and $196 million or $5.09 per share for the first quarter of 2017.

我們 2017 年第二季度的備考淨收入為 2.28 億美元或每股 5.95 美元，而 2016 年第二季度為 2.20 億美元或每股 5.62 美元，2017 年第一季度為 1.96 億美元或每股 5.09 美元。

The $23 million revenue deferral, including the associated deferral of cost of sales and the income tax effects, reduced GAAP and pro forma net income per share in the first quarter of 2017 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 2017 年第一季度的 GAAP 和預計每股淨收入減少了約 0.28 美元。

Earnings per share benefited from the full impact of our $2 billion stock buyback as we retired approximately 2.4 million shares in -- on January 27, 2017.

每股收益受益於我們 20 億美元股票回購的全部影響，因為我們在 2017 年 1 月 27 日退市了約 240 萬股。

At this point, given the increase in the share price since the start of the ASR, the ultimate number of shares delivered under the ASR may not change materially from the initial delivery.

此時，鑑於自 ASR 開始以來股價上漲，根據 ASR 交付的最終股份數量可能不會與初始交付發生重大變化。

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 $222 million or $5.77 per share for the second quarter of 2017 compared with $185 million or $4.71 per share for the second quarter of 2016 and $180 million or $4.67 per share for the first quarter of 2017.

2017 年第二季度 GAAP 淨收入為 2.22 億美元或每股 5.77 美元，而 2016 年第二季度為 1.85 億美元或每股 4.71 美元，2017 年第一季度為 1.80 億美元或每股 4.67 美元。

GAAP net income for the second quarter included a net benefit of $5 million associated with litigation settlements, net of charges, compared with $4 million of charges in the second quarter of 2016 and $21 million of charges last quarter.

第二季度的 GAAP 淨收入包括與訴訟和解相關的淨收益 500 萬美元（扣除費用），而 2016 年第二季度的費用為 400 萬美元，上一季度的費用為 2100 萬美元。

GAAP net income for the second quarter of 2017 also included a charge of approximately $6 million associated with purchased IP.

2017 年第二季度的 GAAP 淨收入還包括與購買的 IP 相關的約 600 萬美元的費用。

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 be paid in capital as in prior periods.

從 2017 年開始，根據美國通用會計準則，我們需要在我們的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，而不是像以前那樣作為資本支付的調整。

The excess tax benefit included in our GAAP results for the second quarter was $31 million, contributing $0.80 per share compared with $33 million, contributing $0.85 per share in the first quarter of 2017.

我們第二季度的 GAAP 業績中包含的超額稅收優惠為 3100 萬美元，每股貢獻 0.80 美元，而 2017 年第一季度為 3300 萬美元，每股貢獻 0.85 美元。

We have excluded these benefits from our pro forma results.

我們已將這些好處排除在我們的備考結果之外。

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

該金額將根據員工股票期權行使量和 RSU 歸屬數量以及我們股票的價值每季度波動。

We ended the quarter with cash and investments of $3.4 billion, up from $3.1 billion as of March 31, 2017.

本季度末，我們的現金和投資為 34 億美元，高於 2017 年 3 月 31 日的 31 億美元。

The increase reflects cash generated from operations and proceeds from stock option exercises.

增加反映了運營產生的現金和股票期權行使的收益。

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

有了這個，我想把它交給帕特里克，他將回顧程序和臨床亮點。

Thanks, Marshall.

謝謝，馬歇爾。

Of our second quarter procedure growth of 16%, U.S. procedures grew approximately 14%.

在我們第二季度 16% 的程序增長中，美國程序增長了大約 14%。

And outside of the United States, procedures grew approximately 22%.

在美國以外，程序增長了大約 22%。

Procedure trends were consistent with the first quarter, with growth led by U.S. general surgery and global urology.

手術趨勢與第一季度一致，增長由美國普通外科和全球泌尿科引領。

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

在美國，成熟手術和成長手術（例如普外科和胸外科）的表現都優於我們的計劃。

The majority of the outperformance was driven by continued growth in our mature procedures.

大部分出色表現是由我們成熟程序的持續增長推動的。

In U.S. urology, the second quarter growth rate for da Vinci Prostatectomy was modestly higher than the first quarter.

在美國泌尿外科，達芬奇前列腺切除術第二季度的增長率略高於第一季度。

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。

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

在美國婦科，第二季度的程序增長維持了第一季度觀察到的趨勢。

Procedure growth in U.S. GYN appears to be driven by consolidation of surgeries towards physicians that specialize in complex and 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和癌症手術的醫生進行整合所推動的，這些醫生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.

疝修補術繼續貢獻美國最大的新手術量。

And existing surgeon retention and utilization remains strong -- sound.

現有外科醫生的保留率和利用率仍然很高——很好。

Growth trends in lobectomies and other thoracic procedures continue to show strength off of a small base.

肺葉切除術和其他胸部手術的增長趨勢繼續顯示出小基數的優勢。

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

第二季度是另一個有大量臨床出版物評估達芬奇手術的季度。

One that we like to highlight is from Dr. Rashidi from the University of Texas and colleagues from Providence Health and Services who published a study of more than 3,500 colorectal patients treated by 58 high-volume surgeons within the Providence Health and Services network in the American Journal of Surgery.

我們要強調的一個來自德克薩斯大學的 Rashidi 博士和 Providence Health and Services 的同事發表了一項研究，研究對像是美國 Providence Health and Services 網絡內的 58 名高手術量外科醫生治療的 3,500 多名結直腸患者外科雜誌。

The authors found that in exchange for a longer operating time, patients treated on the da Vinci system experienced a threefold reduction in conversion rate and nearly a day shorter length of hospital stay compared to laparoscopy.

作者發現，與腹腔鏡相比，接受達芬奇系統治療的患者的轉化率降低了三倍，住院時間縮短了近一天，以換取更長的手術時間。

In addition, the authors found that there was no difference in total direct cost between the 2 cohorts.

此外，作者發現兩個隊列之間的總直接成本沒有差異。

Turning abroad.

轉向國外。

Procedure growth outside of the United States was approximately 22% in the second quarter, led by the global adoption of da Vinci Prostatectomy, with solid contributions from kidney procedures, general surgery and gynecology.

在全球採用達芬奇前列腺切除術的帶動下，第二季度美國以外的手術增長了約 22%，腎臟手術、普通外科和婦科的貢獻巨大。

As we discussed last quarter, the timing of the Easter holidays from Q1 into Q2, which provided a tailwind to our first quarter result, served as a headwind in the quarter, likely reducing our outside of the United States procedure growth by an estimated 3%.

正如我們上個季度所討論的那樣，從第一季度到第二季度的複活節假期為我們第一季度的業績提供了順風，但在本季度卻成為了不利因素，可能會使我們在美國以外的程序增長估計減少 3% .

Taken together, first half procedure growth of 25% provides a better representation of procedure performance outside of the United States and either quarters' result.

總而言之，上半年 25% 的程序增長更好地代表了美國以外的程序性能以及任一季度的結果。

Procedure growth was led by China, Germany and Japan.

程序增長由中國、德國和日本引領。

Procedure growth in China was driven by a strong expansion in system utilization, as system placements remained constrained, pending issuance of 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，因為系統安置仍然受到限制，等待民用醫院新配額的發放。

Procedure growth in China is broad-based with a number of specialties contributing to the strong performance.

中國的手術增長基礎廣泛，許多專業為強勁的表現做出了貢獻。

In Germany, procedure growth is supported by installed base expansion that is driving strong adoption in urology with contributions from general surgery.

在德國，安裝基礎擴展支持程序增長，這在普通外科的貢獻下推動了泌尿外科的廣泛採用。

In Japan, dVP and dVPN continued to grow, though year-to-year comparators have begun to slow, as dVP adoption has crossed 80%.

在日本，dVP 和 dVPN 繼續增長，但隨著 dVP 的採用率已超過 80%，同比比較開始放緩。

During the quarter, the first clinical experience on da Vinci X occurred in Germany.

在本季度，da Vinci X 的首次臨床體驗發生在德國。

Initial procedures include urology and gynecology, with strong early utilization.

初始程序包括泌尿科和婦科，具有很強的早期利用。

Commenting on the experience, Dr. [Witt], from San Antonio's Hospital (inaudible) stated, da Vinci X is "ideal add-on to our existing da Vinci Xi.

聖安東尼奧醫院（聽不清）的 [Witt] 博士在評論這次體驗時說，da Vinci X 是“我們現有 da Vinci Xi 的理想補充。

Same feeling on the console." Globally, evidence continues to build in support of the clinical and economic validation of da Vinci surgery.

在控制台上也有同樣的感覺。”在全球範圍內，越來越多的證據支持達芬奇手術的臨床和經濟驗證。

During the quarter, an economic analysis studying the impact of da Vinci partial nephrectomy in England was published in European Urology.

在本季度，一份研究達芬奇腎部分切除術在英國影響的經濟分析發表在《歐洲泌尿學》雜誌上。

The work was completed by HCD Economics, an affiliate of the University of Chester.

這項工作由切斯特大學的附屬機構 HCD Economics 完成。

Comparing more than 4,200 partial nephrectomy patients between open and da Vinci surgery, the authors found that da Vinci surgery lowered the total cost to treat during the first year after the procedure by an average of GBP 900, primarily by reducing postoperative and patient utilization from length of stay, cancer and other readmissions and 90-day complications.

作者比較了 4,200 多名腎部分切除術患者的開放手術和達芬奇手術，發現達芬奇手術將術後第一年的總治療費用平均降低了 900 英鎊，這主要是通過減少術後和患者對長度的利用住院、癌症和其他再入院以及 90 天並發症。

This concludes my remarks.

我的發言到此結束。

I'll now turn the call over to Calvin.

我現在將電話轉給卡爾文。

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 12% to 14% above the approximately 752,000 procedures performed in 2016.

在我們上次電話會議中，我們估計 2017 年全年的手術數量比 2016 年的大約 752,000 例增長 12% 至 14%。

Now based largely upon continued strong results in U.S. growth and mature procedure categories.

現在主要基於美國增長和成熟程序類別的持續強勁結果。

In China, we are increasing our estimate for 2017.

在中國，我們提高了對 2017 年的預測。

We now anticipate full year 2017 procedure growth within a range of 14% to 15%.

我們現在預計 2017 年全年手術增長率將在 14% 至 15% 之間。

During the second half of the year, we expect our procedure growth rate to moderate, in part, due to 1 fewer operating day during the third quarter.

在今年下半年，我們預計我們的手術增長率將放緩，部分原因是第三季度的營業日減少了 1 個。

As we move into the second half of the year, we also expect contributions from China and Japan to temper until we obtain a new quota and place additional systems in China and obtain additional procedural reimbursements in Japan.

隨著我們進入下半年，我們還預計中國和日本的貢獻會有所緩和，直到我們獲得新的配額並在中國放置額外的系統並在日本獲得額外的程序報銷。

With regards to system placements, a record high of 27 of the 166 second quarter system placements were structured as operating leases.

在系統安置方面，第二季度的 166 個系統安置中有 27 個被安排為經營租賃，創歷史新高。

In the second half of 2017, we expect a proportion of systems placed under operating leases will continue to increase.

2017年下半年，我們預計經營租賃的系統比例將繼續增加。

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

直接售出的每個系統的平均售價將根據產品、區域和以舊換新組合等因素而有所不同。

With increasing placements into cost-sensitive markets, we expect that our average systems selling price will continue to trend gradually lower in the back half of 2017.

隨著對成本敏感市場的佈局越來越多，我們預計我們的平均係統售價將在 2017 年下半年繼續逐漸走低。

As Marshall mentioned, no amounts were either deferred or released in Q2 related to our da Vinci X trade-in program.

正如 Marshall 提到的，與我們的 da Vinci X 以舊換新計劃相關的第二季度沒有任何金額被推遲或發布。

Going forward, we expect to defer no further revenue related to this program and expect to release and recognize substantially all of the $23 million accrued during the first quarter by the end of this year.

展望未來，我們預計不會推遲與該計劃相關的進一步收入，並預計在今年年底前釋放和確認第一季度累計的 2300 萬美元。

Turning to gross profit.

轉向毛利。

On our last call, we forecast 2017 growth pro forma gross profit margin to be within a range of between 70% and 71% of net revenue.

在我們上次電話會議中，我們預測 2017 年預計毛利率增長將在淨收入的 70% 至 71% 之間。

We are now modestly raising the top end of the range and expect pro forma gross profit margin to be between 70% and 71.5% of net revenue.

我們現在適度提高了該範圍的上限，預計預計毛利率將在淨收入的 70% 至 71.5% 之間。

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 term.

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，這些領域將使公司長期受益。

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 at the higher end of a range between 15% and 18% above 2016 levels.

在我們上次電話會議中，我們預測 2017 年備考運營費用將比 2016 年水平增長 15% 至 18% 的較高區間。

We continue to expect results at the high end of the range, between 17% and 18% for the year.

我們繼續預期該範圍的高端結果，即今年的 17% 和 18% 之間。

On our last call, we forecast our noncash stock compensation expense to range between $190 million and $200 million in 2017.

在上次電話會議中，我們預測 2017 年的非現金股票薪酬支出將在 1.9 億美元至 2 億美元之間。

Now, based upon updated Black-Scholes evaluation estimates, we expect our noncash stock compensation expense to range between $200 million and $210 million.

現在，根據最新的 Black-Scholes 評估估計，我們預計我們的非現金股票補償費用將在 2 億美元至 2.1 億美元之間。

We expect 2017 other income to be between $35 million and $40 million compared to the $30 million to $35 million range forecast on our last call.

我們預計 2017 年其他收入將在 3500 萬美元至 4000 萬美元之間，而我們上次電話會議預測的範圍為 3000 萬至 3500 萬美元。

With regard to income tax.

關於所得稅。

We now expect our 2017 pro forma income tax rate to be between 28% and 29.5% of pretax income, higher than our previous guidance of 26.5% to 28.5% based upon a higher anticipated mix of U.S. pretax profits.

我們現在預計我們 2017 年的備考所得稅稅率將在稅前收入的 28% 至 29.5% 之間，高於我們之前基於更高預期的美國稅前利潤組合的 26.5% 至 28.5% 的指引。

During Q2, we had 38.4 million diluted shares outstanding for EPS calculations, roughly equal to the first quarter as the share reduction related to the full quarter impact of the Q1 accelerated share buyback was mostly offset by the dilutive effects of our higher stock price.

在第二季度，我們有 3840 萬股攤薄流通股用於每股收益計算，大致與第一季度持平，因為與第一季度加速股票回購的整個季度影響相關的股票減少大部分被我們較高股價的稀釋效應所抵消。

As a result of our higher stock price, we don't expect the ultimate number of shares received and retired when the ASR closes later this year to vary significantly versus the 2.4 million shares already retired in January.

由於我們的股價較高，我們預計今年晚些時候 ASR 關閉時收到和退役的最終股份數量與 1 月份已經退役的 240 萬股相比不會有顯著差異。

That concludes our prepared comments.

我們準備好的評論到此結束。

We will now open the call to your questions.

我們現在將打開您的問題的電話。

(Operator Instructions) And our first question will come from Tycho Peterson with JPMorgan.

（操作員說明）我們的第一個問題將來自摩根大通的第谷彼得森。

First, on X. I know it's early days, obviously, but any color you can provide on the funnel in terms of new versus existing customers and maybe the types of customers that are emerging?

首先，在 X 上。顯然，我知道現在還處於早期階段，但是您可以根據新客戶與現有客戶以及可能正在出現的客戶類型在漏斗上提供任何顏色嗎？

I don't think we'd -- Tycho, I don't think we'd call out anything surprising here.

我認為我們不會 - 第谷，我認為我們不會在這裡說出任何令人驚訝的事情。

We had indicated to you in prior quarters that we think cost-sensitive customers, particularly in Europe, are going to be interested in, and that remains so.

我們在前幾個季度曾向您表示，我們認為對成本敏感的客戶，尤其是歐洲客戶，將會對此感興趣，而且現在仍然如此。

It may have broader rebate than that over time.

隨著時間的推移，它的回扣可能會比那個更廣泛。

Okay.

好的。

And then urology continue to do well here.

然後泌尿科在這裡繼續做得很好。

That hasn't reverted to lower growth rates, I think it proves the expected.

這並沒有恢復到較低的增長率，我認為這證明了預期。

Can you talk about that sequential pickup?

你能談談順序拾取嗎？

Can you maybe just talk to the sustainability of those trends in the U.S. urology dVP market?

您能否談談美國泌尿外科 dVP 市場這些趨勢的可持續性？

Yes, Tycho.

是的，第谷。

I think -- we continue to believe that our prostatectomy volumes are following broader prostate surgery trends.

我認為——我們仍然相信我們的前列腺切除術數量遵循更廣泛的前列腺手術趨勢。

As you know, prostate surgery really only represents about 1/3 of all men diagnosed in the U.S. with prostate cancer.

如您所知，在美國被診斷出患有前列腺癌的所有男性中，前列腺手術實際上只佔大約 1/3。

So time to time, you'll see movements between watchful waiting, radiation and surgery.

因此，您會時不時地看到觀察等待、放療和手術之間的變化。

We think -- mostly, you've seen the procedures recover from the prior USPSTF decision in 2012, where we worked through patients who had the disease progress.

我們認為 - 大多數情況下，您已經看到程序從 2012 年之前的 USPSTF 決定中恢復過來，當時我們處理了疾病進展的患者。

We think, at this stage, you're just seeing general small movements between populations period to period.

我們認為，在這個階段，你只是看到不同時期人口之間的一般小幅移動。

Our next question is from Bob Hopkins with Bank of America.

我們的下一個問題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？

Bob?

鮑勃？

Okay.

好的。

Okay, great.

好，太棒了。

Good afternoon.

下午好。

So the first thing I wanted to touch on, just kind of looking through the results, which were obviously strong pretty much across the board, but the U.S. capital number really stuck out as a strong number.

所以我想談的第一件事，就是看一下結果，這些結果顯然在所有方面都很強勁，但美國資本數字確實是一個強勁的數字。

And you mentioned more kind of multisystem sales and repeat customers.

你提到了更多種類的多系統銷售和回頭客。

Is this really a function of the increase in procedure volume growth and higher utilization?

這真的是程序量增長和利用率提高的結果嗎？

Or was there something else going on this quarter?

還是這個季度發生了其他事情？

I think it's the former.

我認為是前者。

I -- we're seeing -- first of all, I think the consolidation of U.S. customers into IDNs means that the negotiations are often happening one layer up.

我——我們看到了——首先，我認為將美國客戶整合到 IDN 中意味著談判通常發生在更高一層。

And I think they're looking across their portfolio of MIS opportunities and making decisions in broader settings.

而且我認為他們正在審視他們的 MIS 機會組合，並在更廣泛的環境中做出決策。

I think it's a continuation of a trend we've been seeing for the past several quarters.

我認為這是我們在過去幾個季度看到的趨勢的延續。

Great.

偉大的。

The other thing I just want to follow up is, a couple of quick checks on the pipeline timelines.

我只想跟進的另一件事是，對管道時間表進行一些快速檢查。

You mentioned China and Japan as constraining you in the back half.

你提到中國和日本在後半場製約你。

Is there any update at all on the China quota from a timing perspective?

從時間的角度來看，中國配額是否有任何更新？

Or even your sense as to whether or not it could happen this year?

甚至您認為它今年是否會發生？

And also, wanted to just get a quick update on the timelines for Sp beyond urology and the filings we could expect, either later this year or into 2018?

而且，想快速了解泌尿科以外 Sp 的時間表以及我們可以預期的申請，今年晚些時候或 2018 年？

Sure.

當然。

Marshall, I'll let you take the China quota, and I'll take the Sp.

Marshall，我讓你拿中國配額，我拿Sp。

Okay.

好的。

The China quota, there is no new news here.

中國配額，這裡沒有新消息。

It is, as we stated before, the quota system involves, first, the government is tied up in the overall government -- the government's overall planning process.

正如我們前面所說的，配額制涉及到，首先，政府被捆綁在整個政府中——政府的整體規劃過程。

They did approve their budget in December.

他們確實在 12 月批准了預算。

We -- after that, it then rolls through a series of decisions about province spending as well as hospital spending.

我們——在那之後，它會通過一系列關於省支出和醫院支出的決定。

And then eventually, we will hear something about a quota.

然後最終，我們將聽到有關配額的消息。

We don't know when that will be.

我們不知道那會是什麼時候。

And what we would caution is that you put anything in the models for this year frankly because, last time, when the quota was approved, it took some time before the tender offers that the hospitals have to go through to get something done.

我們要提醒的是，坦率地說，你在今年的模型中加入了任何東西，因為上次，當配額獲得批准時，醫院必須通過招標才能完成一些事情。

On the Sp regulatory question, we are targeting (inaudible) urology in the back half of the year.

關於 Sp 監管問題，我們的目標是在今年下半年（聽不清）泌尿外科。

There's a data collection going on at the IDE sites for transoral robotic surgery and some lab-based clinical development for other procedures as well as the trial site in Asia.

IDE 站點正在進行經口機器人手術的數據收集和其他程序的一些基於實驗室的臨床開發以及亞洲的試驗站點。

We haven't yet publicly projected our timelines for submissions after the urology 510(k).

我們尚未公開預測泌尿外科 510(k) 之後的提交時間表。

There will be a set that come.

將會有一套。

It will be months, not years after the 510(k) submission.

提交 510(k) 後將是幾個月，而不是幾年。

What that looks like will depend on the speed of closure of the clinical trial data and some of the conversations with FDA about what kind of submissions they'd like.

這看起來像什麼將取決於臨床試驗數據的關閉速度以及與 FDA 就他們喜歡什麼樣的提交進行的一些對話。

And we're not ready yet to anchor down those dates.

我們還沒有準備好確定這些日期。

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 maybe a few quick questions here.

也許這裡有幾個簡單的問題。

Gary, just for you.

加里，只為你。

Just SP timing, I know, came up in the pipeline, but on the FC, and I know it's pretty early.

我知道，只是 SP 計時出現在管道中，但在 FC 上，我知道它還很早。

Can you give us any sense of the major markets, U.S., China, Europe, which one?

你能給我們介紹一下主要市場，美國、中國、歐洲，哪個市場？

Our sense is U.S. and China are kind of ahead of Europe, but that's not based on a whole bunch.

我們的感覺是美國和中國領先於歐洲，但這並不是基於一大堆。

Which region do you think precedes the other?

您認為哪個區域先於另一個區域？

And is 2019 a reasonable estimate for a launch in some geographic locale?

2019 年是否是在某些地理區域推出的合理估計？

And so first, to the question of which regions matter.

所以首先，關於哪些地區重要的問題。

We think it will have global appeal, but I think you're right that United States and China and then Europe will be interesting.

我們認為它將具有全球吸引力，但我認為你是對的，美國和中國然後是歐洲會很有趣。

In terms of timing, a lot of it will be predicated on regulatory pathways and what kind of data requirements there are.

就時間而言，其中很多將取決於監管途徑和有什麼樣的數據要求。

We think there are real opportunities in China.

我們認為中國存在真正的機會。

We're going to make sure that we do that right with our joint venture partner.

我們將確保我們與我們的合資夥伴一起做對了。

We likewise think there is in the U.S. I'm not ready yet to call when the launch dates are for both sets, because of negotiations with clinical trial results.

我們同樣認為在美國，由於與臨床試驗結果的談判，我還沒有準備好在兩組的發布日期時打電話。

Europe, likewise.

歐洲，同樣如此。

I think there's a little bit of uncertainty right now as to what kind of submission package will be required, and that's one of the things we're in the midst of working out, both internally and with conversations with regulatory authorities over time.

我認為現在對於需要什麼樣的提交包存在一些不確定性，這是我們正在努力解決的問題之一，包括內部以及隨著時間的推移與監管機構的對話。

We will do a controlled launch when we're ready.

當我們準備好時，我們將進行受控發射。

So we've told you, don't model any revenue into '18.

所以我們告訴過你，不要將任何收入建模到 18 年。

We have not yet published, and are not ready to publish when the final launch will be.

我們尚未發布，也不准備在最終發佈時發布。

We'll let you know as we get closer to some of the certainty on regulatory timelines.

當我們接近監管時間表的某些確定性時，我們會通知您。

Okay, very helpful.

好的，很有幫助。

And Marshall, just two, kind of margin-related questions for you.

Marshall，只有兩個，關於保證金的問題。

The first is on gross margin.

首先是毛利率。

Given a greater systems mix, I guess I was surprised to see gross margins as strong as they were.

鑑於更大的系統組合，我想我很驚訝地看到毛利率如此之高。

And I wonder, who would've thought that X, which wasn't very material in the quarter, would have also pressured margins.

我想知道，誰會想到本季度不是很重要的 X 也會對利潤率造成壓力。

So what's driving the margin strength?

那麼是什麼推動了利潤率？

And as it relates to X, is that just because a lot of the components of X frankly are ready at scale in other places of the business?

當它與 X 相關時，這是否僅僅是因為 X 的許多組件坦率地說已經在業務的其他地方大規模準備就緒？

And the second question related is, you're looking at hiring.

第二個相關問題是，您正在考慮招聘。

We typically don't ask about hiring, but I think your hiring level this quarter is 25% above the next highest level.

我們通常不會詢問有關招聘的問題，但我認為您本季度的招聘水平比下一個最高水平高出 25%。

That's pretty remarkable.

這非常了不起。

I wonder if you would just share with us where you're hiring and where those people are being deployed.

我想知道你是否願意與我們分享你在哪裡招聘以及這些人被部署在哪裡。

Sure.

當然。

On the X margins.

在 X 邊距上。

X margins that we had communicated before, typically, when we introduce a new product you see a little bit of a decrease in the margin and then we work to improve it over time.

X 利潤我們之前已經溝通過，通常，當我們推出新產品時，您會看到利潤略有下降，然後我們會隨著時間的推移努力改進它。

You should -- we did not expect as much of a decrease in margins due to X. X, as you said, really is the result of putting together parts that are already manufactured for other systems.

你應該 - 我們沒想到由於 X.X 而導致的利潤率下降如此之多，正如你所說，X 確實是將已經為其他系統製造的零件放在一起的結果。

And so we have worked out most of the cost effectiveness of that.

因此，我們已經計算出了其中的大部分成本效益。

As far as total margins, yes, the total margin came down a little bit due to the mix of systems.

就總利潤而言，是的，由於系統的混合，總利潤略有下降。

I think it exceeded our expectations just because of the overall strength of procedures and the drive of -- and it driving instrument and accessory revenue above our original expectations.

我認為它超出了我們的預期，僅僅是因為程序的整體實力和驅動力——它推動儀器和配件收入超過我們最初的預期。

As far as the headcount goes, David, we ended the quarter with 4,108 employees.

就員工人數而言，大衛，我們在本季度結束時擁有 4,108 名員工。

That was up a little over 100 from the last quarter-end, and it was 19% year-over-year.

這比上一季度末增加了 100 多一點，同比增長 19%。

And it really does vary up with the strategic investments that we're making in the business on that side.

它確實隨著我們在那方面的業務進行的戰略投資而變化。

The majority of investments were in our product operations group in the quarter.

本季度的大部分投資都在我們的產品運營部門。

Our next question comes from Tao Levy with Wedbush.

我們的下一個問題來自 Tao Levy 和 Wedbush。

America, I wanted to ask on the Sp platform.

美國，我想在sp平台上問問。

So the pathway for, I believe, filing later on, towards the end of this year, and then assuming approval sometime next year, how is the launch going to proceed?

因此，我相信，在晚些時候提交申請，到今年年底，然後假設明年某個時候獲得批准，發射將如何進行？

Is this a -- well -- is an experienced da Vinci surgeon going to be able to sit in front of a -- the Sp -- in front of a console and use the Sp right off the bat?

這是 - 嗯 - 一位經驗豐富的達芬奇外科醫生能夠坐在 - Sp - 控制台前並立即使用 Sp 嗎？

Or are they going to have to go through a proctoring of different types of cases?

還是他們將不得不對不同類型的案件進行監考？

Just any color there would be great.

任何顏色都會很棒。

Yes.

是的。

Just in broad brushes, it's a family member in the da Vinci family, and a lot of -- we believe a lot of the learning and skills will be portable from one of the family members to the other.

粗略地說，它是達芬奇家族的一個家庭成員，而且很多——我們相信很多知識和技能可以從一個家庭成員轉移到另一個家庭成員。

They're not identical.

它們並不相同。

So there'll be some learning that goes through that transition.

所以會有一些學習經歷這個轉變。

We think experienced da Vinci surgeons will find that transition to be pretty manageable.

我們認為經驗豐富的達芬奇外科醫生會發現這種轉變非常易於管理。

What that looks like, and how it's finally framed will evolve as we finish our clinical trials and our validations.

隨著我們完成臨床試驗和驗證，它看起來像什麼，以及它最終是如何構建的，將會發生變化。

But I'd expect a lot of that to be portable.

但我希望其中很多是可移植的。

I think, in terms of rollout, we'll be at a controlled rollout when we come out.

我認為，就推出而言，我們將在推出時進行受控推出。

And part of that controlled rollout will be for data generation at the first sites.

該受控部署的一部分將用於在首批站點生成數據。

And also, we'll have some constraints due to what our labeling will be at the first launch, given the regulatory sequence and pathway.

而且，考慮到監管順序和途徑，由於我們在首次發佈時的標籤將是什麼，我們將有一些限制。

Feedback from the clinical trial sites has been really good about usability of this system and it meeting the expectations they had for what they believe they could do with it clinically.

來自臨床試驗站點的反饋對該系統的可用性非常好，並且它滿足了他們對他們認為可以在臨床上做的事情的期望。

So far, so good there.

到目前為止，一切都很好。

And we also get pretty good insight into the characteristics of the system vis-à-vis what they're used to on Si and Xi, and kind of the response to your initial question.

我們還可以很好地了解系統的特徵，以及他們在 Si 和 Xi 上的習慣，以及對你最初問題的回應。

Got you.

明白了

Perfect.

完美的。

And then just lastly.

然後最後。

What's -- anything special going on in Japan?

日本有什麼特別的事嗎？

They've got way more systems than they have -- than they need it at this point, and they keep on buying more, and I don't know if there -- is there a government incentives or any credit there, that they're using?

他們擁有的系統比他們擁有的系統多得多——超過了他們此時所需要的，而且他們繼續購買更多，我不知道是否有——是否有政府激勵措施或任何信貸，他們”重新使用？

Tao, Japan has a very diffused health care system and hospital network system, so they're not very concentrated in terms of where the patients are.

日本的 Tao 擁有非常分散的醫療保健系統和醫院網絡系統，因此就患者所在的位置而言，它們並不是很集中。

So while we are in that high level of penetration in dVP, you still have a lot of pockets of patients who are treated in fairly remote areas, in local hospitals and so they just continue to buy systems, even being able to access some of the mainly urology patients that are out there.

因此，儘管我們在 dVP 中的滲透率很高，但仍有很多患者在相當偏遠的地區、當地醫院接受治療，因此他們只是繼續購買系統，甚至能夠訪問一些主要是那裡的泌尿科患者。

We've also been in Japan, for just some number of years here, and I think there's a little bit of built-in capacity in hopes of broader reimbursements over time.

我們也一直在日本，在這里呆了幾年，我認為有一點內在的能力，希望隨著時間的推移得到更廣泛的報銷。

And we'll go next to Amit Hazan with Citi.

我們將與花旗一起去 Amit Hazan。

Just one on the quarter, and then a couple of longer-term ones.

只有一個季度，然後是幾個長期的。

So on the quarter, obviously, just going back to the U.S. system number, a really strong number.

所以在這個季度，很明顯，回到美國系統的數字，一個非常強大的數字。

I wanted to ask about trade-ins though.

不過我想問一下以舊換新。

They were weak again in the U.S. it's the second quarter in a row.

他們在美國再次疲軟，這是連續第二個季度。

I'm trying to kind of better understand why , on the one hand you've got this obvious growing pool of systems that need to be replaced, that you should in theory be replacing more systems every year.

我試圖更好地理解為什麼，一方面你有這個明顯增長的系統池需要更換，理論上你應該每年更換更多的系統。

On the other hand, there seems to be relationship between quarters where you had really strong de novo units like this, this year so far, both quarters.

另一方面，今年到目前為止，兩個季度之間似乎都存在像這樣非常強大的新單位的季度之間的關係。

And then trade-ins kind of tend to be inversely recurring in those quarters.

然後以舊換新往往會在這些季度中反復出現。

What's kind of a correct way to be thinking about modeling trade-ins in the U.S.?

在美國考慮以舊換新建模的正確方法是什麼？

Let me speak to our intent a little bit, and then I'll ask Calvin to jump in on the modeling side.

讓我談談我們的意圖，然後我會請 Calvin 參與建模方面的工作。

For us, our thought process really has been to enable accounts with technologies and support that help them get to their clinical goals and in support their MIS and MIS program goals.

對我們來說，我們的思考過程實際上是為客戶提供技術和支持，幫助他們實現臨床目標並支持他們的 MIS 和 MIS 計劃目標。

And if they can do that effectively with an Si, we're happy to support them in that regard.

如果他們可以使用 Si 有效地做到這一點，我們很樂意在這方面支持他們。

If they want to add capacity or grow their system capability in some way that is benefited by our advanced technologies that helps us and drives a new system placement or new system sale.

如果他們想以某種方式增加容量或提高他們的系統能力，我們的先進技術可以幫助我們並推動新系統佈局或新系統銷售。

So our incentives aren't strongly built on trade-outs.

因此，我們的激勵措施並不是建立在權衡取捨之上的。

Much more interested in aligning with how they want to build their programs and giving them access to technologies that make a difference in their procedures.

更感興趣的是與他們想要構建程序的方式保持一致，並讓他們能夠訪問能夠改變其程序的技術。

That leaves the lumpiness in trade-outs, and that's okay with us.

這就留下了權衡取捨的麻煩，這對我們來說沒問題。

Calvin, to the modeling.

卡爾文，到造型。

I just give you a little time to think about it.

我只是給你一點時間考慮一下。

Go ahead.

前進。

When I say -- I mean, is that you have such strong procedure growth and such demand for access to systems among the surgeon population and in a lot of cases, when hospitals are seeking to acquire new systems, they look at the procedures and the surgeons that they want to be able to do in -- within their robotics program.

當我說 - 我的意思是，你有如此強勁的程序增長和外科醫生群體對系統訪問的需求，在很多情況下，當醫院尋求獲得新系統時，他們會查看程序和他們希望能夠在他們的機器人程序中做的外科醫生。

And the Si can still serve a broad range of patients and can help them facilitate that.

Si 仍然可以為廣泛的患者提供服務，並可以幫助他們促進這一點。

So they tend to be buying more incremental systems than trading in.

所以他們傾向於購買更多的增量系統而不是交易。

As X matures in the market, X may be an opportunity for some folks who are happy with their capacity but want to upgrade up to additional capabilities, and that may provide an opportunity for us in future quarters.

隨著 X 在市場上的成熟，對於一些對自己的能力感到滿意但希望升級到更多能力的人來說，X 可能是一個機會，這可能會在未來幾個季度為我們提供機會。

And just quickly, from the modeling perspective that you asked.

從您要求的建模角度來看，很快。

Beware of using our past experience with our Xi and previous system launches as the model for what's going to happen now, because it's a different world we have again, consolidated hospital networks that can align certain procedure characteristics with sets of procedures with a lot more ability to do so now than in the past.

謹防使用我們過去使用 Xi 和以前系統發布的經驗作為現在將要發生的事情的模型，因為我們再次擁有一個不同的世界，整合的醫院網絡可以使某些程序特徵與具有更多能力的程序集保持一致現在比過去這樣做。

So could very well follow a different pattern this go-round, than it has in the past.

因此，與過去相比，這一輪很可能會遵循不同的模式。

Okay.

好的。

So that could maybe possibly lead me to the next question, which is on reimbursement.

所以這可能會引導我到下一個問題，即報銷。

It looks like prostate is getting a new Medicare outpatient reimbursement code for the first time, I believe.

我相信，前列腺似乎是第一次獲得新的 Medicare 門診報銷代碼。

And I realize most of these dVP procedures can't really be done in 1 day just yet.

我意識到這些 dVP 程序中的大部分還不能在 1 天內真正完成。

But it just got me thinking about the question of what the trigger might be for hospitals to start equipping their outpatient settings with da Vincis?

但這讓我想到了一個問題，即觸發醫院開始為門診設置達芬奇設備的觸發因素是什麼？

I have to imagine that between hysterectomies moving that way and things like hernia now, there's already enough volume to justify it nowadays.

我不得不想像，在以這種方式移動的子宮切除術和現在的疝氣之間，現在已經有足夠的體積來證明它是合理的。

So is something like prostate reimbursement any kind of an incur that can maybe drive boxes into outpatient setting?

那麼像前列腺報銷這樣的事情是否可以將盒子推入門診環境？

And if not, then what could be the trigger to do that?

如果不是，那麼觸發它的可能是什麼？

Two important thoughts here, Amit.

阿米特，這裡有兩個重要的想法。

One, is in order to be able to do a surgery like a dVP in an outpatient setting, first off, it has to be done in a minimally invasive fashion, so that you can have the patient be able to recover quick enough to get out of that setting.

第一，為了能夠在門診環境中像 dVP 一樣進行手術，首先，它必須以微創方式進行，這樣您就可以讓患者能夠足夠快地康復，然後出院該設置。

The second thing, is you -- outpatient is really a billing setting, not necessarily a site of care differentiator.

第二件事，是你——門診真的是一種計費方式，不一定是護理地點的差異化因素。

What we see over time is that as programs mature in their robotics capacity, and they have an array of systems that can both serve really complex inpatient surgeries, like thoracic or colorectal, and they have sufficient volume of outpatient procedures like the ones you mentioned in hernia and gynecology and you could potentially dVP, where you have a technique and a surgeon capable of getting a result that can get the patient out in the same day.

隨著時間的推移，我們看到的是，隨著程序在機器人技術能力方面的成熟，它們擁有一系列系統，既可以服務於非常複雜的住院手術，如胸外科或結直腸手術，也有足夠數量的門診手術，就像你在疝氣和婦科，你可能有潛在的 dVP，在那裡你有技術和外科醫生能夠得到可以在同一天讓病人出院的結果。

You'll see them actually put systems into multiple different types of settings.

您會看到他們實際上將系統置於多種不同類型的設置中。

Typically still under the hospitals' umbrella because they're the ones who have the capability of treating the range of patients who come in with different complexities and might need -- be either inpatient or outpatient.

通常仍在醫院的保護傘下，因為他們有能力治療各種複雜程度不同且可能需要住院或門診的患者。

But it's usually a by-product of the maturity of a program as opposed to a specific reimbursable event.

但它通常是項目成熟度的副產品，而不是特定的可報銷事件。

Our next question comes from Isaac Ro with Goldman Sachs.

我們的下一個問題來自高盛的 Isaac Ro。

Question for you on the X. Just trying to think through the gross margin implications of that product cycle as it plays out.

關於 X 的問題。只是想仔細考慮該產品週期對毛利率的影響。

Realize it's a little early, but just trying to think through some of the comments you made earlier around how purchasing is evolving for hospitals and so forth.

意識到現在有點早，但只是想通過您之前就醫院採購如何演變等發表的一些評論進行思考。

As that product cycle plays out, could you give us some sense of what it means for your gross margin profile, based on what you know now, that would be helpful.

隨著產品週期的結束，你能否根據你現在所知道的，告訴我們這對你的毛利率意味著什麼，這會有所幫助。

Initially, the gross margin profile is not substantially different than our other products.

最初，毛利率概況與我們的其他產品沒有實質性不同。

So it kind of fits in nicely.

所以它很適合。

I think what you're asking is, over time, could we see that there's pressure on the ultimate price that we charge for an X?

我想你要問的是，隨著時間的推移，我們能否看到我們對 X 收取的最終價格存在壓力？

I think we'll see.

我想我們會看到的。

We don't know.

我們不知道。

It's only been out in the market for a quarter, and -- but what we've said in the past is that, we're about the market expansion.

它才上市一個季度，而且——但我們過去說過，我們正在擴大市場。

And if there's the opportunity to expand the market at the expense of a little bit of price, we'd do that.

如果有機會以犧牲一點價格來擴大市場，我們會這樣做。

That's helpful.

這很有幫助。

And then just as a follow-up on the expense side.

然後作為費用方面的後續行動。

As you move towards expanding the market, interested in sort of allocation of resources and the sales force, can you talk a little bit about, just qualitatively, how you're moving some of your top performers to help drive X conversion and then at the same time, maybe thinking about adding new heads?

隨著您朝著擴大市場的方向發展，對資源分配和銷售隊伍感興趣，您能否定性地談談您如何調動一些表現最好的員工來幫助推動 X 轉換，然後在同時，也許考慮增加新的負責人？

Just interested in the interplay on investment in sales force.

只對銷售人員投資的相互作用感興趣。

Yes.

是的。

How we think about the sales force investments really varies by region and maturity of the market.

我們對銷售人員投資的看法確實因地區和市場成熟度而異。

So how we're building the sales team in Germany, for example, will look, kind of qualitatively different than what's happening in the United States.

因此，例如，我們如何在德國建立銷售團隊，看起來與美國正在發生的事情在質量上有所不同。

In general, in the United States, we've had a stable structure growth in our key accounts teams, no surprise.

總的來說，在美國，我們的關鍵客戶團隊結構穩定增長，這並不奇怪。

And a little bit better stratification of levels in the force itself that gives us the opportunity to provoke and engage high-level salespeople, at the same time bring in people who can support high-volume accounts that are premature.

力量本身的層次分層更好一點，這讓我們有機會激發和吸引高級銷售人員，同時引進能夠支持過早的大客戶的人。

So the U.S. is a well-stratified sales force.

所以美國是一個層次分明的銷售隊伍。

In Germany, in places like Japan, we're really at the basic building stages.

在德國，在像日本這樣的地方，我們確實處於基礎建設階段。

And so the investments there are a little more filling empty slots and making sort of territory coverages, is right.

因此，那裡的投資更多地填補了空缺並進行了某種領土覆蓋，這是正確的。

We now have a question from Richard Newitter with Leerink Partners.

Leerink Partners 的 Richard Newitter 提出了一個問題。

It seems like for the third quarter in a row, China, on the procedure growth side, is exceeding your expectations.

似乎連續第三個季度，中國在程序增長方面超出了您的預期。

And seemingly, you were at capacity, or you thought you were at capacity in the fourth quarter.

看起來，你已經滿負荷運轉，或者你認為你在第四季度達到了滿負荷運轉。

And yet, this is still kind of -- your capacity utilization seems to be creeping higher.

然而，這仍然有點——你的產能利用率似乎在攀升。

Anything to explain that?

有什麼可以解釋的嗎？

Are there certain types of procedures that are maybe just quicker?

是否有某些類型的程序可能更快？

And that, as a percent of the mix in China, is different than the U.S.?

而且，作為中國組合的百分比，與美國不同嗎？

Or can you explain what might be driving this?

或者你能解釋一下這可能是什麼原因造成的嗎？

So I think, at the top line, what's going on here is, a high belief in the value of the procedures and the technology and the willingness to expand the number of hours that people are able to get procedures.

所以我認為，最重要的是，這裡發生的是對程序和技術的價值的高度信任，以及延長人們能夠獲得程序的時間的意願。

I think the biggest effect is that, which is a willingness to work on weekends and for them to expand to after-hours use of devices.

我認為最大的影響是，他們願意在周末工作，並擴大到下班後使用設備。

That will dwarf underlying which procedures are in the mix.

這將使基礎程序相形見絀。

But Marshall, you can clean up that answer, if you like.

但是馬歇爾，如果你願意，你可以清理那個答案。

It's absolutely right.

這是絕對正確的。

I mean, this is all about -- it's a theoretical capacity that you're quoting.

我的意思是，這就是——這是你引用的理論能力。

And that capacity -- that theoretical capacity is based on just averages that we see around the world.

而這種能力——這種理論能力只是基於我們在世界各地看到的平均水平。

Be careful of averages.

小心平均數。

And in China, they are operating on Saturdays, Sundays and late at night, and -- in order to get things done.

在中國，他們在周六、週日和深夜營業，而且——為了把事情做好。

So I think Gary's answer is right, and...

所以我認為加里的回答是正確的，而且......

I think there's also an opportunity for us to learn from their experiences, which is under capital constraint, what kinds of barriers can they remove, to get both good outcomes and high volumes.

我認為我們也有機會從他們的經驗中學習，在資本約束下，他們可以消除什麼樣的障礙，以獲得良好的結果和高銷量。

And I think that's exciting for us.

我認為這對我們來說是令人興奮的。

And we have an open mind toward how they're approaching it.

我們對他們如何處理它持開放態度。

Great.

偉大的。

Then maybe just one follow-up on Japan.

然後也許只是關於日本的後續行動。

That's the other area where you're kind of seeing capacity constraint.

這是您看到容量限制的另一個領域。

And so you get additional, on the procedure side at least, until you get additional approvals.

因此，至少在程序方面，您會得到額外的，直到您獲得額外的批准。

Can you maybe just remind us the key procedures that you're hoping are up for consideration next year?

您能否提醒我們您希望明年考慮的關鍵程序？

And maybe -- which ones represent the biggest market opportunities?

也許——哪些代表了最大的市場機會？

And do you feel there's any of that might be further along with the approval agencies over there?

你覺得那裡的審批機構是否有任何可能進一步的？

In terms of maturity, there are some that have been going through clinical trials and have a lot of data behind them and others that are using kind of existing data sources.

就成熟度而言，有一些已經通過臨床試驗並且背後有大量數據，還有一些正在使用現有的數據源。

So the one that has the most structured data so far is gastrectomy.

所以到目前為止，結構化數據最多的是胃切除術。

And that is going to be exciting for us over time.

隨著時間的推移，這會讓我們感到興奮。

It is a real market in Japan.

日本是一個真正的市場。

The prevalence is quite high, and so we have good hopes and optimism that, that will go through the process.

患病率相當高，因此我們抱有良好的希望和樂觀態度，認為這將通過這一過程。

Other categories are things like (inaudible) oncology, that is of interest, salpingectomy.

其他類別是（聽不清）腫瘤學，即有趣的輸卵管切除術。

Calvin, there are some others that...?

卡爾文，還有其他人……？

Yes.

是的。

Lobectomy procedures and some of the lower colon LAR procedures are potential.

肺葉切除術和一些下結腸 LAR 手術是有潛力的。

Yes.

是的。

So I think the interest in broad use of da Vinci in Japan is very high.

所以我認為日本對廣泛使用達芬奇的興趣非常高。

We do not have assurance of that MHLW will accept it in the next insurance cycle.

我們無法保證 MHLW 會在下一個保險週期中接受它。

Although, so far, so good.

雖然，到目前為止，一切都很好。

And we don't have assurance that the reimbursement levels will be any particular level.

而且我們無法保證報銷水平會達到任何特定水平。

And again, so far, the indicators are pretty good for us, but that's still a work in process from the government's evaluation point of view, and we stand by to support the surgical societies and answer questions for them as they need it.

而且，到目前為止，這些指標對我們來說非常好，但從政府評估的角度來看，這仍然是一項正在進行的工作，我們隨時準備支持外科協會並在他們需要時為他們解答問題。

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。

Let me just start with hernia.

讓我從疝氣開始。

You received recently a specific inguinal hernia indication, which includes positive data in the label.

您最近收到了特定的腹股溝疝適應症，其中包括標籤中的陽性數據。

Could you talk about the implications of that label and data?

你能談談那個標籤和數據的含義嗎？

And are you pursuing other specific indications for other procedures?

您是否正在尋求其他程序的其他特定適應症？

And I have one follow-up.

我有一個後續行動。

Sure.

當然。

On the first one, this really is something around what gives us a little bit of freedom of -- a little more freedom about what we can claim in our materials.

在第一個方面，這真的是圍繞著什麼給了我們一點自由——更多的關於我們可以在我們的材料中聲明什麼的自由。

And so it allows us to be a little bit more specific versus the general.

因此，它使我們能夠比一般情況更具體一些。

And so for us, we think that, that just clarifies what our teams can speak about.

所以對我們來說，我們認為，這只是澄清了我們的團隊可以談論的內容。

And so we think it's an incremental positive -- it's a small positive.

所以我們認為這是一個漸進的積極因素——這是一個小的積極因素。

I think the data underlying it is supportive, and the interactions with FDA, I think, are ultimately helpful for the whole process.

我認為它背後的數據是支持性的，我認為與 FDA 的互動最終對整個過程有幫助。

This is one of a set of specific indications that we have pursued over the last couple of years.

這是我們在過去幾年中追求的一組具體指示之一。

And we do have a pipeline of the next set of things we want to do and get aligned.

我們確實有下一組我們想做的事情的管道，並保持一致。

And we have not publicly disclosed what those are and what the order is, but I guess what I'd tell you is, I expect more to come.

我們還沒有公開披露這些是什麼以及命令是什麼，但我想我要告訴你的是，我預計會有更多。

And again, I think it's a healthy process between us and the agency to supply data as we get it and that allows us a little more specific capability in terms of what we talk about.

再一次，我認為這是我們和該機構之間的一個健康過程，即在我們獲得數據時提供數據，這使我們能夠在我們談論的內容方面擁有更具體的能力。

And then I think on the -- you're planning to file and launch a 45 millimeter stapler, which should help with bariatric procedures.

然後我想——你打算歸檔並啟動一個 45 毫米的訂書機，這應該有助於減肥手術。

Is there any update on the timing there?

那裡的時間有任何更新嗎？

Sure.

當然。

Yes, we are working on additional staplers besides the ones that are in the market.

是的，除了市場上現有的訂書機外，我們還在研究其他訂書機。

We have a 30 and a 45.

我們有一個 30 和一個 45。

Remember, staplers are characterized by not only their length but also the length of the staples that go in the jaw.

請記住，訂書機的特點不僅在於它們的長度，還在於進入鉗口的訂書釘的長度。

There are set of things that we're working on beyond that.

除此之外，我們正在努力做一些事情。

We do think that there are opportunities to build staplers that can have broader use in general surgery.

我們確實認為有機會製造出可以在普通外科手術中有更廣泛用途的吻合器。

We have not yet predicted or publicly disclosed what the expected time lines are.

我們尚未預測或公開披露預期的時間表。

We do have to take note of the development of those things.

我們確實必須注意這些事情的發展。

Approach maturity, we'll share with you where we are.

接近成熟期，我們將與您分享我們的進展情況。

We'll go next to Brandon Henry with RBC Capital Markets.

我們將與 RBC Capital Markets 一起去 Brandon Henry。

Can you provide an update on the Australian clinical trial for the flexible catheter platform?

您能否提供有關柔性導管平台的澳大利亞臨床試驗的最新信息？

And any lessons you've learned from that trial?

你從那次試驗中學到了什麼？

And then, when and where you think you can see that, the data from the trial being published or presented?

然後，您認為您可以在何時何地看到發表或展示的試驗數據？

And a couple of follow-ups.

還有一些後續行動。

Yes.

是的。

Thanks, Brandon.

謝謝，布蘭登。

I think the short answer is no.

我認為簡短的回答是否定的。

I can't provide an update.

我無法提供更新。

The, that data is being analyzed.

該數據正在分析中。

The clinical teams that are there, are preparing their abstracts, and they'll decide at which meeting they want to show it.

那裡的臨床團隊正在準備他們的摘要，他們將決定要在哪個會議上展示它。

And once they've made that decision, then we're happy to share it with you.

一旦他們做出決定，我們很樂意與您分享。

As we said last time, the results were very positive for us.

正如我們上次所說，結果對我們來說非常積極。

We're really happy with what we saw.

我們對所看到的非常滿意。

I think the scientific principal investigators need the chance to write their manuscripts and analyze the data and present it in a way that makes sense to them.

我認為科學主要研究人員需要有機會撰寫手稿並分析數據並以對他們有意義的方式呈現。

So we will wait for that.

所以我們會等待。

And as we get clarity there, we're sure to share it with you.

當我們在那裡變得清晰時，我們一定會與您分享。

Okay.

好的。

And then -- just more broadly, can you help me understand some of the differences or the benefits for Intuitive's flexible catheter platform, relative to some of the other platforms in the market, like Medtronic with its super dimension platform?

然後 - 更廣泛地說，你能幫助我了解 Intuitive 的柔性導管平台相對於市場上其他一些平台（如美敦力及其超維平台）的一些差異或優勢嗎？

Sure.

當然。

I think what we can bring in our concept and our technology here is a couple of things.

我認為我們可以在這裡引入我們的概念和技術的是幾件事。

One is, we have novel sensing technologies that allow us to sense all the way along the catheter length with a high degree of certainty.

一是，我們擁有新穎的傳感技術，使我們能夠高度確定地沿著導管長度一直進行傳感。

That helps us in terms of understanding and navigating towards those pathways.

這有助於我們理解和導航這些路徑。

That's one.

那是一個。

The second thing is the use of robotic assistance gives you stability and navigation capabilities that are very hard to do manually.

第二件事是機器人輔助的使用為您提供了手動很難做到的穩定性和導航能力。

And so those are technical benefits.

所以這些都是技術優勢。

What could they result in, in terms of clinical benefits?

就臨床益處而言，它們會產生什麼結果？

The hope there is, that you can get to more distal locations that are otherwise hard to get to in tortuous pathways, and that you're more accurate in terms of tissue sampling, because you have high degree of stability and better imaging and targeting now.

希望你可以到達更遠的位置，否則很難在曲折的路徑中到達，並且你在組織採樣方面更準確，因為你現在具有高度的穩定性和更好的成像和瞄準.

Those lines have to be backed up, and so that's the hypothesis.

必須備份這些線路，這就是假設。

And that's the set of trials and data and analysis that we're going after.

這就是我們要進行的一組試驗、數據和分析。

And I think people are excited about flexible technologies in general by some of the technologies that our competitors and other med companies have put out there.

我認為人們對我們的競爭對手和其他醫療公司推出的一些技術總體上對靈活技術感到興奮。

I think the excitement is there, and the question is, can you go little further and get a little more predictability, and we think we have technologies and capabilities that can do that.

我認為令人興奮的是，問題是，你能否更進一步並獲得更多的可預測性，我們認為我們擁有可以做到這一點的技術和能力。

Our next question is from Travis Steed with Cantor Fitzgerald.

我們的下一個問題來自 Travis Steed 和 Cantor Fitzgerald。

Travis, you'll be the last questioner, so make it a good one.

特拉維斯，你將是最後一個提問者，所以好好提問吧。

You placed a decent amount of Si systems in the quarter.

您在本季度放置了大量 Si 系統。

Did those customers have an option to purchase X?

這些客戶是否可以選擇購買 X？

And just any color on how customers are deciding between the 2 systems, recognizing we're still very early on?

關於客戶如何在這兩個系統之間做出決定的任何顏色，認識到我們還處於早期階段？

So I think the question was, there's a fair number of Sis in the system in the quarter, despite the availability of X, right?

所以我認為問題是，儘管 X 可用，但本季度系統中仍有相當數量的 Sis，對嗎？

Yes.

是的。

I think, first, while we were pleased with approval timelines of X in the U.S. and Europe, there are still many markets that X is not yet approved in.

我認為，首先，雖然我們對 X 在美國和歐洲的批准時間表感到滿意，但仍有許多市場 X 尚未獲得批准。

So some of the Sis are just purchases by folks whose choices were Si or Xi.

所以有些 Sis 只是由選擇 Si 或 Xi 的人購買的。

In the case of China, it's -- their choice is Si right now, not Xi.

就中國而言，他們現在的選擇是思，而不是習。

So some of it is just that.

所以其中一些就是這樣。

In other cases, some of the negotiations are multi-quarter negotiations and are right at the endpoint.

在其他情況下，一些談判是多季度談判，並且恰好在終點。

And so they will finish the transaction based on where they started.

因此他們將根據他們開始的地方完成交易。

Those are opportunities for us to go back to those customers over time.

這些是我們隨著時間的推移回到這些客戶的機會。

That's one of the reasons that we have the revenue deferral and the offers for people to evaluate whether they wanted to make a change.

這就是我們推遲收入和讓人們評估他們是否想做出改變的原因之一。

So that's mostly what the dynamics are.

所以這主要是動態。

And Travis, the other part to think about is just the approvals came mid-quarter, so I think Europe was in the beginning of April, and the U.S. was in the beginning of May.

特拉維斯，要考慮的另一部分是批准是在季度中期，所以我認為歐洲是在 4 月初，美國是在 5 月初。

So you didn't really have a full quarter to get out with the team and communicate to all your customers what X is, relative to other products that may have already been in a long sales cycle.

所以你真的沒有一個完整的季度來與團隊一起出去並向所有客戶傳達 X 是什麼，相對於可能已經處於長期銷售週期的其他產品。

Just a little color commentary on X. I think the customer base and our field understood well what X is, what its benefits are, I think, the logic of X is well understood and where it fits in the line is well understood, and we're pleased with that.

只是對 X 的一些顏色評論。我認為客戶群和我們的領域很了解 X 是什麼，它的好處是什麼，我認為，X 的邏輯很容易理解，它在生產線中的位置也很容易理解，我們對此很滿意。

Okay.

好的。

And I one quick follow-up.

我會快速跟進。

I think I know the answer to this, but is it still your view we should be modeling in 2018 expense growth below your revenue growth?

我想我知道這個問題的答案，但你是否仍然認為我們應該將 2018 年的費用增長建模為低於你的收入增長？

Actually, what we said is that expense growth -- operating expense growth will grow 18% for the year.

實際上，我們所說的是費用增長——營業費用增長今年將增長 18%。

I'm sorry, in 2018, kind of longer-term.

對不起，在 2018 年，比較長期。

Do we expect to dial back

我們是否希望撥回

Sorry.

對不起。

In 2018, what we said is, we expect to dial it back so that we are adding leverage.

在 2018 年，我們所說的是，我們希望將其撥回，以便我們增加槓桿作用。

Thanks, Travis.

謝謝，特拉維斯。

Well, that was our last question.

嗯，這是我們的最後一個問題。

As we've said previously, while we focus on financial metrics such as revenues, profit and cash flow during these conference calls, our organization's 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，但我們組織的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'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.

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 the surgery, and we look forward to talking with 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，我們期待在 3 個月後再次與您交談。

Thank you.

謝謝你。

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

女士們，先生們，我們今天的會議到此結束。

Thank you for your participation, and choosing AT&T executive teleconference.

感謝您的參與並選擇 AT&T 高管電話會議。

You may now disconnect.

您現在可以斷開連接。