直覺手術 (ISRG) 2020 Q1 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Intuitive Surgical Q1 2020 Earnings Release. (Operator Instructions) As a reminder, today's conference is being recorded.

女士們，先生們，感謝您的支持，歡迎來到 Intuitive Surgical 2020 年第一季度收益發布。 （操作員說明）提醒一下，今天的會議正在錄製中。

I would now like to turn the conference over to Calvin Darling, Senior Director of Finance, Investor Relations for Intuitive Surgical. Please go ahead.

我現在想將會議轉交給 Intuitive Surgical 投資者關係財務高級總監 Calvin Darling。請繼續。

Thank you. Good afternoon, and welcome to Intuitive's First Quarter Earnings Conference Call. With me today, we have Gary Guthart, our CEO; and Marshall Mohr, our Chief Financial Officer.

謝謝你。下午好，歡迎參加 Intuitive 的第一季度收益電話會議。今天和我在一起的是我們的首席執行官 Gary Guthart；和我們的首席財務官 Marshall Mohr。

Before we begin, I would like to inform you that comments mentioned on today's call may be deemed to contain forward-looking statements. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. These risks and uncertainties are described in detail in our Securities and Exchange Commission filings, including our most recent Form 10-K filed on February 7, 2020. Our SEC filings can be found through our website or at the SEC's website. Investors are cautioned not to place undue reliance on such forward-looking statements.

在開始之前，我想通知您，今天電話會議中提到的評論可能被視為包含前瞻性陳述。由於某些風險和不確定性，實際結果可能與明示或暗示的結果大不相同。這些風險和不確定性在我們的證券交易委員會文件中有詳細描述，包括我們於 2020 年 2 月 7 日提交的最新 10-K 表格。我們的 SEC 文件可以通過我們的網站或在 SEC 的網站上找到。告誡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 intuitive.com on the Latest Events section under our Investor Relations page.

請注意，本次電話會議將在我們的網站上進行音頻重播，網址為：intuitive.com，位於我們投資者關係頁面下的“最新活動”部分。

Today's press release and supplementary financial data tables have been posted to our website. In addition, this quarter, we have also posted charts illustrating da Vinci procedure trends in Q1, which are intended to provide additional perspective and detail regarding the impact of COVID-19 on our business.

今天的新聞稿和補充財務數據表已發佈到我們的網站。此外，本季度，我們還發布了說明第一季度達芬奇程序趨勢的圖表，旨在就 COVID-19 對我們業務的影響提供更多視角和細節。

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. Gary will present the quarter's business and operational highlights; Marshall will provide a review of our financial results; then I will discuss procedure details; and finally, we will host a question-and-answer session.

今天的形式將包括為您提供我們今天早些時候宣布的新聞稿中描述的第一季度業績的亮點，然後是問答環節。 Gary 將介紹本季度的業務和運營亮點； Marshall 將對我們的財務業績進行審查；然後我將討論程序細節；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。

Thank you for joining us today. Our first quarter 2020 performance reflects the rise of COVID-19 and the global response to it. On this call, we'll describe our experience in the quarter, our framework for engaging those who rely on us and our priorities and actions in these challenging times. Our focus now and in the past is the safety and well-being of patients, care teams, our communities and our employees.

感謝您今天加入我們。我們 2020 年第一季度的業績反映了 COVID-19 的興起以及全球對它的反應。在這次電話會議上，我們將描述我們在本季度的經驗、我們與依賴我們的人互動的框架以及我們在這些充滿挑戰的時代的優先事項和行動。我們現在和過去的重點是患者、護理團隊、社區和員工的安全和福祉。

For the first 2.5 months of the quarter, procedure performance was at the high end of our expectations, with procedure trends consistent with the prior quarters. General surgery in the United States was strong as was urology outside the United States.

在本季度的前 2.5 個月，程序性能處於我們預期的高端，程序趨勢與前幾個季度一致。美國的普通外科和美國以外的泌尿外科一樣強大。

As we disclosed previously, recommendations by surgical societies and health care organizations to delay certain surgeries to conserve resources for COVID care are having a material impact on surgery broadly, including robotic-assisted surgery. We support government and hospital policies to direct resources to COVID care and recognize these policies vary greatly by region and by hospital system. We are analyzing customer procedure deferrals in response to COVID.

正如我們之前披露的，外科學會和醫療保健組織建議推遲某些手術以節省 COVID 護理資源，這對包括機器人輔助手術在內的外科手術產生了廣泛的影響。我們支持政府和醫院將資源用於 COVID 護理的政策，並認識到這些政策因地區和醫院系統而異。我們正在分析針對 COVID 的客戶程序延期。

Patients undergoing da Vinci procedures do so in response to an underlying disease. While these procedures may be delayed in the short term, without treatment of some sort, the disease and its impairment persists and often worsens. Said simply, the vast majority of these patients will ultimately seek treatment. We are analyzing both the clinical drivers of return to treatment and customer plans and processes to recover. The categories of benign disease and cancer are not entirely predictive of the urgency of surgical intervention. Clearly, aggressive cancers require treatment and are delayed at significant risk to patients. Likewise, some benign conditions require timely intervention as well. We're working internally and with customers to understand their needs to restart surgery for those patients whose condition requires action.

接受達芬奇手術的患者這樣做是為了應對潛在的疾病。雖然這些程序可能會在短期內延遲，但如果不進行某種治療，疾病及其損害會持續存在並且經常惡化。簡單地說，這些患者中的絕大多數最終都會尋求治療。我們正在分析恢復治療的臨床驅動因素以及客戶恢復計劃和流程。良性疾病和癌症的類別並不能完全預測手術干預的緊迫性。顯然，侵襲性癌症需要治療，並且延遲治療會給患者帶來重大風險。同樣，一些良性情況也需要及時干預。我們正在內部並與客戶合作，以了解他們對那些病情需要採取行動的患者重新開始手術的需求。

The effect of COVID on the surgical market has impacted different regions differently. Starting with China, procedure performance was impacted by COVID earliest, with sharp declines in surgery as resources were diverted to respond to COVID care. Procedures in China have been recovering steadily since that time. However, steep declines in procedures that can be deferred are occurring in other regions, particularly Europe and the United States.

COVID對外科市場的影響對不同地區產生了不同的影響。從中國開始，手術性能最早受到 COVID 的影響，隨著資源被轉移到應對 COVID 護理，手術急劇下降。自那時以來，中國的程序一直在穩步恢復。然而，在其他地區，特別是歐洲和美國，可以推遲的程序急劇下降。

For the quarter, procedures grew 10% over Q1 of 2019. Given early strength followed by sharp declines in the last 2 weeks of the quarter, I refer you to the materials we posted to our website prior to this call to get a better picture of the dynamics in Q1.

在本季度，程序比 2019 年第一季度增長了 10%。鑑於本季度最後兩週的早期實力和急劇下降，我建議您參考我們在本次電話會議之前發佈到我們網站上的材料，以更好地了解第一季度的動態。

With regard to systems, our total number of placements for the quarter was below our expectations in spite of having strong capital performance in the first 2 months of the quarter. In March, rapid changes by hospitals delayed some system placements and are likely to significantly impact system contracts and placements in future quarters.

在系統方面，儘管本季度前 2 個月的資本表現強勁，但本季度的配售總數仍低於我們的預期。 3 月份，醫院的快速變化推遲了一些系統安置，並可能對未來幾個季度的系統合同和安置產生重大影響。

Financial pressures exerted on hospitals in response to treating COVID patients and deferring other care are likely to be significant and are unlikely to resolve quickly. Marshall and Calvin will take you through procedure and capital dynamics in the quarter in greater detail later in the call.

為應對 COVID 患者的治療和推遲其他護理而對醫院施加的財務壓力可能很大，而且不太可能迅速解決。 Marshall 和 Calvin 將在電話會議的稍後部分詳細介紹本季度的程序和資本動態。

To help articulate our priorities and actions during this period of change, we have adopted the phased framework described in the American Enterprise Institute's national coronavirus response. In Phase I, which is the slow the spread phase of coronavirus response, Intuitive's priorities are as follows: First, we are focused on the health and safety of all those we serve, our customers, our communities, our employees and our suppliers, implementing early and continuous updates to our health and safety policies and processes. Second, we are supporting our customers according to their priorities: clinical, operational and economic. Third, we're focused on continuity of supply by working with our suppliers and distributors. To date, our delivery capability and inventory position are on firm footing. Fourth, we are securing our workforce economically. We have built an outstanding team over the years, and we believe their strength will be essential in the recovery that follows. Fifth, in partnership with our Intuitive Foundation, we are contributing material, product and volunteers to the front lines of COVID support. We've designed, produced and delivered PPE to local hospitals, and our staff have volunteered in several communities. And sixth, we are eliminating avoidable spend during the stop the spread phase of the virus.

為了幫助闡明我們在這一變化時期的優先事項和行動，我們採用了美國企業研究所國家冠狀病毒應對措施中描述的分階段框架。在第一階段，即冠狀病毒反應的緩慢傳播階段，Intuitive 的優先事項如下：首先，我們專注於我們所服務的所有人、我們的客戶、我們的社區、我們的員工和我們的供應商的健康和安全，實施對我們的健康和安全政策和流程進行早期和持續的更新。其次，我們根據客戶的優先事項為他們提供支持：臨床、運營和經濟。第三，我們通過與供應商和分銷商合作，專注於供應的連續性。迄今為止，我們的交貨能力和庫存狀況已經站穩腳跟。第四，我們在經濟上保障我們的勞動力。多年來，我們已經建立了一支優秀的團隊，我們相信他們的力量對於接下來的複蘇至關重要。第五，與我們的 Intuitive Foundation 合作，我們正在為 COVID 支持的前線貢獻材料、產品和志願者。我們為當地醫院設計、生產和交付了 PPE，我們的員工在多個社區擔任志願者。第六，我們正在消除病毒停止傳播階段可避免的支出。

The current situation in hospitals responding to viral care is fluid, and the depth and duration of this disruption is difficult to predict. New issues are arising with respect to surgery that will require mitigation and time. Some hospital customers and some of our suppliers will experience significant financial stress in this period. Regulatory agency priorities and resources are shifting globally as they devote their resources to infectious disease detection and treatment needs.

目前醫院對病毒治療的反應是不穩定的，這種破壞的深度和持續時間很難預測。與需要緩解和時間的手術有關的新問題正在出現。在此期間，一些醫院客戶和我們的一些供應商將面臨巨大的財務壓力。監管機構的優先事項和資源正在全球轉移，因為它們將資源用於傳染病檢測和治療需求。

And lastly, surgeons are being dedicated to frontline COVID work or are being idled by a lack of resources in this period. We are adjusting quickly to the issues described, and we're confident in both the need for surgery and in our products as the response to COVID evolves. We're planning for Phase II to return to surgery for those patients who cannot wait. Those countries that have been managing the disease the longest have returned to da Vinci surgery steadily over time or have been able to maintain da Vinci surgery concurrently with COVID care. We are analyzing the order in which different procedures are likely to return and the strategies likely to be employed by hospital systems to manage surgical practices while still providing COVID care. For example, some health systems are dedicating specific sites to COVID care while operating rooms for outpatient surgeries are dedicated in other locations. We will support customers closely as they bring capabilities back online.

最後，外科醫生正致力於一線的 COVID 工作，或者在此期間因缺乏資源而閒置。我們正在迅速適應所描述的問題，並且隨著對 COVID 反應的發展，我們對手術的需求和我們的產品都充滿信心。我們計劃第二階段為那些迫不及待的患者恢復手術。那些控制這種疾病時間最長的國家已經隨著時間的推移穩定地恢復了達芬奇手術，或者已經能夠在 COVID 護理的同時維持達芬奇手術。我們正在分析不同程序可能返回的順序，以及醫院系統在管理手術實踐的同時仍提供 COVID 護理可能採用的策略。例如，一些衛生系統將特定地點專門用於 COVID 護理，而用於門診手術的手術室則專用於其他地點。我們將密切支持客戶，因為他們將功能重新上線。

We're also adapting our training and Intuitive telepresence capabilities to support team training and skills retention in a Phase II world. We're optimizing our R&D facilities and methods to allow us to progress on important innovation programs while employing up-to-date workplace safety guidelines. Lastly, we look forward to accelerating clinical trial activities and the associated regulatory work as trial sites increase their surgical volume.

我們還在調整我們的培訓和直觀遠程呈現功能，以支持第二階段世界中的團隊培訓和技能保留。我們正在優化我們的研發設施和方法，以使我們能夠在採用最新的工作場所安全指南的同時推進重要的創新計劃。最後，隨著試驗場所手術量的增加，我們期待加快臨床試驗活動和相關監管工作。

In constructing our financial plans in the current environment, we're balancing 5 objectives that reflect our priorities mentioned above. They are, first, customer-focused economic policies that meet their needs during this disruption; second, employee policies that secure our valuable workforce needed for hospital recovery and to drive our innovation; third, securing and stabilizing critical supply chain resources; fourth, eliminating spending that is not effective during this period, for example, pausing, hiring and volume-related roles and spend on projects that cannot progress in the current phase; and finally, shareholder policies that don't interfere with the priorities mentioned above.

在當前環境下構建我們的財務計劃時，我們正在平衡反映上述優先事項的 5 個目標。首先，它們是以客戶為中心的經濟政策，可以在這種中斷期間滿足他們的需求；第二，確保醫院康復所需的寶貴勞動力和推動創新的員工政策；第三，保障和穩定關鍵供應鏈資源；第四，消除在此期間無效的支出，例如暫停、僱用和與數量相關的角色以及在當前階段無法進行的項目上的支出；最後，不干涉上述優先事項的股東政策。

We remain in close contact with our customers, our community representatives, our employees and our suppliers during this period. While the depth and duration of the current challenges are difficult to predict, the need for both COVID and non-COVID care is clear. Given time and resources, health systems have continued to choose da Vinci. The collaborations and solutions orientation among our stakeholders is clear and inspiring. I believe our long-term opportunity is substantial and our business is well positioned financially and organizationally to weather this COVID outbreak.

在此期間，我們與客戶、社區代表、員工和供應商保持密切聯繫。雖然當前挑戰的深度和持續時間難以預測，但對 COVID 和非 COVID 護理的需求是明確的。鑑於時間和資源，衛生系統繼續選擇達芬奇。我們的利益相關者之間的合作和解決方案導向是明確和鼓舞人心的。我相信我們的長期機會是巨大的，我們的業務在財務和組織上都處於有利地位，可以度過這次 COVID 爆發。

I'll now turn the call over to Marshall, who will take you through financial matters in greater detail.

我現在將把電話轉給馬歇爾，他將帶你更詳細地了解財務問題。

Good afternoon. I will describe the highlights of our performance on a non-GAAP or pro forma basis. I will also summarize our GAAP performance later in my prepared remarks. A reconciliation between our pro forma and GAAP results is posted on our website.

下午好。我將在非公認會計原則或備考基礎上描述我們表現的亮點。稍後我還將在準備好的評論中總結我們的 GAAP 表現。我們的備考結果和公認會計原則結果之間的對賬發佈在我們的網站上。

Procedures and shipments are consistent with our preliminary press release of April 8. Key business metrics for the first quarter were as follows: First quarter 2020 procedures increased approximately 10% compared with the first quarter of 2019 and decreased approximately 9% compared with last quarter. Procedure growth continues to be driven by general surgery in the U.S. and urology worldwide. Calvin will review details of procedure growth later in this call.

程序和出貨量與我們 4 月 8 日的初步新聞稿一致。第一季度的主要業務指標如下： 2020 年第一季度的程序與 2019 年第一季度相比增加了約 10%，與上一季度相比減少了約 9%。手術增長繼續受到美國普外科和全球泌尿外科的推動。 Calvin 將在本次電話會議稍後審查程序增長的詳細信息。

First quarter system placements of 237 systems increased 1% compared with 235 systems last year and decreased 29% compared with 336 systems last quarter. We expanded our installed base of da Vinci Systems by 11% to approximately 5,669 systems. This growth rate compares with 12% in the last quarter and 13% last year. Utilization of clinical systems in the field, measured by procedures per system, declined approximately 2% compared with 6% growth last quarter and 5% growth last year.

與去年同期的 235 個系統相比，第一季度 237 個系統的系統佈局增加了 1%，與上一季度的 336 個系統相比下降了 29%。我們將達芬奇系統的安裝基礎擴大了 11%，達到約 5,669 個系統。這一增長率與上一季度的 12% 和去年的 13% 相比。以每個系統的程序衡量，該領域臨床系統的利用率下降了約 2%，而上一季度的增長率為 6%，去年的增長率為 5%。

Let me walk through the impact of COVID-19 pandemic on procedures and system placements and how it varied by market. Prior to the spread of COVID-19, we experienced procedure growth trends consistent with those experienced in the fourth quarter, including strength in general surgery, growth in mature procedures in the U.S. and growth in U.S. -- OUS urology. We also saw early strength in capital placements particularly in the U.S., with over half the systems placed in the quarter being arrangements where the sales cycle was mostly completed in the fourth quarter.

讓我來看看 COVID-19 大流行對程序和系統佈局的影響，以及它如何因市場而異。在 COVID-19 傳播之前，我們經歷了與第四季度一致的手術增長趨勢，包括普通外科的實力、美國成熟手術的增長以及美國 - OUS 泌尿外科的增長。我們還看到了資本配置的早期實力，特別是在美國，本季度超過一半的系統是銷售週期大部分在第四季度完成的安排。

Beginning in January, we saw a substantial reduction in da Vinci procedures in China. And by early February, procedures per week in China had declined by 90% compared with the weekly rates experienced in early January. As the COVID-19 subsided in China in March, da Vinci procedures began to recover. And by the end of the quarter, China procedures per week were approximately 70% of the early January rate.

從一月份開始，我們看到中國的達芬奇手術大幅減少。到 2 月初，與 1 月初的每週手術率相比，中國每週的手術量下降了 90%。隨著 3 月份 COVID-19 在中國的消退，達芬奇程序開始恢復。到本季度末，每週在中國辦理的手續約為 1 月初的 70%。

We saw varied impacts on da Vinci procedures in some other early countries affected by COVID-19. COVID-19 had little impact in Korea and Japan in the quarter and severe impact in Italy.

在其他一些受 COVID-19 影響的早期國家，我們看到了對達芬奇程序的不同影響。 COVID-19 在本季度對韓國和日本的影響不大，而在意大利則受到了嚴重影響。

In summary, the COVID-19 disruption to da Vinci procedures varied by country, and the disruption to worldwide da Vinci procedures was not significant through the middle of March.

總之，COVID-19 對達芬奇程序的干擾因國家/地區而異，到 3 月中旬，對全球達芬奇程序的干擾並不顯著。

As the pandemic spread to Western Europe and to the U.S., we experienced a significant decline in da Vinci procedures in the last half of March. Procedures per week in the U.S., which represented approximately 70% of our procedures in 2019, declined approximately 65% relative to earlier in the quarter. Procedures in France, Germany and the U.K. also declined but to a lesser extent than the U.S. We have provided you with supplemental information on our website to enable you to understand the magnitude of the impacts on procedures and the variation between countries.

隨著大流行蔓延到西歐和美國，我們在 3 月下半月經歷了達芬奇手術的顯著下降。美國每週的手術量約占我們 2019 年手術量的 70%，與本季度早些時候相比下降了約 65%。法國、德國和英國的程序也有所下降，但程度低於美國。我們在我們的網站上為您提供了補充信息，以使您了解對程序的影響程度和國家之間的差異。

As I indicated, most of the sales cycle for approximately half of the system placements in the quarter were completed in the fourth quarter. As we progress through the quarter and the impact of the pandemic progressed, customers deferred decisions to purchase or lease systems into future quarters and, in some cases, indefinitely.

正如我所指出的，本季度大約一半的系統佈局的大部分銷售週期都在第四季度完成。隨著我們在本季度的進展以及大流行的影響不斷發展，客戶將購買或租賃系統的決定推遲到未來幾個季度，在某些情況下，甚至無限期推遲。

The depth and extent to which COVID-19 will impact the individual markets will vary based on the availability of testing capabilities, PPE, ICUs and ORs, medical staff and government interventions. As COVID-19 continues to spread, it is likely that da Vinci procedures will decline from those experienced in the first quarter. In addition, we would expect that system placements will follow the decline in procedures. While some markets like China appear to be recovering, it is possible that a recurrence of COVID-19 will negatively impact da Vinci procedures and not all markets will recover at the same pace.

COVID-19 影響各個市場的深度和程度將根據檢測能力、個人防護裝備、重症監護室和手術室、醫務人員和政府乾預措施的可用性而有所不同。隨著 COVID-19 的繼續傳播，達芬奇程序很可能會比第一季度的情況有所下降。此外，我們預計系統安置將跟隨程序的下降。雖然中國等一些市場似乎正在復蘇，但 COVID-19 的複發可能會對達芬奇程序產生負面影響，而且並非所有市場都會以同樣的速度復甦。

Additional revenue statistics and trends are as follows: Utilization of the installed base declined by 2% compared with the fourth quarter of 2019, reflecting the impact of the pandemic on procedures coupled with the fourth quarter system placement strength. When procedures increase, customers will first look to utilize existing da Vinci capacity, which is likely to depress capital placements. First quarter placements included a higher concentration of multiple system arrangements with hospitals and IDNs seeking to standardize on fourth-generation systems. Many of these replacements were completed as capital leases. As a result, first quarter trade-ins were higher and operating leases were lower as a percentage of total placements than in the fourth quarter of 2019. We would anticipate in an environment of COVID-19, as economic pressures increase, more customers will seek leasing or alternative financing arrangements than purchases. Trade-in activity can fluctuate and be difficult to predict. However, given the impacts of COVID-19, we expect the number of trade-ins to decrease.

其他收入統計數據和趨勢如下：與 2019 年第四季度相比，已安裝基礎的利用率下降了 2%，這反映了大流行對程序的影響以及第四季度的系統佈局強度。當程序增加時，客戶將首先尋求利用現有的達芬奇產能，這可能會抑制資本配置。第一季度的安置包括與尋求標準化第四代系統的醫院和 IDN 的多系統安排更加集中。其中許多更換是作為資本租賃完成的。因此，與 2019 年第四季度相比，第一季度以舊換新更高，而經營租賃佔總安置的百分比更低。我們預計，在 COVID-19 的環境中，隨著經濟壓力的增加，更多的客戶將尋求租賃或替代融資安排而不是購買。以舊換新活動可能會波動且難以預測。但是，鑑於 COVID-19 的影響，我們預計以舊換新的數量將會減少。

We recognized $12 million of lease buyout revenue in the first quarter compared with $34 million last quarter and $12 million last year. There were no returns of da Vinci systems for leases that ended in the quarter. Lease buyout revenue has varied significantly from quarter-to-quarter and will likely continue to do so.

我們在第一季度確認了 1200 萬美元的租賃收購收入，而上一季度為 3400 萬美元，去年為 1200 萬美元。本季度結束的租賃沒有達芬奇系統的退貨。每個季度的租賃收購收入差異很大，而且很可能會繼續如此。

Instrument and accessory revenue per procedure grew to just over $2,000 per procedure compared with $1,980 in the fourth quarter of 2019, reflecting instruments and accessory purchases prior to the decline in procedures. We expect that as hospitals adjust inventory levels for lower surgery volumes instrument and accessory revenue will decrease.

與 2019 年第四季度的 1,980 美元相比，每次手術的儀器和附件收入增長至略高於 2,000 美元，這反映了在手術下降之前購買的儀器和附件。我們預計，隨著醫院調整庫存水平以減少手術量，儀器和配件收入將減少。

Three of the systems placed in the first quarter were SP systems, reflecting both our measured rollout of SP and the impact of COVID-19. Our rollout of SP Surgical System will continue to be measured, putting systems in the hands of experienced da Vinci users while we pursue additional indications and optimize training pathways in our supply chain. Given the impact of COVID-19, our ability to perform a clinical trial associated with an SP colorectal procedure is likely delayed.

第一季度放置的三個系統是 SP 系統，既反映了我們對 SP 的測量推出，也反映了 COVID-19 的影響。我們將繼續衡量我們推出的 SP 手術系統，將系統交到經驗豐富的達芬奇用戶手中，同時我們尋求更多適應症並優化我們供應鏈中的培訓途徑。鑑於 COVID-19 的影響，我們進行與 SP 結直腸手術相關的臨床試驗的能力可能會延遲。

We placed 8 Ion systems in the quarter. Ion system placements were also impacted by COVID-19. Ion system placements are excluded from our overall systems count and will be reported separately. Procedures and other information associated with Ion are excluded from our prepared remarks and will be reported separately when they become material. Our rollout of Ion will continue to be measured while we optimize training pathways in our supply chain. The completion of the precise study will be delayed due to COVID-19. We cannot predict when the precise clinical study will be completed.

我們在本季度放置了 8 個 Ion 系統。離子系統的佈置也受到 COVID-19 的影響。離子系統佈置不包括在我們的整體系統計數中，將單獨報告。與 Ion 相關的程序和其他信息不包括在我們準備好的評論中，並將在它們成為重要內容時單獨報告。在我們優化供應鏈中的培訓途徑的同時，我們將繼續衡量我們推出的 Ion。由於 COVID-19，精確研究的完成將被推遲。我們無法預測何時完成精確的臨床研究。

Outside the U.S., we placed 55 systems in the first quarter compared with 81 in the first quarter of 2019 and 140 systems last quarter. Current quarter system placements included 25 in Europe, 10 into Japan and 9 into China compared with 49 into Europe, 13 into Japan and 3 into China in the first quarter of 2019.

在美國以外，我們在第一季度放置了 55 個系統，而 2019 年第一季度為 81 個，上一季度為 140 個。當前季度系統安置包括歐洲 25 個、日本 10 個和中國 9 個，而 2019 年第一季度歐洲有 49 個、日本有 13 個、中國有 3 個。

Moving on to gross margin and operating expenses. Pro forma gross margin for the first quarter was 69.7% compared with 71.2% for the first quarter of 2019, and 72.2% last quarter. The decrease compared with the first quarter of 2019 and last quarter primarily reflects product mix, higher fixed costs on lower production and costs associated with Si product transitions partially offset by cost reductions. As revenues are pressured by COVID-19, we will reduce production levels, which will result in higher labor costs and underabsorbed overhead and a significant reduction of product margin.

繼續討論毛利率和運營費用。第一季度的備考毛利率為 69.7%，而 2019 年第一季度為 71.2%，上一季度為 72.2%。與 2019 年第一季度和上一季度相比的下降主要反映了產品組合、較低產量導致的較高固定成本以及與 Si 產品過渡相關的成本部分被成本降低所抵消。由於收入受到 COVID-19 的壓力，我們將降低生產水平，這將導致更高的勞動力成本和吸收不足的間接費用以及產品利潤率的顯著降低。

Pro forma operating expenses increased 15% compared with the first quarter of 2019 and decreased 8% compared with last quarter. Spending in the first quarter reflected normal business activities into March and then curtailment of costs associated with the impact of COVID-19.

與 2019 年第一季度相比，備考運營費用增加了 15%，與上一季度相比下降了 8%。第一季度的支出反映了到 3 月份的正常業務活動，以及與 COVID-19 影響相關的成本削減。

While certain spending will decrease in the second quarter as a result of the reduction in revenue and activities limited by the pandemic, much of our spending will continue. Major categories of spending and likely trends for the second quarter are as follows: We will continue to support our customers. We will continue to invest in innovation focused on the Quadruple Aim. We will invest in manufacturing in our supply chain to ensure supply for our customers. We will ensure we are prepared for periods when the spread of COVID-19 is contained. Certain costs will decline as underlying activities are restricted by COVID-19, including travel and related expenses, clinical trials, surgeon training and customer data collection. We will eliminate spending that is ineffective due to COVID-19, like surgeon and hospital events. We are pausing the hiring of volume-related roles like sales reps and manufacturing employees. We continue to believe that we have a unique opportunity to expand the benefits of computer-aided surgery and acute interventions around the world and will continue to invest in the business for the long term.

儘管由於大流行限制的收入和活動減少，第二季度某些支出將減少，但我們的大部分支出將繼續。第二季度的主要支出類別和可能的趨勢如下： 我們將繼續支持我們的客戶。我們將繼續投資於以四重目標為重點的創新。我們將投資於我們供應鏈的製造，以確保為我們的客戶提供供應。我們將確保我們為遏制 COVID-19 傳播的時期做好準備。由於基礎活動受到 COVID-19 的限制，某些成本將下降，包括差旅和相關費用、臨床試驗、外科醫生培訓和客戶數據收集。我們將消除因 COVID-19 而無效的支出，例如外科醫生和醫院活動。我們正在暫停招聘銷售代表和製造員工等與數量相關的角色。我們仍然相信，我們有一個獨特的機會來擴大全球計算機輔助手術和急性干預的好處，並將繼續長期投資於該業務。

Our pro forma effective tax rate for the first quarter was 20% compared with our expectations of 20% to 21%, reflecting geographic mix. Our actual tax rate will fluctuate with changes in geographic mix of income, changes in taxation made by local authorities and with the impact of onetime items.

我們第一季度的備考有效稅率為 20%，而我們的預期為 20% 至 21%，反映了地域組合。我們的實際稅率將隨著收入地域組合的變化、地方當局的稅收變化以及一次性項目的影響而波動。

Our first quarter 2020 pro forma net income was $323 million or $2.69 per share compared with $312 million or $2.61 per share for the first quarter of 2019 and $417 million or $3.48 per share for last quarter.

我們 2020 年第一季度的備考淨收入為 3.23 億美元或每股 2.69 美元，而 2019 年第一季度為 3.12 億美元或每股 2.61 美元，上一季度為 4.17 億美元或每股 3.48 美元。

I will now summarize our GAAP results. GAAP net income was $314 million or $2.62 per share for the fourth -- first quarter of 2020 compared with GAAP net income of $307 million or $2.56 per share for the first quarter of 2019 and GAAP net income of $358 million or $2.99 per share for last quarter.

我現在將總結我們的 GAAP 結果。 2020 年第四季度 GAAP 淨收入為 3.14 億美元或每股 2.62 美元，而 2019 年第一季度 GAAP 淨收入為 3.07 億美元或每股 2.56 美元，上一季度 GAAP 淨收入為 3.58 億美元或每股 2.99 美元四分之一。

The adjustments between pro forma and GAAP net income are outlined and qualified -- or quantified in our website and include excess tax benefits associated with employee stock awards, employee stock-based compensation and IP charges, amortization of intangibles and acquisition-related items and legal settlements.

備考和 GAAP 淨收入之間的調整在我們的網站上進行了概述和限定——或量化，包括與員工股票獎勵、員工股票薪酬和知識產權費用、無形資產攤銷和收購相關項目以及法律相關的超額稅收優惠定居點。

We ended the quarter with cash and investments of $5.9 billion compared with $5.8 billion at December 31, 2019. Cash generated from operations was partially offset by stock repurchases and investments in working capital in our infrastructure. We repurchased approximately 192,000 shares for $100 million at an average price of $522 per share.

截至本季度末，我們的現金和投資為 59 億美元，而 2019 年 12 月 31 日為 58 億美元。運營產生的現金被股票回購和基礎設施營運資金投資部分抵消。我們以每股 522 美元的平均價格以 1 億美元的價格回購了大約 192,000 股股票。

Our current thoughts on capital deployment are in the following order: We recognize the hardship that COVID-19 places on our customers, and we'll work with customers to ease the burden of lower device utilization, including providing customers with more flexible financing. We will work to secure a supply chain and build appropriate levels of inventory to ensure customer supply, particularly as procedures resume. We will invest in securing our employees. We will continue to -- our open market repurchase program consistent with our prior practice.

我們目前對資本部署的想法如下：我們認識到 COVID-19 給我們的客戶帶來的困難，我們將與客戶一起減輕設備利用率較低的負擔，包括為客戶提供更靈活的融資。我們將努力確保供應鏈安全並建立適當水平的庫存以確保客戶供應，尤其是在程序恢復時。我們將投資於保護我們的員工。我們將繼續 - 我們的公開市場回購計劃與我們之前的做法一致。

And with that, I'd like to turn it over to Calvin, who will go over procedure performance.

有了這個，我想把它交給 Calvin，他將檢查程序性能。

Thank you, Marshall. Our overall first quarter procedure growth was approximately 10% compared to 18% during the first quarter of 2019 and 19% last quarter. Our Q1 procedure growth was driven by 9% growth in U.S. procedures and 11% growth in OUS markets. Our lower first quarter 2020 procedure growth rates were a direct result of hospitals reallocating resources to meet the increasing demands of managing COVID-19. Hospitals postponed deferrable surgical procedures to make more resources available to treat COVID-19 patients.

謝謝你，馬歇爾。我們第一季度的整體程序增長約為 10%，而 2019 年第一季度為 18%，上一季度為 19%。我們第一季度的程序增長受到美國程序增長 9% 和 OUS 市場增長 11% 的推動。我們較低的 2020 年第一季度手術增長率是醫院重新分配資源以滿足管理 COVID-19 日益增長的需求的直接結果。醫院推遲了可延期的外科手術，以提供更多資源來治療 COVID-19 患者。

Impact to da Vinci procedure volumes were first felt in China in January and moved to other OUS markets as the quarter progressed. As of mid-March, our overall procedures were trending towards the higher end of our expectations, including the benefit of an extra working day in Q1 2020. At this stage of the quarter, the impacts of COVID-19 in the earlier-impacted countries were offset by strength in U.S. general surgery and mature procedures.

1 月份中國首次感受到對達芬奇手術量的影響，並隨著季度的進展轉移到其他 OUS 市場。截至 3 月中旬，我們的整體程序趨向於我們預期的高端，包括 2020 年第一季度額外工作日的好處。在本季度的這個階段，COVID-19 對較早受影響國家的影響被美國普通外科和成熟手術的實力所抵消。

Beginning in mid-March, we saw significant declines in procedure volume in the U.S. and Western Europe. On a worldwide basis, weekly procedures performed exiting Q1 were approximately 50% lower than the run rate through mid-March. In the U.S., weekly procedures exiting the quarter were approximately 65% below the run rate through mid-March. Procedure categories realizing significant declines were hernia repair, benign gynecology and bariatric procedures. Lesser-impacted procedures were thoracic and colorectal surgeries.

從 3 月中旬開始，我們看到美國和西歐的手術量顯著下降。在全球範圍內，從第一季度開始執行的每週程序比到 3 月中旬的運行率低約 50%。在美國，截至 3 月中旬，本季度結束的每週程序比運行率低約 65%。實現顯著下降的手術類別是疝氣修復、良性婦科和減肥手術。影響較小的手術是胸外科和結直腸手術。

Outside of the United States, weekly procedures exiting the quarter were approximately 25% below the run rate through mid-March. The lower OUS decline primarily reflects procedure volume recoveries in China offset by broad declines in Western Europe. In Q1, procedures in Japan were less affected by COVID-19. Growth in Japan procedures continued at a growth rate over 40%. We provide these data points to inform investors of the procedure dynamics experienced during the first quarter, which were unprecedented.

在美國以外的地區，截至 3 月中旬，本季度結束的每週程序比運行率低約 25%。較低的 OUS 下降主要反映了中國的手術量恢復被西歐的廣泛下降所抵消。在第一季度，日本的手術受 COVID-19 的影響較小。日本程序的增長繼續以超過 40% 的速度增長。我們提供這些數據點是為了讓投資者了解第一季度經歷的程序動態，這是前所未有的。

Due to the uncertain scope and duration of the COVID-19 pandemic and uncertain timing of global recovery and economic normalization, we withdrew our financial and procedure guidance on April 8, and these Q1 procedure results aren't necessarily indicative of any forward-looking trend.

由於 COVID-19 大流行的範圍和持續時間不確定以及全球復甦和經濟正常化的時間不確定，我們於 4 月 8 日撤回了我們的財務和程序指導，這些第一季度程序結果並不一定表明任何前瞻性趨勢.

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

我們準備好的評論到此結束。我們現在將打開您的問題的電話。

(Operator Instructions) Our first question will come from David Lewis with Morgan Stanley.

（操作員說明）我們的第一個問題將來自摩根士丹利的 David Lewis。

Can you hear me?

你能聽到我嗎？

We can.

我們可以。

We can.

我們可以。

Can you hear me now?

你能聽到我嗎？

Yes.

是的。

Yes.

是的。

Okay. Sorry about that. I'm not sure what happened. So Gary, I just want to talk about capital cycle a little bit. I mean, I know we're not going to get specifics on 2020. But if I think about the 2008 financial crisis, the strain in hospitals is certainly different today than it was back in 2008, and your business model, frankly, is very different today than it was back in 2008. How would you compare and contrast sort of the impact on your business through COVID '19 relative to what we saw in the last major financial crisis impacting hospitals? And then I have a quick follow-up.

好的。對於那個很抱歉。我不確定發生了什麼。所以加里，我只想談談資本週期。我的意思是，我知道我們不會獲得 2020 年的細節。但如果我考慮 2008 年的金融危機，今天醫院的壓力肯定與 2008 年不同，坦率地說，你們的商業模式非常今天與 2008 年不同。相對於我們在上一次影響醫院的重大金融危機中看到的情況，您如何比較和對比 COVID '19 對您的業務的影響？然後我有一個快速跟進。

Yes. Thank you. I'd start with I think they are apples and oranges from underlying costs. So clearly, this is health care related and policy-driven in terms of deferrals, as a result, a little bit hard to predict how the capital cycle will recover. You had mentioned, and it's true, we have a lot more flexible approaches that are available to us with regard to making systems available. Marshall mentioned in his script, they'll consume existing capacity first as they go.

是的。謝謝你。首先，我認為它們是潛在成本的蘋果和橘子。很明顯，就延期而言，這是與醫療保健相關且受政策驅動的，因此，很難預測資本週期將如何恢復。您提到過，這是真的，在使系統可用方面，我們有很多更靈活的方法可供我們使用。馬歇爾在他的劇本中提到，他們將首先消耗現有容量。

We've been in contact with our customers routinely. There's a backlog growing for surgery. These folks are going to need surgery. And really, our opportunity, our job as a company is to make sure we can support them however we can in terms of access to systems or motion of systems to allow them to use what they have out there. And as those systems become full again, we can think about how to increase capacity going forward, and we have a few tools in the toolkit.

我們經常與客戶保持聯繫。手術的積壓工作越來越多。這些人將需要手術。實際上，我們的機會，我們作為一家公司的工作是確保我們能夠支持他們，但我們可以在訪問系統或系統運動方面支持他們，以允許他們使用他們現有的東西。隨著這些系統再次滿員，我們可以考慮如何在未來增加容量，我們的工具包中有一些工具。

Marshall, anything you'd like to add?

馬歇爾，你有什麼要補充的嗎？

No, I think you hit it. I think you'll see more financing, more leases and alternative financing arrangements.

不，我認為你擊中了它。我認為你會看到更多的融資、更多的租賃和替代融資安排。

Okay. That made perfect sense to me. Just a quick follow-up on capital, Marshall, for you. You talked about in your script a couple of things, but you talked about certain orders that are being delayed or canceled versus sort of pushed indefinitely. Can you give us any sense from a percentage perspective what percent of the order book was, in your mind, delayed versus sort of what was either canceled or indefinitely delayed?

好的。這對我來說很有意義。只是對資本的快速跟進，馬歇爾，給你。您在腳本中談到了幾件事，但您談到了某些訂單被延遲或取消，而不是無限期地推送。您能否從百分比的角度告訴我們，在您看來，訂單中有多少百分比是延遲的，而不是被取消或無限期延遲的？

And then you just mentioned lease rate. You've been hovering around the 40% level. Is there reason to assume we should see a more material step-up in the lease rate? You said it would fluctuate as it has normally, but in my view would be that lease rate could hike up more materially now because you're incentivized to provide flexible financing for hospitals to get these systems in. So any color there would be very helpful, and I'll jump back in queue.

然後你剛剛提到了租賃率。你一直在 40% 左右徘徊。是否有理由假設我們應該看到租賃率出現更實質性的提高？你說它會像往常一樣波動，但在我看來，租賃率現在可能會大幅上漲，因為你被激勵為醫院提供靈活的融資來安裝這些系統。所以任何顏色都會很有幫助，我會跳回隊列。

Sure. For leasing, yes, the -- in the quarter, what happened, we had a number of customers that had started the sales cycle back in Q4 and were interested in standardizing on fourth-generation systems. And it so happens that a number of those customers wanted to do -- wanted to structure the arrangement such that they were purchases, they were accounted for as purchases. And as a result, we had fewer leases this quarter. So I don't think this quarter is indicative of our normal sort of run rate for leases as a result. Leasing going forward probably is more akin to what we were experiencing more in the 38% range. That's under normal circumstances. And I actually believe given the COVID virus and its impacts that it will increase from there. So -- and it's -- but it's hard to predict depending on the customer and the circumstances.

當然。對於租賃，是的，在本季度，發生了什麼事，我們有許多客戶在第四季度就開始了銷售週期，並對第四代系統的標準化感興趣。碰巧的是，其中一些客戶想要做 - 想要構建安排，使他們成為購買，他們被視為購買。結果，本季度我們的租約減少了。因此，我認為本季度並不能說明我們正常的租賃運行率。未來的租賃可能更類似於我們在 38% 範圍內所經歷的更多。這是在正常情況下。實際上，我相信鑑於 COVID 病毒及其影響，它會從那裡增加。所以 - 它是 - 但根據客戶和情況很難預測。

As far as how many customers may have postponed indefinitely or may have postponed a quarter. The conversations with them are always a little bit, "Hey, we're going to postpone," and then they sort of throw in words about maybe another quarter, maybe another couple of quarters. And some say, "Well, we'll get back to it, but we don't have a specific timetable." And for those that say that they don't have a specific timetable, that's what I'm referring to as indefinitely. I don't think that there are customers running from robotic surgery. I think they actually want to do robotic surgery, and I think that they'll come back sometime when COVID virus is handled and the procedures come back.

至於有多少客戶可能無限期推遲或推遲了一個季度。與他們的談話總是有一點點，“嘿，我們要推遲了”，然後他們會說也許再過一個季度，也許再過幾個季度。有人說，“好吧，我們會回到它，但我們沒有具體的時間表。”對於那些說他們沒有具體時間表的人，這就是我所說的無限期。我不認為有客戶從機器人手術中跑出來。我認為他們實際上想做機器人手術，我認為他們會在處理 COVID 病毒並且程序恢復的某個時候回來。

The next question will come from Bob Hopkins, Bank of America.

下一個問題將來自美國銀行的 Bob Hopkins。

Sure. I want to thank you for the incremental data that you provided this quarter on the trends throughout the quarter by geography. That was very helpful to see.

當然。我要感謝您在本季度提供的有關按地理區域劃分的整個季度趨勢的增量數據。這很有幫助。

And so my first question is really on the chart on China. We're showing a pretty nice recovery from trough to where you are right now. I was wondering if you could just walk through your views on how good a proxy China might be for a U.S. recovery. Like, why or why not? How could that be different? Just your general thoughts on that would be great.

所以我的第一個問題真的是關於中國的圖表。從低谷到現在的位置，我們顯示出相當不錯的複蘇。我想知道你是否可以簡單地談談你對中國作為美國經濟復甦的代理人的看法。比如，為什麼或為什麼不？那怎麼可能不同？只是您對此的一般想法會很棒。

Thanks, Bob. Yes, you see in that chart China. You see other countries as well, Japan and so on. And what you can really see is that country policy changes the shape. I think we're encouraged by a couple of things. One is people's interest -- our customers' interest in using da Vinci is durable. That's been great.

謝謝，鮑勃。是的，你在那個圖表中看到了中國。你也看到其他國家，日本等等。你真正可以看到的是國家政策改變了形式。我認為有幾件事讓我們感到鼓舞。一是人們的利益——我們的客戶對使用達芬奇的興趣是持久的。那太好了。

You had asked a specific question of how predictive is China. And I think the answer there is too soon to tell for the rest of the regions. I'm encouraged by it. I think it indicates the durability of demand. Having said that, I think policy matters, and I think how people allocate their health care resources are going to change, too. You can see in Japan already that the progress of their approach to disease is evolving, and what that looks like on procedures will evolve. So stay tuned is the short answer.

你問了一個具體的問題，即中國的預測能力如何。我認為對於其他地區來說答案還為時過早。我很受鼓舞。我認為這表明需求的持久性。話雖如此，我認為政策很重要，而且我認為人們分配醫療保健資源的方式也將發生變化。您已經可以在日本看到，他們治療疾病的方法正在不斷發展，程序上的樣子也將不斷發展。所以請繼續關注是簡短的答案。

Calvin, anything you'd like to add?

卡爾文，你有什麼要補充的嗎？

No, I think that described it pretty well.

不，我認為這描述得很好。

Okay. And then just one quick follow-up. Yes, just maybe a comment on why Japan has been so resilient. And then you did mention in the prepared remarks something about -- I think I missed it -- on one of the clinical trials that's been delayed. I was wondering if you could just highlight or reiterate exactly what you were communicating there.

好的。然後只是一個快速的跟進。是的，也許只是對日本為何如此堅韌的評論。然後你確實在準備好的評論中提到了一些關於 - 我想我錯過了 - 關於一項被推遲的臨床試驗的內容。我想知道你是否可以突出或重申你在那裡交流的確切內容。

Okay. On the Japan side, I think that their -- in general, their system for managing the coronavirus is a little bit different than we've seen in other countries, and it's evolving in time. So to date, hospital operations were relatively lightly impacted as it relates to surgery relative to other countries. What that will look like in the future, I don't know. We'll see how that evolves. It's been interesting and instructive for us to look at data from Japan, look at data from Korea, from China, from Europe, Germany, Italy, U.K., France, and that informs us going forward in terms of getting prepared for the reopening of some of those hospital wings and surgical wings as they happen. So too soon to make the final call, but we have, I think, pretty good real-time information.

好的。在日本方面，我認為他們——總的來說，他們管理冠狀病毒的系統與我們在其他國家看到的有點不同，而且它正在及時發展。迄今為止，與其他國家相比，醫院運營受到的影響相對較小，因為它與手術有關。未來會是什麼樣子，我不知道。我們將看到它是如何演變的。看看日本的數據，看看韓國、中國、歐洲、德國、意大利、英國、法國的數據對我們來說是有趣和有啟發性的，這讓我們在為一些地區的重新開放做好準備方面向前邁進了一步。那些醫院翼和手術翼發生時。做出最後決定還為時過早，但我認為，我們有非常好的實時信息。

I'm going to refer to Marshall the question about clinical trial.

關於臨床試驗的問題，我將參考馬歇爾。

The clinical trial, what I was referring to was SP. We planned on doing a -- we believe we have to do a clinical trial to get the next indication, which is colorectal. Doing a clinical trial when -- at this point in time is probably not going to happen right away. Having said that, I don't think we had plans to do it right away. We had several steps we had to go through before we got there. So I say it's delayed -- could be delayed and don't know exactly when it will get done.

臨床試驗，我指的是SP。我們計劃做一個 - 我們相信我們必須進行臨床試驗以獲得下一個適應症，即結直腸癌。在這個時間點可能不會立即進行臨床試驗。話雖如此，我認為我們沒有計劃立即這樣做。在到達那里之前，我們必須經過幾個步驟。所以我說它被推遲了——可能會被推遲，並且不知道它什麼時候完成。

Calvin, you had more to add.

卡爾文，你還有更多要補充的。

Yes. And on the Ion side as well, data capture for the Ion PRECISE study that we've talked about on these calls is currently delayed. We believe that positive clinical data will be an important catalyst for broader usage of the platform. But given the lack of visibility, we're not in a position to provide a definitive revised time line, but it's unlikely that the PRECISE study will read out this year.

是的。在 Ion 方面，我們在這些電話中談到的 Ion PRECISE 研究的數據採集目前也被延遲。我們相信，積極的臨床數據將成為更廣泛使用該平台的重要催化劑。但鑑於缺乏可見性，我們無法提供明確的修訂時間表，但 PRECISE 研究不太可能在今年宣讀。

But you look at the new platforms, both Ion and SP are both in the measured rollout phases of market introduction, and early-stage utilization rates for both platforms has been encouraging. Ion commercial procedure rates were up over 110% from Q4 of '19 to Q1 of 2020. SP procedure rates grew 14% from the fourth quarter, and they're up about 190% year-over-year. So yes, really encouraging in these early phases. In Korea, specifically, where we have a broad clearance for SP, the utilization per system is at this point in time higher than it is for Xi.

但你看看新平台，Ion 和 SP 都處於市場引入的可測量推出階段，兩個平台的早期利用率都令人鼓舞。從 19 年第四季度到 2020 年第一季度，離子商業手術率增長了 110% 以上。SP 手術率比第四季度增長了 14%，同比增長了約 190%。所以，是的，在這些早期階段真的很鼓舞人心。特別是在韓國，我們對 SP 有廣泛的許可，此時每個系統的利用率高於 Xi。

Our next question will come from Tycho Peterson with JPMorgan.

我們的下一個問題將來自摩根大通的 Tycho Peterson。

I'm wondering if you could just talk a little bit about procedure mix, the types of procedures that may come back a little bit faster versus others. Presumably, low-score price state cases may lag and nonemergent hernias may lag. But I'm just curious, even based on your experience in China in terms of the procedures that came back a little bit faster, if you could comment on that at all.

我想知道您是否可以談談程序組合，與其他程序相比，這些程序可能會更快地返回。據推測，低分價格州病例可能滯後，非緊急疝氣可能滯後。但我只是好奇，即使根據你在中國的經驗，如果你能對此發表評論的話，程序會更快一點。

Sure. Just as a broad brush, clearly, high-risk cancers are things delayed at real risk to patients and emergent or inflamed benign disease likewise. One caution, each country has a little bit different mix of procedures going into 2020 prior to COVID becoming a bigger issue. So the mixes are a little bit different.

當然。就像一個粗略的描述一樣，很明顯，高風險癌症是對患者和緊急或發炎的良性疾病有真正風險的延遲。需要注意的是，在 COVID 成為一個更大的問題之前，每個國家在 2020 年的程序組合都會有所不同。所以混合有點不同。

Calvin, why don't you speak a little bit to what we've seen today?

卡爾文，你為什麼不對我們今天看到的內容講一點？

Oh yes. And again, procedures, it's really they're following a continuum of urgency that are applied situationally. Like you say, clearly, the aggressive cancers require treatment and are delayed at significant risk of patients. And likewise, some benign conditions require timely intervention as well. We're working with customers to best understand the segments and our future plans and elaborate thing -- we'll elaborate further as the things progress.

哦是的。再一次，程序，它真的是他們遵循一個連續的緊急情況，根據情況應用。就像你說的，很明顯，侵襲性癌症需要治療，並且在患者面臨重大風險的情況下被延遲。同樣，一些良性情況也需要及時干預。我們正在與客戶合作，以最好地了解細分市場和我們的未來計劃並詳細說明——隨著事情的進展，我們將進一步詳細說明。

I've mentioned in the prepared comments the -- at least in the ending parts of the first quarter, the more impacted procedures were things like hernia repair, benign gynecology and bariatrics with lesser impacts on things like thoracic procedures and colorectal procedures.

我在準備好的評論中提到過——至少在第一季度的最後部分，受影響較大的手術是疝氣修復、良性婦科和減肥手術，而對胸部手術和結直腸手術等手術的影響較小。

On my just personal channel checks, hospitals are now creating large backlogs of patients who are going to need surgery. And there's -- I'm encouraged about their commitment to da Vinci as they go through that. So I think at some point, the logistics, the availability of PPE and other resources will start to free up a little bit. And as they have time, then they'll have to attend to that group of patients, and we'll be there to support.

根據我個人的渠道檢查，醫院現在正在積壓大量需要手術的患者。還有——當他們經歷這些時，我對他們對達芬奇的承諾感到鼓舞。所以我認為在某個時候，物流、PPE 的可用性和其他資源將開始釋放一點點。因為他們有時間，所以他們必須照顧那群病人，我們會在那裡提供支持。

And then maybe a follow-up on capital comments. I appreciate the nature and the tone of the discussions may shift more toward alternative financing. But can you just talk maybe to the degree to which hospitals are actually engaging in capital discussions at this point as opposed to still dealing with COVID work? And also curious on your thoughts on Europe just given capital outlook there.

然後可能會跟進資本評論。我很欣賞討論的性質和基調可能會更多地轉向替代融資。但是，您能否談談醫院目前實際參與資本討論的程度，而不是仍在處理 COVID 工作？並且也很好奇你對歐洲的想法剛剛給出了那裡的資本前景。

Like I said in prepared remarks, capital demand, we saw a deferral of purchase decisions at the end of the quarter. I would expect that to continue. I would expect that -- also that hospitals as COVID -- as they are able to dedicate resources to the procedures that may be in backlog that they'll use up existing capacity, and therefore, it won't immediately result in capital demand. We still have conversations with some of the hospitals on capital. It's just not possible to predict exactly where it's going to come out for the quarter.

就像我在準備好的評論中所說的那樣，資本需求，我們在本季度末看到了購買決定的推遲。我希望這種情況會繼續下去。我希望這 - 以及像 COVID 一樣的醫院 - 因為他們能夠將資源用於可能積壓的程序，他們將用完現有容量，因此，它不會立即導致資本需求。我們仍在與首都的一些醫院進行對話。只是無法準確預測該季度將在哪裡出現。

With regard to Europe, any color you want to give, Marshall?

關於歐洲，你想給什麼顏色，馬歇爾？

Europe. Europe, we didn't see quite the same level of reduction in terms of procedures at the end of the quarter. That's not -- that doesn't mean to say that, that will sustain itself. It's possible that as the virus spreads that there could be additional pressures on procedures.

歐洲。在歐洲，我們在本季度末的程序方面沒有看到完全相同的減少水平。那不是——這並不意味著這樣說，那將持續下去。隨著病毒的傳播，可能會給程序帶來額外的壓力。

And having said that, capital, as you know, we did 25 systems this quarter in -- which is what I reported in my prepared remarks. That's far lower than what we had anticipated for the quarter. And so we're still -- we're seeing the same kinds of interactions with customers in Europe as we are in U.S.

話雖如此，資本，如你所知，我們在本季度做了 25 個系統——這就是我在準備好的評論中報告的內容。這遠低於我們對該季度的預期。所以我們仍然——我們在歐洲看到與在美國一樣的客戶互動。

Tycho, you've heard us say this before, and it's really true in the data this quarter as well. Europe doesn't act as one. So what's happening in Italy feels and looks different than in Germany from our perspective, from France and from the U.K. So each will progress a little bit -- on a little bit different pathway.

第谷，你以前聽過我們這樣說，本季度的數據也是如此。歐洲不作為一個。因此，從我們、法國和英國的角度來看，意大利發生的事情感覺和看起來都與德國不同。所以每個人都會進步一點——在一點不同的道路上。

Our next question will come from Larry Biegelsen with Wells Fargo.

我們的下一個問題將來自富國銀行的拉里·比格爾森。

One on procedures, one just on systems. On procedures, I appreciate the numbers, the percentages you provided us. I think those were exit rates from March, and the slides look like those percentages continue to go down. So I apologize if I missed this, but did -- would you be willing to provide any color on what you've seen in the first couple of weeks here in April, just to give us a better sense to how to think about Q2? And I did have one follow-up.

一個是關於程序的，一個是關於系統的。關於程序，我很欣賞你提供給我們的數字和百分比。我認為這些是 3 月份的退出率，幻燈片看起來這些百分比繼續下降。因此，如果我錯過了這一點，我深表歉意，但確實 - 你願意就你在四月份的前幾週看到的情況提供任何顏色，只是為了讓我們更好地了解如何考慮第二季度？我確實有一個後續行動。

We're not ready to publish what's happened thus far in April. I don't think it's shockingly different from what the beginnings of you're seeing -- of what you're seeing in the charts we've given you there. But I'd also say that I don't think the next 2 weeks are particularly predictive of anything. I think this will flow globally here over the next weeks and months, and we're really focused on how to make sure that we're supporting our customers well and flow out of it.

我們還沒有準備好公佈 4 月份迄今為止發生的事情。我不認為這與你剛開始看到的情況有驚人的不同——你在我們給你的圖表中看到的情況。但我還要說，我認為接下來的 2 週不會特別預示任何事情。我認為這將在接下來的幾周和幾個月內在全球範圍內流動，我們真正專注於如何確保我們能夠很好地支持我們的客戶並從中流出。

And Gary, thinking ahead, hospitals are going to be faced with 2 challenges: I think one is capacity constraints to handle postponed procedures; and second, moving procedures to alternative sites. I think you mentioned in your prepared remarks like ASCs, potentially, to isolate non-COVID patients or vice versa. What can you do to help hospitals with these 2 challenges?

加里，提前思考，醫院將面臨兩個挑戰：我認為一個是處理延期手術的能力限制；其次，將程序轉移到其他站點。我認為您在準備好的評論中提到了 ASC，可能是為了隔離非 COVID 患者，反之亦然。您可以做些什麼來幫助醫院應對這兩個挑戰？

Yes. No, I appreciate it. Well, a couple of things. We are well represented in outpatient departments and hospitals already. We are absolutely able and willing to move systems to locations of care wherever they might be. We do have experience with systems and ASCs to the extent that people want to move into ASC environments. We work fine in those environments.

是的。不，我很感激。嗯，有幾件事。我們已經在門診部和醫院中佔有一席之地。我們絕對有能力並且願意將系統移動到任何可能的護理地點。我們確實擁有系統和 ASC 方面的經驗，以至於人們希望進入 ASC 環境。我們在這些環境中工作正常。

We will be working on getting training and other resources geographically positioned where we think that folks can need additional support as they start to ramp up, recognizing that we don't think a lot of people will be jumping on planes in Phase II. So we can sort of forward deploy our resources to help people as they get ready.

我們將努力獲取培訓和其他資源的地理位置，我們認為人們在開始增加時可能需要額外的支持，認識到我們認為在第二階段不會有很多人會跳上飛機。所以我們可以提前部署我們的資源來幫助人們做好準備。

And lastly, it's staying in touch with our customers and surgery departments and making sure that we have inventory forward deployed for them for the kind of procedures they want to do.

最後，它與我們的客戶和手術部門保持聯繫，並確保我們為他們提前部署庫存，以完成他們想做的手術。

Our next question will come from Rick Wise, Stifel.

我們的下一個問題將來自 Stifel 的 Rick Wise。

Gary, Marshall, a couple of things. Maybe let's start with thinking about the slowdown in capital you've talked about and obviously related procedure decline. And I know I'm looking ahead -- far ahead and you're not comfortable really predicting the next quarter. But I just want to think about the recovery. Gary, how do we think about, let's say, if the slowdown in capital persists throughout 2020 or well into 2020, does that suggest that 2020 recovery won't be back to, let's say, 2019 levels and it's going to -- it would take probably possibly until 2022 for us to see you get back at sort of a historical growth because of that slowdown in capital, which might be slower to recover and, therefore, procedure is slower to accelerate overall, if you follow what I'm trying to get at?

加里，馬歇爾，還有幾件事。也許讓我們首先考慮一下您所說的資本放緩以及明顯相關的程序下降。而且我知道我正在展望未來 - 遙遙領先，你對真正預測下一個季度感到不舒服。但我只想想想恢復。加里，我們如何考慮，比如說，如果資本放緩持續到 2020 年或到 2020 年，這是否表明 2020 年的複蘇不會回到 2019 年的水平，它會 - 它會可能要等到 2022 年，我們才能看到你恢復到某種歷史增長，因為資本放緩，這可能恢復得更慢，因此，如果你遵循我正在嘗試的方法，整個過程的加速速度會更慢得到？

No, I think the way I'd have you think about it is from the point of view of demand for surgery -- demand for robotic-assisted surgery. In that setting, I think the world is queuing up a set of patients who will need care. Makes sense. I understand it. I think conserving of PPE and ICUs and other valuable resources at this time makes sense. As some of those constraints start to loosen, I think everybody will have to adjust and adapt to caring for patients who have other conditions. That is the demand that will drive everything behind it, from I&A and other inventory to access to capital and systems.

不，我認為我想讓你考慮的方式是從手術需求的角度來看——對機器人輔助手術的需求。在這種情況下，我認為世界正在排隊等待一組需要護理的患者。說得通。我明白了。我認為此時保護 PPE 和 ICU 以及其他有價值的資源是有道理的。隨著其中一些限制開始放鬆，我認為每個人都必須調整和適應照顧有其他疾病的患者。這種需求將推動其背後的一切，從 I&A 和其他庫存到獲取資本和系統。

We are well positioned from an inventory point of view. We are well positioned operationally and financially to move systems where they need to go, to put systems out on lease or usage-based models or other things to support customers the way they want to be supported, and we'll be quite agile.

從庫存的角度來看，我們處於有利地位。我們在運營和財務上處於有利地位，可以將系統移動到他們需要去的地方，將系統置於租賃或基於使用的模型或其他東西上，以支持客戶希望得到支持的方式，我們將非常敏捷。

So on the capital side, you may see shifts in the way capital is deployed and the way that we're compensated for that capital relative to prior quarters sort of historical norms. But we'll be leaning forward to help people when they need that help. How fast that happens, I think that has a lot to do with government policy and health system policy, is to when they pivot to go treat other patients. That will determine everything else.

因此，在資本方面，您可能會看到資本配置方式的變化，以及我們相對於前幾個季度的歷史規範獲得資本補償的方式。但是，當人們需要幫助時，我們會傾向於幫助他們。這種情況發生的速度有多快，我認為這與政府政策和衛生系統政策有很大關係，取決於他們何時轉向治療其他患者。這將決定其他一切。

Got you. And just a sort of a separate but related question, Gary. Several of our ongoing physician conversations sort of suggests that as things recover, actually, robotic capacity won't be sufficient to meet demand, which is an interesting thought. And they've suggested actually that on a recovery, robotic surgery will lose market share, so to speak, of some of those deferred patients to laparoscopic surgery, to open surgery. I have no idea. I'd be curious to know if you have any high-level thoughts about that -- those physician comments.

得到你。加里，這只是一個單獨但相關的問題。我們正在進行的一些醫生對話表明，隨著情況的恢復，實際上，機器人的能力將不足以滿足需求，這是一個有趣的想法。他們實際上暗示，在恢復期，機器人手術將失去市場份額，可以說，其中一些推遲進行腹腔鏡手術的患者，以進行開放手術。我不知道。我很想知道你是否對此有任何高層次的想法——那些醫生的評論。

Yes. Thanks, Rick. It's possible. I think that folks rotating into open surgery patients who are great candidates for MIS is doing that set of patients a disservice. So we will see. That may happen, hard for us to control.

是的。謝謝，瑞克。這是可能的。我認為那些輪換為適合 MIS 候選人的開放手術患者的人正在對這組患者造成傷害。所以我們會看到的。這可能會發生，我們很難控制。

With regard to capacity for robotics, remember, there are a lot of robots out there, and they are right now underutilized. As that flows back, we can help. Will some folks want to use lap? Maybe. From the point of view of surgeon preference, surgeon comfort, what their choices are, just remember, surgeons are intentional about the method of surgery they choose. They don't accidentally fall into robotic surgery training. They make those commitments and time investments for a reason, and they have a preference. So if we can fulfill their preference, great. That will be great. If we're unable to do so and they choose lap because they couldn't get access where they wanted, well, that may happen. But that's really, I think, Intuitive's job to make those systems available to them if they would like to use them.

關於機器人技術的能力，請記住，那裡有很多機器人，它們現在沒有得到充分利用。當它回流時，我們可以提供幫助。有些人會想用膝上嗎？也許。從外科醫生的偏好、外科醫生的舒適度、他們的選擇是什麼的角度來看，請記住，外科醫生對他們選擇的手術方法是有意識的。他們不會意外地參加機器人手術培訓。他們做出這些承諾和時間投資是有原因的，而且他們有偏好。所以如果我們能滿足他們的喜好，那就太好了。那挺棒的。如果我們不能這樣做，而他們選擇 lap 因為他們無法進入他們想要的地方，那麼這可能會發生。但這確實是，我認為，如果他們想使用這些系統，Intuitive 的工作就是讓他們可以使用它們。

Our next question will come from Larry Keusch, Raymond James.

我們的下一個問題將來自拉里·科施 (Larry Keusch) 和雷蒙德·詹姆斯 (Raymond James)。

I guess, Gary, to start with, just curious, thinking about R&D. What changes are you making to allow the innovation engine to not stall out here? I'm just curious how you're accomplishing that and what sort of processes, procedures you're putting in place.

我想，加里，首先，只是好奇，考慮研發。您正在做出哪些改變以使創新引擎不會在這裡停滯不前？我只是好奇你是如何完成的，以及你正在實施什麼樣的流程和程序。

Yes, thank you. First thing has been to employ the -- to ensure to protect the safety of our staff and those who supply us while we do our R&D. So step 1 has been to stay up-to-date on the latest employee work safety methods. We started our incident response team relatively early. We were up and running at full speed in terms of our incident response team in early January. And so they started looking at best practice, relaying out our on-site facilities as they need to be relayed out, enabling work from home where we can. We were pretty capable at remote work capabilities just given the distributed nature of our campuses. So it's really flexing in that regard. And then we've put in place a robust process for allowing on-site work where we think it can't be done otherwise for training our staff and staying with it. And so we've done that. Of course, there's a loss of efficiency as you go through this. And so there's no doubt that in the first weeks of this, you start to slow down.

是的，謝謝。首先是僱傭——以確保在我們進行研發時保護我們的員工和為我們提供服務的人的安全。因此，第一步是了解最新的員工工作安全方法。我們相對較早地啟動了我們的事件響應團隊。 1 月初，我們的事件響應團隊開始全速運行。因此，他們開始尋找最佳實踐，在需要轉發時轉發我們的現場設施，讓我們能夠在家中工作。考慮到我們校園的分佈式特性，我們在遠程工作方面非常有能力。所以在這方面它真的很靈活。然後，我們制定了一個強大的流程，允許在我們認為無法進行的現場工作，以培訓我們的員工並堅持下去。所以我們已經做到了。當然，執行此操作時會降低效率。所以毫無疑問，在最初幾週，你開始放慢速度。

And then we're fighting hard to recover. Team attitudes have been fantastic. The agility and creativity of teams to get the work done, their willingness and desire to do so has been really encouraging. So, so far, so good.

然後我們正在努力恢復。團隊的態度非常棒。團隊完成工作的敏捷性和創造力，他們這樣做的意願和願望確實令人鼓舞。所以，到目前為止，一切都很好。

Some things will go slower. To the extent that we have clinical trials out there and those are being conducted in hospitals that are being impacted by COVID, those things will slow down. The principal investigators in those places are highly committed, first, to patient care and then, as a second priority, to doing the research they'd like to do. And so that will come back as time permits for them to do so.

有些事情會變得更慢。如果我們有臨床試驗，並且這些試驗是在受 COVID 影響的醫院進行的，那麼這些事情就會放緩。這些地方的主要研究人員首先致力於患者護理，然後作為第二優先事項進行他們想做的研究。因此，只要時間允許，他們就會這樣做。

Okay, terrific. And then I guess the other question is, you guys are obviously having a lot of conversations with surgeons, with hospitals. I'm just sort of curious if you can comment on what you are hearing relative to maybe some of the bigger geographies in Europe or in the U.S. when they may be able to start to get some of these surgeries going. As you guys have indicated multiple times on this call, there is a continuum, and there are procedures that can be deferred but not for potentially long periods of time. So I'm just curious. I know it's a fluid situation, but just anything you might be hearing as to when this might start up again?

好的，棒極了。然後我想另一個問題是，你們顯然與外科醫生、醫院進行了很多對話。我只是有點好奇你是否可以評論你所聽到的相對於歐洲或美國的一些較大地區的情況，當他們可能開始進行其中一些手術時。正如你們在本次電話會議中多次指出的那樣，這是一個連續的過程，有些程序可以推遲但不能推遲很長時間。所以我只是好奇。我知道這是一個不穩定的情況，但是您可能會聽到關於何時會再次開始的任何消息？

Clearly varies by country. And it's the reason that we put a couple of those charts on our website for you to look at, is just to see the difference in how different countries are doing it. The places that are able to engage earliest have taken strategies where they have put COVID care in one location and allowed surgery to occur in a different location or hot and cold zones within their own institutions that have allowed them to manage both concurrently so long as they have staff and PPE to do it. Giving you a general answer is really not possible at this time because of the puts and takes by region.

顯然因國家而異。這就是我們在我們的網站上放一些圖表供您查看的原因，只是為了了解不同國家/地區的做法差異。能夠最早參與的地方已採取策略，將 COVID 護理放在一個地點，並允許在不同地點或他們自己機構內的冷熱區域進行手術，這使得他們能夠同時管理這兩者，只要他們有工作人員和個人防護裝備來做。由於地區的看跌期權，目前確實不可能給您一個一般性的答案。

What I will say is surgeons are there for a reason. They are -- it's impressive. They are both community oriented and clearly understanding the need to support their communities as they flex into this crisis. At the same time, they're surgeons, and they're looking forward to going back to surgery. The backlogs that you hear about are significant, and they are concerned about those patients who are surgical patients who need care.

我要說的是外科醫生的存在是有原因的。他們是——令人印象深刻。他們都以社區為導向，並且清楚地了解在他們陷入這場危機時支持他們的社區的必要性。同時，他們是外科醫生，他們期待著重返手術室。您聽說的積壓工作很重要，他們擔心那些需要護理的外科手術患者。

The last comment I'd make is that very few of the procedures that are done using robotic-assisted surgery are easily resolved by nonsurgical means, that we are in a part of surgery that -- where surgery is, by and large, the first choice. And as a result, I don't think a lot of these procedures are going to dissolve in time just by waiting. I think they're going to have to be done surgically. So it really will be a question of where do they get done, when do they get done and what kind of technology is used to do it.

我要說的最後一點是，使用機器人輔助手術完成的手術很少能通過非手術方式輕鬆解決，我們正處於手術的一部分——總的來說，手術是第一個選擇。因此，我認為這些程序中的很多不會僅僅通過等待而及時解散。我認為他們將不得不通過手術完成。所以這真的是一個問題，他們在哪裡完成，什麼時候完成以及使用什麼樣的技術來完成。

Our next question will come from Amit Hazan, Goldman Sachs.

我們的下一個問題將來自高盛的 Amit Hazan。

And just a quick follow-up on the European system side. Just thinking about operating leases out there and how that situation might evolve, can you just kind of maybe remind us of the tendency of certain countries to adopt via leases out there and whether you're sensing any kind of a change or improvement in that outlook as we think about them being more constrained to spend on capital potentially over the next year or so?

並且只是歐洲系統方面的快速跟進。想想那裡的經營租賃以及這種情況可能會如何發展，您能否提醒我們某些國家/地區通過租賃採用的趨勢，以及您是否感覺到這種前景的任何變化或改善當我們考慮到他們可能在未來一年左右的資本支出方面受到更多限制時？

Marshall, will you take that?

馬歇爾，你會接受嗎？

Yes, there were -- there are limitations as to what you can do within each European country. All of them have different rules as to registration and with different regulators around financing. Having said that, we really had launched leasing in Germany and the U.K. a year or 2 years ago or so and France a little bit after that. And we did see a nice uptick in leasing in -- particularly in Germany.

是的，有——在每個歐洲國家你可以做什麼是有限制的。他們都有不同的註冊規則，以及在融資方面的不同監管機構。話雖如此，我們確實在一兩年前左右在德國和英國推出了租賃服務，之後又在法國推出了租賃服務。而且我們確實看到了租賃的良好增長——尤其是在德國。

I think going forward, we'll be doing -- you'll see leasing in all those markets. We're prepared to be able to offer it. We now understand structures we can do and what the requirements are from a reporting perspective, and I think we're set. So I would anticipate given the impact of the COVID-19 that we would see additional leasing there.

我認為展望未來，我們將在所有這些市場中看到租賃。我們準備好提供它。我們現在從報告的角度了解了我們可以做的結構以及要求是什麼，我認為我們已經確定了。因此，鑑於 COVID-19 的影響，我預計我們會在那裡看到額外的租賃。

And then just one quick kind of bigger question, bigger-picture, longer term one for Gary. It's early days, but how are you thinking, if at all, about secular changes for hospital systems and health care more broadly after this crisis is over as it kind of relates to your markets?

然後只是一個快速的更大的問題，更大的圖景，加里的長期問題。現在還為時過早，但你如何看待這場危機結束後醫院系統和更廣泛的醫療保健的長期變化，因為它與你的市場有關？

Yes, I think it's a little too soon to tell. We certainly are thinking about how customers might adapt, and you can think about a few things. I guess I'd focus you on really kind of Phase II and Phase III of this coronavirus response: the economy starts opening back up, and we have a fair amount of testing, but you're still dealing with COVID as it -- as an uncured disease. How do hospitals manage that? I think that's a lot of where our thoughts are now. That may have to do with site of care and other kind of flexible ways.

是的，我認為現在下結論還為時過早。我們當然在考慮客戶如何適應，你可以考慮一些事情。我想我會把你的注意力集中在這種冠狀病毒反應的第二階段和第三階段：經濟開始重新開放，我們進行了大量的測試，但你仍然在處理新冠病毒——因為一種未治癒的疾病。醫院是如何管理的？我認為這就是我們現在的很多想法。這可能與護理現場和其他靈活的方式有關。

We think minimally invasive surgery broadly and robotic-assisted surgery is important in that setting. Keeping people out of the hospital, allowing them to recover quickly at home, these are things that I think are generally good for the health care system, and there may be some adaptation by health systems to be flexible about how to deliver that. And we're working through that internally and with them, and it gets exciting.

我們認為微創手術和機器人輔助手術在這種情況下很重要。讓人們遠離醫院，讓他們在家中快速康復，這些都是我認為通常對醫療保健系統有益的事情，而且醫療系統可能會做出一些調整，以便靈活地提供這些服務。我們正在內部和他們一起努力解決這個問題，這變得令人興奮。

What happens after that, as this goes on a couple of years, I think we'll all have to wait and see.

之後會發生什麼，因為這會持續幾年，我想我們都必須拭目以待。

Last questioner, please.

請最後一位提問者。

Yes, that will come from Matt Taylor, UBS.

是的，這將來自瑞銀的馬特泰勒。

So I just wanted to ask a follow-up question on some of the things you were talking about qualitatively earlier in regards to helping systems when they get back to working normally and helping them be efficient and flex up on the upside. I know you've done some work there with your internal consulting groups to make systems more efficient. It seems to be working. And I was just wondering if you could offer some thoughts on how much more they could flex up in the short run? And what are some of the best practices? And what are the best systems doing with regards to utilization today?

所以我只是想問一個後續問題，關於你之前在質量上談論的一些事情，這些事情是關於幫助系統恢復正常工作並幫助他們提高效率和向上彈性。我知道您已經與您的內部諮詢小組一起完成了一些工作，以提高系統的效率。它似乎正在工作。我只是想知道你是否可以提供一些關於他們在短期內可以彎曲多少的想法？有哪些最佳實踐？就今天的利用率而言，最好的系統在做什麼？

Yes. If you think forward, the major things here have been really making sure that teams are consistent; teams that know how to work together, work together frequently; they know how to parallelize tasks; and they use kind of best practices. It is not limited to robotic surgery but works really well therein.

是的。如果你向前看，這裡的主要事情就是確保團隊保持一致。知道如何一起工作的團隊，經常一起工作；他們知道如何並行化任務；他們使用某種最佳實踐。它不僅限於機器人手術，而且在其中非常有效。

With regard to how we can help, making sure that training resources are available. We have been investing, as you know, in Intuitive telemedicine network. I'm really pleased that we made that set of investments. And in the future, that allows us to project expertise in at a distance. That means people don't have to be on planes. In a post-COVID world, that's probably helpful for us and something that we want to rotate towards as we go. As I said earlier in the call, I think we can forward deploy some of our training resources and help get teams up and running and trained that would help people work through backlogs as best as they can.

關於我們如何提供幫助，請確保培訓資源可用。如您所知，我們一直在投資 Intuitive 遠程醫療網絡。我真的很高興我們進行了那套投資。在未來，這使我們能夠遠距離投射專業知識。這意味著人們不必在飛機上。在後 COVID 世界中，這可能對我們有所幫助，並且我們希望隨著我們的發展而轉向。正如我之前在電話會議中所說，我認為我們可以提前部署我們的一些培訓資源，幫助團隊啟動、運行和培訓，這將幫助人們盡可能地解決積壓工作。

All right. Well, thank you. That was our last question. In closing, we continue to believe there's a substantial and durable opportunity to fundamentally improve surgery and acute interventions. During this period, our continued -- our teams continue to work closely with hospitals, physicians and care teams to support them in their mission, wherever that may lead. We believe value creation in surgery and acute care is foundationally human. It flows from respect for and understanding of patients and care teams, their needs and their environment.

好的。嗯，謝謝。那是我們的最後一個問題。最後，我們仍然相信，從根本上改善手術和急性干預是一個巨大而持久的機會。在此期間，我們繼續 - 我們的團隊繼續與醫院、醫生和護理團隊密切合作，以支持他們的使命，無論這可能導致什麼。我們相信，手術和急症護理的價值創造從根本上說是人性化的。它源於對患者和護理團隊、他們的需求和環境的尊重和理解。

Thank you for your support. We look forward to talking with you again in 3 months. Thank you.

謝謝您的支持。我們期待在 3 個月後再次與您交談。謝謝你。

Thank you. And that does conclude your conference for today. Thank you for using AT&T Event Conferencing. You may now disconnect.

謝謝你。這確實結束了您今天的會議。感謝您使用 AT&T 活動會議。您現在可以斷開連接。