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，感謝您的耐心等待，歡迎參加直覺外科公司2020年第一季財報發布會。 （操作說明）提醒您，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.

現在我將會議交給直覺外科公司（Intuitive Surgical）財務及投資者關係高級總監卡爾文·達林（Calvin Darling）。請開始吧。

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。下午好，歡迎參加Intuitive第一季財報電話會議。今天與我一起出席的有我們的執行長Gary Guthart和財務長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.

在會議開始之前，我想告知各位，今天電話會議中提及的評論可能包含前瞻性陳述。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有重大差異。這些風險和不確定性已在提交給美國證券交易委員會（SEC）的文件中詳細描述，包括我們於2020年2月7日提交的最新10-K表格。您可以透過我們的網站或SEC網站查閱我們的SEC文件。投資者請勿過度依賴此類前瞻性陳述。

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

請注意，本次電話會議的音訊回放將在我們網站intuitive.com的「投資者關係」頁面下的「最新動態」欄位中提供。

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在我們的網站上。此外，本季我們也發布了圖表，展示了第一季達文西手術的趨勢，旨在提供更多關於新冠疫​​情對我們業務影響的視角和細節。

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.

今天的會議流程如下：首先，我們將重點介紹今天早些時候發布的新聞稿中概述的第一季業績；隨後進行問答環節。 Gary 將介紹本季的業務和營運亮點；Marshall 將回顧我們的財務表現；之後，我將討論流程細節；最後，我們將進行問答環節。

With that, I will turn it over to Gary.

接下來，我將把麥克風交給蓋瑞。

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.

感謝您今天參加我們的電話會議。 2020年第一季的業績反映了新冠肺炎疫情的爆發以及全球應對措施。在本次電話會議上，我們將介紹本季我們的經驗、我們與依賴我們的各方溝通的框架，以及我們在這段充滿挑戰的時期所採取的優先事項和行動。我們始終將病人、醫護團隊、社區和員工的安全與福祉放在首位。

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.

本季前兩個半月，手術量達到預期上限，手術趨勢與前幾季保持一致。美國境內的普通外科手術表現強勁，美國境外的泌尿外科手術也是如此。

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.

正如我們之前所揭露的，外科協會和醫療機構建議推遲某些手術以節省資源用於新冠肺炎治療，這對包括機器人輔助手術在內的整個外科手術行業都產生了實質影響。我們支持政府和醫院將資源集中用於新冠肺炎治療的政策，並認識到這些政策因地區和醫院系統而異。我們正在分析客戶因新冠肺炎疫情而延後手術的情況。

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.

接受達文西手術的患者通常是為了治療潛在疾病。雖然這些手術短期內可能會被推遲，但如果不進行任何治療，疾病及其損傷會持續存在，並且往往會惡化。簡而言之，絕大多數患者最終都會尋求治療。我們正在分析促使患者重返治療的臨床因素，以及客戶的復健計畫和流程。良性疾病和癌症的分類並不能完全預測手術介入的迫切性。顯然，侵襲性癌症需要治療，延誤治療會對患者造成重大風險。同樣，一些良性疾病也需要及時介入。我們正在內部以及與客戶合作，了解他們的需求，以便為那些病情需要治療的患者重新啟動手術。

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.

新冠疫情對外科手術市場的影響因地區而異。中國受疫情衝擊最早，手術量急劇下降，因為醫療資源被轉移到對抗新冠疫情。此後，中國的手術量一直在穩定恢復。然而，其他地區，尤其是歐洲和美國，可延期手術的數量卻大幅下降。

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.

本季手術量較 2019 年第一季成長 10%。鑑於季度初的強勁勢頭以及最後兩週的急劇下滑，我建議您參閱我們在本次電話會議之前發佈在我們網站上的資料，以便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.

就係統而言，儘管本季前兩個月資本表現強勁，但我們本季的系統安裝總數仍低於預期。 3月份，醫院的快速調整導致部分系統安裝延遲，並可能對未來幾季的系統合約和安裝產生重大影響。

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.

醫院為應對新冠患者治療和延遲其他醫療服務而面臨的財務壓力可能十分巨大，且短期內難以緩解。馬歇爾和卡爾文將在稍後的電話會議中更詳細地介紹本季的流程和資金動態。

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.

為了更好地闡明我們在這段變革時期的優先事項和行動，我們採用了美國企業研究所（American Enterprise Institute）國家新冠病毒應對方案中所描述的分階段框架。在第一階段，即減緩新冠病毒傳播階段，Intuitive 的優先事項如下：首先，我們專注於所有服務對象（包括客戶、社區、員工和供應商）的健康和安全，並持續更新我們的健康和安全政策及流程。其次，我們根據客戶的優先事項（臨床、營運和經濟方面）提供支援。第三，我們與供應商和經銷商合作，確保供應的連續性。迄今為止，我們的交付能力和庫存狀況良好。第四，我們保障員工的經濟利益。多年來，我們打造了一支卓越的團隊，我們相信他們的力量對於未來的復甦至關重要。第五，我們與 Intuitive 基金會合作，為對抗新冠疫情的第一線提供物資、產品和志工。我們設計、生產並向當地醫院交付了個人防護裝備，我們的員工也在多個社區參與了志願服務。第六，在阻止病毒傳播的階段，我們要消除不必要的支出。

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.

目前醫院應對病毒感染的情況瞬息萬變，這次疫情造成的衝擊程度和持續時間難以預測。外科手術方面也出現了一些新的問題，需要採取緩解措施並等待時間。在此期間，部分醫院客戶和供應商將面臨巨大的財務壓力。隨著監管機構將資源集中用於傳染病檢測和治療，全球監管機構的優先事項和資源也正在轉變。

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，外科醫生們要不是被投入到對抗新冠疫情的第一線工作中，就是因為資源匱乏而被迫停工。我們正在迅速調整以應對上述問題，隨著新冠疫情應對措施的不斷演變，我們對手術的必要性以及我們自身的產品都充滿信心。我們正在籌備第二階段的手術恢復計劃，以滿足那些無法等待的患者的需求。那些對抗疫情時間最長的國家已經逐步恢復了達文西手術，或者能夠在進行達文西手術的同時兼顧新冠治療。我們正在分析不同手術流程可能恢復的順序，以及醫院系統可能採取的策略，以便在提供新冠治療的同時管理手術工作。例如，一些醫療系統將特定區域專門用於新冠治療，而將其他地點的手術室用於門診手術。我們將密切支援客戶恢復各項手術功能。

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.

我們也在調整訓練和直覺的遠距呈現功能，以支援二期臨床試驗環境下的團隊訓練和技能維持。我們正在優化研發設施和方法，以便在遵循最新工作場所安全準則的同時，推動重要的創新專案。最後，隨著試驗中心手術量的增加，我們期待加速臨床試驗活動及相關監管工作的發展。

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.

在當前環境下制定財務計劃時，我們力求平衡以下五個項目標，這些目標反映了我們上述的優先事項。首先，制定以客戶為中心的經濟政策，以滿足客戶在此次危機期間的需求；其次，制定員工政策，保障我們寶貴的員工隊伍，以支持醫院的復甦和創新；第三，確保並穩定關鍵供應鏈資源；第四，削減在此期間無效的支出，例如暫停招聘、減少與業務量相關的職位以及削減在當前階段無法推進的項目支出；最後事項

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。儘管當前挑戰的深度和持續時間難以預測，但對新冠肺炎和非新冠肺炎醫療服務的需求顯而易見。在時間和資源允許的情況下，醫療系統仍然選擇達文西手術系統。我們各利害關係人之間的合作和解決方案導向清晰可見，令人鼓舞。我相信我們的長期發展機會巨大，而且我們的業務在財務和組織方面都處於有利地位，足以應對這次新冠疫情。

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

現在我將把電話交給馬歇爾，他將更詳細地為您講解財務事宜。

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.

午安.我會先介紹我們依照非GAAP準則或備考財務報表編製的績效重點。稍後，我也會在我的發言稿中概述我們按GAAP準則編制的業績。我們網站上已公佈備考財務報表與GAAP財務報表的調節表。

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.

手術量和出貨量與我們4月8日發布的初步新聞稿一致。第一季的關鍵業務指標如下：2020年第一季手術量較2019年第一季成長約10%，較上一季下降約9%。手術量的成長主要由美國的普通外科手術和全球的泌尿外科手術所推動。 Calvin將在本次電話會議稍後詳細介紹手術量增長。

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.

第一季系統安裝量為237套，較去年同期的235套成長1%，但較上季的336套下降29%。達文西手術系統的裝機量成長11%，達到約5,669套。這一成長率低於上季的12%和去年同期的13%。臨床系統在現場的使用率（以每套系統完成的手術量衡量）較上季度的6%和去年同期的5%分別下降了約2%。

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.

讓我詳細分析新冠疫情對手術量和系統部署的影響，以及不同市場受到的影響差異。在新冠疫情爆發之前，我們的手術量增長趨勢與第四季度基本一致，包括普通外科手術的強勁增長、美國成熟手術的增長以及美國-美國境外泌尿外科手術的增長。我們也看到，尤其是在美國，資本部署方面早期表現強勁，該季度部署的系統中超過一半的銷售週期在第四季度基本完成。

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1月開始，我們看到中國達文西手術量大幅下降。到了2月初，中國每週的手術量與1月初的水平相比下降了90%。隨著3月新冠疫情在中國逐漸緩解，達文西手術量開始回升。到季度末，中國每週的手術量已恢復到1月初水準的約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.

我們看到，在其他一些較早受到新冠疫情影響的國家，達文西手術受到的影響各不相同。新冠疫情在本季對韓國和日本的影響很小，而對義大利的影響則十分嚴重。

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.

總而言之，COVID-19 對達文西手術的影響因國家而異，截至 3 月中旬，全球達文西手術受到的影響並不顯著。

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.

隨著疫情蔓延至西歐和美國，我們在3月下半月經歷了達文西手術量的顯著下降。美國每週的手術量（約占我們2019年手術總量的70%）較上季下降了約65%。法國、德國和英國的手術量也有所下降，但降幅小於美國。我們已在網站上提供了補充信息，以便您了解疫情對手術量的影響程度以及各國之間的差異。

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.

正如我之前提到的，本季約一半系統部署的銷售週期大部分是在第四季完成的。隨著季度的推進和疫情影響的加劇，客戶將購買或租賃系統的決策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.

新冠疫情對各市場的影響程度和深度將取決於檢測能力、個人防護裝備、重症​​監護室和手術室的可用性、醫務人員以及政府乾預措施。隨著新冠疫情的持續蔓延，達文西手術量可能會低於第一季的水平。此外，我們預期系統植入量也會隨著手術量的下降而減少。雖然中國等一些市場似乎正在復甦，但新冠疫情的再次爆發仍有可能對達文西手術量產生負面影響，而且並非所有市場的復甦速度都會相同。

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年第四季相比，已安裝設備的利用率下降了2%，這反映了疫情對手術量的影響，以及第四季度系統部署的強勁勢頭。當手術量增加時，客戶會先考慮利用現有的達文西手術系統，這可能會抑制新設備的部署。在第一季的部署中，醫院和綜合交付網路（IDN）尋求統一使用第四代系統，因此多系統部署的比例較高。這些更換項目大多以融資租賃的方式完成。因此，與2019年第四季相比，第一季以舊換新數量佔總部署量的比例更高，而經營租賃數量佔比更低。我們預計，在新冠疫情的影響下，隨著經濟壓力的增加，更多客戶會尋求租賃或其他融資方式，而不是購買。以舊換新活動可能會波動且難以預測。然而，鑑於新冠疫情的影響，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.

第一季我們確認了1,200萬美元的租賃買斷收入，而上一季為3,400萬美元，去年同期為1,200萬美元。本季沒有達文西手術系統租賃到期後的退租。租賃買斷收入的季度間波動較大，而且這種情況可能會持續下去。

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.

每台手術的器械及配件收入增長至略高於 2,000 美元，而 2019 年第四季為 1,980 美元，這反映了手術量下降之前器械及配件的採購情況。我們預計，隨著醫院調整庫存水準以應對手術量減少，器械及配件收入將會下降。

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.

第一季部署的三套系統皆為SP系統，這不僅反映了我們對SP系統的穩定推廣，也體現了新冠疫情的影響。我們將繼續穩步推進SP手術系統的推廣，優先將系統交付給經驗豐富的達文西用戶，同時探索更多適應症並優化供應鏈中的訓練路徑。鑑於新冠疫情的影響，我們進行與SP結直腸手術相關的臨床試驗的能力可能會有所延遲。

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.

本季我們共安裝了8套Ion系統。 Ion系統的安裝也受到了新冠疫情的影響。 Ion系統的安裝數量不計入我們的系統總數，將單獨報告。與Ion系統相關的操作流程和其他資訊不包含在我們的準備報告中，將在相關資訊變得重要時單獨報告。我們將持續評估Ion系統的推廣情況，同時優化供應鏈中的訓練路徑。由於新冠疫情的影響，精準臨床研究的完成時間將會延後。我們目前無法預測精準臨床研究的完成時間。

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.

除美國以外，我們第一季共部署了55套系統，而2019年第一季為81套，上季為140套。本季部署的系統包括歐洲25套、日本10套和中國9套，而2019年第一季則分別為歐洲49套、日本13套和中國3套。

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.

接下來是毛利率和營運費用。第一季的備考毛利率為69.7%，低於2019年第一季的71.2%和上季的72.2%。與2019年第一季和上季相比，毛利率下降主要反映了產品組合的變化、產量下降導致的固定成本上升以及矽產品轉型相關的成本，這些成本部分被成本削減所抵消。由於新冠疫情對收入造成壓力，我們將降低產量，這將導致勞動成本上升、管理費用未充分攤銷以及產品毛利率大幅下降。

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.

經核算，第一季營運費用較2019年第一季成長15%，較上一季下降8%。第一季的支出反映了3月份之前的正常業務活動，之後則因新冠疫情的影響而削減了相關成本。

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.

儘管受疫情影響，收入減少和業務活動受限，第二季部分支出將會下降，但我們的大部分支出仍將持續。第二季主要支出類別及可能趨勢如下：我們將持續為客戶提供支援。我們將繼續投資以「四重目標」為核心的創新。我們將投資於供應鏈中的生產環節，以確保客戶的供應。我們將確保做好應對疫情控制後的準備。由於疫情限制了部分基礎業務活動，某些成本將會下降，包括差旅及相關費用、臨床試驗、外科醫師培訓和客戶資料收集。我們將取消因疫情而無效的支出，例如外科醫生和醫院活動。我們將暫停招募與業務量相關的職位，例如銷售代表和生產員工。我們仍然相信，我們擁有獨特的機會，可以在全球範圍內推廣電腦輔助手術和急診介入治療的益處，並將繼續對這項業務進行長期投資。

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.

第一季的預估有效稅率為20%，低於我們先前預期的20%至21%，這反映了地域組成的變化。實際稅率會隨著收入地域組成的變化、地方政府稅收政策的調整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.

2020 年第一季度，我們的備考淨收入為 3.23 億美元，即每股 2.69 美元，而 2019 年第一季為 3.12 億美元，即每股 2.61 美元，上一季為 4.17 億美元，即每股 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.

現在我將總結一下我們的GAAP業績。 2020年第一季（即第四季）的GAAP淨利為3.14億美元，即每股2.62美元；而2019年第一季的GAAP淨利為3.07億美元，即每股2.56美元；上一季的GAAP淨利為3.58億美元，即每股2.99美元。

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.

備考淨收入與 GAAP 淨收入之間的調整已在我們的網站中列出並加以說明或量化，其中包括與員工股票獎勵、員工股票薪酬和知識產權費用相關的超額稅收優惠、無形資產攤銷和收購相關項目以及法律和解。

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.

截至本季末，我們的現金及投資總額為59億美元，而2019年12月31日為58億美元。經營活動產生的現金流量部分被股票回購和基礎設施營運資金投資所抵銷。我們以平均每股522美元的價格回購了約19.2萬股股票，總額達1億美元。

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.

我們目前對資金部署的考量如下：我們深知新冠疫情對客戶帶來的困難，並將與客戶攜手合作，減輕設備利用率下降帶來的負擔，包括為客戶提供更靈活的融資方案。我們將努力保障供應鏈穩定，並建立適當的庫存水平，以確保客戶供應，尤其是在手術流程恢復後。我們將投資保障員工權益。我們將繼續執行公開市場回購計劃，這與我們以往的做法一致。

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

接下來，我將把發言權交給卡爾文，他將介紹手術流程。

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.

謝謝馬歇爾。我們第一季的整體手術量成長率約為10%，而2019年第一季為18%，上一季為19%。第一季手術量成長主要得益於美國市場9%的成長和美國境外市場11%的成長。 2020年第一季手術量成長率下降，是醫院重新分配資源以因應日益增長的新冠肺炎疫情需求所致。醫院推遲了可以延期的手術，以便騰出更多資源用於治療新冠肺炎患者。

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.

達文西手術量受到的影響首先在1月的中國顯現，並隨著季度的推進蔓延至其他美國境外市場。截至3月中旬，我們的整體手術量正朝著預期的高端發展，這得益於2020年第一季多出的一個工作日。在本季度初期，早期受新冠疫情影響的國家所受到的影響，已被美國普通外科手術和成熟手術的強勁表現所抵消。

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.

自三月中旬起，美國和西歐的手術量顯著下降。在全球範圍內，第一季末的每週手術量比三月中旬之前的正常水平下降了約50%。在美國，第一季末的每週手術量比三月中旬之前的正常水平下降了約65%。手術量顯著下降的類別包括疝氣修補術、良性婦科手術和減重手術。受影響較小的手術包括胸腔外科手術和大腸直腸手術。

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.

除美國以外，本季末的每週手術量比3月中旬之前的正常水平低約25%。美國以外地區降幅較小主要反映了中國手術量的復甦，但被西歐的普遍下滑所抵消。第一季度，日本的手術量受新冠疫情的影響較小，持續維持40%以上的成長速度。我們提供這些數據旨在讓投資人了解第一季前所未有的手術量變化。

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 疫情的範圍和持續時間尚不確定，全球經濟復甦和正常化的時間也尚不確定，我們於 4 月 8 日撤回了財務和程序指引，這些第一季度的程序結果並不一定代表任何前瞻性趨勢。

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

我們的發言到此結束。現在開始接受各位提問。

(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戴維·劉易斯。

Can you hear me?

你聽得到我嗎？

We can.

我們可以。

We can.

我們可以。

Can you hear me now?

現在能聽到我說話嗎？

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。抱歉，我不太清楚發生了什麼事。 Gary，我想跟你稍微聊聊資本週期。我知道我們無法具體分析2020年的情況。但如果回顧2008年的金融危機，如今醫院面臨的壓力肯定與2008年截然不同，坦白說，你們的商業模式也與2008年大相逕庭。你會如何比較和對比新冠疫情對你們業務的影響，以及上次金融危機對醫院的影響？我還有一個後續問題。

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。首先，我認為從根本成本來看，它們根本無法相提並論。顯然，這與醫療保健相關，並且由於延期支付等政策因素，導致資本週期難以預測復甦情況。您剛才提到過，而且確實如此，我們在系統可用性方面有許多更靈活的方法可以選擇。馬歇爾在他的演講稿中也提到，他們會優先利用現有容量。

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.

我們一直與客戶保持定期聯繫。目前手術積壓越來越多。這些患者都需要手術。實際上，作為一家公司，我們的職責是盡我們所能為他們提供支持，包括系統存取和系統運作方面的支持，讓他們能夠使用現有資源。隨著這些系統再次飽和，我們可以考慮如何提高未來的容量，我們有一些工具可以運用。

Marshall, anything you'd like to add?

馬歇爾，你還有什麼要補充的嗎？

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

不，我覺得你說對了。我認為你會看到更多的融資、更多的租賃和替代融資方案。

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。我完全明白了。馬歇爾，關於資金方面，我還有一個問題想跟進。你在稿子裡提到了一些事情，其中​​提到了一些訂單被延遲或取消，以及一些訂單被無限期推遲的情況。你能否從百分比的角度，大致估算一下訂單簿中，你認為被延遲的訂單佔比是多少，被取消或無限期推遲的訂單佔比又是多少？

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.

您剛才提到了租賃費率。您一直把費率維持在40%左右。我們是否有理由認為租賃費率會大幅增加？您說過它會像往常一樣波動，但我認為現在租賃費率可能會大幅上漲，因為您有動力為醫院提供靈活的融資方案來引進這些系統。所以，如果您能提供一些相關信息，將非常有幫助。我稍後會重新排隊。

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。關於租賃業務，是的——本季度的情況是，我們有一些客戶在第四季度就開始了銷售流程，並且有意將系統標準化為第四代系統。碰巧的是，其中一些客戶希望將租賃安排視為購買，並按購買進行會計處理。因此，本季的租賃業務量有所減少。所以我認為本季的數據並不能代表我們正常的租賃業務水準。未來租賃業務的佔比可能更接近我們之前在38%左右的水平。這是在正常情況下。考慮到新冠疫情及其影響，我認為租賃業務的佔比仍會持續成長。所以——但具體情況取決於客戶和具體情況，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了手術，或者推遲了一個季度，我跟他們的溝通總是這樣：「嘿，我們要推遲一下。」然後他們會補充說可能再推遲一個季度，或者再推遲幾個季度。有些客戶會說：「我們會恢復的，但目前還沒有具體的時間表。」對於那些表示沒有具體時間表的客戶，我所說的「無限期」指的就是這種情況。我不認為有客戶在逃避機器人手術。我認為他們實際上想做機器人手術，而且我認為等到新冠疫情得到控制、手術恢復正常後，他們就會回來。

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

下一個問題將來自美國銀行的鮑伯霍普金斯。

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。非常感謝您本季提供的按地域劃分的季度趨勢增量數據，這些數據對我很有幫助。

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是關於中國經濟復甦的圖表。圖表顯示，中國經濟已經從低谷復甦到目前的水平，而且復甦勢頭相當不錯。我想請您談談您認為中國經濟能否作為美國經濟復甦的參考指標。例如，為什麼中國經濟復甦可以作為美國經濟復甦的參考指標，或者為什麼不行？兩者之間可能存在哪些差異？您對此的任何想法都將不勝感激。

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，鮑伯。是的，您在圖表中可以看到中國。您也能看到其他國家，例如日本等等。您確實可以看到，各國的政策會影響圖表的格局。我認為有兩點讓我們感到鼓舞。一是人們的興趣－我們的客戶對使用達文西手術系統的興趣一直很持久。這真是太好了。

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.

您之前問過一個具體問題，即中國的情況對預測的參考價值有多大。我認為，就其他地區而言，現在下結論還為時過早。不過，我對此感到鼓舞。我認為這表明需求具有持久性。話雖如此，我認為政策至關重要，人們分配醫療資源的方式也將隨之改變。在日本，我們已經可以看到他們應對疾病的方法正在不斷改進，而這些改進將體現在醫療程序上。所以，簡而言之，敬請關注。

Calvin, anything you'd like to add?

卡爾文，你還有什麼要補充的嗎？

No, I think that described it pretty well.

不，我覺得這樣描述得已經很清楚了。

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。還有一個後續問題。是的，我想談談日本為何如此具有韌性。您在準備好的演講稿中提到了——我想我錯過了——一項臨床試驗被推遲的情況。我想請您重點強調或重申您當時所說的內容。

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。就日本而言，我認為他們應對新冠病毒的體系總體上與其他國家略有不同，而且還在不斷改進。因此，到目前為止，與其他國家相比，日本醫院的手術運作受到的影響相對較小。未來會怎樣，我並不清楚。我們會觀察事態發展。研究來自日本、韓國、中國、歐洲（包括德國、義大利、英國和法國）的數據對我們來說很有啟發意義，也讓我們更能為醫院病房和手術室的重新開放做好準備。所以現在下最終結論還為時過早，但我認為我們掌握了相當可靠的即時資訊。

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

關於臨床試驗的問題，我將請馬歇爾回答。

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.

我之前提到的臨床試驗，指的是SP。我們計劃進行一項臨床試驗——我們認為必須進行這項試驗才能獲得下一個適應症，也就是大腸癌。至於何時進行臨床試驗——目前來看，可能不會立即進行。話雖如此，我認為我們原本也沒有立即進行這項試驗的計畫。在此之前，我們還需要完成幾個步驟。所以我認為試驗會延期——可能會延期，而且我們也不知道確切的完成時間。

Calvin, you had more to add.

卡爾文，你還有話要說。

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。 Ion方面，我們在先前的電話會議中提到的Ion PRECISE研究的數據收集目前也出現了延遲。我們相信，積極的臨床數據將是推動該平台更廣泛應用的重要催化劑。但鑑於目前情況不明朗，我們無法提供明確的修訂時間表，PRECISE研究的結果不太可能在今年公佈。

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.

但看看這兩個新平台，Ion 和 SP 目前都處於市場推廣的穩定推進階段，兩個平台的早期使用率都令人鼓舞。 Ion 的商業手術率從 2019 年第四季到 2020 年第一季成長了 110% 以上。 SP 的手術率從第四季度增長了 14%，年增約 190%。所以，是的，在早期階段，這些進展確實令人鼓舞。尤其是在韓國，SP 已獲得廣泛批准，目前其單一系統的使用率高於 Xi。

Our next question will come from Tycho Peterson with JPMorgan.

下一個問題將來自摩根大通的泰科彼得森。

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.

我想請您談談手術組合方面的情況，哪些類型的手術可能比其他手術恢復得更快一些。我想，價格較低的手術案例和非緊急疝氣手術的恢復速度可能會比較慢。我只是好奇，即使根據您在中國的經驗，您能否就哪些手術恢復得更快發表一下看法。

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。總的來說，高風險癌症是指那些延誤治療會對患者造成實際風險的疾病，而新發生或發炎性良性疾病也是如此。需要注意的是，在新冠疫情成為更大問題之前，每個國家在2020年初的醫療程序組合略有不同。因此，各國的具體情況略有差異。

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

卡爾文，你能否就我們今天所看到的景象談談你的看法？

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.

是的。再說一遍，關於診療流程，實際上是根據具體情況，按照緊急程度依次進行的。正如您所說，很明顯，侵襲性癌症需要治療，延誤治療會對患者造成巨大的風險。同樣，一些良性疾病也需要及時介入。我們正在與客戶合作，以便更好地了解各個細分市場以及我們未來的計劃和具體細節——隨著專案的進展，我們將進一步闡述。

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階段，受影響較大的手術是疝氣修補術、良性婦科疾病和減肥手術，而胸腔外科手術和結直腸手術受到的影響較小。

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.

就我個人管道了解的情況來看，醫院目前積壓了大量需要手術的病人。令人欣慰的是，他們正積極推進達文西手術系統的使用。所以我認為，在某個階段，後勤支援、個人防護裝備和其他資源的供應情況會有所改善。屆時，醫院將有時間處理這些病人，而我們將全力支持。

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.

接下來或許可以談談關於資本的討論。我理解討論的性質和基調可能會更多地轉向替代融資方式。但您能否談談目前醫院在多大程度上真正參與到資本方面的討論中，而不是仍然忙於應對新冠疫情？另外，鑑於歐洲的資本前景，我也很想聽聽您對歐洲的看法。

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.

正如我在事先準備好的演講稿中所說，關於資本需求，我們在季度末看到採購決策有所延遲。我預計這種情況還會持續下去。我也預計，隨著醫院能夠將資源投入可能積壓的手術中，它們會充分利用現有資源，因此不會立即產生資本需求。我們仍在與一些醫院就資本問題進行磋商。只是目前還無法準確預測本季的情況。

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

至於歐洲，你想賦予它什麼顏色，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.

歐洲方面，我們在本季末並沒有看到手術量有同樣程度的下降。但這並不意味著這種情況會持續下去。隨著病毒的傳播，手術量可能會面臨更大的壓力。

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，如您所知，本季度我們在資本方面完成了25套系統——這正是我在準備好的演講稿中提到的。這遠低於我們本季的預期。因此，我們仍然看到，我們在歐洲與客戶的互動方式與在美國相同。

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.

泰科，你之前也聽我們說過，而且本季的數據也印證了這一點。歐洲並非步調一致。所以，從我們的角度來看，義大利的情況與德國、法國和英國的情況截然不同。因此，每個國家的發展路徑都會略有不同。

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

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.

一份是關於流程的，一份是關於系統的。關於流程，我很感謝您提供的數字和百分比。我認為那些是三月的離職率，幻燈片顯示這些百分比似乎還在持續下降。如果我錯過了什麼，我深表歉意——您能否就四月份前幾週的情況提供一些細節，以便我們更好地了解第二季度的情況？我還有一個後續問題。

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.

我們目前還不方便公佈四月至今的情況。我認為它與你們目前看到的——也就是我們提供的圖表中顯示的情況——並沒有太大的不同。但我也想說，未來兩週的情況並不有特別的預測意義。我認為這種情況會在未來幾週甚至幾個月內在全球蔓延，而我們目前的重點是確保能夠為客戶提供良好的支持，並順利度過難關。

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，展望未來，醫院將面臨兩大挑戰：一是處理延期手術的能力有限；二是將手術轉移到其他地點。我記得你在事先準備好的發言稿中提到過，例如日間手術中心（ASC），或許可以用來隔離非新冠患者，反之亦然。你能為醫院應付這兩大挑戰做些什麼呢？

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，有幾點要說明。我們在門診和醫院已經擁有相當數量的客戶。我們完全有能力並且願意將系統遷移到任何醫療機構。我們確實擁有在門診手術中心（ASC）部署系統的經驗，並且能夠滿足客戶在門診手術中心環境中的需求。我們在這些環境中運作良好。

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.

我們將努力把培訓和其他資源部署到我們認為人們在逐步恢復工作時可能需要額外支援的地區，因為我們意識到在第二階段，預計不會有很多人會搭飛機。因此，我們可以提前部署資源，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，我們也要與客戶和手術部門保持聯繫，確保我們為他們預先部署了他們想要進行的手術所需的庫存。

Our next question will come from Rick Wise, Stifel.

我們的下一個問題將來自 Stifel 公司的 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，有幾個問題。或許我們可以先談談你提到的資本成長放緩以及由此導致的業務下滑。我知道我正在展望未來——而且是相當長遠的未來，你也不太願意預測下一個季度的情況。但我只想探討一下復甦的問題。加里，假設資本增速放緩持續到2020年全年甚至更久，這是否意味著2020年的經濟復甦無法恢復到2019年的水平，甚至可能要到2022年才能恢復到歷史增長水平？因為資本成長放緩，經濟復甦的速度可能會更慢，因此，業務整體成長也會放緩，你懂我的意思嗎？

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，我認為你應該從手術需求的角度來思考這個問題——尤其是機器人輔助手術的需求。在這種情況下，我認為全世界都在排隊等待需要治療的病人。這很合理，我理解。我認為在這個時候節約個人防護裝備、重症​​監護室和其他寶貴資源是合理的。隨著一些限制措施開始放鬆，我認為每個人都必須調整和適應，去照顧那些患有其他疾病的病人。這種需求將驅動一切，從設備維護和其他庫存，到資金和系統的取得。

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.

從庫存角度來看，我們處於有利地位。從營運和財務角度來看，我們也處於有利地位，能夠將系統調配到需要的地方，以租賃或按使用量計費的模式或其他方式為客戶提供支持，滿足客戶的需求，我們將非常靈活。

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，您可能會看到資本部署方式以及我們獲得資本補償的方式與前幾季的歷史慣例相比有所變化。但我們會積極主動地幫助需要幫助的人。我認為，這種轉變的速度很大程度上取決於政府政策和醫療系統政策，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.

明白了。加里，我還有一個相關的問題。我們和幾位醫生的討論表明，隨著疫情好轉，機器人手術的產能實際上可能無法滿足需求，這確實是一個值得探討的觀點。他們也指出，在疫情恢復後，機器人手術可能會失去一些市場份額，例如一些原本計劃接受腹腔鏡手術的患者會轉而選擇開腹手術。我對此並不清楚。我很想知道你對這些醫生的評論有什麼高屋建瓴的看法。

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，里克。這有可能。我認為讓那些非常適合微創手術的患者輪流接受開放性手術，對這部分患者來說是一種傷害。所以我們拭目以待。這種情況可能會發生，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.

關於機器人手術的產能，請記住，市面上有許多機器人，但目前它們的使用率很低。隨著這種潛力的釋放，我們可以提供幫助。有些人會想用腹腔鏡手術嗎？也許會。從外科醫生的偏好、舒適度以及他們的選擇來看，請記住，外科醫生會慎重選擇手術方式。他們不會偶然選擇機器人手術訓練。他們投入時間和精力是有原因的，而且他們有自己的偏好。所以，如果我們能夠滿足他們的偏好，那就太好了。如果我們無法滿足他們的偏好，而他們因為無法達到理想的手術入路而選擇腹腔鏡手術，這種情況也可能發生。但我認為，如果他們想使用這些系統，Intuitive 的職責就是提供這些系統給他們。

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

下一個問題將來自 Raymond James 公司的 Larry Keusch。

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.

加里，首先，我只是好奇，關於研發方面。為了防止創新引擎停滯不前，你們正在做出哪些改變？我很好奇你們是如何實現這一目標的，以及你們正在實施哪些流程和程序。

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。首要任務是確保員工和供應商在研發過程中的人身安全。因此，第一步是隨時了解最新的員工工作安全方法。我們較早組建了事故響應團隊，並在1月初就全面投入運作。他們開始研究最佳實踐，根據需要重新安排現場設施，並盡可能地支援居家辦公室。鑑於我們園區的分散性，我們在遠距辦公方面相當有優勢。因此，這方面我們一直在靈活調整。此外，我們還制定了一套完善的流程，允許在無法進行現場工作的情況下，員工能夠到崗工作，並對員工進行培訓和持續改進。我們已經做到了這一點。當然，在實施這些措施的過程中，效率會下降。毫無疑問，在最初的幾周里，工作進度會放緩。

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，我們正在全力以赴地恢復。團隊態度非常好。團隊展現出的敏捷性和創造力，以及完成工作的意願和熱情，都非常令人鼓舞。所以，目前為止，一切順利。

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.

有些事情進展會放緩。例如，我們正在進行的臨床試驗，尤其是在受新冠疫情影響的醫院進行的那些，進展速度就會減慢。這些醫院的主要研究人員首先要全力以赴照顧病人，其次才是進行他們想做的研究。所以，這些研究會在時間允許的情況下逐漸恢復。

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，太好了。接下來我想問的是，你們顯然與外科醫生和醫院進行了許多溝通。我很好奇，你們能否就歐洲或美國一些較大地區何時能夠開始恢復手術的情況發表一下看法？正如你們在這通電話中多次提到的，這是一個循序漸進的過程，有些手術可以推遲，但不能無限期推遲。所以我很想知道，我知道目前情況瞬息萬變，但你們是否了解手術何時可能恢復？

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，各國情況不盡相同。我們之所以在網站上放了幾張圖表供您查看，就是為了讓您了解不同國家採取的措施有何差異。那些能夠儘早採取行動的地區，採取的策略包括將新冠肺炎治療集中在一個地點，而將手術安排在另一個地點，或者在醫療機構內部設立“熱區”和“冷區”，以便在人員和個人防護裝備充足的情況下，能夠同時管理這兩種治療。由於各地情況不盡相同，目前很難給出統一的答案。

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.

我想說的是，外科醫生們堅守崗位是有原因的。他們——這令人欽佩。他們既有社區意識，又清楚地認識到在應對這場危機時支持社區的必要性。同時，他們也是外科醫生，他們期待重返手術台。你們聽到的積壓病例確實很多，他們非常關心那些需要手術治療的病人。

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.

最後我想說的是，目前採用機器人輔助手術完成的許多問題都無法透過非手術方式輕鬆解決，我們現在所處的階段，手術仍然是首選方案。因此，我認為許多這類問題不會因為等待而自行消失，最終還是需要透過手術解決。所以，真正的問題在於手術在哪裡進行、何時進行、採用何種技術。

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

下一個問題將來自高盛的阿米特·哈贊。

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?

關於歐洲體系方面，我還有一個後續問題。考慮到目前的經營租賃情況以及未來的發展趨勢，您能否簡要回顧一下某些國家傾向於採用租賃方式的現狀，並說明鑑於這些國家在未來一年左右的資本支出可能會受到更多限制，您是否認為這種趨勢會有任何變化或改善？

Marshall, will you take that?

馬歇爾，你願意接嗎？

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，確實存在一些限制──每個歐洲國家對租賃業務的發展都有不同的規定。各國的註冊規則各不相同，融資方面的監理機構也各有差異。話雖如此，我們大約在一兩年前就在德國和英國推出了租賃業務，之後不久又在法國推出了。而且我們確實看到租賃業務出現了顯著成長，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開展租賃業務。我們已經做好了提供租賃服務的準備。我們現在了解了我們可以採用的架構以及從報告角度來看的要求，我認為我們已經準備就緒。因此，考慮到新冠疫情的影響，我預計這些地區的租賃業務將會進一步成長。

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?

最後，我想問加里一個更宏觀、更長遠的問題。現在還為時過早，但您認為這場危機結束後，醫院系統和更廣泛的醫療保健領域將會發生哪些長期變化，以及這些變化與您的市場有何關聯？

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，我覺得現在下結論還太早。我們當然在考慮客戶可能會如何調整，您也可以考慮以下幾點。我想專注於應對新冠病毒疫情的第二階段和第三階段：經濟開始逐步重啟，檢測量也相當可觀，但新冠病毒仍然是一種尚未治癒的疾病。醫院該如何應對？我認為這正是我們目前思考的重點。這可能與治療地點和其他一些靈活的方式有關。

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，尤其是機器人輔助手術，在醫療領域至關重要。讓患者無需住院，能夠在家快速康復，我認為這對整個醫療體係都有好處。醫療系統可能需要做出一些調整，以更靈活地提供這些服務。我們正在內部以及與醫療系統合作，共同探討這些問題，這令人振奮。

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

至於接下來幾年會發生什麼，我想我們都只能拭目以待了。

Last questioner, please.

最後一位提問者，請繼續。

Yes, that will come from Matt Taylor, UBS.

是的，這消息將來自瑞銀集團的馬特泰勒。

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?

所以我想就您之前定性討論的一些關於如何幫助系統恢復正常運作、提高效率並進一步提升效能的問題，再問一個後續問題。我知道您已經和內部諮詢團隊一起做了一些工作來提高系統效率，而且看起來效果不錯。我想請教一下，在短期內，系統還能提升多少效能？有哪些最佳實務？目前，性能最佳的系統在資源利用率方面做得如何？

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。展望未來，關鍵在於確保團隊的一致性；團隊成員懂得如何協作，經常合作；他們知道如何並行處理任務；並且運用最佳實踐。這不僅限於機器人手術，但在機器人手術中尤其有效。

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.

關於我們如何提供協助，關鍵在於確保培訓資源的可用性。如您所知，我們一直在投資Intuitive遠距醫療網路。我很高興我們進行了這筆投資。未來，這將使我們能夠遠端提供專業知識。這意味著人們無需搭乘飛機。在後疫情時代，這對我們來說可能很有幫助，也是我們希望逐步推進的方向。正如我之前在電話會議中提到的，我認為我們可以提前部署一些培訓資源，幫助團隊快速上手並接受培訓，從而盡可能地幫助人們解決積壓的工作。

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，謝謝。這是我們最後一個問題。最後，我們仍然相信，在從根本上改善外科手術和急診介入方面，存在著巨大且持久的機會。在此期間，我們的團隊將繼續與醫院、醫生和護理團隊緊密合作，以支持他們完成使命，無論未來走向何方。我們相信，外科手術和急診的價值創造根植於人性。它源自於對病人和照護團隊、他們的需求以及他們所處環境的尊重和理解。

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

感謝您的支持。我們期待三個月後再次與您交流。謝謝。

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

謝謝。今天的會議到此結束。感謝您使用 AT&T 會議服務。您現在可以斷開連線了。