直覺手術 (ISRG) 2024 Q3 法說會逐字稿

Thank you, everyone, for standing by, and welcome to the Intuitive third-quarter 2024 earnings release. (Operator Instructions)

感謝大家的耐心等待，歡迎來到 Intuitive 2024 年第三季財報發布。 （操作員說明）

I will now turn the conference over to your host, Brandon Lamm within Investor Relations for Intuitive. Please go ahead.

我現在將把會議轉交給主持人，Intuitive 投資者關係部門的布蘭登·拉姆 (Brandon Lamm)。請繼續。

Good afternoon, and welcome to Intuitive third-quarter earnings conference call. With me today, we have Gary Guthart, our CEO; Dave Rosa, our President; and Jamie Samath, our CFO.

下午好，歡迎參加直覺第三季財報電話會議。今天和我在一起的還有我們的執行長加里·古特特 (Gary Guthart)；戴夫·羅莎，我們的總裁；和我們的財務長 Jamie Samath。

Before we begin, I would like to let you know that Brian Kane has moved on to pursue his next opportunity. We appreciate his contributions over the past nine years and wish him well in his next endeavor. A search for his replacement is in progress.

在我們開始之前，我想讓您知道布萊恩凱恩已經開始尋找下一個機會。我們感謝他在過去九年中所做的貢獻，並祝福他在接下來的努力中一切順利。尋找他的繼任者的工作正在進行中。

Moving on, 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 for the fiscal year ended December 31, 2023, and subsequent filings. 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.

接下來，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有重大差異。這些風險和不確定性在我們向美國證券交易委員會提交的文件中進行了詳細描述，包括我們截至 2023 年 12 月 31 日的財年的最新 10-K 表格以及後續文件。我們的 SEC 備案文件可以透過我們的網站或 SEC 網站找到。投資者應注意不要過度依賴此類前瞻性陳述。

Please note that this conference call will be available for audio replay on our website at intuitive.com on the Events section under our Investor Relations page. Today's press release and supplementary financial data tables have been posted to our website.

請注意，本次電話會議將在我們網站直覺的投資者關係頁面下的「活動」部分進行音訊重播。今天的新聞稿和補充財務數據表已發佈到我們的網站上。

Today's format will consist of providing you with highlights of our third quarter results, as described in our press release announced earlier today, followed by a question-and-answer session. Gary will introduce the call and provide a business overview. Dave will present the quarter's business operational and clinical highlights. Jamie will provide a review of our financial results and procedure highlights. Then, I will provide our updated financial outlook for 2024. And finally, we will host a question-and-answer session.

今天的形式將包括向您提供我們第三季業績的亮點，如我們今天早些時候宣布的新聞稿中所述，然後是問答環節。加里將介紹這次電話會議並提供業務概述。戴夫將介紹本季的業務運作和臨床亮點。傑米將對我們的財務業績和程序要點進行審查。然後，我將提供 2024 年最新的財務展望。

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

有了這個，我會把它交給加里。

Thank you for joining us today. Q3 of 2024 was a good quarter forms, with healthy procedure growth, solid capital placements, and strong operational execution in a dynamic global environment. I'll kick off by providing a perspective on our platforms and our regions.

感謝您今天加入我們。 2024 年第三季是一個良好的季度表現，在動態的全球環境中擁有健康的流程成長、穩健的資本配置和強大的營運執行力。首先，我將提供對我們的平台和區域的看法。

Starting with our multi-port system, we now have an installed base of roughly 9,300 globally. Our five-year procedure compound annual growth rate in multiport has been 17%, with approximately 16 million total patients treated using da Vinci multiple platforms, of which approximately $10 million were in the past five years. Manufacturing, logistics, and service capability has increased over the past several years, helping ensure availability for our customers while managing margins.

從我們的多連接埠系統開始，我們現在在全球擁有約 9,300 個安裝基數。我們的多埠手術五年複合成長率為 17%，使用達文西多平台治療的患者總數約為 1,600 萬，其中過去五年的治療費用約為 1,000 萬美元。在過去幾年中，製造、物流和服務能力不斷增強，有助於確保客戶的可用性，同時管理利潤。

System stability taken across our multi-port product lines has been outstanding, setting the standard for dependability. We launched our fifth generation multi-port system in March this year, and have installed 188 today with over 12,000 procedures completed using da Vinci 5 and roughly six months.

我們的多埠產品線的系統穩定性非常出色，樹立了可靠性標準。我們於今年 3 月推出了第五代多連接埠系統，至今已安裝 188 個，使用 da Vinci 5 在大約六個月內完成了超過 12,000 個程序。

da Vinci 5 is bringing outstanding improvements for surgeons care teams and hospitals, in addition to the first-of-their-kind features that we think will improve patient outcomes. We're moving towards our broad launch and are well into the process of securing additional global regulatory clearances for da Vinci 5, which you'll hear about later in the call.

除了我們認為將改善患者治療效果的同類首創功能外，達文西 5 還為外科醫生護理團隊和醫院帶來了顯著的改進。我們正在朝著廣泛發布的目標邁進，並正在積極爭取達文西 5 的更多全球監管許可，您將在稍後的電話會議中聽到這一消息。

Turning to our endoluminal system, we launched Ion in Q3 of 2019. Today, the Ion install bases 736, of which 722 are in the United States. Physicians have completed more than 150,000 lung biopsies using Ion to date. Each one of which uses machine learning created anatomically segmented long model based on a patient-specific anatomy, personalized digital intervention for every case.

談到我們的腔內系統，我們在 2019 年第三季推出了 Ion。迄今為止，醫生已使用 Ion 完成了超過 150,000 例肺部活檢。每一個都使用機器學習根據患者特定的解剖結構創建了解剖分段的長模型，並針對每個病例進行個性化的數位幹預。

Our five-year compound annual growth rate for Ion procedures has been 205%. There are over 100 peer-reviewed articles assessing Ion. Overall safety and accuracy data has been outstanding.

我們 Ion 手術的五年複合年增長率為 205%。有 100 多篇同行評審文章評估了 Ion。整體安全性和準確性數據非常出色。

Over the past year, we are focused on excellence in product quality, product availability, and customer experience. We have updated Ion with significant feature and software upgrades five times since its launch and have made dozens of improvements to our catheters and vision programs. Over the next two years, we will expand our efforts to place systems beyond the United States to continue system and software innovation, to increase utilization in existing US accounts, and in continued pursuit of additional indication.

在過去的一年裡，我們專注於卓越的產品品質、產品可用性和客戶體驗。自推出以來，我們已對 Ion 進行了五次重大功能和軟體升級，並對我們的導管和視覺程序進行了數十項改進。在接下來的兩年裡，我們將加強努力，將系統部署到美國以外的地區，以繼續系統和軟體創新，提高現有美國帳戶的利用率，並繼續尋求更多指示。

We launched da Vinci SP in Q3 of 2018, and the installed base now stands at 243. SP procedures have been growing at a five-year category of 55%, with 67,000 total procedures completed to date. We've seen strong SP performance in Korea, encouraging early growth in Europe and Japan, and have increased our cadence of regulatory activity globally to broaden its applicability. The SP clinical evidence base stands at over 500 peer-reviewed journal articles.

我們於 2018 年第三季推出了達文西 SP，目前安裝數量已達 243 台。我們在韓國看到了 SP 的強勁表​​現，鼓勵了歐洲和日本的早期成長，並在全球範圍內增加了監管活動的節奏，以擴大其適用範圍。 SP 臨床證據庫包含 500 多篇同行評審的期刊文章。

SP has found stronger uptake outside the United States. Its clinical indications in Europe, Japan, Korea, and now Taiwan, are broader than the US. Our SP team is focused on extending our instrument lineup, including stapling and advanced energy on increasing indications in the US, on enabling proctoring networks and global markets, and on next-generation SP system innovation.

SP 在美國以外地區的使用率較高。它在歐洲、日本、韓國以及現在台灣的臨床適應症比美國更廣泛。我們的 SP 團隊專注於擴展我們的儀器陣容，包括在美國增加適應症的裝訂和先進能源、支援監考網路和全球市場以及下一代 SP 系統創新。

In our digital efforts, nearly 3,000 da Vinci virtual reality simulators are in the install base, and surgeons complete approximately 15,000 hours of training on simulators per quarter. Our active surgeon users for My Intuitive app now exceed 14,000. Intuitive Hub is enabled in approximately 2,000 operating rooms. We outperformed our analytics program, Custom Hospital Analytics, over 4,000 times and at a run rate of 700 per quarter.

在我們的數位化工作中，安裝基地有近 3,000 個達文西虛擬實境模擬器，外科醫生每季完成約 15,000 小時的模擬器培訓。 My Intuitive 應用程式的活躍外科醫生用戶現已超過 14,000 名。大約 2,000 個手術室啟用了 Intuitive Hub。我們的表現優於我們的分析程式 Custom Hospital Analytics，超過 4,000 倍，運行率為每季 700 次。

Our digital team is focused on three enabling digital pillars: digital tools that improve outcomes in the OR and interventional suite, tools that help create better care teams faster, and tools that drive efficiencies and lower total cost of ownership, all while pursuing outstanding capabilities and cybersecurity and data privacy. Dave will touch on our digital progress shortly.

我們的數位團隊專注於三個數位化支柱：改善手術室和介入套件結果的數位工具、幫助更快創建更好的護理團隊的工具以及提高效率和降低總體擁有成本的工具，同時追求卓越的能力和水平。戴夫很快就會談到我們的數位化進展。

Regionally, we have been investing to build a balanced country and regional teams that allow us to serve customers globally with high-quality interactions. These include commercial activity, payer engagement, R&D, logistics, and production capabilities in region. This has been a multi-year effort that has increased customer satisfied action and strengthen our global capability.

在區域方面，我們一直在投資建立一個平衡的國家和區域團隊，使我們能夠透過高品質的互動為全球客戶提供服務。其中包括該地區的商業活動、付款人參與、研發、物流和生產能力。這是我們多年的努力，提高了客戶滿意的行動並增強了我們的全球能力。

Our five-year compound annual growth rate for procedures in the Europe region has been 21%. In the Asia region our five-year procedure CAGR has been 25%. And other markets outside the US has been 18%. Reimbursement coverage for robot-assisted surgery has been obtained or expanded for dozens of procedures and many of the countries we serve. That said, we're still relatively early in our opportunity to localize our capabilities to serve more patients around the world.

我們歐洲地區手術的五年複合年增長率為 21%。在亞洲地區，我們的五年手術複合年增長率為 25%。美國以外的其他市場則為18%。我們服務的許多國家和地區已獲得或擴大了機器人輔助手術的報銷範圍。也就是說，我們還處於相對較早的階段，將我們的能力在地化，為世界各地的更多患者提供服務。

Overall, our teams have been strengthening our ability to serve our customers globally at industrial scale, expanding the applicability of robot-assisted surgery and other interventions by pursuing new platforms, products and services, and obtaining new clinical indications. We've also been strengthening our digital ecosystem to support our customers and our company with high-quality data and insight. The opportunity to improve outcomes for patients and our customers quintuple aim through advanced technology ecosystems like ours, is bigger than ever. And we are focused on disciplined execution to get there.

總體而言，我們的團隊一直在加強我們在工業規模上為全球客戶提供服務的能力，透過尋求新的平台、產品和服務以及獲得新的臨床適應症來擴大機器人輔助手術和其他幹預措施的適用性。我們也一直在加強我們的數位生態系統，以透過高品質的數據和洞察來支持我們的客戶和我們的公司。透過像我們這樣的先進技術生態系統，改善患者和客戶五重目標的結果的機會比以往任何時候都更大。我們專注於嚴格執行以實現這一目標。

And I'll turn the time over to Dave to take you through clinical R&D and operational updates.

我將把時間交給戴夫，帶您了解臨床研發和營運更新。

Thank you, Gary. Starting with procedures. da Vinci procedure growth in the quarter was 18%, aided by an additional business day relative to Q3 2023. Growth, again, centered on general surgery in the US, with accretive contributions to the global growth rate from Japan, Germany, France, and the UK. In Asia, we have mixed market conditions, largely consistent with the first half of the year. Jamie will describe these dynamics later in the call.

謝謝你，加里。從程序開始。與2023 年第三季相比，達文西手術成長了18%，這得益於增加了一個工作日。貢獻不斷增加。在亞洲，我們的市場狀況好壞參半，與上半年基本一致。傑米將在稍後的電話會議中描述這些動態。

Turning to capital, we placed 379 da Vinci systems in the quarter, including 110 da Vinci 5 systems and 21 SP systems. We also installed 58 Ion systems in the quarter.

資金方面，本季我們投放了379套達文西系統，其中110套達文西5系統和21套SP系統。本季我們也安裝了 58 個 Ion 系統。

Capital placements were solid in the US, Japan, India, and our distribution markets; and capital pressure in Europe and China continue. System utilization defined as procedures per installed clinical system per quarter grew 4% globally year over year four our multi-port platforms, 9% for SP, and 11% for Ion.

美國、日本、印度和我們的分銷市場的資本配置穩健；歐洲和中國的資本壓力仍在持續。系統利用率定義為每季度每個已安裝臨床系統的程序，我們的四個多端口平台在全球範圍內同比增長了 4%，SP 增長了 9%，Ion 增長了 11%。

Turning to our finances, revenue grew 17% in the quarter and spending was within our expectations. Our spending reflects investment in research and development to support the growth of our platforms and digital tools. Expansion of our manufacturing facilities and plan leverage from our enabling functions. Jamie will take you through our financials in greater detail later in the call.

談到我們的財務狀況，本季營收成長了 17%，支出符合我們的預期。我們的支出反映了對研發的投資，以支持我們的平台和數位工具的成長。擴大我們的製造設施並計劃利用我們的支援功能。傑米將在稍後的電話會議中向您詳細介紹我們的財務狀況。

In Q3, we continued our measured rollout of da Vinci 5, placing 110 systems as the launch progresses in line with our plans. We are encouraged by broad use of the platform across specialties, with customers expressing a preference for da Vinci 5. Last month, about 1,200 healthcare professionals gathered at our annual user conference, Intuitive 360, to highlight various aspects of their robotic programs.

在第三季度，我們繼續有計劃地推出達文西 5，隨著發布進度按照我們的計劃部署了 110 個系統。我們對該平台在各個專業領域的廣泛使用感到鼓舞，客戶表達了對達文西5 的偏好。介紹他們的機器人程式的各個方面。

Customers have completed over 12,000 cases with da Vinci 5 and several presented their early case data around efficiency and Force Feedback. A number of customers have reported console time savings when comparing da Vinci 5 to Xi, and we look forward to broader analyses as more data becomes available.

客戶已使用達文西 5 完成了超過 12,000 個案例，其中一些客戶展示了他們有關效率和力回饋的早期案例數據。許多客戶報告說，在將 da Vinci 5 與 Xi 進行比較時，控制台時間節省了，我們期待隨著更多數據的出現，進行更廣泛的分析。

For Force Feedback, Dr. Laila Rashidi from MultiCare Health in Tacoma, a leading voice on gentler surgery and its impact on recovery for her colorectal patients described her results. Even with our focus on managing surgical forces, Dr. Rashidi's initial cases with da Vinci 5 show a further review action in force of about 20%, when Force Feedback is used.

對於力回饋，來自塔科馬 MultiCare Health 的 Laila Rashidi 博士描述了她的結果，她是溫和手術及其對結直腸患者康復影響的領導者。即使我們專注於管理手術力量，Rashidi 博士使用達文西 5 的最初案例顯示，當使用力回饋時，進一步審查行動的效力約為 20%。

Force Feedback is a complex technology that we have been pursuing for more than two decades. And it stems from a belief that less force on tissue can lead to improved patient experiences. We also believe Force Feedback may accelerate learning for care teams, and we will continue to study the use of Force Feedback that our customers. We expect more publications over the coming quarters in our teams continue working hard to improved product margin, increased supply of Force Feedback instruments. As we have said before, maturing these insights will take time.

力回饋是一項複雜的技術，我們二十多年來一直在追求。它源於這樣一種信念，即減少對組織的作用力可以改善患者的體驗。我們也相信力回饋可以加速護理團隊的學習，我們將繼續研究客戶對力回饋的使用。我們預計未來幾季我們的團隊將繼續努力提高產品利潤，增加力回饋儀器的供應，從而發表更多出版物。正如我們之前所說，這些見解的成熟需要時間。

Turning to our digital efforts. We believe that digital innovations on our da Vinci and Ion platforms can extract unique, clinical, and operational insights. Coupled with electronic medical record data, these insights should become a core part of improving outcomes learning inefficiencies in the future. To date, we have data from millions of procedures that enable customers to review operational metrics, such as instruments used, procedure duration, and more.

轉向我們的數位化努力。我們相信，達文西和 Ion 平台上的數位創新可以提取獨特的臨床和操作見解。與電子病歷資料結合，這些見解應該成為未來改善結果學習效率低下的核心部分。迄今為止，我們擁有來自數百萬個程式的數據，使客戶能夠查看操作指標，例如使用的儀器、程式持續時間等。

In addition, hundreds of thousands of these cases are connected corresponding the identified electronic medical records, enabling certain clinical and operational hypotheses to be tested. Case Insights is our new analytical tool in My Intuitive that will add kinematics, Force Feedback, and video data to physician's post-operative case reports, further enabling analyses to identify a connection between da Vinci system data and clinical or operational outcomes. We are at the early stages of innovative technology we believe will be powerful, but it will require rapid cycles of innovation and take time to build validated datasets.

此外，數十萬個此類病例與已識別的電子病歷相對應，從而可以測試某些臨床和操作假設。 Case Insights 是 My Intuitive 中的新分析工具，它將向醫生的術後病例報告添加運動學、力回饋和視訊數據，進一步實現分析以確定達文西系統數據與臨床或操作結果之間的聯繫。我們正處於創新技術的早期階段，我們相信該技術將是強大的，但它需要快速的創新週期，並且需要時間來建立經過驗證的資料集。

In Q3, we submitted our CE technical file in Europe. Last week, we received clearance for da Vinci 5 in Korea, and are back and forth in the regulatory process in Japan. This quarter, we began shipping our da Vinci 5 broad launch hardware, and completed a software update that addresses aspects of early customer feedback. We are driving toward broad launch midyear of 2025, when we expect to be at scale in our manufacturing operations, and will have released a software update and enabling the integrated hub and simulator along with various digital and imaging features.

第三季度，我們在歐洲提交了CE技術文件。上週，我們在韓國獲得了達文西 5 的許可，並正在日本的監管程序中反覆進行。本季度，我們開始運送達文西 5 廣泛發布的硬件，並完成了軟體更新，以解決早期客戶回饋的各個方面。我們正努力在 2025 年年中廣泛推出，屆時我們預計將在製造業務中實現規模化，並將發佈軟體更新並啟用整合集線器和模擬器以及各種數位和成像功能。

Moving to instruments and accessories. In Q3, we obtained 510(k) clearance for 8-millimeter SureForm 30 stapler, expanding our advanced instrument portfolio of SureForm staplers that currently includes 12-millimeter versions of 60-, 45-, and 33-millimeter lengths. 8-millimeter SureForm 30 is primarily used in cases where the decrease diameter enables surgeons to better visualize and access tissue in tight spaces as often seen in thoracic or kidney procedures.

轉向儀器和配件。在第三季度，我們獲得了8 毫米SureForm 30 訂書機的510(k) 許可，擴大了我們先進的SureForm 訂書機器械產品組合，目前包括60 毫米、45 毫米和33 毫米長度的12 毫米版本。 8 毫米 SureForm 30 主要用於直徑減小的情況，使外科醫生能夠更好地觀察和接觸狹小空間內的組織，這在胸部或腎臟手術中經常出現。

We are starting our commercial journey in China with Ion, where we placed two systems in soft physicians performing the first cases. We will begin working with a number of medical centers to collect data that will inform our broader commercialization strategy in the country. In Europe, our early launch expanded into Germany and Italy.

我們正在與 Ion 一起開始在中國的商業之旅，我們在軟醫師中放置了兩個系統來執行第一批病例。我們將開始與許多醫療中心合作收集數據，為我們在該國更廣泛的商業化策略提供資訊。在歐洲，我們的早期發布擴展到德國和義大利。

Turning to SP. In the quarter, we received clearance with broad indications in Taiwan, similar to Korea, Japan, and Europe. We also completed a US 510(k) submission for colorectal indication. Commercialization in Europe continues according to plan, and we're encouraged by early customer interest for SP.

轉向SP。本季度，我們在台灣獲得了與韓國、日本和歐洲類似的廣泛適應症的許可。我們也完成了結直腸適應症的 US 510(k) 提交。歐洲的商業化繼續按計劃進行，我們對早期客戶對 SP 的興趣感到鼓舞。

Now, I'd like to share with you some recently published peer-reviewed literature that we found to be notable. In addition to this specific data highlighted on this call, we encourage you to consider the wide body of evidence detailing these topics in published scientific studies over the years.

現在，我想與您分享一些我們認為值得注意的最近發表的同行評審文獻。除了本次電話會議中強調的具體數據之外，我們鼓勵您考慮多年來發表的科學研究中詳細介紹這些主題的廣泛證據。

In August, at the 2024 American Association for Oncology and Interventional Pulmonology Annual Conference, Dr. Bryan Husta from Memorial Sloan Kettering Cancer Center presented results from the CONFIRM study. CONFIRM is a prospective multicenter study evaluating outcomes from the integrated Ion endoluminal system and mobile cone beam CT in the biopsy of pulmonary nodules less than 2 centimeters in size.

8月，在2024年美國腫瘤學和介入肺病學協會年會上，紀念斯隆凱特琳癌症中心的Bryan Husta博士介紹了CONFIRM研究的結果。 CONFIRM 是一項前瞻性多中心研究，評估整合離子腔內系統和移動錐形束 CT 在尺寸小於 2 公分的肺結節活檢中的結果。

155 patients from six centers throughout the US were enrolled. With a median nodules size of 14 millimeters, the integrated platform enabled to tool in nodule rate of 99.4%, with a diagnostic yield of 90% and zero pneumothorax observed. Subgroup analysis demonstrated consistent results across all centers, with high diagnostic yields observed regardless of nodule size, location, or presence of CT bronchus sign.

來自美國 6 個中心的 155 名患者入組。結節中位數尺寸為 14 毫米，整合平台的結節率為 99.4%，診斷率為 90%，觀察到的氣胸為零。亞組分析顯示所有中心的結果一致，無論結節大小、位置或是否存在 CT 支氣管徵象，都觀察到高診斷率。

The presented conclusion noted, quote, integrated shape sensing robotic-assisted bronchoscopy and mobile cone-beam CT demonstrated a higher diagnostic yield and excel the safety for small complex modules, with reproducible results across physicians and institutions. These results suggested that integrated platform may be able to compete with the transthoracic biopsy approach and small nodules, close quote.

所提出的結論指出，整合形狀感測機器人輔助支氣管鏡檢查和移動錐形束CT 表現出更高的診斷率，並且優於小型複雜模組的安全性，並且在醫生和機構中具有可重複的結果。這些結果表明，整合平台或許能夠與經胸活檢方法和小結節競爭，密切報價。

Earlier this year, Dr. Maegawa from the Department of Surgery at Emory University in Atlanta, Georgia, published in the journal surgery. The study comparing robotic and laparoscopic cholecystectomy procedures for benign indications performed in 2022. Using the American College of Surgeons' National Surgical Quality Improvement Program database, over 59,000 patients were included in this study, with over 53,000 in the laparoscopic arm in approximately 5,500 in the robotic-assisted arm.

今年早些時候，喬治亞州亞特蘭大埃默里大學外科系的前川博士在《外科》雜誌上發表了一篇文章。該研究比較了2022 年針對良性適應症進行的機器人和腹腔鏡膽囊切除術。 53,000 名患者接受腹腔鏡手術，另外約5,500 名患者接受腹腔鏡手術。

Through a multi-variable logistic regression analysis, which controlled for confounding factors, patients undergoing a robotic-assisted cholecystectomy at an 18% lower chance of experiencing a serious complication, as well as a 56% lower chance of a conversion to open, and 24% lower risk of requiring hospitalization for more than 24 hours.

透過控制混雜因素的多變量邏輯回歸分析，接受機器人輔助膽囊切除術的患者出現嚴重併發症的幾率降低了 18%，轉換為開腹手術的幾率降低了 56%，24需要住院超過24 小時的風險降低%。

The authors also looked at elective cholecystectomies only that reported a 46% lower chance of conversion to open, 59% lower chance of reoperation, and 30% lower odds of a hospitalization of over 24 hours associated with robotic-assisted cholecystectomies.

作者也僅研究了擇期膽囊切除術，報告顯示，與機器人輔助膽囊切除術相關的轉為開放性膽囊切除術的幾率降低了46%，再次手術的幾率降低了59%，住院超過24 小時的幾率降低了30%。

The authors concluded, quote, using a large and recent National Surgical database, this study showed that overall, robotic cholecystectomies were independently associated with a lower risk of serious complications, lower rate of conversions to open, and lower risk of hospitalization greater than 24 hours when compared to laparoscopy. These findings suggest that the adoption of new technologies might enhance the safety of minimally invasive surgery in selected cases, close quote.

作者總結道，引用最新的大型國家外科資料庫，這項研究表明，總體而言，機器人膽囊切除術與較低的嚴重併發症風險、較低的轉開腹手術率以及較低的住院超過24 小時的風險獨立相關。這些發現表明，新技術的採用可能會提高特定病例中微創手術的安全性，並密切引用。

In closing, we are committed to our 2024 priorities, supporting our measured launch of da Vinci 5 and our other new platforms by region; supporting surgeons' adoption of focused procedures continuing to improve product quality and margins; and finally, improving productivity in those functions that benefit from a global scale.

最後，我們致力於 2024 年的優先事項，支援按地區有序推出達文西 5 和其他新平台；支持外科醫師採用重點手術，持續提高產品品質和利潤；最後，提高那些受益於全球規模的職能部門的生產力。

I'll now turn the time over to Jamie, who will take you through our finances and procedure highlights in greater detail.

現在我將把時間交給傑米，他將帶您更詳細地了解我們的財務和程序亮點。

Good afternoon. I will describe the highlights of our performance on a non-GAAP or pro forma basis, and 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.我將描述我們在非 GAAP 或備考基礎上的業績亮點，並將在稍後我準備好的發言中總結我們的 GAAP 業績。我們的預估結果與公認會計準則結果之間的對帳已發佈在我們的網站上。

Core metrics continued to be strong in Q3, but da Vinci procedure growth of 18%, installed base growth of da Vinci systems of 15%, and overall da Vinci system utilization up 3%.

第三季核心指標持續強勁，但達文西程式成長了 18%，達文西系統安裝基數成長了 15%，達文西系統整體利用率成長了 3%。

Procedure growth in Q3 benefited from a higher number of business days compared to the year ago perio. On a day-adjusted basis, Q3 procedure growth was 17%. US procedures grew 16%, driven by growth in benign general surgery.

與去年同期相比，第三季的程序成長得益於工作日數量的增加。按日調整後，第三季手術成長率為 17%。在良性普通外科手術成長的推動下，美國手術成長了 16%。

On a day-adjusted basis, bariatric procedures in the US declined in the mid-single-digit range, similar to last quarter. OUS procedures grew 24%, reflecting strong growth in general surgery, gynecology, and thoracic procedures.

按日調整後，美國的減重手術數量下降了中個位數，與上季類似。 OUS 手術成長了 24%，反映出一般外科、婦科和胸部手術的強勁成長。

Within our OUS markets, growth was strong in the UK and India, and solid in Japan, Germany, France, and Italy. Procedure growth in South Korea improved from the prior quarter, but was still below longer-term historical trends given the ongoing precision strike. In China, procedure growth was below the corporate average, given recent system placement trends reflecting several market dynamics that we have previously described and domestic robotic competition.

在我們的海外市場中，英國和印度成長強勁，日本、德國、法國和義大利成長強勁。韓國的程序成長較上一季有所改善，但鑑於持續的精確打擊，仍低於長期歷史趨勢。在中國，鑑於最近的系統佈局趨勢反映了我們之前描述的幾個市場動態以及國內機器人競爭，程式成長低於企業平均值。

With respect to capital performance, we placed 379 systems in the third quarter, compared with 312 systems in Q3 of last year. In the US, we placed 219 systems in quarter three, compared to 159 systems placed in Q3 of last year. US system placements in the quarter included 110 da Vinci 5 placements. As supply of da Vinci 5 increases and we move into broad launch mid-next year, we expect the placements in the US will progressively shift toward trade-ins.

在資本表現方面，我們在第三季投放了 379 個系統，而去年第三季為 312 個系統。在美國，我們在第三季部署了 219 個系統，而去年第三季部署了 159 個系統。本季美國系統投放量包括 110 個達文西 5 投放量。隨著達文西 5 供應量的增加以及我們在明年中期開始廣泛推出，我們預計美國的銷售情況將逐漸轉向以舊換新。

Outside the US, we placed 160 systems in quarter three compared with 153 systems last year. Excluding trading transactions, net new system placements in OUS markets increased 28% year over year. Q3 system placements included 65 into Europe, 39 into Japan, and 14 into China, compared with 60 into Europe, 32 into Japan, and 10 into China in quarter three of last year. Placements in Europe continued to be challenged by ongoing government budget pressures impacting health care capital spending.

在美國以外的地區，我們第三季部署了 160 個系統，而去年則為 153 個系統。不包括交易交易，OUS 市場的新系統淨投放量年增 28%。第三季的系統投放量包括歐洲 65 個、日本 39 個和中國 14 個，而去年第三季歐洲 60 個、日本 32 個、中國 10 個。歐洲的安置持續受到影響醫療保健資本支出的持續政府預算壓力的挑戰。

Third-quarter revenue was $2 billion, an increase of 17% from last year driven by da Vinci procedure growth, expansion of the da Vinci installed base and growth in our Ion business.

第三季營收為 20 億美元，比去年成長 17%，這得益於達文西程式的成長、達文西安裝基礎的擴大以及 Ion 業務的成長。

On a constant currency basis, revenue growth was also 17%. Additional revenue statistics and trends are as follows: leasing represented 58% of Q3 placements, higher than recent periods, reflecting relative capital strength in the US where a much greater proportion of our customers prefer to lease systems. Q3 system average selling prices were $1.51 million, as compared to $1.4 million last year. Higher year-over-year system ASPs reflected a higher mix of da Vinci 5 and a lower mix of trade-ins.

以固定匯率計算，營收成長也為 17%。其他收入統計數據和趨勢如下：租賃佔第三季度投放量的 58%，高於近期水平，反映了美國的相對資本實力，其中更大比例的客戶更喜歡租賃系統。第三季系統平均售價為 151 萬美元，去年為 140 萬美元。系統平均售價較去年同期上升反映出達文西 5 的組合增多，而以舊換新的組合減少。

We recognized $24 million of lease buyout revenue in quarter three compared with $28 million last quarter and $17 million last year. da Vinci instrument and accessory revenue per procedure was approximately $1,800, flat to the prior quarter and lower than last year's $1,830. The year-over-year decline in I&A per procedure was primarily driven by a lower mix of bariatric procedures and a higher mix of procedures in markets served by distributors.

我們在第三季確認了 2,400 萬美元的租賃買斷收入，而上季為 2,800 萬美元，去年為 1,700 萬美元。達文西儀器和配件每次手術的收入約為 1,800 美元，與上一季持平，且低於去年的 1,830 美元。每項手術的 I&A 年比下降主要是由於減肥手術組合減少以及分銷商服務的市場中手術組合增加所致。

Turning to our Ion platform. Procedures grew 73% to approximately 25,000 procedures in the third quarter. In Q3, we placed 58 Ion systems compared to 55% last year and 74% last quarter. As a reminder, first half Ion placements reflected a catch-up of backlog as supply of catheters and vision probes improved.

轉向我們的 Ion 平台。第三季手術量增加了 73%，達到約 25,000 例。在第三季度，我們放置了 58 個 Ion 系統，而去年為 55%，上季度為 74%。提醒一下，上半年的離子放置反映出隨著導管和視覺探頭供應的改善，積壓的情況增加。

Q3 Ion system placements included three placements in Europe and our first two placements in China. The installed base of Ion systems increased 50% year over year to 736 systems, of which 296 are under operating lease arrangements.

第三季 Ion 系統佈局包括在歐洲的三個佈局和在中國的前兩個佈局。 Ion 系統的安裝量年增 50%，達到 736 套系統，其中 296 套採用營業租賃安排。

Third-quarter SP procedure growth was 70% with strong multi-specialty growth in Korea, strong growth in the US, and early stage growth in Japan and Europe. 21 of the systems placed in the quarter were SP systems, of which 15 placements were in OUS markets. The SP installed base grew 54% from the year-ago quarter to 243 systems.

第三季 SP 手術成長率為 70%，韓國的多專科成長強勁，美國成長強勁，日本和歐洲的早期成長。本季部署的系統中有 21 個是 SP 系統，其中 15 個部署在 OUS 市場。 SP 安裝基數較去年同期成長 54%，達到 243 個系統。

Moving on to the rest of the P&L. Pro forma gross margin for the third quarter of 2024 was 69.1% compared with 68.8% for the third quarter of 2023 and 70% last quarter. The year-over-year improvement in pro forma gross margin primarily reflects leverage to fixed overhead, lower component costs, and lower logistics costs partially offset by higher inventory reserves.

繼續討論損益表的其餘部分。 2024 年第三季預估毛利率為 69.1%，而 2023 年第三季為 68.8%，上季為 70%。預計毛利率的年比改善主要反映了固定管理費用的槓桿作用、零件成本的降低以及物流成本的降低，但部分被庫存儲備的增加所抵消。

During the quarter, we opened our new system manufacturing facility at our East Coast hub in Peachtree Corners, Georgia, commencing production of X and Xi systems at that site. We also opened our new global capability center in Bangalore, India, where we are co-locating our local commercial and training teams and the global center for IT and other shared service resources.

本季度，我們在喬治亞州 Peachtree Corners 的東海岸中心開設了新的系統製造工廠，開始在該工廠生產 X 和 Xi 系統。我們也在印度班加羅爾開設了新的全球能力中心，當地的商業和培訓團隊以及全球 IT 和其他共享服務資源中心位於同一地點。

As a reminder, given recent and ongoing capital investments, we expect a significant increase in depreciation expense in 2025 as we bring online additional facilities. Third quarter pro forma operating expenses increased 13% compared with last year, driven by higher head count, increased legal expenses, and higher customer-facing activities.

提醒一下，考慮到最近和正在進行的資本投資，我們預計隨著我們在線上提供額外設施，2025 年折舊費用將大幅增加。由於員工數量增加、法律費用增加以及面向客戶的活動增加，第三季預計營運費用將比去年增加 13%。

Consistent with the last couple of years, we have held pro forma R&D expenses of roughly 11% of revenue, given our prioritization of investments in innovation that drive the quintuple aim and our growth. SG&A expenses continue to leverage, as we benefit from prior investments that allow us to scale efficiently with growth.

與過去幾年一致，考慮到我們優先投資於推動五倍目標和成長的創新投資，預計研發費用將約佔營收的 11%。 SG&A 費用繼續發揮槓桿作用，因為我們受益於先前的投資，這些投資使我們能夠隨著成長而有效地擴大規模。

During the quarter, we added approximately 670 employees, of which just over half were in our high-volume INA manufacturing facility in Mexicali to support procedure growth.

本季度，我們增加了約 670 名員工，其中一半以上在墨西卡利的大批量 INA 製造工廠工作，以支持流程成長。

On a year-to-date basis, through Q3 2024, pro forma operating margin was 36% of revenue, an increase of 184 basis points compared to the same period in 2023, driven by higher gross margin and leverage of SG&A expenses as a result of revenue growth and higher operating margins on a year-to-date basis pro forma EPS increased 25% from the prior year.

年初至今，截至 2024 年第三季度，預計營業利潤率的 36%，與 2023 年同期相比增加了 184 個基點，這主要是由於毛利率和 SG&A 費用槓桿率上升所致收入增長和營業利潤率提高，預計每股收益較上年增長25%。

Pro forma other income was $94.6 million for Q3, higher than $79.4 million in the prior quarter primarily due to higher interest income. Given the interest rate environment, we expect the average interest yield on our cash and investments will decline going into 2025. Our pro forma effective tax rate for the third quarter was 20.5%, reflecting discrete benefits of approximately $12 million, primarily relating to the expiration of statutory limitations for certain tax reserves and an adjustment to our deferred tax assets.

第三季預計其他收入為 9,460 萬美元，高於上一季的 7,940 萬美元，主要是由於利息收入增加。鑑於利率環境，我們預期現金和投資的平均利息收益率將在 2025 年之前下降。稅收儲備的法定限制以及對我們的遞延所得稅資產的調整。

Third quarter 2024 pro forma net income was $669 million or $1.84 per share compared with $524 million or $1.46 per share for the third quarter of last year.

2024 年第三季預計淨利為 6.69 億美元，即每股 1.84 美元，去年第三季為 5.24 億美元，即每股 1.46 美元。

I will now summarize our GAAP results. GAAP net income was $565 million or $1.56 per share for the third quarter of 2024 compared with GAAP net income of $416 million or $1.16 per share for the third quarter of 2023. The adjustments between pro forma and GAAP net income are outlined and quantified on our website and include excess tax benefits associated with employee equity plans, employee stock-based compensation, amortization of intangibles, litigation charges, and gains and losses on strategic investments.

現在我將總結我們的 GAAP 結果。 2024 年第三季的GAAP 淨利為5.65 億美元，即每股1.56 美元，而2023 年第三季的GAAP 淨利為4.16 億美元，即每股1.16 美元。在我們的網站上進行了概述和量化。

We ended Q3 with cash and investments of $8.3 billion, higher than the $7.7 billion we ended last quarter. The sequential increase in cash and investments reflected cash generated from operating activities, partially offset by capital expenditures of $248 million.

第三季末，我們的現金和投資為 83 億美元，高於上季末的 77 億美元。現金和投資的連續成長反映了經營活動產生的現金，部分被 2.48 億美元的資本支出所抵銷。

And with that, I would like to turn it over to Brandon to discuss our updated outlook.

說到這裡，我想把它交給布蘭登討論我們最新的前景。

Thank you, Jamie. I will now turn to our financial outlook for 2021. Starting with procedures. On our last call, we forecasted full year 2024 procedure growth within a range of 15.5% and 17%. We are now raising the low end from 15.5% and to 16%, and expect full-year 2024 procedure growth within a range of 16% and 17%.

謝謝你，傑米。我現在將談談我們 2021 年的財務展望。在上次電話會議中，我們預測 2024 年全年手術成長將在 15.5% 至 17% 的範圍內。我們現在將低端從 15.5% 提高到 16%，預計 2024 年全年流程將成長在 16% 到 17% 的範圍內。

The low end of the range assumes further softening in bariatric procedures, along with increasing headwinds in Asia from physician strikes in Korea and from delayed tenders in domestic robotic systems in China impacting capital placements and therefore, procedure growth. At the high end of the range, we assume bariatric stabilizes at current quarter growth rates, and headwinds in Korea and China do not get worse. The range does not reflect significant impact to elective procedures as a result of IV shortages or other hurricane-related impacts.

該範圍的低端假設減重手術進一步疲軟，韓國醫生罷工和中國國內機器人系統招標延遲影響亞洲的阻力，影響資本配置，從而影響手術成長。在該範圍的高端，我們假設肥胖症穩定在當前季度的成長率，韓國和中國的逆風不會變得更糟。該範圍並未反映出由於 IV 短缺或其他颶風相關影響而對選擇性程序產生重大影響。

Turning to gross profit. We continue to expect pro forma gross profit margin to be within a range of 68.5% and 69% of net revenue. Our actual gross profit margin will vary quarter-to-quarter depending largely on product, regional and trade-in mix and the impact of new product introductions.

轉向毛利。我們繼續預計毛利率預計將在淨收入的 68.5% 至 69% 之間。我們的實際毛利率將隨季度而變化，很大程度上取決於產品、區域和以舊換新的組合以及新產品推出的影響。

Turning to operating expenses. On our last call, we forecasted full year 2024 pro forma operating expense growth to be within a range of 10% and 13%. We are now lowering the high end of our estimate and expect full-year 2024 pro forma operating expense growth to be within a range of 10% and 12%.

轉向營運費用。在上次電話會議中，我們預計 2024 年全年預計營運費用成長將在 10% 至 13% 之間。我們現在降低了預期的上限，預計 2024 年全年預計營運費用成長將在 10% 至 12% 的範圍內。

We expect noncash stock compensation expense to range between $670 million and $690 million in 2024. We are increasing our estimate for other income, which is comprised mostly of interest income to total between $325 million and $345 million in 2024.

我們預計2024 年非現金股票補償費用將在6.7 億美元至6.9 億美元之間。億美元之間。

With regard to capital expenditures, we continue to estimate a range of $1 billion to $1.2 billion, primarily for planned facility construction activities. With regard to income tax, we expect the pro forma income tax rate for 2024 to be within a range of 22% and 23% of pretax income.

關於資本支出，我們繼續估計在 10 億至 12 億美元之間，主要用於計劃的設施建設活動。所得稅方面，我們預計2024年預計所得稅稅率將在稅前收入的22%至23%範圍內。

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。我們現在將開始電話詢問您的問題。

(Operator Instructions) Travis Steed, Bank of America.

（操作員指示）Travis Steed，美國銀行。

Sure. Maybe just a little more on thinking about the dV5 ramp between now and the mid-2025 broad launch. Do you expect to make any more upgrades or ad software? And I'd love to dig in a little bit on the customer actions to some of the contribution margin benefits, contribution margin benefits of dV5 kind of on the early data and the hospital CFOs are resonating with some of that fairly profitable data with dV5?

當然。也許只是更多地考慮從現在到 2025 年中期廣泛發布之間的 dV5 升級。您希望進行更多升級或廣告軟體嗎？我很想深入了解客戶對一些貢獻邊際收益的操作，dV5 的貢獻邊際收益類似於早期數據，醫院首席財務官是否對 dV5 的一些相當有利可圖的數據產生共鳴？

Hey, Travis, this is Dave. I will answer some of your questions around kind of where are we going from here to broad launch. So in terms of software updates, we'll continue to make them as they're scheduled in our plans. And you'll see those come out on a semi routine basis.

嘿，崔維斯，這是戴夫。我將回答你們關於我們從這裡到廣泛發布的方向的一些問題。因此，在軟體更新方面，我們將繼續按照計劃中的安排進行更新。你會看到這些是半例行公事地出現的。

We have to get to broad launch. As described in my comments, we have a release that will enable some of that hardware and some additional software features in that broad launch time frame.

我們必須進行廣泛的發布。正如我的評論中所述，我們發布的版本將在廣泛的發佈時間範圍內啟用部分硬體和一些附加軟體功能。

For the supply side of dV5, we expect that to increase modestly quarter over quarter as we get into next year and into broad launch. On the contribution margin side, maybe, Jamie --?

對於 dV5 的供應方面，我們預計隨著明年的廣泛推出，供應量將逐季小幅增長。在邊際貢獻方面，或許，傑米──？

Yeah. I'd just say that, obviously, there was a publication in one of the executive publications that we assisted with. It was illustrative in terms of the contribution margin gains that an institution might get given what we're seeing with respect to efficiency.

是的。我只想說，顯然，我們協助的一份執行出版物中有一份出版物。鑑於我們在效率方面所看到的情況，就機構可能獲得的貢獻邊際收益而言，這是說明性的。

We have a number of early surgeons that are KOLs that have sophistication in terms of use of da Vinci that are reporting improvements in console time, and that allows for both efficiency in a given procedure and perhaps the opportunity to have higher throughput on the platform. And I think that's part of the conversation with administration.

我們有許多早期外科醫生都是KOL，他們在使用達文西方面擁有豐富的經驗，他們報告說控制台時間有所改進，這既提高了給定手術的效率，也可能有機會在平台上獲得更高的吞吐量。我認為這是與政府對話的一部分。

I'd say that's early, and I think we look to collect evidence and validation as we get into the broad launch, but early feedback from a number of our surgeons has been focused on the efficiency gains they've seen.

我想說這還為時過早，我認為我們在進入廣泛發布階段時希望收集證據和驗證，但我們許多外科醫生的早期反饋主要集中在他們所看到的效率提升上。

Larry Biegelsen, Wells Fargo.

拉里·比格爾森，富國銀行。

Thanks for taking the questions. One on international for me, one on procedures, if I may. The Korean approval, I think, came earlier than people expected. Do you have supply to launch that right away?

感謝您提出問題。如果可以的話，一本是關於國際的，一本是關於程序的。我認為韓國的批准比人們預期的要早。你們有供應立即啟動嗎？

And just what's the update on Japan timing? I heard the back and forth in the prepared remarks. And how long are you expecting the review process in Europe to take? And I have one follow-up.

日本的最新消息是什麼？我聽到了準備好的發言中的來回聲音。您預計歐洲的審核過程需要多長時間？我還有一個後續行動。

Yes, thanks. We do have supply to be able to support Korea demand. And so that is true. We have not outlined timing in Japan. So we remain in that back and forth.

是的，謝謝。我們確實有供應能夠支持韓國的需求。確實如此。我們尚未概述在日本的具體時間。所以我們就這樣來來回回。

And then with respect to CE Mark in Europe, no different from last quarter where we expect that near the end of next year 2025

然後就歐洲的 CE 標誌而言，與上個季度沒有什麼不同，我們預計明年年底 2025 年

Got it. That's helpful. And for Dave or Gary, we've heard you and key opinion leaders recently started talking about new procedures such as appendectomy, foregut, hepatobiliary, and emergent procedures. Could you please tell us where you are in addressing these from a clinical, regulatory, and commercial standpoint? And how would you size some of these new procedures? Thanks.

知道了。這很有幫助。對於戴夫或加里，我們聽說您和關鍵意見領袖最近開始談論新手術，如闌尾切除術、前腸、肝膽和急診手術。您能告訴我們您從臨床、監管和商業角度解決這些問題的進展如何嗎？您將如何調整其中一些新程式的規模？謝謝。

Yeah. With respect to foregut and HPB, we've actually been in those procedures in the US for some time. They've been growing nicely for us. Currently, the growth rates for them are accretive to the US average. They are both relatively small categories, and that's probably why they haven't gone a lot of the air time in terms of our commentary.

是的。關於前腸和 HPB，我們實際上在美國進行這些手術已經有一段時間了。他們為我們成長得很好。目前，它們的成長率高於美國平均。它們都是相對較小的類別，這可能是為什麼它們在我們的評論中沒有花很多時間的原因。

Appendectomy is much earlier for us. It's quite a small procedure. It is also accretive growth. I think what you're seeing with appendectomy is as surgeons have adopted Xi over time as they've expanded their kind of taking a practice approach to general surgery.

闌尾切除術對我們來說早很多。這是一個相當小的過程。這也是累加性成長。我認為你在闌尾切除術中看到的是，隨著時間的推移，外科醫生們已經採用了 Xi，因為他們已經將他們的實踐方法擴展到普通外科。

What you see is that then gets extended into the emergent care settings, acute care settings, and they start to use Xi more routinely. We have done some clinical work on appendectomy. We do have an indication with the FDA in the U.S. and appendectomy, that's a small procedure for us, and obviously, it's concentrated in emergent savings.

你看到的是，然後擴展到緊急護理機構、急性護理機構，他們開始更常規地使用 Xi。我們在闌尾切除術方面做了一些臨床工作。我們確實向美國 FDA 提出了闌尾切除術的指示，這對我們來說是一個小手術，顯然，它集中在緊急儲蓄上。

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Congrats on a great quarter. Two for me, might both be for Jamie, I'll let you decide. Maybe first, the margins were once again really impressive, both gross margin and operating margin. Really, the question is how much more room do you feel like there is to go? We're just starting to see da Vinci 5 flow through. And I know there is definitely some depreciation benefit flowing through this year that probably wanes into next year. And we're coming off a very heavy investment period.

恭喜您度過了一個出色的季度。兩個給我，也可能都給傑米，我讓你決定。也許首先，毛利率和營業利潤率再次令人印象深刻。真的，問題是你覺得還有多少空間可以去？我們才剛開始看到達文西 5 的進展。我知道今年肯定會產生一些折舊收益，這些收益可能會減弱到明年。我們正在經歷一個非常大的投資時期。

So I guess the question is, as we move forward, how should we think about the margin progression as you have these new products flowing through and the mix starts to evolve?

所以我想問題是，隨著我們前進，當你有這些新產品流動並且組合開始演變時，我們應該如何考慮利潤成長？

Yeah. Maybe just some framing first. I think we've consistently said we look to have margins that are kind of top tier with respect to our med tech peers. We've also said that we don't have a management expectation to have op margins above 40%. I know they were -- had that level back pre-COVID, but we don't have a management objective to be back at that level. And that's just us balancing the rate of investment with what we think is the right level of profitability.

是的。也許只是先一些框架。我認為我們一直說我們希望擁有相對於我們的醫療技術同行來說是頂級的利潤率。我們也說過，管理層預計營運利潤率不會超過 40%。我知道他們在新冠疫情之前就恢復了這一水平，但我們沒有恢復到這一水平的管理目標。這只是我們在投資率與我們認為合適的獲利水準之間進行平衡。

We were 37% of margin this quarter, 36% year to date. What I would expect is, for 2025 on the gross margin front, just given the significant incremental depreciation that we've described, you should expect gross margins to be a little lower next year as we start to take on board that incremental depreciation expense.

本季我們的利潤率為 37%，今年迄今為 36%。我預計，2025 年的毛利率方面，鑑於我們所描述的大幅增量折舊，隨著我們開始考慮增量折舊費用，您應該預計明年的毛利率會略低。

And you'll have a period, as those new facilities come online, where, in fact, we're period expensing that depreciation because you're early in the phase of ramping production in those facilities versus capitalizing them into inventory. I think what we've said in the midterm is we have the opportunity, we think, on gross margin to get back to 70%. That's our aspiration.

當這些新設施上線時，您將會經歷一段時期，事實上，我們會在這段期間內將折舊費用化，因為您仍處於這些設施的產量增加階段，而不是將其資本化到庫存中。我認為我們在中期所說的是我們認為毛利率有機會恢復到 70%。這是我們的願望。

But if you think about where we are right now, year to date, 36%, we don't have a management objective to be above 40% is a relatively narrow range over the midterm to improve. The question of what we do on that midterm will also be balanced by how much we invest in R&D, which is going to be a function of the opportunities that we see.

但如果你想想我們現在的情況，今年到目前為止，36%，我們沒有設定高於 40% 的管理目標，這是中期需要改進的一個相對狹窄的範圍。我們在中期做什麼的問題也將透過我們在研發上的投資量來平衡，這將取決於我們看到的機會。

Great. Appreciate that. And then as a follow-up, as we move into next year and you talked about expect more of the trade-ins coming from da Vinci 5 as you move into full launch. There's an opportunity, obviously, to repurpose and resell some of the refurbished is that you get traded in. Just maybe speak to the opportunity there, how we should think about that? And any immediate plans you can talk about? Thanks a lot.

偉大的。很欣賞這一點。然後作為後續行動，當我們進入明年時，您談到，當您進入全面發布階段時，預計會有更多來自達文西 5 的以舊換新。顯然，有一個機會可以重新利用和轉售一些翻新的東西，那就是你可以進行交易。您可以談談近期的計畫嗎？多謝。

Yeah. So you should expect us to as the trading cycle occurs, which, by the way, we think will be progressive and will occur over multiple of years, as Xi come back, we will, as we've done in the past, refurbished those, that does allow for segmentation that could be site of care segmentation, for example, in the US and segmentation in markets internationally that are more cost sensitive. We haven't worked through exactly how -- what those plans will be, but you could expect within that framing, that's kind of what we'll do with respect to refurbished excise.

是的。因此，你應該期望我們隨著交易週期的發生而進行，順便說一句，我們認為這將是漸進的，並將在數年內發生，當習近平回來時，我們將像過去所做的那樣，翻新那些，這確實允許進行細分，例如，在美國可以進行護理細分，也可以在對成本更加敏感的國際市場進行細分。我們還沒有具體研究這些計劃將是什麼，但你可以期望在這個框架內，這就是我們將在翻新消費稅方面所做的事情。

David Roman, Goldman Sachs.

大衛羅曼，高盛。

Thank you and good afternoon, everybody. Maybe we can start on Ion. I think if you look in a variety of public forums, there's been a considerable amount of promotional activity, both in the US and Europe, as you've launched in new markets. Maybe you could help us think about where we are in the Ion launch and adoption curve in each of the target geographies and how we should think about growth in that segment on a go-forward basis? And then I have one P&L follow-up.

謝謝大家，大家下午好。也許我們可以從 Ion 開始。我認為，如果你查看各種公共論壇，你會發現，隨著你在新市場的推出，在美國和歐洲都有大量的促銷活動。也許您可以幫助我們思考我們在每個目標地區的 Ion 推出和採用曲線中所處的位置，以及我們應該如何考慮該細分市場的未來成長？然後我有一份損益表跟進。

Sure, I'll take that one. David, it's Gary. In the US, I think Ion is progressing well in its first indication, biopsy of suspicious lung nodules. We think it's crossed the chasm. It should be in double-digit prevalence in terms of total biopsy use.

當然，我會接受那個。大衛，我是加里。在美國，我認為 Ion 在其第一個適應症（可疑肺結節活檢）方面進展順利。我們認為它已經跨越了鴻溝。就總活檢使用而言，其盛行率應為兩位數。

So I think there, the focus is a little bit less now on the earliest customers. I think the early customers have done great. We're pretty deeply penetrated into those sites of care, and the focus there will be on high utilization, high customer satisfaction, some innovation, and pursuit of additional indications inside the lung using the Ion platform.

所以我認為，現在對最早的客戶的關注有點少了。我認為早期的客戶做得很好。我們已經相當深入地滲透到這些護理場所，重點將放在高利用率、高客戶滿意度、一些創新以及使用 Ion 平台追求肺部內的其他適應症。

We're much earlier in our journey outside of the United States. So early experiences so far in Europe first started in the UK. They're building some momentum off an early base and then early, early steps into Germany; likewise, early steps into China. So it's a little bit of a two-phased approach here in the US strong move toward high utilization, high satisfaction moving out of the first concentrated set of customers.

我們在美國以外的旅程中處於更早的階段。迄今為止，歐洲的早期經驗首先始於英國。他們正在透過早期基地建立一些勢頭，然後儘早進入德國；同樣，早期進入中國。因此，在美國，這有點像是兩階段的方法，從第一批集中的客戶群中朝向高利用率、高滿意度邁進。

And in OUS, it's really initiating the journey in different

在OUS，它確實以不同的方式開始了旅程

That's super helpful. And then maybe just a follow-up on the P&L. One of the things that was notable this quarter and has been the past couple is the increased percentage of systems being placed under usage agreements. I think it's gone from about 12% earlier this year to about 15% now.

這非常有幫助。然後也許只是損益表的後續行動。本季和過去幾季值得注意的事情之一是遵守使用協議的系統百分比增加。我認為這個比例已經從今年早些時候的 12% 左右上升到現在的 15% 左右。

Can you help us think about the trajectory of that contribution to the placement model and what that means for the P&L?

您能否幫助我們思考這種對配售模型的貢獻軌跡以及這對損益表意味著什麼？

Well, so those arrangements are a subset of operating leases. And obviously, those arrangements are where the customer pays for system and service as they use the system. Those arrangements with the customers have an expectation of what the procedures will be done per year that's reflected in the arrangement.

嗯，所以這些安排是經營租賃的子集。顯然，這些安排是客戶在使用系統時為系統和服務付費的地方。與客戶的這些安排預計每年將完成哪些程序，這反映在安排中。

And so then at target economics, you should think of it as similar to a regular offering, at least it's a fixed payment arrangement and operating leases in general are slightly accretive to purchase because of the embedded interest rate in there. Of course, the difference for the usage-based arrangement is then you have the risk of what is the actual usage by the customer in those uses-based arrangements.

因此，從目標經濟學角度來看，您應該將其視為與常規發行類似，至少它是一種固定付款安排，並且由於其中嵌入的利率，經營租賃總體上會稍微增加購買量。當然，基於使用的安排的差異在於您面臨客戶在這些基於使用的安排中實際使用情況的風險。

We have a distribution, as you would expect in terms of what the usage rates are and we engage with the customers regularly with respect to what their business plans are, particularly when they're not at the target.

我們有一個分佈，正如您所期望的使用率一樣，我們定期與客戶接觸，了解他們的業務計劃，特別是當他們沒有達到目標時。

In terms of trajectory, obviously, you've seen it grow. It is popular with customers. It is a way to both access additional capacity without having to consume capital budgets, and it does lower the risk for the customer in terms of taking a new system relative to how well that's going to be utilized.

就軌跡而言，顯然，你已經看到它的成長。它很受顧客歡迎。這是一種無需消耗資本預算即可獲得額外容量的方法，而且它確實降低了客戶在採用新系統方面相對於新系統的利用情況的風險。

We have provisions and protections in those arrangements for us and for the customer, and we look at those routinely. I would expect it to continue to grow, but it's relatively highly penetrated in the US. And so that the rate of growth will likely moderate. In the international markets, we're at a much earlier stage. So I think that's too early to call in terms of how that might grow.

我們在這些安排中為我們和客戶提供了規定和保護，我們會定期查看這些規定和保護。我預計它會繼續增長，但它在美國的滲透率相對較高。因此成長率可能會放緩。在國際市場上，我們還處於早期階段。因此，我認為現在判斷其成長方式還為時過早。

Rick Wise, Stifel.

瑞克懷斯，史蒂菲爾。

Gary, Dave everybody, we continue to have a lot of conversations with surgeons who are interested or potentially interested in da Vinci 5. And I'm not saying this is an accurate sample, but just it's our sample. I get to see some of the larger hospitals, the academic centers that they're more waiting, they're waiting for dual console availability.

蓋瑞、戴夫，大家，我們繼續與對達文西 5 感興趣或可能感興趣的外科醫生進行大量對話。我看到一些較大的醫院、學術中心，他們在等待，他們在等待雙控制台的可用性。

And they're saying to me, as our smaller hospitals that you're more focused right now on, I'll call it, mid- to smaller institutions, non-academic. They're making decisions faster.

他們對我說，作為我們現在更關注的小型醫院，我稱之為中小型機構，非學術機構。他們做出決定的速度更快。

They're less dependent on dual console. Is that right? Is that what's going on? And I wonder what -- a couple of things, whether procedure growth implications are affected positively or negative by that. And when dual console is more available middle of next year when you're full launch, I assume do we see an acceleration in sort of multisystem, bigger hospital decision making?

他們不太依賴雙控制台。是這樣嗎？是這樣的嗎？我想知道有幾件事，程式成長的影響是否會受到正面或負面的影響。當明年年中全面推出雙控制台時，我想我們是否會看到多系統、更大的醫院決策的加速？

Dave, I'll let you speak to just dual console availability and what's going on there, and then we can speak a little bit to what the trends are will answer the question.

戴夫，我會讓你談談雙控制台的可用性以及那裡發生的事情，然後我們可以談談趨勢是什麼，以回答這個問題。

Hey, Rick, and you said it. So in this as we're ramping our supply capabilities, dual console is being prioritized with incremental single system deals. And so as we build our capacity, we will start producing additional consoles for dual system placements.

嘿，瑞克，你也說過了。因此，在我們提高供應能力的同時，雙控制台將優先考慮增量單系統交易。因此，當我們建造產能時，我們將開始生產用於雙系統放置的額外控制台。

In terms of prioritization and whether being prioritized, I think our team is working with a broad set of customers and to understand what their needs are. And if da Vinci 5 is the right system to meet their needs for their program. And I don't have a lot of information about how that may differ between smaller customers as you put it or in academics or larger institutions.

在優先事項和是否優先事項方面，我認為我們的團隊正在與廣泛的客戶合作並了解他們的需求是什麼。如果 da Vinci 5 是滿足他們的程序需求的正確系統。我沒有太多關於小型客戶之間或學術界或大型機構中的差異的資訊。

I wouldn't anticipate a significant forecast model change one way or another. I think as we go to broad launch and the pipe opens up, we will seek to serve all those customers. I don't think it inflects procedure growth rate one way or another because of dual console and large versus small. I suspect that's a hard analysis to do. And if you do it, I suspect the differences will be relatively small relative to what we expect.

我預計預測模型不會以某種方式發生重大變化。我認為，當我們廣泛推出並開放管道時，我們將尋求為所有這些客戶提供服務。我不認為它會以某種方式影響程式成長率，因為雙控制台和大與小。我懷疑這是一個很難做的分析。如果你這樣做，我懷疑相對於我們的預期，差異會相對較小。

Got it, sir. And a quick follow-up, if I could, on Hub. I think it was exciting to hear our in over 2,000 ORs, just help us think through the early experience there and maybe the implications for both da Vinci 5 and again, procedures. Thank you.

明白了，先生。如果可以的話，請在 Hub 上進行快速跟進。我認為聽到我們在 2,000 多個手術室中聽到我們的聲音是令人興奮的，這只是幫助我們思考那裡的早期經驗，以及可能對達文西 5 和程序的影響。謝謝。

Yes. So Hub as it exists today, and that includes our generation four compatibility, as well as those that are linked to Gen 5. What does it do? It's a strong data recorder and media management device A lot of those early installs are on-premise implementations versus the cloud. Customers enjoy for their ability to track their data and to assess post-op performance, which has been great.

是的。因此，現在的集線器包括我們的第四代相容性，以及與第五代相關的兼容性。它是一個強大的資料記錄器和媒體管理設備，許多早期安裝都是本地部署，而不是雲端部署。客戶喜歡他們追蹤數據和評估術後表現的能力，這非常棒。

Over time, as we move forward and move toward cloud implementations and other things, I think that it provides them a lot of leverage. There's a lot that we like about it. I think the core capability is really good. There are some things we want to work on.

隨著時間的推移，隨著我們向前邁進並轉向雲端實施和其他事情，我認為這為他們提供了巨大的優勢。我們喜歡它的地方有很多。我覺得核心能力真的很好。我們想要做一些事情。

I think refinement, workflow, making those things really easy integration in dV5 is going to be great. We're really excited about it. I think it matters.

我認為細化、工作流程、使這些東西真正輕鬆地整合到 dV5 中將會很棒。我們對此感到非常興奮。我認為這很重要。

So far, so good. I think we're at the beginning of the Hub journey, both in terms of penetration and in terms of future content not the end of it. And I'm proud of the progress the team is making.

到目前為止，一切都很好。我認為我們正處於 Hub 旅程的開始，無論是在滲透率還是未來內容方面，而不是結束。我為團隊所取得的進步感到自豪。

Adam Maeder, Piper Sandler.

亞當梅德，派珀桑德勒。

Hi, good afternoon. Congrats on the quarter and thank you for taking the questions. I wanted to ask for some additional color around the capital environment and how you're thinking about hospital budgets and appetite for larger piece of the capital heading into the end of the year in 2025?

嗨，下午好。恭喜本季度，感謝您提出問題。我想詢問有關首都環境的一些額外信息，以及您如何看待 2025 年年底的醫院預算和對更大一部分首都的需求？

And I heard the commentary around Europe and China, it sounds like there's continued pressure there. Just curious, is that kind of status quo versus the first half of the year? Is it getting worse? And kind of how do you expect that to evolve going forward? And then I have a follow-up. Thanks.

我聽到了歐洲和中國各地的評論，聽起來那裡的壓力持續存在。只是好奇，這種現狀與上半年相比是這樣嗎？情況變得更糟了嗎？您預計未來會如何發展？然後我有一個後續行動。謝謝。

Thanks. Jamie, why don't you take the broad answer, and then I'll touch on China at the end.

謝謝。傑米，你為什麼不接受廣泛的答案，然後我最後會談到中國。

Yes. I think I'd characterize US is relatively stable, albeit with a lot of interest in da Vinci 5. I think that's kind of raised the profile again in interest in robotics to some extent. But I'd characterize the overall capital environment is relatively stable.

是的。我認為我認為美國相對穩定，儘管對達文西 5 很感興趣。但我認為整體資本環境是相對穩定的。

In Europe, what you're seeing particularly in countries like the UK and Germany is pressure on capital spending in the health care space, again, related to government budget pressures that exist there.

在歐洲，尤其是在英國和德國等國家，您會看到醫療保健領域的資本支出面臨壓力，這又與那裡存在的政府預算壓力有關。

And I think that's been similar for the last quarter or so. In the case of Europe, we have some government-related events that come in the next couple of quarters, but too early to predict how that might play out in terms of the changes in the capital dynamics.

我認為上個季度左右的情況也類似。就歐洲而言，我們將在未來幾季發生一些與政府相關的事件，但就資本動態的變化而言，預測這些事件可能會如何發生還為時過早。

Yeah. Just turning to China. There's clearly broad stress across the health care market in total in China, there's kind of a rebaselining there in some of the value-based pricing that has gone through as well as some of the price caps that have gone through in our end of the market.

是的。剛剛轉向中國。中國的醫療保健市場總體上顯然面臨著廣泛的壓力，一些基於價值的定價以及我們市場端的一些價格上限都在重新調整基準。

So I think that pressure is still there. I think it will be there for some quarters. I don't think that resolves quickly.

所以我認為壓力仍然存在。我認為它會存在幾個季度。我認為這不會很快解決。

There's also, in our universe, the entry of some domestic competitors that tend to get provincial preferences, the province in which they're headquartered tends to have a preference for them as they launch. And so you see that kind of show up as popcorn as it goes around. I think that will persist for a little while, too. So for us, I think it's not a surprise given the year we've had.

在我們的宇宙中，還有一些國內競爭對手的進入往往會獲得省級優惠，他們總部所在的省份往往會在他們推出時優先考慮他們。所以你會看到這種東西在傳播時就像爆米花一樣。我認為這種情況也會持續一段時間。所以對我們來說，考慮到我們這一年的表現，我認為這並不奇怪。

I think, ultimately, these things will wash through how long it takes for it to walk through and stabilizes as yet on them.

我認為，最終，這些東西會經歷它需要多長時間才能穿過並穩定下來。

Brandon Vazquez, William Blair.

布蘭登·巴斯克斯，威廉·布萊爾。

Thanks for taking the question. You have a good amount of da Vinci 5 systems out there. I was just curious if you could compare and contrast. Are there any kind of unique insights that you have in that da Vinci 5 installed base, whether it's what types of procedures they're doing or utilization within those accounts are those systems relative to the rest of the Xi base?

感謝您提出問題。市面上有大量的 da Vinci 5 系統。我只是好奇你是否可以進行比較和對比。您對 da Vinci 5 安裝基礎是否有任何獨特的見解，無論是他們正在執行哪些類型的程序，或者這些系統相對於 Xi 基礎的其他系統在這些帳戶中的使用情況？

And then maybe just one quick follow-up, I'll throw here now. Can you talk a little bit -- it sounds like innovation on a go-forward basis is really going to be coming a lot from software. Can you kind of compare and contrast the innovation cycle the speed at which you can launch new features on the software side versus what has historically been, I would guess, a little bit of a longer cycle in hardware? Thank you.

然後也許只是一個快速的後續行動，我現在就放在這裡。您能談談嗎？您能否比較和對比創新週期（即在軟體方面推出新功能的速度）與歷史上（我猜）硬體方面較長的周期？謝謝。

Yeah. So I may try to hit both of those -- on the da Vinci 5 side and the comparison to Xi, one of the things that we're pleased with is it is being used across a broad set of procedures. And so customers with the limited supply are really using them to their fullest.

是的。因此，我可能會嘗試同時解決這兩個問題 - 在 da Vinci 5 方面以及與 Xi 的比較方面，我們感到滿意的事情之一是它正在廣泛的程序中使用。因此，供應有限的客戶確實充分利用了它們。

With respect to how do you compare da Vinci 5 utilization to Xi, it's really too soon to say. The installed base isn't big enough with a long enough history yet to give us a good data set to make those comparisons.

至於如何將 da Vinci 5 的利用率與 Xi 進行比較，現在說還為時過早。安裝基數還不夠大，歷史也不夠長，還不足以為我們提供良好的資料集來進行這些比較。

On the software side, there's kind of two buckets that we operate in there are sets of software and products that are nonmedical device. And those are able to have more rapid cycles of innovation and our ability to roll it out to the field. And then there is a second set that our 510(k) or governed by regulatory processes around the globe. And those will generally follow a longer cadence, probably still a bit quicker than you would see in major hardware changes and things like that.

在軟體方面，我們經營的軟體和產品有兩個類別，即非醫療設備。這些能夠擁有更快的創新週期以及我們將其推廣到該領域的能力。第二組是我們的 510(k) 或受全球監管流程管轄的。這些通常會遵循更長的節奏，可能仍然比您在重大硬體變化和類似事情中看到的要快一些。

And so on the average, likely we'll see software upgrades and updates happen on a more -- on a higher cadence, but it kind of depends on which bucket they fall into.

因此，平均而言，我們可能會看到軟體升級和更新的頻率更高，但這取決於它們屬於哪個類別。

I might challenge the assumption a little bit. I think there's still some hardware we want to do. I don't think hardware is going away. I think that's going to continue and dV5 has some opportunities for that, too. and we'll do the software that you just described.

我可能會稍微挑戰一下這個假設。我認為我們仍然想做一些硬體。我不認為硬體會消失。我認為這種情況將會持續下去，dV5 也有一些機會。我們將製作您剛才所描述的軟體。

I think it's great, but we get a chance to do both. Operator, we'll take one more questioner, and then we'll close.

我認為這很棒，但我們有機會兩者兼得。接線員，我們將再接受一位提問者，然後我們就結束了。

Matt Miksic, Barclays.

馬特·米克西奇，巴克萊銀行。

Matt Miksic, squeezing in. Hey. Maybe just a big picture kind of a follow-on question. I get some version of this question often from investors, talking about growth drivers, opportunities in procedure growth.

馬特·米克西奇（Matt Miksic），擠了進來。也許只是一個後續問題的大局。我經常從投資者那裡得到這個問題的一些版本，談論成長動力、流程成長的機會。

And so maybe if you're looking at the US market and the rate that you're growing now, obviously, where penetration is and where it could go over time, do you expect maybe in the next couple of years or three years to be driven more by driving deeper into existing procedures and categories? Or do you see any sort of new large segments, important segments that you expect to help drive that growth would you say the mix looks like or any color you'd be able to add would be super helpful? Thanks.

因此，如果您關注美國市場以及您現在的成長速度，顯然，滲透率以及隨著時間的推移可能會走向何方，您是否預計在未來幾年或三年內透過更深入地了解現有程序和類別來推動更多？或者您看到任何類型的新的大型細分市場、您希望有助於推動成長的重要細分市場，您認為這種組合看起來像什麼，或者您能夠添加的任何顏色都會非常有幫助？謝謝。

Yeah. Thank you, Matt. It's a great question. I look at. I think in the US, we're -- I won't give you the exact split, but I think it's a balanced perspective. Clearly, we have approaching the back half of some curves and some procedures where it's really about depth. What do the folks who have not yet participated or are participating fully, what do they need from us to keep going and to serve the patients that way.

是的。謝謝你，馬特。這是一個很好的問題。我看著。我認為在美國，我們——我不會給你確切的劃分，但我認為這是一個平衡的觀點。顯然，我們已經接近了一些曲線的後半部分和一些真正與深度有關的程序。那些尚未參與或正在充分參與的人們需要做什麼，他們需要我們提供什麼來繼續前進並以這種方式為患者服務。

There's still opportunity there. In some ways, there's plenty of opportunity. At the same time, as you start getting to the back half, you want to make sure you're looking for, we want to make sure we're looking for new opportunities and opportunities to serve a different set of patients that we haven't engaged before, and you're starting to see us do that, whether it's in new indications for Ion or SP.

那裡仍然有機會。從某些方面來說，有很多機會。同時，當你開始進入後半部分時，你要確保你正在尋找，我們要確保我們正在尋找新的機會和機會來為我們沒有的不同患者群體提供服務。看到我們這樣做，無論是在Ion 還是SP 的新適應症。

And we think actually in multiport, there's some opportunity and new indication also, although they'll tend to be more niche markets than really big ones. Over time, over the coming quarters, we'll tell you more about that as those opportunities mature.

我們認為，實際上在多端口領域，也存在一些機會和新的跡象，儘管它們往往是利基市場，而不是真正的大市場。隨著時間的推移，在接下來的幾個季度，隨著這些機會的成熟，我們將告訴您更多相關資訊。

So thank you, that was our last question. In closing, we believe there's a substantial and durable opportunity to fundamentally improve surgery and acute intervention. Our teams continue to work closely with hospitals, physicians and care teams in pursuit of what our customers have termed the quintupling, better, more predictable patient outcomes, better experiences for patients, better experiences for their care teams that are access to great care, and ultimately, a lower total cost of care.

謝謝，這是我們的最後一個問題。最後，我們相信有一個實質和持久的機會從根本上改善手術和急性幹預。我們的團隊繼續與醫院、醫生和護理團隊密切合作，以追求客戶所說的五倍更好、更可預測的患者治療結果、更好的患者體驗、為獲得優質護理的護理團隊提供更好的體驗，以及最終，降低總護理成本。

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. At Intuitive, we envision a future of care that is less invasive and profoundly better where diseases are identified earlier and treated quickly so patients can get back to what matters most.

我們相信手術和急診護理中的價值創造本質上是人的。它源自於對病人和照護團隊、他們的需求和環境的尊重和理解。在 Intuitive，我們設想了一個侵入性更小、效果更好的未來護理，可以更早發現疾病并快速治療，以便患者能夠回到最重要的事情上。

Thank you, again, for your support on this extraordinary journey. We look forward to talking with you again in three months.

再次感謝您對這非凡旅程的支持。我們期待三個月後再次與您交談。

And ladies and gentlemen, that does conclude your conference. We do thank you for joining. You may now disconnect.

女士們、先生們，你們的會議到此結束。我們非常感謝您的加入。您現在可以斷開連線。