直覺手術 (ISRG) 2025 Q1 法說會逐字稿

Thank you for standing by, and welcome to the Intuitive Surgical, Inc.'s first quarter 2025 earnings release. (Operator Instructions) As a reminder, today's program is being recorded.

感謝您的支持，歡迎閱讀 Intuitive Surgical, Inc. 2025 年第一季財報。（操作員指示）提醒一下，今天的節目正在錄製。

And now I'd like to introduce your host for today's program, Dan Connally, Head of Investor Relations at Intuitive Surgical. Please go ahead, sir.

現在，我想介紹今天節目的主持人，Intuitive Surgical 投資者關係主管 Dan Connally。先生，請繼續。

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

下午好，歡迎參加 Intuitive 第一季財報電話會議。今天和我一起的還有我們的執行長 Gary Guthart；我們的總裁 Dave Rosa，我們的財務長 Jamie Samath。

Before we begin, I would like to inform you that comments made 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 January 31, 2025 and Form 10-Q filed on October 18, 2024. 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.

在我們開始之前，我想通知您，今天電話會議上發表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提交給美國證券交易委員會的文件中進行了詳細描述，包括我們於 2025 年 1 月 31 日提交的最新 10-K 表和於 2024 年 10 月 18 日提交的 10-Q 表。您可以透過我們的網站或美國證券交易委員會 (SEC) 網站查閱我們的 SEC 文件。提醒投資者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. 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.

請注意，您可以在我們網站 intuitive.com 的「投資者關係」頁面下的「活動」部分中收聽本次電話會議的音訊重播。今天的新聞稿和補充財務數據表已發佈到我們的網站。今天的會議形式將包括向您介紹我們今天早些時候發布的新聞稿中所述的第一季業績重點，然後進行問答環節。

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 discuss our updated financial outlook for 2025. And finally, we will host a question-and-answer session.

加里將介紹此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。傑米將回顧我們的財務業績和程序亮點。然後我將討論我們對 2025 年的最新財務展望。最後，我們將舉辦問答環節。

With that, I will turn the call over to Gary.

說完這些，我將把電話轉給加里。

Thank you for joining us on the call today. Our business performed well in the first quarter of the year with physicians using our products at the high end of our expectations, driven by strong procedure growth in core general surgery in the United States, and strong procedures outside the United States, new system placements in the solid with particular strength in the US with performance of each of our platforms with continued adoption of DV5 in solid results in ION and acceleration in procedures using our single port platform. Given the dynamic changes in trade policy, I'd like to describe our principles for navigating the current environment, rather than detailing any particular scenario.

感謝您今天參加我們的電話會議。我們的業務在第一季表現良好，醫生使用我們產品的情況超出了我們的預期，這得益於美國核心普通外科手術的強勁增長以及美國以外手術的強勁增長，實體領域的新系統部署尤其在美國具有優勢，我們每個平台的性能隨著 DV5 在實體領域的持續採用導致 ION 和使用我們的單端口平台的手術加速。鑑於貿易政策的動態變化，我想描述我們應對當前環境的原則，而不是詳細說明任何特定的情境。

Our first priority is to ensure supply of our products to our customers globally. We have spent years becoming a trusted provider of great products and services. First commitment is to maintaining the status for those who depend upon us. We believe that high-quality minimally invasive care at industrial scale will remain a global need regardless of trade policy and our long-term opportunity remains robust.

我們的首要任務是確保向全球客戶供應我們的產品。我們花了數年時間才成為值得信賴的優質產品和服務提供者。首要的承諾是維護那些依賴我們的人的地位。我們相信，無論貿易政策如何，工業規模的高品質微創治療仍將是全球需求，我們的長期機會仍然強勁。

We will continue to manage the business for the long term and invest towards improvement in the Quintile lane. Given potential changes in our costs and our customers' costs across their enterprise, we do not plan reflexive changes to our pricing in the dynamic near-term environment.

我們將繼續長期管理該業務，並投資改善 Quintile 車道。考慮到我們的成本以及我們客戶整個企業的成本可能會發生變化，我們不打算在動態的短期環境中對我們的定價進行反射性改變。

Our second priority will be to optimize our production costs and rebalance product flows within our existing manufacturing and supply chain footprint as policies begin to stabilize. Finally, we will adjust our supply chain strategy and assess adjustments to our pricing when we see the signs of a durable planning environment for trade.

隨著政策開始穩定，我們的第二要務是優化生產成本，並在現有製造和供應鏈範圍內重新平衡產品流。最後，當我們看到貿易規劃環境持久的跡象時，我們將調整我們的供應鏈策略並評估對我們的定價的調整。

I'll now turn the call over to Dave to take you through our product, services and operating highlights. Dave?

現在我將把電話轉給戴夫，讓他向您介紹我們的產品、服務和營運亮點。戴夫？

Thank you, Gary. Intuitive Surgical was founded in 1995. In this, our 30th year of operations, our global da Vinci installed base in Q1 2025 exceeded 10,000 systems and over 50,000 surgeons across 70 countries perform procedures in the quarter. Thank you to our customers, our employees, and all our stakeholders for your ongoing collaboration and commitment as we continue to advance minimally.

謝謝你，加里。直覺外科成立於 1995 年。這是我們營運的第 30 年，2025 年第一季我們的全球達文西安裝基數超過 10,000 套系統，本季有來自 70 個國家的 50,000 多名外科醫生執行了手術。感謝我們的客戶、員工和所有利害關係人在我們不斷進步的過程中給予的持續合作和承諾。

Starting with procedures, da Vinci procedure growth in the quarter was 17%. Areas of strength included general surgery in the US and regional performance in India, Korea distribution markets in the UK. In the US, after hours procedure growth accelerated to 36% year-over-year. Jamie will describe procedure dynamics later in the call.

從程序開始，本季達文西程式成長率為 17%。優勢領域包括美國的普通外科手術以及印度、韓國和英國分銷市場的地區表現。在美國，下班後業務成長速度年增 36%。傑米將在稍後的通話中描述程序動態。

Turning to capital. We placed 367 da Vinci systems in the quarter, including 147 da Vinci 5 systems and 19 SP systems. We also installed 49 ION systems in the quarter. Capital placements were strong in the US with mixed performance outside of the US, reflecting stresses in Germany, the UK and Japan. System utilization defined as procedures per installed clinical system per quarter, grew 2% year-over-year for our multiport platforms, 26% for SP and 5% for ION.

轉向資本。本季我們安裝了 367 套達文西系統，其中包括 147 套達文西 5 系統和 19 套 SP 系統。本季我們也安裝了 49 個 ION 系統。美國的資本配置強勁，而美國以外地區的表現則參差不齊，反映出德國、英國和日本的壓力。系統利用率定義為每季每個已安裝臨床系統的程式數，我們的多埠平台年增 2%，SP 成長 26%，ION 成長 5%。

Solid procedure growth and capital performance supported strong revenue growth of 19% in the quarter. Product margins were within our expectations, reflecting increased depreciation from new facilities and a higher mix of newer platforms. Operating expenses were within our expectations. Jamie will take you through our finances in greater detail later in the call.

穩健的流程成長和資本表現支撐了本季 19% 的強勁收入成長。產品利潤率符合我們的預期，反映了新設施折舊增加和新平台組合增加。營運費用符合我們的預期。傑米將在稍後的通話中向您更詳細地介紹我們的財務狀況。

In Q1, our rollout of da Vinci 5 progressed within our expectations with 147 systems placed and over 32,000 procedures performed across a broad set of specialties. We installed our first fully integrated system this month, which now feature to enable the integrated hub and simulator along with a host of other enhancements. Several additional features, including real-time surgical video review, real-time 3D model review and visual force feedback ages will be enabled upon 510(k) clearance later this year.

在第一季度，我們推出的 da Vinci 5 進展順利，已安裝 147 個系統，並在廣泛的專業領域執行了超過 32,000 個程序。我們本月安裝了第一個完全整合的系統，該系統現在具有整合集線器和模擬器以及許多其他增強功能的功能。今年晚些時候，通過 510(k) 批准後，將啟用一些附加功能，包括即時手術視訊回顧、即時 3D 模型回顧和視覺力回饋技術。

We continue to ramp our manufacturing operations and supply chain capabilities to support broad launch of da Vinci 5 midyear. Broad launch means that incorporate the latest fully integrated hardware and software and we're able to meet customer demand, including trade-ins and dual consoles. As we've discussed previously, we remain in the regulatory losses in Japan and expect clearance in Europe near the end of 2025.

我們將繼續提升我們的製造營運和供應鏈能力，以支援達文西 5 在年中廣泛推出。廣泛推出意味著結合最新的完全整合的硬體和軟體，我們能夠滿足客戶的需求，包括以舊換新和雙控制台。正如我們之前所討論的，我們在日本仍處於監管損失之中，預計歐洲將在 2025 年底前獲得批准。

Force Feedback is one of the core features of da Vinci 5. We are starting to see early single institution studies evaluating the impact of force feedback on clinical outcomes and in an abstract presented at the North American Robotic Urology Symposium, a team led Dr. Michael Steifelman, Chair of Urology at Hackensack University Medical Center, studied return of bowel function in a small cohort of patients. Return of bowel function in less than 24 hours is an important metric for certain operations. Of the 28 patients included, 16 patients underwent transparent neo partial nephrectomy or radical nephrectomy where force feedback technology was used paired with 12 patients undergoing the same procedure with standard da Vinci Xi instruments.

力回饋是 da Vinci 5 的核心功能之一。我們開始看到早期的單一機構研究評估力回饋對臨床結果的影響，在北美機器人泌尿外科研討會上發表的一份摘要中，由哈肯薩克大學醫學中心泌尿外科主任邁克爾·斯泰費爾曼博士領導的團隊研究了一小部分患者的腸道功能恢復情況。對於某些手術來說，24 小時內恢復腸道功能是一項重要指標。在納入的 28 名患者中，16 名患者接受了透明新部分腎切除術或根治性腎切除術，其中使用了力回饋技術，另外 12 名患者接受了使用標準達文西 Xi 儀器的相同手術。

The authors reported a significantly higher rate of recovery of bowel function within 24 hours with 83% of the force feedback cohort compared to 25% in the non-force feedback cohort. The authors concluded that force feedback instruments and robotic-assisted kidney surgery are associated with faster bowel function recovery, suggesting potential reductions in colonic trauma. As robotic-assisted surgery advances, integrating force feedback into retained practice could enhance precision and improved recovery across disciplines.

作者報告稱，力回饋組在 24 小時內腸道功能恢復率明顯高於非力回饋組，前者為 83%，後者為 25%。作者得出結論，力回饋儀器和機器人輔助腎臟手術與更快的腸道功能恢復有關，這表明​​結腸創傷的潛在減少。隨著機器人輔助手術的進步，將力回饋整合到保留實踐中可以提高精確度並改善跨學科的恢復。

Regarding time to proficiency, a second study led by a team, including Dr. Andrew Hung, Associate Professor of Urology and Computational Biomedicine at Sinai Medical Center in Los Angeles, evaluated the impact of force feedback technology on the suturing performance of 29 novice surgeon in a randomized preclinical study. The study showed that force feedback technology has the potential to improve novice surgeon performance by significantly reducing tissue trauma and errors during suturing and time to complete suturing.

關於熟練時間，由洛杉磯西奈醫學中心泌尿外科和計算生物醫學副教授 Andrew Hung 博士領導的團隊進行了第二項研究，在一項隨機臨床前研究中評估了力回饋技術對 29 名新手外科醫生縫合表現的影響。研究表明，力回饋技術有可能透過顯著減少縫合過程中的組織創傷和錯誤以及完成縫合的時間來提高新手外科醫生的表現。

These results are consistent with the value hypothesis of force feedback technology, and we expect more of these types of studies to publish in 2025 and beyond. Force feedback instruments are in limited supply, and we expect broad availability at the end of 2025.

這些結果與力回饋技術的價值假設一致，我們預計2025年及以後會有更多此類研究發表。力回饋儀器的供應有限，我們預計到 2025 年底將廣泛普及。

Use of case insight with da Vinci 5 is growing nicely, with case insights delivered on over 22,000 procedures to date. These data sets include video, kinematic energy and force data and are delivered in the context of surgical procedure steps, enabling surgeons to easily navigate the procedure video and identify meaningful operational and clinical insights. These insights will form the basis of key performance indicators and help of novice and expert surgeons identify objective measures that underpin surgical performance. As we said before, the long-term opportunity for computational tools is both significant and difficult. Validations at scale will take time and are worthy pursuit.

達文西 5 對案例洞察的使用正在順利發展，迄今為止已在超過 22,000 個程式中提供了案例洞察。這些數據集包括影片、運動能和力數據，並在手術過程步驟的背景下傳遞，使外科醫生能夠輕鬆瀏覽手術影片並識別有意義的操作和臨床見解。這些見解將構成關鍵績效指標的基礎，並幫助新手和專家外科醫生確定支撐手術表現的客觀指標。正如我們之前所說，計算工具的長期機會既重大又困難。大規模驗證需要時間並且值得追求。

Moving to ION. Procedures grew 58% to approximately 31,000 in the quarter. In April, we received our Ion platform in Australia. And in China, we received our first provincial charge code. In this early phase of launch in China, we are focused on the collection of clinical data to support our broader commercialization strategy. Our priorities for ION in the near term are supporting utilization growth in the US, expansion in the international markets and improving product costs.

移至 ION。本季手術量增加了 58%，達到約 31,000 例。四月份，我們在澳洲收到了我們的 Ion 平台。在中國，我們收到了第一個省級收費代碼。在中國推出該產品的早期階段，我們專注於收集臨床數據，以支持我們更廣泛的商業化策略。我們對 ION 的近期重點是支持美國的利用率成長、國際市場的擴張和改善產品成本。

Turning to SP. Procedure growth accelerated in the quarter to 94%, with solid growth in the US and OUS procedures more than doubling compared to the year ago period, driven by Korea, Japan and early adoption in Europe. In the quarter, we received US 510(k) clearance for da Vinci SP SureForm 45 stapler, which will support the use of SP in thoratic in colorectal indications. Our commercialization efforts in these indications will be measured as we look to establish first access sites and develop key opinion leaders in the coming quarters.

轉向 SP。本季度，手術量成長加速至 94%，其中，美國和其他國家手術量穩健成長，與去年同期相比成長了一倍多，這主要得益於韓國、日本和歐洲的早期採用。本季度，我們獲得了 da Vinci SP SureForm 45 縫合器的美國 510(k) 許可，這將支援 SP 在胸腔和結直腸手術中的使用。我們將在未來幾季建立首個訪問站點並培養關鍵意見領袖，以此衡量我們在這些適應症方面的商業化努力。

In closing, we admitted to our 2025 priorities. First, focusing on the full launch of da Vinci 5, its regional clearances and follow-on feature releases. Second, we'll pursue increased adoption for our focused procedures by country through training, commercial activities and market access efforts. Third, we'll drive continued progress in building industrial scale, product quality and manufacturing optimization. And finally, we'll focus on excellence and availability of our digital tools. While periods of rapid change can create inefficiencies, as we have debt to a dynamic environment, we are well positioned to operate and financially to execute against our priorities.

最後，我們承認了我們的 2025 年優先事項。首先，重點關注達文西5的全面上市、區域通關以及後續功能的發布。其次，我們將透過培訓、商業活動和市場准入努力，推動各國更多地採用我們的重點程序。三是推動產業規模化、產品品質化、生產優化化持續推進。最後，我們將注重數位工具的卓越性和可用性。雖然快速變化的時期可能會造成效率低下，但由於我們受制於動態環境，因此我們已做好充分的準備來運作並在財務上執行我們的優先事項。

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

現在我將時間交給 Jamie，他將向您詳細介紹我們的財務狀況和重點內容。

Good afternoon. I will describe the highlights of our performance on a 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. Given that the current global trade environment is relatively dynamic before we dive into Q1 results, let me address tariffs. To provide some context, the footprint of our manufacturing operations is as follows: In 2024, Intuitive manufactured 98% of our robotic systems in the United States, 70% of our endoscopes in Europe and approximately 80% of our instruments and accessories in Mexico.

午安.我將根據 GAAP 或備考基礎描述我們業績的亮點，並將在稍後的準備好的發言中總結我們的 GAAP 業績。我們的考試結果與 GAAP 結果之間的對帳已發佈在我們的網站上。鑑於當前的全球貿易環境相對活躍，在我們深入了解第一季業績之前，讓我先來談談關稅問題。為了提供一些背景信息，我們的製造業務足跡如下：2024 年，Intuitive 在美國製造了 98% 的機器人系統，在歐洲製造了 70% 的內視鏡，在墨西哥製造了約 80% 的儀器和配件。

We source raw materials and other components that go into these finished products from suppliers around the world. The net result of our manufacturing footprint and global customer demand is that Intuitive is both a significant US manufacturer and has become a significant net US exporter.

我們從世界各地的供應商採購這些成品所需的原料和其他零件。我們的製造足跡和全球客戶需求的最終結果是，Intuitive 既是美國重要的製造商，也已成為美國重要的淨出口商。

In terms of the impact of tariffs to Intuitive, broadly, in order of magnitude, I would characterize tariffs into the following three buckets. First, those tariffs relating to US-China trade we import into China subassemblies for domestic Xi production and completely finished excise, both of which were expected to incur Chinese tariffs of 125%. We also import components from Chinese-based suppliers into the US to be incorporated into the manufacture of our products, which incur US tariffs of 145%. In addition, our China JV manufactures certain products for our Ion platform that are subject to US tariffs when imported for US procedure demand.

就關稅對 Intuitive 的影響而言，大致上，依照數量級，我將關稅分為以下三個類別。首先，與中美貿易有關的關稅包括我們進口到中國用於國內生產的零件和成品消費稅，預計這兩項都將徵收 125% 的中國關稅。我們也從中國供應商進口零件到美國，用於生產我們的產品，這需要繳納 145% 的美國關稅。此外，我們的中國合資企業為我們的 Ion 平台生產某些產品，當根據美國程序需求進口時，這些產品需繳納美國關稅。

Second, imports into the US of procured components from US-based suppliers and imports of endoscopes from our factories in Europe are subject to the 10% baseline tariffs and then increased tariff rates after the current 90-day pause period has elapsed. Third, while most of our products manufactured in Mexico are certified under the requirements of USMCA, and therefore, are not subject to current US input tariffs. A small portion do not currently meet the requirements and therefore, incur 25% tariffs upon import to the US.

其次，從美國供應商採購的零件進口到美國，以及從我們位於歐洲的工廠進口的內視鏡，均需繳納 10% 的基準關稅，在目前的 90 天暫停期過後，關稅稅率將提高。第三，雖然我們在墨西哥生產的大多數產品都根據 USMCA 的要求進行了認證，因此不受當前美國投入關稅的約束。一小部分目前不符合要求，因此在進口到美國時需繳納25%的關稅。

Based on the impacts just described, reflecting those tariffs that have been implemented and those that have been announced with both the stated percentage and implementation date and assuming such tariffs remain in place. We currently expect the impact to our income statement for 2025 to be additional cost of approximately 1.7% of revenue, plus or minus 30 basis points.

根據剛才所描述的影響，反映已實施的關稅和已宣布的關稅，包括規定的百分比和實施日期，並假設這些關稅保持不變。我們目前預計，這對我們 2025 年損益表的影響將是額外成本約佔收入的 1.7%，上下浮動 30 個基點。

The impact of tariffs will vary with the volume of capital sales in China, the mix of procured components from OUS suppliers and the proportion of products manicured in Mexico that are certified under USMCA. Given that tariff costs are capitalized into inventory and then recognizing cost of sales as products are sold, we would expect the impact of tariffs to increase each quarter over the remainder of the year.

關稅的影響將隨著中國資本銷售量、從美國供應商採購的零件組合以及根據 USMCA 認證的墨西哥產品的比例而變化。鑑於關稅成本被資本化到庫存中，然後在產品銷售時確認銷售成本，我們預計關稅的影響將在今年剩餘時間內每季增加。

As a result, we are updating our estimate for pro forma gross margin to be within a range of 65% and 66.5% of revenue. This range does not reflect any potential additional tariffs or any potential inflationary impact on labor cost or the cost of procured components. To the extent that tariffs and their derivative impact has a durable impact on our store sales and/or demand for our products, we will consider implementation over time of a range of mitigating operational actions. However, we do not expect any such measures to have a significant beneficial impact in 2025.

因此，我們將預測毛利率預測更新為營收的 65% 至 66.5% 之間。此範圍並未反映任何潛在的附加關稅或對勞動力成本或購買零件成本的任何潛在通膨影響。如果關稅及其衍生影響對我們商店的銷售和/或產品需求產生持久影響，我們將考慮逐步實施一系列緩解措施。然而，我們預計任何此類措施都不會在 2025 年產生重大的有益影響。

Turning to Q1. Core metrics were strong. Da Vinci procedures grew 17%, the installed base of da Vinci Systems grew 15% and average system utilization grew 2%. Procedure growth in Q1 was adversely impacted by a lower number of business days compared to the year ago period. On a day-adjusted basis, Q1 procedure growth was 18.5%. US procedures grew 13%, driven by growth in behind general surgery with relative strength in cholecystectomy, forgot and appendectomy procedures.

轉向 Q1。核心指標強勁。達文西程式成長了 17%，達文西系統的安裝基數成長了 15%，平均係統利用率成長了 2%。與去年同期相比，第一季的流程成長受到工作日數量減少的不利影響。以日調整後計算，第一季的程式成長率為 18.5%。美國外科手術數量增加了 13%，這得益於普通外科手術的成長，而膽囊切除術、胃切除術和闌尾切除術的手術相對強勁。

System with recent trends, bariatric procedures in the US declined in the mid-single-digit range. OUS procedures grew 24%, driven by strength in India, Korea, distributor markets and the UK. Procedure growth in improved sequentially. Some portion of that higher growth may be a catch-up in procedures from prior periods as a result of the ongoing precision strike.

根據最近的趨勢，美國的減肥手術數量下降到了中等個位數範圍。受印度、韓國、分銷商市場和英國的強勁推動，OUS 業務成長了 24%。程序增長連續改善。由於正在進行的精確打擊，這種較高增長的一部分可能是對前期程序的追趕。

Procedure growth in China improved from the prior quarter and was a little above the global average driven primarily by urologic procedures. Looking at OUS performance in we see strong procedure growth in colorectal, hysterectomy, benign general surgery and thoracic categories. Reviewing capital performance, we placed 367 systems in the first quarter, 17% higher than the 313 systems we placed in the same period last year.

中國的手術成長較上一季有所改善，略高於全球平均水平，這主要得益於泌尿外科手術的成長。從 OUS 的表現來看，我們發現結直腸手術、子宮切除術、良性普通手術和胸腔外科手術數量強勁增長。回顧資本表現，我們在第一季安裝了 367 個系統，比去年同期安裝的 313 個系統高出 17%。

First quarter placements included 147 da Vinci 5 systems, taking the total install base to 509 systems. There were 67 trading transactions in Q1 compared to 29 trade-ins last year, driven by some US customers upgrading to da Vinci 5. It is important to note that we expect trade-ins to occur progressively over multiples of years as we build da Vinci 5 evidence and customers evaluate associated returns on such investments. In the US, we placed 204 systems in Q1 and up from 148 systems last year, reflecting positive customer response to da Vinci 5.

第一季安裝了 147 個達文西 5 系統，總安裝量達到 509 個系統。第一季有 67 筆以舊換新交易，而去年同期有 29 筆，這主要是由於一些美國客戶升級到 da Vinci 5。值得注意的是，隨著我們累積達文西 5 證據並且客戶評估此類投資的相關回報，我們預計以舊換新將在數年內逐步發生。在美國，我們在第一季安裝了 204 套系統，高於去年的 148 套，這反映了客戶對 da Vinci 5 的正面反應。

Outside the US, we placed 163 systems in the first quarter down from 165 systems placed in quarter one of last year. In the first quarter of this year, we placed 88 systems in Europe, 16 in China and 10 in Japan compared with 84 in Europe, 10 in China and 20 in Japan in Q1 of last year.

在美國以外，我們在第一季安裝了 163 個系統，低於去年第一季的 165 個系統。今年第一季度，我們在歐洲安裝了 88 個系統，在中國安裝了 16 個系統，在日本安裝了 10 個系統，而去年第一季度我們在歐洲安裝了 84 個系統，在中國安裝了 10 個系統，在日本安裝了 20 個系統。

OUS placement performance reflects financial pressures and health care spending constraints in several key markets including Japan, Germany and the UK. Customers with existing da Vinci capacity have opportunities to increase utilization, which we actively support. The environment in China continues to reflect the ongoing impact of domestic competition and policy-driven pressure on pricing.

OUS 的投放表現反映了日本、德國和英國等幾個主要市場的財務壓力和醫療保健支出限制。擁有現有達文西容量的客戶有機會提高使用率，我們對此積極支持。中國的環境繼續反映國內競爭和政策驅動的定價壓力的持續影響。

With respect to the previously mentioned tariffs of 125% on imports of excise systems and excise subassemblies into China, these tariffs have a material impact to the product cost of excise systems in China and may adversely impact our ability to win future tenders. Given the trade environment, financial pressures faced by hospitals and risks to the macro, we may see customers globally reprioritize capital budgets or extend timelines to invest in robotic programs.

關於前面提到的對進口到中國的消費稅系統和消費稅子組件徵收 125% 的關稅，這些關稅對中國消費稅系統的產品成本產生重大影響，並可能對我們贏得未來投標的能力產生不利影響。鑑於貿易環境、醫院面臨的財務壓力以及宏觀風險，我們可能會看到全球客戶重新調整資本預算或延長投資機器人專案的時間表。

First quarter revenue was $2.25 billion, a 19% increase over last year. On a constant currency basis, revenue growth was 20%. Systems revenue grew 25% year-over-year, driven by a 17% increase in da Vinci system placements and higher system ASP, reflecting a higher mix of da Vinci 5 placements.

第一季營收為22.5億美元，較去年同期成長19%。以固定匯率計算，收入成長率為20%。系統營收年增 25%，這得益於達文西系統配置量成長 17% 以及系統平均售價上漲，反映了達文西 5 配置量的更高組合。

Recurring revenue grew 19% in Q1, representing 85% of total revenue. Additional revenue statistics and trends are as follows: Leading represented 54% of Q1 placements compared with 51% last year, driven by a higher mix of US placements where given customer preference the greater proportion of systems are placed under lease arrangements. While leasing may fluctuate quarter-to-quarter, we continue to expect the rate of leasing to increase over time.

第一季經常性收入成長 19%，佔總營收的 85%。其他收入統計數據和趨勢如下：領先系統佔第一季配置的 54%，而去年為 51%，這得益於美國配置比例較高，考慮到客戶的偏好，大部分系統都是按照租賃安排進行配置的。雖然租賃可能會逐季度波動，但我們仍然預期租賃率會隨著時間的推移而上升。

Q1 system average selling prices were $1.62 million as compared to [$1.9 million] last year, primarily driven by a higher mix of da Vinci 5. Looking forward to the second half of 2025 following broad launch of da Vinci 5 to the extent that we see higher trading volumes, you should expect that such transactions reflect significantly higher trading credits relative to recent periods.

Q1 系統平均售價為 162 萬美元，而去年同期為 190 萬美元，主要原因是達文西 5 的混合比例更高。展望 2025 年下半年，隨著達文西 5 的廣泛推出，如果我們看到交易量增加，您應該預期此類交易將反映出相對於近期而言顯著更高的交易信用。

We recognized $39 million of lease buyout revenue in the first quarter compared with $29 million last year. Da Vinci instrument and revenue per procedure was approximately $1,780, flat to last year, reflecting 2 offsetting dynamics. First, we see I&A per procedure come down due to procedure mix given a lower mix of bariatric procedures and higher mixed cholecystectomy. Second, we see an offsetting positive mix effect from a higher mix of procedures on our SP platform and insufflator accessory and force feedback instrument revenue coming from da Vinci 5 procedures.

我們第一季的租賃買斷收入為 3,900 萬美元，而去年同期為 2,900 萬美元。達文西儀器和每項手術的收入約為 1,780 美元，與去年持平，反映了兩個抵消動態。首先，我們發現由於手術組合導致每項手術的 I&A 下降，因為減肥手術組合較少，而混合膽囊切除術較多。其次，我們看到 SP 平台上更高程度的程序組合以及來自達文西 5 程序的充氣器配件和力反饋儀器收入產生了抵消性的積極組合效應。

Turning to ION. There were approximately 31,000 ION procedures in the first quarter, an increase of 58% as compared to last year. In Q1, we placed 49 ION systems compared to 70 in Q1 of 2024. 4 of the 49 systems were placed in OUS markets. We estimate the penetration of lung biopsy in the US is approaching the halfway point.

轉向 ION。第一季約有 31,000 例 ION 手術，比去年同期成長了 58%。在第一季度，我們安裝了 49 個 ION 系統，而 2024 年第一季安裝了 70 個。其中 4 個系統安裝在 OUS 市場。我們估計，美國肺活檢的滲透率接近一半。

And then looking ahead, an increasing proportion of our focus will be helping customers convert transthoracic needle aspiration biopsies to ION, while driving increases in utilization of the existing capacity. Where we have a clearance for ION in our US markets, we are in the early phase of adoption where our current focus is on building local ends, engaging societies and health care systems to see adoption of our products for the benefit of patients. We expect this to be a multiyear effort.

展望未來，我們將更著重於幫助客戶將經胸針吸切片轉換為 ION，同時提高現有產能的使用率。在美國市場上，ION 已獲得批准，我們正處於採用的早期階段，目前的重點是建立本地終端，讓社會和醫療保健系統參與進來，以看到我們的產品被採用，從而造福患者。我們預計這將是一項多年的努力。

First quarter SP procedures grew [94%], driven by strong growth in Korea and early-stage multispecialty growth in Europe and Japan. We placed 19 SP systems in Q1 compared to 24 systems last year. Quarter placements included 7 in Europe, 6 in Korea from 5 in the US. Average system utilization for our SP perform grew 26% in Q1. In absolute terms, SP utilization is the highest of any of our platforms in Korea and Japan.

第一季 SP 手術量成長 [94%]，主要得益於韓國的強勁成長以及歐洲和日本早期多專業手術的成長。我們在第一季安裝了 19 個 SP 系統，而去年安裝了 24 個。本季度，歐洲有 7 家，韓國有 6 家，美國有 5 家。我們 SP 執行的平均係統利用率在第一季成長了 26%。從絕對值來看，SP 使用率是我們在韓國和日本所有平台中最高的。

Utilization in Europe is increasing steadily. We expect utilization in the US to increase as we expand indications -- moving on to the rest of the P&L. Pro forma gross margin for the first quarter of 2025 was 66.4% compared with 67.6% for the first quarter of 2024. The year-over-year decline in pro forma gross margin primarily reflects higher facilities costs, including depreciation as we bring on additional manufacturing capacity and a higher mix of Ion and da Vinci 5 revenue that can lower gross margins.

歐洲的利用率正在穩步增長。我們預計，隨著我們擴大適應症，美國的利用率將會增加——繼續關注損益表的其餘部分。2025 年第一季的預測毛利率為 66.4%，而 2024 年第一季為 67.6%。預計毛利率年減主要反映了設施成本的增加，包括由於我們增加製造能力而產生的折舊，以及 Ion 和 da Vinci 5 收入比例的提高，從而可能降低毛利率。

Our Q1 results did not reflect any significant impact from tariffs. During the quarter, we opened two new facilities at our Sunnyvale, California headquarters that expand our US manufacturing and R&D footprint significantly, a 912,000 square foot facility that will contain da Vinci systems manufacturing and R&D teams and a 315,000 square foot facility containing our Ion manufacturing and R&D team.

我們的第一季業績並未反映出關稅的任何重大影響。在本季度，我們在加州桑尼維爾總部開設了兩家新工廠，大大擴展了我們在美國的製造和研發足跡，一家佔地 912,000 平方英尺的工廠將容納達文西系統製造和研發團隊，另一家佔地 315,000 平方英尺的工廠將容納我們的 Ion 製造和研發團隊。

Along with our recently opened factory in Pestre Corners, Georgia, that manufactures X and Xi Systems, these facilities provide a space to grow over the midterm. Looking ahead to the rest of the year, we continue to expect to open new manufacturing facilities in Germany and Bulgaria and expand instrument manufacturing capacity in Mexico. In addition to supporting our growth plans, we believe, over time, these new manufacturing facilities give us supply availability, quality and cost advantages from scale and factory automation.

加上我們最近在喬治亞州佩斯特角開設的生產 X 和 Xi 系統的工廠，這些設施為我們中期發展提供了空間。展望今年剩餘時間，我們將繼續期待在德國和保加利亞開設新的製造工廠，並擴大在墨西哥的儀器製造能力。除了支持我們的成長計劃之外，我們相信，隨著時間的推移，這些新的製造設施將透過規模和工廠自動化為我們提供供應可用性、品質和成本優勢。

First quarter pro forma operating expenses increased 12% compared with last year, driven by increased headcount, higher facilities-related costs and increased legal fees. During the quarter, we increased headcount sequentially by just over 500 employees, of which approximately half were in manufacturing roles to support revenue growth. Given long-term opportunities to drive the Quintuple Aim and grow revenue, our resolve to invest in R&D and innovation remain unchanged.

第一季預計營業費用較去年同期增加 12%，主要由於員工人數增加、設施相關成本增加以及法律費用增加。在本季度，我們的員工人數連續增加了 500 多人，其中約一半從事製造工作，以支持收入成長。鑑於推動五重目標和增加收入的長期機會，我們投資研發和創新的決心保持不變。

Income was $91 million for Q1, up from $88 million in the prior quarter, primarily driven by higher interest income. Our pro forma effective tax rate for the first quarter was 22.3%, in line with our expectations. First quarter 2025 pro forma net income was $662 million or $1.81 per share compared with $541 million or $1.50 per share for the first quarter of last year.

第一季的收入為 9,100 萬美元，高於上一季的 8,800 萬美元，主要由於利息收入增加。我們第一季的預測有效稅率為 22.3%，符合我們的預期。2025 年第一季預計淨收入為 6.62 億美元，即每股 1.81 美元，去年第一季為 5.41 億美元，即每股 1.50 美元。

I will now summarize our GAAP results. GAAP net income was $698 million or $1.92 per share for the first quarter of 2025 compared with GAAP net income of $545 million or $1.51 per share for the first quarter of 2024. The adjustments between pro forma and GAAP net income are outlined and quantified on our website.

我現在將總結我們的 GAAP 結果。2025 年第一季的 GAAP 淨收入為 6.98 億美元或每股 1.92 美元，而 2024 年第一季的 GAAP 淨收入為 5.45 億美元或每股 1.51 美元。我們的網站概述並量化了備考淨收入和 GAAP 淨收入之間的調整。

We ended the quarter with cash and investments of $9.1 billion compared with $8.8 billion at the end of last year. The sequential increase in cash and investments reflected cash generated from operating activities, partially offset by taxes paid related to net share settlement of equity awards and capital expenditures of $117 million.

本季末，我們的現金和投資為 91 億美元，而去年年底為 88 億美元。現金和投資的環比增長反映了經營活動產生的現金，但部分被與股權獎勵淨股份結算相關的稅款和 1.17 億美元的資本支出所抵消。

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

接下來，我想讓丹來討論我們最新的展望。

Thank you, Jamie. I will now turn to our financial outlook for 2025. Starting with procedures. On our last call, we forecast full year 2025 for growth within a range of 13% and 16%. We are now increasing our forecast and expect full year 2025 procedure growth within a range of 15% to 17%.

謝謝你，傑米。現在我將談談我們對 2025 年的財務展望。從程序開始。在我們上次預測中，我們預測 2025 年全年成長率將在 13% 至 16% 之間。我們現在提高了預測，預計 2025 年全年業務量成長率將在 15% 至 17% 之間。

The low end of the range assumes growth in China is impacted by trade, environmental and competitive dynamics. Governments in key OUS markets continue to constrain CapEx budgets, which limits the expansion of capacity in the field and bariatric procedures continue to decline at rates similar to recent trends. The high end of the range assumes China procedure growth improves relative to 2024, the CapEx environment improves in key OUS markets and perceived declines in bariatrics moderate. The high end of the range also assumes that procedures are not impacted by the current trade environment.

該範圍的低端假設中國的成長受到貿易、環境和競爭動態的影響。美國主要市場的政府繼續限制資本支出預算，這限制了該領域產能的擴張，減肥手術的數量繼續以與近期趨勢類似的速度下降。該範圍的高端假設中國手術成長相對於 2024 年有所改善，主要 OUS 市場的資本支出環境有所改善，且減重手術的預期下降幅度有所緩和。該範圍的高端也假設程序不受當前貿易環境的影響。

Turning to gross profit. On our last call, we forecast pro forma gross profit margin in 2025 to be within a range of 67% and 68% of revenue, which reflected significant incremental depreciation as we bring on new facilities the impact of growth in newer products and the impact of the stronger US dollar. As Jamie described earlier, we currently expect the impact of recently implemented and announced tariffs globally to impact our cost of sales by approximately 1.7% of revenue, plus or minus 30 basis points. As a result, we are updating our estimate for pro forma gross margin to be within the range of 65% and 66.5% of revenue.

轉向毛利。在我們上次電話會議上，我們預測 2025 年的預計毛利率將在收入的 67% 至 68% 之間，這反映了隨著我們引入新設施、新產品增長的影響以及美元走強的影響而出現的大幅增量折舊。正如 Jamie 之前所述，我們目前預計最近在全球範圍內實施和宣布的關稅將對我們的銷售成本產生約 1.7% 的收入影響，上下浮動 30 個基點。因此，我們將預測毛利率更新為營收的 65% 至 66.5% 之間。

In regards to operating expenses, we now expect pro forma operating expense growth to between 10% and 14%. The projected operating expense growth reflects increased depreciation from new facilities and investments to drive our growth objectives. We now expect our noncash stock compensation expense to range between $770 million and $790 million in 2025. We continue to expect other income, which is comprised mostly of interest income, to total between $370 million and $400 million in 2025.

關於營運費用，我們現在預計預計營運費用成長率將在 10% 至 14% 之間。預計的營運費用成長反映了新設施和投資的折舊增加，以推動我們的成長目標。我們現在預計，2025 年的非現金股票薪酬支出將在 7.7 億美元至 7.9 億美元之間。我們繼續預計，到 2025 年，其他收入（主要包括利息收入）總額將在 3.7 億美元至 4 億美元之間。

With regard to capital expenditures, we now estimate a range of $650 million to $750 million, primarily for planned facility construction activity. With regard to income tax, we continue to estimate our 2025 pro forma income tax rate to be between 22% and 23% of pretax income.

關於資本支出，我們現在估計範圍為 6.5 億美元至 7.5 億美元，主要用於計劃中的設施建設活動。關於所得稅，我們繼續估計 2025 年的預計所得稅稅率為稅前收入的 22% 至 23% 之間。

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

其中包括我們準備好的評論。我們現在開始回答你們的問題。

(Operator Instructions) Travis Steed, Bank of America Securities.

（操作員指示）美國銀行證券的 Travis Steed。

First of all, have a question on tariffs. Just the 170 basis point impact in '25. Just curious how to think about that on an annualized basis, any way to kind of break out how much of that is China versus Mexico and how to think about the cadence over 2025, how much of that impacts in kind of Q4 and in Q3 this year?

首先，我想問一下關於關稅的問題。'25 年的影響僅 170 個基點。只是好奇如何從年度化角度考慮這個問題，有什麼方法可以區分出其中中國與墨西哥的差距有多大，以及如何考慮 2025 年的節奏，這對今年第四季和第三季度的影響有多大？

Yes. Travis, in terms of the breakout for this year, roughly half-ish of the impact is US-China trade, both directions. And about 40% of the impact is imports into the US, ex China, Mexico, Canada of raw materials and components from US-based suppliers and imports of endoscopes from our factories in Europe. So that kind of gives you a sense of what's driving the 1.7% of revenue.

是的。特拉維斯，就今年的突破而言，大約一半的影響來自中美貿易，雙向的。其中約 40% 的影響來自美國（除中國、墨西哥、加拿大外）從美國供應商進口的原材料和零件以及從我們位於歐洲的工廠進口的內視鏡。這樣您就可以了解是什麼推動了 1.7% 的收入。

As we said in prepared remarks, the impact of tariffs kind of increases each but through the year. So the exit rate in Q4 is going to be higher than the 1.7%. There is some variability there with respect to -- for example, where Chinese capital sales fall. So we're not going to be precise on the quarterly profile. Beyond '25, I think from our perspective at this point, we'd like to see where tariffs stable, stabilized, we'd like to obviousness what moves can we make over time that we'll assess. So we'll get into what the impact may be in '26, I think when we get through that process.

正如我們在準備好的演講中所說，關稅的影響每年都在增加。因此第四季的退出率將高於1.7%。例如，中國資本銷售額下降的地方存在一些變化。因此，我們不會精確地描述季度概況。25年以後，我認為從我們目前的角度來看，我們希望看到關稅穩定下來，我們希望清楚地知道隨著時間的推移我們可以採取哪些舉措，然後進行評估。因此，當我們完成這個過程後，我們將了解 26 年可能產生的影響。

Okay. And then a follow-up on the capital environment. Just it sounds like you kind of called out at the risk, but you're not seeing it yet. Does trying to think about how this compares to like 2022 when you saw it in the funnel versus kind of what you're seeing in the capital environment at this point.

好的。然後是資本環境的後續情況。聽起來你已經意識到了風險，但你還沒有意識到。試著思考這與 2022 年您在漏斗中看到的情況相比如何，以及您目前在資本環境中看到的情況如何。

Yes. I'd say through Q1, if you look at the US, what we've seen is strong customer response to da Vinci 5. I think the capital environment has been relatively strong for us. Customers there are using our leasing and user-based arrangements. So that allows them, to some extent, to avoid kind of their formal capital budgets, gives them some flexibility to expand their programs.

是的。我想說，透過第一季度，如果你看看美國，我們看到的是客戶對達文西 5 的強烈反應。我認為資本環境對我們來說相對強勁。那裡的客戶正在使用我們的租賃和基於用戶的安排。這樣，在某種程度上，他們就可以避免正式的資本預算，並且可以靈活地擴展他們的專案。

In OUS markets, as we described in prepared remarks, you see some markets where they're getting constrained by government budgets. That's either to do with kind of the elimination of post COVID funding or it reflects governments reprioritizing funding to other areas. For example, in Europe, you see some funding that moves towards military spending. So some pressures there. I think our focus in a situation like that is to first help customers increase utilization where they have the existing capacity and can have greater throughput through their assets than we have Genesis resources and other teams that can help them do that.

在 OUS 市場中，正如我們在準備好的評論中所描述的，您會看到一些市場受到政府預算的限制。這要么與取消新冠疫情後的資金有關，要么反映出政府將資金重新優先分配到其他領域。例如在歐洲，你會看到一些資金用於軍事開支。因此存在一些壓力。我認為在這種情況下我們的重點是首先幫助客戶提高現有產能的利用率，並且可以透過他們的資產獲得比我們擁有的 Genesis 資源和其他可以幫助他們做到這一點的團隊更高的吞吐量。

We also have a growing set of economic capabilities, tools that we can help customers understand what the returns of those programs are. That's a growing part of our toolkit internally. And then we look to expand what we've seen in the US with respect to use of leasing and usage-based arrangements, which are at earlier stages of adoption with our customers there. In terms of what customers had to us, we've had questions about tariffs and the environment.

我們還擁有不斷增長的經濟能力和工具，可以幫助客戶了解這些計劃的回報。這是我們內部工具包中不斷增長的一部分。然後，我們希望擴大我們在美國看到的租賃和基於使用情況的安排的使用範圍，這些安排在我們那裡的客戶中仍處於早期採用階段。就客戶向我們提出的問題而言，我們對關稅和環境有疑問。

I don't think that's shown up yet in terms of core capital demand. But I think we're flagging the that could have an impact. And certainly, to the extent that our customers' hospitals see increased pricing as a derivative effect of tariffs, then that creates pressure for them.

我認為核心資本需求方面尚未反映這一點。但我認為我們正在標記可能產生影響的東西。當然，如果我們的客戶醫院將價格上漲視為關稅的衍生效應，那麼這會給他們帶來壓力。

Larry Biegelsen, Wells Fargo.

富國銀行的拉里·比格爾森。

Jamie, a follow-up on tariffs. Just on the -- did I hear you say that you're including the European reciprocal tariffs, which I think are 20% in 90 days assumed in that 1.7%. And Jamie, how should we think about your ability to mitigate the tariffs? Just maybe flesh that out a little bit more for us and how quickly you might be able to do that. I had one follow-up.

傑米，關於關稅的後續問題。剛才我是否聽到您說過，您包括了歐洲的互惠關稅，我認為在 90 天內假設為 20%，即 1.7%。那麼傑米，我們該如何看待您減輕關稅的能力呢？也許可以為我們進一步充實這一點，以及您能夠多快做到這一點。我有一個後續行動。

Yes. We are assuming in the 1.7% estimate for '25 that the retry tariffs go into effect once the 90-day ports period has lapsed. Obviously, we'll see how that plays out, but we've reflected that in the 1.7%.

是的。我們假設，在 25 年 1.7% 的估計中，重試關稅將在 90 天的港口期過後生效。顯然，我們會觀察其結果如何，但我們已在 1.7% 中反映了這一點。

With respect to the manufacturing operations in our supply chain to the extent there are low-hanging fruit that isn't disruptive to our partners and our employees, then, of course, we'll pursue those. But I think our first move is to let things stabilize and evaluate then what's possible. We'll do that concurrently across the year, and we will consider things like do you have to invest to mitigate what's the time to receive the benefit, what's the economic return of that. And there are complexities in some of the things that you might do from an operational perspective. And so we don't want to move too quickly given how dynamic the environment is.

就我們供應鏈中的製造業務而言，只要存在一些唾手可得的成果，且不會對我們的合作夥伴和員工造成乾擾，那麼我們當然會追求這些成果。但我認為我們的第一步是讓事態穩定下來，然後再評估可能發生的情況。我們將在全年同時進行這項工作，並考慮您是否需要投資以減輕獲得收益的時間以及其財務回報是什麼等問題。從營運角度來看，您可能做的一些事情會很複雜。因此，考慮到環境的動態，我們不想行動太快。

That's helpful. And just for my follow-up, Jamie, on da Vinci 5, it looks like da Vinci 5 placements as a percent of US placements actually was lower in Q1 from Q4. Hopefully, I'm not doing the math wrong. Why would da Vinci 5 placements in the US as a percent decline in Q4? And how should we think about the ramp going forward?

這很有幫助。傑米，關於《達文西 5》，我的後續問題似乎是，第一季《達文西 5》在美國的投放比例實際上低於第四季。希望我的計算沒有錯。為什麼《達文西 5》在美國的播放量在第四季會下降？我們該如何看待未來的發展？

I believe, Brandon, correct me, I believe DV5 placements as a percent of total in the US was higher in Q1 than Q4. But if I look at Q1 capital performance, supply for da Vinci 5 was where we expected it to be. And with respect to placement performance for all of the models, including da Vinci 5, I'd characterize it as normal seasonality, no concerns there for us.

我相信，布蘭登，請糾正我，我相信 DV5 在美國的安置佔總數的百分比在第一季高於在第四季度。但如果我看一下第一季的資本表現，達文西 5 的供應量符合我們的預期。至於包括達文西 5 在內的所有型號的定位表現，我將其描述為正常的季節性，我們無需擔心。

Robbie Marcus, JPMorgan.

摩根大通的羅比·馬庫斯。

Great. Maybe on the first one, the procedure volume was excellent in first quarter, and it's rare to see such a big raise after just one quarter. You touched on it in the prepared remarks, but maybe you could spend a little more time walking through what gave you the confidence to raise this early in the year? Yes, I'll just leave it there, and I have a follow-up question.

偉大的。可能首先，第一季的處理量非常出色，僅一個季度後就出現如此大的增長是很罕見的。您在準備好的發言中提到了這一點，但也許您可以花更多的時間解釋是什麼讓您有信心在今年年初提出這個建議？是的，我就說到這裡，我還有一個後續問題。

Yes. We routinely have a process where we obviously, like many companies construct a forecast, that reflects customer input. We look at, obviously, our plans and that -- that guidance is a function of that routine process. Day adjusted Q1 procedure performance was 18.5%. I think that gives us a little bit of momentum into the rest of the year.

是的。我們通常會有一個流程，顯然，像許多公司一樣，我們會制定一個反映客戶意見的預測。顯然，我們會審視我們的計劃，而指導是常規流程的功能。日內調整後 Q1 程式效能為 18.5%。我認為這給我們在今年剩餘的時間裡帶來了一些動力。

Obviously, we're watching the macro cable. If you look at the low end of the range of 15%, that would say the rest of the year would have to be 14% procedure growth. And so I think we have a decent range for kind of our bottoms-up process.

顯然，我們正在觀察宏觀電纜。如果你看一下 15% 這一範圍的低端，那就意味著今年剩餘時間的程式成長率必須達到 14%。所以我認為我們的自下而上的流程有相當不錯的範圍。

Just some anecdotes back from the road, and Dave has been out front of the customer, too. I think we're perceived as part of the solution, not part of the problem. I think that customers continue to adopt I think to see the economic benefits and the patient and outcome benefits. So, so far, so good.

這只是路上的一些趣聞，戴夫也曾走在顧客前面。我認為我們被視為解決方案的一部分，而不是問題的一部分。我認為客戶繼續採用我認為能夠看到經濟效益以及患者和結果效益。所以，到目前為止，一切都很好。

Great. And sorry to harp on it, but tariffs are a big focus, unfortunately, in everybody's world right now. Just to follow up on Larry's question. It feels like you're taking a worst-case approach here where you're putting all the negatives and there aren't a lot of offsets, or any booked into the guide. You talked about maybe evaluating where you are at the end of the year.

偉大的。我很抱歉一再強調這一點，但不幸的是，關稅現在是每個人關注的焦點。只是為了跟進拉里的問題。感覺你在這裡採取了一種最壞的情況，你把所有的負面因素都考慮進去了，而且沒有很多的抵消，或者在指南中沒有任何預定。您談到也許要評估一下自己在年底的狀況。

What are some of the potential levers you have to offset this? And how meaningful can they be? And when do you think we might be able to see some offsets if you do choose to do that?

您可以使用哪些潛在手段來抵消這種影響？它們到底有多大意義？如果您選擇這樣做，您認為什麼時候我們才能看到一些補償？

I'd just say on the philosophy on the tariff guide, from our perspective, we're playing it straight down the middle. Is tariffs that are in effect all that have been announced. And we felt like that was the most responsible way to go with respect to what we guided.

我只想說，關於關稅指南的理念，從我們的角度來看，我們的做法是走中間路線。已經宣布的都是有效的關稅嗎？我們覺得，就我們的指導而言，這是最負責任的方式。

We didn't want to predict what may or may not change. And so we guided under that kind of a philosophy. In terms of potential mitigating operational activities for which we said we didn't expect a beneficial impact in 2025, maybe I'll let Dave touch on what some of those may be.

我們不想預測什麼可能會改變或不會改變。因此，我們遵循這樣的理念進行指導。關於我們預計在 2025 年不會產生有益影響的潛在緩解營運活動，也許我會讓戴夫談談其中的一些可能。

Yes, sure. Happy to. Robbie, some of the mitigations that we're considering in some -- on our side, if you look at our supply chain, they are -- Jamie mentioned a little bit of it, but it's really -- two frames of reference that you ought to use. One is thinking about the parts that are coming into our factories, the ones that we assemble and then the other frame of reference are the parts that are leaving our factories. And so as we look about how do we optimize within those two frames of reference on the parts coming into our factories, our teams have been working to get to industrial scale for years now.

是的，當然。很開心。羅比，我們正在考慮一些緩解措施——就我們而言，如果你看看我們的供應鏈，它們是——傑米提到了一點，但實際上——你應該使用兩個參考框架。一方面考慮進入我們工廠的零件，我們組裝的零件，另一方面考慮離開我們工廠的零件。因此，當我們研究如何在這兩個參考框架內對進入我們工廠的零件進行最佳化時，我們的團隊多年來一直致力於實現工業規模。

And so some of the processes that exist within this framework with inside of Intuitive, really center around assessing skin all of our supply chain. We procure thousands of parts for our systems and instruments. And so our teams look through there, assess the risk and then ensure appropriate mitigations are in place. And mitigations there can include dual sourcing. They can include strategic reserves.

因此，Intuitive 內部的這個框架內存在的一些流程實際上都圍繞著評估我們整個供應鏈的皮膚。我們為我們的系統和儀器採購數千個零件。因此，我們的團隊會仔細檢查，評估風險，然後確保採取適當的緩解措施。緩解措施可以包括雙重採購。它們可以包括戰略儲備。

And so that's for a robust process that runs on a daily basis here for parts coming in. If you look about our parts, our and our products going to customers. Here, we've done a lot of work to qualify some of our products under USMCA. We've optimized inventory around the globe has some of these tariffs ahead of some of these tariffs taking place. And then if you look in the midterm, we have -- we can use our existing manufacturing footprint that we have around the globe and optimize what products are factored in what area around growth to help optimize some of the supply for our customers.

這就是每天在這裡運行的、用於處理零件進來的強大流程。如果您看一下我們的零件，我們以及我們的產品是否正在流向客戶。在這裡，我們做了大量工作來使我們的部分產品符合 USMCA 的資格。我們已經優化了全球的庫存，提前解決了部分關稅問題。如果你從中期來看，我們可以利用我們在全球現有的製造足跡，並優化在成長領域考慮哪些產品，以幫助優化客戶的部分供應。

And then in the long term, we can build our overall manufacturing footprint against the trade environment that ultimately stabilize. And so that's going to be a long-term way in which we help mitigate some of the supply risk, if you will, within our supply chains.

從長遠來看，我們可以根據最終穩定的貿易環境建立我們的整體製造業足跡。因此，這將是我們幫助減輕供應鏈中部分供應風險的長期方法。

Rick Wise, Stifel.

瑞克懷斯（Rick Wise），Stifel。

I thought maybe just to change the focus briefly. OUS growth was particularly robust at 24%. Maybe you can talk about the drivers there, the sustainability of the drivers, the key markets and just what you've assumed in coming up with your new forecast as well?

我想也許只是簡單地改變一下焦點。OUS 成長尤為強勁，達到 24%。也許您可以談談其中的驅動因素、驅動因素的可持續性、主要市場以及您在得出新的預測時所考慮的內容？

Yes. We saw solid procedure growth -- invested 13% and obviously, day adjusted is a little higher than that. I do think that we are seeing a relatively significant benefit from the adoption of da Vinci 5 in the US. I think customer response has been quite positive. You're generally seeing higher --

是的。我們看到了穩健的程序成長——投資了 13%，顯然，日調整後的投資金額略高於這個數字。我確實認為我們看到了美國採用達文西 5 所帶來的相對顯著的效益。我認為客戶的反應非常正面。你通常會看到更高的--

It was -- he was asking OUS.

是的——他正在詢問 OUS。

I'm sorry. I'm sorry. I'm sorry, Rick, you're going to have to ask your question, I missed it.

對不起。對不起。對不起，瑞克，你必須問你的問題，我錯過了。

Jamie, just big -- just talking about the OUS growth, the international growth at 24%. It was particularly strong I thought and just drivers there and key drivers and the sustainability of those drivers into the rest of the year and beyond.

傑米，剛才談到美國本土的成長，國際成長達到 24%。我認為它特別強勁，而且只是那裡的驅動因素和關鍵驅動因素，以及這些驅動因素在今年剩餘時間及以後的可持續性。

Sorry. Rick, you're talking about the 24% procedure growth for OUS.

對不起。里克，你談論的是 OUS 24% 的程式成長。

Exactly.

確切地。

Yes. So you see some maybe earlier stage markets for us doing quite well. India, smaller market; Taiwan, those are starting to grow at really nice rates. I think we see our teams making real progress with respect to engagements with key opinion leaders with surgical societies and adoption across a broader set of tees. I think that's going well.

是的。因此，您會看到，我們的一些早期市場表現相當不錯。印度，較小的市場；台灣，這些地區正開始以非常好的速度成長。我認為，我們的團隊在與外科協會關鍵意見領袖的接觸以及在更廣泛的範圍內採用方面取得了真正的進展。我認為一切進展順利。

Same in Taiwan. We benefited from some incremental reimbursements in Taiwan. Across Europe, you see relatively solid growth that progresses each quarter. UK kind of leads that growth.

台灣也一樣。我們受益於台灣的一些增量報銷。在整個歐洲，你可以看到每季都呈現相對穩健的成長動能。英國在某種程度上引領了這一增長。

And in the UK, they're seeing real value with respect to resource consumption savings addressing waiting list in the UK. And then we've been actually kind of placing capital distributor markets a little bit of a higher rate over the last several quarters, and we're seeing that create capacity for growth. So I think those elements all look good for us. I think the watch out for us is to the extent that in Germany, Japan, UK, ongoing capacity constraints for capital continues then at some point, that starts to limit procedure growth. We have room to grow with respect to utilization there.

在英國，他們看到了解決英國候補名單問題在節省資源消耗的真正價值。過去幾個季度，我們實際上一直在將資本分銷商市場置於更高的水平，我們看到這正在創造成長能力。所以我認為這些因素對我們來說都是好的。我認為我們需要注意的是，在德國、日本和英國，持續存在的資本產能限制會在某個時候開始限制流程的成長。我們在利用率方面還有成長空間。

And so that's what we'll pursue to the extent they're constrained. If you look at our long-term OUS procedure growth, it's been in the 20s for a long period of time. We're at early stages of adoption. And I think we feel quite good about how our teams are performing there. There are particular markets where you have unique dynamics like China.

這就是我們在限制範圍內所追求的目標。如果你看一下我們的長期 OUS 程式成長，它已經長期保持在 20 左右。我們正處於採用的早期階段。我認為我們對我們的團隊在那裡的表現感到非常滿意。在某些特定市場，例如中國，存在著獨特的活力。

Got you. And just a follow-up. You've highlighted recently that increased customer interest in two areas. And it went by too quickly, I missed what you said about after our surgery growth. I just didn't get the number.

明白了。這只是後續行動。您最近強調了兩個領域客戶興趣的增加。時間過得太快了，我錯過了你說的我們手術後成長的情況。我只是沒有得到號碼。

But after I was surgery and you recently hired a new leader for the cardiac surgery area, can you update us on these two areas? And where are you in sort of pursuing them? What's next? And again, maybe just talk about the growth outlook, if you would.

但是在我做完手術之後，您最近又為心臟外科手術領域聘請了一位新領導，您能向我們介紹一下這兩個領域的最新情況嗎？您在哪裡追求他們？下一步是什麼？再說一次，如果可以的話，也許可以談談成長前景。

Sure. Rick, so the two areas that you mentioned after I was -- on the after-hour side, this really is being driven by customers who want to provide equal access to high-quality minimally-invasive surgery to those patients who are so-called after hours and having it be the same as the patients who are entering the hospital during the day.

當然。里克，所以你在我之後提到的兩個方面是——在下班時間方面，這實際上是由客戶推動的，他們希望為那些所謂的下班時間的患者提供平等的高質量微創手術機會，並使其與白天進入醫院的患者相同。

And so that has been the primary sort of motivation behind it. And the ability for our customers to access capital for our teams to train the after-hours care teams are just parts or components to the equation that enable customers to access systems to have the right trained teams to support the surgeons who are delivering that care after hours. And so these would be patients who are generally coming in with sort of emergent condition. And oftentimes, those teams for treating those patients, they offer some kind generally some laparoscopic and minimally invasive surgery, oftentimes a lot of open surgery. And so the ability to have da Vinci as an option there is meaningful to the outcomes of those programs.

這就是背後的主要動機。我們的客戶能夠獲得資金，為我們的團隊培訓下班後的護理團隊，這只是整個計劃的一部分或組成部分，該計劃使客戶能夠訪問系統，擁有經過適當培訓的團隊來支持在下班後提供護理的外科醫生。這些患者通常都是因某種緊急狀況而入院的。通常，治療這些患者的團隊會提供某種類型的手術，通常是腹腔鏡手術和微創手術，通常還會提供大量開放性手術。因此，能夠將達文西作為一種選擇對於這些項目的結果具有重要意義。

On the cardiac side, the way that I kind of think about it is, for many years, the interventional side of cardiac intervention, so structural heart and other components from interventional cardiologists have been on the rise and you've seen them offer great outcomes to patients. And we've gone to the now where I think there's also a set of patients where high-quality, minimally invasive surgery is great and the best option for them. And so we're at the point now where we think the technology with DV5 and other parts of our ecosystem, our work with societies, our work with academic institutions and with surgeons who have been doing this around the world, it's the right time for this investment. It's been growing year-over-year off of a small base. And so the need is there.

在心臟方面，多年來我一直認為它是心臟介入的介入方面，因此介入心臟科醫生的結構性心臟和其他組件一直在增加，並且您已經看到它們為患者帶來了良好的治療效果。現在，我認為對於一部分患者來說，高品質、微創的手術是極好的，也是最好的選擇。因此，我們現在認為，對於 DV5 技術以及我們生態系統的其他部分、我們與社會、學術機構以及世界各地從事此工作的外科醫生而言，現在是進行這項投資的最佳時機。它從很小的基礎開始逐年增長。所以有這個需求。

There is patient benefit that is there. And so we'll line up these investments and continue our journey here for cardiac.

這對患者有好處。因此，我們將安排這些投資並繼續我們的心臟研究之旅。

Adam Maeder, Piper Sandler.

亞當梅德、派珀桑德勒。

I'll keep it to one multipart question on force feedback technology. So I guess the first question is, can you just maybe give us a little bit more color around the percentage of DV5 cases that are using force sensing instruments today? Remind us the portfolio, how many instruments have this technology, how can that evolve going forward?

我將把它保留為一個有關力回饋技術的多部分問題。所以我想第一個問題是，您能否向我們詳細介紹一下目前使用力感測儀器的 DV5 案例的百分比？提醒我們投資組合中有多少種工具擁有這項技術，未來又會如何發展？

And then lastly, I saw there was a post-market study. I think it was 200 patients posted to clinicaltrials.gov, evaluating for feedback instruments. So just maybe flesh out the clinical strategy going forward to validate this exciting technology.

最後，我看到了一項上市後研究。我認為有 200 名患者被發佈到 clinicaltrials.gov，用於評估回饋工具。因此，也許可以充實未來的臨床策略來驗證這項令人興奮的技術。

Sure. So on the force feedback on the number of instruments that currently have the capability enabled that we have six different instruments that were chosen for their -- what they do inside the procedure. And so we're looking at components of the procedure that we think would best benefit from force feedback technology. So that's how those instruments were chosen. In terms of how many today, how many cases are using force feedback.

當然。因此，關於力回饋，就目前已啟用該功能的儀器數量而言，我們選擇了六種不同的儀器，它們是根據其在手術過程中的作用而選擇的。因此，我們正在研究我們認為最能從力回饋技術中受益的程序組成部分。這就是選擇這些樂器的方式。就目前而言，有多少案例正在使用力回饋。

I don't have the number in front of me. There are many thousands of cases that are being done with force feedback, but I don't know the exact number. And -- when you look forward, I think what you're going to see is like any technology that's being studied you'll see these early single institution studies that we referenced. And that's where a single surgeon or a group of surgeons can study their results and look at it look at it within their own institution and against their own data. And then as you look out, you'll start to see cross institute studies.

我面前沒有這個號碼。有數千個案例正在利用力回饋進行處理，但我不知道具體數字。而且——當你展望未來時，我認為你會看到，就像任何正在研究的技術一樣，你會看到我們引用的這些早期的單一機構研究。在這裡，單一外科醫生或一組外科醫生可以研究他們的結果，並在他們自己的機構內根據他們自己的數據進行審查。然後當你觀察時，你會開始看到跨機構的研究。

In Intuitive and perhaps other investigators will put together larger studies that will include more patients that could be the one at trials, that you're referencing. But it's a steady progression of data starting from the small and getting to the more statistically relevant studies. And that's when we'll be able to see what force feedback means at scale.

在直覺上，也許其他研究人員會進行更大規模的研究，其中將包括更多的患者，這些患者可能是您所引用的試驗對象。但這是一個從小數據開始，逐漸發展到更具統計相關性的研究的過程。那時我們將能夠看到力回饋在規模上意味著什麼。

Two comments I'd make here. One is, so far, we're seeing hypothesis that drove the inclusion of -- force feedback instruments and force feedback technologies to bear out, better learning for younger surgeons and the right force at the right time during the procedure as being linked to outcome. As you said, those are hypotheses that will be tested over time, but we're going to start seeing those studies progress. On the point of prevalence, how much is being used, just remember, a couple of things. One is force sensing and non-force sensing it can be used on DV5.

我在此提出兩點評論。一是，到目前為止，我們看到的假設推動了力回饋儀器和力回饋技術的納入，以證實年輕外科醫生能夠更好地學習，並且在手術過程中在正確的時間施加正確的力量與結果相關。正如你所說，這些都是需要隨著時間的推移進行檢驗的假設，但我們將開始看到這些研究的進展。關於流行程度，使用量，只需記住幾件事。一種是力感應，一種是非力感應，可以在DV5上使用。

So Gen 4 instruments can also be used on DV5. And we're supply constrained on force-sensing instruments. So we're not able to meet demand yet. Now we're working hard on that, both from lives in the instrumentation and the manufacturing capacity. So that's coming. But right now, the answer to what fraction are being used, that's an artificial limitation imposed by our manufacturing constraint.

因此 Gen 4 儀器也可以在 DV5 上使用。我們的力感測儀器的供應受到限制。所以我們還不能滿足需求。現在我們正在為此而努力，無論是從儀器儀表的壽命還是製造能力方面。這就是即將發生的事情。但目前，對於使用比例的答案是，這是我們製造限制所施加的人為限制。

Ryan Zimmerman, BTIG.

Ryan Zimmerman，BTIG。

I'll stick to one in the interest of time. There's been a lot of discussion on Medicaid cuts and the impact to patients. I don't know, Dave, if you've quantified this or you're out there, but I'm going to ask anyway, which is if you were to characterize the payer mix, particularly within the Medicaid population, what you could or could not be exposed to? And what potentially that impact would be as the government kind of considers this as option? I'd appreciate your thoughts there.

為了節省時間，我將堅持一個。關於醫療補助削減及其對病人的影響已經有很多討論。戴夫，我不知道您是否已經量化了這一點，或者您是否在那裡，但我還是要問，如果您要描述付款人組合，特別是在醫療補助人群中，您可能會或可能不會接觸到什麼？當政府將此視為一種選擇時，可能會產生什麼影響？我很感激您的想法。

I'd just say it's a healthy mix between private and Medicare depending on the marketplace. I think I'd say it's too early for us to give any specific comments we obviously have discussions with customers. I think much of that is speculation as to how it may play out. But I think it's too early for us to comment, frankly.

我只是想說，根據市場情況，這是私人保險和醫療保險之間的健康組合。我想現在就給出任何具體的評論還為時過早，我們顯然已經與客戶進行了討論。我認為其中很大一部分都是對事情將如何發展的一種猜測。但坦白說，我認為現在發表評論還為時過早。

Yes. This one on Medicaid, in particular, impact on Medicaid, right, versus Medicare? I think it was --

是的。這是關於醫療補助 (Medicaid) 的具體內容，它對醫療補助的影響與醫療保險相比如何？我認為是--

Yes, that's correct, Gary. Yes. I guess if it were to be amended, what kind of impact would utilization potentially have, particularly for robotics.

是的，沒錯，加里。是的。我想，如果它被修改了，利用率可能會產生什麼樣的影響，特別是機器人技術。

Yes. The team has done a little bit of a back of the envelope. I think it's too soon to speculate what that might be. It's not a dominant part of the mix. It's in our procedure mix, Medicaid, but it is not dominant what that looks like too soon to say.

是的。團隊做了一些簡單的工作。我認為現在猜測那是什麼還為時過早。它不是混合物的主要部分。它在我們的醫療補助計劃 (Medicaid) 程序組合中，但它並不占主導地位，現在說它看起來還為時過早。

David Roman, Goldman Sachs.

高盛的大衛‧羅曼（David Roman）。

I wanted just to continue along the thread of potential Medicaid cuts to hospitals. And maybe, Gary, you could expand a little bit on the comment you made earlier about Intuitive being potentially part of the solution and not part of the problem. In contrast to kind of the comments that Jamie made or in conjunction with the comments Jamie made about a potentially worsening hospital CapEx environment and some of the factors we need to consider given the external environment?

我只是想繼續討論醫院醫療補助可能被削減的問題。加里，也許你可以稍微擴展一下你之前關於直覺可能是解決方案的一部分而不是問題的一部分的評論。與 Jamie 所做的評論相反，或者與 Jamie 所做的關於醫院資本支出環境可能惡化的評論以及我們在外部環境下需要考慮的一些因素相結合？

Yes. Thank you for that. I think it's a great question. Why don't I think we're a part of the solution and just back from the road. And I think for a well-run program, total cost to treat per patient episode is outstanding, as good as any approach often better certainly better than open and often better than lap.

是的。謝謝你。我認為這是一個很好的問題。我為什麼不認為我們是解決方案的一部分，只是剛從路上回來。我認為，對於一個運作良好的計畫來說，治療每位患者的總成本非常高，與任何方法一樣好，通常肯定比開放式更好，通常比腹腔鏡更好。

So I think if hospitals look out at this and say, look, we're going to provide care. This issue -- I'm just -- one thing they can do is stop giving care. Well, that's a train rank. So their mission is to provide care. If they have a well-run program, they both get better outcomes, higher physician and surgeon satisfaction and patient satisfaction and lowest total cost to treat in their hands.

所以我認為如果醫院注意到這一點並說，看，我們將提供護理。這個問題——我只是——他們可以做的一件事就是停止提供護理。嗯，這就是火車等級。所以他們的使命是提供護理。如果他們有一個運作良好的項目，他們都會獲得更好的結果，更高的醫生和外科醫生滿意度以及患者滿意度，並且獲得最低的治療總成本。

So of course, there's a whole bunch of different procedures and a whole bunch of different hospitals, but in aggregate, that's a true -- so they want to do it. And if they do it, they do better economically. But you have this issue of stress on capital, particularly in some US markets. And the reason that, that stress for them is that the budgets, the operating budgets are not always held by the same budget holder, as the capital budget.

當然，有很多不同的程序和很多不同的醫院，但總的來說，這是真的——所以他們想這樣做。如果他們這樣做，他們的經濟狀況就會更好。但存在資本壓力問題，尤其是在美國一些市場。他們感到壓力的原因是，預算、營運預算並不總是與資本預算由同一個預算持有人持有。

So the operating person is saying, this is going great. I'm getting really nice returns, but the capital person is being incented by other means. And so Jamie had said in the prepared remarks, and he was right, the first thing to do is help them with utilization. And we will. That's what our genesis teams do.

因此操作員說，一切都進行得很順利。我獲得了非常好的回報，但資本家卻受到其他方式的激勵。傑米在準備好的發言中說過，他是對的，首先要做的就是幫助他們利用。我們會的。這就是我們的創世團隊所做的事情。

We're happy to help them with analytical tools so they really understand their total cost to treat and what the probability of those programs are. At the same time, if ultimately they need additional capital, that's part of the conversation with the other side of the insurance house, which is the one that controls the capital. They're in live some of the stress. So early on, it's go help them with utilization. Sometimes we can help them with workflow management and also move machines around move systems where they need to.

我們很樂意為他們提供分析工具，以便他們真正了解治療的總成本以及這些方案的可能性。同時，如果他們最終需要額外的資本，那麼這就是與保險公司另一方（即控制資本的一方）進行對話的一部分。他們正承受著一些壓力。所以從早期開始，它就會幫助他們利用。有時我們可以幫助他們進行工作流程管理，也可以移動機器，將系統移動到他們需要的位置。

You've seen us do that in our history, back in the day. But in general, I think in many of these economies in many of these countries, high-quality minimally invasive care as provided by da Vinci systems and the like has been fantastic for them. They want to do more less.

在我們的歷史上，您已經看到我們曾經這樣做過。但總的來說，我認為在許多經濟體和許多國家，達文西系統等提供的高品質微創治療對他們來說非常棒。他們想用更少的錢做更多的事情。

Okay. We are at our last question, thank you for the questions. In closing, we continue to believe there's a substantial and durable opportunity to fundamentally improve surgery and acute interventions. Our teams continue to work closely with hospitals, physicians and care teams in pursuit of what our customers have termed it better, more predictable patient outcomes, better experiences for patients, better experiences for their care teams, lower total cost of care; and finally, increased access to care. We believe value creation in surgery and acute care is foundationally human.

好的。我們現在是最後一個問題，謝謝大家的提問。最後，我們仍然相信，從根本上改善手術和急性幹預措施存在巨大而持久的機會。我們的團隊繼續與醫院、醫生和護理團隊密切合作，追求我們的客戶所說的更好、更可預測的患者結果、更好的患者體驗、更好的護理團隊體驗、更低的總護理成本；最後，增加獲得護理的機會。我們相信，外科手術和急性護理中的價值創造以人為本。

It flows from respect for and understanding of patients and care teams, their needs in their environment. At Intuitive, we envision a future of care that is less invasive and profoundly better where diseases are identified earlier in treated equity, so patients can get back to what matters most.

它源於對患者和護理團隊以及他們在環境中的需求的尊重和理解。在 Intuitive，我們設想未來的照護將侵入性更小、品質更高，在公平治療中能夠更早發現疾病，這樣患者就可以重新關注最重要的事情。

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

感謝您在這次非凡旅程中給予的支持。我們期待三個月後再次與您交談。

Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect.

女士們、先生們，感謝各位參加今天的會議。該計劃確實就此結束。您現在可以斷開連線。