直覺手術 (ISRG) 2025 Q2 法說會逐字稿

Hello everyone and welcome to the Intuitive second-quarter 2025 earnings release. (Operator Instructions)

大家好，歡迎閱讀 Intuitive 2025 年第二季財報。（操作員指示）

Please note, this event is being recorded. Now it's my pleasure to turn the call over to Dan Connolly, head of investor relations. Please go ahead, sir.

請注意，此事件正在被記錄。現在我很高興將電話轉給投資者關係主管 Dan Connolly。先生，請繼續。

Good afternoon, and welcome to Intuitive's second-quarter earnings conference call. With me today, we have Dave Rosa, our CEO; and Jamie Samath, our CFO.

下午好，歡迎參加 Intuitive 第二季財報電話會議。今天和我一起的有我們的執行長戴夫·羅薩 (Dave Rosa) 和我們的財務長傑米·薩馬斯 (Jamie Samath)。

Before we begin, I would like to inform you that comments mentioned on today's call may be deemed to contain forward-looking statements. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. These risks and uncertainties are described in our Securities and Exchange Commission filings, including our most recent 10-K filed on January 31, 2025, and Form 10-Q filed on April 23, 2025.

在我們開始之前，我想通知您，今天電話會議上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提交給美國證券交易委員會的文件中有所描述，包括我們於 2025 年 1 月 31 日提交的最新 10-K 表和於 2025 年 4 月 23 日提交的 10-Q 表。

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.

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.

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。

Today's format will consist of providing you with highlights of our second quarter results as described in our press release announced earlier today, followed by a question-and-answer session. Dave will review business and operational highlights. Jamie will provide a review of our financial results and procedure highlights. I will review clinical highlights and discuss our updated financial outlook for 2025. And finally we will host a question-and-answer session. With that, I will turn it over to Dave.

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二季度業績亮點，然後進行問答環節。戴夫將回顧業務和營運亮點。傑米將回顧我們的財務業績和程序亮點。我將回顧臨床亮點並討論我們對 2025 年的最新財務展望。最後我們將舉辦問答環節。說完這些，我會把麥克風交給戴夫。

Good afternoon and thank you for joining us today. Before we proceed, I'd like to take a moment to recognize and thank Gary Guthart. As you know, after more than 15 years as Intuitive's CEO, Gary transitioned to Executive Chair of the Board earlier this month.

下午好，感謝您今天加入我們。在我們繼續之前，我想花點時間認識並感謝 Gary Guthart。如您所知，在擔任 Intuitive 執行長 15 年後，加里 (Gary) 本月初轉任董事會執行主席。

It's been a privilege to work alongside Gary for nearly 30 years. We joined within a month of each other as engineers at what was a tiny California-based company in 1996, where a small group of us developed the first da Vinci prototype. Since then we have worked together with many extraordinary colleagues to build a company that is today a global enterprise, employing more than 16,000 people, supporting over 11,000 robotic systems across 74 countries, with over 17 million procedures performed.

能夠與加里共事近 30 年是我的榮幸。1996 年，我們在一個月內加入了一家位於加州的小公司，擔任工程師，我們一小群人開發了第一台達文西原型。從那時起，我們與許多傑出的同事共同努力，將公司打造成了一家全球性企業，擁有超過 16,000 名員工，支持 74 個國家的 11,000 多個機器人系統，執行了超過 1700 萬個手術。

On behalf of the patients, surgeons, and care teams we support, our employees, and so many other stakeholders, we thank Gary for his leadership at Intuitive and his contributions to advancing minimally invasive care. I am grateful for the strong foundation he's created and honored to serve as Intuitive's next CEO. I'm excited to lead the company forward as we continue to advance the Quadruple Aim and deliver value for our stakeholders.

我們代表我們支持的患者、外科醫生和護理團隊、我們的員工以及許多其他利益相關者，感謝 Gary 在 Intuitive 的領導以及他對推動微創治療的貢獻。我很感激他所創建的堅實基礎，並很榮幸能夠擔任 Intuitive 的下一任執行長。我很高興能夠帶領公司繼續前進，繼續推進四重目標並為我們的利害關係人創造價值。

Moving to the business, our financial metrics were strong in the second quarter with solid procedure growth and capital placements, despite ongoing macro challenges in certain international markets. Our teams achieved significant milestones across our ecosystem, our products and services, while navigating dynamic market conditions globally. Our product operations teams continue to build capacity and deliver for our customers, while optimizing production costs within our existing manufacturing and supply chain footprint.

談到業務，儘管某些國際市場持續面臨宏觀挑戰，但我們第二季的財務指標依然強勁，業務流程成長穩健，資本配置充足。我們的團隊在應對全球動態市場條件的同時，在我們的生態系統、產品和服務方面取得了重大里程碑。我們的產品營運團隊不斷提高產能並為客戶提供服務，同時在現有製造和供應鏈範圍內優化生產成本。

Our research and development efforts continue to build momentum in the quarter. Our newest platform, da Vinci 5, is in broad launch in the United States and received clearances in Europe and Japan, where we will begin measured launches. We are pleased with customer feedback and adoption of our newer platforms and remain committed to supporting high-quality, minimally invasive care with a comprehensive and impactful product portfolio.

本季度，我們的研發工作持續保持強勁勢頭。我們的最新平台 da Vinci 5 已在美國廣泛推出，並在歐洲和日本獲得批准，我們將在這些地方開始測量發布。我們對客戶回饋和新平台的採用感到非常滿意，並將繼續致力於透過全面且有影響力的產品組合來支持高品質、微創的護理。

Reviewing procedure performance, da Vinci procedure growth in the quarter was 17%. Benign general surgery led US procedure growth with a strong contribution from after-hours procedures, while international growth was led by non-urology procedures.

回顧程式效能，本季達文西程式成長率為 17%。良性普外科手術引領了美國手術的成長，其中下班後手術的貢獻巨大，而國際成長則由非泌尿科手術引領。

Regional performance highlights included strength in India, Korea, and distribution markets. Jamie will provide further details on procedure dynamics later in the call.

區域業績亮點包括印度、韓國和分銷市場的強勁表現。傑米將在稍後的通話中提供有關程序動態的更多詳細資訊。

Turning to capital, we placed 395 da Vinci systems, including 180 da Vinci 5 systems and 23 SP systems. Capital placements were strong in the US, while macro challenges in Japan, China, and Europe continued. We also placed 54 Ion systems in the quarter.

資本方面，我們投放了395套達文西系統，其中包括180套達文西5系統和23套SP系統。美國的資本配置強勁，而日本、中國和歐洲的宏觀挑戰仍在持續。我們還在本季安裝了 54 個 Ion 系統。

System utilization, defined as procedures per installed clinical system per quarter, grew 2% year-over-year for our multiport platforms and accelerated to 30% and 8% for SP and Ion, respectively. Moving to our finances, revenue growth of 21% reflects solid procedure performance and capital placements and a benefit from higher purchase mix. Product margins and operating expenses were slightly favorable to our expectations.

系統利用率（定義為每季每個已安裝臨床系統的程式數）對於我們的多埠平台而言年增 2%，而對於 SP 和 Ion 而言則分別加速至 30% 和 8%。談到我們的財務狀況，21% 的收入成長反映了穩健的流程績效和資本配置以及更高採購組合帶來的好處。產品利潤率和營運費用略高於我們的預期。

Turning to our Multiport business, da Vinci 5 has been an important addition to our robotic surgical system portfolio with more than 100,000 procedures performed to date in what had been a measured US launch. We are pleased to offer da Vinci 5 broadly in the United States.

談到我們的多端口業務，達文西 5 是我們機器人手術系統產品組合的重要補充，迄今為止，它在美國進行了超過 100,000 例手術。我們很高興在美國廣泛提供 da Vinci 5。

Commercialization in Europe and Japan will be measured as we work through additional clearances to fully enable the da Vinci 5 ecosystem. We also added to our advanced energy instrument portfolio with 510(k) clearance for Vessel Sealer Curved, giving surgeons greater precision in narrow anatomical spaces. Additionally, we received a procedure clearance for tracheobronchoplasty, a surgical treatment for a collapsed trachea and main bronchi during normal breathing.

我們將透過額外的審批來全面實現達文西 5 生態系統，並衡量其在歐洲和日本的商業化程度。我們還在我們的先進能量儀器產品組合中增加了 510(k) 許可的曲面血管封閉器，使外科醫生能夠在狹窄的解剖空間內獲得更高的精度。此外，我們還獲得了氣管支氣管成形術的手術許可，這是一種針對正常呼吸過程中塌陷的氣管和主支氣管進行的手術治療。

With respect to our digital ecosystem, customers continue to collect and publish data about force feedback and other aspects of da Vinci 5 through their use of Case Insights. Dan will highlight some of this data later in the call.

關於我們的數位生態系統，客戶透過使用 Case Insights 繼續收集和發布有關力回饋和 da Vinci 5 其他方面的數據。丹將在稍後的通話中重點介紹其中的一些數據。

Since launching dual-console capability with da Vinci Si in 2009, we have developed a range of digital collaboration tools for our customers. We believe these telecollaboration capabilities can advance clinician training, enhance patient care, and optimize care delivery. Intuitive Telepresence with our latest Hub software will enable customers to use on-demand scheduling, connecting easily with a known group of peers, similar to the favorites screen on your phone.

自 2009 年推出 da Vinci Si 雙控制台功能以來，我們已經為客戶開發了一系列數位協作工具。我們相信這些遠端協作功能可以促進臨床醫生培訓、增強患者護理並優化護理服務。我們最新的 Hub 軟體的直覺式遠端呈現將使客戶能夠使用按需調度，輕鬆地與已知的一組同伴建立聯繫，類似於手機上的收藏夾螢幕。

Last week at the Society of Robotic Surgery Conference, Dr. Doug Stoddard, Director of Surgery and Robotics at CHRISTUS Health, and Dr. Andrea Pakula, Medical Director of Robotic Surgery at Dignity Health, performed a telesurgery demonstration between Atlanta and Strasbourg on an advanced tissue model using da Vinci 5, including force feedback.

上週，在機器人手術學會會議上，CHRISTUS Health 的外科手術和機器人技術主任 Doug Stoddard 博士和 Dignity Health 的機器人手術醫學主任 Andrea Pakula 博士在亞特蘭大和斯特拉斯堡之間使用達文西 5 對先進組織模型進行了遠端手術演示，包括力回饋。

While the long-term opportunity for telesurgery is potentially significant, we recognize that achieving safe, consistent adoption will require robust cybersecurity and privacy infrastructure, new workflows at hospitals, revised medical and legal policies, and appropriate business economics. As with our approach to innovation broadly, our work here is focused on applying our experience and expertise to deliver safe, meaningful, grounded solutions that address real-world healthcare challenges.

雖然遠距手術的長期機會可能很大，但我們認識到，要實現安全、一致的應用，需要強大的網路安全和隱私基礎設施、醫院的新工作流程、修訂的醫療和法律政策以及適當的商業經濟。與我們廣泛的創新方法一樣，我們在這裡的工作重點是運用我們的經驗和專業知識來提供安全、有意義、紮實的解決方案，以應對現實世界的醫療保健挑戰。

Turning to SP, procedure growth was strong at 88% year over year, with growth accelerating in Korea. We are still early in our European launch and are pleased with progress to date. Our SP team achieved several milestones, including receiving clearance for our 50-use endoscope, along with 510(k) clearance for transanal local excision and resection, adding to a suite of transabdominal colorectal procedures. Our priorities for SP in the near term include additional indications in the US, expansion in international markets, enhancing core capability, and improving product costs.

談到 SP，程式成長強勁，年增 88%，其中韓國的成長速度加快。我們在歐洲的推廣活動仍處於早期階段，對迄今為止的進展感到滿意。我們的 SP 團隊取得了多個里程碑，包括獲得 50 次使用內視鏡的許可，以及經肛門局部切除和切除的 510(k) 許可，從而增加了一系列經腹結直腸手術。我們對 SP 的短期重點包括在美國增加適應症、擴大國際市場、增強核心能力以及改善產品成本。

Moving to Ion, procedures grew 52% to approximately 35,000 in the quarter. We recently sold our first systems in Australia and Korea and performed our first commercial procedures. Our priorities for Ion in the near term are supporting utilization growth in the US, expansion in international markets, enhancing overall procedure workflow, and improving product costs.

轉向 Ion，本季程式成長了 52%，達到約 35,000 件。我們最近在澳洲和韓國銷售了我們的第一批系統並進行了首次商業化運作。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、增強整體工作流程以及改善產品成本。

Over recent years, we have highlighted our investments in and focus on delivering for our customers across all aspects of our ecosystem at industrial scale. Customers around the globe rely on Intuitive for high-quality products and services and rock-solid supply continuity to ensure they can serve their patients safely, reliably, and effectively at volumes approaching 3 million patients per year globally.

近年來，我們專注於工業規模的生態系統的各個方面，並致力於為客戶提供服務。全球各地的客戶都依賴 Intuitive 提供高品質的產品和服務以及堅如磐石的供應連續性，以確保他們能夠安全、可靠、有效地為全球每年近 300 萬名患者提供服務。

As has been the case throughout our 30-year history, we will continue to innovate across our instrument portfolio as illustrated by the introduction of our Force Feedback and extended-use instrumentation. Our work here is guided by our commitment to the Quintuple Aim, including patient safety, product quality and reliability, and informed by data from millions of procedures.

正如我們 30 年的歷史一樣，我們將繼續在我們的儀器產品組合中進行創新，正如我們推出的力回饋和擴展用途儀器一樣。我們的工作以對五重目標的承諾為指導，包括病患安全、產品品質和可靠性，並以數百萬個程式的資料為依據。

We are aware that third parties have sought to offer products or services to healthcare providers that would modify some of our instruments to extend their use. As customers consider remanufactured instruments from third-party suppliers, we expect key areas such as safety, performance, quality, reliability, supply continuity, and pricing will be carefully evaluated and compared. Our strong belief is that high-quality instruments with consistent performance, broad operational support, and predictable supply chains provide the greatest value to our customers.

我們知道第三方試圖向醫療保健提供者提供產品或服務，以修改我們的一些儀器以延長其用途。當客戶考慮從第三方供應商購買再製造儀器時，我們預計安全性、性能、品質、可靠性、供應連續性和定價等關鍵領域將仔細評估和比較。我們堅信，具有穩定性能、廣泛營運支援和可預測供應鏈的高品質儀器能夠為我們的客戶提供最大的價值。

In closing, we are committed 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.

最後，我們致力於實現 2025 年的優先事項；首先，專注於全面推出達文西 5、其區域審批和後續功能發布；其次，我們將透過培訓、商業活動和市場准入努力，爭取各國更多地採用我們的重點程序；第三，我們將推動在建設工業規模、產品質量和製造優化方面不斷取得進展；最後，我們將專注於我們的數字工具的卓越和可用性。

Our core businesses have momentum, and our teams are focused on the significant long-term opportunity to improve the Quintuple Aim through our connected ecosystem. We are well positioned operationally and financially to execute against our priorities. I’ll now turn the time over to Jamie, who will take you through our finances in greater detail.

我們的核心業務發展勢頭強勁，我們的團隊專注於透過互聯的生態系統改善五重目標的重大長期機會。我們在營運和財務上都處於有利地位，可以執行我們的優先事項。現在我將時間交給傑米，他將向您更詳細地介紹我們的財務狀況。

Good afternoon. I will begin by highlighting our second-quarter performance on a non-GAAP or pro forma basis, and I will summarize our GAAP results later in my remarks. A reconciliation between our pro forma and GAAP results is available on our website.

午安.我將首先重點介紹我們第二季度的非 GAAP 或備考業績，並在稍後的發言中總結我們的 GAAP 結果。我們的網站上提供了備考結果與 GAAP 結果之間的對帳表。

Our second quarter financial results were strong. Revenue growth was 21%. Pro forma operating margin was 39%, and pro forma earnings per share increased 23%. Our underlying core metrics were solid and as follows: da Vinci procedures grew 17%; our installed base of da Vinci systems increased 14% to almost 10,500 systems globally; and average system utilization rose by 2%. Taking da Vinci and Ion together, total procedure growth was 18%.

我們第二季的財務業績強勁。收入成長了21%。預計營業利潤率為 39%，預計每股收益將成長 23%。我們的核心指標穩健，具體如下：達文西手術成長了 17%；我們安裝的達文西系統基數增加了 14%，全球系統數量達到近 10,500 套；平均係統利用率上升了 2%。將 da Vinci 和 Ion 合併起來，整體流程成長率為 18%。

Strength in Q2 financial results reflected a higher mix of systems purchased by customers as compared to last quarter and last year and leverage of fixed costs. In the US, da Vinci procedures grew 14%, driven by continued strength in benign general surgery, with notable growth in cholecystectomy and appendectomy, reflecting in part our partnership with customers to support growth in after-hours procedures.

第二季財務表現的強勁表現反映了與上一季和去年相比，客戶購買的系統組合更高，且固定成本的槓桿率更高。在美國，達文西手術量增加了 14%，這得益於良性普通外科手術的持續強勁增長，其中膽囊切除術和闌尾切除術顯著增長，這在一定程度上反映了我們與客戶的合作夥伴關係，以支持下班後手術量的增長。

When considering the environment in the US, we recognize the potential impacts of fiscal policy to Medicaid recipients. There are approximately 70 to 80 million Americans covered through this program, for which uncertainty remains about whether some patients may lose coverage, how that plays through health systems, and what the ultimate impact might be.

考慮美國的環境時，我們認識到財政政策對醫療補助受益人的潛在影響。大約有 7,000 萬至 8,000 萬美國人享受該計劃的保障，但對於某些患者是否會失去保障、該計劃對醫療系統有何影響以及最終會產生什麼影響，仍存在不確定性。

At this point, I would highlight the following: first, currently Intuitive's relative penetration is lower for patients covered by Medicaid as compared to all other types of coverage; second, Medicaid patients tend to be a younger demographic as compared to the overall population; and third, to the extent that Intuitive can demonstrate an advantage clinically and economically, we believe we are in a position of relative strength.

在這一點上，我想強調以下幾點：首先，目前，與所有其他類型的保險相比，Intuitive 對醫療補助 (Medicaid) 患者的相對滲透率較低；其次，與總體人口相比，醫療補助患者往往更年輕；第三，就 Intuitive 在臨床和經濟上的優勢而言，我們相信我們處於相對優勢的地位。

Outside the US, da Vinci procedures grew 23%, with strong contributions from India, Korea, and distributor markets. Clinical performance in India has been driven by expansion of the installed base at greenfield accounts and adoption by surgeons across a broad set of surgical specialties.

在美國以外，達文西手術成長了 23%，其中印度、韓國和經銷商市場做出了巨大貢獻。印度的臨床表現受到綠地客戶安裝基礎的擴展以及廣泛外科專業的外科醫生的採用的推動。

Strength in Korea procedure growth partly reflected a weaker comparison period, given the impact of physician strikes last year. We also continue to see strong adoption and use of SP in Korea across a broad set of procedures.

受去年醫生罷工的影響，韓國手術量成長強勁，部分反映了同期的疲軟表現。我們也繼續看到韓國在廣泛的程序中大力採用和使用 SP。

In China, procedure growth slightly exceeded the global average and continues to reflect the impact of a constrained and a competitive capital environment. Overall, outside the US, we observed robust growth across colorectal, benign general surgery, thoracic, kidney, and HPB procedures. The breadth of OUS procedure growth reflects our focus in supporting customer adoption beyond urology and is an ongoing opportunity for Intuitive to reach more patients.

在中國，流程成長略高於全球平均水平，並繼續反映受限和競爭激烈的資本環境的影響。總體而言，在美國以外，我們觀察到結直腸、良性普通外科、胸腔外科、腎臟外科和 HPB 手術的強勁成長。OUS 程序成長的廣度反映了我們致力於支持泌尿科以外客戶採用的重點，也是 Intuitive 接觸更多患者的持續機會。

Turning to capital performance, we placed 395 systems in quarter two, a 16% increase from the 341 systems placed in the same quarter last year. Following our progression into US broad launch of da Vinci 5 during Q2, we placed 180 da Vinci 5 systems, bringing the installed base to 689 systems.

談到資本表現，我們在第二季安裝了 395 個系統，比去年同期的 341 個系統增加了 16%。繼第二季在美國廣泛推出達文西 5 之後，我們已安裝了 180 套達文西 5 系統，使安裝基數達到 689 套系統。

We saw 83 trade-in transactions in Q2, up from 21 a year ago, primarily driven by US customers upgrading to da Vinci 5. While there are a number of customers expressing interest in upgrading to da Vinci 5, we expect trade-ins to occur over multiple years as customers assess it's clinical and financial benefits.

我們在第二季度看到了 83 筆以舊換新交易，比去年同期的 21 筆有所增加，這主要是由於美國客戶升級到 da Vinci 5。雖然有許多客戶表示有興趣升級到 da Vinci 5，但我們預計以舊換新將在多年後發生，因為客戶會評估其臨床和財務效益。

In the US, we placed 216 systems, up from 149 last year. Outside the US, we placed 179 systems compared to 192 last year. OUS placements included [73] systems in Europe, 15 in Japan, and 13 in China, compared to 71, 41, and 14 respectively last year.

在美國，我們安裝了 216 個系統，比去年的 149 個有所增加。在美國以外，我們安裝了 179 個系統，而去年為 192 個。OUS 的部署包括歐洲的 [73] 個系統、日本的 15 個系統和中國的 13 個系統，而去年分別為 71 個、41 個和 14 個。

Performance in markets served by distributors has been strong in recent periods. In Q2, we placed 79 systems compared to 70 systems last year. Recent strength has been driven by growth in Brazil, Eastern Europe, and Southeast Asia, reflecting expansion into customers, establishing their first robotic programs.

近期，分銷商所服務的市場表現強勁。在第二季度，我們安裝了 79 個系統，而去年安裝了 70 個系統。近期的強勁成長得益於巴西、東歐和東南亞的成長，反映了客戶的擴張以及他們首個機器人專案的建立。

Our capital performance outside the US continues to be impacted by ongoing financial and budgetary pressures in Japan, China, and Europe. These pressures reflect government budget challenges and uncertainties over the trade environment.

我們在美國以外的資本表現持續受到日本、中國和歐洲持續的財政和預算壓力的影響。這些壓力反映了政府預算挑戰和貿易環境的不確定性。

During the quarter, NHS England issued its 10-year plan to improve healthcare outcomes and associated priorities. We are encouraged to see a commitment to expanding access to robotic surgery as one of the key elements of the plan. However, we do not expect any positive impact this year from incremental NHS investments in robotics.

本季度，英國國家醫療服務體系 (NHS England) 發布了改善醫療保健成果和相關優先事項的十年計畫。我們欣慰地看到，擴大機器人手術的使用範圍是該計劃的關鍵要素之一。然而，我們預計今年 NHS 對機器人技術的增量投資不會產生任何積極影響。

Total revenue for the quarter was $2.44 billion, representing 21% growth over the prior year. On a constant currency basis, revenue growth is also 21%. Systems revenue increased 28%, reflecting lower lease rates, increased placements, and a higher mix of da Vinci 5 systems, which drove higher average selling prices.

本季總營收為 24.4 億美元，比上年成長 21%。以固定匯率計算，收入成長率也達到 21%。系統收入成長了 28%，反映了較低的租賃率、增加的配置以及達文西 5 系統更高的組合，從而推動了平均售價的上漲。

Recurring revenue also grew 21% and accounted for 85% of total revenue. Leasing represented 49% of Q2 placements, lower than 54% last year, primarily driven by a higher mix of placements with distributors, most of whom do not qualify to lease systems.

經常性收入也成長了21%，佔總收入的85%。租賃佔第二季投放量的 49%，低於去年的 54%，主要原因是與經銷商的投放組合較高，而大多數經銷商不具備租賃系統的資格。

While leasing rates may vary from quarter to quarter, we continue to expect the trend toward leasing to increase over time, driven primarily by a higher mix of leasing by OUS customers.

雖然租賃率可能每季都有所不同，但我們仍然預期租賃趨勢將隨著時間的推移而增加，這主要受到 OUS 客戶的租賃組合增加的推動。

The average selling price for systems was $1.5 million, compared to $1.44 million last year, reflecting the increasing mix of da Vinci 5 systems, partially offset by a higher mix of trade-in transactions. Instrument and accessory revenue per procedure was approximately $1,800, relatively consistent with the prior year.

該系統的平均售價為 150 萬美元，而去年為 144 萬美元，這反映了達文西 5 系統組合的增加，但部分被以舊換新交易組合的增加所抵消。每項手術的儀器和配件收入約為 1,800 美元，與前一年基本持平。

On a year-over-year basis, we saw downward pressure from lower bariatric procedures and higher cholecystectomy procedures, offset by customer ordering patterns, higher SP procedures, and da Vinci 5-specific INA.

與去年同期相比，我們看到減肥手術減少和膽囊切除術增加帶來的下行壓力，但被客戶訂購模式、SP 手術增加和達文西 5 專用 INA 所抵消。

Second quarter SP procedures grew 88%, driven by 112% growth in Korea and strong growth in Europe and Japan. We placed 23 SP systems in Q2 compared to 21 systems last year. These included six in the US, six in Korea, and five in Taiwan.

第二季 SP 程式成長了 88%，這得益於韓國 112% 的成長以及歐洲和日本的強勁成長。我們在第二季安裝了 23 個 SP 系統，而去年安裝了 21 個。其中包括美國 6 家、韓國 6 家和台灣 5 家。

SP utilization rose 30%, with Korea and Japan continuing with highly efficient, high-usage SP programs. Utilization is also steadily increasing in Europe and the US. We are progressing through the early phase of a measured rollout of our SP stapler, which we believe is a key enabler for SP adoption in colorectal and thoracic procedures.

SP利用率上漲了30%，韓國和日本持續推行高效率、高利用率的SP計畫。歐洲和美國的利用率也在穩定上升。我們目前正在對 SP 縫合器進行有計劃的早期推廣，我們相信這是 SP 在結直腸和胸腔手術中得到應用的關鍵推動因素。

Now turning to Ion, we performed approximately 35,000 Ion procedures in Q2, a 52% increase over the prior year. We placed 54 Ion systems compared to 74 in Q2 of 2024, seven of these systems were placed in markets outside the US. The installed base of Ion systems expanded to 905 systems, and average system utilization increased 8% from the year-ago period.

現在談到 Ion，我們在第二季度執行了大約 35,000 次 Ion 程序，比前一年增加了 52%。我們安裝了 54 套 Ion 系統，而 2024 年第二季安裝了 74 套，其中 7 套安裝在美國以外的市場。Ion 系統的安裝基數擴大到 905 個系統，平均係統利用率比去年同期增加了 8%。

Turning now to the rest of the P&L, pro forma gross margin for the quarter was 67.9%, down from 70% in Q2 of last year. The year-over-year decline reflects higher facilities costs, including depreciation related to new manufacturing capacity, a greater mix of lower-margin Ion and da Vinci 5 revenue, and higher service costs related to da Vinci 5. In addition, Q2 results also reflected an impact of approximately 60 basis points from tariffs.

現在來看看損益表的其餘部分，本季的預測毛利率為 67.9%，低於去年第二季的 70%。同比下降反映了設施成本的增加，包括與新製造能力相關的折舊、利潤率較低的 Ion 和 da Vinci 5 收入的較大比例，以及與 da Vinci 5 相關的服務成本的增加。此外，第二季業績也反映出關稅約 60 個基點的影響。

Clearly, the trade environment continues to be dynamic. We are currently estimating the impact of tariffs for the year to be approximately 100 basis points, plus or minus 20 basis points, lower than the estimate we provided on last quarter's earnings call, primarily reflecting the reduction of bilateral tariff rates relating to US-China trade.

顯然，貿易環境持續保持動態。我們目前估計，今年關稅的影響約為 100 個基點，上下浮動 20 個基點，比我們在上個季度的收益電話會議上提供的估計低，這主要反映了與中美貿易有關的雙邊關稅稅率的降低。

Our estimate for the year assumes the following: imports from China to the US bear a tariff rate of 30%; imports into China of subassemblies and finished goods from the US are subject to a 10% tariff; imports into the US from all other countries bear a 10% tariff rate; and the imports from Mexico and Canada that comply with USMCA continue to be exempt from tariffs.

我們對今年的估計假設如下：從中國進口到美國的產品徵收30%的關稅；從美國進口到中國的組件和製成品徵收10%的關稅；從所有其他國家進口到美國的產品徵收10%的關稅；從符合USMCA的墨西哥和加拿大進口的產品繼續免徵關稅。

As a reminder, we expect the impact of tariffs to increase each quarter this year as tariff expense rolls through inventory into cost of sales. Given the uncertainty surrounding what tariff rates will ultimately be enacted, it is possible future tariff rates could have a significant incremental impact on our cost of sales.

提醒一下，我們預計今年關稅的影響每季都會增加，因為關稅費用會透過庫存轉入銷售成本。鑑於最終實施的關稅稅率存在不確定性，未來的關稅稅率可能會對我們的銷售成本產生顯著的增量影響。

During the quarter, we opened a new 187,000-square-foot manufacturing facility in Bulgaria, with the land to expand further as needed. This site will initially be focused on our portfolio of more mature endoscope products.

本季度，我們在保加利亞開設了一家佔地 187,000 平方英尺的新製造工廠，並將根據需要進一步擴大土地面積。網站最初將集中介紹我們較成熟的內視鏡產品組合。

Over time, we expect to further increase our manufacturing footprint in Germany and Mexico, given our mid-term needs for additional capacity to support revenue growth and our strategy to operate at industrial scale. Second quarter pro forma operating expenses increased 9% year-over-year, driven by higher headcount and increased facility costs, including depreciation, partially offset by lower legal expenses.

隨著時間的推移，考慮到我們中期需要額外的產能來支持收入成長以及我們的工業規模營運策略，我們預計將進一步擴大在德國和墨西哥的製造足跡。第二季度預計營業費用年增 9%，原因是員工人數增加和設施成本（包括折舊）增加，但法律費用減少部分抵消了這一增長。

We added approximately 300 employees during the quarter, approximately half of whom were in manufacturing roles in support of customer demand. Pro forma other income was $93 million for the quarter, up from $91 million in the prior quarter, reflecting higher interest income.

本季我們增加了約 300 名員工，其中約一半從事製造工作，以滿足客戶需求。本季預測其他收入為 9,300 萬美元，高於上一季的 9,100 萬美元，反映了更高的利息收入。

Our pro forma effective tax rate for Q2 was 22.7%, in line with our expectations. We are at the early stages of evaluating recent US tax reform. And at this point, we do not anticipate a material impact to our 2025 tax rate. We are still evaluating potential impacts for 2026.

我們第二季的預測有效稅率為 22.7%，符合我們的預期。我們正處於評估最近美國稅制改革的早期階段。目前，我們預計這不會對 2025 年的稅率產生重大影響。我們仍在評估 2026 年的潛在影響。

Pro forma net income for the second quarter was $798 million, compared with $641 million last year. Pro forma earnings per share increased 23% year-over-year to $2.19 per share.

第二季的淨收入預估為 7.98 億美元，去年同期為 6.41 億美元。每股收益年增 23% 至每股 2.19 美元。

Now turning to our GAAP results, GAAP net income for the quarter was $658 million, or $1.81 per share, compared to $527 million, or $1.46 per share in Q2 of last year. The differences between our pro forma and GAAP results are outlined and quantified on our website.

現在來看看我們的 GAAP 結果，本季 GAAP 淨收入為 6.58 億美元，即每股 1.81 美元，而去年第二季為 5.27 億美元，即每股 1.46 美元。我們的考試結果和 GAAP 結果之間的差異已在我們的網站上列出並量化。

We ended the quarter with $9.5 billion in cash and investments, up from $9.1 billion last quarter. The sequential increase was driven by operating cash flow, partially offset by stock repurchases of $181 million and $155 million in capital expenditures. During the quarter, we repurchased 350,000 shares at an average price of $518 per share. With that, I'll turn it over to Dan to discuss recent clinical publications and our outlook for 2025.

本季末，我們的現金和投資為 95 億美元，高於上一季的 91 億美元。環比成長主要由營運現金流推動，但被 1.81 億美元的股票回購和 1.55 億美元的資本支出部分抵銷。本季度，我們以每股 518 美元的平均價格回購了 350,000 股。接下來，我將把主題交給丹，討論最近的臨床出版物以及我們對 2025 年的展望。

Thank you, Jamie. Turning to the clinical side of our business, I'd like to share with you data from recent studies that we found notable. In addition to the specific data highlighted on this call, we encourage you to consider the wide body of evidence detailing these topics and published scientific studies over the years.

謝謝你，傑米。談到我們業務的臨床方面，我想與大家分享我們發現的值得注意的近期研究數據。除了本次電話會議中強調的具體數據外，我們還鼓勵您考慮詳細說明這些主題的大量證據以及多年來發表的科學研究。

This past June in the Journal of the American Medical Association, or JAMA, Dr. Fang from Chongqing Hospital, Fudan University, on behalf of the investigator team, reported three-year results from a randomized trial comparing robotic and laparoscopic surgery for middle and low rectal cancer. Known as the REAL study, this study examined local regional recurrence rates with more than 580 subjects in each of the robotic-assisted arm and laparoscopic arm.

今年 6 月，復旦大學附屬重慶醫院的方博士代表研究團隊在《美國醫學會雜誌》（JAMA）上報告了一項隨機試驗的三年結果，該試驗比較了機器人手術和腹腔鏡手術治療中低位直腸癌。這項名為 REAL 研究的研究對機器人輔助臂和腹腔鏡臂各 580 多名受試者的局部區域復發率進行了調查。

Recall, secondary short-term outcomes from this study were published in The Lancet Gastroenterology and Hematology in November 2022 and described on our earnings call in January 2023. That publication reported robotic-assisted surgery resulted in a better oncological quality of resection, less surgical trauma, and better postoperative recovery when compared to the laparoscopic approach.

回想一下，這項研究的次要短期結果於 2022 年 11 月發表在《柳葉刀胃腸病學和血液學》上，並在 2023 年 1 月的收益電話會議上進行了描述。該出版物報告稱，與腹腔鏡手術相比，機器人輔助手術可實現更好的腫瘤切除品質、更少的手術創傷和更好的術後恢復。

In the current JAMA publication, the primary outcome was the three-year local regional recurrence rate, which was defined as any case of cancer recurrence in the pelvic or perineal area at three years after surgery. The authors reported that the robotic-assisted group demonstrated a 55% lower risk of local regional recurrence at three years compared to laparoscopy. The authors concluded, quote, compared with conventional laparoscopic surgery, robotic surgery significantly improved long-term oncological outcomes in patients with middle or low rectal cancer. With additional real-world clinical data and modern improved training programs for surgeons, robotic surgery could be the preferred choice for patients with middle or low rectal cancer, end quote.

在目前的 JAMA 出版物中，主要結果是三年局部區域復發率，其定義為手術後三年內骨盆或會陰區域發生癌症復發的任何病例。作者報告稱，與腹腔鏡手術相比，機器人輔助組三年內局部區域復發的風險降低了 55%。作者總結道，與傳統腹腔鏡手術相比，機器人手術顯著改善了中低位直腸癌患者的長期腫瘤學結果。有了更多的真實世界臨床數據和現代改進的外科醫生培訓計劃，機器人手術可能成為中低位直腸癌患者的首選。

With the launch of the da Vinci 5 platform, we are starting to see evidence emerge that describes the value that new features such as Force Feedback technology and Case Insights may bring to minimally invasive surgery. At this month's Society of Robotic Surgery Annual Meeting, Dr. Laila Rashidi from MultiCare Health System in Tacoma, Washington, presented data from her single-surgeon experience. Dr. Rashidi analyzed relationships between clinical outcomes and objective performance indicators, or OPIs, such as the force measured during surgery using Force Feedback instruments.

隨著達文西 5 平台的推出，我們開始看到證據表明力回饋技術和 Case Insights 等新功能可能為微創手術帶來的價值。在本月舉行的機器人手術學會年會上，華盛頓州塔科馬市 MultiCare 醫療系統的 Laila Rashidi 博士展示了她作為單人外科醫生的經驗數據。Rashidi 博士分析了臨床結果與客觀績效指標（OPI）之間的關係，例如使用力回饋儀器在手術過程中測量的力道。

To conduct the study, Dr. Rashidi and colleagues used OPIs generated by Case Insights, an AI-enabled solution that combines surgical video with data from the da Vinci platform. Their analysis of 28 low anterior resection cases revealed that certain patient factors and OPIs were associated with the outcomes in these colorectal procedures.

為了進行這項研究，Rashidi 博士及其同事使用了 Case Insights 產生的 OPI，Case Insights 是一種將手術影片與達文西平台的數據相結合的人工智慧解決方案。他們對 28 例低位前切除術病例的分析表明，某些患者因素和 OPI 與這些結直腸手術的結果有關。

Specifically, higher forces, especially during the dissection phase of surgery and prior surgery, were associated with increased length of stay. The strongest predictor of length of stay was the percent of force time above 6.5 newtons. Dr. Rashidi and team concluded in part, quote, this early dV5 experience demonstrates that patient factors and OPIs are associated with clinical outcomes and robotic-assisted low anterior resection.

具體來說，較大的力量，特別是在手術的解剖階段和先前的手術中，與住院時間的增加有關。停留時間最強的預測因子是作用力時間百分比高於 6.5 牛頓。Rashidi 博士和團隊總結道，早期的 dV5 經驗表明，患者因素和 OPI 與臨床結果和機器人輔助低位前切除術相關。

Advancements in the technologies integrated with robotic platforms can assist surgeons by identifying factors that predict complications and aiding the optimization of techniques for specific patients, ultimately supporting safer, gentler, and more precise surgery, end quote.

與機器人平台結合的技術進步可以協助外科醫生識別預測併發症的因素並幫助優化針對特定患者的技術，最終支持更安全、更溫和、更精確的手術。

While these results are early, we are encouraged to see results that are consistent with the core hypothesis of the value that Force Feedback technology and Case Insights may bring to minimally invasive surgery. We continue to expect clinical evidence to build over the coming quarters and years.

雖然這些結果還處於早期階段，但我們很高興看到這些結果與力回饋技術和案例洞察可能為微創手術帶來的價值的核心假設一致。我們繼續期待未來幾季和幾年內臨床證據的累積。

I will now turn to our updated financial guidance for 2025, starting with da Vinci procedures. On our last call, we forecast full-year 2025 da Vinci procedure growth within a range of 15% and 17%. We are updating our 2025 da Vinci procedure growth guidance to be within a range of 15.5% and 17%.

現在我將介紹我們 2025 年的最新財務指導，首先從達文西計畫開始。在我們上次電話會議上，我們預測 2025 年全年達文西手術的成長率將在 15% 至 17% 之間。我們正在更新 2025 年達文西程式成長指導，使其介於 15.5% 至 17% 之間。

Consistent with last quarter, 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 hospital CapEx budgets, which limits the expansion of capacity in the field and bariatric procedures continue to decline at rates similar to recent trends.

與上一季一致，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醫院的資本支出預算，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相似的速度下降。

The high end of the range assumes China procedure growth improves relative to 2024, the CapEx environment improves in key OUS markets, and bariatric procedure declines moderate. The high end of the range also assumes that da Vinci procedures are not impacted by the current trade environment.

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，減重手術下降幅度適中。該範圍的高端也假設達文西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 65% and 66.5% of revenue, which reflected significant incremental depreciation as we bring on new facilities, the contribution from growth and newer products, and the expected impact of tariffs.

談到毛利，我們上次預測 2025 年的預期毛利率將在營收的 65% 至 66.5% 之間，這反映了我們引入新設施帶來的大幅增量折舊、成長和新產品的貢獻以及關稅的預期影響。

As Jamie described earlier, we currently expect the recently implemented tariffs globally to increase our 2025 cost of sales by approximately 1% of revenue, plus or minus 20 basis points. As a result, we are updating our estimate for pro forma gross margin to be within a range of 66% and 67% of revenue.

正如 Jamie 之前所述，我們目前預計最近在全球範圍內實施的關稅將使我們 2025 年的銷售成本增加約 1% 的收入，上下浮動 20 個基點。因此，我們將對備考毛利率的估計更新為收入的 66％ 至 67％ 之間。

In regards to operating expenses, we continue to expect pro forma operating expense growth to be between 10% and 14%, which includes increased depreciation from new facilities and investments to drive our growth objectives.

關於營運費用，我們繼續預期營運費用成長率將在 10% 至 14% 之間，其中包括新設施和投資帶來的折舊增加，以推動我們的成長目標。

We continue to expect our non-cash stock compensation expense to range between $770 million and $790 million. We now expect other income, which is comprised mostly of interest income, to total between $370 million and $390 million. With regards to capital expenditures, we now estimate a range of $650 million to $725 million, primarily for planned facility construction activities.

我們繼續預期非現金股票薪酬支出將在 7.7 億美元至 7.9 億美元之間。我們現在預計其他收入（主要包括利息收入）總額將在 3.7 億美元至 3.9 億美元之間。關於資本支出，我們現在估計範圍為 6.5 億美元至 7.25 億美元，主要用於計劃中的設施建設活動。

With regard to income tax, we continue to estimate our 2025 pro forma income tax rate to be between 22% and 23% of pre-tax income. That concludes our prepared comments. As we open the line for questions, we ask that you please limit yourself to one or two questions.

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。我們的準備好的評論到此結束。當我們開放提問熱線時，我們要求您將問題限制在一兩個範圍內。

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

（操作員指示）美國銀行證券的 Travis Steed。

Hey, thanks for your question and congrats. I guess maybe I'll start with a margin question. It was kind of one of the highest margins you've had in a long time, even with the tariff headwind. I don't know how much of this is the new facility coming on in Q1 or what, just trying to think about what drove the margin upside this quarter and kind of what's sustainable on the margin side.

嘿，謝謝你的提問，恭喜你。我想也許我應該從一個邊際問題開始。即使面臨關稅阻力，這也是長期以來最高的利潤率之一。我不知道其中有多少是由於第一季新工廠的投入使用，我只是想知道是什麼推動了本季利潤率的上升，以及利潤率的可持續性。

Hey Travis, it's Jamie. Yeah, I'd just say we had a strong revenue growth quarter at 21%. Part of that was the increased purchase mix, which obviously the purchase/lease mix can vary from quarter to quarter. We did underspend on OpEx just a little bit, and that grew 9% year over year.

嘿，崔維斯，我是傑米。是的，我想說的是，我們本季的營收成長強勁，達到了 21%。其中一部分原因是購買組合增加，顯然購買/租賃組合每季都會有所不同。我們的營運支出確實略有不足，但年增了 9%。

And so part of what fell through them was just the revenue be leveraged through the entire P&L, produced the operating margin result. I would not characterize that as the new normal because obviously you've got some benefit from, again, the purchase mix and spending just growing 9%.

因此，他們失敗的部分原因只是透過整個損益表利用收入，產生了營業利潤率結果。我不會將其描述為新常態，因為顯然你會從購買組合和支出成長 9% 中獲得一些好處。

Understood and I guess I'll go ahead and get the one reprocessing question out of the way too. I guess the question would be, one, is there any more you could add to what you said in the prepared remarks? Is this something you can kind of do yourself? Or could you also potentially extend useful lives on your own instrumentation as well, just kind of thinking about longer term how you kind of protect the business?

明白了，我想我會繼續解決這個重新處理的問題。我想問題是，第一，除了您在準備好的演講中所說的內容之外，您還有什麼可以補充的嗎？這是你自己能做的事情嗎？或者您是否也可以延長您自己的儀器的使用壽命，只是考慮一下從長遠來看如何保護業務？

Yeah, no. Travis, it's Dave. I think, as I said in my prepared remarks, customers care about the Quintuple Aim as they establish robotic programs. They want to deliver high-quality care, great outcomes for their patients. And we know they want to do it with the right value too.

是的，不。崔維斯，我是戴夫。我認為，正如我在準備好的演講中所說的那樣，客戶在建立機器人程式時會關心五重目標。他們希望為患者提供高品質的照護和良好的治療效果。我們知道他們也想以正確的價值觀來做到這一點。

And so as customers consider remanufactured instruments from third-party providers, it's been my experience that oftentimes hospitals will use value committees to assess these types of supply chains. Those value committees often consist of a variety of stakeholders from the hospital. It may be OR leadership, it could be medical personnel, risk management, supply chain, care team, folks like surgeons and nurses, and maybe others.

因此，當客戶考慮從第三方供應商購買再製造的儀器時，根據我的經驗，醫院通常會使用價值委員會來評估這些類型的供應鏈。這些價值委員會通常由醫院的各種利害關係人組成。它可能是手術室領導，可能是醫務人員、風險管理、供應鏈、護理團隊、外科醫生和護士等人，也可能是其他人。

And so these value committees have established processes that they look through and assess a whole bunch of variables like we talked about. Safety, reliability, performance, continuity of supply, ongoing support, all will be weighed against the expected savings.

因此，這些價值委員會已經建立了流程，以審查和評估我們所討論的一大堆變數。安全性、可靠性、性能、供應的連續性、持續的支持，所有這些都將與預期的節省進行權衡。

And so that's where our strong belief is that high-quality instruments, the performance that we have demonstrated over time, the operational support that we engage through our teams, and a very predictable supply chain will provide the greatest value.

因此，我們堅信高品質的儀器、我們長期以來所展示的性能、我們透過團隊提供的營運支援以及非常可預測的供應鏈將提供最大的價值。

As you look forward, I think innovation plays a strong role here. And so you've seen us increase the breadth of our portfolio over time. You've seen us extend instrument uses, introduce Force Feedback here recently with da Vinci 5. And throughout that entire time we've worked really hard on instrument reliability and supporting the safety and performance of robotic surgery in our portfolio, importantly, from the first use and through the last use.

展望未來，我認為創新將發揮重要作用。因此，您會看到我們隨著時間的推移不斷擴大產品組合的廣度。您已經看到我們擴展了儀器的用途，最近在 da Vinci 5 中引入了力回饋。在整個過程中，我們一直非常努力地提高儀器的可靠性，並支援我們產品組合中機器人手術的安全性和性能，重要的是，從第一次使用到最後一次使用。

And so we're going to continue to invest and innovate to differentiate across our portfolio. And that will bring, I think, best-in-class performance and innovation in pursuit of the Quintuple Aim. And we're also going to strive to a lower cost and provide the best value for our customers.

因此，我們將繼續投資和創新，以實現我們產品組合的差異化。我認為，這將帶來一流的表現和創新，以實現五重目標。我們還將努力降低成本並為客戶提供最佳價值。

And so this journey with remanufactured instruments will have many phases, and we will innovate in a variety of different ways and provide the best value for our customers.

因此，再製造儀器的旅程將分為多個階段，我們將以各種不同的方式進行創新，為客戶提供最佳價值。

Really helpful. Thanks Dave. I appreciate the question.

真的很有幫助。謝謝戴夫。我很感謝你提出這個問題。

David Roman, Goldman Sachs.

高盛的大衛‧羅曼（David Roman）。

Thank you and good afternoon. I appreciate your taking the question. Maybe Jamie, I could start as a follow up to your comments regarding some of the policy changes that are evolving. I think on the last quarter call you had talked -- you and Gary had talked about the dynamic with the potential for risk around US hospital CapEx spending, but at the same time where Intuitive could be part of the solution.

謝謝，下午好。感謝您回答這個問題。也許傑米，我可以開始跟進你關於一些正在發生的政策變化的評論。我認為在上個季度的電話會議上您和 Gary 討論了美國醫院資本支出的潛在風險，但同時 Intuitive 可以成為解決方案的一部分。

Tonight you talked about the dynamic around the unfortunate potential loss of coverage for Medicaid patients and what that might do to the business. Can you maybe give us an update on your latest thinking on the capital side and how you're approaching those conversations as you think about aiding hospitals and their objectives to advance patient care? And then I had a follow-up on the Force Feedback study.

今晚，您談到了醫療補助患者可能不幸失去保險的動態以及這可能對企業造成的影響。您能否向我們介紹一下您在資本方面的最新想法，以及您在考慮幫助醫院及其提高患者護理水平的目標時如何處理這些對話？然後我對力回饋研究進行了跟進。

Yeah, on Medicaid specifically, I think we would generally say, it's too early to make any comments with respect to how US hospitals are responding to that, at least based on our engagements with customers. We recognize that to the extent that hospitals experience lower admissions because patients lose coverage or they have less reimbursement. Then, of course, that just creates incremental financial challenges for hospitals that they may need to respond to in terms of how they manage capital budgets or even operational budgets.

是的，具體到醫療補助計劃，我認為我們通常會說，現在就美國醫院如何應對這一問題發表評論還為時過早，至少根據我們與客戶的接觸來看是這樣。我們認識到，醫院入院人數減少是因為患者失去了保險或報銷金額減少。當然，這只會為醫院帶來越來越多的財務挑戰，他們可能需要在如何管理資本預算甚至營運預算方面做出應對。

So we're just acknowledging that and providing that some context with respect to our relative penetration relative to Medicaid. I do think that we have a growing number of engagements we have with customers, particularly in the US relative to what we call customer hospital analytics, where we can look at their data from a clinical and economic perspective.

因此，我們只是承認這一點，並提供一些關於我們相對於醫療補助的相對滲透率的背景資訊。我確實認為我們與客戶的合作越來越多，特別是在美國，關於我們所謂的客戶醫院分析，我們可以從臨床和經濟的角度查看他們的數據。

And oftentimes, we see that da Vinci can be actually part of the solution where there's an economic challenge in the form of the things we've talked about, lowering length of stay, lower complication rates, saving precious resources, etc. And so we'll look to engage customers if and as that's needed over time.

我們經常發現，達文西實際上可以成為解決方案的一部分，以我們所討論的形式解決經濟挑戰，例如縮短住院時間、降低併發症發生率、節省寶貴資源等。因此，如果需要，我們會隨著時間的推移吸引客戶。

In terms of the overall capital environment, I'd just say if we look at system placements at 395, we'd characterize that as solid performance and in the range of our expectations, but you actually have to double-click in terms of the kind of market breakdown of that performance. Placements in the US grew 45%, reflecting the move into broad launch for da Vinci 5 in Q2 and strength and interest in da Vinci 5.

就整體資本環境而言，我只想說，如果我們看一下 395 的系統配置，我們會將其描述為穩健的表現並在我們的預期範圍內，但實際上你必須雙擊該表現的市場區隔類型。美國的投放量成長了 45%，反映了達文西 5 在第二季的廣泛推出以及市場對達文西 5 的強勁需求和濃厚興趣。

And then we talked about Japan, which was down 26 systems year over year. Europe and China are essentially flat. And that's mostly to do with government budget deficits and conserving government spending, including impacts on healthcare. So I think we feel good about the US and recognize some challenges internationally.

然後我們談到了日本，其係統同比去年有 26 個癱瘓。歐洲和中國基本持平。這主要與政府預算赤字和節省政府開支有關，包括對醫療保健的影響。所以我認為我們對美國感覺良好，並且認識到國際上存在的一些挑戰。

In OUS customers, we do have some levers and opportunities. Many of those customers and markets experienced lower levels of utilization. And we have tools, resources, and levers to help customers increase utilization to support procedure growth.

在 OUS 客戶中，我們確實有一些槓桿和機會。許多客戶和市場的利用率都較低。我們擁有工具、資源和槓桿來幫助客戶提高使用率，以支持流程成長。

We've refined some of our leasing models to more localize them in the past quarter, I think can help with alleviating the pressures that they face. And of course we have the launch of da Vinci 5 now with the clearance in Europe and Japan. And at least we think some early adopters will be responding to that technology. Finally, I'd say as we are able to drive trade-ins in the US, that then gives us the opportunity to add XIR to the portfolio, which can be attractive to OUS customers where they're cost sensitive.

我們在過去的一個季度改進了一些租賃模式，使其更加本地化，我認為這有助於緩解他們面臨的壓力。當然，我們現在已經推出了達文西 5，並在歐洲和日本獲得了批准。至少我們認為有些早期採用者會對這項技術做出回應。最後，我想說，由於我們能夠在美國推動以舊換新，這使我們有機會將 XIR 添加到產品組合中，這對於對成本敏感的 OUS 客戶來說很有吸引力。

Very helpful. I appreciate all the detail. And maybe just to follow up on on the force feedback launch, can you give us kind of an update on where you are with customer evaluations as well as capacity expansion and the extent to which that may already be impacting the INA per procedure number and how we should think about the progression of the rollout there.

非常有幫助。我感謝所有的細節。也許只是為了跟進力回饋的推出，您能否向我們介紹一下客戶評估和容量擴展的最新情況，以及這可能對每個程式的 INA 數量產生多大程度的影響，以及我們應該如何考慮在那裡推出的進展。

Yeah, David, maybe I'll take the first part and I think Jamie will jump in towards the end. Just on the supply of Force Feedback instruments, we do expect that to be constrained through first quarter of next year. And I'd say more broadly, pleased with adoption thus far, the early feedback's been encouraging, particularly with Case Insights. I think you heard us describe, we and surgeons were building evidence and continue to -- we'll share that over time.

是的，大衛，也許我會選擇第一部分，而我認為傑米會在最後加入。僅就力回饋儀器的供應而言，我們預計到明年第一季將會受到限制。我想更廣泛地說，到目前為止，我對採用情況感到滿意，早期的回饋令人鼓舞，特別是 Case Insights。我想您聽到我們描述了，我們和外科醫生正在收集證據並將繼續——我們會隨著時間的推移分享這些證據。

And again, that evidence is mainly looking to demonstrate that Force Feedback can improve outcomes and then separately, maybe quick in the learning curve for surgeons adopting robotics for the first time.

再次強調，這些證據主要是為了證明力回饋可以改善結果，並且可能加快首次採用機器人技術的外科醫生的學習曲線。

I'm sorry. Remind me the second part of your question.

對不起。提醒我你問題的第二部分。

To see the extent to which Force Feedback may have impact, it looks like INA outgrew procedure volumes this quarter, whether that's having a positive impact even in its early launch and when we might start to see. It sounds like the first quarter '26 is the dynamic with capacity, but when we might start to see a more significant impact from Force Feedback on that INA per procedure number?

要了解 Force Feedback 可能產生的影響程度，看起來 INA 本季的程序量已經超出預期，這是否在其早期推出時就產生了積極影響，以及我們何時可以開始看到。聽起來 26 年第一季的產能是動態的，但是什麼時候我們才能開始看到力回饋對每個程式的 INA 數量產生更顯著的影響？

Yeah. In the prepared remarks, it was one of the contributing factors to upward momentum on INA per procedure, although it's a small -- the smallest component, and the way I characterized it was da Vinci 5 INA-specific contributions. That's the combination of Force Feedback and the tube sets that go along with or integrate into software. So one of the smaller factors, and obviously that becomes an opportunity for us to the extent that we can demonstrate value and when we get to full supply.

是的。在準備好的評論中，它是每個程式中 INA 上升勢頭的因素之一，儘管它是一個小的 - 最小的組成部分，我將其描述為達文西 5 INA 特定的貢獻。這是力回饋和與軟體配合或整合到軟體中的管道的組合。因此，這是一個較小的因素，但顯然，當我們能夠展示價值並獲得全面供應時，這對我們來說是一個機會。

Great. Thank you very much.

偉大的。非常感謝。

Robert Marcus, JPMorgan.

摩根大通的羅伯特馬庫斯。

Great. Congratulations on a very nice quarter. And, Dave, congratulations as I believe it's your first call as a CEO. Two for me. Maybe first just to kind of pick up a threat in one of David's questions on da Vinci 5 and productivity. And I was wondering -- I know it's still early in the launch, but you now have a couple of quarters on some of these robots in the US.

偉大的。恭喜您度過了一個非常愉快的季度。戴夫，恭喜你，我相信這是你作為執行長的第一次通話。對我來說是兩個。也許首先只是想從大衛關於達文西 5 和生產力的問題中發現一種威脅。我很好奇——我知道現在還處於發布初期，但您現在已經在美國推出了一些此類機器人。

And you know, are you seeing any improvements in productivity? It could obviously be really helpful as we think about the upgrade cycle and the ability to do more procedures, generate more revenue, and treat more patients. So first, I'd love to hear what you're seeing in terms of improved productivity on da Vinci 5 versus Xi. Thanks.

您知道嗎，您看到生產力有任何提升嗎？當我們考慮升級週期以及執行更多程序、產生更多收入和治療更多患者的能力時，它顯然會非常有幫助。因此首先，我很想聽聽您認為 da Vinci 5 與 Xi 相比在生產效率方面有何提升。謝謝。

What I would say is, it's one area where we look to build evidence to support the value proposition. And we've described to you in the past a number of the anecdotal inputs that we get from surgeons. Some of them have been presented on stage.

我想說的是，這是我們尋求建立證據來支持價值主張的領域。我們過去曾向您描述過一些從外科醫生那裡得到的軼事資訊。其中一些已在舞台上演出過。

We've seen some analysis and various publications. But we'd like to get to a state where that is robust evidence and is part of how we engage with the customers. And that will take us some time to build that collateral.

我們已經看到了一些分析和各種出版物。但我們希望達到這樣的狀態：既有確鑿的證據，也能成為我們與客戶互動的一部分。我們需要花一些時間來建立抵押品。

I would say that recently, average system utilization on da Vinci 5 surpassed Xi. Obviously, we'd like to see that sustained. And we'd like to know that that actually is a function of increased efficiency. It could be that parts of that are just surgeons' interest to try and get on the platform versus the Xi. But that seems consistent from where those lines crossed.

我想說的是，最近，達文西 5 的平均係統利用率超過了 Xi。顯然，我們希望這種狀況能夠持續下去。我們希望知道這實際上是否是效率提高的結果。這可能只是外科醫生的興趣，他們想利用這個平台對抗習近平。但從這些線的交叉處看，這似乎是一致的。

So I think that's an opportunity for us, but we have work to do to get to a level of evidence that's sufficiently robust that we can engage customers that way. And I just maybe let Dave make any additional comments.

所以我認為這對我們來說是一個機會，但我們需要做一些工作來獲得足夠有力的證據，以便我們可以以這種方式吸引客戶。我可能只是讓戴夫發表一些補充評論。

No, you're right on, Jamie. The dV5, da Vinci 5, one of its areas of focus from our design teams was exactly around efficiency. And so you have heard some of the capabilities and features described around head end UI and placements of screens. And so all of those things are contributing and integrating to some of the efficiency gains that Jamie described.

不，你說得對，傑米。dV5、da Vinci 5，我們的設計團隊關注的重點之一就是效率。您已經聽說了有關頭端 UI 和螢幕位置的一些功能和特性描述。因此，所有這些因素都對 Jamie 所描述的一些效率提升做出了貢獻並相互融合。

And we have seen -- we are tracking at individual institutions and individual surgeons. And you see on short cases to very to longer cases, savings that can exceed 20%. And so as more and more data comes to life there, we will start seeing how that impacts utilization.

我們已經看到——我們正在追蹤個別機構和個別外科醫生的情況。您會發現，無論是短期案件還是長期案件，節省的金額都可能超過 20%。隨著越來越多的數據出現，我們將開始看到這對利用率有何影響。

And I think here our one goal would be to enable hospital teams to add another case during the day. And so as we continue our journey here with dV5, we look forward to collecting and analyzing and publishing more data.

我認為我們的一個目標是讓醫院團隊能夠在白天增加一個病例。因此，隨著我們繼續與 dV5 合作，我們期待收集、分析和發布更多數據。

Great. Maybe a quick follow up for you Jamie. I saw you repurchased shares in the quarter. It's the first time in a while. Just wanted to hear the thought process and your latest thoughts on capital deployment. And just how do you think about that. Thanks a lot.

偉大的。也許對你來說這是一個快速的跟進，傑米。我看到您在本季度回購了股票。這是好久以來的第一次。只是想聽聽您的思考過程以及您對資本部署的最新想法。您對此有何看法？多謝。

Yeah, our capital allocations remain consistent. And I probably sound like a broken record. It's first to organically invest in the business. And you've seen us do that with R&D and CapEx more recently.

是的，我們的資本配置保持一致。我聽起來可能就像一張破唱片。首先對業務進行有機投資。您最近已經看到我們透過研發和資本支出做到了這一點。

Second is we look for smaller tuck-in acquisitions where we can find technology that's differentiated or can help us accelerate the business, and then we return capital to shareholders when we have opportunistic times to do that.

其次，我們尋找規模較小的補充收購，從中我們可以找到差異化的技術或可以幫助我們加速業務發展的技術，然後在適當的時機將資本回饋給股東。

And so what you saw us recognize in the quarter is just the volatility that's in the environment in part because of the trade environment. And so we exercised that opportunistically. We review what we do with capital allocation each quarter with our Board, and so we have a relatively formalized process by which we evaluate what we do.

因此，您看到我們在本季度認識到，環境的波動部分是由於貿易環境造成的。因此，我們抓住機會實施了這項措施。我們每季都會與董事會一起審查我們的資本配置情況，因此我們有一個相對正式的流程來評估我們的工作。

Larry Biegelsen, Wells Fargo.

富國銀行的拉里·比格爾森。

Good afternoon. Thanks for taking the question. Congrats to Dave on the new role. I think for Jamie, two on systems. I'm going to try to get them both in here.

午安.感謝您回答這個問題。祝賀戴夫擔任新職務。我認為對於 Jamie 來說，有兩個系統。我將嘗試將他們兩個都帶到這裡。

How should we think about system placements outside the US going forward, given the recent CE Mark and Japan approval? Is there any reason we wouldn't see system placements start to grow again like we did when you launched dV5 in the US?

鑑於最近的 CE 標誌和日本的批准，我們應該如何考慮未來在美國以外的系統部署？有沒有理由認為，我們不會再看到系統部署量像你們在美國推出 dV5 時那樣開始成長？

And secondly, now that the full dV5 launch has started in the US, how should we think about the rate of increase in trade-ins going forward and any color on kind of the financial implications of the trade-ins?Thanks for taking the questions.

其次，既然 dV5 已在美國全面上市，我們該如何看待未來以舊換新車的成長率？能否透露一下以舊換新車的財務影響？謝謝回答問題。

Yeah, with respect to clearance of dV5 in Europe and Japan, as our history has been, we're planning for a measured rollout. And there's work to do there. We have to obviously build training pathways, posting capabilities, and actually engage customers in terms of the relative value of da Vinci 5, in particular given its higher price. And of course you have to wait for clearance before you can directly engage customers in that way.

是的，關於在歐洲和日本批准 dV5，正如我們的歷史一樣，我們計劃分步推出。那裡還有工作要做。顯然，我們必須建立培訓途徑、發布能力，並真正吸引客戶，以了解達文西 5 的相對價值，特別是考慮到它的價格較高。當然，您必須等待批准才能以這種方式直接與客戶接觸。

I would say that Force Feedback instruments for Europe is not yet cleared, and actually we don't expect that before the end of next year. So there may be some European customers that want to wait for that capability. I would expect, as we've seen in the US, there will be early adopter kinds of companies, customers that will be interested in getting access to da Vinci 5 because of the effects of their program and the desires of their surgeons. But I would consider it to be a measured rollout through the second half as we like to do that the right way with building the infrastructure that drives long-term success.

我想說的是，歐洲的力回饋儀器尚未獲得批准，實際上我們預計明年年底前不會批准。因此，可能有些歐洲客戶想要等待這種能力。我預計，正如我們在美國看到的那樣，將會有早期採用者類型的公司和客戶對使用達文西 5 感興趣，因為他們的程序效果很好，而且符合外科醫生的願望。但我認為這是下半年的一次有計劃的推出，因為我們希望以正確的方式來建立推動長期成功的基礎設施。

With respect to moving into broad launch in the US in Q2 and the implication for trade-ins, yes, we would expect then trade-ins to increase given that we have now appropriate levels of supply for those customers that want to upgrade.

關於第二季在美國的廣泛推出以及對以舊換新的影響，是的，我們預計以舊換新會增加，因為我們現在為想要升級的客戶提供適當的供應水平。

But as we've said, we think that occurs progressively over multiples of years because customers are in different places with respect to their programs, the populations they serve, their relative financial priorities in terms of capital budgets and the operational challenges that they face. And a number of them will want to evaluate da Vinci 5, and they'll take their time to do it from a clinical efficiency and financial perspective. Thanks so much.

但正如我們所說，我們認為這會在數年內逐步發生，因為客戶的計劃、服務人群、資本預算方面的相對財務優先級以及面臨的營運挑戰各不相同。他們中的許多人都想評估達文西 5，並且他們會花時間從臨床效率和財務角度進行評估。非常感謝。

Rick Wise, Stifel.

瑞克懷斯 (Rick Wise)，Stifel。

Good afternoon, Dave. Hi, Jamie. Dave, at the SRS meeting, we heard about the potential for robotics utilization in other spaces beyond current core focuses of the industry like endovascular, broadly, ASCs, etc.

下午好，戴夫。你好，傑米。戴夫，在 SRS 會議上，我們聽說了機器人技術在除血管內、廣義、 ASC 等行業當前核心重點之外的其他領域的應用潛力。

I'm just wondering as things evolve and as dV5 rolls out, it's early to say what's next, but how are you thinking about what's next broadly in terms of new locations, new opportunities?

我只是想知道，隨著事態的發展和 dV5 的推出，現在談論下一步做什麼還為時過早，但從新地點、新機會的角度來看，您如何看待下一步的廣泛發展？

Yeah, Rick, you know you had mentioned ASCs and ambulatory care kind of outpatient environments and so you know that was a focus at SRS. And if I step back from that and say what do customers need within an ASC to provide high quality care, a piece of that puzzle is consistent and reliable technology.

是的，里克，你知道你提到 ASC 和門診護理類型的門診環境，所以你知道這是 SRS 的重點。如果我退一步思考，並問客戶需要 ASC 提供什麼才能獲得高品質的護理，那麼這個難題的一部分就是一致且可靠的技術。

And so that surgeons who come from the main hospital and have some of their practice at an ASC are able to efficiently do procedures at a volume and with outcomes that are appropriate. And that's where I'm excited about the technology in our portfolio that we have today.

這樣，來自主醫院並在 ASC 有部分實踐經驗的外科醫生就能夠有效地進行一定數量的手術並獲得適當的結果。這就是我對我們今天所擁有的產品組合中的技術感到興奮的地方。

And I like some of the opportunity. As Jamie was talking about trade-ins, customers can put the newest technology like dV5 into their main institutions and focus on some of the inpatient procedures and then oftentimes take the capital that they already own, be it Xi or X, and move that into ASC environments.

我喜歡這樣的機會。正如 Jamie 談到以舊換新時所說，客戶可以將 dV5 等最新技術引入他們的主要機構，並專注於一些住院程序，然後通常會利用他們已經擁有的資本（無論是 Xi 還是 X），將其轉移到 ASC 環境中。

And so you know one way to help meet customers' needs. But again, as we're looking at how to solve customers' problems and their goals about Quintuple Aim, I think increasingly we're seeing some attention around the outpatient environments and ASCs and feel good about the products that we have there.

所以你知道一種幫助滿足客戶需求的方法。但是，當我們研究如何解決客戶的問題以及他們對 Quintuple Aim 的目標時，我認為我們越來越多地看到人們對門診環境和 ASC 的關注，並且對我們在那裡擁有的產品感到滿意。

Great. And just as a second question, Dave, I'm very conscious that you all have said repeatedly that the da Vinci 5 will continue to evolve. You've touched on a couple of the aspects. But I was lucky enough to hear, as you know from your colleague Iman Jeddi who's leading the dV5 rollout, that with a full launch of the system, which -- a broad launch, I think, were your words, that there would be additional features, additional software, different additional capabilities.

偉大的。第二個問題，戴夫，我很清楚你們都曾多次說過，達文西 5 將會不斷發展。您已經談到了幾個方面。但我很幸運地聽到，正如您從領導 dV5 推出工作的同事 Iman Jeddi 那裡得知的那樣，隨著系統的全面推出——我想，您說的是廣泛推出，將會有額外的功能、額外的軟體和不同的附加功能。

And I was hoping you could expand on that and maybe help us understand the implications for adoption, for utilization. And maybe, does this help, Jamie, the ASP or margins as the rollout continues. Thank you very much.

我希望您能進一步闡述這一點，或許能幫助我們理解其對採用和利用的影響。也許，隨著推出的繼續，這對 Jamie、ASP 或利潤率有幫助嗎？非常感謝。

Yeah, thanks, Rick. So one of the things about robotic systems as a whole is there are platform technologies. And you start in one place with a product that is launched at the beginning of last year, and I think you can draw a good analogy to Xi when it was first launched and then look, a decade later at the features and capabilities that were added along the way. And the exact same journey will happen with dV5.

是的，謝謝，里克。因此，機器人系統作為一個整體的特點之一就是擁有平台技術。如果你從去年年初推出的產品開始，我認為你可以將其與 Xi 首次推出時的情況進行類比，然後看看十年後在此過程中添加的功能和性能。dV5 也將經歷同樣的歷程。

And so yes, Samath had talked about some of the things that were upcoming. And there are many. One in particular that we've talked about before is we have the ability to integrate now 3D models in a different way than we used to with Xi, and so that is part of the compute increase. In terms of the compute power increase we're now able to do things graphically and through integration and imaging that we were not able to do before.

是的，薩馬斯談到了一些即將發生的事情。還有很多。我們之前特別討論過的一點是，我們現在能夠以不同於 Xi 的方式整合 3D 模型，這是運算能力提升的一部分。就運算能力的提高而言，我們現在能夠以圖形方式、透過整合和成像來完成以前無法做到的事情。

And so again with the expectation that these kinds of capabilities will advance one or more aspects of the Quintuple Aim, sometimes outcomes, sometimes the care and patient experiences, or sometimes perhaps cost.

因此，我們再次期望這些能力能夠推進五重目標的一個或多個方面，有時是結果，有時是護理和患者體驗，有時可能是成本。

And so I think as we look over the coming quarters and coming years, we'll keep you informed about the features and capabilities and instruments that will continue to be added to the platform. And excited about where it's going to take us.

因此，我認為，展望未來幾季和幾年，我們隨時會向您通報平台將持續增加的功能、能力和工具。並且對它將帶我們去的地方感到興奮。

Rick, we have a roadmap of features to come over time. Some of them are committed and some of them are obviously ideas that we'll explore and make conclusions on.

里克，我們有一個未來功能路線圖。其中一些是我們已經承諾的，而另一些顯然是我們將要探索並得出結論的想法。

I'd say most of those features to come, we won't directly charge for. But of course they then enhance the surgeon experience and the overall capability of the system.

我想說，對於即將推出的大多數功能，我們不會直接收費。但當然，它們會增強外科醫生的經驗和系統的整體能力。

So in that sense then for customers that are looking at the price and maybe pausing on whether to make the incremental investment, as you increase actually the capability and feature set of the system, then it makes the likelihood of a sale for a customer that was waiting higher.

因此從這個意義上講，對於那些正在考慮價格並可能正在猶豫是否進行增量投資的客戶來說，隨著您實際上增加系統的功能和特性集，等待的客戶購買的可能性就會更高。

There are some digital capabilities that we're considering charging for. And that's going to be a function of incremental value, and can we demonstrate that to the customer.

我們正在考慮對一些數字功能進行收費。這將是增量價值的函數，我們能否向客戶證明這一點。

I think we've got time for one more question.

我想我們還有時間再回答一個問題。

Adam Maeder, Piper Sandler.

亞當梅德、派珀桑德勒。

Hi, good afternoon. Thank you for squeezing me in and congrats on a nice quarter. I'll keep it to just one question. I did want to ask about the Curved Vessel Sealer which recently got FDA approval. I've been seeing some buzz on LinkedIn and other sites.

嗨，下午好。感謝您抽出時間給我，並祝賀您取得了一個美好的季度。我只問一個問題。我確實想詢問一下最近獲得 FDA 批准的曲面血管封口機。我在 LinkedIn 和其他網站上看到了一些熱門話題。

To just help us kind of better understand, any potential impact from that device in the marketplace? What is the benefit of the technology? Which procedures will utilize that device? And is there anything to call out from a pricing standpoint as it relates to INA procedure? Thank you.

只是為了幫助我們更了解該設備對市場可能產生的影響嗎？這項技術有什麼好處？哪些程式將使用該設備？從定價角度來看，與 INA 程序相關的問題有什麼需要注意的嗎？謝謝。

Yeah, we're excited about that device. It's primary value prop -- it's quite a bit slimmer profile than the existing Vessel Sealers that we have. It has a ceiling indication for 7 millimeter vessels, which is important.

是的，我們對該設備感到很興奮。它的主要價值支柱是——它比我們現有的容器密封器要纖薄得多。它具有 7 毫米血管的上限指示，這很重要。

The tip of the instrument actually allows for better tissue manipulation. And so of course then it's best suited to those procedures that have narrow spaces in which the surgeon works. So that's thoracic, colorectal, hiatal hernia as examples.

儀器的尖端實際上可以實現更好的組織操作。因此，它當然最適合外科醫生在狹窄的空間內進行手術。這就是胸腔、大腸直腸、食道裂孔疝氣等例子。

The way I would think about it is that it sets us up for the possibility, the probability that we can penetrate those procedures with advanced energy more fully than we would with the existing portfolio. And we'd also look at a value hypothesis that we'd also see higher stick rates from surgeons.

我的想法是，它為我們提供了可能性，即我們能夠比現有投資組合更充分地利用先進能源滲透這些程序。我們也會考慮一個價值假設，即我們也會看到外科醫生的堅持率更高。

And so it doesn't open up new procedures for us. It does have a minor impact to relative INA per procedure given the value prop, but it's really for us about having a greater degree of penetration and success in those procedures that need a narrow space for energy.

因此它不會為我們開闢新的程序。考慮到價值主張，它對每個程序的相對 INA 確實有很小的影響，但對我們來說，這實際上是為了在那些需要狹窄能量空間的程序中獲得更大程度的滲透和成功。

Okay, that was 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 the Quintuple Aim.

好的，這是我們的最後一個問題。謝謝您的提問。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，以追求我們的客戶所稱的五重目標。

Better and 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. It flows from respect for and understanding of patients and care teams and their needs in their environment.

患者治療結果更好、更可預測，患者獲得更好的體驗，護理團隊獲得更好的體驗，整體護理成本更低，最終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。它源於對患者和護理團隊以及他們所處環境的需求的尊重和理解。

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

在 Intuitive，我們設想未來的照護將侵入性更小、品質更高，可以更早發現疾病並快速治療，讓患者重新專注於最重要的事情。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。

And thank you, everyone. This concludes our program. You may know -- we may now disconnect. Have a great day, everyone.

謝謝大家。我們的節目到此結束。您可能知道——我們現在可以斷開連接了。祝大家有個愉快的一天。