直覺手術 (ISRG) 2025 Q3 法說會逐字稿

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

感謝您的耐心等待，歡迎收看 Intuitive 2025 年第三季財報發表會。（操作說明）提醒各位，今天的節目正在錄製中。

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

現在，我謹向大家介紹今天節目的主持人，Intuitive 投資者關係主管 Dan Connally。先生，請繼續。

Good afternoon, and welcome to Intuitive's Third Quarter Earnings Conference Call. Joining me today are Dave Rosa, our CEO; and Jamie Samath, our CFO. Before we begin, I would like to remind you that comments on today's call may contain forward-looking statements. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties.

下午好，歡迎參加 Intuitive 第三季財報電話會議。今天和我一起出席的有我們的執行長戴夫·羅薩和我們的財務長傑米·薩馬斯。在開始之前，我想提醒各位，今天電話會議中的評論可能包含前瞻性陳述。由於存在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。

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 July 23, 2025. Our SEC filings can be found through our website at intuitive.com or at the SEC's website. Investors are cautioned not to place undue reliance on such forward-looking statements.

這些風險和不確定性已在我們的證券交易委員會文件中進行了描述，包括我們最近於 2025 年 1 月 31 日提交的 10-K 表格和於 2025 年 7 月 23 日提交的 10-Q 表格。您可以透過我們的網站 intent-intuitive.com 或美國證券交易委員會 (SEC) 的網站找到我們提交給 SEC 的文件。投資者應注意，不要過度依賴此類前瞻性陳述。

Please note that this conference call will be available for audio replay on our website in the Events section under our Investor Relations page. We have posted today's press release and supplementary financial data tables to our website. Our format for this afternoon's earnings conference call is as follows: 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.

請注意，本次電話會議的音訊回放將在我們網站的「投資者關係」頁面下的「活動」欄位中提供。我們已將今天的新聞稿和補充財務資料表發佈到我們的網站上。今天下午的財報電話會議形式如下：Dave 將回顧業務和營運亮點。Jamie將對我們的財務表現和流程要點進行回顧。我將回顧臨床亮點，並討論我們更新後的 2025 年財務展望。最後，我們將舉行問答環節。

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

接下來，我將把麥克風交給戴夫。

Good afternoon, and thank you for joining us today. Q3 2025 was an excellent quarter for Intuitive, with strength in worldwide procedure growth and capital placements as well as increasing utilization across all platforms. Globally, customer interest in and adoption of da Vinci 5 expanded. Domestically, customers responded to our first full quarter of broad da Vinci 5 availability with increased demand for system upgrades and dual consoles. Internationally, we placed our first systems in Japan and Europe with surgeons performing initial cases in those geographies.

下午好，感謝各位今天蒞臨。2025 年第三季對於 Intuitive 來說是一個非常好的季度，全球業務成長和資本配置強勁，所有平台的利用率也不斷提高。在全球範圍內，客戶對達文西5的興趣和採用率不斷提高。在國內，客戶對我們第一個完整的季度全面推出 da Vinci 5 系統做出了積極響應，對系統升級和雙控制台的需求有所增加。在國際上，我們首先在日本和歐洲部署了我們的系統，外科醫生在這些地區進行了初步手術。

Turning to procedures. da Vinci procedures increased by 19% and Ion procedures were higher by 52%, leading to total worldwide procedure growth of 20%. da Vinci procedure growth reflected strength in benign general surgery in the US and accretive growth in general surgery and gynecology internationally. System utilization, defined as procedures for installed clinical system per quarter, grew 4% for our da Vinci multiport platforms, 35% for SP and 14% for Ion.

再來看手術方面。達文西手術量增加了19%，離子手術量增加了52%，帶動全球手術總量增加了20%。達文西手術量的成長反映了美國良性普通外科手術的強勁勢頭，以及國際上普通外科和婦科手術的持續成長。系統利用率（定義為每季已安裝臨床系統的手術量）方面，達文西多連接埠平台成長了 4%，SP 成長了 35%，Ion 成長了 14%。

In the first 18 months since launch, da Vinci utilization is validating our design intent already outpacing Xi. Procedure demand has been healthy. And as da Vinci 5 catalyzed upgrades, we saw the multiport installed base utilization ticking up to absorb that demand. This is healthy for our customers and for our company. Turning to capital.

自發布以來的前 18 個月，達文西的使用率已經驗證了我們的設計意圖，並且已經超過了 Xi。手術需求一直保持良好狀態。隨著達文西 5 的推出推動了升級，我們看到多埠安裝基礎利用率不斷上升，以滿足這一需求。這對我們的客戶和公司都有好處。轉向資本。

We placed 427 da Vinci systems, including 240 da Vinci 5 systems and 30 SP systems as well as 50 Ion systems. Demand for da Vinci 5 upgrades drove strong domestic placements. We believe upgrades are an effective way for customers to expand throughput and capabilities. These capabilities include force sensing, surgeon autonomy, telepresence and various other digital tools that may lead to enhanced understanding of what great surgery looks like and further adoption of robotic-assisted surgery over time.

我們安裝了 427 台達文西手術系統，其中包括 240 台達文西 5 系統和 30 台 SP 系統以及 50 台 Ion 系統。對達文西5升級的需求推動了國內市場的強勁成長。我們認為升級是客戶擴展吞吐量和提升能力的有效方法。這些功能包括力感應、外科醫生自主性、遠端呈現以及其他各種數位工具，這些工具可能會加深人們對優秀手術的理解，並隨著時間的推移進一步推廣機器人輔助手術。

Additionally, it is our intent to offer refurbished Xi systems as part of our broader portfolio, which will help expand access in certain geographies and sites of care. Internationally, da Vinci placements reflected ongoing external dynamics in Japan, China and the UK, offset by broad-based strength in other international markets. Customer adoption of our products resulted in strong financial performance reflected in 23% revenue growth and combined with strong operating discipline, 30% earnings growth.

此外，我們計劃將翻新的 Xi 系統納入我們更廣泛的產品組合中，這將有助於擴大某些地區和護理場所的覆蓋範圍。從國際上看，達文西手術系統的部署反映了日本、中國和英國持續的外部動態，但被其他國際市場的廣泛強勁勢頭所抵消。客戶對我們產品的接受帶來了強勁的財務業績，收入成長了 23%，再加上嚴格的營運紀律，獲利成長了 30%。

Jamie will provide further details on procedures, systems and finances later in the call. Last month, we hosted our 10th Annual Intuitive 360 User Conference in San Diego, where more than 1,100 health care professionals representing over 450 institutions from around the world gathered to exchange ideas and shape the future of patient care. Customers remained acutely focused on improving patient outcomes, reducing clinical and operational variation, driving efficiency and increasing access to minimally invasive care.

Jamie 將在稍後的通話中提供有關流程、系統和財務方面的更多細節。上個月，我們在聖地牙哥舉辦了第十屆年度 Intuitive 360​​ 用戶大會，來自世界各地 450 多家機構的 1100 多名醫療保健專業人員齊聚一堂，交流思想，共同塑造患者護理的未來。客戶始終高度關注改善患者治療效果、減少臨床和營運差異、提高效率以及增加獲得微創治療的機會。

More than 30 institutions presented their own clinical and financial outcomes data, which further validated the value of our three existing platforms. I had the opportunity to sit down with multiple customers and dive deep into their robotic programs, including the impact of da Vinci 5 and potential fleet standardization, site-of-care dynamics and their overall lung cancer programs. I was encouraged to see the depth of their data and analyses and how these customers were able to quantify the impact of their Intuitive programs on aspects of the Quintuple Aim.

超過 30 家機構展示了他們自己的臨床和財務結果數據，這進一步驗證了我們三個現有平台的價值。我有機會與多位客戶坐下來，深入了解他們的機器人項目，包括達文西 5 的影響和潛在的設備標準化、護理地點動態以及他們的整體肺癌項目。看到他們的數據和分析如此深入，以及這些客戶如何量化他們的 Intuitive 計畫對五重目標各個方面的影響，我感到非常鼓舞。

Domestically, while we remain in limited launch with force feedback instrumentation, we are working closely with customers to support their analyses of the impact of force feedback on clinical outcomes and learning progression. I am encouraged by early feedback and excited to see where some of these studies are leading. Dan will highlight some of this data later in the call. Across all of our platforms, we consistently upgrade capability and reliability through software and hardware releases.

在國內，雖然我們仍處於力回饋儀器的有限推廣階段，但我們正在與客戶密切合作，支持他們分析力回饋對臨床結果和學習進展的影響。早期的回饋令我備受鼓舞，我很期待看到這些研究的進展。丹將在稍後的電話會議中重點介紹其中的一些數據。我們透過軟體和硬體的發布，不斷提升所有平台的功能和可靠性。

In Q3, we received FDA 510(k) clearance for the first in a series of software updates for da Vinci 5. With the addition of Network Central Configuration Management, we are now able to deploy updates remotely, which significantly streamlines workflow for both our customers and Intuitive. This release also includes the visual representation of force through Force Gauge and Focus Mode, which enables In-Console Video Replay and viewing registration and manipulation of 3D models.

第三季度，我們獲得了 FDA 510(k) 許可，這是達文西 5 系列軟體更新的第一個。透過新增網路中央配置管理功能，我們現在能夠遠端部署更新，這大大簡化了我們客戶和 Intuitive 的工作流程。此版本還包括透過力計和聚焦模式對力進行視覺化表示，從而實現主機內視訊回放以及查看註冊和操作 3D 模型。

These features enhance surgeon awareness and intraoperative decision-making. You will see us continue to make improvements to the platform that advance our vision of delivering real-time insights at the point of care to support clinical efficiency with the aim of improving outcomes. Internationally, we placed our first nine systems in Japan and Europe and have received positive early feedback. We look forward to engaging customers as they continue to evaluate da Vinci 5.

這些功能增強了外科醫師的意識和術中決策能力。您將會看到我們不斷改進平台，以推進我們的願景，在護理點提供即時見解，以支持臨床效率，從而改善治療效果。在國際上，我們在日本和歐洲部署了首批九套系統，並已收到正面的早期回饋。我們期待與客戶互動，共同評估達文西5號手術系統。

Our da Vinci single-port platform made further progress in Q3. Procedures increased 91%, led by ongoing growth in Korea, continued early progress in other international markets and initial domestic use of the SP stapler in colorectal and thoracic procedures. At 360, I had a conversation with a long-time da Vinci thoracic surgeon about his initial experience using SP on about 40 patients. He's enthusiastic both about the reduction and length of stay and also his first few cases of using the SP stapler.

我們的達文西單埠平台在第三季取得了進一步進展。手術量增加了 91%，這主要得益於韓國市場的持續成長、其他國際市場的早期進展以及 SP 吻合器在國內結直腸和胸腔外科手術中的初步應用。在 360 節目中，我與一位長期使用達文西胸腔外科醫生就他最初在約 40 名患者身上使用 SP 的經驗進行了交談。他對縮短住院時間和減少住院時間都感到非常興奮，並且對他最初使用 SP 縫合器的幾個病例也感到滿意。

I share his enthusiasm about these early results and look forward to seeing more data from colorectal and thoracic procedures as our launch progresses. Recent 5(k) clearances -- 510(k) clearances support several advanced features, including Sensitive Firefly and various control algorithms aimed at further improving SP stapler usability. Since we last spoke with you on our Q2 call, we have completed US regulatory submissions for nipple-sparing mastectomy and other general surgery procedures. We look forward to updating you on these efforts on future calls.

我和他一樣對這些初步結果感到興奮，並期待隨著我們產品的上市推進，看到更多關於結直腸和胸腔外科手術的數據。最近的 5(k) 許可——510(k) 許可支援多項高級功能，包括 Sensitive Firefly 和旨在進一步提高 SP 訂書機可用性的各種控制演算法。自從我們上次在第二季電話會議上與您交談以來，我們已經完成了保留乳頭乳房切除術和其他普通外科手術的美國監管申報。我們期待在以後的電話會議中向您報告這些工作的最新進展。

Turning to Ion. Worldwide procedures grew 52% to just under 38,000. We are now delivering Ion's differentiated value at scale, providing precise and individualized patient-specific navigation plans using AI to segment each CT scan and plan the biopsy trajectory. This quarter, we received FDA clearance for a significant software release that improves workflow and imaging options, including upgraded system software that uses real-time AI to enable even more precise airway navigation and tomosynthesis integration, broadening the suite of imaging offerings when cone-beam CT is not available.

轉向離子。全球手術量增加了 52%，達到近 38,000 例。我們現在正在大規模地提供 Ion 的差異化價值，利用人工智慧分割每個 CT 掃描並規劃活檢軌跡，從而提供精確的、個性化的患者特定導航計劃。本季度，我們獲得了 FDA 的批准，發布了一項重要的軟體版本，該版本改進了工作流程和成像選項，包括升級的系統軟體，該軟體使用實時 AI 來實現更精確的氣道導航和斷層合成集成，從而在錐形束 CT 不可用時擴展了成像產品組合。

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 of 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，我們將繼續致力於實現2025年各項優先事項。首先，重點關注達文西5的全面發布、其區域許可和後續功能發布。其次，我們將透過培訓、商業活動和市場准入努力，推動各國更多地採用我們重點關注的程序。第三，我們將持續推動工業規模建設、產品品質提升和生產製造最佳化。最後，我們將重點關注我們數位工具的卓越性和可用性。

Looking ahead, by virtue of our focus on patients, our alignment with customers in pursuit of the Quintuple Aim, our investments in both industrial scale and innovation, and our commercial excellence, we are well positioned operationally and financially to further increase value to patients, physicians, hospitals and payers globally.

展望未來，憑藉我們對患者的關注、與客戶共同追求五重目標、對工業規模和創新方面的投資以及卓越的商業能力，我們在營運和財務方面都處於有利地位，能夠進一步提升全球患者、醫生、醫院和支付方的價值。

With that, I'll turn the time over to Jamie to take you through our business and finances in greater detail.

接下來，我將把時間交給傑米，讓他更詳細地向大家介紹我們的業務和財務狀況。

Good afternoon. I will begin by highlighting our third quarter performance on a non-GAAP or pro forma basis, and I will also summarize our GAAP results later in my remarks. A reconciliation between our pro forma and GAAP results is available on our website. The third quarter was a strong quarter for Intuitive. Taking da Vinci and Ion together, total procedure growth was 20% compared to 18% growth for the first half of 2025.

午安.首先，我將重點介紹我們第三季的非GAAP或準備業績，稍後我將在發言中總結我們的GAAP業績。我們的網站上提供了模擬財務報表與GAAP財務報表之間的核對錶。第三季是Intuitive表現強勁的一個季度。達文西手術系統和 Ion 手術系統加起來，總手術量增加了 20%，而 2025 年上半年的成長率為 18%。

In quarter three, revenue grew 23% to $2.5 billion, pro forma operating margin was 39% and pro forma earnings per share increased 30%. The strength of our financial results reflected the broad launch of da Vinci 5 and expanded adoption of our Ion and SP platforms. For our da Vinci business, procedures grew 19%, the installed base of da Vinci systems increased by 13% to almost 10,800 systems and average system utilization increased by 4%.

第三季度，營收成長 23% 至 25 億美元，備考營業利潤率為 39%，備考每股收益成長 30%。我們強勁的財務業績反映了達文西 5 的廣泛推出以及 Ion 和 SP 平台的廣泛應用。對於我們的達文西手術系統業務，手術量成長了 19%，達文西系統的安裝量增加了 13%，達到近 10,800 台，平均係統利用率增加了 4%。

We continue to see robust growth for our Ion platform with procedures increasing 52%, the installed base up by 30% to approximately 950 systems and average system utilization increasing by 14%. In the US, total procedures, da Vinci and Ion, increased 18%, reflecting 16% growth in da Vinci procedures and 48% growth in Ion procedures. da Vinci utilization in the US increased 2% in Q3 compared to flat utilization in the first half of this year and 2% growth last year.

我們的 Ion 平台持續保持強勁成長，手術量成長了 52%，安裝量成長了 30%，達到約 950 套系統，平均係統利用率成長了 14%。在美國，手術總量（包括達文西手術和離子導入手術）增加了18%，其中達文西手術增加了16%，離子導入手術增加了48%。與今年上半年持平以及去年同期2%的成長相比，美國第三季達文西手術的使用率成長了2%。

Increased growth in US da Vinci utilization reflected strong Q3 procedure growth and the higher mix of da Vinci 5 in the installed base, where utilization is higher than Xi. This reflects surgeon interest in using our latest technology and efficiency gains from da Vinci 5's higher levels of surgeon autonomy and integration. As one example, in quarter 3, almost 90% of da Vinci 5 procedures used our integrated insufflation technology.

美國達文西手術系統使用率的提高反映了第三季度手術量的強勁增長，以及已安裝設備中達文西5型手術系統佔比更高，而達文西5型手術系統的使用率高於達文西Xi型手術系統。這反映了外科醫生對使用我們最新技術的興趣，以及達文西 5 手術系統提高外科醫生自主性和整合度所帶來的效率提升。例如，在第三季度，近 90% 的達文西 5 手術使用了我們整合的充氣技術。

Outside the US, total procedures, da Vinci and Ion, grew 25%, driven by 24% growth in da Vinci procedures and a quadrupling of Ion procedures from a small base. OUS procedure growth reflected an approximate 1 percentage point benefit as a result of the timing of certain local holidays. da Vinci procedure growth in OUS markets included strong results in India, Canada, Korea, Taiwan and Brazil, and solid growth in China, the UK, Italy and France.

在美國以外，手術總量（包括達文西手術和離子手術）增加了 25%，其中達文西手術增加了 24%，離子手術在較小基數的基礎上增加了四倍。受部分當地假日的影響，美國境外（OUS）手術量增加約1個百分點。達文西手術在海外市場的成長包括：印度、加拿大、韓國、台灣和巴西的強勁表現，以及中國、英國、義大利和法國的穩健成長。

Procedure growth in Japan was a little lower than our expectations, reflecting lower capital placements over the last several quarters. Globally, we continue to see strong procedure growth for SP at 91% for Q3, with strength in Korea and earlier stage growth in Europe and Japan. In total, for our OUS markets, we saw accretive da Vinci procedure growth across benign general surgery, up 39%; colorectal, up 28%; hysterectomy, which grew 27%; and thoracic procedures, which increased 26%.

日本的手術量成長略低於我們的預期，反映出過去幾季的資本投入減少。全球範圍內，SP 手術量第三季持續強勁成長，達到 91%，其中韓國市場表現強勁，歐洲和日本的早期階段手術量也有所增長。總體而言，對於我們的 OUS 市場，我們看到達文西手術在良性普通外科手術中增長了 39%；結直腸手術增長了 28%；子宮切除術增長了 27%；胸腔外科手術增長了 26%。

Combined, those categories are approximately 40% of OUS da Vinci procedures. Average system utilization in OUS markets combined grew 8% in Q3 as compared to 6% in the first half of this year and 4% growth in 2024. Accelerating utilization in Q3 is driven by strong multi-specialty procedure growth in India, Korea, Taiwan and distributor markets and customers in countries with capital constraints, driving increasing use of the existing installed base.

這些類別加起來約佔 OUS 達文西手術的 40%。今年第三季度，美國境外市場的平均係統利用率成長了 8%，而今年上半年為 6%，預計 2024 年將成長 4%。第三季利用率加速成長，主要得益於印度、韓國、台灣以及資金受限國家的經銷商市場和客戶的多專科手術的強勁成長，從而推動了現有設備基礎的日益普及。

As of Q3, aggregate average system utilization in OUS markets is approximately 20% below that of systems in the US. As a result of our clinical performance, total I&A revenue in quarter three grew 20% to $1.5 billion, consistent with overall procedure growth. da Vinci I&A revenue per procedure was approximately $1,800, flat with last quarter and last year.

截至第三季度，美國境外市場的整體平均係統利用率比美國市場的系統利用率低約 20%。由於臨床表現出色，第三季手術及抽吸總收入成長20%至15億美元，與整體手術量成長趨勢一致。達文西手術的單次手術及抽吸收入約為1,800美元，與上季及去年同期持平。

On a year-over-year basis, we saw downward pressure from lower bariatric procedures and higher cholecystectomy procedures, offset by higher SP procedures and da Vinci 5 specific I&A. For our ion platform, I&A revenue per procedure was approximately $2,200, relatively consistent with prior periods. Turning to capital performance and starting with our da Vinci business.

與前一年相比，我們看到減肥手術減少和膽囊切除手術增加帶來了下行壓力，但 SP 手術增加和達文西 5 手術特有的 I&A 手術抵消了這種壓力。對於我們的離子平台，每次手術的 I&A 收入約為 2,200 美元，與前期基本一致。接下來談談資本績效，先從我們的達文西業務說起。

We placed 427 da Vinci systems in quarter three, a 13% increase from the 379 systems placed in the same quarter last year. 240 of the 427 placements were da Vinci 5, including 12 in OUS markets following recent clearances in Japan and Europe. The installed base of da Vinci 5 is now 929 systems. In the US, we have at least one da Vinci 5 system in 18 of the largest 20 IDNs. And of hospitals that have three or more multiport systems, 21 of those hospitals have fully standardized to da Vinci 5.

第三季我們共安裝了427台達文西手術系統，較去年同期的379台成長了13%。其中240台為達文西5型手術系統，包括近期在日本和歐洲獲得批准後在美國以外市場安裝的12台。目前達文西5系統的安裝量為929套。在美國，排名前 20 名的綜合交付網路 (IDN) 中，至少有 18 個網路擁有一台達文西 5 系統。在擁有三個或更多多端口系統的醫院中，有 21 家醫院已完全標準化為達文西 5 型手術系統。

We saw 141 trade-in transactions in Q3, up from 38 a year ago, primarily driven by US customers upgrading to da Vinci 5. Some customers are shifting budgets to upgrades, partly with the intention of taking advantage of the efficiency potential of da Vinci 5. We are also actively working with some customers to acquire da Vinci 5 and move their Xis to alternative sites within their network.

第三季我們看到了 141 筆以舊換新交易，比去年同期的 38 筆有所增加，這主要是由於美國客戶升級到達芬奇 5 型​​手術系統所致。一些客戶正在將預算轉移到升級上，部分原因是希望利用達文西 5 的效率潛力。我們目前也積極與一些客戶合作，幫助他們購買達文西5型手術系統，並將他們的Xi手術系統遷移到其網路內的其他站點。

In the US, we placed 263 systems, up from 219 last year, driven by demand for da Vinci 5. Outside the US, we placed 164 systems compared to 160 last year. OUS placements included 63 systems in Europe, 16 in Japan and 13 in China, compared to 65, 39 and 14, respectively, last year. We continue to see government budget challenges in Japan and the UK and the constrained and competitive marketplace in China.

在美國，我們安裝了 263 套系統，比去年的 219 套有所增加，主要得益於對達文西 5 的需求。在美國以外，我們安裝了 164 套系統，而去年為 160 套。OUS 的部署包括歐洲 63 個系統、日本 16 個系統和中國 13 個系統，而去年分別為 65 個、39 個和 14 個。我們持續看到日本和英國政府預算面臨挑戰，以及中國市場受限且競爭激烈。

Performance in markets served by distributors continue to be relatively strong. In Q3, we placed 64 systems compared to 52 systems last year. Q3 performance was driven by strength in Brazil and the Middle East. Within the 427 da Vinci placements, we placed 30 SP systems in the third quarter, higher than the 21 systems last year driven primarily by OUS markets. For our Ion platform, we placed 50 systems in the quarter compared to 58 systems last year.

分銷商所服務的市場表現依然相對強勁。第三季度，我們安裝了 64 套系統，而去年同期為 52 套。第三季業績主要得益於巴西和中東市場的強勁表現。在 427 台達文西手術系統中，第三季我們安裝了 30 台 SP 系統，高於去年的 21 台，主要得益於美國境外市場的成長。本季度，我們的 Ion 平台共安裝了 50 套系統，而去年同期為 58 套。

Q3 Ion placements included nine systems in OUS markets. Lower Ion placements in the US primarily reflects a joint focus with our customers on increasing utilization. As a function of our capital performance, quarter three systems revenue grew 33% to $590 million. For our da Vinci business, leasing represented 54% of da Vinci placements as compared to 49% last quarter and 58% last year, driven primarily by customer mix.

第三季 Ion 系統在海外市場的安裝量達到 9 套。美國 Ion 設備安裝量的下降主要反映了我們與客戶共同致力於提高設備利用率。由於資本表現良好，第三季系統收入成長了 33%，達到 5.9 億美元。就我們的達文西手術系統業務而言，租賃佔達文西手術系統安裝量的 54%，而上一季為 49%，去年同期為 58%，這主要是由於客戶組成的變化所致。

We continue to expect that rates of leasing will increase over time, primarily driven by OUS markets. da Vinci leasing revenue increased 33%, reflecting an 18% expansion of the installed base under operating lease arrangements and a 10% increase in lease revenue per system driven by a higher mix of da Vinci 5.

我們仍然預期租賃率會隨著時間的推移而上升，主要受美國境外市場（OUS）的推動。達文西手術系統的租賃收入增長了33%，這反映出採用經營租賃方式的裝機量增長了18%，以及由於達文西5型手術系統佔比提高，單台系統的租賃收入增長了10%。

The average selling price for purchased da Vinci systems was $1.6 million in Q3 as compared to $1.5 million last year, driven by a higher mix of da Vinci 5 and the higher mix of dual console systems, partially offset by higher trade-ins. Lease buyout revenue was $22 million as compared to $30 million last quarter and $24 million last year. Quarter three service revenue increased 20% to $396 million, reflecting an increase of the da Vinci installed base of 13% and the Ion installed base of 30%.

第三季達文西系統的平均售價為 160 萬美元，而去年同期為 150 萬美元，這主要得益於達文西 5 的銷量佔比增加以及雙控制台系統的銷量佔比增加，但部分被更高的以舊換新銷量所抵消。租賃買斷收入為 2,200 萬美元，而上一季為 3,000 萬美元，去年同期為 2,400 萬美元。第三季服務收入成長 20% 至 3.96 億美元，反映出達文西手術系統安裝基數成長 13%，Ion 手術系統安裝基數成長 30%。

Service revenue per system for our da Vinci installed base increased 5% year-over-year, primarily reflecting a higher mix of da Vinci 5 systems. Total revenue for the quarter was $2.51 billion, representing 23% growth over the prior year. On a constant currency basis, revenue growth was also 23%. Recurring revenue grew 21% continuing to account for 85% of total revenue.

我們達文西手術系統安裝基礎的每套系統服務收入年增 5%，主要反映出達文西 5 系統的比例較高。本季總營收為 25.1 億美元，比上年同期成長 23%。以固定匯率計算，收入成長也達到了 23%。經常性收入成長了 21%，繼續佔總收入的 85%。

Turning now to the rest of the P&L. Pro forma gross margin for the quarter was 68%, down from 69.1% in Q3 of last year. The year-over-year decline reflects a 90-basis point impact from tariffs, higher facility costs, a greater mix of lower margin da Vinci 5 and Ion revenue and higher service costs related to da Vinci, partially offset by cost reductions.

現在來看損益表的其餘部分。本季以準備考試計算的毛利率為 68%，低於去年第三季的 69.1%。較去年同期下降 90 個基點，反映出關稅、設施成本上升、低利潤率的達文西 5 和 Ion 收入佔比增加以及與達文西相關的服務成本上升的影響，部分被成本削減所抵消。

Quarter three pro forma operating expenses increased 11% year-over-year, driven by higher headcount, increased facility costs and higher R&D prototype expenses, partially offset by lower legal spending. We added approximately 340 employees during the quarter, primarily in our core commercial, engineering and manufacturing functions.

第三季備考營運費用年增 11%，主要原因是員工人數增加、設施成本增加以及研發原型費用增加，但部分被法律支出減少所抵銷。本季我們新增了約 340 名員工，主要集中在我們的核心商業、工程和製造部門。

As a reminder, we are planning to go direct in Italy, Spain and Portugal in the first half of next year. This will involve the transfer of approximately 250 employees. We expect to describe the impact of this in greater detail at our next earnings call. Pro forma other income was $93 million for the quarter, flat to the prior quarter, reflecting lower interest income, offset by a lower FX impact from remeasurement of the balance sheet.

再次提醒大家，我們計劃明年上半年直接進入義大利、西班牙和葡萄牙市場。這將涉及大約 250 名員工的調動。我們預計將在下次財報電話會議上更詳細地描述此事的影響。本季其他收入以備考計算為 9,300 萬美元，與上一季持平，反映出利息收入減少，但被資產負債表重新計量帶來的外匯影響減少所抵銷。

Our pro forma effective tax rate for quarter three was 18.3%, lower than our expectations, reflecting the impact of the new US tax provisions for the treatment of R&D expenses and a $16 million discrete benefit from the release of tax reserves associated with statute of limitation expiration.

第三季的備考有效稅率為 18.3%，低於我們的預期，這反映了美國新的研發費用處理稅收規定的影響，以及因時效到期而釋放的稅收儲備帶來的 1600 萬美元的單獨收益。

We are still evaluating potential impacts of US tax reform for our 2026 tax rate. Pro forma net income for the third quarter was $867 million compared with $669 million last year. Pro forma earnings per share was $2.40 per share. Excluding the benefit of tax expense in Q3 from the US tax reform and the release of tax reserve, pro forma EPS would have been $2.28 per share.

我們仍在評估美國稅制改革對我們 2026 年稅率的潛在影響。第三季以備考計算的淨利為 8.67 億美元，而去年同期為 6.69 億美元。調整後的每股收益為 2.40 美元。如果排除第三季美國稅改帶來的稅收支出收益以及稅收準備金的釋放，則預計每股收益將為 2.28 美元。

Now turning to our GAAP results. GAAP net income for the quarter was $704 million or $1.95 per share compared to $565 million or $1.56 per share in Q3 of last year. The differences between our pro forma and GAAP results are outlined and quantified on our website. We ended the quarter with $8.4 billion in cash and investments, down from $9.5 billion last quarter.

現在來看我們的GAAP業績。本季GAAP淨利為7.04億美元，即每股1.95美元，去年同期為5.65億美元，即每股1.56美元。我們的模擬財務報表與GAAP財務報表之間的差異已在我們的網站上列出並量化。本季末，我們的現金和投資總額為 84 億美元，低於上一季的 95 億美元。

In line with our capital allocation priorities, during the quarter, we used $1.9 billion of cash to repurchase approximately 4 million of Intuitive shares. The sequential reduction in cash and investments reflects the stock repurchases, partially offset by strong free cash flow of $736 million.

根據我們的資本配置優先事項，本季我們使用 19 億美元現金回購了約 400 萬股 Intuitive 股票。現金和投資的環比減少反映了股票回購，但被 7.36 億美元的強勁自由現金流部分抵消。

With that, I'll turn it over to Dan to discuss recent clinical publications and our updated outlook for 2025.

接下來，我將把發言權交給丹，讓他來討論最近的臨床出版物以及我們對 2025 年的最新展望。

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

謝謝你，傑米。接下來談談我們業務的臨床方面。我想和大家分享一些近期重要研究的數據。除了本次通告中重點介紹的具體數據外，我們還鼓勵您參考多年來發表的科學研究中詳細闡述這些主題及其他主題的大量證據。

Last month, at the European Respiratory Society's Annual Conference, we saw continued growth in evidence describing the Ion endoluminal systems impact in geographies outside the United States. At the conference, Dr. Carolin Steinack from University Hospital Zurich in Switzerland presented an abstract that detailed results from an open-label randomized controlled trial that compared Ion plus integrated mobile cone-beam CT to conventional bronchoscopy.

上個月，在歐洲呼吸學會年會上，我們看到越來越多的證據表明，離子腔內系統對美國以外的地區產生了影響。在會議上，來自瑞士蘇黎世大學醫院的卡羅琳·斯坦納克博士發表了一篇摘要，詳細介紹了一項開放標籤隨機對照試驗的結果，該試驗比較了 Ion plus 集成移動錐形束 CT 與傳統支氣管鏡檢查。

Conducted at University Hospital Zurich, this study compared outcomes from pulmonary nodule biopsies performed in 78 patients with 39 patients in each group. Median nodule size was just 11 millimeters in each group. Results demonstrated an increase in diagnostic yield between the two groups in excess of 60 percentage points, with the Ion group at 84.6% and the conventional bronchoscopy group at 23.1%. Procedure times and complication rates in both groups were comparable.

這項研究在蘇黎世大學醫院進行，比較了 78 位肺結節活檢患者的檢查結果，每組 39 位。各組結節中位數大小僅 11 毫米。結果顯示，兩組的診斷率相差超過 60 個百分點，Ion 組的診斷率為 84.6%，而傳統支氣管鏡組的診斷率為 23.1%。兩組患者的手術時間和併發症發生率均相當。

Additionally, in the same presentation, the group showed a center-wide increase in early-stage cancer diagnosis after implementation of the integrated Ion and mobile cone-beam CT system with an increase of Stage 1a non-small cell lung cancer diagnosis of approximately 30 percentage points.

此外，在同一份報告中，該團隊還展示了中心在實施整合離子和移動錐形束 CT 系統後，早期癌症診斷率顯著提高，其中 1a 期非小細胞肺癌的診斷率提高了約 30 個百分點。

Dr. Steinack concluded, even with minimal training, Ion robotic-assisted bronchoscopy with integrated cone-beam CT is a pivotal tool for effective early lung cancer diagnosis and a potential driver of a shift towards early-stage diagnosis. On previous calls, we have shared published studies that describe the impact of Force Feedback technology across multiple specialties.

Steinack 博士總結道，即使接受的培訓很少，配備整合錐形束 CT 的 Ion 機器人輔助支氣管鏡也是有效早期肺癌診斷的關鍵工具，並且有可能推動肺癌診斷轉向早期階段。在先前的電話會議中，我們分享了已發表的研究，這些研究描述了力回饋技術對多個專業領域的影響。

In September, Dr. Peter Kneuertz from the Ohio State University in collaboration with other thoracic surgeons and Intuitive published Force Feed force in robotic thoracic surgery, a one-year analysis of da Vinci 5 Force Feedback in the Journal of Robotic Surgery. To date, the inability for surgeons to feel force exerted in the operative field has been a meaningful limitation of robotic-assisted thoracic surgery.

9 月，俄亥俄州立大學的 Peter Kneuertz 博士與其他胸腔外科醫生和 Intuitive 公司合作，在《機器人外科雜誌》上發表了《機器人胸腔外科手術中的力回饋》，這是對達文西 5 力回饋進行為期一年的分析。迄今為止，外科醫生無法感受到手術區域內施加的力一直是機器人輔助胸腔外科手術的一個重要限制。

This study incorporated data from over 400 common thoracic procedures performed by 70 surgeons with da Vinci 5 and Force Feedback technology. The analysis showed that median instrument tip forces decreased stepwise based on Force Feedback sensitivity setting across all procedures.

這項研究納入了 70 位外科醫生使用達文西 5 和力回饋技術進行的 400 多例常見胸腔外科手術的數據。分析表明，在所有手術過程中，隨著力回饋靈敏度設定的增加，器械尖端作用力的中位數呈階梯式下降。

Moreover, there was a significant difference in the amount of time at peak force greater than 6.5 newtons across Force Feedback settings with a reduction of approximately 20% in peak force application when Force Feedback instruments were set to medium or high. The authors noted that this study provides clinical evidence that Force Feedback technology may help reduce force during robotic-assisted thoracic surgery and result in objectively gentler surgery.

此外，在力回饋設定的差異下，峰值力大於 6.5 牛頓的時間有顯著差異，當力回饋儀器設定為中等或高時，峰值力施加量減少了約 20%。作者指出，這項研究提供了臨床證據，顯示力回饋技術可以幫助減少機器人輔助胸腔外科手術期間的用力，並帶來客觀上更溫和的手術。

The first step in evaluating the impact of Force Feedback is to see an intraoperative difference in applied force. Here, we are encouraged by early results across specialties on the value that we believe Force Feedback technology brings to patients and surgeons. The next step in evaluating the impact of Force Feedback is to assess whether changes in forces applied during surgery translate to the patient experience on measures like pain or other functional patient outcomes.

評估力回饋影響的第一步是觀察術中施加力的變化。我們對各個專科領域的早期結果感到鼓舞，這些結果證明了力回饋技術能為患者和外科醫生帶來價值。評估力回饋影響的下一步是評估手術過程中施加的力的變化是否會轉化為患者在疼痛或其他功能性患者結果等指標上的體驗。

These studies are underway, and we look forward to their publication and discussion in the coming quarters and years. I will now turn to our updated financial guidance for 2025 starting with da Vinci procedure growth. On our last call, we forecast full year 2025 da Vinci procedure growth within a range of 15.5% and 17%. We are updating our 2025 da Vinci procedure growth guidance to be within a range of 17% and 17.5%.

這些研究正在進行中，我們期待在未來幾季和幾年內看到研究成果的發表和討論。接下來，我將介紹我們更新後的 2025 年財務預測，首先從達文西手術的成長說起。在上一次電話會議上，我們預測 2025 年全年達文西手術量成長率將在 15.5% 到 17% 之間。我們正在更新 2025 年達文西手術成長指導方針，使其在 17% 到 17.5% 的範圍內。

Turning to gross profit. On our last call, we forecast pro forma gross profit margin in 2025 to be within a range of 66% and 67% of revenue. Given Q3 results, which reflected greater leverage of fixed costs and benefits from cost reductions as well as a lower expected tariff impact for the year, we are updating our estimate of pro forma gross margin to be within a range of 67% and 67.5% of revenue.

接下來討論毛利。在上次電話會議上，我們預測 2025 年的備考毛利率將佔營收的 66% 至 67%。鑑於第三季業績反映了對固定成本的更大槓桿作用和成本削減帶來的收益，以及預計全年關稅影響的降低，我們將備考毛利率的估計值更新為收入的 67% 至 67.5%。

Within that range, we now expect the impact of tariffs for the year to be 70 basis points, plus or minus 10 basis points. We expect pro forma operating expense growth to be between 11% and 13%, which includes increased depreciation from new facilities and investments to drive our growth objectives. We estimate noncash stock compensation expense to be between $785 million and $795 million.

在這個範圍內，我們現在預計今年關稅的影響為 70 個基點，上下浮動 10 個基點。我們預計備考營運費用成長將在 11% 至 13% 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。我們估計非現金股票補償費用在 7.85 億美元至 7.95 億美元之間。

We forecast other income, which is comprised mostly of interest income to total between $350 million and $360 million. We expect capital expenditures to range between $625 million and $675 million, which reflects planned facility construction activities. With regard to income tax, due primarily to the lower Q3 non-GAAP effective tax rate that Jamie described earlier, we now estimate our 2025 pro forma income tax rate to be between 21% and 22%.

我們預測其他收入（主要包括利息收入）總額將在 3.5 億美元至 3.6 億美元之間。我們預計資本支出將在 6.25 億美元至 6.75 億美元之間，這反映了計劃中的設施建設活動。關於所得稅，主要由於 Jamie 前面提到的第三季非 GAAP 實際稅率較低，我們現在估計 2025 年的備考所得稅率將在 21% 到 22% 之間。

This concludes our prepared comments. As we open the line for questions, we ask that you please limit yourself to one or two questions.

我們的發言到此結束。在開放式提問環節時，請每位提問者盡量只提出一到兩個問題。

(Operator Instructions)

（操作員指示）

Robert Marcus, JPMorgan.

Robert Marcus，摩根大通。

Congratulations on a great quarter here. Two for me. One, I'll start with the procedures, and then I have one on margins. 20% procedure volume growth was just a really impressive uptick year-over-year as well as quarter-over-quarter.

恭喜你們本季業績出色。對我來說是兩個。首先，我先說說手術量，然後再說說利潤率。手術量較去年同期成長20%，無論年比或季比，都是非常可觀的成長。

I was hoping if you could talk to the trends you're seeing both US and outside US that are driving that? How sustainable is it? And how much do you think is attributed to the introduction of da Vinci 5?

我希望您能談談您觀察到的美國國內外推動這種趨勢的原因嗎？它的可持續性如何？你認為這其中有多少要歸功於達文西5的推出？

Yes, I'll take that first, Robbie. So if you look at US da Vinci procedure growth, maybe just to frame it, in Q1, it was 13%; Q2, 14%; and then in Q3, 16%. So obviously, that Q3 US da Vinci procedure growth number was strong relative to recent trends. We saw strong growth in after-hours surgery in acute care and in a subset of the benign general surgery procedures that I think we've referenced in the past in cholecystectomy, appendectomy.

是的，羅比，我先拿那個。所以，如果你看一下美國達文西手術的成長情況，或許可以這樣概括：第一季成長了 13%；第二季成長了 14%；第三季成長了 16%。顯然，第三季美國達文西手術量的成長數據相對於近期趨勢而言十分強勁。我們看到，在急診護理中，下班後的手術量大幅增長，而且良性普通外科手術也有一部分增長，例如我們過去提到的膽囊切除術和闌尾切除術。

And then there were a couple of categories that were a little above our expectation also in benign general surgery. So hernia repair, a couple of the benign gyn procedures. We have had just anecdotally indications that there may have been, let's say, acceleration of procedures in July and August for elective procedures, given all of the noise around Medicare funding and even ACA premium changes.

此外，在良性一般外科領域，還有幾個類別的結果略高於我們的預期。所以，疝氣修補術，算是婦科良性手術中的兩種。我們只是從一些零星的跡像中得知，鑑於圍繞醫療保險資金甚至《平價醫療法案》保費變化的各種傳言，7 月和 8 月的擇期手術數量可能有所加快。

We have looked at third-party data, which obviously lags. It's not clear that they're supported by the third-party data. So we don't have evidence to that effect. We've heard it from some customers, and we've heard other commentary to that effect. And so that may be an effect in terms of what's reflected in the Q3 US strength.

我們查看了第三方數據，但顯然這些數據存在滯後性。目前尚不清楚這些觀點是否得到第三方數據的支持。所以我們沒有這方面的證據。我們從一些顧客那裡聽到了這樣的說法，也聽到了其他類似的評論。因此，這可能對第三季美國經濟的強勁表現產生影響。

I'd just say in terms of OUS da Vinci procedure growth, as I said in the prepared remarks, there is about a 1 percentage point benefit to the growth there relative to just the timing of holidays. There's a set of autumn festivals in Asia markets that last year occurred in September. In this year, that will occur in October.

就 OUS 達文西手術的成長而言，正如我在準備好的發言稿中所說，與假期時間相比，手術的增長大約有 1 個百分點的益處。亞洲市場有一系列秋季節日，去年這些節日都在九月舉行。今年，這件事將在十月發生。

And Robbie, you had mentioned dV5 as we talked about it. It was our intent to design dV5 to be easier to learn, easier to use and support higher efficiencies. The data that we're seeing from the customers who are adopting da Vinci 5, it is supporting that design intent. And so there -- to the extent that customers are adopting dV5, then that too supports some of this utilization within the existing accounts.

羅比，我們之前討論的時候你也提到dV5。我們設計 dV5 的目的是使其更容易學習、更容易使用，並支援更高的效率。我們從採用達文西5的客戶看到的數據，也印證了這個設計意圖。因此，如果客戶採用 dV5，那麼這也有助於在現有帳戶中實現這種利用。

Yes. Maybe as a reference point, Robbie, there was about 67,000 da Vinci 5 procedures done in Q3. That compares to 50,000 da Vinci 5 procedures done in Q2.

是的。羅比，或許可以作為參考，第三季大約進行了 67,000 例達文西 5 手術。相比之下，第二季完成了 50,000 例達文西 5 手術。

Great. And I mentioned margins from my second question, but I've actually changed my mind. I want to ask about refurbished Xis. And you mentioned how some of your customers were interested in upgrading and moving their Xis to new sites of care. And this is 1 area I don't think many street models have Xi refurbished units in them as of now.

偉大的。我在第二個問題中提到了邊距，但我現在改變主意了。我想諮詢一下翻新版的Xis手機。您還提到，您的一些客戶有興趣升級他們的 Xi 設備並將其遷移到新的護理地點。而且我認為目前市面上很少有車型配備 Xi 翻新機。

Maybe you could just speak to how you're thinking about the progress in '26 and beyond in terms of new channels, new countries? Just how much greenfield can refurbished Xis add and where do you think there'll be -- clients will be most interested?

或許您可以談談您對 2026 年及以後在拓展新通路、開拓新國家方面取得進展的看法？翻新後的Xi車型究竟能為綠地市場帶來多少成長？你認為客戶最感興趣的領域會是哪些？

Yes, Robbie, maybe I can just speak from a portfolio perspective, and then Jamie, please fill in with any other color. And so we -- the trade-in cycle or the upgrade cycle that da Vinci 5 is catalyzing obviously gets us a number of Xi systems coming back to Intuitive. We're able to refurbish those and then offer those at -- within our portfolio.

是的，羅比，或許我可以只從作品集的角度談談，然後傑米，請你補充其他方面。因此，達文西 5 所催化的以舊換新周期或升級週期，顯然會讓許多 Xi 系統回歸 Intuitive。我們可以對這些產品進行翻新，然後將它們納入我們的產品組合中。

And so what I always think about in terms of satisfying or meeting our customers' needs is having a portfolio that spans a range of capability from X now to the refurbished Xi up through da Vinci 5 in a range of financial instruments to help customers acquire those portfolios. And so, the refurbished Xi is going to be an important part of that certainly for certain sites of care within the US, but also outside the US.

因此，我一直在思考的是如何滿足客戶的需求，即擁有涵蓋從 X 到翻新的 Xi，再到達芬奇 5 等一系列功能的產品組合，並提供一系列金融工具來幫助客戶獲得這些產品組合。因此，翻新後的 Xi 將會成為其中的重要組成部分，不僅在美國境內的某些醫療機構，而且在美國境外也是如此。

And for those customers who are cost sensitive and trying to really look carefully at the economics of their programs and how they initiate a robust robotic-assisted surgery program, we really think that the refurbished Xi is an important component in that.

對於那些對成本敏感，並試圖認真研究其項目的經濟效益以及如何啟動一個強大的機器人輔助手術項目的客戶來說，我們認為翻新的 Xi 確實是其中一個重要組成部分。

We've sold 20 refurbished Xis so far. Our regional leaders are excited to have both that and da Vinci 5 in the portfolio. And I think it provides some really nice segmentation for those customers that want to be early adopters of the latest technology and for those sites that are cost sensitive. And that includes all the way to the US and maybe surgery centers.

我們目前已售出 20 台翻新版 Xi。我們的區域領導很高興能將達文西5和達文西手術系統都納入產品組合。我認為它為那些想要率先採用最新技術的客戶以及那些對成本敏感的網站提供了非常好的細分。這甚至包括遠至美國以及可能的手術中心。

I think where we have, I think, really nice flexibility in terms of what the pricing might be for a refurbished Xi, we're not ready to kind of describe what the range of that might be because we're early but I think it's giving our commercial team some really nice options.

我認為，在翻新版 Xi 的定價方面，我們擁有非常大的彈性。目前我們還不方便描述具體的定價範圍，因為現在還處於早期階段，但我認為這會為我們的銷售團隊提供一些非常好的選擇。

Great. Congrats again. Appreciate the color.

偉大的。再次恭喜。欣賞這種顏色。

Thanks Robbie.

謝謝你，羅比。

Thanks Robbie.

謝謝你，羅比。

Travis Steed, BofA.

Travis Steed，美國銀行。

Hey, congrats on the good quarter. Maybe just a follow-up on that. You talked also about some of the Xis are being redeployed within the same hospitals to be used in alternative sites. And curious like when you see the hospital by the dV5 and keep the older Xi and redeploy it, what are you seeing in terms of utilization on that system, new categories getting opened up? Is it tending to go into the ASC? Or just help us understand how that's working and how many hospitals are taking up on that opportunity?

嘿，恭喜你本季業績出色。或許可以就此做個後續說明。您還提到，一些 Xi 設備正在同一家醫院內重新部署，以便在其他地點使用。我很好奇，例如當你看到醫院使用 dV5 系統，保留舊的 Xi 系統並重新部署時，你看到該系統的使用率如何？是否有新的類別被開放？它有可能會進入門診手術中心嗎？或者，請幫助我們了解這種方式的運作情況，以及有多少家醫院正在利用這個機會？

One, I appreciate the question. One of the dynamics that we do see when hospitals engage with dV5 and move Xi to other sites of care, the nice thing is the systems are able -- or were designed to have very consistent user interfaces. So those surgeons could work back and forth across those platforms.

首先，我很感謝你的提問。當醫院採用 dV5 並將 Xi 轉移到其他護理場所時，我們看到的一個動態是，這些系統能夠（或說被設計成）擁有非常一致的使用者介面。這樣，這些外科醫生就可以在這些平台之間來回工作了。

So if it happens to be where the dV5 is in the flagship hospital and the Xi was moved to an alternative site of care like an ASC, then it allows those surgeons to move back and forth in their care teams easily. There's not retraining or relearning to do. The other nice thing, as I think you know, is the inventory of instruments across both Xi and dV5 can largely be used interchangeably.

因此，如果 dV5 恰好位於旗艦醫院，而 Xi 被轉移到其他護理地點（如 ASC），那麼這些外科醫生就可以在他們的護理團隊中輕鬆地來回移動。無需進行再培訓或重新學習。另一個好處，我想您也知道，是 Xi 和 dV5 中的儀器庫存可以很大程度上互換使用。

And so that's another advantage that allows our customers to deploy these fleets as they need to suit what they're trying to get on, be it decanting their main OR into ambulatory environments or perhaps adjusting where they're trying to treat patients within their larger IDN. And so we're -- we think that's a powerful component of the dV5 upgrade cycle that will allow some -- our customers some flexibility in how they build out their fleets.

因此，這是另一個優勢，它允許我們的客戶根據自身需求部署這些車隊，以適應他們想要實現的目標，無論是將主要手術室轉移到流動環境中，還是調整他們在更大的 IDN 內治療患者的位置。因此，我們認為這是 dV5 升級週期中一個強大的組成部分，它將使我們的一些客戶在建立其車隊方面擁有一定的靈活性。

Great. And then a follow-up. Jamie, do you have anything else jump in.

偉大的。然後還有後續報道。傑米，你還有什麼要補充的嗎？

No, all good from my side.

不，我這邊一切都好​​。

Okay. But I had a follow-up on -- you mentioned new platforms recently and maybe opening up new disease states. Curious if you could elaborate on that. And the cardio is an area that you guys are clearly investing in. And curious what you see is like the problems with the current standard of care and places you could kind of apply the Quintuple Aim to cardio.

好的。但我還有一個後續問題──您最近提到了新的平台，或許還會涉及新的疾病領域。能否詳細解釋一下？你們顯然在有氧運動方面投入了許多精力。我很好奇你會看到什麼，例如當前護理標準存在的問題，以及你可以將五重目標應用於有氧運動的地方。

Sure, sure. There's kind of two separate components in there. So maybe starting with the cardiac side of things, and so we've talked about for a long time, cardiac surgeons have been using off of a very small base, our current systems, X and Xi to perform cardiac surgery. And with the capabilities of dV5 around precision, motion control, integration of imaging, we think that those capabilities, coupled with some new instrumentation that we need to develop, it really brings some differentiated capability to cardiac surgery.

當然，當然。這裡面其實包含兩個獨立的部分。所以，或許可以從心臟方面入手，我們已經討論過很長時間了，心臟外科醫生一直以來都是基於非常小的基礎，使用我們目前的系統 X 和 Xi 來進行心臟手術。dV5 在精確度、運動控制、影像整合等方面的能力，我們認為，再加上我們需要開發的一些新儀器，確實能為心臟外科手術帶來一些差異化的能力。

And so if you look within the cardiac surgery patient community, many, many are served well with percutaneous approaches, but there's a subsegment of patients where surgery is the best option for them and minimally invasive surgery, I think with da Vinci is a better option for them.

因此，如果你觀察心臟外科手術患者群體，會發現很多患者透過經皮手術就能獲得良好的治療效果，但也有一部分患者，手術是他們的最佳選擇，而我認為使用達文西機器人進行微創手術對他們來說是更好的選擇。

So we think that it's a meaningful segment of the market and that da Vinci 5 and plus ongoing development with instruments and software and other areas can make a difference for cardiac surgeons and their patients. When you look at new platforms, here's the way that I think about it.

因此，我們認為這是一個重要的市場區隔領域，達文西 5 以及儀器、軟體和其他領域的持續發展可以為心臟外科醫生及其患者帶來改變。當你審視新的平台時，我是這樣想的。

So Intuitive -- if you say what is Intuitive good at, I think we're really good at advanced robotic platforms that include precision motion control, integration of advanced imaging and other types of sensors, the precise control of complex, rigid and flexible instrumentation, the integration of digital tools in the emerging field of AI.

所以，Intuitive——如果你要說Intuitive擅長什麼，我認為我們非常擅長先進的機器人平台，包括精確的運動控制、先進成像和其他類型感測器的整合、複雜、剛性和柔性儀器的精確控制，以及在新興的人工智慧領域整合數位工具。

And so you say, those are our core capabilities. Then I look out in the world and say, where are there problems -- health care problems to be solved where existing solutions aren't meeting the needs of physicians and their patients? And there are many. And where those two intersect, our capabilities plus an unmet need, I think that's where some magic can happen. And so that's where we're looking. And we believe there are -- we have some opportunities where those do intersect. We have ongoing R&D in those areas and just look forward to updating you more in the future.

所以您說，這些就是我們的核心能力。然後我環顧四周，問自己，哪裡有問題──哪些醫療保健問題需要解決，而現有的解決方案又無法滿足醫生及其病人的需求？還有很多。當這兩者交會時——我們的能力加上未被滿足的需求——我認為奇蹟就會發生。所以，這就是我們關注的方向。我們相信，在這些方面存在一些交集，我們有機會實現這些目標。我們正在這些領域進行持續的研發，期待未來能向您報告更多進展。

Great. Can't wait to see some of the magic. Thanks a lot.

偉大的。迫不及待想看看那些神奇的景象。多謝。

Larry Biegelsen, Wells Fargo.

拉里·比格爾森，富國銀行。

Congrats on a great quarter. Just two for me, one on the US, one on margins. How are you -- Dave or Jamie, how are you thinking about utilization in the US going forward? As da Vinci 5 becomes a higher percent of the installed base, could we continue to see it trend higher?

恭喜你本季表現出色。我只有兩個選擇，一個是關於美國的，一個是關於邊際效益的。Dave 或 Jamie，你們好嗎？你們如何看待美國未來的資源運用？隨著達文西5型手術系統在安裝用戶群中所佔比例越來越高，我們是否會看到其安裝量持續成長？

And net placements have been down recently year-over-year. I think that's primarily because of a tough comp last year. But how do you think about that metric? Investors have been -- or some investors are focused on it? And I have one follow-up.

近幾年來，淨安置人數較去年同期有所下降。我認為這主要是因為去年的競爭非常激烈。但你如何看待這個指標？投資者一直關注著它——或者說，一些投資者正在關注它？我還有一個後續問題。

Yes. I'm going to maybe zoom out for a second, Larry, and recognize the discussion on net placements that's been occurring. In terms of our approach, we're first focused on aligning with customers in ways where they need extra capacity for da Vinci because it brings patient benefit, patient value.

是的。拉里，我或許應該暫時把視角拉遠一點，關註一下目前正在進行的關於淨勝球位置的討論。就我們的方法而言，我們首先專注於與客戶保持一致，滿足他們對達文西手術額外容量的需求，因為達文西手術能為患者帶來好處和價值。

And so we actually look, first and foremost, at procedure growth as our primary metric of success because, obviously, that reflects adoption and use of our technology for patients. And so therefore, we take a customer-by-customer approach in terms of how we engage with them on the capital side.

因此，我們首先關注的是手術量的成長，將其作為衡量成功的主要指標，因為這顯然反映了患者對我們技術的接受度和使用。因此，我們在與客戶進行資金方面的溝通時，採取的是逐一客戶具體處理的方式。

And we're as happy to help them expand their installed base as a way to increase capacity as we are to do an upgrade, give them da Vinci 5, particularly in the context of what we see are opportunities to have efficiency benefits in da Vinci 5 that in effect also create a capacity expansion opportunity.

我們非常樂意幫助他們擴大安裝基礎，以此來增加產能，就像我們樂意為他們進行升級，提供達文西 5 手術系統一樣，尤其是在我們看到達文西 5 手術系統能夠帶來效率提升，從而創造產能擴張機會的情況下。

And so you see that reflected in Q3 results now that we're in broad launch and that you have 900-plus systems in the field. And we think that whichever the way we go as long as it's in alignment with the customer, it's healthy for them and for us. And I think that's well illustrated in Q3 results.

因此，隨著我們全面推出產品，目前已有 900 多套系統投入使用，第三季業績也反映了這一點。我們認為，無論我們採取哪種方式，只要符合客戶的利益，對客戶和我們來說都是有益的。我認為第三季業績很好地說明了這一點。

Now in terms of the question, what will long-term US utilization growth be, I think we're focused more on the segments of customers than the US average because I do think, as we've talked about in the past, there are likely some mixed dynamics, particularly as we look to capture benign procedures.

至於美國長期利用率成長會如何這個問題，我認為我們更關注的是客戶群體而不是美國平均水平，因為正如我們過去討論過的，我認為可能會有一些複雜的動態，尤其是在我們尋求獲取良性手術方面。

They're in community and rural hospitals that are going to have smaller programs. But think of large institutions with the larger number of procedures utilizing dV5, we'd expect them to be able to drive improvements to utilization. Where that nets out to, I think, we'll see because it's so early with respect to the dV5 launch.

他們所在的社區醫院和鄉村醫院規模較小，計畫也相對較少。但對於使用 dV5 的大型機構來說，由於其手術量較大，我們預計它們能夠推動 dV5 利用率的提高。最終結果如何，我認為我們拭目以待，因為距離 dV5 發布還為時過早。

That's super helpful. Jamie, on margins, excuse me, it looks like the implied gross margin in Q4 at the midpoint of the guidance range is slightly below 67%. So my question is on next year, just what are some of the puts and takes to consider?

這非常有幫助。Jamie，關於利潤率，不好意思，看起來第四季的隱含毛利率在指引範圍的中點略低於 67%。所以我的問題是，關於明年，有哪些值得考慮的投資和投資機會？

Is that kind of Q4 number starting point for next year for the gross margin? Or are there additional headwinds or tailwinds to consider? And any directional color on the impact of going direct in those three markets you called out net positive, negative or just anything directional.

這個第四季的數字會成為明年毛利率的起點嗎？或是有其他需要考慮的逆風或順風嗎？對於您提到的這三個市場採取直接營運模式的影響，您能否提供一些方向性的意見，例如淨正面影響、淨負面影響，或任何方向性的意見？

Yes. I understand the question on gross margins for '26. Larry, we're going to wait until January to provide color on what the outlook is there. With respect to going direct in Italy, Spain, Portugal, we continue to expect that to be slightly accretive to pro forma EPS upon going direct, and that's really a function of you eliminate the margin of the distributor, and that gets partially offset by the team that we take on the transfers from them to us.

是的。我理解關於2026年毛利率的問題。拉里，我們將等到一月份再詳細說明那裡的前景。關於在義大利、西班牙、葡萄牙直接銷售，我們仍然預計這將略微增加備考每股收益，這實際上是因為你消除了分銷商的利潤，而這部分會被我們從他們那裡接收的轉入團隊所抵消。

All right. Thanks so much, Jamie.

好的。非常感謝，傑米。

Rick Wise, Stifel.

Rick Wise，Stifel。

Good afternoon, everybody. Thanks for another stellar quarter. I guess I'll start with -- let me start with the two softer areas that you talked about, Dave, the downward pressure on the bariatric side and China, you just described the environment as constrained and competitive.

大家下午好。感謝大家又一個出色的季度。我想先從你提到的兩個比較容易理解的方面說起，戴夫，一個是減肥手術方面的下行壓力，另一個是中國，你剛才把那裡的環境描述為受限且競爭激烈。

Maybe you could talk about both of these. And when do we get past the -- when is bariatrics less of a drag? It seems like it's been going on for a while. We should be almost largely over that impact at some point. I don't know, maybe you can share some thoughts there. And China, how do we think about the outlook from here? And then I have one follow-up.

或許你可以談談這兩方面。我們什麼時候才能擺脫──什麼時候減重手術才不會那麼令人沮喪？這件事似乎已經持續了一段時間。我們應該在某個時候基本上擺脫這種影響。我不知道，或許你可以分享一些想法。那麼中國，我們該如何看待未來的前景呢？然後我還有一個後續問題。

Hey Rick, it's Dan. On bariatrics domestically, we haven't seen a change in trajectory. I think in Q3, domestic bariatric procedures continued to decline at high single digits. So it's roughly six quarters of down mid-single digits to down high single digits. I think in total domestic bariatrics is a little less than 3% of overall da Vinci procedures. Maybe I'll pass it Jamie on the China question.

嘿，里克，我是丹。就國內而言，減重手術的發展軌跡還沒有改變。我認為第三季國內減肥手術數量繼續以接近兩位數的百分比下降。所以，大約有六個季度的降幅在個位數中段到個位數高段之間。我認為，國內的減重手術總共只佔達文西手術總量的不到3%。關於中國的問題，或許我會把這個問題轉告給傑米。

Maybe just on bariatrics for a second. Dave and I actually met with about 25 bariatric surgeons earlier this week. We met with another group about that size about six weeks ago and obviously had an exchange here about the impact of GLP-1s and what they're seeing in their practices. They are not yet at a position where they feel like they can predict when the declines are going to end.

或許就先說說減肥手術吧。本週早些時候，我和戴夫實際上與大約 25 位減肥外科醫生見了面。大約六週前，我們與另一個規模相近的團體進行了會面，顯然，我們在這裡就 GLP-1 的影響以及他們在實踐中看到的情況進行了交流。他們目前還無法預測下跌何時結束。

They're not seeing the dynamics in the practice that gives them the confidence to make that prediction. So honestly, it feels like we're still in this realm where you have some patients that have been on GLP-1s and are starting to come off because of cost and side effects, but that's offset by new patients starting on kind of the regimen of the drugs. But none of the surgeons we engage with are yet at a point where they're predicting a change in trajectory.

他們沒有看到實踐中的動態變化，所以才沒有信心做出這樣的預測。說實話，感覺我們仍然處於這樣的階段：有些患者一直在服用 GLP-1 類藥物，但由於費用和副作用，他們開始停藥，但同時，也有新患者開始接受這種藥物治療方案。但我們接觸過的所有外科醫師中，沒有一個人預測病情發展軌跡會改變。

On China, and Dave and I were recently in China several weeks ago. I'd say the environment is quite consistent from what we've seen over the last year or so in terms of tenders are slow, competition is pretty healthy. I think there's generally a preference technology-wise for da Vinci. And I think that there are many local provinces that want the local player to win. And so we're just navigating and executing within that environment, price pressure on the capital side and on the I&A side continue.

關於中國，我和戴夫幾週前才去過中國。我認為，從過去一年左右的情況來看，市場環境相當穩定，招標速度緩慢，競爭也相當健康。我認為從技術角度來看，人們普遍更傾向於達文西。我認為很多地方省份都希望本土選手獲勝。因此，我們只能在這種環境下摸索和執行，資本方面和投資與資產的價格壓力仍然存在。

Got you. And just as a follow-up question. I was curious to what extent is Hub, what's its role in driving some of this da Vinci uptake. When I talk to doctors, I'm just continually stuck by their interest in and what sounds like the potential utilization of Hub features. Just this quarter, I saw that you got approval for system software modifications to include something called surgeon cloud accounts.

明白了。還有一個後續問題。我很好奇 Hub 在多大程度上推動了達文西手術系統的普及，它在其中扮演了什麼角色。當我與醫生交談時，我總是對他們對 Hub 功能的興趣以及似乎對其潛在用途的關注感到困惑。就在本季度，我看到你們獲得了系統軟體修改的批准，其中包括一個名為「外科醫生雲端帳戶」的功能。

Just can you -- my question is sort of, can you talk about what inning are we here in the Hub story, the hub evolution, the potential to enhance da Vinci 5 performance users? Just any color and direction you could give us would be great. Thank you so much.

我的問題有點像是，您能談談我們現在在 Hub 的故事中處於哪個階段嗎？ Hub 的發展歷程，以及它如何有可能提升 da Vinci 5 用戶的效能？您能提供任何顏色和方向建議就太好了。太感謝了。

Sure. Sure. Let me take that question. And so I might just reframe it a bit from Hub. But just kind of the digital foundation of da Vinci 5 that we've talked about. When we launched the system, we were talking about its 10,000 times increased compute power. And the Hub is a part of that story. So we had -- we now have the integrated Hub hardware that is foundational to collecting some of the video data and getting it processed by Intuitive and then return back to customers through case insights, kind of said simply.

當然。當然。讓我來回答這個問題。所以我可能會稍微調整一下 Hub 的框架。但這就是我們之前討論過的達文西5的數字基礎。系統發佈時，我們曾談到其運算能力提升了 10,000 倍。而樞紐站也是這個故事的一部分。所以，我們現在有了整合的 Hub 硬件，它是收集一些視訊資料並由 Intuitive 進行處理，然後透過案例分析返回給客戶的基礎，簡單來說就是這樣。

And so this digital promise, if you will, of how it's going to impact surgery through da Vinci 5 and more, you have to remember, it has layers. It's going to be a progressive kind of growth over time. And it starts with really good data. And we talked about that before. So different sources of data, one of which is video data, and that's where Hub is integral in collecting that video data and getting it to Intuitive, so it can be segmented and have other measures and analyses performed.

因此，這種數位化承諾，即透過達文西 5 等技術將如何影響外科手術，你必須記住，它是多層次的。這將是一個循序漸進的成長過程。而這一切都始於非常優質的數據。我們之前也討論過這個問題。因此，數據來源多種多樣，其中之一是視訊數據，而 Hub 在收集視訊數據並將其傳輸到 Intuitive 的過程中發揮著至關重要的作用，以便對其進行細分並執行其他測量和分析。

And there are all sorts of other kinds of data, including kinematic data and force data, electronic medical record data for certain customers when we have an agreement signed. So you take those data and then you can start analyzing the data using these powerful tools that we have increasingly available to us with AI and machine learning and you start drawing meaningful insights from those data.

此外，還有各種其他類型的數據，包括運動學數據和力學數據，以及與某些客戶簽訂協議後的電子病歷數據。所以，你可以取得這些數據，然後利用人工智慧和機器學習等日益強大的工具來分析這些數據，並從中獲得有意義的見解。

And so that's that progression, ultimately leading, we think, to augmented dexterity or intraoperative guidance to really bring to life how do we help surgeons and care teams make better decisions, different decisions to optimize outcomes, economics or other measures of surgery. And so that is that progression.

因此，這就是發展過程，我們認為，最終將帶來增強的靈巧性或術中指導，從而真正實現我們如何幫助外科醫生和護理團隊做出更好的決策、不同的決策，以優化手術結果、經濟效益或其他手術指標。這就是發展過程。

And Hub, to your question specifically is really an important part of that because of its integration around video. But overall, we're excited about this area and what it can mean to progress in the Quintuple Aim. And so da Vinci 5 is at foundational platform that will bring aspects of our AI, ML digital world to life and impact surgery.

至於你的問題，Hub 確實是其中非常重要的一部分，因為它與影片整合在一起。但總的來說，我們對這個領域以及它在實現五重目標方面所能取得的進展感到興奮。因此，達文西5是一個基礎平台，它將把我們的人工智慧、機器學習數位世界的各個方面變為現實，並對外科手術產生影響。

Thanks so much, Dave.

非常感謝，戴夫。

Patrick Wood, Morgan Stanley.

派崔克‧伍德，摩根士丹利。

Beautiful. Thank you so much. I'll keep it to one in the interest of time. I want to see more on the alternative side of care side of things. And I know you guys have talked in the past about Xi is going into the ASC. I guess my question is, how much do you think the original capital cost is a constraint versus Medicare coverage and commercial rates relative to I&A instrumentation costs.

美麗的。太感謝了。為了節省時間，我就只說一個吧。我想更多地了解替代療法方面的資訊。我知道你們之前討論過習近平將進入國務院高級專員公署。我想問的是，相對於 I&A 儀器的成本而言，您認為原始資本成本在多大程度上會受到醫療保險覆蓋範圍和商業費率的限制？

And then there's also like that sterilization challenge in that. So I guess the crux of the question is, how much do you guys think you need to continue to bend the cost curve down for I&A to make it welcome the ASC? And do you feel like the sterilization challenge is small enough that it kind of doesn't really matter and you don't need to develop like disposable instrumentation or something like that?

此外，還有消毒方面的挑戰。所以我想問題的關鍵在於，你們認為需要將 I&A 的成本曲線降低到什麼程度，才能使其符合 ASC 的要求？您是否覺得消毒方面的挑戰很小，以至於可以忽略不計，無需開發一次性器械之類的東西？

Yes. I would just say maybe our experience so far in the US is by some way, the greater constraint is on the capital side. A number of the systems we have in ASCs have been leased. The majority of systems in US ASCs are Xi, but we do have a number of Xs just obviously because of the lower price point.

是的。我想說的是，就我們目前在美國的經驗來看，最大的限製或許在於資金方面。我們ASC中的許多系統都是租賃的。美國 ASC 中的大多數系統都是 Xi 型，但我們也有一些 X 型，這顯然是因為 X 型的價格較低。

While it's a relatively small installed base, procedure growth in ASCs in the US, it's quite a bit accretive to what we see in terms of overall US procedure growth. I think that with XIR, ASCs are going to be an area of increased interest and focus for us. And obviously, we're going to look carefully at the economics.

雖然美國門診手術中心 (ASC) 的安裝基數相對較小，但其手術量的增長對美國整體手術量的增長起到了相當大的促進作用。我認為隨著XIR技術的發展，ASC將成為我們越來越感興趣和關注的領域。顯然，我們還要仔細研究經濟因素。

It's fair to say that as we stand today, the reimbursement in an ASC is a fraction of the reimbursement in a HOPD. And so that creates a barrier, particularly for ASCs owned by IDNs. I have not had a lot of pushbacks on I&A prices at this point in ASCs. But I think from a strategic perspective, within the Quintuple Aim, we look to lower total cost to treat. And I think, therefore, it's a topic of strategic interest to us.

公平地說，就目前而言，門診手術中心的報銷金額僅為醫院門診的一小部分。因此，這就造成了一種障礙，特別是對於由 IDN 擁有的 ASC 而言。目前為止，ASCs在I&A定價方面還沒有遇到太多反對意見。但我認為從策略角度來看，在五重目標框架內，我們著眼於降低治療總成本。因此，我認為這對我們來說是一個具有戰略意義的議題。

It is. And to your last kind of part of your question around sterilization and I&A, my experience in the ASCs that I visited and talking with our teams is that sterilization hasn't been an impediment to the overall program and the consideration of placing a robotic system there. And so I don't believe that single-use I&A is a requirement to go into the ASC environment.

這是。至於你最後一部分關於消毒和I&A的問題，根據我參觀過的ASC以及與我們團隊的交流，消毒並沒有對整個項目以及在那裡放置機器人系統造成阻礙。因此，我不認為一次性 I&A 是進入 ASC 環境的必要條件。

Super clear. Thanks for taking the question, guys.

超級清晰。謝謝各位回答這個問題。

David Roman, Goldman Sachs.

大衛羅曼，高盛集團。

Good afternoon and thank you for taking the question. I had one on haptics and a follow-up on Ion/SP. Maybe starting on the haptics and Force Feedback side, I think a little over a year ago when you launched dV5, you got the question on an earnings call, what are the specific procedure categories where you see dV5 was applicable?

下午好，感謝您回答我的問題。我參加了一次關於觸覺回饋的研討會，之後又參加了一次關於 Ion/SP 的後續研討會。或許可以從觸覺和力道回饋方面說起。我想，大約一年多前，當你們推出 dV5 時，在一次財報電話會議上，有人問你們，dV5 適用於哪些特定的手術類別？

And I think your response was something to the effect of dV5 is about making robotic surgery ubiquitous. Today, you're talking about, I think, expansion of procedures into benign general surgery, and I don't know if that's a reflection of that strategy of making robotic surgery ubiquitous. But maybe you just sort of talk to how you're seeing that unfold and where Force Feedback fits into that trajectory.

我認為你的回應大致意思是，dV5 的目標是讓機器人手術普及化。今天，你們談論的是將手術擴展到良性普通外科手術領域，我不知道這是否反映了使機器人手術普及化的策略。但或許你可以談談你如何看待這件事的發展，以及力回饋在這發展軌跡中所扮演的角色。

Sure. Let me start with the Force Feedback side. So you heard from Dan a little bit about the journey of Force Feedback and what it's going to take. Starting with instruments that are robust enough to be used on a daily basis and getting sterilized and getting to scale for our customers, and we're well on our way there.

當然。先來說說力回饋方面。所以你從丹那裡聽到了一些關於力回饋技術的發展歷程以及它需要付出的努力。我們首先生產足夠堅固耐用、可以日常使用的儀器，然後進行消毒，並逐步擴大規模以滿足客戶的需求，目前我們正朝著這個目標穩步前進。

And then what we've seen is data and Dan did talk about this, data that shows that through the use of Force Feedback, you can see lower forces in surgery. And so now we have to connect that to outcomes and see whether or not that lower force is actually leading to either improved outcomes or speeding up of learning.

然後我們看到的數據，丹也談到了這一點，數據顯示，透過使用力回饋，可以在手術中看到更小的力道。因此，現在我們必須將此與結果聯繫起來，看看這種較低的壓力是否真的能帶來更好的結果或加快學習速度。

And so that is where we are today. We've seen some early data that shows, it's very interesting and I think very, very aligned to the hypothesis of Force Feedback, which says if we can actually apply lower forces, we do expect that to have an improvement on outcomes. And so that has to happen procedure by procedure. Because as you look inside of each procedure, it's likely that those forces will impact outcomes in a different way.

這就是我們今天所處的境地。我們已經看到了一些早期數據，這些數據非常有趣，而且我認為與力回饋的假設非常吻合，即如果我們能夠施加更小的力，我們確實期望結果會有所改善。因此，這必須按部就班地進行。因為當你深入了解每個流程時，你會發現這些因素很可能會以不同的方式影響結果。

For example, with prostatectomy, you might be looking at functional outcomes as a result of how much force is applied to nerves. If you're in nephrectomies or other colorectal procedures, you might be looking at recovery of bowel function as a result of how much force is applied to the bowel during those procedures.

例如，在前列腺切除術中，你可能需要根據施加在神經上的力的大小來觀察功能性結果。如果您正在接受腎臟切除術或其他大腸直腸手術，由於手術過程中腸道受到很大的壓力，您可能會考慮腸道功能的恢復情況。

And so each one of those will happen in varying ways. And I think as that evidence emerges, that's the catalyst. That's the catalyst to broader adoption and how you see now Force Feedback impact aspects of the Quintuple Aim at scale. And so that just goes to, I think, the overall thesis of robotic-assisted surgery improving aspects of the Quintuple Aim. We've seen that throughout our history, and now with the addition of Force Feedback, that's just one more piece of the puzzle here.

因此，每件事都會以不同的方式發生。我認為，隨著這些證據的出現，這就是催化劑。這就是推動更廣泛應用的催化劑，也是你現在看到力回饋如何大規模影響五重目標各個面向的原因。因此，我認為這正好印證了機器人輔助手術改善五重目標各個面向的整體論點。縱觀我們的歷史，我們已經看到了這一點，而現在隨著力回饋的加入，這只是拼圖中的另一塊而已。

That's very helpful. And then maybe quickly, just a follow-up on Ion and SP, I think you talked about a little over 50% procedure growth in Ion, and I think I heard 91% in SP. You've had a number of SP clearances over the past 6 months or so, maybe just help us contextualize performance in those segments and how we should think about them on a go-forward basis.

這非常有幫助。然後，也許可以快速地跟進 Ion 和 SP，我想您提到 Ion 的手術量增加了 50% 以上，而我聽說 SP 的手術量增加了 91%。在過去的六個月左右，您獲得了一些 SP 許可，或許可以幫我們分析這些領域的業績表現，以及我們應該如何看待它們的未來發展。

Here's the way I think about SP. It is doing great. We're seeing growing body of evidence that there's patient value beyond cosmesis. You are right, growth in SP procedures at 92% is strong. Utilization in Korea outpaces that of Xi. And our team is focused on continuing to deliver software and instruments and other enhancements to the platform to continue to increase its capability.

我對SP的看法是這樣的。它運行良好。我們看到越來越多的證據表明，除了美容效果之外，它還具有對患者的價值。您說得對，SP手術量成長92%，增幅非常強勁。韓國的使用率超過了習近平。我們的團隊致力於繼續為該平台提供軟體、儀器和其他增強功能，以不斷提高其能力。

Another area we're working hard in the US, in particular, are clearances. And so we know that a broad set of clearances is important for the use of single-port. You see that in Korea, we see that elsewhere. And so in the US, we are on the pathway to continue to add more clearances to SP, and that will be a part of how that grows and continues to grow in the future.

我們在美國尤其努力的另一個領域是安全許可。因此我們知道，廣泛的間隙對於單一連接埠的使用非常重要。在韓國可以看到這種情況，我們在其他地方也能看到這種情況。因此，在美國，我們正在繼續為SP增加更多許可，這將是SP發展壯大並在未來持續發展的一部分。

Adam Maeder, Piper Sandler.

亞當梅德，派珀桑德勒。

Hi, good afternoon. Congrats on the quarter and thank you for squeezing me in here. I will keep it to one. I wanted to ask about the dV5 OUS launch in Europe and Japan. And was wondering if you could share just a little bit more kind of early feedback that you've gathered to date. Help us better understand the rollout strategy there?

嗨，下午好。恭喜你本季取得佳績，也感謝你抽空讓我來這裡。我只打算用一個。我想詢問一下 dV5 OUS 在歐洲和日本的發布情況。我想問您能否再分享一下您目前收集到的一些早期回饋意見。請幫助我們更了解當地的推廣策略？

And any broad color around the pace of the dV5 placements outside the US in subsequent quarters into 2026 would be much appreciated. Thank you for taking the question.

如果能提供一些關於 dV5 在美國以外地區 2026 年後續幾個季度部署速度的大致信息，我們將不勝感激。感謝您回答這個問題。

Yes. I'd just say it's relatively early. We take a local approach to each of those launches. Obviously, we have a pipeline in Europe and in Japan. You see the larger institutions and those institutions want to be early adopters and want to get hold of the latest technology to be those that are most interested.

是的。我覺得現在還為時過早。我們對每一次發射都採取本地化的方法。顯然，我們在歐洲和日本都有輸油管。你看，規模較大的機構都想成為早期採用者，想掌握最新技術，他們才是最感興趣的。

There is a little bit more of a segmentation discussion in terms of some incremental cost sensitivity to the da Vinci 5 pricing relative to, say, the US market. I think we have a healthy pipeline in both markets, but there's work to be done to have customers work through the evaluation process.

相對於美國市場，達文西 5 的價格對成本的敏感度存在一些增量，因此在市場區隔方面還有一些討論空間。我認為我們在兩個市場都有健康的銷售管道，但還需要做很多工作來幫助客戶完成評估過程。

Okay. That was our last question. Thank you for all the interesting 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。這是我們最後一個問題。感謝大家提出的所有精彩問題。最後，我們仍然相信，從根本上改善外科手術和急診幹預措施存在著巨大而持久的機會。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.

更好的、可預測的患者治療效果，更好的患者體驗，更好的患者護理團隊體驗，更低的醫療總成本；最終，增加獲得醫療服務的機會。我們認為，外科手術和急診護理中的價值創造本質上是人性的。它源於對患者和護理團隊及其在環境中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 again for your support on this extraordinary journey. We look forward to talking with you again in three months.

在 Intuitive，我們設想未來的醫療保健將更加微創，效果也將顯著提升，疾病能夠更早被發現並迅速治療，讓患者能夠重返最重要的生活。再次感謝您在這段非凡旅程中的支持。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. Good day.

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