直覺手術 (ISRG) 2025 Q4 法說會逐字稿

Good day, everyone, and welcome to Intuitive's fourth-quarter 2025 earnings conference call. (Operator Instructions) Please note, this conference is being recorded.

大家好，歡迎參加 Intuitive 公司 2025 年第四季財報電話會議。 （操作說明）請注意，本次會議正在錄音。

Now it's my pleasure to turn the call over to the Vice President of Investor Relations, Dan Connally.

現在我很高興將電話轉交給投資者關係副總裁丹康納利。

Good afternoon, and welcome to Intuitive's fourth-quarter earnings conference call. Joining me today are Dave Rosa, our CEO; and Jamie Samath, our CFO.

下午好，歡迎參加Intuitive第四季財報電話會議。今天與我一同出席的有我們的執行長Dave Rosa和財務長Jamie Samath。

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. 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 October 22, 2025.

在會議開始之前，我想提醒各位，今天電話會議中的發言可能包含前瞻性陳述。由於某些風險和不確定性，實際結果可能與明示或暗示的結果有重大差異。這些風險和不確定性已在提交給美國證券交易委員會的文件中進行了描述，包括我們於2025年1月31日提交的最新10-K表格和於2025年10月22日提交的10-Q表格。

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.

您可以透過我們的網站intuitive.com或美國證券交易委員會（SEC）的網站查閱我們提交的文件。投資者請勿過度依賴此類前瞻性陳述。

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

請注意，本次電話會議的音訊回放可在我們網站「投資者關係」頁面下的「活動」欄位中找到。我們已在網站上發布了今天的新聞稿和補充財務數據表。

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 2026. And finally, we will host a question-and-answer session.

今天下午的財報電話會議流程如下：Dave 將回顧業務和營運亮點；Jamie 將回顧財務業績和流程亮點；我將回顧臨床亮點並討論我們更新後的 2026 年財務展望；最後，我們將進行問答環節。

With that, I will 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. I'll begin with summarizing our performance in 2025 and sharing our perspective as we enter 2026.

下午好，感謝各位參加。首先，我將總結我們2025年的工作表現，並分享我們對2026年的展望。

2025 was a strong year for Intuitive, driven by multi-specialty da Vinci procedure growth across the globe, increasing adoption of da Vinci 5, and higher utilization across our three platforms. Physicians use our systems to treat more than 3.1 million patients in the year.

2025年對Intuitive來說是業績強勁的一年，這主要得益於達文西手術系統在全球範圍內多專科手術量的增長、達文西5系統日益普及以及三大平台整體利用率的提高。當年，醫生們使用我們的系統治療了超過310萬名患者。

Since the first procedure in 1997, more than 20 million patients have been treated using Intuitive platforms. While meaningful progress has been made in advancing minimally invasive care, we continue to believe we are in the early stages of this journey.

自1997年首例手術以來，已有超過2,000萬名患者使用Intuitive平台接受了治療。儘管在推動微創治療方面取得了顯著進展，但我們仍然相信，我們仍處於這段旅程的早期階段。

We started 2025 with four strategic priorities: first, focusing on the full launch of da Vinci 5, its regional clearances, and follow-on feeds releases; second, pursuing increased adoption for our focused procedures by country through training, commercial activities, and market access efforts; third, driving continued progress in building industrial scale product quality and manufacturing optimization; and finally, focusing on excellence and availability of our digital tools.

2025 年伊始，我們制定了四項戰略重點：第一，專注於全面推出達文西 5 手術系統、獲得區域許可並發布後續產品；第二，透過培訓、商業活動和市場准入工作，推動各國對我們重點手術流程的採用率提高；第三，持續推進工業規模產品質量的提升和生產優化工具最後，專注於我們重點手術流程的卓越可用性；第三，持續推進工業規模產品質量的提升和生產優化工具；最後，專注於我們重點手術流程的卓越性和可用性。

I was pleased with our progress across these priorities. In 2025, da Vinci procedures increased approximately 18% with multiport procedures growing 17% and single-port procedures growing 87%, combined with 51% Ion procedure growth, total procedures grew 19% for the year.

我對我們在這些重點領域的進展感到滿意。 2025年，達文西手術量成長約18%，其中多埠手術成長17%，單一連接埠手術成長87%，加上離子治療手術51%的成長，全年手術總量成長19%。

In the US, da Vinci procedures increased 15% to more than 2 million, with notable contributions from general surgery procedures, including after-hours use.

在美國，達文西手術量增加了 15%，超過 200 萬例，其中普通外科手術（包括下班後的手術）貢獻顯著。

Internationally, da Vinci procedures increased by 23% to over 1.1 million. The growth rates were 21% in Europe, 24% in Asia, and 27% in rest of world markets. As a result, procedures outside the US accounted for roughly 35% of our global procedures, reflecting clinical demand, improved market access, broad training initiatives, and supportive economics. Going forward, we will continue to invest in market access activities and local evidence generation to meet our customers' clinical and economic objectives.

在全球範圍內，達文西手術量增加了23%，超過110萬例。其中，歐洲成長率為21%，亞洲為24%，世界其他地區為27%。因此，美國以外的手術量約占我們全球手術量的35%，這反映了臨床需求、市場准入的改善、廣泛的培訓計畫以及有利的經濟環境。展望未來，我們將繼續增加對市場准入活動和本地證據開發的投入，以滿足客戶的臨床和經濟目標。

In 2025, global system utilization increased 3% across our da Vinci platforms. Multiport grew 3%, single port 29%, and Ion 9%.

2025年，我們達文西手術平台的全球系統利用率成長了3%。其中，多端口手術平台增長了3%，單端口手術平台增長了29%，Ion手術平台增長了9%。

Turning to capital. We placed 1,721 da Vinci systems in 2025, including 870 da Vinci 5 systems and 107 SP systems and 195 Ion systems. Demand for da Vinci 5 strengthened throughout the year with customers responding to broader availability as we scale manufacturing and increasing capability through subsequent software and product releases.

再來看資金方面。我們計劃在2025年交付1,721台達文西手術系統，其中包括870台達文西5系統、107台SP系統和195台Ion系統。隨著我們擴大生產規模並透過後續軟體和產品更新提升效能，客戶對達文西5系統的需求全年持續成長，並積極回應其更廣泛的供應。

In the US, we saw robust demand for system upgrades and dual console systems, reflecting customer interest in standardization, training, and mentoring.

在美國，我們看到對系統升級和雙控制台系統有強勁的需求，這反映出客戶對標準化、培訓和指導的興趣。

In the second half of the year, we launched da Vinci 5 in Europe, the UK and Japan. For the year, we placed 58 da Vinci 5 systems outside the US, mostly in Europe, and we are pleased with feedback from these early adopters.

下半年，我們在歐洲、英國和日本推出了達文西5手術系統。全年，我們在美國以外地區共安裝了58套達文西5系統，主要集中在歐洲，我們對這些早期用戶的回饋非常滿意。

In 2025, we began offering refurbished da Vinci Xi systems as an integral part of our system strategy and placed 42 XiR systems in the year. Looking ahead, we believe there is a sizable long-term opportunity for our da Vinci XiR system and related economic programs to expand access to da Vinci surgery internationally and in US ambulatory surgery centers.

2025年，我們開始提供翻新的達文西Xi系統，作為我們系統策略的重要組成部分，當年共交付了42台XiR系統。展望未來，我們相信達文西XiR系統及相關經濟項目具有巨大的長期發展潛力，能夠擴大達文西手術在國際市場和美國門診手術中心的普及範圍。

Financially, revenue grew 21% year over year to $10.1 billion. Operating margins of 37% reflected our deliberate investments in R&D and manufacturing scale as well as the impacts of tariffs and newer platform mix. Cost efficiency initiatives helped to partially offset these pressures.

財務方面，營收年增21%至101億美元。 37%的營業利潤率反映了我們對研發和生產規模的持續投入，以及關稅和新型平台組合帶來的影響。成本效益措施在一定程度上抵銷了這些壓力。

Turning to our da Vinci platforms. Customer feedback remains positive as da Vinci 5 continues to expand to new indications and geographies. Surgeons highlight the benefits of greater autonomy and enhanced efficiency, reflected in the higher utilization trends we're seeing relative to Xi. Improved vision, Force Feedback capabilities, and ongoing UI enhancements have also supported broad interest in da Vinci 5.

接下來談談我們的達文西手術平台。隨著達文西5系統不斷拓展至新的適應症和地區，客戶回饋仍然積極。外科醫生強調了其更高的自主性和更有效率的手術體驗，這體現在我們觀察到的達文西5系統相對於達文西Xi系統更高的使用率。此外，改進的視覺系統、力回饋功能以及持續的使用者介面優化也促進了人們對達文西5系統的廣泛關注。

We are excited to fully launch our Force Feedback instruments and work with customers to establish the clinical impact of Force Feedback at scale.

我們很高興能夠全面推出我們的力回饋儀器，並與客戶合作，大規模地確定力回饋的臨床影響。

This month, we received FDA clearance for several cardiac procedures on da Vinci 5 using non-Force Feedback instruments. Given the complexity of minimally invasive cardiac surgery, we are planning a measured rollout to training, education, and adoption. We believe deeply that patients requiring cardiac surgery can benefit from a minimally invasive approach with da Vinci and look forward to actively supporting our customers through these procedures.

本月，我們獲得了FDA的批准，可以使用非力回饋器械在達文西5手術系統上進行多項心臟手術。鑑於微創心臟手術的複雜性，我們計劃採取循序漸進的方式進行培訓、教育和推廣。我們深信，需要進行心臟手術的患者能夠從達文西微創手術中獲益，並期待積極為我們的客戶提供這些手術的支持。

Over the past year, we released two software updates that improve surgeon awareness in the console, support a better intraoperative decision-making, and establish the foundation for future remote updates. In 2026, da Vinci 5 capabilities will continue to grow as we introduce additional products and features.

過去一年，我們發布了兩項軟體更新，旨在提升外科醫生在控制台上的操作體驗，支援更佳的術中決策，並為未來的遠端更新奠定基礎。 2026年，隨著更多產品和功能的推出，達文西5系統的功能將持續增強。

My Intuitive+, our digital subscription package offered with da Vinci 5 includes simulation, telecollaboration and case insights and is designed to help customers understand their surgical performance, collaborate in real time, and receive personalized training recommendations. Adoption of our telepresence capabilities continues to increase, supported by recent software changes that enable surgeon-initiated scheduling.

My Intuitive+ 是我們為達文西5系統提供的數位訂閱套餐，包含類比、遠端協作和病例分析功能，旨在幫助客戶了解自身的手術表現、即時協作並獲得個人化的培訓建議。隨著近期軟體更新（支援外科醫生自主安排手術時間），我們遠端呈現功能的應用率持續成長。

Surgeons are now able to more easily tap into the collective knowledge of the da Vinci community through real-time case observation, collaboration, and mentoring. Increasingly, we are hearing from IDN executives that they value the ability to connect flagship hospitals within their broader network to provide consistent high-quality care to more patients.

如今，外科醫生可以透過即時病例觀察、協作和指導，更便捷地利用達文西機器人社群的集體智慧。我們越來越常聽到整合醫療網絡（IDN）的高層表示，他們重視將旗下旗艦醫院納入更廣泛的醫療網絡，從而為更多患者提供持續的高品質醫療服務。

Our single port platform continued to build operating and clinical momentum in 2025. Procedures grew 87%, driven by high rates of growth in Korea and the US with accretive early growth in Europe, Japan, and Taiwan. Our installed base increased by 39% to 377 systems. Since clearance in 2018, we have methodically added indications and capabilities to the platform.

2025年，我們的單埠平台持續保持強勁的營運和臨床發展動能。手術量增加了87%，主要得益於韓國和美國的高速成長，以及歐洲、日本和台灣地區的早期穩定成長。我們的系統裝置量成長了39%，達到377套。自2018年獲批以來，我們穩步拓展了該平台的適應症和功能。

In Q4, we received 510(k) clearance for several additional indications, including nipple-sparing mastectomy, inguinal hernia repair, cholecystectomy and appendectomy.

第四季度，我們獲得了 510(k) 許可，用於多種其他適應症，包括保留乳頭的乳房切除術、腹股溝疝氣修補術、膽囊切除術和闌尾切除術。

For NSM in particular, we plan a measured rollout to support education, training and adoption in 2026 and beyond. Feedback on our single port stapler during its initial launch has been very positive and moving into broad launch this quarter will support deeper penetration in thoracic and colorectal procedures. We have additional regulatory submissions planned for 2026, and we'll update you on our progress throughout the year.

特別是對於NSM，我們計劃採取循序漸進的推廣策略，以支持2026年及以後的教育、培訓和應用。我們的單孔吻合器在初期上市後獲得了非常積極的回饋，本季全面上市將有助於其在胸腔外科和大腸直腸手術領域實現更深層的市場滲透。我們計劃在2026年提交更多監管申請，並將全年持續向您報告進度。

Turning to Ion. Worldwide procedures grew 51% to just over 144,000. Since FDA clearance in 2019, physicians have performed over 325,000 Ion procedures with a global installed base approaching 1,000 systems. In 2026, we remain focused on growing utilization of existing domestic systems and ensuring excellent early results in international markets.

轉向 Ion 系統。全球手術量成長 51%，超過 14.4 萬例。自 2019 年獲得 FDA 批准以來，醫生已完成超過 32.5 萬例 Ion 手術，全球系統裝機量接近 1000 套。展望 2026 年，我們將繼續專注於提高現有國內系統的使用率，並確保在國際市場上取得卓越的早期成果。

We are committed to expanding capabilities of Ion, including our efforts in ROSE, our rapid on-site tissue evaluation technology and the integration of endobronchial ultrasound. We believe Ion with these capabilities will help minimize the time from detection to treatment as we work to improve the survival rate of lung cancer patients.

我們致力於拓展 Ion 的功能，包括我們在快速現場組織評估 (ROSE) 技術方面的努力，以及支氣管內超音波的整合。我們相信，具備這些功能的 Ion 將有助於最大限度地縮短從發現到治療的時間，從而提高肺癌患者的生存率。

As we enter 2026, our company priorities are as follows: First, the global expansion of our platforms, digital feature releases and ecosystem enhancements; second, increased adoption for our focused procedures by country through training, commercial activities and market access efforts; third, building industrial scale, product quality and manufacturing optimization; and finally, advancing innovation to reach more patients in current and new disease states.

進入 2026 年，我們公司的優先事項如下：第一，在全球範圍內擴展我們的平台、發布數位功能和增強生態系統；第二，透過培訓、商業活動和市場准入努力，提高各國對我們重點流程的採用率；第三，建立工業規模、產品質量和製造優化；最後，推進創新，以惠及更多患有現有和新型疾病的患者。

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 describe our 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.

午安.我會先介紹我們以非GAAP準則或備考財務報表編製的業績，稍後也會概述我們的GAAP業績。我們的備考財務報表與GAAP績效的調節表可在我們的網站上查閱。

To facilitate a deepening of understanding of the trends within our Ion business, we have added disclosures to the data tables posted on our website. All references to total procedures and their related growth rates include da Vinci and Ion procedures taken together.

為了幫助大家更深入了解我們Ion業務的發展趨勢，我們在網站上發布的數據表中增加了相關資訊揭露。所有關於手術總量及其相關成長率的參考數據均包含達文西手術和Ion手術的總和。

Q4 and 2025 revenue procedures and system placements are in line with our preliminary press release on January 14. I will briefly review full year 2025 performance before describing our Q4 results in greater detail.

第四季和 2025 年的收入流程和系統部署情況與我們 1 月 14 日發布的初步新聞稿一致。在更詳細地介紹第四季業績之前，我將簡要回顧 2025 年全年業績。

2025 financial performance was strong. Total procedures grew 19% and total revenue grew 21%. Despite the impact of tariffs, pro forma operating margin improved approximately 70 basis points to 37% for the year. Given the strong financial performance, 2025 pro forma EPS increased 22%, marking the third consecutive year of pro forma EPS growth above 20%.

2025年的財務業績表現強勁。手術總量成長19%，總收入成長21%。儘管受到關稅的影響，全年的備考營業利潤率仍提升約70個基點，達到37%。鑑於強勁的財務業績，2025年的備考每股收益成長22%，連續第三年實現20%以上的成長。

Consistent with our financial objectives for 2024, we saw a significant increase in free cash flow to $2.5 billion, up from free cash flow of $1.3 billion in 2024, driven by increased profitability and lower capital expenditures. During the year, we repurchased $2.3 billion of Intuitive's stock at an average price of $478 per share.

為實現我們2024年的財務目標，我們的自由現金流顯著增長至25億美元，高於2024年的13億美元，這主要得益於盈利能力的提升和資本支出的減少。年內，我們以每股478美元的平均價格回購了價值23億美元的Intuitive股票。

Turning to Q4. Total procedure growth was 18%, driven by general surgery in the US and broad-based growth in OUS markets. In quarter four, revenue grew 19% to $2.87 billion with recurring revenue higher by 20% to $2.3 billion, accounting for 81% of total revenue. On a constant currency basis, revenue growth was 18%.

第四季度，手術總量成長18%，主要得益於美國普通外科手術的成長以及美國以外市場的整體成長。第四季度，營收成長19%至28.7億美元，其中經常性營收成長20%至23億美元，佔總營收的81%。以固定匯率計算，營收成長率為18%。

Pro forma operating margin was 37%, which included an impact of approximately 95 basis points from tariffs and a $70 million contribution to the Intuitive Foundation. The strength of our financial results reflected continuing global expansion and procedure adoption of our da Vinci 5, Ion, and SP platforms.

經調整後的營業利潤率為37%，其中包括關稅帶來的約95個基點的影響以及向Intuitive基金會捐贈的7000萬美元。我們強勁的財務表現反映了達文西5、Ion和SP手術平台在全球範圍內的持續擴張和手術流程的廣泛應用。

For our da Vinci business, procedures grew 17%, the installed base of da Vinci systems increased by 12% to just over 11,100 systems and average system utilization increased by 4%.

對於我們的達文西手術系統業務，手術量成長了 17%，達文西系統的安裝量增加了 12%，達到 11100 多台，平均係統利用率增加了 4%。

For our Ion platform, we continue to see robust clinical growth with procedures increasing 44%, the installed base up by 24% to just under 1,000 systems, and average system utilization increasing by 11%.

對於我們的 Ion 平台，我們繼續看到強勁的臨床成長，手術量增加了 44%，安裝量增加了 24%，達到近 1,000 套系統，平均係統利用率增加了 11%。

In the US, total procedures increased 16%, reflecting 15% growth in da Vinci procedures and 41% growth in Ion procedures. Da Vinci procedures performed after hours, a proxy for acute care increased by 35% in Q4, primarily driven by cholecystectomy and appendectomy procedures and reflects our support for customers who are expanding access to da Vinci surgery.

在美國，手術總量增加了16%，其中達文西手術量增加了15%，Ion手術量增加了41%。第四季度，非工作時間進行的達文西手術量（可作為急診護理的指標）增加了35%，主要受膽囊切除術和闌尾切除術的推動，這體現了我們對正在擴大達文西手術服務範圍的客戶的支持。

Da Vinci utilization in the US increased 3% in Q4, driven by continued adoption of da Vinci 5, where customers are leveraging the system's efficiency advantages to increase cases performed per day.

第四季度，美國達文西手術系統的使用率成長了 3%，這主要得益於達文西 5 的持續普及，客戶正在利用該系統的效率優勢來增加每天完成的手術例數。

Over the past few years, our customers have increased their efforts to distribute surgeries across different sites of care from hospitals to hospital outpatient departments to ambulatory surgery centers or ASCs. Minimally invasive surgery has helped enable this shift. As this occurs, we have increased our efforts to expand our footprint in which we expect to be a multiyear effort.

過去幾年，我們的客戶加強了將手術分散到不同醫療機構的力度，從醫院到醫院門診部，再到日間手術中心（ASC）。微創手術的出現推動了這一轉變。隨著這一趨勢的發展，我們也加大了拓展業務範圍的力度，預計這將是一項持續多年的工作。

Our initiative currently leverages our XiR system and its associated ecosystem with economic and capital acquisition offerings we believe are well suited to meet the clinical and financial needs of this environment. Not all ASCs run at the same volume, but with the same mix of procedures and we have started our efforts focused on higher-volume ASCs that can sustain a robotic program.

我們目前的計劃是利用我們的XiR系統及其相關生態系統，結合我們認為能夠很好地滿足該環境臨床和財務需求的經濟和資本購買方案。並非所有門診手術中心的手術量都相同，但手術組合基本上相同，因此我們已開始著重關注那些能夠維持機器人手術計畫的高手術量門診手術中心。

Approximately 70% of the ASC procedure opportunity is in ASCs affiliated with our existing IDN customers where a number of surgeons are already da Vinci trained. In addition, we actively support customers to upgrade to da Vinci 5 in their efforts to slide our existing Xi to the HOPD or ASC setting.

大約70%的門診手術機會來自與我們現有IDN客戶合作的門診手術中心，這些中心的許多外科醫生已經接受過達文西手術系統的培訓。此外，我們積極支援客戶升級到達芬奇5系統，以便他們能夠將我們現有的Xi系統應用於醫院門診部（HOPD）或門診手術中心（ASC）。

Outside the US, in quarter four, total procedures grew 22%, and on a day-adjusted basis, total OUS procedure growth was 23%. Da Vinci procedures grew 21% in OUS markets, reflecting strong results in Canada, India, Korea and distributor markets and solid growth in Germany, the UK, Italy, Spain, and Taiwan.

在美國以外，第四季度手術總量增加了 22%，按日調整後，美國以外地區的手術總量增加了 23%。達文西手術在美國以外市場成長了 21%，反映出加拿大、印度、韓國和經銷商市場的強勁表現，以及德國、英國、義大利、西班牙和台灣的穩健成長。

Consistent with the last quarter, procedure growth in Japan was a little lower than our expectations reflecting lower capital placements over the last several quarters. The Japanese Ministry of Health, Labor and Welfare is currently in the final stages of evaluating granting reimbursement for additional robotic procedures starting in June of 2026. We will provide an update on the outcome on our next earnings call.

與上季一致，日本的手術量成長略低於預期，反映出過去幾季的資本投入有所減少。日本厚生勞動省目前正處於評估的最後階段，計劃從2026年6月起對新增機器人手術進行報銷。我們將在下次財報電話會議上公佈評估結果。

Taking OUS markets combined, benign general surgery procedures increased 27%, driven by cholecystectomy and hernia repair. Globally, we continue to see strong procedure growth for our SP platform at 78% for Q4 with strength in Korea and continuing strong early-stage growth in Europe, Japan, and Taiwan.

綜合美國境外市場來看，良性一般外科手術量增加了27%，主要得益於膽囊切除術和疝氣修補術的成長。在全球範圍內，我們的SP平台手術量在第四季度繼續保持強勁增長，增幅達78%，其中韓國市場表現尤為突出，歐洲、日本和台灣地區也持續保持強勁的早期增長勢頭。

In the US, SP average system utilization accelerated, growing 21% as compared to quarter four of last year. We also see encouraging initial growth in thoracic procedures following clearance in 2024 and positive customer feedback on the limited launch of our SP stapler. As a result of our clinical performance, total I&A revenue in quarter four grew 17% to $1.7 billion, relatively consistent with overall procedure growth.

在美國，SP系統平均利用率加速成長，較去年第四季成長21%。我們也看到，在2024年獲得批准後，胸腔外科手術量出現了令人鼓舞的初步增長，並且客戶對我們SP吻合器的有限上市也給予了積極的反饋。由於臨床表現良好，第四季I&A（切口和縫合）總收入成長17%至17億美元，與整體手術量成長基本持平。

Da Vinci I&A revenue per procedure was approximately $1,850 compared to $1,860 last year, primarily driven by customer ordering patterns. We also continue to see downward pressure from lower bariatric procedures and higher cholecystectomy procedures, offset by higher SP procedures and da Vinci 5-specific I&A.

達文西手術的單次手術收入約為 1,850 美元，而去年為 1,860 美元，主要受客戶訂單模式的影響。此外，減重手術量下降和膽囊切除術量上升也持續對收入構成下行壓力，但部分被手術量增加和達文西 5 手術特有的手術收入所抵消。

For our Ion platform, I&A revenue per procedure was approximately $2,200 relatively consistent with prior periods.

對於我們的 Ion 平台，每次手術的 I&A 收入約為 2,200 美元，與前期基本一致。

Turning to capital performance and starting with our da Vinci business, we placed 532 da Vinci systems in quarter four, an 8% increase from the 493 systems placed in the same quarter last year. 303 of the 532 placements with da Vinci 5, including 43 in OUS markets following recent clearances in Europe and Japan. The installed base of da Vinci systems is now 1,232 systems, used by over 10,000 surgeons since the launch of da Vinci 5.

再來看資本業績，首先是我們的達文西手術系統業務。第四季我們共安裝了532台達文西手術系統，較去年同期的493台成長了8%。其中303台為達文西5型，包括近期在歐洲和日本獲得批准後在美國以外市場安裝的43台。目前，達文西手術系統的裝置量已達1,232台，自達文西5型上市以來，已有超過1萬名外科醫師使用過該系統。

We saw 146 trading transactions in Q4, up from 62% a year ago, primarily driven by US customers upgrading to da Vinci 5. In the US, we placed 304 systems, up from 204 -- 284 last year driven by adoption of da Vinci 5.

第四季我們完成了 146 筆交易，比去年同期成長了 62%，這主要得益於美國客戶升級到達芬奇 5 系統。在美國，我們安裝了 304 套系統，比去年同期的 204 套至 284 套有所增加，這主要得益於達文西 5 系統的普及。

Outside the US, we placed 228 systems compared to 209 last year. OUS placements included 118 in Europe, 40 in Japan, and 17 in China compared to 89, 43, and 20, respectively, last year. We continue to see government budget challenges in Japan and the UK and robotic competition in China intensified in Q4, where we saw provincial tenders express preference for local suppliers and lower pricing impacting our win ratio in the quarter.

在美國以外，我們共安裝了228套系統，去年同期為209套。其中，歐洲118套，日本40套，中國17套，去年同期分別為89套、43套和20套。我們持續看到日本和英國政府預算面臨挑戰，而中國第四季的機器人競爭加劇，省級招標更傾向於本地供應商，較低的價格也影響了我們本季的中標率。

Within the 532 da Vinci placements, we placed 35 SP systems in Q4, higher than 30 systems last year, driven primarily by OUS markets. For our Ion platform, we placed 42 systems in Q4 compared to 69 systems last year, including six systems placed in OUS markets. Lower Ion placements in the US continue to reflect a joint focus with our customers on increasing utilization in the US increased by 11% in Q4.

在第四季完成的532例達文西手術系統中，我們安裝了35台SP系統，高於去年同期的30台，主要得益於美國以外市場的推動。我們的Ino平台在第四季度安裝了42台，而去年同期為69台，其中包括6台在美國以外市場安裝的系統。 Ion平台在美國的安裝量下降，繼續反映出我們與客戶共同致力於提高美國市場的使用率，第四季度美國市場的使用率成長了11%。

Given our capital performance, [Core of 4] Systems revenue grew 20% to $786 million. For our da Vinci business, leasing represented 47% of da Vinci placements, as compared to 54% last quarter and 45% last year, driven by the mix of customers who prefer to purchase.

鑑於我們的資本表現，[核心4]系統營收成長20%，達到7.86億美元。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總安裝量的47%，而上一季為54%，去年同期為45%，這主要是由於部分客戶傾向於購買。

However, over time, we continue to expect the proportion of systems placed under operating lease arrangements to increase, primarily driven by OUS customers.

然而，隨著時間的推移，我們仍然預期採用經營租賃安排的系統比例將會增加，這主要是由 OUS 客戶推動的。

Da Vinci leasing revenue increased 34%, reflecting a 15% expansion of the installed base under operating lease arrangements and a 13% increase in lease revenue per system driven by a higher mix of da Vinci 5 systems. The average selling price for purchased da Vinci Systems was $1.68 million in Q4 as compared to $1.6 million last year, driven by a higher mix of da Vinci systems and a higher mix of dual console systems, partially offset by higher trade-ins.

達文西系統租賃收入成長34%，這主要得益於經營租賃模式下裝機量成長15%，以及單套系統租賃收入成長13%，後者主要由達文西5系統佔比提高所驅動。第四季度達文西系統的平均售價為168萬美元，高於去年同期的160萬美元，主要得益於達文西系統和雙控台系統佔比的提高，但部分被以舊換新業務的成長所抵銷。

Lease buyout revenue was $39 million as compared to $22 million last quarter and $28 million last year. Core of 4 service revenue increased 21% to $422 million, reflecting an increase of the da Vinci installed base of 12% and the Ion installed base of 24%. Service revenue per system for our da Vinci installed base increased 7% year over year, primarily reflecting a higher mix of da Vinci 5 systems.

租賃買斷收入為 3,900 萬美元，高於上季的 2,200 萬美元和去年同期的 2,800 萬美元。核心 4 項服務收入成長 21% 至 4.22 億美元，主要得益於達文西手術系統裝機量成長 12% 和 Ion 手術系統裝機量成長 24%。達文西手術系統單系統服務收入年增 7%，這主要反映了達文西 5 系統佔比的提高。

Turning now to the rest of the P&L. Pro forma gross margin for the quarter was 67.8%, down from 69.5% in Q4 of last year. The year-over-year decline reflects a 95 basis points 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 5, partially offset by product cost reductions and purchase component savings.

接下來來看損益表的其他部分。本季備考毛利率為67.8%，低於去年第四季的69.5%。年減95個基點主要受關稅、設施成本上漲、低利潤率的達文西5和Ion手術收入佔比增加以及達文西5相關服務成本上升的影響，部分被產品成本降低和零件採購節省所抵消。

Quarter-four pro forma operating expenses increased 16% year over year driven by a $17 million donation to the Intuitive Foundation, increased headcount, higher variable compensation costs, and increased facility costs, partially offset by lower legal expenses.

第四季備考營運費用年增 16%，主要原因是向 Intuitive 基金會捐贈了 1,700 萬美元、員工人數增加、可變薪酬成本上升以及設施成本上升，部分被法律費用下降所抵消。

We added approximately 200 employees during the quarter, primarily in our core commercial and engineering functions. The increased donation to the Intuitive Foundation as compared to the $45 million donated in quarter four of last year reflects our decision to make a multiyear donation given the impact of new US tax rules effective in 2026.

本季我們新增了約 200 名員工，主要集中在核心商業和工程部門。與去年第四季捐贈的 4,500 萬美元相比，我們增加了對 Intuitive 基金會的捐款，這反映了我們考慮到 2026 年生效的美國新稅法的影響，決定進行多年捐贈。

With respect to our plans to go direct in Italy, Spain, and Portugal, we currently expect to close by the end of Q1 and resulting in the transfer of approximately 250 employees. Pro forma other income was $86 million for the quarter as compared to $93 million last quarter, reflecting lower interest income. Our pro forma effective tax rate for quarter four was 20.6%, slightly below our expectations, driven by $11 million in net discrete benefits primarily related to releases of tax reserves due to statute of limitation expirations and other various adjustments to our tax reserves.

關於我們計劃在義大利、西班牙和葡萄牙直接開展業務，目前預計在第一季末完成，屆時將轉移約250名員工。本季其他收入（按備考數據）為8,600萬美元，低於上季的9,300萬美元，主要原因是利息收入下降。第四季實際稅率（按備考數據）為20.6%，略低於預期，主要原因是淨一次性收益為1100萬美元，這主要與因訴訟時效到期而釋放的稅務準備金以及其他各項稅務準備金調整有關。

Pro forma net income for the fourth quarter was $914 million, compared with $805 million last year. Pro forma earnings per share was $2.53 per share as compared to $2.21 per share in quarter four of last year.

第四季備考淨利為9.14億美元，去年同期為8.05億美元。備考每股收益為2.53美元，去年同期為2.21美元。

Now turning to our GAAP results. GAAP net income for the quarter was $795 million or $2.21 per share compared to $686 million or $1.88 per share in Q4 of last year. The differences between our pro forma and GAAP results are outlined and quantified on our website.

現在來看我們的GAAP業績。本季GAAP淨利為7.95億美元，合每股2.21美元，去年同期為6.86億美元，合每股1.88美元。我們網站上詳細列出了備考業績與GAAP業績之間的差異及具體量化數據。

We ended the year with $9 billion in cash and investments, up from $8.4 billion last quarter driven primarily by cash from operations, partially offset by stock repurchases of $201 million and capital expenditures of $155 million.

截至年底，我們擁有 90 億美元的現金和投資，高於上一季的 84 億美元，主要得益於經營活動產生的現金流，但部分被 2.01 億美元的股票回購和 1.55 億美元的資本支出所抵銷。

With that, I'll turn it over to Dan to discuss recent clinical publications and our outlook for 2026.

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 2026 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 to be notable.

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我們發現的值得關注的近期研究數據。

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 and published scientific studies over the years.

除了本次通告中重點介紹的具體數據外，我們還鼓勵您考慮多年來詳細闡述這些主題及其他主題的大量證據和已發表的科學研究。

This past November, Dr. Antonio Gangemi of Alma Mater Studiorum, Universita di Bologna in Bologna Italy, along with co-authors published, the conversion study open conversion risk in robotic or laparoscopic surgery, a 20-year meta-analysis in the analysis of surgery.

去年 11 月，義大利博洛尼亞大學 Alma Mater Studiorum 的 Antonio Gangemi 博士及其合作者發表了題為《機器人或腹腔鏡手術的轉換風險》的研究報告，這是一項為期 20 年的手術分析統合分析。

Through a meta-analysis of literature from 30 different countries, the study compared conversion rates to open surgery for da Vinci and laparoscopic procedures, including abdominal wall and inguinal hernia repairs, gastrectomy, cholecystectomy and rectal resections. The study included over 200,000 patients treated with da Vinci and over 1.3 million patients treated laparoscopically.

研究透過30個不同國家的文獻進行統合分析，比較了達文西機器人手術和腹腔鏡手術（包括腹壁和腹股溝疝氣修補術、胃切除術、膽囊切除術和直腸切除術）的開腹手術轉換率。研究納入了超過20萬例接受達文西機器人手術治療的患者和超過130萬例接受腹腔鏡手術治療的患者。

The results demonstrated that patients undergoing robot-assisted surgery were approximately 50% less likely to experience a conversion to open surgery than patients undergoing a laparoscopic procedure, with similar results across randomized controlled studies, prospective studies, and retrospective study types.

結果表明，接受機器人輔助手術的患者比接受腹腔鏡手術的患者轉為開放性手術的可能性低約 50%，隨機對照研究、前瞻性研究和回顧性研究類型均得出類似結果。

The authors hypothesize that technical advantages of robotic-assisted systems, specifically wristed instruments with 7 degrees of freedom, 3D high-definition visualization and physiological tremor filtration or potential explanatory factors for the results.

作者假設機器人輔助系統的技術優勢，特別是具有 7 個自由度的腕式儀器、3D 高清視覺化和生理震顫過濾，可能是造成結果的潛在解釋因素。

The authors concluded, quote, this meta-analysis, which spans over 20 years of peer-reviewed literature includes 14 oncological and non-oncological surgeries across general surgery and related specialties suggests that robotic-assisted surgery offers a reduced risk of open conversion compared to laparoscopy. These findings may inform decision makers considering the adoption of robotic-assisted surgery in general surgery and associated specialties, close quote.

作者總結：「這項薈萃分析涵蓋了20多年來同行評審的文獻，包括普通外科及相關專科的14例腫瘤和非腫瘤手術，結果表明，與腹腔鏡手術相比，機器人輔助手術可降低中轉開腹手術的風險。這些發現可為考慮在普通外科及相關專科中採用機器人輔助手術的決策者提供參考。」

This past November, Dr. Nadia Henriksen from Bispebjerg Hospital in Copenhagen, Denmark published procedural cost robot-assisted and laparoscopic ventral and incisional hernia repair, a propensity score matched a nationwide database study in the Journal of Abdominal Wall Surgery using data from the Danish hernia database, which includes all hernia repairs performed in Denmark.

去年 11 月，丹麥哥本哈根 Bispebjerg 醫院的 Nadia Henriksen 博士在《腹壁外科雜誌》上發表了一項關於機器人輔助和腹腔鏡下腹壁和切口疝修補術的程序成本的研究，該研究採用了傾向評分匹配的全國數據庫數據，數據來自丹麥疝數據庫，該數據庫包含了丹麥疝進行的所有疝氣修補術。

The authors compared subjects undergoing elective primary ventral hernia repair or incisional hernia repair via the robotic-assisted approach or the laparoscopic approach from January 2017 to December 2022. After one-to-one propensity score matching with 554 patients in each of the robotic-assisted and laparoscopic arms, study results showed a significantly shorter length of stay for robotic-assisted procedures at 0.5 days versus 1.2 days for the laparoscopic group as well as a 44% reduction in the readmission rate for robotic-assisted procedures compared to the laparoscopic group.

作者比較了 2017 年 1 月至 2022 年 12 月期間接受擇期原發性腹壁疝氣修補術或切口疝氣修補術的患者，分別採用機器人輔助手術和腹腔鏡手術。在機器人輔助手術組和腹腔鏡手術組各納入 554 例患者後，採用一對一傾向評分配對法進行配對。研究結果顯示，機器人輔助手術組的住院時間顯著短於腹腔鏡手術組（分別為 0.5 天和 1.2 天），且機器人輔助手術組的再入院率比腹腔鏡手術組降低了 44%。

Comparing costs, the mean total perioperative cost of robotic-assisted procedures was significantly lower than laparoscopic procedures with a EUR660 difference in total costs between approaches.

從成本來看，機器人輔助手術的平均總圍手術期成本明顯低於腹腔鏡手術，兩種手術方式的總成本相差 660 歐元。

For robotic primary ventral hernia repair, multivariate regression analysis further confirmed independent association with decreased overall costs. The authors concluded, quote, while the cost of the robotic surgical equipment surpassed out of conventional laparoscopy, it is offset by the need of more expensive meshes and tacker devices and higher readmission rates following the laparoscopic approach. This nationwide database study showed that for primary ventral hernias, the mean procedural costs of a robot-assisted and laparoscopic repair are comparable, but for incisional hernia repairs the mean procedural cost has decreased with a robot-assisted approach, close quote.

對於機器人輔助腹壁原發性疝氣修補術，多因子迴歸分析進一步證實了其與整體成本降低的獨立相關性。作者總結：「雖然機器人手術設備的成本高於傳統腹腔鏡手術，但由於需要更昂貴的網片和縫合器，以及腹腔鏡手術後更高的再入院率，其成本優勢被抵消了。」這項基於全國數據庫的研究表明，對於原發性腹壁疝，機器人輔助手術和腹腔鏡手術的平均手術成本相當；但對於切口切除手術成本，機器人輔助疝氣手術的平均手術成本有所降低。

I will now turn to our financial outlook for 2026. Starting with da Vinci procedures. As detailed in our announcement earlier this month, 2025 total da Vinci procedures grew approximately 18% year over year to more than 3.1 million procedures performed worldwide.

接下來，我將談談我們對2026年的財務展望。首先是達文西手術。正如我們本月稍早發布的公告中所詳述的，2025年達文西手術總量年增約18%，達到全球310萬例以上。

For 2026, we anticipate full year da Vinci procedure growth within a range of 13% and 15%. We anticipate primary growth drivers in 2026 to be generally consistent with those in 2025, including general surgery in the US and procedures outside of urology internationally. This range considers the potential impact of changes to ACA premium subsidies and Medicaid funding on hospital and patient behavior in the US, capital pressure in parts of Europe related to macroeconomic impact, and shifting governmental priorities.

我們預計2026年達文西手術全年成長率將介於13%至15%之間。我們預計2026年的主要成長驅動因素與2025年基本一致，包括美國的普通外科手術以及國際上泌尿外科以外的手術。這項預測範圍考慮了《平價醫療法案》（ACA）保費補貼和醫療補助資金變化可能對美國醫院和患者行為產生的影響、歐洲部分地區宏觀經濟影響帶來的資本壓力以及政府優先事項的轉變。

China tender volumes and competitive intensity in that market, recent capital challenges in Japan, how long those persist in 2026 and any related impact on procedures and new pharmaceutical products for obesity management.

中國招標數量和市場競爭強度，日本近期面臨的資本挑戰，這些挑戰在 2026 年會持續多久，以及對肥胖症治療程序和新藥產品的任何相關影響。

Turning to gross profit. In 2025, our pro forma gross profit margin was 67.6%. In 2026, we expect our pro forma gross profit margin to be within the range of 67% and 68% of net revenue. This year, we forecast an impact from tariffs of 1.2% of net revenue, plus or minus 10 basis points. Other factors impacting the projected pro forma gross profit margin guidance include faster growth of newer products in da Vinci 5 and Ion, modest incremental depreciation from recent facility expansion, and the impact from higher da Vinci system upgrades, partially offset by cost reductions.

接下來談談毛利。 2025年，我們的備考毛利率為67.6%。 2026年，我們預計備考毛利率將佔淨收入的67%至68%。今年，我們預期關稅的影響將佔淨收入的1.2%，上下浮動10個基點。影響預考毛利率預計的其他因素包括：達文西5和Ion等新產品的快速成長、近期設施擴建帶來的適度折舊增加，以及達文西系統升級帶來的更高影響（部分被成本降低所抵銷）。

Our actual gross profit margin will vary quarter to quarter depending largely on product, regional and trade-in mix and pricing.

我們的實質毛利率會因產品、地區和以舊換新組合以及定價而逐季度波動。

Turning to operating expenses. In 2025, our pro forma operating expenses grew 12%. In 2026, we expect pro forma operating expense growth to be within a range of 11% and 15%, and due to higher spending in support of advancing early-stage R&D programs as well as incremental expenses associated with our distributor acquisition.

接下來談談營運費用。 2025年，我們的備考營運費用成長了12%。 2026年，我們預計備考營運費用成長率將在11%至15%之間，這主要是由於支援推動早期研發項目的支出增加，以及與收購經銷商相關的額外費用。

We estimate noncash stock compensation expense between $890 million and $920 million. We forecast other income, which is comprised mostly of interest income to total between $355 million and $375 million. At this time, given our expectation that capital expenditures will return to more normalized levels, we are no longer providing specific capital expenditure guidance.

我們預計非現金股權激勵支出在 8.9 億美元至 9.2 億美元之間。我們預測其他收入（主要包括利息收入）總額在 3.55 億美元至 3.75 億美元之間。鑑於我們預期資本支出將恢復到較正常的水平，目前我們不再提供具體的資本支出指引。

With regard to income tax, in 2025, our pro forma income tax rate was approximately 21%. As we look forward, we estimate our 2026 pro forma income tax rate to be within a range of 22% and 23% of pretax income.

關於所得稅，2025 年我們的預計所得稅率約為 21%。展望未來，我們預計 2026 年的預計所得稅率將在稅前收入的 22% 至 23% 之間。

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

我們的發言到此結束。現在開始接受各位提問。

(Operator Instructions) Travis Steed, Bank of America.

（操作員說明）特拉維斯·斯蒂德，美國銀行。

First, I wanted to ask about the FDA approval for the cardiac non-Force Feedback instruments. Just trying to get a little more color on what that is and what it owns up. When I was looking at your 2026 priorities that you mentioned you added new disease states. So if you could elaborate on that, if that's cardiac or there's more there?

首先，我想問FDA核准的非力回饋心臟監測儀器的相關問題。我想更詳細地了解這項批准的具體內容和作用。我在查看您提到的2026年優先事項時，發現您新增了一些疾病領域。您能否詳細說明一下，這些新增疾病領域是否僅限於心臟疾病，還是涵蓋了其他方面？

Sure. Travis, thank you for the question. I'll start maybe with some framing around cardiac and the work we're doing, and then Jamie can follow up a bit.

當然。崔維斯，謝謝你的提問。我先簡單介紹一下心臟方面以及我們正在進行的工作，然後傑米可以接著講。

And so you know, we've been supporting cardiac surgery for decades and have a good understanding of what cardiac programs need to do to be successful and have great patient outcomes. And so there are some foundational aspects that we're working on today.

所以，你知道，我們幾十年來一直支持心臟外科手術，對心臟計畫需要做些什麼才能取得成功並獲得良好的患者療效有著深刻的理解。因此，我們目前正在努力解決一些基礎性問題。

Those include the clearances on the platform on dV5 in certain geographies, we just received the US clearance for working through approval in Europe and several other countries. Part of those indications as well will include Force Feedback instruments. And so cardiac surgery is a wide variety of procedures with a wide variety of tasks.

這些包括dV5平台在特定地區的審批，我們剛剛獲得了美國的審批，這將有助於我們在歐洲和其他幾個國家獲得批准。部分適應症也將包括力回饋儀器。心臟外科手術涵蓋多種手術，涉及的任務也多種多樣。

And we do think that Force Feedback can have some benefit in certain parts of certain procedures. And so the initial clearance here, I think, incorporates our entire portfolio of non-Forced Feedback instruments and has value today for cardiac procedures. And again, we'll work to add Force Feedback in time through the regulatory pathway.

我們認為力回饋在某些手術流程的某些環節確實具有一定的益處。因此，我認為此次的初步批准涵蓋了我們所有非力回饋器械產品組合，並且目前已對心臟手術具有價值。我們將繼續努力，透過監管審批程序，逐步將力回饋功能納入產品線。

We are also developing training pathways to support a unique pathway through to learn the cardiac robotic surgery business, if you will, for minimally invasive approaches with da Vinci. And so we're investing there. We are developing cardiac-specific instrumentation, including Force Feedback, some accessories, and tuning some of the digital tools we have. Those will be multiyear efforts to bring all of those to the market.

我們也正在開發培訓路徑，旨在為學員提供一條獨特的學習途徑，讓他們能夠掌握達文西微創心臟機器人手術技術。為此，我們正在加大投入。我們正在研發心臟專用器械，包括力回饋系統、一些配件，並改進我們現有的部分數位化工具。這些都是需要多年才能完成並推向市場的環節。

And then finally, worked with surgical societies. It's an important aspect of, I think, doing this well for training and other parts that they are helping to develop. And so that lays this kind of foundation, if you will, for the beginning -- for this cardiac journey that we're on, particularly with dV5.

最後，我們也與外科協會合作。我認為這對於培訓以及他們正在協助發展的其他方面至關重要。因此，這為我們正在進行的這段心臟之旅，特別是dV5手術，奠定了基礎。

And so maybe, Jamie?

所以，或許是這樣，傑米？

Yes. Travis, I'll just give some numbers maybe for grounding. So in '25 globally, there are about 17,000 cardiac procedures performed. That's on Si and Xi, that business has been growing for multiples of years. But obviously, from a small base, the growth in recent years, including '25 was accretive to the corporate average, while obviously, the cardiac TAM is really quite large.

是的，Travis，我先舉幾個數字，方便大家懂。 2025年全球大約進行了17,000例心臟手術。這是Si和Xi的數據，這項業務已經連續多年成長。但顯然，由於基數較小，近年來（包括2025年）的成長拉高了公司平均水平，而且心臟手術的潛在市場規模（TAM）也相當大。

When we do our clinical analysis, when we look at where cardiac is cleared for da Vinci 5, which currently is now the US and Korea, we think the opportunity from a da Vinci 5 perspective or a robotic perspective is about 160,000 procedures per year. And obviously, that has the opportunity to expand if and as we add additional geographies.

當我們進行臨床分析，檢視目前已獲準使用達文西5機器人輔助心臟手術的地區（目前是美國和韓國）時，我們認為從達文西5機器人輔助手術或機器人手術的角度來看，每年大約有16萬例手術機會。顯然，隨著我們拓展到其他地區，這個數字還有可能會成長。

Great. That's really helpful. And you've talked a lot on advanced imaging. Just curious how you think about incorporating these additional advanced imaging features into the robotic ecosystem. Did you leverage the existing hardware? Or is there a new hardware?

太好了，這真的很有幫助。您也談了很多關於高階成像的內容。我很好奇您是如何考慮將這些額外的高級成像功能整合到機器人生態系統中的。您是利用了現有的硬件，還是需要新的硬體？

How do you think about recognizing the value of the -- that you're providing to customers? Is it just deeper penetration? Or is there a potential for new revenue streams? Just want to try to understand like how some of the imaging stuff could come into the business in a more detailed way.

您認為如何體現您為客戶提供的服務的價值？僅僅是提高市場滲透率嗎？還是有可能開闢新的收入來源？我想更詳細地了解一下，成像技術如何融入業務中。

Yes, Travis, some of the advanced imaging capabilities that we've talked about are additional molecules that we're working on, and those are long timelines that will add to the fluorescence imaging capability of the system. Those molecules will have revenue streams attached to them.

是的，特拉維斯，我們之前討論的一些先進成像技術，指的是我們正在研發的其他分子，這些分子的研發週期很長，但它們將增強系統的螢光成像能力。這些分子也將帶來收益。

We recently have talked about kind of a form of hyperspectral imaging that shows tissue oxygenation. That is going to be a capability of the system that requires some new software and instituting of some of our hardware. All of those are pointed at trying to give more information to the surgeon and to the system where we're able to add perhaps some AI layers to it, but really with the intent of improving ultimately improving outcomes, be it in prostate cancer or [uteri] injuries or perhaps in areas of surgery where perfusion, which is where the tissue oxygenation is pointed can make a difference in outcomes.

我們最近討論過一種可以顯示組織氧合情況的高光譜成像技術。這將是系統的一項功能，需要一些新的軟體和硬體投入。所有這些都是為了向外科醫生和系統提供更多信息，我們或許可以為其添加一些人工智慧層，但最終目的都是為了改善治療效果，無論是在前列腺癌、子宮損傷，還是在其他一些手術中，組織氧合情況（即灌注）對治療結果至關重要。

Larry Biegelsen, Wells Fargo.

拉里·比格爾森，富國銀行。

I wanted to start with the ASC commentary, Dave. I'd love to hear you expand on your comments about expanding your footprint in ASCs. How large is the ASC opportunity for your focused procedures today? And what are those key procedures moving to the ASC? And what do you need to do to unlock the opportunity?

戴夫，我想先談談你對門診手術中心（ASC）的看法。我很想聽你詳細闡述你關於擴大在門診手術中心業務範圍的觀點。目前，你重點關注的手術計畫在門診手術中心的市場機會有多大？哪些關鍵手術項目正在轉移到門診手術中心？你需要做些什麼才能抓住這個機會？

And I did have one follow-on.

我確實還有一個後續問題。

Yes. Maybe, Larry, I'll start just kind of -- I always try to start with a problem we're solving or what the customer needs are. And I'm going to start there and then Jamie can jump in on some of the numbers here.

是的。或許，拉里，我先從──我總是盡量從我們正在解決的問題或是客戶的需求著手。我會從這裡開始，然後傑米可以補充一些數據。

If I when I meet with ASC leaders and what they're wanting to say, I want to establish a soft tissue program within one or more of our ASCs, really what they're looking for are repeatable, high-quality clinical outcomes technology systems that work every day and operating infrastructure, training, supply chain, reprocessing, those sorts of things that is routine and easily accessible and all of that has to fit into an economic structure that works for the reimbursement levels of that particular ASC.

如果我與 ASC 領導會面，了解他們的想法，例如我想在我們的一家或多家 ASC 中建立一個軟組織項目，他們真正想要的是可重複的、高質量的臨床結果技術系統，這些系統能夠每天正常運行，以及運營基礎設施、培訓、供應鏈、再處理等日常且易於獲取的事項，所有這些都必須符合該特定 ASC 的報銷水平的經濟。

And so when I look at what we have in our current portfolio of systems, including now XIR, the broader ecosystem of all the other products and training and services, that is well positioned to serve the names that we're hearing from our customers. the procedures that are generally within that environment are the ones that you know, cholecystectomy, hernia repairs, benign GYN, it oftentimes is the lower acuity procedures where the volume and the repeatability can be managed in the ASC environment.

因此，當我審視我們目前的系統組合，包括現在的XIR系統，以及所有其他產品、培訓和服務構成的更廣泛的生態系統時，我發現它完全能夠滿足我們從客戶那裡了解到的需求。通常情況下，這類手術包括膽囊切除術、疝氣修補術、良性婦科疾病手術等，這些手術的複雜程度較低，其數量和可重複性都可以在門診手術中心（ASC）環境中得到有效控制。

I'd just say, Larry, in terms of numbers today, it's a relatively small proportion of US procedures done, but we do see it growing at an accretive rate. I think those trends have been talked about just broadly most of our commentary today reflects what we've heard from customers. I think that in part reflects desire of payers to take advantage of the lower reimbursement in the ASC setting.

拉里，我想說的是，就目前的數據而言，這種手術在美國手術總量中所佔比例相對較小，但我們確實看到它正以穩步增長的速度發展。我認為這些趨勢已經被廣泛討論過了，我們今天的大部分評論都反映了我們從客戶那裡聽到的回饋。我認為這在一定程度上反映了支付方希望利用門診手術中心較低的報銷率。

And for us now, with the launch of da Vinci 5, the trade cycle has commenced, and we get the excise back and we can refurbish them. We think the XIR in combination with our instrument portfolio is well positioned for that saying as procedures grow in ASCs.

對我們來說，隨著達文西5的推出，交易週期已經開始，我們可以收回稅款並進行翻新。我們認為，隨著日間手術中心手術量的增長，XIR結合我們的儀器產品組合，將很好地滿足這一需求。

That's super helpful. Jamie, how should we think about utilization in 2026 in system ASPs in 2026 after we saw strong growth in 2025? Do the refurbished excise, put some downward pressure on the ASPs and the move into the ASCs maybe put some downward pressure on utilization?

這非常有幫助。 Jamie，鑑於2025年系統平均售價（ASP）的強勁成長，我們該如何看待2026年的使用率？翻新消費稅是否會對ASP造成一些下行壓力？而向門診手術中心（ASC）的轉型是否也會對利用率造成一些下行壓力？

Yes. I'd just say, if you look at the last couple of quarters, in each case, we saw overall debenture utilization grow 4%. We think that's a healthy level, but we're not ready to predict what that will be in '26 for the presence that we already have in ASCs because we've been focused primarily with our existing IDN customers and we've looked for programs that have strong soft tissue surgery volumes that can support a revised program.

是的。我想說的是，如果你看一下過去幾個季度，你會發現每季債券的整體使用率都成長了4%。我們認為這是一個健康的水平，但我們目前還無法預測2026年我們在門診手術中心（ASC）現有業務的債券使用率會是多少，因為我們主要專注於現有的綜合醫療網絡（IDN）客戶，並且我們一直在尋找那些軟組織手術量大、能夠支持我們修訂後方案的項目。

The existing utilization that we have in ASCs is actually pretty good. And I think economically, then, obviously, that works for them. On system ASPs, I'm not going to predict what the overall '26 direction will be.

我們目前在ASC的使用率其實相當不錯。我認為從經濟角度來看，這顯然對他們有利。至於系統平均售價（ASP），我不會預測2026年的整體走向。

Obviously, we don't guide capital. I'd just say you should expect a higher da Vinci mix in '26 versus '25. That reflects, of course, the fact that we have, in part, new geographies clear with da Vinci 5. You should also expect a higher mix of XIR. That's going to be ASPs that are quite a bit below where Xi is today, but we haven't said yet what the XIR price range is likely to be and I would expect higher trade-ins.

顯然，我們不負責指導資本流動。我只想說，預計2026年da Vinci的比例會高於2025年。這當然部分反映了da Vinci 5在新地區的上市。同時，預計XIR的佔比也會更高。 XIR的平均售價會比現在的Xi低很多，但我們尚未公佈XIR的可能價格區間，而且我預計以舊換新的數量也會更多。

And so there's a set of offsetting mix dynamics there that, frankly, will let you model. I'd just also say in terms of system ASPs, of course, that is only on systems purchased, which roughly is about half of the system placements today.

因此，這裡存在一系列相互抵消的混合動態，坦白說，這可以讓你進行建模。我還想補充一點，就係統平均售價而言，當然，這僅指已購買的系統，而目前系統部署數量大約只有一半。

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Congratulations again on a great quarter. Jamie, you touched on this a little bit, but I was hoping you could give a little more color into the gross margin and OpEx assumptions. There's obviously a lot of moving pieces under the hood wondering if you could tease out some of them as we think about how XIR ramps and impacts or positively or negatively margins and trade-ins.

再次恭喜你們季度業績出色。 Jamie，你剛才稍微提到了這一點，但我希望你能更詳細地解釋一下毛利率和營運成本的假設。顯然，這裡面有很多變數，我想知道你能否梳理一下其中的一些因素，以便我們思考XIR的逐步實施如何對毛利率和以舊換新產生正面或負面影響。

And then what's assumed at the high and the low end of the OpEx expense? And I have a follow-up.

那麼，營運支出的上限和下限分別假設是多少呢？我還有一個後續問題。

Yes. With respect to gross margin, there's actually a number of dynamics. You have the higher trade-ins that we just described. You have a higher mix of da Vinci 5 that's not yet at target product costs. The procedure guidance is reflected in that gross margin range. We also have had for a couple of years now, kind of post-COVID recovery, a number of product cost reduction efforts that have had a growing impact within what you see in gross margin. In '25, you saw the impact of all the new facilities with incremental depreciation and facility costs, and that starts to -- start to get leveraged in '26.

是的。關於毛利率，實際上有很多因素在起作用。正如我們剛才提到的，以舊換新率較高。達文西5手術系統尚未達到目標產品成本，其比例也較高。手術指導意見已反映在毛利率範圍內。此外，在後疫情時代的復甦階段，我們近年來也採取了一系列產品成本削減措施，這些措施對毛利率的影響日益顯著。 2025年，所有新設施的投入使用都帶來了額外的折舊和設施成本，這些影響在2026年開始出現。

And so there's a set of offsetting dynamics there in gross margin, the kind of net to the guidance that we provided, which effectively is flattish. I would highlight again, we have 120 basis points of tariffs reflected in the '26 guidance that was about 65 basis points in '25. So an incremental 50-ish basis points from tariffs. With respect to XiR, like I said, we expect the pricing to be lower than currently what you pay for a new Xi, but the margin is relatively healthy on XiR.

因此，毛利率方面存在一系列相互抵消的因素，淨利潤與我們先前提供的指引基本持平。我再次強調，我們在2026年的指引中反映了120個基點的關稅，而2025年約為65個基點。因此，關稅帶來的增量約為50個基點。至於XiR，正如我所說，我們預計其定價將低於目前新款Xi的價格，但XiR的利潤率相對健康。

Great. Appreciate that. And a quick follow-up. You mentioned increased pricing competition in China. I saw there were a new reimbursement program put out, some helps favor local competition. I was wondering if you could just comment on how you think about your position in China and your ability to continue to win there?

太好了，非常感謝。還有一個後續問題。您提到中國的價格競爭日益激烈。我看到一項新的報銷計劃出台了，其中一些措施有利於本地競爭。我想請您談談您如何看待貴公司在中國的市場地位，以及貴公司能否繼續在中國取得成功？

And also, if you have any update on the latest tender?

另外，請問您有關於最新招標的任何最新消息嗎？

Yes. I might start. So just to answer that question specifically, around the local robotic competitors that are in China, many -- as you know, many of the architectures are very similar to Xi. And over time, there are instances where they may be favored by home provinces. And certainly, over the past several quarters, the number of robotic companies in China have been increasing. And as a result, what you see is that pricing has become even more intense.

是的，我可能會開始。具體來說，為了回答這個問題，關於中國本土的機器人競爭對手，很多——正如你所知——它們的架構都與Xi非常相似。隨著時間的推移，它們可能會受到所在省份的青睞。當然，在過去的幾個季度裡，中國的機器人公司數量一直在增加。因此，你會看到價格競爭變得更加激烈。

Tenders are published and competed for. So given that sort of environment, you look at how are we competing? And that's with an Xi system were manufacturing it locally. We have a very strong team in China, and so feel very good about how we're positioned with our system, our team, the broader ecosystem to compete in China with those local robotic companies that are increasingly coming to market.

招標已經發布，各方競標。在這種環境下，我們需要考慮如何參與競爭？我們採用的是Xi系統，並且是本地生產的。我們在中國擁有一支非常強大的團隊，因此我們對自身的系統、團隊以及更廣泛的生態系統都非常有信心，能夠與那些不斷湧入市場的本土機器人公司在中國市場競爭。

And we believe we can do so at a price point that is healthy for them and healthy for us and can do and can effectively compete on price where we want to and where it matters.

我們相信，我們可以以對他們和我們都有利的價格做到這一點，並且能夠在我們想要且重要的領域有效地進行價格競爭。

Robbie, I would just add. There's about 273 systems left in the current quota. And I would just say, as we said in the prepared remarks, the tender win ratio was lower in Q4. If you look at 2025 as a whole, it was slightly higher than the prior year. And obviously, Dave described our ability to compete.

羅比，我還要補充一點。目前的配額還剩下約273套系統。正如我們在準備好的發言稿中所提到的，第四季的得標率有所下降。但如果從2025年全年來看，得標率略高於前一年。顯然，戴夫也闡述了我們的競爭力。

I think I missed, Robbie, your question on OpEx. So I would just say in the 11% to 15% range, it does reflect the impact of going direct in Italy, Spain and Portugal but the range mostly is in relation to the procedure range.

羅比，我想我錯過了你關於營運成本的問題。所以我想說的是，11%到15%的範圍內確實反映了義大利、西班牙和葡萄牙直接採購的影響，但這個範圍主要與流程範圍有關。

Rick Wise, Stifel.

Rick Wise，Stifel。

Dave, I was reflecting on your comment, your words, if I'm quoting you accurately, you said you still see Intuitive as being in the early stages of your journey. I mean that's similar language I've heard from Intuitive for years. And I was reflecting on it in the context of a slide you posted during the JPMorgan comments a couple of weeks ago. About 9 million procedures in direct line of sight and went back and looked at '24 and you all said 7 million at the time.

戴夫，我一直在思考你的評論，或者說你的話，如果我沒記錯的話，你說你仍然認為Intuitive還處於發展初期。我的意思是，這些年來我一直聽到Intuitive這麼說。我當時是在思考你幾週前在摩根大通評論中展示的那張幻燈片。投影片上說，當時有大約900萬例手術在可預見範圍內，而我回顧了2024年的數據，當時你們都說是700萬例。

That's nearly a 30% increase in procedures and direct line of sight. And I just wondered -- I'm guessing maybe the cardiac opportunity, is that part of it? Is it the ambulatory surgery opportunity? Is it something instrument specific. Just I was hoping you just reflect on that with me and us and maybe unpack that a little bit.

這相當於手術量增加了近30%，而且視野也更開闊了。我只是在想──我猜想這或許與心臟手術的機會有關？還是與門診手術的機會有關？還是與某種特定器械有關？我希望您能和我一起思考一下，並對此進行一些分析。

Thank you for the question. And maybe I'll comment on the early part of the journey at least as I meant with my words, and then Dan and Jamie can jump in. When I think about the journey with the ultimate destination, really improving outcomes substantially, eliminating complications to the extent that we possibly can. And you choose a procedure today and there's still variability.

謝謝你的提問。或許我可以先談談我之前想表達的關於這段旅程早期階段的看法，然後丹和傑米也可以補充。我思考這段旅程的最終目標是大幅改善治療效果，盡可能地減少併發症。即使你今天選擇了一個手術方案，結果仍然存在變數。

There are still poor outcomes for a given set of patients even in the very best of hands with the very best of technology. And so that's when I think about the journey, it's the journey of impacting patients meaningfully and more than we even have today. With respect to the line of sight procedures and the growth and how that has increased over the years, maybe I'll look to Dan.

即使在科技最先進的醫療機構中，某些特定患者的治療效果仍然不佳。因此，我思考的是這條路的意義所在，它關乎如何更有意義地改善患者的治療效果，並超越我們目前的水平。至於視野手術及其發展，以及這些年來它如何不斷進步，或許我應該向丹請教。

Yes, Rick, 2024, $7 million; '25, $8 million; '26, $9 million. I'd say primarily strengthening clinical validation and supportive economics and benign procedures kind of the largest impact also saw a modest impact from additional procedure clearances like nipple sparing mastectomy, SP in the US.

是的，里克，2024年700萬美元；2025年800萬美元；2026年900萬美元。我認為，主要影響因素是加強臨床驗證、支持經濟政策以及良性手術，此外，像保留乳頭乳房切除術（SP）這樣的其他手術獲批也帶來了一定程度的影響。

And then lastly, contributing as well kind of demographic impact from an aging population. So generally consistent with prior increases and the factors underneath that generally consistent as well.

最後，人口老化也帶來了一定的社會影響。總體而言，這與先前的成長趨勢以及背後的因素基本一致。

Okay. And just a quick follow-up. Dave, you also highlighted digital subscription. And I'm just not sure if I personally, maybe I've missed it, heard that language it sounds like a positive economic factor and something potentially incremental.

好的。還有一個後續問題。戴夫，你也提到了數位訂閱。我個人不太確定，也許是我錯過了什麼，但我聽到的說法聽起來像是一個正面的經濟因素，而且可能有增量效應。

Again, could you just expand on your comments and what it might mean to the growth outlook or adoption of da Vinci 5, et cetera?

您能否進一步闡述您的評論，以及這些評論對達文西5等的成長前景或普及意味著什麼？

Yes, I'll take that, Rick. So David is referring to MIA plus, which comes with da Vinci 5, incorporates telepresence integrated skill simulation and case insights. When we launched da Vinci 5, that package came with one year free use for customers. We actually did a significant software update in Q2 of last year. And so we extended that free period for customers technically, what happened when we did that was a portion of the system purchase price got carved out of systems revenue and deferred and put into service revenue over time is just the way the accounting rules work.

是的，我接受，瑞克。所以大衛指的是MIA Plus，它是達文西5的標配，整合了遠端呈現、技能模擬和病例分析功能。我們推出達文西5時，軟體包為客戶提供一年的免費使用期。實際上，我們在去年第二季進行了一次重要的軟體更新。因此，我們延長了客戶的免費使用期。嚴格來說，我們延長免費期的原因是，系統購買價格的一部分從系統收入中扣除，並遞延到服務收入中，這只是會計準則的運作方式。

Come Q2-ish of '26, then customers now have the opportunity to renew for that subscription package where they'll now have to pay. And in the end, then the value that surgeons and the customers are experiencing with that package would determine both what is the renewal rate and what is the ASP that we realize.

到2026年第二季左右，客戶將有機會續訂該訂閱套餐，屆時他們需要付費。最終，外科醫生和客戶從該套餐中獲得的價值將決定續訂率和我們實現的平均售價。

With respect to the case insights portion of that package, we've got good early customer feedback. I think we have some work to do to continue to refine and enhance the capability there. And I think we see long-term value in what that could ultimately do. It also has quite a bit of synergy with Force Feedback, which has not been in full supply.

關於該軟體包中的案例分析部分，我們已經收到了一些不錯的早期客戶回饋。我認為我們還需要繼續完善和增強這方面的功能。而且我認為我們看到了它最終的長期價值。它與力回饋功能也有很大程度的協同效應，而力回饋功能目前尚未充分利用。

And so as we get that into full supply later this year, you then get to kind of see the impact of force more clearly in the case insights reporting that gets done. And so there is then some invoicing that we'll do for customers that renew and that starts to get reflected in revenue.

因此，隨著我們在今年稍後全面實現供應，您就能在案例分析報告中更清楚地看到武力部署的影響。屆時，我們將為續約客戶開立發票，這些發票也將開始反映在收入中。

David Roman, Goldman Sachs.

大衛羅曼，高盛集團。

I wanted to maybe come back to SP and it seems like the second half of 2025 represented at least in the US, the potential of putting in place the dynamics you need to really see an inflection in growth in both SP placements as well as associated procedures.

我原本想回到 SP 領域，而 2025 年下半年似乎至少在美國，代表著建立必要的動力機制的潛力，從而真正看到 SP 植入和相關手術的增長拐點。

As you kind of look at the portfolio indications you have entering 2026, is there anything left either from a technology standpoint, maybe a vessel dealer that you think would be necessary to really unlock the opportunity and how you're thinking about the SP strategy now that you have more full portfolio of instruments as well as indications?

展望 2026 年，從技術角度來看，是否還有什麼需要改進的地方，例如船舶交易商，才能真正抓住機會？鑑於您現在擁有更完整的金融工具組合和投資跡象，您如何看待 SP 策略？

I have one follow-up.

我還有一個後續問題。

Thanks, David. It's Dan. I think, broadly, very encouraged by the response to the technology and the procedure growth rates that we've seen here recently. Looking to continue to build the platform internationally, we're still relatively early Europe, Japan, and Taiwan. And then in the US with recent clearances, colorectal, thoracic and NSM indications as well.

謝謝，David。我是Dan。總的來說，我對這項技術的市場反應以及近期手術量的成長速度感到非常鼓舞。我們正著眼於繼續在國際上拓展平台，目前在歐洲、日本和台灣仍處於相對早期階段。在美國，我們最近也獲得了結直腸、胸腔和NSM適應症的批准。

You mentioned on instrumentation, we do need to continue development of vessel sealer device, add that clearance and then add stapler clearances globally. I think we're encouraged by the early feedback from initial launch on SP stapler and thoracic and colorectal and excited to bring that forward more fully. And I'd say, over time, we've also got the opportunity to take SP to additional geographies as well.

您提到器械方面，我們確實需要繼續研發血管封閉器，增加其間隙，並在全球增加吻合器間隙。 SP吻合器在胸腔外科和大腸直腸手術的早期上市回饋令人鼓舞，我們很高興能更全面地推進其發展。而且我認為，隨著時間的推移，我們也有機會將SP推廣到更多地區。

Okay. And then maybe on the guidance, I think you talked about reflecting some of the risk around macro pressures, whether those are hospital purchasing on Medicaid cuts or potential changes in utilization associated with the exchange subsidies expiring. Maybe could you just help us understand how you saw these dynamics play out through the back half of 2025?

好的。關於指導意見，我想您提到要反映一些宏觀壓力帶來的風險，例如醫療補助削減導致的醫院採購減少，或者交易所補貼到期可能導致的醫療資源利用率變化。您能否幫我們了解一下，您認為這些因素在2025年下半年會如何發展？

I know, in Q3, you talked about the potential of some pull forward of procedure volumes, what you saw kind of exiting the year and how you're kind of observing trends here early in January?

我知道，在第三季度，您談到了手術量提前完成的可能性，您在年底觀察到的情況，以及您在1月初觀察到的趨勢？

Yes. No specific comment on kind of early trend in January, but I'd say over Q4 do not have any evidence either way from an impact, but we haven't heard that from customers at all. I know we spoke about that potentially in Q3 related to some intra-quarter dynamics there, but have not heard that from customers more broadly recently.

是的。對於一月份的早期趨勢，我沒有具體評論，但就第四季度而言，目前還沒有任何證據表明其會產生影響，而且我們也完全沒有收到客戶的回饋。我知道我們在第三季討論過這可能與季度內的一些動態有關，但最近我們沒有收到客戶更廣泛的回饋。

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

接線員，我想我們還有時間再回答一個問題。

Patrick Wood, Morgan Stanley.

派崔克‧伍德，摩根士丹利。

Beautiful. I guess, conceptually, thinking medium term into the future, how do you guys think about new form factors and cost competition? We've talked about lower acuity cases and going down. Is the solution here in your mind, like a lower end form factor? Or do we stick with refurbished systems or is it the case that you think you can get to the point where speed innovation is getting us faster than LAP with a lower cost curve than LAP and that's the solution to the lower acuity.

太好了。我想，從概念上講，展望中長期未來，你們如何看待新的外形尺寸和成本競爭？我們討論過低視力病例以及價格下移的問題。你們認為解決方案是推出低階外形尺寸的產品嗎？還是繼續使用翻新系統？或者你們認為，透過快速創新，我們可以比傳統雷射設備更快地推出價格更低的產品，從而解決低視力問題？

So is it a lower form factor? Or is it getting the tech to the point where automation and speed is just bet in lap anyway?

所以，它的尺寸更小嗎？還是說，它所採用的技術已經發展到自動化和速度方面，最終只會勝負已定？

Yes. It's an interesting question. And I will turn it back around to the problem to be solved. And -- and I think it varies depending on where you look. And so if you're in a complex cancer procedure where you're trying to move the needle on, let's say, cancer margins, it's going to require a different solution set then if you're looking for routine use and ambulatory setting that is working on a very different set of procedures.

是的，這確實是個有趣的問題。我再回到需要解決的問題。我認為答案會因觀察角度而異。例如，如果你正在進行一項複雜的癌症手術，試圖改善腫瘤切緣，那麼所需的解決方案就與常規門診手術所需的解決方案截然不同。

And so I think we don't have enough time to look through each one of those areas where customers are trying to work in particular. If we focus on let's say, the ASC setting. I'd go back to what we described before and say, what is required there is great clinical outcomes, routine use, repeatable use, reliability, those parts the needs there that exist, I think, are really well served by the existing ecosystem that we have today.

所以我覺得我們沒有足夠的時間去逐一了解客戶正在努力工作的每個領域。如果我們聚焦在例如門診手術中心（ASC）這個場景，我會回到我們之前描述的內容，那就是：卓越的臨床效果、常規使用、可重複使用、可靠性——我認為，我們現有的生態系統已經能夠很好地滿足這些需求。

Can it be optimized through new platform development or some other tweaks within the ecosystem? Maybe we'd have to go see and see what that looks like. But today, I think what we have can serve the complex portion of the procedures customers are trying to do as well as these lower acuity, higher volume ones.

能否透過開發新平台或對生態系統進行其他調整來優化它？或許我們需要實地考察一下。但就目前而言，我認為我們現有的系統既能滿足客戶進行複雜手術的需求，也能滿足那些難度較低、數量較多的手術需求。

Patrick, I'd just add that I think segmentation can be important depending on the IDN and you can segment by using dV5 across a broad set of procedures that can do cancer and whatever other procedures are done in the hospital. But you can also segment by HOPD or by an ASC.

派崔克，我還要補充一點，我認為根據IDN的不同，細分可能很重要。你可以使用dV5對一系列廣泛的手術進行細分，這些手術包括癌症治療以及醫院進行的其他任何手術。但你也可以按HOPD（醫院門診部）或ASC（門診手術中心）進行細分。

And where we are today, we have the portfolio to do that. I think we have confidence in there. Of course, things change over time, and I think that's part of our strat planning, and we wouldn't comment on how we might further develop that just yet.

就我們目前的狀況而言，我們擁有實現這一目標的投資組合。我認為我們對此充滿信心。當然，情況會隨著時間推移而變化，我認為這屬於我們策略規劃的一部分，所以我們現在不方便透露未來將如何進一步發展。

Okay. That was our last question. Thank you for the questions.

好的，這是我們最後一個問題。謝謝大家的提問。

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 quintupling, 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.

最後，我們仍然堅信，在從根本上改善外科手術和急診幹預方面存在著巨大且持久的機會。我們的團隊將繼續與醫院、醫生和護理團隊緊密合作，力求實現客戶所說的「五倍提升」：更佳且更可預測的患者療效、更佳的患者體驗、更佳的護理團隊體驗、更低的醫療總成本，以及最終，更便捷的醫療服務。

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

我們相信，外科手術和急診的價值創造根植於人性。它源自於對病人、護理團隊及其需求和環境的尊重和理解。在Intuitive，我們展望未來，希望醫療照護更加微創、更有高效，疾病能夠更早被發現並迅速治療，讓患者盡快回歸最重要的生活。

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

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流。

And this concludes today's conference. Thank you all for participating, and you may now disconnect.

今天的會議到此結束。感謝各位的參與，現在可以斷開連結了。