直覺手術 (ISRG) 2026 Q2 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Intuitive Q2 Earnings Conference Call. (Operator Instructions) Please be advised that today's conference is being recorded. I would now like to turn the conference over to your speaker for today, Dan Connally. Please go ahead.

大家好，感謝您稍候等候。歡迎參加 Intuitive 2026 年第二季財報電話會議。(接線員指示) 請注意，今天的會議將被錄音。現在我想把會議交給今天的發言人 Dan Connally。請開始。

Good afternoon, and welcome to Intuitive's Second Quarter 2026 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 made 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.

各位下午好，歡迎參加 Intuitive 2026 年第二季財報電話會議。今天與我一同出席的有我們的執行長 Dave Rosa，以及財務長 Jamie Samath。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。由於某些風險與不確定性，實際結果可能與明示或暗示的內容有重大差異。

These risks and uncertainties are described in our Securities and Exchange Commission filings, including our most recent Form 10-K filed on February 3, 2026, and Form 10-Q filed on April 22, 2026. 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.

這些風險與不確定性已在我們向美國證券交易委員會（SEC）提交的文件中說明，包括我們最近於 2026 年 2 月 3 日提交的 Form 10-K，以及於 2026 年 4 月 22 日提交的 Form 10-Q。我們的 SEC 申報文件可透過我們的網站 intuitive.com 或 SEC 的網站查閱。提醒投資人不要過度依賴此類前瞻性陳述。

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.

本次電話會議的錄音回放將可在我們網站投資人關係頁面下的「活動」區取得。我們已將今天的新聞稿與補充財務資料表張貼於我們的網站。今天下午財報電話會議的流程如下。

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.

Dave 將回顧業務與營運重點。Jamie 將回顧我們的財務結果與手術量重點。我將回顧臨床重點，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'll turn it over to Dave.

接下來我把時間交給 Dave。

Good afternoon and thank you for joining us today. If Jamie's and my voices sound a bit different today, we're both recovering from head colds. So I appreciate you bearing with us. Our performance in Q2 was solid. We saw continued global adoption across our multi-port, single-port, and iON platforms and steady execution by our teams.

各位下午好，感謝今天加入我們。如果 Jamie 和我的聲音今天聽起來有點不一樣，是因為我們都在從感冒中恢復。因此感謝各位的包容。我們第二季的表現穩健。我們看到多孔（multi-port）、單孔（single-port）以及 iON 平台在全球持續被採用，同時我們的團隊也穩定執行。

In Q2, total procedures increased 16% and driven by 15% growth in da Vinci procedures and 36% growth in ION procedures. The global installed base of da Vinci and Ion systems increased by 12% and 21%, respectively, and we exited the quarter with almost 13,000 systems installed worldwide.

第二季總手術量成長 16%，其中 da Vinci 手術量成長 15%，iON 手術量成長 36%。da Vinci 與 Ion 系統的全球裝機基數分別成長 12% 與 21%，本季結束時全球已安裝系統接近 13,000 台。

In the U.S., da Vinci procedure growth was 12%, led by general surgery with after-hours procedures increasing 26%. Growth in the U.S. moderated from recent trends and our expectations at the start of the year, predominantly in procedures that can be deferred.

在美國，da Vinci 手術量成長 12%，由一般外科帶動，其中非上班時間（after-hours）手術增加 26%。美國的成長相較近期趨勢與我們年初的預期有所放緩，主要出現在可延後的手術類別。

In our customer conversations, some have said that changes in patient coverage and premium dynamics may be affecting when patients seek care and move forward with treatment. Importantly, the underlying disease burden is unchanged and deferred conditions typically progress and will ultimately require treatment.

在與客戶的對話中，有些人表示，病患保險涵蓋變化與保費動態可能影響病患就醫與推進治療的時點。重要的是，基礎疾病負擔並未改變，而被延後的病況通常會惡化，最終仍需要治療。

As patients return to care, we expect da Vinci will remain a clear choice for their surgeons and care teams. Outside the U.S., da Vinci procedure growth was 20%. Regionally, growth was consistent with Europe and Asia each up 20% and rest of world markets up 22%.

隨著病患回到醫療照護體系，我們預期 da Vinci 仍將是其外科醫師與照護團隊的明確選擇。在美國以外地區，da Vinci 手術量成長 20%。就區域而言，歐洲與亞洲均成長 20%，其他世界市場成長 22%，表現一致。

In China, the environment remains challenging. We continue to see lower tender activity increased domestic robotic competition and policy-driven pricing pressure, and we continue to operate through a dynamic policy environment, including charge code changes and the 15th five year plan quota process.

在中國，環境仍具挑戰。我們持續看到招標活動減少、國產機器人競爭加劇以及政策驅動的價格壓力；同時我們也持續在動態的政策環境中營運，包括收費碼（charge code）變更與第十五個五年計畫配額流程。

We are engaging with provincial governments on their charge code policy, and are progressing through the green channel process for both SP and da Vinci 5. When cleared, these platforms will bring additional differentiated capabilities to Chinese customers and their patients.

我們正與各省政府就其收費碼政策進行溝通，並正推進 SP 與 da Vinci 5 的綠色通道流程。一旦獲准，這些平台將為中國客戶及其病患帶來更多差異化能力。

In Japan, new policies supporting robotic surgery went into effect on June 1, including reimbursement for additional procedures, and economic incentives for higher utilization programs. We are encouraged by the direction of the policy environment as well as early response to these initiatives.

在日本，支持機器人手術的新政策已於 6 月 1 日生效，包括對更多手術項目的給付，以及對高使用率計畫的經濟誘因。我們對政策環境的走向以及這些措施的早期反應感到鼓舞。

India had another strong quarter with momentum across a broad set of procedures. This week, we received da Vinci 5 clearance in India, and we're excited to bring our latest generation platform to customers in that market.

印度本季再度表現強勁，涵蓋廣泛手術類別皆具動能。本週我們在印度取得 da Vinci 5 的核准，我們很期待將最新一代平台帶給該市場的客戶。

Turning to systems. Q2 was a strong capital quarter, reflecting continued customer demand for our newer platforms and confidence in the value of our ecosystem. We placed 468 da Vinci systems and 55 Ion systems in the quarter.

接著談系統。第二季是強勁的資本設備季度，反映客戶對我們較新平台的持續需求，以及對我們生態系價值的信心。本季我們安裝（placed）了 468 台 da Vinci 系統與 55 台 Ion 系統。

Within multiport, placements reflected strong adoption of da Vinci 5, including dual consoles and continued demand for our fourth generation systems where their proven capabilities and value meet customer needs. In the quarter, we rolled out the first phase of more than 100 planned updates to the da Vinci 5 platform.

在多孔產品線方面，安裝量反映 da Vinci 5 的強勁採用（包括雙控制台），以及在其經驗證的能力與價值符合客戶需求之處，客戶對我們第四代系統的持續需求。本季我們推出了 da Vinci 5 平台超過 100 項規劃更新中的第一階段。

These updates are directed to improving telepresence, simulation-based training and Care Team workflow. We have also submitted multiple innovations for FDA 510(k) clearance that leverage these updates.

這些更新旨在提升遠距臨場（telepresence）、以模擬為基礎的訓練，以及照護團隊（Care Team）工作流程。我們也已提交多項利用這些更新的創新項目，申請 FDA 510(k) 核准。

In line with our strategy, we are seeing increased adoption of da Vinci X IR, particularly in more cost-constrained countries outside the U.S. and in ambulatory surgery centers in the U.S. XIR expands access to da Vinci surgery where the customer's procedure mix and economic profile align well with the capabilities and cost profile of our fourth generation systems.

符合我們的策略方向，我們看到 da Vinci X IR 的採用增加，特別是在美國以外、成本較受限的國家，以及美國的門診手術中心。XIR 在客戶的手術組合與經濟特性與我們第四代系統的能力與成本結構高度匹配時，可擴大 da Vinci 手術的可及性。

With more than 13 million procedures completed on da Vinci Xi globally, customers continue to value the breadth, reliability, clinical capability and support of the intuitive ecosystem. Turning to instrumentation. I want to expand further on the extended use program we announced in May. This initiative reflects many years of investment in instrument design and manufacturing consistent with our long-standing approach of strengthening the value of our ecosystem.

全球已有超過 1,300 萬例手術在 da Vinci Xi 上完成，客戶持續重視 Intuitive 生態系的廣度、可靠性、臨床能力與支援。接著談器械。我想進一步說明我們在 5 月宣布的延長使用計畫。此項倡議反映我們多年來在器械設計與製造上的投資，並與我們長期以來強化生態系價值的方法一致。

In the first half of 2027, we expect to increase the number of uses on a subset of EndoWrist instruments with the benefit targeted to reduce costs in a set of benign procedures. By lowering customer cost per procedure, we expect to support broader adoption of da Vinci surgery particularly in those procedures and geographies where cost constraints may be greater.

我們預期在 2027 年上半年，將提高部分 EndoWrist 器械子集的可使用次數，其效益目標是降低一組良性（benign）手術的成本。透過降低客戶每例手術成本，我們預期可支持 da Vinci 手術更廣泛的採用，特別是在成本限制可能較大的手術類別與地理區域。

Ultimately, these efforts help reinforce a virtuous cycle, where lower costs support broader adoption, which drives utilization and scale, and in turn enables continued innovation across our platforms. Moving to our da Vinci single port platform. We placed 38 da Vinci SP systems in the quarter, bringing our global installed base to 445 systems.

最終，這些努力有助於強化一個良性循環：較低成本支持更廣泛採用，進而帶動使用量與規模，而這又反過來使我們能在各平台上持續創新。接著談我們的 da Vinci 單孔平台。本季我們安裝了 38 台 da Vinci SP 系統，使全球裝機基數達到 445 台。

SP procedures grew 61%, reflecting continued momentum in Korea and the U.S., where expanded indications, new instrumentation and recent enhancements, including extended range instruments, custom remote center software and reach assist software are supporting broader adoption.

SP 手術量成長 61%，反映韓國與美國的持續動能；在這些市場中，適應症擴大、新器械與近期強化（包括延伸範圍器械、客製化遠端中心（remote center）軟體與 reach assist 軟體）正支持更廣泛的採用。

In the U.S., adoption of the SP stapler continues to grow in colorectal and thoracic procedures. We remain focused on expanding SP adoption through product innovation, training and geographic expansion. Turning to Ion. -- lung cancer diagnosis and time to treatment remain major challenges globally.

在美國，SP 釘合器（stapler）在大腸直腸與胸腔手術中的採用持續成長。我們仍專注於透過產品創新、訓練與地理擴張來擴大 SP 的採用。接著談 Ion。-- 肺癌診斷與治療啟動時間在全球仍是重大挑戰。

Customers and policymakers are recognizing the value of our iON platform, and we are encouraged by the adoption of the technology as well as the increase in five year survival rates for lung cancer. Ion procedures increased 36% to 48,000 and now exceed 400,000 cumulatively.

客戶與政策制定者正逐步認識到我們 iON 平台的價值；我們對該技術的採用情況以及肺癌五年存活率的提升感到鼓舞。Ion 手術量成長 36% 至 48,000 例，累計已超過 400,000 例。

We remain focused on supporting utilization growth in the U.S. and continuing to generate the evidence required internationally to drive adoption. Our commercial teams have now installed Ion systems in 12 countries outside the U.S., and our development teams are making strong progress on our Rose and e-bus programs.

我們仍專注於支持美國的使用量成長，並持續在國際上產出推動採用所需的證據。我們的商業團隊目前已在美國以外的12個國家完成Ion系統裝機，而我們的開發團隊在Rose與e-bus計畫上也取得強勁進展。

Aligned with our priority of reaching more patients, we continue to advance multiple early-stage R&D programs, exploring the application of robotic-assisted technologies in new disease states. Recently, we submitted for FDA 510(k) clearance of foundational non commercial, next-generation flexible robotic endoscope system for use in the gastrointestinal tract.

為了與我們「觸及更多病患」的優先事項一致，我們持續推進多項早期研發（R&D）計畫，探索機器人輔助手術技術在新疾病領域的應用。近期，我們已向FDA提交申請，尋求對一套用於胃腸道的基礎性、非商用、次世代柔性機器人內視鏡系統之510(k)許可。

We look forward to updating you on this program and others as they advance through development and regulatory milestones. Stepping back, as robotic-assisted surgery has evolved from an emerging technology to a globally adopted surgical platform. We continue to see increasing segmentation across customer needs.

我們期待在該計畫及其他計畫隨著開發與法規里程碑推進時，向各位更新進展。回過頭來看，機器人輔助手術已從新興技術演進為全球採用的手術平台。我們持續看到客戶需求的分眾化日益增加。

These needs range from highly complex reconstructive procedures, such as coronary artery bypass grafting to high-volume repeatable procedures, including cholecystectomy and hernia repair. We have positioned Intuitive to serve customers across this continuum.

這些需求涵蓋從高度複雜的重建手術（例如冠狀動脈繞道移植術）到高量且可重複的手術（包括膽囊切除與疝氣修補）。我們已將Intuitive定位為能在此連續光譜上服務各類客戶。

Our portfolio includes innovative platforms such as SP and Ion, which expand the reach of robotics into new clinical applications, while continued enhancements across our core platforms improve reliability, usability, efficiency and throughput.

我們的產品組合包含SP與Ion等創新平台，將機器人技術的觸角延伸至新的臨床應用；同時，對核心平台的持續強化也提升了可靠性、易用性、效率與產能。

These innovations are designed to help providers advance key health care objectives, including clinical outcomes, patient experience, provider experience, access and affordability. We are also innovating across manufacturing and supply chain operations to better serve value-sensitive markets.

這些創新旨在協助醫療提供者推進關鍵醫療目標，包括臨床結果、病患體驗、醫護人員體驗、可近性與可負擔性。我們也在製造與供應鏈營運方面持續創新，以更好地服務對價值敏感的市場。

Programs such as XIR and EUP are intended to expand access to robotic-assisted surgery while maintaining the quality, reliability and service levels our customers expect. Supporting these efforts require sustained investment across multiple technology domains, including artificial intelligence and machine learning, robotics, instrumentation, imaging and advanced materials.

XIR與EUP等計畫旨在擴大機器人輔助手術的可近性，同時維持客戶所期待的品質、可靠性與服務水準。支持這些努力需要在多個技術領域持續投資，包括人工智慧與機器學習、機器人技術、器械、影像與先進材料。

Ultimately, we believe customers respond to compelling value regardless of procedure type, in novel and complex applications, value is driven by innovation and clinical capability in high-volume settings, value focuses on reliability, efficiency and economics.

最終，我們相信客戶會對具吸引力的價值主張做出回應，不論手術類型為何；在新穎且複雜的應用中，價值由創新與臨床能力所驅動；在高量場景中，價值則聚焦於可靠性、效率與經濟性。

With our technology leadership, manufacturing scale and global infrastructure, we believe Intuitive is uniquely positioned to deliver value across this broad range of customer needs, and we'll continue investing accordingly including increasing R&D to accelerate those innovations, we believe will meaningfully differentiate our solutions, improve durability and reduce total cost of care.

憑藉我們的技術領先、製造規模與全球基礎設施，我們相信Intuitive具備獨特優勢，能在廣泛的客戶需求範圍內交付價值；我們也將持續相應投資，包括增加研發以加速我們認為能顯著差異化解決方案、提升耐用性並降低整體照護成本的創新。

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

接下來，我把時間交給Jamie，請他更詳細地帶各位了解我們的財務狀況。

Good afternoon. I will describe our performance on a non-GAAP basis and summarize our GAAP results later in my remarks. A reconciliation between the two is available on our website. All references to total procedures and their related growth rates encompass both da Vinci and Ion. Q2 marked another strong financial quarter for Intuitive.

各位下午好。我將以非GAAP基礎說明我們的表現，並在稍後的發言中總結GAAP結果。兩者之間的調節表可在我們的網站上取得。所有對總手術量及其相關成長率的提及，均包含da Vinci與Ion。第二季（Q2）對Intuitive而言是另一個強勁的財務季度。

Revenue rose 19%. Non-GAAP operating margin was 42%, and non-GAAP earnings per share increased 28% from the prior year. Strength in our financial results continue to reflect robust adoption of da Vinci 5 and SP and in addition, reflected a $36 million pre-tax benefit tied to the refund of previously paid IEEPA tariffs.

營收成長19%。非GAAP營業利益率為42%，非GAAP每股盈餘較去年同期增加28%。我們強勁的財務結果持續反映da Vinci 5與SP的強勁採用；此外，也反映與退還先前已支付的IEEPA關稅相關的3,600萬美元稅前利益。

Total procedures for Q2 grew 16% and reflecting 15% growth in da Vinci procedures and 36% growth in Ion procedures. Quarter two revenue increased 19% to $2.89 billion with recurring revenue higher by 19% to $2.47 billion, accounting for 85% of total revenue.

第二季總手術量成長16%，其中da Vinci手術量成長15%，Ion手術量成長36%。第二季營收成長19%至28.9億美元；經常性收入成長19%至24.7億美元，占總營收的85%。

On a constant currency basis, revenue growth was 18%. Overall utilization growth remained healthy with da Vinci system utilization increasing 3% and Ion system utilization increasing by 11%. Turning to the clinical side of our business. In the U.S., total procedures increased 13%, reflecting 12% growth in da Vinci procedures and 34% growth in Ion procedures.

以固定匯率計，營收成長為18%。整體使用量成長仍維持健康，da Vinci系統使用量增加3%，Ion系統使用量增加11%。接著談我們業務的臨床面。在美國，總手術量增加13%，其中da Vinci手術量成長12%，Ion手術量成長34%。

Based on customer feedback, we believe there was a modest adverse impact to Q2 U.S. da Vinci procedure growth from those patients impacted by the expiration of subsidies for ACA Enhanced premiums. Looking at benign procedures, a subset of which can be deferred, we saw a slight moderation in procedure growth rate that started in Q1.

根據客戶回饋，我們認為因ACA加強版保費補貼到期而受影響的病患，對第二季美國da Vinci手術量成長造成了輕微的不利影響。就良性手術而言，其中一部分可延後，我們看到自第一季開始手術量成長率略有趨緩。

U.S. da Vinci bariatric cases continued to feel the impact of rising GLP-1 usage declining high single digits during the quarter. Da Vinci utilization in the U.S. increased 3% in Q2, driven by a growing installed base of higher utilized da Vinci 5 systems.

美國da Vinci減重手術病例持續受到GLP-1使用率上升的影響，本季下滑高個位數百分比。第二季美國da Vinci使用量增加3%，主要由已裝機的高使用率da Vinci 5系統基礎擴大所帶動。

Outside the U.S., total procedures grew 21% and with da Vinci procedure growth of 20%, reflecting strong results in India, Italy, Taiwan and the U.K. as well as solid growth in distributor markets and Germany. Da Vinci procedure growth in China and Japan was slightly ahead of the global average but continued to be impacted by the market-specific dynamics we have previously described.

美國以外地區（OUS），總手術量成長21%，其中da Vinci手術量成長20%，反映印度、義大利、台灣與英國的強勁表現，以及經銷市場與德國的穩健成長。中國與日本的da Vinci手術量成長略高於全球平均，但仍持續受到我們先前所描述之各市場特定動態的影響。

We were pleased to see increased system placements in Japan in Q2, partially reflecting recent positive reimbursement decisions by the Japanese Ministry of Health, Labor and Welfare. While da Vinci adoption for benign procedures in OUS markets remains at an early stage, we estimate it represents just over 25% of our international business and volume growth in this category accelerated to 37% in Q2.

我們很高興看到第二季日本的系統裝機量增加，部分反映日本厚生勞動省近期做出的正向給付決策。雖然在美國以外市場，da Vinci在良性手術的採用仍處於早期階段，但我們估計其占我們國際業務的比重略高於25%，且此類別的量成長在第二季加速至37%。

This will remain an ongoing area of focus. SP procedures grew 61% in the quarter powered by strength in the U.S. and Korea and encouraging early-stage momentum in Europe, Japan and Taiwan. In the United States, SP average system utilization accelerated from Q1 expanding 25% compared with the second quarter of last year.

這將仍是我們持續關注的重點領域。本季SP手術量成長61%，主要受美國與韓國的強勁表現帶動，並在歐洲、日本與台灣展現令人鼓舞的早期動能。在美國，SP平均系統使用量較第一季加速，較去年第二季成長25%。

Our SP stapler launch continued to progress well in the U.S. where it is in broad release, it was used in nearly 60% of eligible cases, up from just under 40% last quarter. Internationally, the stapler is now in broad launch across Europe and Korea with positive early adoption, and we expect availability to extend to Japan in Q3.

我們的SP縫合器（stapler）在美國的上市持續進展順利，目前已廣泛釋出；其在符合條件的病例中使用率接近60%，高於上季的略低於40%。在國際市場方面，該縫合器目前已在歐洲與韓國全面上市，早期採用表現正向；我們預期第三季（Q3）可延伸至日本供貨。

Total I&A revenue in quarter two grew 18% to $1.73 billion. Da Vinci I&A revenue per procedure increased to approximately $1,830 compared to $1,800 last year, driven by a higher mix of SP and da Vinci 5 procedures, offset by customer ordering patterns, higher cholecystectomy procedures and lower bariatric procedures. The decline in revenue per procedure from last quarter can largely be attributed to customer ordering patterns, which were elevated in Q1, especially in OUS markets.

第二季器械與配件（I&A）總營收成長18%至17.3億美元。da Vinci每例手術的I&A營收提高至約1,830美元，去年為1,800美元，主要由SP與da Vinci 5手術占比提高所帶動，但部分被客戶訂購模式、較高的膽囊切除手術量以及較低的減重手術量所抵銷。相較上季，每例手術營收的下降主要可歸因於客戶訂購模式；第一季（尤其在美國以外市場）訂購偏高。

Beginning in the first half of 2027, we plan to introduce an updated subset of EndoWrist instruments for use with our fourth and fifth generation da Vinci platforms that feature increased useful lives and lower customer cost per use. The lower cost for customers is targeted towards high-volume benign procedures where we see opportunities for incremental growth.

自2027年上半年起，我們計畫推出一部分更新版EndoWrist器械，供第四代與第五代da Vinci平台使用，其特點為使用壽命延長並降低客戶每次使用成本。此一對客戶的成本降低，目標鎖定在高量的良性手術，我們在該領域看到額外成長的機會。

Force feedback instruments, and stapling and energy products will not be part of the extended use program. We are still finalizing pricing for this initiative, and we'll provide additional quantification on our next earnings call. Other dynamics shaping da Vinci I&A per procedure include increasing adoption of force feedback instruments, the ongoing mix shift towards da Vinci 5 in SP, each of which were accretive as well as procedure and geographic mix.

力回饋器械，以及縫合與能量產品，將不納入延長使用計畫。我們仍在敲定此項計畫的定價，並將在下一次財報電話會議提供更多量化資訊。其他影響da Vinci每例手術I&A的動態包括：力回饋器械採用率提升、產品組合持續轉向da Vinci 5與SP（兩者皆具增益效果），以及手術類型與地理區域組合。

Amongst our most anticipated long-term opportunities, cardiac procedures accelerated to 39% growth in Q2, and nipple-sparing mastectomy procedures increased 43%. Although both remain early stage, we continue to advance the ecosystem investments needed to unlock broader adoption including development of cardiac specific instruments and the accumulation of clinical evidence supporting NSM.

在我們最受期待的長期機會中，心臟手術在第二季加速至39%的成長，保留乳頭乳暈的乳房切除（NSM）手術增加43%。儘管兩者仍處於早期階段，我們仍持續推進促成更廣泛採用所需的生態系投資，包括開發心臟專用器械，以及累積支持NSM的臨床證據。

Turning to capital performance and starting with our da Vinci business. We placed 468 da Vinci systems in quarter two, an 18% increase from the 395 systems placed in the same quarter last year. 246 of the 468 placements were da Vinci 5 placements, including 114 dual consoles.

接著談資本表現，先從我們的 da Vinci 業務開始。我們在第二季安裝了 468 套 da Vinci 系統，較去年同期安裝的 395 套增加 18%。在這 468 套安裝中，有 246 套為 da Vinci 5，其中包含 114 套雙主控台。

The installed base of da Vinci 5 is just over 1,700 systems used by over 15,000 surgeons since launch. Customers acquired 64 refurbished Xi systems and 58 X systems in Q2 compared to 10 and 49 in the year ago period reflecting investments into robotic programs by more cost-constrained customers that want access to our broad Gen 4 ecosystem.

自推出以來，da Vinci 5 的裝機基數已略高於 1,700 套，並由超過 15,000 名外科醫師使用。第二季客戶購置了 64 套翻新 Xi 系統與 58 套 X 系統，相較去年同期分別為 10 套與 49 套，反映出較受成本限制、但希望使用我們廣泛第四代（Gen 4）生態系的客戶，正加大對機器人手術計畫的投資。

There were 144 trade-in transactions in quarter two, up from 83 a year ago, driven primarily by U.S. customers upgrading to da Vinci 5. Capital performance was strong in the U.S., where we placed 267 systems up 24% from the 216 systems placed last year, driven by adoption of an upgrades to da Vinci 5.

第二季共有 144 筆以舊換新交易，較去年同期的 83 筆增加，主要由美國客戶升級至 da Vinci 5 所帶動。美國的資本表現強勁，我們安裝了 267 套系統，較去年安裝的 216 套增加 24%，主要受惠於升級至 da Vinci 5 的採用。

We also placed 27 systems -- as significantly higher than our history, reflecting our recent focus on this customer segment. 20 of the 27 placements at ASCs were XIR systems. Outside the U.S. we placed 201 systems, an increase of 12% compared to the 179 systems placed last year.

我們也在 ASC（門診手術中心）安裝了 27 套系統——顯著高於我們過往水準，反映我們近期對此客群的聚焦。在 ASC 的 27 套安裝中，有 20 套為 XIR 系統。在美國以外地區，我們安裝了 201 套系統，較去年安裝的 179 套增加 12%。

Our OUS placements included 75 systems in Asia, 79 in Europe, and 47 in rest of world markets compared to 69, 73 and 37, respectively, last year. Higher placements in Asia were driven by Japan, where we placed 25 systems as compared to 15 systems last year.

我們的 OUS（美國以外）安裝量包含：亞洲 75 套、歐洲 79 套、以及世界其他市場 47 套；相較去年分別為 69、73 與 37 套。亞洲安裝量增加主要由日本帶動，我們在日本安裝了 25 套系統，去年為 15 套。

In China, we continue to face competitive dynamics, placing two systems, including our first da Vinci system in Hong Kong. Da Vinci 5 is not cleared in Mainland China at this time. We continue to see relative strength in distributor markets despite a number of these markets being targeted by competitors.

在中國，我們仍面臨競爭態勢，本季安裝了 2 套系統，其中包含我們在香港的第一套 da Vinci 系統。目前 da Vinci 5 尚未在中國大陸獲得核准。儘管其中多個市場正受到競爭對手鎖定，我們仍持續看到經銷商市場相對強勁。

The strength of our segmented system portfolio in combination with the competitive advantage of our broad Gen 4 ecosystem is core to our success. During the quarter, we placed 71 systems in these markets as compared to 46 systems last quarter and 65 systems last year.

我們分眾化的系統產品組合之優勢，結合我們廣泛第四代（Gen 4）生態系的競爭優勢，是我們成功的核心。本季我們在這些市場安裝了 71 套系統，較上季的 46 套增加，也高於去年的 65 套。

42 of the 71 placements were X or XIR systems, we will continue to pursue accelerated growth in these markets. Within the 468 da Vinci placements, we placed 38 SP systems in Q2 and higher than the 23 systems last year, primarily driven by increased placements in the U.S. and Japan.

在這 71 套安裝中，有 42 套為 X 或 XIR 系統；我們將持續在這些市場追求加速成長。在 468 套 da Vinci 安裝中，我們第二季安裝了 38 套 SP 系統，高於去年同期的 23 套，主要由美國與日本安裝量增加所帶動。

For our Ion platform, we placed 55 systems in Q2 compared to 54 systems last year. Given our capital performance, Quarter two systems revenue grew 19% to $685 million. For our da Vinci business, leasing represented 54% of da Vinci placements, as compared to 56% last quarter and 49% last year.

在 Ion 平台方面，我們第二季安裝了 55 套系統，去年同期為 54 套。受惠於我們的資本表現，第二季系統營收成長 19% 至 6.85 億美元。在 da Vinci 業務中，租賃占 da Vinci 安裝量的 54%，相較上季為 56%，去年同期為 49%。

Da Vinci leasing revenue increased 22%, reflecting a 15% expansion of the installed base under operating lease arrangements and a 7% increase in lease revenue per system driven by a higher mix of da Vinci systems. The average selling price for purchased da Vinci Systems was $1.6 million in Q2 as compared to $1.5 million last year, driven by a higher mix of da Vinci 5 and dual console systems, partially offset by higher trade-ins and a higher mix of lower ASP X and XIR systems.

da Vinci 租賃營收增加 22%，反映在營運租賃安排下的裝機基數擴大 15%，以及每套系統租賃營收增加 7%，主要由較高比例的 da Vinci 系統組合所帶動。第二季購置型 da Vinci 系統的平均售價為 160 萬美元，去年同期為 150 萬美元，主要由 da Vinci 5 與雙主控台系統占比提高所帶動，但部分被以舊換新增加以及較低 ASP 的 X 與 XIR 系統占比提高所抵銷。

Lease buyout revenue was $56 million as compared to $51 million last quarter and $30 million last year. Quarter 2 service revenue increased 21% to $472 million, reflecting an increase of the da Vinci installed base of 12% and the Ion installed base of 21%. Service revenue per system for our da Vinci installed base increased 8% year-over-year, also reflecting a higher mix of da Vinci 5 systems.

租賃買斷（lease buyout）營收為 5,600 萬美元，相較上季為 5,100 萬美元、去年同期為 3,000 萬美元。第二季服務營收增加 21% 至 4.72 億美元，反映 da Vinci 裝機基數增加 12% 以及 Ion 裝機基數增加 21%。我們 da Vinci 裝機基數的每套系統服務營收年增 8%，同樣反映 da Vinci 5 系統占比提高。

During the quarter, we executed our first wave of my Intuitive Plus renewals our integrated da Vinci offering of tele present simulation and AI-driven case insights. While the initial renewal cohort was small, no customer chose to opt out of their (inaudible) arrangement

本季我們完成了第一波 my Intuitive Plus 續約；這是我們整合式 da Vinci 方案，包含遠距臨場（tele present）模擬與 AI 驅動的病例洞察。雖然初始續約的客戶群規模不大，但沒有任何客戶選擇退出其（聽不清）安排

Turning now to the rest of the P&L. Non-GAAP gross margin for the quarter was 70%, an increase from 67.9% in Q2 of last year. Excluding the $36 million benefit from a IEEPA tariff refunds, Q2 non-GAAP gross margin would have been 68.7%.

接著談損益表的其餘部分。本季非 GAAP 毛利率為 70%，高於去年第二季的 67.9%。若排除 IEEPA 關稅退稅帶來的 3,600 萬美元利益，第二季非 GAAP 毛利率將為 68.7%。

The year-over-year improvement reflects product cost reductions, fixed overhead leverage and the tariff refund. Quarter two non-GAAP operating expenses increased 13% year-over-year, driven by higher headcount, increased variable compensation and higher facility costs.

年對年改善反映產品成本下降、固定間接費用槓桿效益，以及關稅退稅。第二季非 GAAP 營業費用年增 13%，主要由人員增加、變動薪酬提高與設施成本上升所帶動。

We added 215 employees during the quarter, of which about half were in manufacturing to support increased customer demand. We are intentionally growing R&D at a higher rate than SG&A as we prioritize innovation investments that allow us to reach more patients in new diseases, drive long-term growth and advance the quintuple.

本季我們新增 215 名員工，其中約一半在製造部門，以支援客戶需求增加。我們刻意讓研發（R&D）成長速度高於銷售、一般及行政（SG&A），因為我們優先投入創新，以便在新的疾病領域觸及更多病患、推動長期成長，並推進「五重」（quintuple）。

Non-GAAP other income was $83 million for the quarter as compared to $85 million last quarter. Our non-GAAP effective tax rate for quarter two was 22.6% consistent with our expectations. Non-GAAP net income for the second quarter was $1 billion compared with $798 million last year. Non-GAAP earnings per share was $2.80 per share compared to $2.19 per share in quarter two of last year.

本季非 GAAP 其他收益為 8,300 萬美元，上一季為 8,500 萬美元。第二季非 GAAP 有效稅率為 22.6%，符合我們的預期。第二季非 GAAP 淨利為 10 億美元，去年同期為 7.98 億美元。第二季非 GAAP 每股盈餘為 2.80 美元，去年第二季為 2.19 美元。

Now turning to our GAAP results. GAAP net income for the quarter was $818 million or $2.29 per share compared to $658 million or $1.81 per share in Q2 of last year. We ended the quarter with $8.6 billion in cash and investments, up from $8 billion last quarter driven by cash flow from operating activities, offset by stock repurchases of $379 million at an average price of $439 per share and capital expenditures of $112 million.

接著談我們的 GAAP 結果。本季 GAAP 淨利為 8.18 億美元，或每股 2.29 美元；去年第二季為 6.58 億美元，或每股 1.81 美元。本季期末我們的現金與投資為 86 億美元，高於上季的 80 億美元，主要由營運活動現金流入帶動，但部分被 3.79 億美元的庫藏股回購（平均每股 439 美元）以及 1.12 億美元的資本支出所抵銷。

Free cash flow in the first half of 2026 was $1.8 billion, an increase of 71% compared to the first 6 months of 2025. With that, I'll turn it over to Dan to discuss recent clinical publications and our updated outlook for 2026.

2026 年上半年自由現金流為 18 億美元，較 2025 年前 6 個月增加 71%。接下來我把時間交給 Dan，請他分享近期臨床發表，以及我們對 2026 年更新後的展望。

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. 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.

謝謝你，Jamie。接著談我們業務的臨床面，我想與各位分享近期研究中我們認為值得關注的數據。除了本次電話會議中特別提到的數據外，我們也鼓勵各位參考多年來已發表的大量科學研究證據，涵蓋這些主題及其他相關議題。

In November, Emily Thomas and Dr. Andrew Schneider of the University of South Carolina School of Medicine Greenville and Prisma Health in Greenville, South Carolina. Along with co-authors published comparative analysis of laparoscopic and robotic appendectomy, a multi-hospital retrospective cohort study in the journal Surgical Endoscopy.

11 月時，南卡羅來納大學格林維爾分校醫學院（University of South Carolina School of Medicine Greenville）以及南卡羅來納州格林維爾 Prisma Health 的 Emily Thomas 與 Andrew Schneider 醫師。與共同作者在《Surgical Endoscopy》期刊發表了腹腔鏡與機器人闌尾切除術的比較分析，這是一項多院回溯性隊列研究。

In this study across a regional multi-hospital health system that ran from August 2021 through February 2024, the authors compared outcomes for robotic-assisted and laparoscopic appendectomy and 1,431 patients, including 352 treated with da Vinci and 1,079 treated laparoscopically.

在這項涵蓋區域性多院健康系統、研究期間自 2021 年 8 月至 2024 年 2 月的研究中，作者比較了機器人輔助與腹腔鏡闌尾切除術在 1,431 名病患的結果，其中 352 名使用 da Vinci 治療，1,079 名接受腹腔鏡治療。

The results demonstrated that robotic-assisted surgery was associated with significantly lower rates of conversion to open surgery at 0% for the robotic cohort versus 3.2% for laparoscopy. The results also demonstrated that robotic-assisted surgery was associated with significantly lower rates of unexpected extended [valorie] sections at 0% for the robotic cohort versus 1.7% for laparoscopy.

結果顯示，機器人輔助手術與顯著較低的轉為開腹手術比率相關：機器人組為 0%，腹腔鏡組為 3.2%。結果也顯示，機器人輔助手術與顯著較低的非預期延長 [valorie] 切除比例相關：機器人組為 0%，腹腔鏡組為 1.7%。

After adjusting for differences between the two groups through multivariable regression, the robotic-assisted approach was associated with a 66% decreased risk of any complication relative to the laparoscopic approach.

在透過多變量迴歸調整兩組之間的差異後，相較於腹腔鏡方式，機器人輔助手術方式與任何併發症風險降低 66% 相關。

The authors attribute this difference to improved three dimensional visualization and dexterity of wristed instruments in managing intraoperative complications such as a necrotic appendiceal base extensive adhesions or bleeding.

作者將此差異歸因於更佳的三維視覺化，以及具腕關節器械在處理術中併發症（例如壞死的闌尾基底、廣泛沾黏或出血）時更高的靈活性。

The authors concluded that robotic-assisted appendectomy is safe and may be associated with significantly lower complication rates compared to the laparoscopic approach and that these findings support broader adoption of robotic assistance in general surgery.

作者總結，機器人輔助闌尾切除術是安全的，且相較於腹腔鏡方式，可能與顯著較低的併發症發生率相關；這些發現支持在一般外科更廣泛採用機器人輔助。

In May, at the American Urological Association Annual Meeting, Dr. Jacob Ohara and Dr. Michael Steelman, of Hackensack Meridian Health in New Jersey, along with co-authors, presented use of force feedback is associated with faster return of bowel function after partial and radical nephrectomy in a supplement of the Journal of Urology.

5 月在美國泌尿科醫學會（American Urological Association）年會上，新澤西州 Hackensack Meridian Health 的 Jacob Ohara 醫師與 Michael Steelman 醫師及共同作者，在《Journal of Urology》增刊中發表：在部分與根治性腎切除術後，使用力回饋與更快恢復腸道功能相關。

In this prospective cohort study, the authors evaluated 73 patients who underwent multi-port transperitoneal partial or radical nephrectomy with da Vinci performed by three high-volume robotic surgeons. There were compared 48 patients in whom force feedback was used against 25 in whom it was not.

在這項前瞻性隊列研究中，作者評估了 73 名接受多孔道經腹腔（transperitoneal）部分或根治性腎切除術的患者，手術使用 da Vinci 系統並由三位高量能機器人手術醫師執行。其中比較了 48 名使用力回饋的患者與 25 名未使用力回饋的患者。

The results demonstrated that 63% of patients in the force feedback cohort achieved a return of bowel function within one day compared to 28% in the cohort without force feedback. The authors hypothesize that force feedback improved return of bowel function by decreasing trauma to the colon and duodenum during mobilization.

結果顯示，力回饋隊列中有 63% 的患者在一天內恢復腸道功能，而未使用力回饋的隊列為 28%。作者假設，力回饋可在游離過程中降低對結腸與十二指腸的創傷，因而改善腸道功能恢復。

And they concluded that its use in robotic-assisted partial and radical nephrectomy is associated with significantly faster return of bowel function. I will now turn to our updated financial outlook for 2026. Starting with da Vinci procedures. In April, we forecast full year 2026 da Vinci procedure growth to be within a range of 13.5% to 15.5%.

他們並總結，在機器人輔助的部分與根治性腎切除術中使用力回饋，與顯著更快的腸道功能恢復相關。接下來我將說明我們對 2026 年更新後的財務展望。先從 da Vinci 手術量開始。在 4 月，我們預測 2026 全年 da Vinci 手術量成長將落在 13.5% 至 15.5% 的區間。

We are maintaining our forecast to be within this range with an expectation to be closer to the midpoint. We continue to expect the primary growth drivers to be general surgery in the U.S., including after hours and procedures outside of urology internationally.

我們維持此區間的預測，並預期更接近中位數。我們仍預期主要成長動能來自美國的一般外科（包括下班後手術），以及國際上泌尿科以外的手術。

Our range considers the impact of changes to ACA premium subsidies and patient behavior in the U.S., China tender volumes and competitive intensity in that market. Capital pressure in parts of Europe related to macroeconomic impact and shifting governmental priorities, prior capital challenges in Japan and how long those persist in 2026 in pharmaceutical products for obesity management.

我們的區間考量了美國 ACA 保費補貼變動與病患行為的影響、中國招標量以及該市場的競爭強度。也考量歐洲部分地區因總體經濟影響與政府優先事項轉移所帶來的資本壓力、日本先前的資本挑戰及其在 2026 年可能持續的時間，以及用於肥胖管理的藥品產品。

Turning to gross profit. On our last call, we forecast non-GAAP gross profit margin to be within a range of 67.5% and 68.5% of revenue which reflected 100 basis points of impact from tariff. We are updating our estimate for non-GAAP gross profit margin to be within a range of 68% and 69% of revenue. We continue to expect higher input costs in certain areas, including freight and semiconductor memory.

接著談毛利。在上次電話會議中，我們預測非 GAAP 毛利率將介於營收的 67.5% 至 68.5%，其中反映關稅帶來的 100 個基點影響。我們更新非 GAAP 毛利率估計為介於營收的 68% 至 69%。我們仍預期某些領域的投入成本較高，包括運輸與半導體記憶體。

Other factors for the year 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 product cost reductions.

年度其他因素包括 da Vinci 5 與 Ion 等較新產品的更快成長、近期設施擴建帶來的溫和增量折舊，以及較高的 da Vinci 系統升級所造成的影響，部分由產品成本降低所抵銷。

Our actual non-GAAP gross profit margin will vary quarter-to-quarter depending largely on product, regional and trade-in mix and pricing. In regard to operating expenses, we now expect non-GAAP operating expense growth to be between 11% and 13%. In recent periods, R&D has grown faster than SG&A. We expect that trend to continue over the remainder of 2026.

我們實際的非 GAAP 毛利率將因產品、區域與以舊換新組合及定價而在各季間波動。就營業費用而言，我們目前預期非 GAAP 營業費用成長介於 11% 至 13%。近幾期研發費用成長快於銷售、一般及行政費用（SG&A）。我們預期此趨勢在 2026 年剩餘期間將持續。

Additionally, in Q4 2025 we made a $70 million multiyear contribution to the Intuitive Foundation. We do not expect to make a contribution to the foundation in 2026. We now estimate noncash stock compensation expense between $880 million and $900 million. We continue to forecast other income, which is comprised mostly of interest income, to total between $315 million and $335 million.

此外，在 2025 年第四季我們對 Intuitive Foundation 進行了 7,000 萬美元的多年期捐助。我們預期 2026 年不會再對該基金會捐助。我們目前估計非現金股票酬勞費用介於 8.8 億至 9.0 億美元。我們仍預測其他收入（主要由利息收入構成）合計介於 3.15 億至 3.35 億美元。

With regard to income tax, we continue to expect our non-GAAP income tax rate to be between 22% and 23% of pre-tax income. This concludes our prepared remarks. As we open the line to questions, we ask that you limit yourselves to one question so that we may reach as many analysts as possible.

就所得稅而言，我們仍預期非 GAAP 所得稅率將介於稅前所得的 22% 至 23%。以上為我們事先準備的發言。在開放提問前，我們請各位每人僅提一個問題，以便我們能讓盡可能多的分析師發問。

(Operator Instructions)

（接線員指示）

Travis Steed, Bank of America.

Travis Steed，美國銀行（Bank of America）。

Hey. Thanks for taking the question. I'll start with the U.S. procedure growth. First question is, how do you know how much of this is ACA versus just the market maturing or something else, other med tech companies aren't calling it out or seeing it. So especially in ACA, such a small percent of the total covered lives. I mean do you expect any of these delayed procedures to come back in the second half of the guide?

嗨。謝謝讓我提問。我先從美國手術量成長談起。第一個問題是，你們如何判斷其中有多少是 ACA 的影響，而不是市場成熟或其他因素？其他醫療科技公司並沒有特別提到或看到這點。尤其 ACA 在整體受保人數中占比很小。你們是否預期這些延後的手術會在指引的下半年回補？

Travis, it's Jamie. Two things actually that we're looking at. First and most importantly is just feedback from our customers as we look at their procedure trends with us and engage with them in terms of what they're seeing.

Travis，我是 Jamie。我們其實主要看兩件事。第一且最重要的是，當我們觀察客戶在我們這邊的手術趨勢並與他們互動時，從客戶那裡得到的回饋，了解他們看到的情況。

If you look at those procedure types where we know that a subset of them can be deferred, we see a difference in terms of what's happening in the procedure trends, particularly in Q2 relative to those procedures where they're less deferrable or not deferrable, so it's just a combination of those two things.

如果你看那些我們知道其中一部分可被延後的手術類型，我們會看到手術趨勢上出現差異，特別是第二季相較於那些較不容易延後或無法延後的手術；因此就是這兩者的綜合。

If you look at what we saw in Q2, U.S. procedure growth overall for da Vinci was 12% versus the 14% we saw in Q1 there's likely some combination thereof the impact from ACA, but also we're just seeing a little bit of the law of large numbers as well.

如果你看我們在第二季看到的情況，美國 da Vinci 手術量整體成長為 12%，相較第一季的 14%；這很可能是 ACA 影響與「大數法則」效應同時存在的結果。

Okay. Thank you. And then on the I&A revenue impact and extended use, I realize not wanting to put a fine point on it yet, but we'd estimated it as kind of a five-point total impact over a couple of years, a little less than the seven points in 2020. I don't if you can kind of if that's in the ballpark or put some sort of framework around it for investors? And then also maybe talk about how this is going to open up maybe ASCs and international procedures.

好的。謝謝。另外關於 I&A 營收影響與延長使用，我理解你們不想現在就下定論，但我們估計這可能是在幾年內合計約 5 個百分點的影響，略低於 2020 年的 7 個百分點。不知道你能否說這是否大致在合理範圍內，或提供投資人一個框架？另外也請談談這將如何可能開啟 ASC（門診手術中心）以及國際手術量。

Yes, not ready to quantify it yet, Travis, as we said in the prepared remarks, we'll do that on the next earnings call. I'd just say a couple of things. The improvements that allow us to extend the lives have been years in the work by our engineering teams, it is intended to lower cost where we see cost constraints in both certain procedures and geographies.

是的，Travis，我們現在還沒準備好量化；如同我們在事先準備的發言中所說，我們會在下一次財報電話會議上提供。我只想補充幾點。讓我們得以延長使用壽命的改良，是我們工程團隊多年來的成果，目的在於在某些手術與地區存在成本限制之處降低成本。

Think of benign outpatient procedures and those markets that just generally have health care systems with lower reimbursements. In terms of how it starts to impact as we release those in the first half of next year, think of it as being a progressive impact over 2027 versus some step function just in terms of how it will adopt and how it will be rolled out by the various countries.

可以想像為良性門診手術，以及那些整體醫療體系給付較低的市場。至於當我們在明年上半年推出後會如何開始產生影響，可以把它視為 2027 年逐步發酵的影響，而非一次性的跳升，因為採用速度與各國推廣節奏會不同。

We looked back at what we did in the first extended use program back in 2020 and obviously, we've had the time to assess the impact of that both in our own data trends and in feedback from customers. And I think we have confidence that as you make innovations that allow you to lower cost for customers, when there's opportunity to grow, that's a good strategic thing to do.

我們回顧了 2020 年第一次延長使用計畫的作法，顯然我們也有時間從自身數據趨勢與客戶回饋中評估其影響。我認為我們有信心：當你做出能為客戶降低成本的創新，而市場又有成長機會時，這是一項良好的策略作為。

Robert Marcus, JPMorgan.

Robert Marcus，摩根大通。

Great. Thanks for taking the question. So one for me. The CapEx environment is one of the most important catalyst and background items for Intuitive there is obviously concern amongst investors as bad debt might build at hospitals as people fall off ACA and Medicaid.

很好。謝謝讓我提問。我這邊一個問題。資本支出（CapEx）環境是 Intuitive 最重要的催化因素與背景之一；投資人顯然擔心，隨著民眾退出 ACA 與 Medicaid，醫院端可能會累積更多壞帳。

What are you seeing today in terms of the capital environment in the U.S. and outside the U.S. and the willingness to invest in capital and I think more importantly is the go forward. So what are you expecting? What's assumed in guidance, both U.S. and OUS for the future health of the CapEx cycle? Thanks a lot.

就目前而言，您在美國及美國以外看到的資本環境、以及投資資本的意願如何？我想更重要的是往後的走勢。所以你們預期會如何？在財測指引中，對於未來 CapEx 週期的健康度（美國與美國以外 OUS）分別假設了什麼？非常感謝。

The U.S. capital environment, at least in our experience, has been stable for some time now. And you see that, I think, in the healthy system placements in Q2 in the U.S., up 24%. I do think that we have a relative advantage in the around 70-ish percent of the systems acquired in the U.S. are under leasing arrangements.

就我們的經驗而言，美國的資本環境在一段時間以來都相當穩定。我想你也能從美國第二季健康的系統裝機量看出來，年增 24%。我確實認為我們有相對優勢，因為在美國取得的系統中，大約 70% 左右是採租賃安排。

And so that gives customers, I think, greater flexibility relative to when they have capital budget constraints. But I think we feel good about how capital has performed in the U.S. in recent periods and our pipeline at least up until this point has been healthy.

因此，當客戶面臨資本預算限制時，我認為這能讓客戶擁有更大的彈性。但我想我們對於近期美國資本表現感到滿意，而且至少到目前為止，我們的案源（pipeline）也一直很健康。

Much of that has been driven by interest in da Vinci 5. So to some extent, there's some uniqueness relative to customers wanting to get access to the latest technology to differentiate themselves in the marketplace and take advantage of the features that embedded.

其中很大一部分是由對 da Vinci 5 的興趣所帶動。所以在某種程度上，客戶希望取得最新技術以在市場上做出差異化，並利用其中內建的功能，這點具有一定的獨特性。

If you look at the U.S. placements in Q2, 267 systems, relative to the 216 in the year ago period. Almost the entirety of that increase is in trades, and so it shows the extent to which customers are interested in upgrading embedded in that, given how we designed da Vinci 5 structurally, it does give customers incremental capacity, and that's reflected in how we've described the higher utilization of da Vinci 5 versus XI.

如果看美國第二季的裝機量，為 267 台系統，相較去年同期的 216 台。幾乎全部的增量都來自換機（trade-ins），這顯示客戶對升級的興趣程度；而且就我們在結構上對 da Vinci 5 的設計而言，它確實能為客戶帶來額外產能，這也反映在我們所描述的 da Vinci 5 相較於 XI 更高的使用率上。

We also saw green fields up in Q2, and that was mostly the 27 systems that we placed at ASCs. So we feel pretty good about the U.S. environment to this point. Of course, there are some customers that express caution over ACA enrollment trends, but we haven't seen that impact our pipeline, at least to this point.

我們也看到第二季綠地（greenfield）增加，而那主要是我們在門診手術中心（ASC）所裝機的 27 台系統。因此截至目前，我們對美國環境感覺相當不錯。當然，有些客戶對 ACA 投保趨勢表達謹慎，但至少到目前為止，我們尚未看到這對我們的案源造成影響。

In international markets, it's basically what we've described on the call, China is competitive and challenging from a pricing perspective. Japan has been impacted by government funding. We think the reimbursement decisions that went into effect in June are positive, and we have a kind of cautious tone of optimism for -- as we look forward in Japan.

在國際市場方面，基本上如同我們在電話會議中所描述的：中國在價格面競爭激烈且具挑戰。日本則受到政府資金的影響。我們認為 6 月生效的給付（reimbursement）決策是正面的，展望日本未來，我們抱持一種審慎的樂觀。

The distributor markets have responded well, particularly to our portfolio of systems. Europe, it depends on the market. There are some that are stressed by government budgets and some that look pretty healthy.

經銷商市場的反應良好，特別是對我們的系統產品組合。歐洲則視各市場而定。有些市場受到政府預算壓力，有些看起來相當健康。

Rick Wise, Stifel.

Rick Wise，Stifel。

Good afternoon, everybody. Could you talk, Dave, a little bit more about the May 21 press release? You highlighted and you highlighted it went quickly. I think you said over 100 such da Vinci 5 upgrades and enhancements ahead. If I heard that correctly, correct me, please, if I'm wrong, but at what rate are these going to unfold and happen and roll out, I know, subject to FDA approval.

各位下午好。Dave，你能否再多談一點 5 月 21 日的新聞稿？你有提到，而且帶過得很快。我想你說未來會有超過 100 項 da Vinci 5 的升級與強化。如果我聽得沒錯，若有錯請指正；但這些會以什麼速度逐步推出與上線？我知道這也取決於 FDA 核准。

But how do we think about these incremental adds? Are there one or two or five that are likely to be more impactful and impactful on growth or procedure volumes or new procedures than others?

但我們該如何看待這些增量新增功能？是否有一、兩項或五項，可能比其他項目更具影響力，對成長、手術量或新術式的推動更大？

Rick, I appreciate the question. So the way to think about this cadence that we've committed to, as we take da Vinci 5 as a platform and its compute power, the 10,000 times we're able to add capabilities and features to that on a regular basis. And so the press release that you're referring to has 100 updates. And some of those updates will be not visible to the customer.

Rick，謝謝你的問題。我們承諾的更新節奏可以這樣理解：我們把 da Vinci 5 視為一個平台，憑藉其運算能力（提升到 10,000 倍），我們能夠定期新增能力與功能。因此你提到的那份新聞稿包含 100 項更新。其中有些更新對客戶而言不會是可見的。

They're kind of under the hood, so to speak, and many will be visible to the customer. And they're focused in the areas that we talked about, three of them in particular, that take advantage of these updates, we submitted for 510(k) clearance.

可以說是「引擎蓋底下」的改進，而也有許多會是客戶可見的。它們聚焦在我們談到的幾個領域，尤其其中三項更新我們已提交 510(k) 申請以取得核准（clearance）。

And so those updates center -- two of them center on really I would say, kind of usability and efficiency features where the care team and the surgeon may be able to minimize some communication back and forth on the surgeon tool inject feature, for example, where they can indicate exactly which tool is going to be needing to be changed.

這些更新中，有兩項主要聚焦在我會稱之為可用性與效率的功能：例如在「外科醫師工具注入（surgeon tool inject）」功能上，照護團隊與外科醫師可以減少一些來回溝通，因為外科醫師能精確指示需要更換的是哪一個工具。

The other one on as we are able to adjust multiple arms either preoperatively or during the case will help efficiency of the case. And now we're finally adding this digital ruler too, and that's another one that requires clearance. And that one, you can imagine in a variety of cases, where it can be used by the surgeon to measure a particular part of the anatomy and what they're trying to ensure meets the needs of the patient.

另一項是我們能在術前或手術過程中調整多個機械臂，這將有助於提升手術效率。另外我們也終於加入了數位尺（digital ruler），這也是需要取得核准的一項。你可以想像在各種手術中，外科醫師可用它來量測特定解剖部位，並確保符合病患需求。

And so those are the three that are submitted for clearance. Others will be kind of circling around some of the efficiencies and effectiveness of the system. And then that's what you'll see going forward, too, as we look at next year and years beyond, is a set of updates many of which will be kind of standout features that improve the capability of the system.

以上是已提交核准的三項。其他更新則會圍繞在系統的效率與效能提升。而這也是你未來會看到的方向：展望明年及更往後的年度，將會有一系列更新，其中許多會是相當突出的功能，用以提升系統能力。

And Dave, I hope you'd expand on your comments about this new GI robot? Why this area? Why now? And maybe you can give us a flavor for the potential incremental TAM and impact on Intuitive outlook?

另外 Dave，我希望你能延伸談談你對這款新的 GI 機器人的評論。為什麼選這個領域？為什麼是現在？也許你可以讓我們大致了解一下，這對潛在新增的總可服務市場（TAM）以及對 Intuitive 展望的影響？

Yes, sure. So the way I would frame GI is basically a natural extension of our mission to bring better minimally invasive care to more patients. I would say that Ion has demonstrated we can develop and commercialize platforms beyond core soft tissue surgery. And I'm excited. We're in a good place to bring the learnings from da Vinci and the learnings from Ion, bring those together inform our work in the GI tract.

好的，當然。我會這樣看待 GI：它基本上是我們使命的自然延伸，也就是把更好的微創照護帶給更多病患。我會說 Ion 已經證明，我們能在核心軟組織手術之外，開發並商業化其他平台。我很興奮。我們處在一個很好的位置，能把 da Vinci 的學習與 Ion 的學習結合起來，並用以指引我們在 GI 腸胃道方面的工作。

And so we have spent time with GI physicians and care teams to understand where a robotic approach could improve therapeutic outcomes, the care team experiences, really all aspects of the Quintle and we're excited about what's possible. And I just want to reinforce this remains early, right? The 510(k) submission is for non commercial and aluminum system.

因此，我們花了時間與 GI 醫師及照護團隊交流，以了解機器人方式在哪些地方能改善治療結果、照護團隊的體驗，基本上是 Quintle 的各個面向；我們對可能性很期待。我也想再次強調，這仍處於早期階段，對吧？這次 510(k) 申請是針對非商業用途的鋁製系統。

And we'll build clinical evidence and work through the regulatory review processes, and we'll provide updates along the way. Just not ready today to describe kind of timing or size of the opportunity but encouraged by what we're learning and the potential for GI to become another area where minimally invasive robotics can create real value over time.

我們會建立臨床證據並完成法規審查流程，也會在過程中提供更新。只是目前還不準備描述機會的時間點或規模，但我們對所學到的內容以及 GI 有潛力在時間推移下成為另一個微創機器人能創造實質價值的領域，感到受到鼓舞。

Lawrence Bigelsen, Wells Fargo.

Lawrence Bigelsen，富國銀行。

I just wanted to ask about China. We recently saw that the government is creating a centralized VBP for imaging and other surgical equipment. Are surgical robotics part of that VBP program? And how might that impact Intuitive in China?

我想問一下中國。我們最近看到政府正在為影像設備及其他手術設備建立集中式的 VBP（帶量採購）。手術機器人是否也屬於該 VBP 計畫的一部分？這可能會如何影響 Intuitive 在中國的業務？

Hey Larry. So to the best of our knowledge, I wouldn't compare this tender centralization necessarily with VBP. What we think the government is really trying to do here is manage some of the duplication and waste that they see in the tender process when it's individualized to hospitals and all the provinces.

嗨，Larry。就我們目前所知，我不會把這種招標集中化必然拿來和 VBP 相提並論。我們認為政府在這裡真正想做的是，管理他們在招標流程中看到的一些重複與浪費，因為當招標是以各家醫院、各省分別進行時，就容易出現這些問題。

And so we think actually, in a way, what they're going to do is more structurally develop the tenders to take advantage or to basically reinforce the need for strong robotic programs and not just bespoke features that are system by system kind of tailored by depending on who's writing the tender.

因此我們其實認為，某種程度上，他們將會以更結構化的方式來制定招標，以便利用、或基本上強化對強健機器人計畫的需求，而不只是一些客製化功能；那些功能往往是依系統逐一量身打造，取決於誰在撰寫招標文件。

And so we do believe that robotics will be part of it. Again, I wouldn't compare it to VBP, and we'll see how it starts to kind of phase in now over the next quarters.

所以我們確實相信機器人會是其中的一部分。再說一次，我不會把它和 VBP 做比較；我們也會看看它在接下來幾個季度如何開始逐步推行。

That's helpful. Dave, one follow-up. The recent press release that Rick asked about also talked about instrument security and how Intuitive is enhancing instrument encryption technology to improve the security and monitoring of its products. So my question is, what's the tangible benefit of that? And do you think this will incentivize hospitals to stick with your instruments as opposed to remanufactured instruments?

這很有幫助。Dave，我再追問一個。Rick 剛才提到的那份近期新聞稿也談到器械安全，以及 Intuitive 正在強化器械加密技術，以提升其產品的安全性與監控能力。所以我的問題是，這帶來的具體好處是什麼？你認為這會不會促使醫院繼續使用你們的器械，而不是改用再製器械？

Yes. Here's what I'd say about that is it's clear that cybersecurity is front and center when you talk to our customers and across the globe. And so really, the introduction of this new encryption technology is just part of our continued investment to strengthen the security of our products, the quality of our products, the availability of our products. And really, that's what it is centered on in this case.

是的。我會這麼說：很明顯，當你和我們的客戶交流時，網路資安在全球都是最受關注的議題。因此，導入這項新的加密技術，只是我們持續投資的一部分，用來強化產品的安全性、產品品質，以及產品可用性。而這次的重點確實就是在這些面向。

Ryan Zimmerman, BTIG.

Ryan Zimmerman，BTIG。

Good afternoon. Thanks for takin the question. First question for me is going back to the capital demand and the environment. I mean, there's a bit of a dichotomy, I think, between capital demand and procedure growth. And I'm wondering, Dave, when you think about the capital cycle that you're seeing, particularly what you saw this quarter, -- does it reflect assumptions of increasing demand ahead?

下午好。謝謝讓我提問。我的第一個問題想回到資本需求與整體環境。我認為資本需求和手術量成長之間似乎有點兩極。Dave，當你看你們所看到的資本循環，特別是本季的情況時——這是否反映了對未來需求增加的假設？

Because I think if I think about what Gary has said in the past in terms of system growth, typically, hospitals are buying systems ahead of increasing demand. And so just maybe speak to the differences between the system placements versus what you saw with procedures this quarter, please?

因為如果我回想 Gary 過去談到系統成長時的說法，通常醫院會在需求增加之前就先購買系統。所以能否請你談談系統裝機（placements）與本季你們看到的手術量之間的差異？

Brian, it's Jamie. Maybe I'll take that. If I could take the U.S. a couple of things just to consider, -- about half of the placements in the U.S. in Q2 were trades. So while you can get incremental capacity in the field, if you're upgrading to da Vinci 5. Obviously, then the half of those placements are not expanding the installed base.

Brian，我是 Jamie。也許我來回答。如果我以美國為例，有幾點可以考量——美國第二季約有一半的裝機是以舊換新（trade）。所以雖然如果你升級到 da Vinci 5，現場確實可能增加一些增量產能。但顯然，其中一半的裝機並沒有擴大已安裝基礎（installed base）。

And you have seen the U.S. installed base expansion kind of moderate slightly over the last several quarters. If you look at system utilization, which I think is an important metric relative to your question in the U.S., that grew 3% in Q2, which is a healthy level and a metric that we'll watch carefully.

而且你也看到，美國的已安裝基礎擴張在過去幾個季度略為放緩。如果看系統使用率（system utilization）——我認為這是針對你問題在美國很重要的指標——第二季成長了 3%，這是健康的水準，也是我們會密切關注的指標。

Again, I would just say, we have heard from some customers, some caution on ACA enrolment trends. But again, that hasn't affected the capital pipeline so far. Obviously, we're going to watch the procedure trends across the U.S. in the coming quarters.

再說一次，我只想說，我們確實從一些客戶那裡聽到，對 ACA 投保趨勢有些謹慎。但到目前為止，這還沒有影響資本管線（capital pipeline）。當然，我們會在接下來幾個季度觀察全美的手術量趨勢。

Okay. And then just second question for me is on dV5 upgrade cycle durability. We did a recent survey. The bulk of respondents in our survey, about 77% or so, we're already upgrading to DV5 and we're actively pursuing an upgrade.

好的。那我的第二個問題是關於 dV5 升級循環的持續性。我們最近做了一份調查。調查中多數受訪者，大約 77% 左右，已經在升級到 DV5，並且正在積極推進升級。

But when I step back and I think about kind of the DV5 installed base relative to the broader installed base, I mean how do you think about the ability to upgrade to DB5 in the existing installed base relative to greenfield? And where would you kind of characterize what inning you're in, if you will, with the DB5 upgrade cycle, given the broader installed base that is out in the field today?

但當我退一步看，思考 DV5 的已安裝基礎相對於更廣泛的已安裝基礎——你們如何看待在既有已安裝基礎中升級到 DB5 的能力，相對於綠地（greenfield）？另外，若用棒球局數來比喻，在目前外部既有已安裝基礎的情況下，你會如何描述 DB5 升級循環目前進行到第幾局？

I don't think we have a perfect prediction, I would just say, if you look at the when we introduced Xi, it took about seven years before we got to the peak trading volumes going from SI to Xi. I just give that as a historical reference, nothing more.

我不認為我們能做出完美的預測；我只能說，如果你回顧我們推出 Xi 的時候，從 SI 換到 Xi 的以舊換新量，大約花了七年才到達高峰。我只是提供這個歷史參考，沒有更多含義。

I think that as with Xi, the da Vinci 5 capability and its ecosystem increases over time with the software updates and the ability to improve other elements of the ecosystem. And each time we do those updates, that then makes the system more attractive.

我認為，和 Xi 一樣，da Vinci 5 的能力及其生態系會隨時間推進而提升，透過軟體更新，以及改善生態系其他要素的能力。而每次我們做這些更新，都會讓系統更具吸引力。

Of course, there will be some segmentation in the U.S. that's likely along the lines of what ASCs and HOPDs want to use given the procedure mix in those settings versus in the hospital. But we've said for some time now, we think the upgrade cycle is progressive and occurs over multiples of years.

當然，美國市場可能會出現一些區隔，可能大致取決於 ASC 與 HOPD 在那些場域的手術組合（procedure mix）相較於醫院，會想使用什麼。但我們已經說了一段時間，我們認為升級循環是循序漸進的，並且會跨越多年發生。

Matt Taylor, Jefferies.

Matt Taylor，Jefferies。

Hi. Thanks for taking the question. I guess I wanted to ask you a little bit more about XIR. You mentioned there's momentum in those programs especially in ASCs and kind of cost-sensitive areas. I was wondering if you could give us more color on how many of those you're placing? And maybe kind of an outlook about how you think that will evolve and what percentage of the mix those could represent in the future?

嗨。謝謝讓我提問。我想再多問一些關於 XIR。你提到這些計畫有動能，特別是在 ASC 以及一些對成本敏感的領域。我想知道你能否提供更多細節：你們大概放置了多少台？以及你們認為未來會如何演變、在未來可能占整體組合的百分比會是多少？

Yes, I might just start, and Jamie, please follow up. If you look across the globe. And you just -- you mentioned, we have segments, and we're seeing segmentation across our customer base through in the U.S. ASCs and smaller hospitals outside the U.S., certainly in those geographies where kind of the health care system is more cost constrained.

好的，我先說幾句，Jamie 也請補充。如果你放眼全球。你剛才提到我們有不同區隔，而我們確實在客戶群中看到區隔：在美國是 ASC；在美國以外則是較小型的醫院；當然也包括那些醫療體系在成本上更受限制的地區。

And XIR is just a fantastic option for them is it -- it takes advantage of our entire fourth gen ecosystem and it has just great capability across a broad set of procedures. And so I'm -- I think I'm excited about where that's positioned and what it's offering customers because we've seen it be able to meet their economic need.

而 XIR 對他們來說就是一個非常出色的選擇——它能充分利用我們完整的第四代生態系，並且在廣泛的手術類別上具備很強的能力。所以我對它目前的定位以及它能為客戶提供的價值感到很振奮，因為我們看到它能滿足客戶的經濟需求。

That's why I think you've seen the placements come up this quarter. Our teams are focused on working with customers to understand their needs and we think XIR going to be just a strong option for them. And so I would expect it to be a significant part of our placements over the coming quarters.

這也是為什麼我認為你會看到本季的裝機量上升。我們的團隊專注於與客戶合作、了解他們的需求，而我們認為 XIR 將會是他們一個很強的選項。因此我預期在接下來幾個季度，它會占我們裝機的一個重要部分。

What's exciting about XIR is it gives us the opportunity to access customers that have not yet invested in robotics allows them to have their first program start to get through the learnings, see the benefits of it. and becomes then a customer that we can bring to more advanced technology over time. We've had XIR for about a year now.

XIR 令人興奮之處在於，它讓我們有機會觸及那些尚未投資機器人的客戶，讓他們能啟動第一個計畫，完成學習曲線、看到其效益，並在時間推進下成為我們可以導入更先進技術的客戶。我們推出 XIR 大約一年了。

I think the installed base is something like 130 XIRs in the field. About 50 of those are in the U.S. that's concentrated with the 27 ASCs placements, 20, 27 were XIR and some other customers in the U.S. But a large portion of them are in international markets. And again, it gives us the opportunity to go to customers that are new to robotics.

我認為目前在外部的已安裝基礎大概是 130 台 XIR。其中約 50 台在美國，主要集中在 27 家 ASC 的裝機；在那 20、27 台中有 20 台是 XIR，另外還有一些美國的其他客戶。但其中很大一部分是在國際市場。同樣地，這讓我們有機會接觸到對機器人而言是新客戶的族群。

And so there's 11 or 12 customers in that year period, 11 or 12 countries rather in that year period that have taken in XIR. And so I think there's diverse interest in those places where it's cost sensitive and it's advantaged by the breadth of the Gen 4 ecosystem.

因此，在那段年度期間內，有 11 或 12 個客戶——更確切地說，是 11 或 12 個國家——已採用 XIR。因此我認為，在那些對成本敏感、且能受惠於第 4 代生態系廣度的地區，確實存在多元的興趣。

Vic capture of BMO.

BMO 的 Vic 採訪。

So given the paper reimbursement changes that took effect in Japan on June 1. I'm just curious how significant the contribution from Japan to come over the next few years if adoption trends develop as you expect. Thank you.

因此，鑑於日本自 6 月 1 日起生效的紙本報銷變更。我只是好奇，如果採用趨勢如你們預期發展，日本在未來幾年將帶來多大程度的貢獻。謝謝。

Yeah. I think we expect procedure adoption to take some time given the newer categories and in some cases, you need to work through surgeon training and so forth. And despite the new reimbursements, I think we're balanced about the continuing financial challenges along with some of the financial incentives that now exist.

是的。我認為我們預期手術採用需要一些時間，因為類別較新，而且在某些情況下，你需要完成外科醫師訓練等等。即便有新的報銷，我們也會在持續的財務挑戰與目前已存在的一些財務誘因之間保持平衡看法。

So I think that will be progressive over some time. What have we said about the size of the market opportunity down?

所以我認為這會在一段時間內逐步推進。我們對市場機會規模的下修是怎麼說的？

I think incrementally relative to prior increases, it's somewhat smaller, but -- and will take time to develop.

我認為相較於先前的增幅，邊際上是小一些，但——而且需要時間發展。

And the TAM of the new opportunity, we described that.

至於新機會的 TAM（總可服務市場），我們有描述過。

Not specifically described.

沒有特別描述。

Inge Norena is the largest of the procedures with the new reimbursement. So we'll see how that progresses over time, and we'll keep you updated.

在新的報銷項目中，Inge Norena 是手術量最大的。所以我們會看看它隨時間如何進展，並會持續向你更新。

Michael Polark, Wolfe Research.

Wolfe Research 的 Michael Polark。

Good afternoon. Thank you for taking the question. I want to take another crack at extended use impact in 2027. So Travis alluded to the last cycle was a 7% impact, the adjustments that were made were described as 9% to 15%. You have some good things going through the I&A per case line right now, DB5 generally, force feedback, SP mix, all good guys.

下午好。謝謝讓我提問。我想再試著問一次 2027 年延長使用（extended use）的影響。Travis 提到上一個週期影響是 7%，而所做的調整被描述為 9% 到 15%。你們目前在每例 I&A（器械與配件）這條線上有一些正向因素在發生：DB5 整體、力回饋、SP 組合占比，都是好因素。

Is it fair to think that you're investing kind of away that upside with extended use in the per case line would be flat? Or is that not a great assumption and there is risk that I&A per case as we roll through '27 and '28 year-on-year could be down a little bit.

是否可以合理地認為，你們是在用延長使用把這些上行空間投資掉，使得每例這條線會持平？或者這不是個好假設，且當我們進入 2027 與 2028 年、以年對年來看，每例 I&A 可能會小幅下滑，存在風險？

Mike, I totally understand the question from a modeling perspective for next year. I'm not going to provide the quantification until we've been through the analysis and made our decisions. I think that in the way that we think about managing the company, where we're balancing two objectives, growth and profitability and where we see opportunities to have incremental growth in these lower acuity procedures than we're willing to pursue those.

Mike，從明年建模的角度我完全理解這個問題。在我們完成分析並做出決策之前，我不會提供量化數字。我認為，就我們管理公司的方式而言，我們是在平衡兩個目標：成長與獲利；而在我們看到這些較低急性度手術中有增量成長機會時，我們願意去追求。

I think that you're right, what you called out is there is the opportunity for mix on those products that have incremental innovation embedded in them that is manifested in higher pricing or higher I&A per procedure then you have some dynamics that can offset, and that's what we tried to describe in the script. But I'm not going to go through the kind of quantification until we've been through our process internally.

我認為你說得對，你點出的部分是：在那些內含增量創新的產品上，確實存在組合（mix）機會，這會體現在更高的定價或每例更高的 I&A；同時也會有一些動態可以相互抵銷，這就是我們在講稿中試圖說明的。但在我們內部走完流程之前，我不會進一步做量化說明。

Vijay Kumar, Evercore.

Evercore 的 Vijay Kumar。

Hi guys. Thank you for taking my question. Maybe just one from my side. I know there's nervousness around the utilization metric. Can you talk about your exposure to Medicaid or exchanges, if you will?

嗨，各位。謝謝讓我提問。我這邊可能只有一個問題。我知道大家對使用率（utilization）指標有些緊張。你們能談談你們在 Medicaid 或醫療保險交易所（exchanges）方面的曝險嗎？

I'm sorry, Vijay, do you mind just repeating the question?

抱歉，Vijay，你介意把問題再重複一次嗎？

What is your procedure exposure to health care exchanges and Medicaid?

你們的手術量中，有多少曝險於醫療保險交易所與 Medicaid？

We don't have a precise estimate. A significant portion of the business is private pay insurance or commercial insurance; Medicare is a lower proportion of our business as -- and Medicaid is lower yet again. But we don't have a precise estimate of what portion of our procedure business is under ACA.

我們沒有精確估計。業務中相當大一部分是私人付費保險或商業保險；Medicare 在我們業務中的占比相對較低——而 Medicaid 的占比又更低。但我們沒有精確估計在 ACA（平價醫療法案）之下的手術業務占比是多少。

Understood. And Jamie, I know you gave the preceded guidance for the annual third quarter comps get tougher. Is that something we need to be cognizant enough.

了解。另外，Jamie，我知道你先前的指引提到，年度第三季的比較基期會變得更具挑戰。這是否是我們需要足夠留意的事情？

Yeah. Just thinking about the second half of the year, obviously, the first half of the year, closer to 15% on da Vinci procedure growth guiding more towards the midpoint for the rest of the year. There is a little bit of a tougher comp in the U.S. in Q3.

是的。就下半年來看，顯然上半年達文西手術量成長接近 15%，而對於今年剩餘期間的指引更偏向中點。美國在第三季確實有一點較具挑戰的比較基期。

I think we noted at the time last year, additionally, Q3 internationally had some seasonal holiday movements that moved from Q4 to Q3. So a little bit of an impact in Q3 and Q4 on the international side as well.

我想我們去年當時也提到，此外，國際市場第三季有一些季節性假期的移動，從第四季移到第三季。因此在國際端，第三季與第四季也會有一些影響。

That was our last question. Thank you for the questions. In closing, we continue to believe there's a substantial and durable opportunity to fundamentally improve surgery and acute interventions. Our teams continue to work closely with hospitals, physicians and care teams in pursuit of what our customers have termed the quintuple better, more predictable patient outcomes, better experiences for patients, better experiences for their care teams, lower total cost of care and finally, increased access to care.

這是我們最後一個問題。謝謝各位的提問。最後總結，我們仍然相信，在根本性改善手術與急性介入方面，存在龐大且持久的機會。我們的團隊持續與醫院、醫師與照護團隊密切合作，追求客戶所稱的「五重更好」：更好且更可預測的病患結果、病患更好的體驗、照護團隊更好的體驗、更低的總照護成本，最後是提升照護可近性。

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，手術與急性照護的價值創造在根本上是以人為本。它源自對病患與照護團隊的尊重與理解，以及對其需求與所處環境的理解。在 Intuitive，我們想像一個侵入性更低且顯著更好的照護未來：疾病能更早被辨識並迅速治療，讓病患能回到最重要的事物上。

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

感謝你在這段非凡旅程中的支持。我們期待三個月後再次與你交流。

This concludes today's program. Thank you so much. You may now disconnect.

今天的節目到此結束。非常感謝。你現在可以斷線。