直覺手術 (ISRG) 2026 Q3 法說會逐字稿

Hello, and welcome to Intuitive third quarter 2026 earnings release.

各位好，歡迎參加 Intuitive 2026 年第三季財報發布會。

(Operator Instructions)

（接線員指示）

I would now like to turn the call over to Dan Connally, Head of Investor Relations. You may begin

現在我想把電話會議交給投資人關係主管 Dan Connally。您可以開始了。

Good afternoon, and welcome to Intuitive's Q3 2026 earnings conference call. Joining me today are Dave Rosa, our CEO; Jamie Samath, our CFO; Dr. Jamie Wang, our Chief Medical Officer; and Gary Lowe, our Chief Legal and Compliance Officer.

各位下午好，歡迎參加 Intuitive 2026 年第三季（Q3）財報電話會議。今天與我一同出席的有：執行長 Dave Rosa、財務長 Jamie Samath、首席醫療長 Jamie Wang 醫師，以及首席法務與法規遵循長 Gary Lowe。

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. These risks and uncertainties are described in our Securities and Exchange Commission filings, including our most recent 10-K filed on February 3, 2026, and 10-Q filed on July 21, 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.

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。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，包括我們於 2026 年 2 月 3 日提交的最新 10-K，以及於 2026 年 7 月 21 日提交的 10-Q。我們的 SEC 文件可透過 intuitive.com 的網站或 SEC 網站查閱。投資人請勿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.

本次電話會議的音訊重播將可於我們網站投資人關係頁面下的「活動（Events）」區取得。

We have posted today's press release and supplementary financial data tables to our website. Our format for this afternoon's conference call is as follows: Dave will review our business and operational highlights. Jamie will review our financial results and procedure highlights. Jamie Wong will review clinical highlights. I will review our updated financial outlook for 2026.

我們已將今日新聞稿與補充財務資料表發布於網站。今天下午電話會議的流程如下：Dave 將回顧我們的業務與營運重點；Jamie 將回顧我們的財務結果與手術量重點；Jamie Wong 將回顧臨床重點；我將回顧我們更新後的 2026 年財務展望。

And finally, we will host a question-and-answer session. With that, I will turn it over to Dave.

最後，我們將進行問答環節。接下來我把時間交給 Dave。

Good afternoon, and thank you for joining us today. Q3 was a strong quarter for Intuitive, with broad-based adoption across our multiport, single-port and Ion platforms. In Q3, total procedures increased 15%, driven by 14% growth in da Vinci procedures and 31% growth in Ion procedures. In the US, da Vinci procedure growth was 10% and outside the US, da Vinci procedure growth was 20%. We exited the quarter with more than 13,200 da Vinci and Ion systems installed worldwide.

各位下午好，感謝今天加入我們。第三季對 Intuitive 而言是強勁的一季，我們的多孔（multiport）、單孔（single-port）與 Ion 平台均呈現廣泛採用。第三季總手術量成長 15%，其中 da Vinci 手術量成長 14%，Ion 手術量成長 31%。在美國，da Vinci 手術量成長 10%；在美國以外地區，da Vinci 手術量成長 20%。本季結束時，全球已安裝超過 13,200 台 da Vinci 與 Ion 系統。

Over time, our customers have adopted operationalized and standardized on the da Vinci ecosystem to provide their patients with improved care. That adoption has been driven by our commitment to innovation robust training and clinical evidence, and it is apparent in how customers use da Vinci today.

長期以來，我們的客戶已採用並在營運上制度化、標準化 da Vinci 生態系，以為病患提供更佳照護。這樣的採用來自我們對創新、完善訓練與臨床證據的承諾，並且可從客戶今日使用 da Vinci 的方式中清楚看見。

In the quarter, almost 7,000 customers in more than 70 countries performed da Vinci procedures at a rate of over 10,000 procedures per day. On the clinical evidence front, more than 48,000 peer-reviewed publications have evaluated the effectiveness of da Vinci surgery, including the recent benign COMPARE study which Jamie Wong will discuss in more detail shortly.

本季，在超過 70 個國家的近 7,000 家客戶以 da Vinci 進行手術，平均每天執行超過 10,000 台手術。在臨床證據方面，已有超過 48,000 篇同儕審查論文評估 da Vinci 手術的有效性，其中包括近期的良性 COMPARE 研究，Jamie Wong 稍後將更詳細說明。

As I described last quarter, we continue to see increasing segmentation across our customer base, need to vary by procedure, site of care, geography and health care system. We have been investing to support this segmentation, and we have positioned Intuitive to serve current and future customers with both our existing technologies and those in development. Meeting those needs also requires that we evolve our commercial approach to tailor how we engage, price and provide solutions for customers in each segment. In Q3, global customer demand across our da Vinci portfolio remains strong. Da Vinci system placements increased 28% worldwide, with da Vinci 5 in SP accounting for 65% of global placements.

如同我在上季所述，我們持續看到客戶群的需求分眾化日益增加，需求會因手術類型、照護場域、地理區域與醫療體系而異。我們一直在投資以支援這種分眾化，並讓 Intuitive 能以現有技術與開發中的技術服務現在與未來的客戶。滿足這些需求也要求我們演進商業模式，以便針對各分眾客戶調整我們的互動方式、定價與解決方案提供方式。第三季，全球客戶對我們 da Vinci 產品組合的需求仍然強勁。da Vinci 系統全球裝機量成長 28%，其中 da Vinci 5 與 SP 合計占全球裝機量的 65%。

Installations of Xi RNX more than doubled in the quarter. Customers continue to adopt da Vinci 5 and its growing capabilities with demand for both capacity expansion and system upgrades. We exited the quarter with more than 2,000 da Vinci 5 systems installed worldwide, used by over 18,000 surgeons since launch. We continue to see strong interest in XiR both in the US and internationally, where customers are leveraging its familiarity, capabilities and cost profile to build programs around a focused set of procedures.

本季 Xi RNX 的安裝量較去年同期增加逾一倍。客戶持續採用 da Vinci 5 及其不斷擴增的能力，需求同時來自產能擴充與系統升級。本季結束時，全球已安裝超過 2,000 台 da Vinci 5 系統，自上市以來已有超過 18,000 名外科醫師使用。我們持續看到美國與國際市場對 XiR 的高度興趣，客戶正利用其熟悉度、能力與成本結構，圍繞一組聚焦的手術建立專案。

Our da Vinci single port platform is playing an increasingly important role for our customers and their patients. Our investments in additional clearances and instrumentation are yielding results as SP procedures expand in the US and internationally. Adoption of the new SP stapler continues to broaden and in Q4, we plan to make a US submission for the SP vessel sealer, which we believe is a key enabler for wider adoption of our SP platform.

我們的 da Vinci 單孔平台對客戶及其病患而言正扮演愈來愈重要的角色。我們在額外核准與器械方面的投資正在產生效果，SP 手術在美國與國際市場皆持續擴張。新款 SP 釘合器（stapler）的採用持續擴大；在第四季，我們計畫在美國提交 SP 血管封合器（vessel sealer）的申請，我們相信這是推動 SP 平台更廣泛採用的關鍵推手。

Increasingly, customers that adopt both multiport and single port describe benefits to their overall da Vinci programs, with SP opening new approaches for the surgeon, while existing procedure demand fills their multiport capacity.

愈來愈多同時採用多孔與單孔的客戶表示，這對其整體 da Vinci 專案帶來效益：SP 為外科醫師開啟新的手術途徑，而既有手術需求則填補其多孔系統的產能。

In Q3, we finalized a set of pricing actions for a subset of high-volume benign procedures where costs may be a constraint to broader access to da Vinci surgery. We believe these actions, in conjunction with increased availability of XiR will expand our addressable opportunity and enable da Vinci technology to reach more patients around the world. Jamie will describe the anticipated impact shortly.

第三季，我們針對部分高量的良性手術完成一系列定價措施，因為成本可能限制 da Vinci 手術更廣泛的可近性。我們相信，這些措施結合 XiR 供應量的提升，將擴大我們可服務的市場機會，並讓 da Vinci 技術觸及全球更多病患。Jamie 稍後將說明預期影響。

Outside the US, we are elevating our focus and increasing our investments to help customers establish and expand their da Vinci programs. As of Q3, nearly 4,000 international customers have a da Vinci program and nearly 25% operate two or more systems. These customers are moving beyond urology and cancer procedures into benign hysterectomy in Germany, cholecystectomy in the UK and India and inguinal hernia repair in Japan. To support this growth, we are continuing to build the foundation of market access country by country through regulatory clearances, reimbursement, training and clinical and economic validation.

在美國以外地區，我們正提升聚焦並增加投資，以協助客戶建立並擴大其 da Vinci 專案。截至第三季，近 4,000 家國際客戶已擁有 da Vinci 專案，其中近 25% 營運兩台或以上系統。這些客戶正從泌尿科與癌症手術，擴展至德國的良性子宮切除術、英國與印度的膽囊切除術，以及日本的腹股溝疝氣修補術。為支援此成長，我們持續逐國建立市場進入的基礎，包括法規核准、給付（reimbursement）、訓練，以及臨床與經濟效益驗證。

Da Vinci placements outside the US increased 29% in the quarter, with broad-based global demand.

本季美國以外地區的 da Vinci 裝機量成長 29%，全球需求呈現廣泛且均衡的成長。

In Europe, Germany led the region with 20 system installations. We also placed systems in more than 20 other European countries in benign procedures led procedure growth. In Asia, Japan improved on both system placements and procedure growth for the second consecutive quarter while India had another strong quarter with 42% procedure growth, surpassing 200,000 cumulative da Vinci procedures.

在歐洲，德國以 20 台系統安裝量領先該區。我們也在另外超過 20 個歐洲國家完成系統裝機，良性手術帶動了手術量成長。在亞洲，日本連續第二季在系統裝機與手術量成長方面皆有改善；印度也再度交出強勁表現，手術量成長 42%，累計 da Vinci 手術量突破 200,000 例。

In China, the operating environment remains challenging. To support expected long-term growth in Asia, we recently announced plans for a significant new INA manufacturing facility in Penang, Malaysia. We expect this facility to begin operations in 2028. Beyond da Vinci, we are investing in Ion outside the US through multiyear country-by-country work that is foundational to broadening access and shortening the time between detection and treatment of lung cancer.

在中國，營運環境仍具挑戰。為支援亞洲預期的長期成長，我們近期宣布計畫在馬來西亞檳城興建一座重要的新 INA 製造設施，預期該設施將於 2028 年開始營運。除 da Vinci 之外，我們也透過多年、逐國推進的方式在美國以外地區投資 Ion，這是擴大可近性並縮短肺癌從偵測到治療時間的基礎性工作。

During Q3, we received reimbursement for Ion in Korea, and we expect further reimbursement actions in other geographies in the coming quarters. This quarter, we received several CE marks including Force Feedback instrumentation and cardiac procedures on da Vinci 5 as well as transvaginal gynecological procedures on SP. We now have da Vinci 5 cleared for cardiac procedures in the US, Europe, India, Japan and Korea.

第三季期間，我們在韓國取得 Ion 的給付（reimbursement），並預期未來幾季在其他地區也會有進一步的給付進展。本季我們取得多項 CE 認證（CE marks），包括 da Vinci 5 的力回饋（Force Feedback）器械與心臟手術適應症，以及 SP 的經陰道婦科手術。我們目前已在美國、歐洲、印度、日本與韓國取得 da Vinci 5 用於心臟手術的核准。

During Q3, we received FDA 510(k) clearance on da Vinci 5 for a surgeon initiated tool eject and multi-arm targeting, both of which bring incremental efficiency in surgeon autonomy to procedures. Surgeons have reported that these innovations support extending access to da Vinci surgery beyond traditional work days and hours. Recently, we submitted a capitational ultrasonic aspirator instrument for FDA 510(k) clearance for use in liver and pancreas procedures. And last week, we received FDA 510(k) clearance for an integrated version of the da Vinci 5 handheld endoscope.

第三季期間，我們取得 FDA 510(k) 對 da Vinci 5 的核准，涵蓋由外科醫師啟動的工具彈出（tool eject）與多機械臂瞄準（multi-arm targeting），兩者皆可在手術中提升外科醫師自主性並帶來額外效率。外科醫師回饋指出，這些創新有助於將 da Vinci 手術的可近性延伸至傳統工作日與工時之外。近期我們也提交一款用於肝臟與胰臟手術的囊式超音波抽吸器（capitational ultrasonic aspirator）器械，申請 FDA 510(k) 核准。上週，我們取得 FDA 510(k) 核准，通過 da Vinci 5 手持式內視鏡的整合版本。

In August, we received FDA 510(k) clearance for our foundational noncommercial next-generation flexible robotic endoscope system for use in the gastrointestinal tract. This program is early in its development, but we are encouraged by our progress and look forward to updating you as we advance. Adoption of Intuitive telepresence continues to increase with surgeons using these sessions, the share techniques and to scale training in ways that were not previously practical. Telepresent on da Vinci 5 serves as a foundation for our efforts in telesurgery where we expect several regulatory clearances in the first half of 2028. Our teams continue to develop additional digital and AI capabilities on da Vinci 5, including a voice-activated user interface and automated fourth arm control to further enhance efficiency and the user experience.

8 月，我們取得 FDA 510(k) 核准，通過我們的基礎型、非商用（noncommercial）下一代柔性機器人內視鏡系統，用於胃腸道。此專案仍處於早期開發階段，但我們對進展感到鼓舞，並期待在推進過程中向各位更新。Intuitive 遠距臨場（telepresence）的採用持續增加，外科醫師使用這些連線來分享技術並以過去不切實際的方式擴大訓練規模。da Vinci 5 上的 Telepresent 作為我們遠距手術（telesurgery）工作的基礎，我們預期在 2028 年上半年取得數項法規核准。我們的團隊也持續在 da Vinci 5 上開發更多數位與 AI 能力，包括語音啟動的使用者介面，以及自動化第四機械臂控制，以進一步提升效率與使用者體驗。

AI controlled motion and surgery has the potential to improve efficiency and outcomes, but it is early and must earn the confidence of regulators, surgeons, care teams and patients before we deploy it at scale.

AI 控制的動作與手術有潛力提升效率與結果，但目前仍處於早期階段；在我們大規模部署之前，必須先取得主管機關、外科醫師、照護團隊與病患的信任。

Looking ahead, our objective at Intuitive is to reach more patients with the best care available by combining robotics, human expertise, data and artificial intelligence so that minimally invasive care becomes more accessible and less variable.

展望未來，Intuitive 的目標是透過結合機器人技術、人類專業、數據與人工智慧，讓更多病患獲得可用的最佳照護，使微創照護更容易取得且變異性更低。

The problems we are working to address are significant and specific. Minimally invasive surgery access and adoption remain uneven around the world. Patients wait too long between detection and treatment, and the care a patient receives still varies more than it should, depending on the hospital they enter and the surgeon available that day. Over time, we are focused on significantly advancing Quintuple Aim to ensure that the broader patient journey can become more predictable, more connected and less disruptive to a patient's life.

我們正致力於解決的問題既重大也具體。全球微創手術的可及性與採用仍不均衡。患者從發現到治療之間等待時間過長，而患者所接受的照護仍因其進入的醫院以及當天可提供服務的外科醫師而出現超出合理範圍的差異。長期而言，我們專注於大幅推進「五重目標（Quintuple Aim）」的實現，以確保更廣泛的患者就醫旅程能變得更可預測、更互聯，並且對患者生活的干擾更小。

Before I pass the time to Jamie, today, we announced that we have reached an agreement, subject to court approval, with US customers who participated in the class action lawsuit on third-party remanufacturing of da Vinci instruments and third-party servicing of da Vinci systems. We believe that this no-fault settlement provides certainty for both our customers and Intuitive and maintains our ability to advance the safety, quality and security of our products.

在我把時間交給 Jamie 之前，今天我們宣布，我們已與參與「達文西（da Vinci）器械第三方再製造」及「達文西系統第三方維修」集體訴訟的美國客戶達成協議，該協議仍需法院核准。我們相信，這項無過失和解可為客戶與 Intuitive 雙方提供確定性，並維持我們推進產品安全、品質與資安的能力。

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，請他帶各位更深入了解我們的財務狀況。

Good afternoon. I'll describe our performance on a non-GAAP basis, and I'll summarize our GAAP results later in my remarks. A reconciliation between our non-GAAP and GAAP results is available on our website. The strength of our financial performance this quarter reflects the durability of our business model, driven by an expanding portfolio of differentiated products that provide clear clinical and economic value for our customers and their patients. Increasingly, our da Vinci and Ion systems and the Intuitive ecosystem are being integrated into customers' core infrastructure across a variety of procedures, sites of care and geographies, driving value for hospitals and health care providers and recurring revenue 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。非 GAAP 與 GAAP 結果之間的調節表可在我們的網站上取得。本季財務表現的強勁反映了我們商業模式的韌性，這主要由不斷擴大的差異化產品組合所驅動，該組合為客戶及其患者提供明確的臨床與經濟價值。愈來愈多地，我們的達文西（da Vinci）與 Ion 系統以及 Intuitive 生態系正被整合進客戶在多種手術、照護場域與地理區域的核心基礎設施中，為醫院與醫療服務提供者創造價值，並為 Intuitive 帶來經常性收入。

Today, we are also quantifying the instrument pricing actions we discussed in July, which we expect to reduce da Vinci I&A revenue per procedure by approximately 3% to 5% on a mixed constant basis once fully implemented. This is a deliberate choice to broaden adoption in high-volume benign procedures, and I will describe these actions in more detail shortly.

今天，我們也對 7 月討論過的器械定價措施進行量化；在全面落實後，我們預期在「混合不變基礎（mixed constant basis）」下，將使每例手術的達文西 I&A 收入約下降 3% 至 5%。這是我們為了擴大在高量良性手術中的採用而做出的刻意選擇，我稍後將更詳細說明這些措施。

Key financial highlights for the quarter are as follows: Revenue grew 22% to just over $3 billion, of which 84% was recurring revenue. Net da Vinci placements, that is placements that expand the installed base grew 40%. Non-GAAP operating margin was 42% of revenue or 41%, excluding a onetime pretax tariff refund of $28 million. Non-GAAP earnings per share grew 25% to $3 per share. Core metrics were solid in Q3.

本季主要財務重點如下：營收成長 22%，略高於 30 億美元，其中 84% 為經常性收入。達文西淨裝機量（亦即擴大裝機基礎的裝機）成長 40%。非 GAAP 營業利益率為營收的 42%；若排除一次性稅前關稅退稅 2,800 萬美元，則為 41%。非 GAAP 每股盈餘成長 25%，至每股 3 美元。第三季核心指標表現穩健。

Taking da Vinci and Ion together, total procedures grew 15%. The installed base of systems grew 13% and average system utilization increased 2%. Revenue growth of 22% against total procedure growth of 15% reflects our innovation-led strategy and growth in system placements. As da Vinci 5, SP and Ion become a greater proportion of our business, revenue growth benefits from a richer product mix higher levels of integration and incremental upgrade volumes.

將達文西與 Ion 合併來看，總手術量成長 15%。系統裝機基礎成長 13%，平均系統使用率提升 2%。在總手術量成長 15% 的情況下，營收成長 22% 反映了我們以創新為導向的策略以及系統裝機量的成長。隨著達文西 5、SP 與 Ion 在我們業務中的占比提高，營收成長將受益於更豐富的產品組合、更高程度的整合，以及額外的升級量。

Additionally, the scale and cost advantages we have built allows us to broaden our platform portfolio, which customers in more geographies and expand access by lowering the cost of da Vinci surgery. The price reductions are concentrated in high-volume benign procedures where costs may be a barrier to adoption. Those procedures particularly outside the US and in ambulatory settings where we see the largest opportunity to serve incremental patients. This is a strategic decision to reinvest a portion of the value our innovation creates in lower customer costs where they will have the greatest impact on adoption.

此外，我們所建立的規模與成本優勢，使我們得以擴大平台產品組合、服務更多地理區域的客戶，並透過降低達文西手術成本來擴大可及性。降價主要集中在高量良性手術上，因為成本可能是採用的障礙。這些手術，特別是在美國以外以及門診環境中，是我們看到服務新增患者的最大機會所在。這是一項策略性決策：將我們創新所創造價值的一部分再投資於降低客戶成本，並聚焦在對採用率影響最大的領域。

We believe broader adoption creates more long-term value than near-term revenue per procedure.

我們相信，更廣泛的採用所創造的長期價值，將高於短期的每例手術收入。

Turning to the clinical side of our business. In the US, total procedures increased 11%, reflecting 10% growth in da Vinci procedures and 29% growth in Ion procedures. US da Vinci growth of 10% was consistent with the expectations we described in July and reflects in part a 16% growth in the prior year quarter, our most difficult comparison of the year after hours procedures and benign gynecology procedures other than hysterectomy continued to lead growth. Da Vinci 5 accounted for more than one-fourth of US procedures in Q3, up from 13% a year ago and da Vinci 5 systems continue to run a utilization above our Xi base.

接著談我們業務的臨床面。在美國，總手術量增加 11%，其中達文西手術量成長 10%，Ion 手術量成長 29%。美國達文西 10% 的成長符合我們 7 月所描述的預期，部分原因在於去年同期成長 16%，是今年最具挑戰性的比較基期；在下班後手術與除子宮切除術以外的良性婦科手術持續領先帶動成長。第三季達文西 5 占美國手術量超過四分之一，高於一年前的 13%；且達文西 5 系統的使用率持續高於我們的 Xi 裝機基礎。

Looking ahead, we believe the breadth of surgeon adoption, the continued expansion of benign general surgery and a growing da Vinci 5 an SP installed base, together with procedures early in adoption, including emergent general surgery, cardiac and nipple sparing mastectomy positions us for durable US procedure growth over the long term. In the short term, we continue to monitor the impacts from lower ACA enrollment, changes to Medicaid eligibility and potential changes to 340(b). Outside the US, total and da Vinci procedures grew 20% with Europe up 20%; Asia, up 19% and rest of world geographies up 22%. In Europe, growth was led by the UK, Germany and Italy.

展望未來，我們相信外科醫師採用的廣度、良性一般外科的持續擴張，以及不斷成長的達文西 5 與 SP 裝機基礎，再加上仍處於早期採用階段的手術（包括急診一般外科、心臟手術與保留乳頭乳房切除術），使我們具備長期穩健的美國手術量成長動能。短期內，我們持續關注 ACA 投保人數下降、Medicaid 資格變更，以及 340(b) 潛在變動所帶來的影響。美國以外地區，總手術量與達文西手術量成長 20%，其中歐洲成長 20%；亞洲成長 19%；其他世界地區成長 22%。在歐洲，成長主要由英國、德國與義大利帶動。

In Asia, India and Taiwan led growth and Japan procedure growth accelerated, reflecting early signs of a response to the June reimbursement changes.

在亞洲，成長由印度與台灣領先，日本的手術量成長加速，反映出對 6 月給付變更的回應已出現早期跡象。

Procedure growth in China was roughly in line with the corporate average, reflecting lower recent capital placements. In Rest of World markets, growth was led by Canada, Australia and Brazil. Within OUS results, da Vinci adoption for benign procedures continued to accelerate, growing 41% in Q3 up from 37% in Q2 and 34% in Q1 with the strongest growth in hernia repair and cholecystectomy.

中國的手術量成長大致與公司平均水準一致，反映近期資本設備裝機量較低。在其他世界市場，成長由加拿大、澳洲與巴西帶動。在美國以外（OUS）的結果中，達文西在良性手術的採用持續加速，第三季成長 41%，高於第二季的 37% 與第一季的 34%，其中以疝氣修補與膽囊切除術的成長最為強勁。

Benign procedures represent over one-fourth of our international volume today and a significant majority of the gap between our current international volumes and the addressable opportunity, which is why they are a focus of our investments.

良性手術目前占我們國際手術量的四分之一以上，並且構成我們目前國際手術量與可服務市場機會之間差距的絕大部分，這也是我們投資聚焦於此的原因。

As we build local clinical and economic evidence, a growing number of customers in OUS markets are recognizing the clinical benefits of da Vinci for these procedures and our tiered system portfolio, including XiR together with the pricing actions I will describe shortly, provides customers the flexibility to rightsize their programs relative to local reimbursement. Third quarter SP procedure growth was 55%, reflecting accelerated growth in the US of 50% and growth of 40% in Korea, our largest SP market. We now have 487 SP systems installed across 27 countries and procedures in the 25 markets other than the US and Korea nearly doubled from Q3 last year.

隨著我們建立在地臨床與經濟證據，愈來愈多 OUS 市場的客戶正認知到達文西在這些手術上的臨床效益；而我們分層的系統產品組合（包括 XiR），再加上我稍後將說明的定價措施，讓客戶能依據當地給付情況，彈性地調整其計畫規模。第三季 SP 手術量成長 55%，反映美國成長加速至 50%，以及我們最大 SP 市場韓國成長 40%。目前我們在 27 個國家已安裝 487 套 SP 系統；在美國與韓國以外的 25 個市場，手術量較去年第三季幾乎翻倍。

Total I&A revenue in quarter three grew 18% to $1.8 billion. Da Vinci I&A revenue per procedure was approximately $1,860 compared to $1,800 last year, primarily driven by higher SP procedures and da Vinci 5 specific I&A, partially offset by procedure mix.

第三季 I&A 總收入成長 18%，至 18 億美元。每例手術的達文西 I&A 收入約為 1,860 美元，去年為 1,800 美元；主要由較高的 SP 手術量與達文西 5 特定 I&A 所驅動，但部分被手術組合所抵銷。

With respect to instrument pricing, there are two developments to describe. The first is a set of pricing actions we will implement beginning in the first half of 2027 including the expansion of our extended use program announced in May. The second is a policy-driven price reduction in China that starts to take effect next month. As Dave described earlier, customer needs are increasingly segmented and complex procedures, value comes from innovation and clinical capability in high-volume benign procedures such as cholecystectomy, and inguinal hernia repair it comes from a reliability, efficiency and economics, and that's where our pricing actions are focused.

就器械定價而言，有兩項進展需要說明。第一項是我們將自 2027 年上半年起開始實施的一系列定價措施，其中包括 5 月宣布的延長使用計畫擴大。第二項是中國由政策驅動的降價，將於下個月開始生效。如 Dave 先前所述，客戶需求正日益分眾且更為複雜：在複雜手術中，價值來自創新與臨床能力；在高量良性手術（如膽囊切除術與腹股溝疝氣修補）中，價值則來自可靠性、效率與經濟性，而我們的定價措施正聚焦於此。

Beginning in the first half of 2027, we will extend the useful lives of a subset of core endorse instruments on our fourth and fifth generation platforms and introduce volume-based pricing, both lower our customers' cost per procedure, years of investment in instrument design and manufacturing scale enable us to preserve the quality and reliability customers count on.

自 2027 年上半年起，我們將延長第四代與第五代平台上一部分核心 EndoWrist 器械的可用壽命，並導入按量計價（volume-based pricing），兩者都將降低客戶的每例手術成本。多年在器械設計與製造規模上的投資，使我們能在降低成本的同時，維持客戶所倚賴的品質與可靠性。

In the U.S., the extended use instruments require a 510(k) clearance, which is in process. In China, the charge curve policy changes we described last quarter will result in a significant reduction in our I&A prices in that market beginning in November. We continue to engage with provincial governments on implementation and to progress through the green channel process for SP and da Vinci 5.

在美國，延長使用器械需要取得 510(k) 核准，目前正在進行中。在中國，我們上季所描述的收費曲線政策變更，將使我們在該市場的 I&A 價格自 11 月起大幅下降。我們持續與各省政府就落地執行進行溝通，並推進 SP 與達文西 5 的綠色通道流程。

Taken together, we expect these pricing actions in the China price reduction to lower da Vinci I&A revenue per procedure by approximately 3% to 5% on a mixed constant basis once fully implemented, meaning holding procedure product and geographic mix constant to isolate the pricing changes themselves. For reference, that is less than the 7% we estimated when we launched our first extended use program in 2020. The accretive dynamics we described last quarter, including Force Feedback adoption, and the mix shift towards da Vinci 5 and SP are not included and will be positive contributors to I&A revenue per procedure.

綜合而言，我們預期這些定價措施與中國降價在全面落實後，將使每例手術的達文西 I&A 收入在混合不變基礎下約下降 3% 至 5%；也就是在固定手術產品與地理組合不變的前提下，以便單獨衡量定價變動本身。作為參考，這低於我們在 2020 年推出第一個延長使用計畫時所估計的 7%。我們上季所描述的增益動態（包括 Force Feedback 的採用，以及產品組合向達文西 5 與 SP 的轉移）未納入上述估算，且將對每例手術 I&A 收入帶來正向貢獻。

In terms of timing, the China reduction takes effect in the fourth quarter while the extended life instruments as part of our broader I&A pricing actions will roll out by country beginning in the first half of 2027. So the remaining impact will build progressively over 2027 rather than as a step function. Turning to clear procedure categories that we expect to be future growth drivers. Cardiac procedures grew 40% in Q3. And during the quarter, we received CE Mark for use of da Vinci 5 in cardiac procedures in Europe.

就時程而言，中國的降幅將於第四季生效；而作為我們更廣泛 I&A 定價行動一部分的延長使用壽命器械，將自 2027 年上半年起按國家逐步推出。因此，其餘影響將在 2027 年逐步累積，而非以階梯式一次到位。接著談談我們預期將成為未來成長驅動因素的明確手術類別。心臟手術在第三季成長 40%。此外，在本季期間，我們取得 CE Mark，允許在歐洲將 da Vinci 5 用於心臟手術。

We now estimate that the line of sight cardiac opportunity is between 300,000 and 400,000 procedures a year in the regions we are cleared. Separately, breast surgery grew 42%. Both remain early-stage opportunities whose near-term pace is linked to the training of surgeons and the accumulation of clinical evidence, and we are investing in both. Today, these procedure volumes are still small relative to our total volume. Turning to capital performance and starting with our da Vinci business.

我們目前估計，在我們已獲核准的地區，心臟手術可見度高的機會約為每年 30 萬至 40 萬例。另方面，乳房手術成長 42%。兩者仍屬早期機會，其短期成長速度與外科醫師訓練及臨床證據累積密切相關，我們也正在對兩者加大投資。目前，這些手術量相較於我們的總手術量仍然偏小。接著談資本端表現，先從我們的 da Vinci 業務開始。

We placed 546 da Vinci systems in quarter three, an increase of 28% compared to 427 systems in Q3 last year. Demand was broad-based across our platform portfolio, 315 da Vinci 5 systems, 87Xi,65XiR, 42 SP and 37X systems. Da Vinci 5 placements included 41 in OUS markets, up from 12 last year as da Vinci 5 becomes available in more countries. In the US, we placed 335 systems up 27% from the 263 systems placed last year, driven by an increased number of multi-system deals as customers continue to convert to da Vinci 5.

我們在第三季共裝機 546 台 da Vinci 系統，較去年第三季的 427 台成長 28%。需求在我們各平台產品組合上呈現廣泛分布：da Vinci 5 系統 315 台、87 台 Xi、65 台 XiR、42 台 SP，以及 37 台 X 系統。da Vinci 5 的裝機包含 41 台在美國以外（OUS）市場，較去年 12 台增加，反映 da Vinci 5 在更多國家上市。在美國，我們裝機 335 台，較去年裝機 263 台成長 27%，主要由多系統交易數量增加所帶動，因客戶持續轉換至 da Vinci 5。

Building on our focus on ambulatory surgery centers, we installed 18 systems at US ASCs in Q3, including 15 XiR systems. This is an early-stage multiyear effort and placements will be uneven quarter-to-quarter, but our pipeline of ASC opportunities continues to build informed by customer familiarity with XiR's capabilities and reliability and its favorable cost profile. Outside the US, we placed 211 systems, an increase of 29% compared to the 164 systems placed last year. By region, we placed 115 systems in Europe, up 83% from 63 last year, 78 in Asia, up 30% from 60 and 18 in rest of world countries compared to 41 last year.

延續我們對門診手術中心（ASC）的聚焦，我們在第三季於美國 ASC 安裝 18 台系統，其中包含 15 台 XiR 系統。這是一項處於早期、為期多年的投入，裝機量在各季之間可能不均衡；但在客戶逐步熟悉 XiR 的能力與可靠性，以及其具吸引力的成本結構後，我們的 ASC 機會管線仍持續累積。美國以外方面，我們裝機 211 台，較去年 164 台成長 29%。按區域來看，歐洲裝機 115 台，較去年 63 台成長 83%；亞洲 78 台，較去年 60 台成長 30%；世界其他地區 18 台，去年則為 41 台。

Rest of World placements tend to be uneven quarter-to-quarter. Europe's performance reflected our broadening focus with record partly placements in Portugal, Turkey and Austria and solid growth in Poland, Croatia and Romania. Across all geographies, we placed 37 X systems and 65 XiR systems with purchased ASPs of approximately $0.5 million and $1.2 million, respectively, demonstrating our ability and willingness to compete effectively across the broad spectrum of customers and their economic objectives.

世界其他地區的裝機通常在各季之間波動較大。歐洲的表現反映我們更廣泛的聚焦：葡萄牙、土耳其與奧地利的裝機部分創下紀錄，波蘭、克羅埃西亞與羅馬尼亞亦有穩健成長。跨所有地理區域，我們裝機 37 台 X 系統與 65 台 XiR 系統，其購置平均售價（ASP）分別約為 50 萬美元與 120 萬美元，展現我們有能力且願意在廣泛客群及其不同經濟目標之間有效競爭。

Over the last three years, we have entered new geographies and including Croatia, Peru, Morocco and Lithuania. And in 2027, we plan to accelerate our expansion into additional countries we do not serve today. Given increasing investments in OUS markets and planned expansion into new geographies, in January, we plan to update our estimate of the long-term opportunity in soft tissue surgery. We placed a record 42 SP systems in Q3 including 21 in the U.S. and 12 in Korea, and the installed base of SP systems increased 42% from the year ago period to 487 systems.

過去三年，我們已進入新的地理市場，包括克羅埃西亞、秘魯、摩洛哥與立陶宛。並且在 2027 年，我們計畫加速擴張至目前尚未服務的其他國家。鑑於對美國以外（OUS）市場的投資增加，以及規劃中的新地理擴張，我們預計於 1 月更新我們對軟組織手術長期機會的估計。我們在第三季創紀錄地裝機 42 台 SP 系統，其中美國 21 台、韓國 12 台；SP 系統的裝機基數較去年同期增加 42%，達到 487 台。

For our Ion platform, we placed 56 systems in Q3 compared to 50 systems last year. Given our capital performance, Quarter three systems revenue grew 30% to $769 million. The average selling price for purchased da Vinci Systems was approximately $1.6 million, flat to last year as a higher mix of Da Vinci 5 was primarily offset by a higher mix of XiRs. Quarter three service revenue increased 22% to $482 million, reflecting the increased installed base of da Vinci and Ion systems and a higher mix of da Vinci 5.

就 Ion 平台而言，我們在第三季裝機 56 台系統，去年同期為 50 台。受惠於我們的資本端表現，第三季系統營收成長 30% 至 7.69 億美元。已售出 da Vinci 系統的平均售價約為 160 萬美元，與去年持平；其中較高的 da Vinci 5 組合占比，主要被較高的 XiR 組合占比所抵銷。第三季服務營收成長 22% 至 4.82 億美元，反映 da Vinci 與 Ion 系統裝機基數增加，以及 da Vinci 5 組合占比提高。

Turning now to the rest of the P&L. Non-GAAP gross margin for the quarter was 69.9%, an increase from 68% in Q3 of last year. Q3 results included a onetime benefit of $28 million from the refund of previously paid IEEPA tariffs. Excluding this benefit, non-GAAP gross margin would have been 68.9%, an improvement of 90 basis points year-over-year. The underlying improvement primarily reflects product cost reductions and fixed overhead leverage and our engineering and operations teams continue to execute on cost reduction programs across each of our platforms.

接著看損益表（P&L）的其餘部分。本季非 GAAP 毛利率為 69.9%，高於去年第三季的 68%。第三季結果包含一次性利益 2,800 萬美元，來自先前已支付 IEEPA 關稅的退還。若排除此項利益，非 GAAP 毛利率將為 68.9%，年增 90 個基點。此一改善主要反映產品成本下降與固定間接費用的規模效益；我們的工程與營運團隊也持續在各平台推動成本降低計畫並落實執行。

Quarter three non-GAAP operating expenses increased 18% year-over-year, driven by increased variable compensation, reflecting our results, higher head count and higher prototype expenses as several programs advanced in development, R&D, again, grew faster than SG&A, a portion of the increase reflects the timing of expenses between quarters.

第三季非 GAAP 營業費用年增 18%，主要由變動薪酬增加（反映我們的業績表現）、人力增加，以及多項計畫進入開發推進階段所帶動的原型費用增加所致。研發（R&D）再次快於銷售、一般及行政（SG&A）成長；部分增幅反映費用在季度間認列時點的差異。

Given the progress our R&D teams are making and the opportunities in front of us, we will continue to prioritize incremental investment in our existing and new platform and in advancing our AI capabilities, which we believe will meaningfully differentiate our solutions and expand the number of patients we can serve. Non-GAAP other income was $75 million for the quarter compared to $83 million last quarter, reflecting lower average cash balances following our share repurchases.

鑑於我們研發團隊取得的進展以及眼前的機會，我們將持續優先增加對既有與新平台的投資，並推進我們的 AI 能力；我們相信這將顯著差異化我們的解決方案，並擴大我們可服務的病患數量。本季非 GAAP 其他收益為 7,500 萬美元，較上季的 8,300 萬美元下降，反映在股份回購後平均現金餘額較低。

Our non-GAAP effective tax rate for the quarter -- for quarter three was 21.4%, consistent with our expectations. Now turning to our GAAP results. GAAP net income for the quarter was $523 million or $1.49 per share compared to $704 million or $1.95 per share in Q3 of last year. Our GAAP results reflect the $450 million litigation settlement that Dave described earlier. This settlement is subject to court approval, and we do not expect that decision until next year.

本季（第三季）非 GAAP 有效稅率為 21.4%，符合我們的預期。接著看 GAAP 結果。本季 GAAP 淨利為 5.23 億美元，或每股 1.49 美元；相較之下，去年第三季為 7.04 億美元，或每股 1.95 美元。我們的 GAAP 結果反映 Dave 先前提到的 4.5 億美元訴訟和解金。此和解仍需法院核准，我們預期要到明年才會有該項裁定。

We ended the quarter with $6.8 billion in cash and investments, down from $8.6 billion last quarter. Cash generated from operating activities was more than offset by stock repurchases of $2.9 billion at an average price of $377 per share and capital expenditures of $113 million.

本季末我們持有的現金與投資為 68 億美元，較上季的 86 億美元下降。營運活動產生的現金流入，已被股票回購所抵銷：我們以每股平均 377 美元回購 29 億美元股票，另有資本支出 1.13 億美元。

With that, I'll turn it over to Jamie to discuss recent clinical publications.

接下來，我把時間交給 Jamie，請他談談近期的臨床發表。

Thank you, Jamie. It's a pleasure to speak with you this afternoon. As we routinely do on these calls, I'd like to share with you recently published peer review literature that we found to be notable. In addition to the specific data highlighted on this call, we encourage you to consider this data alongside the wider body of evidence detailing these topics and others and published scientific studies over the years. On our Q4 2024 earnings call, we described the landmark COMPARE study a med analysis where the authors reported multiple benefits for the da Vinci approach when compared to alternative minimally invasive or open approaches in commonly performed oncologic procedures.

謝謝你，Jamie。很高興在今天下午與各位交流。依照我們在這類電話會議上的慣例，我想與各位分享我們認為值得關注的近期同儕審查文獻。除了本次電話會議中特別強調的數據外，我們也鼓勵各位將這些數據與多年來已發表、涵蓋這些主題及其他主題的更廣泛證據與科學研究一併考量。在我們 2024 年第四季財報電話會議上，我們曾介紹具里程碑意義的 COMPARE 研究（統合分析），作者報告指出：在常見的腫瘤手術中，與其他微創或開腹方式相比，採用 da Vinci 方式具有多項益處。

Last month, Dr. Thomas Shen and colleagues from the Massachusetts General Brigham and the University of Virginia School of Medicine in collaboration with researchers from Intuitive published the benign COMPARE study, comparing perioperative outcomes of benign minimally invasive, laparoscopic, da Vinci robotic and open procedures, a systematic review and meta-analysis of evidence in of surgery open. This benign COMPARE study looked primarily at standard perioperative and 30-day clinical outcomes of 13 high-volume benign procedures across general surgery, gynecology, urology and bariatrics, including, but not limited to, benign hysterectomy, cholecystectomy, benign colon and various hernia repairs.

上個月，麻省總醫院布萊根醫療體系（Massachusetts General Brigham）與維吉尼亞大學醫學院（University of Virginia School of Medicine）的 Thomas Shen 醫師及其同事，並與 Intuitive 的研究人員合作，發表了良性 COMPARE 研究，透過系統性回顧與統合分析，比較良性疾病的微創手術之圍手術期結果，包括腹腔鏡、da Vinci 機器人以及開腹手術。此良性 COMPARE 研究主要檢視 13 項高量良性手術在一般外科、婦科、泌尿科與減重手術領域的標準圍手術期與 30 天臨床結果，包含但不限於良性子宮切除術、膽囊切除術、良性結腸手術以及各類疝氣修補。

In many of these procedures, conventional laparoscopy has long been the standard of care. This met analysis included data from 366 studies across 32 countries, published between 2010 and 2024 and included randomized controlled trials, prospective and retrospective cohort studies and large real-world database studies.

在上述許多手術中，傳統腹腔鏡長期以來一直是照護標準。此統合分析納入 32 個國家、2010 年至 2024 年間發表的 366 篇研究，包含隨機對照試驗、前瞻性與回溯性隊列研究，以及大型真實世界資料庫研究。

In total, the analysis covered roughly 1.5 million da Vinci patients, 10.7 million laparoscopic patients and 1.7 million open patients. Results identified lower conversions to open surgery as the most clinically important and consistent finding. Compared with laparoscopy, da Vinci procedures were associated with 54% lower odds of conversion with significant reductions observed in benign hysterectomy, ventral inguinal hernia repair, myomectomy, cholecystectomy and benign colon surgery.

整體而言，該分析涵蓋約 150 萬名 da Vinci 病患、1,070 萬名腹腔鏡病患，以及 170 萬名開腹手術病患。結果顯示，轉為開腹手術的比例較低，是臨床上最重要且最一致的發現。與腹腔鏡相比，da Vinci 手術與轉開腹的勝算降低 54% 相關，且在良性子宮切除術、腹壁與腹股溝疝氣修補、子宮肌瘤切除術、膽囊切除術及良性結腸手術中觀察到顯著下降。

As the authors noted, conversion of open surgery is an important intraoperative event associated with increased morbidity and prolonged hospitalization, which is negative implications for patients and health care systems. Da Vinci patients also had 13% lower odds of blood transfusion and a shorter length of stay than laparoscopic patients, with the largest reductions in benign colon surgery, adrenalectomy and benign hysterectomy.

如作者所指出，轉為開腹手術是一項重要的術中事件，與較高的併發症風險與住院時間延長相關，對病患與醫療體系皆有負面影響。相較於腹腔鏡病患，da Vinci 病患的輸血勝算亦降低 13%，且住院天數更短；其中降幅最大者出現在良性結腸手術、腎上腺切除術與良性子宮切除術。

Rates of 30-day complications, readmissions and mortality were comparable between da Vinci and laparoscopy, while average da Vinci operative time were about 24 minutes longer. Compared with open surgery, Da Vinci is associated with larger differences across nearly every studied measure, including 46% lower odds of postoperative complications and hospital stays that were nearly two days shorter. These differences are positive implications for patients and health care systems.

達文西與腹腔鏡手術在30天併發症、再入院與死亡率方面的比率相當，但達文西的平均手術時間約長24分鐘。與開腹手術相比，達文西在幾乎所有研究衡量指標上都呈現更大的差異，包括術後併發症機率降低46%，且住院天數縮短近兩天。這些差異對病患與醫療照護體系都具有正面意涵。

The authors concluded that da Vinci was associated with fewer conversions, less pain and faster recovery compared with open and laparoscopic surgery supporting its effectiveness for benign indications. From my perspective as a surgeon, this large-scale analysis of millions of patients provides meaningful data on the expanding use of da Vinci surgery beyond oncology. These clinical correlations point toward a compelling value proposition for the use of da Vinci in these commonly performed high-volume benign procedures.

作者總結指出，相較於開腹與腹腔鏡手術，達文西與較少的轉換手術、較少疼痛及更快復原相關，支持其在良性適應症上的有效性。以我作為外科醫師的觀點，這項涵蓋數百萬名病患的大規模分析，為達文西手術在腫瘤學以外的擴大使用提供了具意義的數據。這些臨床相關性指向一個具吸引力的價值主張：在這些常見、手術量高的良性手術中使用達文西。

With that, I'll pass the time over to Dan.

接下來我把時間交給Dan。

Thank you, Jamie. Our updated financial outlook for 2026 is as follows: Starting with da Vinci procedures. In July, we forecast full year 2026 procedure growth to be within a range of 13.5% to 15.5%. And with an expectation to be closer to the midpoint. We are narrowing our forecast to be within a range of 14% to 15%, with an expectation to be closer to the midpoint.

謝謝你，Jamie。我們對2026年的最新財務展望如下：先從達文西手術量（procedures）談起。7月時，我們預估2026全年手術量成長將落在13.5%到15.5%的區間，且預期更接近中點。我們現將預測區間收斂至14%到15%，並預期更接近中點。

Our range continues to consider the impact of changes to ACA premium subsidies on patient behavior in the U.S. as well as tender volumes and competitive intensity in China among other factors.

我們的區間仍持續納入多項因素的影響，包括美國ACA保費補貼變動對病患行為的影響，以及中國的招標量與競爭強度等其他因素。

Turning to gross profit. On our last call, we forecast non-GAAP gross profit margin to be within a range of 68% and 69% of revenue, including an estimated 100 basis point impact from tariffs as well as related refunds. We are updating our estimate to be within a range of 68.7% and 69.3% of revenue, including an estimated 90 basis points impact from tariffs as well as related refunds. Factors impacting the range include faster growth of newer products in da Vinci 5 and Ion, partially offset by product cost reductions. We continue to forecast higher input costs in certain areas like freight and semiconductor memory.

接著談毛利。上次電話會議中，我們預估非GAAP毛利率將落在營收的68%到69%之間，其中包含關稅及相關退費（refunds）約100個基點的影響。我們現更新估計為營收的68.7%到69.3%之間，其中包含關稅及相關退費約90個基點的影響。影響區間的因素包括達文西5與Ion等較新產品的成長更快，部分被產品成本降低所抵銷。我們仍預期某些領域的投入成本較高，例如運輸與半導體記憶體。

Our actual non-GAAP gross profit margin will vary depending largely on product, regional and trade-in mix and pricing. For operating expenses, we continue to expect 2026 non-GAAP operating expense growth of 11% to 13%.

我們實際的非GAAP毛利率將主要取決於產品、地區與以舊換新（trade-in）組合以及定價。就營業費用而言，我們仍預期2026年非GAAP營業費用成長為11%到13%。

As a reminder, 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. Throughout the year and in Q3, in particular, we grew R&D at a rate above SG&A. We expect that trend to continue over the remainder of the year. We now estimate noncash stock compensation expense between $860 million and $870 million.

提醒一下，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。全年期間，尤其在第三季，我們以高於SG&A的速度增加研發（R&D）投入。我們預期這個趨勢在今年剩餘期間將持續。我們目前估計非現金股票薪酬費用介於8.60億至8.70億美元。

We now forecast non-GAAP other income, which is comprised mostly of interest income, of between $300 million and $310 million, due primarily to the impact of share repurchase activity in Q3.

我們目前預估非GAAP其他收入（主要由利息收入構成）介於3.00億至3.10億美元，主要是因第三季股票回購活動的影響。

With regard to income tax, we expect our non-GAAP effective tax rate in Q4 to be 22%, plus or minus 50 basis points. That concludes our prepared remarks. As we open the line to your 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，我們預期第四季非GAAP有效稅率為22%，上下浮動50個基點。以上為我們的準備發言。接下來開放提問時，我們請各位每人僅提一個問題，以便我們能回答盡可能多位分析師。

(Operator Instructions)

（接線員指示）

Lawrence Biegelsen, Wells Fargo.

Lawrence Biegelsen，富國銀行（Wells Fargo）。

I'll just keep it at one here, focused on US procedure growth. So Jamie or Dave, US da Vinci procedure growth was stable on a stack two-year basis. But the 10% growth in the quarter was the lowest we've seen since COVID.

我這裡就只問一個，聚焦在美國手術量成長。所以Jamie或Dave，美國達文西手術量成長以兩年疊加（stack）基礎來看是穩定的。但本季10%的成長是我們自COVID以來看到的最低水準。

Shipments were strong and it sounds like you have a ton of innovation and the extended use program is coming. So are we seeing a temporary lull in US da Vinci procedure growth and the innovations and the pricing actions will help accelerate US da Vinci procedures as soon as next year? I'd love any color on that.

出貨量很強，而且聽起來你們有大量創新，延長使用（extended use）計畫也即將推出。所以我們看到的是美國達文西手術量成長的短暫放緩嗎？而這些創新與定價措施是否最快在明年就能幫助美國達文西手術量加速？希望你們能提供一些看法。

Larry, this is Dave, and I appreciate the question. Let me frame up the US opportunity a bit and then Jamie can dive in with some specifics. So for me, the US opportunity really breaks down into two areas.

Larry，我是Dave，謝謝你的問題。讓我先把美國的機會稍微框架一下，接著Jamie可以補充一些細節。對我而言，美國的機會主要可分成兩個面向。

The first is about the addressable opportunity right in front of us that we're going after on a daily basis and the second is a longer-term opportunity to expand the indications that da Vinci can have an impact in. And so if we look at the first part, for the procedures that we know where the US procedure opportunity is significant, particularly in benign general surgery. When I'm talking to customers, in order for them to adopt robotics across the benign general surgery areas as well as other benign indications. They really want to see how it compares to the alternatives where laparoscopy as well in trends like Jamie described and against open surgery sometimes.

第一個是我們眼前、每天都在積極推進的可服務市場機會；第二個是較長期的機會，也就是擴大達文西能產生影響的適應症範圍。先看第一部分：就我們已知美國手術量機會很大的領域而言，特別是在良性一般外科。當我與客戶交流時，若要他們在良性一般外科以及其他良性適應症中採用機器人手術，他們真的想看到它與替代方案相比如何——包括如Jamie所描述的腹腔鏡趨勢，以及有時與開腹手術的比較。

They want to see how they're doing clinically, how is it doing economically and that is something we've invested in for a long time. We've worked hard to provide customers the data that they need from Intuitive, combine it with their data so they can understand how those modalities are doing against each other.

他們想了解臨床表現如何、經濟效益如何，而這也是我們長期投入的方向。我們一直努力提供客戶所需的Intuitive數據，並與他們自身的數據結合，讓他們能理解這些手術方式彼此之間的表現差異。

In Q3, I had the opportunity actually to meet with about five large IDN customers. And when I was meeting with them, what I'm seeing is now they are developing their own real-time dashboards, looking at the economics and the clinical outcomes relative of da Vinci relative to laparoscopy and open. And I think that's a shift that I believe is worth noting because it's moving from anecdotes and sort of episodic data that they may look at once a year, and they're looking at it on a routine basis.

在第三季，我實際上有機會與大約五家大型IDN客戶會面。與他們會面時，我看到他們現在正在建立自己的即時儀表板，檢視達文西相對於腹腔鏡與開腹手術的經濟性與臨床結果。我認為這是一個值得注意的轉變，因為它正從軼事與零星資料（可能一年看一次）轉為例行性地持續檢視。

And so when I saw those data and talk to those customers, robotics is comparing favorably as compared to the other modalities. And so you take that, that sort of foundation of data. You get directional data from studies like COMPARE but you get the actual data in our customers' hands through these interactions like I'm describing. Combine that with our portfolio, the rest of our ecosystem with the commercial performance of our capital expanding capacity with the focus of our commercial teams broadly, clinical service, training and in the pricing actions that Jamie described. And I think that's the foundation of durable US procedure growth into that significant opportunity.

因此，當我看到那些數據並與客戶討論時，機器人手術相較其他方式的比較結果是有利的。你把這種數據基礎納入考量：像COMPARE這類研究提供方向性的資料，但透過我所描述的互動，我們也把實際數據交到客戶手上。再結合我們的產品組合、其餘生態系統、資本設備的商業表現以擴充產能、商業團隊的廣泛聚焦、臨床服務、訓練，以及Jamie所提到的定價措施。我認為這些構成了在龐大機會之下，美國手術量能夠持續成長的基礎。

Larry, I might just add. The way we think about it, the unit opportunity in front of us in the US is significant. I understand investor attention on the US kind of growth over the last several quarters.

Larry，我再補充一下。我們的看法是，美國眼前的裝機（unit）機會非常可觀。我理解投資人過去幾季對美國成長的關注。

There's four things that we're focused on that we're driving, maybe just to add some color. First is adding capacity, particularly to support the benign general surgery growth. And what you saw in this quarter was US net placements increased 41% and that's a little bit of a change from what we've seen in more recent quarters. Second thing is, as we've talked about, we've more recently added a focus on the ASC opportunity.

我們聚焦並推動的有四件事，提供一些補充說明。第一是增加產能，特別是為了支援良性一般外科的成長。本季你們看到的是，美國淨裝機（net placements）增加了41%，這與近幾季的情況相比有些不同。第二件事是，如同我們談過的，我們近期更聚焦於ASC的機會。

If you look at the number of systems we've placed in ASCs last 2 quarters combined, that's more than we've placed in ASCs in almost the last three years and we think that continues to be an attractive opportunity for us.

如果你看我們在過去兩季合計放置在ASC的系統數量，已經超過我們在過去將近三年放置在ASC的數量，而我們認為這仍是對我們很有吸引力的機會。

And those first two areas are supported by both the I&A pricing actions that we've described and our tiered portfolio if you want to invest in da Vinci 5 in the hospital with its capability with the capability that will only grow every year as we do software updates and extend the ecosystem, that's a good investment. But our tier portfolio offers those customers an XiR in HOPD or an ASC. The other two areas that we're driving, we're focused on over longer horizons, three is to kind of progressed cardiac and breast along the early-stage adoption curve it's in, and that requires both investment and execution.

而前兩個領域同時受到我們所描述的I&A定價措施，以及我們分層（tiered）的產品組合所支援：如果你想在醫院投資達文西5，憑藉其能力——而且隨著我們進行軟體更新並延伸生態系統，其能力每年都會持續增強——那是一項好的投資。但我們的分層產品組合也讓客戶可在HOPD或ASC選擇XiR。另兩個我們推動的領域，則是著眼於更長的時間跨度：第三是讓心臟與乳房手術沿著目前所處的早期採用曲線持續推進，這需要投資與執行。

And then the fourth is what Dave described. We have programs today in R&D that have the potential to add new indications in the US and elsewhere, and those are moving along and progressing and those are quite interesting. Again, they're on longer-term horizons.

第四則是Dave所描述的。我們目前在研發（R&D）上有一些計畫，具備在美國及其他地區新增適應症的潛力，這些計畫正在推進中，也相當有意思。不過同樣地，它們屬於較長期的時間範圍。

Robert Marcus, JPMorgan.

Robert Marcus，摩根大通（JPMorgan）。

Great. I want to follow up on the extended use, and it's great. I appreciate the 3% to 5% headwind over the total enactment period both between that and the China pricing. How do we think about necessarily the time lines? Will there be any stocking ahead of the implementation of this?

很好。我想追問延長使用（extended use），這很棒。我也感謝你們提到在整個生效期間，延長使用加上中國定價合計會帶來3%到5%的逆風。我們該如何看待時間線？在實施之前，會不會出現提前備貨（stocking）的情況？

And how do we think about it down the P&L both from a gross and operating margin. if I could add 1 more there. Last program, you did have a price elasticity benefit on volumes. How are you thinking about volumes in response to the pricing actions.

那麼我們如何在損益表（P&L）上思考這件事，無論是從毛利率還是營業利潤率的角度？如果我可以再補充一點：上一個方案中，你們確實在出貨量上受惠於價格彈性。你們如何看待在這些定價行動之後，出貨量的反應？

You'll probably have to remind me of your questions, Robbie, as I go along. But there may well be a little bit of stocking kind of customer ordering patent volatility across the period in which we launch. I wouldn't expect that at this point to be significant, and obviously, we'll call that out as that occurs. In terms of the impact on gross margin, I would say that it would be a modest impact on gross margin that will look across '27 to offset with the cost reduction programs that we have in play. And therefore, whatever impact there is on gross margin can fall through to operating margin, but I expect that to be smaller and offset at some point in the year.

Robbie，我可能得在我回答的過程中請你提醒我你的問題。不過在我們推出的那段期間，客戶下單可能會出現一些備貨性質的波動、以及訂單節奏的波動。我目前不預期這會很顯著；當然，一旦發生，我們也會明確說明。就對毛利率的影響而言，我會說這對毛利率的影響屬於溫和，並且會在 2027 年期間，透過我們正在推進的成本降低計畫來抵消。因此，毛利率的任何影響可能會傳導到營業利潤率，但我預期幅度會更小，並在年度中的某個時間點被抵消。

With respect to elasticity, I would just say we believe that these actions will drive elasticity. That's the underlying intention because where we're applying them to the greatest extent is where there are cost sensitivity or cost as a barrier to adoption. And the benefit for those high-volume benign procedures is quite a bit greater than the blended 3% to 5%. Obviously, that's our intention. We have looked back at the first EUP program that we did in 2020 on our data supports the existence of elasticity, and we have confidence that, that implementation was was successful.

關於彈性，我只想說，我們相信這些行動會帶動價格彈性。這正是其根本目的，因為我們最主要施行的地方，是那些對成本敏感、或成本成為採用障礙的領域。而對於那些高量、良性（benign）手術，其效益會遠高於綜合後的 3% 到 5%。顯然，這就是我們的意圖。我們回頭檢視了 2020 年我們做的第一個 EUP 計畫，我們的數據支持彈性確實存在，而且我們對當時的落地執行是成功的有信心。

That, of course, is looking at our own data, but also gaining feedback from our customers. And so over time, as we address economics, when you think about how we frame our line of sight opportunities. As we address economics and bring costs down, we expect to increase the addressable market for Intuitive. And so those are the underlying intents. But I think we have relative confidence in the elasticity.

當然，那是基於我們自己的數據，同時也結合了客戶的回饋。因此，隨著時間推進，當我們處理經濟性問題時——你可以想想我們如何界定我們可見的機會（line of sight opportunities）——當我們改善經濟性並降低成本時，我們預期 Intuitive 的可服務市場（addressable market）會擴大。這些就是背後的核心意圖。不過我認為，我們對價格彈性是相對有信心的。

That doesn't obviously turn on immediately in 2027, but over time.

這顯然不會在 2027 年立刻就完全顯現，但會隨著時間逐步發生。

I know that pricing is a focus of the question as it relates to benign procedures and addressable opportunity, but I also -- I want to make sure that we are recognizing the value of our entire portfolio. And so da Vinci 5 and its innovation, we're pricing such that innovation is correlated to the value it creates. And so we have that thrust and that focus in our portfolio while actively doing the lowering of costs that Jamie described because that's where broader access matters. And so it's not a trade-off. It's our strategy to really expand our addressable market and serve more patients around the globe, and we're confident that it's going to make a difference as we look forward.

我知道，當談到良性手術與可服務機會時，定價是問題的焦點；但我也——我想確保我們同時認知到我們整體產品組合的價值。因此，da Vinci 5 及其創新，我們的定價方式是讓創新與其所創造的價值相匹配。因此，在我們的產品組合中，我們一方面維持這樣的推進方向與聚焦，同時也積極推動 Jamie 所描述的降成本，因為那是更廣泛可近性（broader access）真正重要的地方。所以這不是取捨，而是我們的策略：真正擴大我們的可服務市場，為全球更多病患提供服務；我們有信心，展望未來，這會帶來實質差異。

Travis Steed, Bank of America.

Travis Steed，美國銀行（Bank of America）。

Maybe just a pipeline question, especially with this quarter being probably the biggest quarterly buyback you've ever done. So congrats on that. There's a lot of focus on US procedures. And one of the things I've thought about is there are things that in the pipeline that can add revenue for procedure.

也許問一個產品管線（pipeline）相關的問題，特別是本季可能是你們做過最大的單季庫藏股回購。所以恭喜。市場非常關注美國的手術量。而我一直在想的是，管線中是否有一些項目可以提高每台手術（per procedure）的收入。

And as we're looking at the pipeline, I know there's anything you'd like to point to or what could be coming on AI use cases or imaging things or even anything that's interesting on the GI robot or lung cancer that could be helpful for investors at this point.

在看管線時，我想知道你們是否有什麼特別想指出的，或是接下來可能會推出什麼——例如 AI 的使用情境、影像相關的東西，甚至是 GI 機器人或肺癌方面有什麼有趣的進展，對投資人此刻可能有幫助？

Yeah. Thanks, Travis. It's a great point and one that we've described a couple of times in previous quarters. Starting maybe with Ion actually, the two active development programs that we have that are progressing strongly. One is around a Rose system, and that's on-site cytology so that the physician and the care team can understand if they the cells may be cancer or not real time.

是的，謝謝你，Travis。這是個很好的觀點，我們在前幾季也描述過幾次。也許先從 Ion 談起：我們目前有兩個正在積極開發、且進展很強勁的計畫。第一個是 Rose 系統，這是院內即時細胞學（on-site cytology），讓醫師與照護團隊能即時了解細胞是否可能為癌症。

And so they can get better answers than they do today and do it more quickly. And the second program there is endobronchial ultrasound integrated into the ION platform. And so that allows us to do staging. Both of those should be in bring value to the Ion program, speed up at the time, we think from detection to diagnosis and ultimately treatment, but will be accretive to the revenue per case on the Ion platform.

因此，他們能比現在獲得更好的答案，而且更快。第二個計畫是將支氣管內超音波（endobronchial ultrasound）整合到 ION 平台中。這讓我們能進行分期（staging）。這兩項都應能為 Ion 計畫帶來價值，縮短我們認為從偵測到診斷、最終到治療的時間，同時也會提高 Ion 平台每例（per case）的收入貢獻。

You mentioned Vision is another area that we're very excited about when it comes to da Vinci. And so we have multiple programs going there with advanced visualization technology around hyperspectral imaging, fluorescent molecules and some AI features that we do think will bring that incremental value, and we're going to be able to add some revenue per procedure as a result. And so it is exactly my point of this is where innovation can bring outsized value to the customer and then bring some accretive revenue on a per procedure basis to Intuitive and we have that across our portfolio.

你提到 Vision，這也是我們在 da Vinci 上非常興奮的另一個領域。因此我們在那裡有多個計畫，包含以高光譜影像（hyperspectral imaging）、螢光分子（fluorescent molecules）為核心的先進可視化技術，以及一些我們認為能帶來增量價值的 AI 功能；因此我們也將能在每台手術上增加一些收入。這正好呼應我的重點：創新可以為客戶帶來超額價值，並在每台手術的基礎上為 Intuitive 帶來一些增益性（accretive）的收入，而我們在整個產品組合中都有這樣的布局。

Rick Wise, Stifel.

Rick Wise，Stifel。

Another question about the ASC opportunity. Can you talk about your progress and what's next? And maybe frame the contribution to future growth and how these next-generation extended use approach maybe impacts the opportunity. But related to that, maybe you can touch on now just with the Stryker CMR news, we have two competitors likely offering modular systems in the ASC. How are the competitive dynamics play in there?

再問一個關於 ASC 機會的問題。你能談談你們的進展以及下一步嗎？也許也請你框架一下它對未來成長的貢獻，以及這些下一代延長使用（extended use）方法可能如何影響這個機會。另外相關地，或許你也能談談：現在隨著 Stryker CMR 的消息，我們可能會有兩個競爭對手在 ASC 提供模組化系統。那裡的競爭動態會如何發展？

Does Intuitive need a modular offering of some kind? And just help us think through those various points.

Intuitive 是否需要某種模組化的產品？也請幫我們把這些點串起來思考。

I appreciate the question, Rick. And maybe I'll break it down into kind of two parts because one is around the ASCs. And again, we've described this before. If you talk to ASC customers, what they're asking for is not a particular architecture. What they're asking for is something that can be repeatable, easy to learn, easy to use, reliable and serve the procedures that they're targeting for the ASCs in a very consistent away because it's about volume and it's about getting patients out in a repeatable noble way.

謝謝你的問題，Rick。我可能把它拆成兩個部分來回答，其中一部分是關於 ASC。再一次，我們之前也描述過：如果你去跟 ASC 客戶談，他們要的不是某一種特定架構。他們要的是可重複、容易學、容易用、可靠，並且能以非常一致的方式服務他們在 ASC 鎖定的手術，因為那裡的核心是量（volume），以及以可重複、可預期的方式讓病患出院。

So if you use that as the problem to be solved in the ASC environment, now you can start saying, what kind of technology matches that invest serves that problem or solve the problem to be solved. And so if you look at how might customers look at robotic competitors and make a choice. And for me, it comes down to basically three areas.

所以，如果你把這當作 ASC 環境要解決的問題，你就可以開始問：什麼樣的技術最符合、最能服務這個要解決的問題？因此，當你看客戶如何評估不同的手術機器人競品並做出選擇，對我而言，基本上可歸結為三個面向。

One is it's got to be the right architecture for the ASC. It's got to be have the right portfolio of systems so that it can be priced in a manner that fits their economics. You got to have that broader ecosystem because we know that's what leads to good outcomes. And then you have to have the supporting infrastructure. All the teams and capabilities that are required to make sure a program runs at pace.

第一，它必須是適合 ASC 的正確架構。第二，它必須有合適的系統產品組合，才能以符合其經濟性的方式定價。第三，你必須有更廣泛的生態系，因為我們知道那才會帶來良好結果。然後你還必須具備支援性基礎設施——所有必要的團隊與能力——以確保一個計畫能以應有的速度推進。

And so customers understand this.

而客戶是理解這些的。

They're now looking across potentially multiple solutions, and they're they understand that it takes more than a robot. It does take an ecosystem, but the robot is front and center. And so you asked about the architectures. And if I look back over our 30 years, we have engineered and tested just about every form of architecture there is out there.

他們現在可能在多種解決方案之間做比較，而且他們也理解，這不只是需要一台機器人；確實需要一個生態系，但機器人仍然是核心。你問到架構。如果我回顧我們 30 年來的經驗，我們幾乎把市面上各種形式的架構都設計過、測試過。

And that includes modular, table-mounted and other types of robots. We brought in customers to assess them and to evaluate them side-by-side with us. And we continue to believe that a cart-based architecture consistent with da Vinci is the best option. It's the best balance of capability and usability no matter where you look, and it might be in the main OR or in the ASC environment. And so if you we believe that it is not required to have a modular type of architecture to serve the needs of the customer in these segments where they are doing benign procedures and maybe increasingly complex procedures over time.

其中包括模組化、手術台安裝式（table-mounted）以及其他類型的機器人。我們也邀請客戶來評估，並與我們的系統並排比較。我們仍然相信，與 da Vinci 一致的推車式（cart-based）架構是最佳選擇；無論你看的是哪個場景，它在能力與易用性之間提供最佳平衡，可能是在主要手術室（main OR）或 ASC 環境。因此，我們認為，為了滿足客戶在這些區隔（他們在做良性手術，且可能隨時間推進做更複雜手術）的需求，並不需要模組化架構。

And so I think we are well positioned with our portfolio, the pricing that Jamie described to serve the needs of our customers there, and we look forward to earning their first choice.

因此，我認為我們在產品組合上、以及 Jamie 所描述的定價上，都已具備良好定位來滿足那裡客戶的需求，我們也期待贏得他們的首選。

And Rick, maybe just some framing in terms of numbers. These are a bit lagged, but we think a little under 10% of the US soft tissue surgery business is in ASCs today that's growing. About 70% of those volumes are ASCs associated with or affiliated with existing IDNs. So they are customers and surgeons that we know.

Rick，也許我再用一些數字來做框架說明。這些數據有些滯後，但我們認為目前美國軟組織手術業務中，略低於 10% 是在 ASC 進行，而且這個比例正在成長。其中約 70% 的量是在與既有 IDN 相關或隸屬的 ASC，因此那些是我們熟悉的客戶與外科醫師。

That's our initial focus our penetration of kind of all of the ASC opportunity is low in the first quarter. And that's why now that we have XiR and we have the supply XiR, it's a focus of ours.

這是我們最初的聚焦方向。我們在第一季對整體 ASC 機會的滲透率仍然偏低。也正因如此，現在我們有了 XiR，也有了 XiR 的供應，這成為我們的重點之一。

Adam Maeder, Piper Sandler.

Adam Maeder，Piper Sandler。

I wanted to ask about UP 2.0 and specifically one of the offsets the potential offsets for sensing instruments. And if I heard directly, it doesn't sound like there's any offset assumed in the 300 to 500 basis point headwind for these. So I would love just any update on for sensing instrumentation, where is adoption today? What percentage of procedures are being done with for sensing? And how do you think it could evolve over time?

我想問 UP 2.0，特別是其中一個可能的抵消項：力回饋（force sensing）器械。如果我理解得沒錯，聽起來在這些器械上，300 到 500 個基點的不利因素（headwind）並沒有假設任何抵消。我很想請你更新一下：目前力回饋器械的採用情況如何？現在有多少比例的手術是在使用力回饋進行？以及你認為它隨時間可能如何演進？

And would also just appreciate any color in terms of kind of primary use cases for the for sensing technology.

也想請您補充一些背景說明，關於感測技術的主要使用情境。

Adam, I appreciate the question. Maybe I'll start with a quick story that just happened. And so a few weeks ago, we hosted the surgeon event here where the early surgeons that were involved with da Vinci came to our campus and we had a nice event. I had the opportunity to meet with a very well-versed prostatectomy surgeon who has done over 10,000 cases, and he showed me his results that were a comparator between Xi and da Vinci 5 and he was showing the return of potency in this case from time zero through 12 months. And so and you watch it gradually increase from about 50% or so out of the gate to above about 80%.

Adam，謝謝你的提問。我先分享一個剛發生的小故事。幾週前，我們在這裡舉辦了一場外科醫師活動，早期參與達文西（da Vinci）的外科醫師來到我們園區，我們辦了一場很棒的活動。我有機會與一位非常資深的前列腺切除術醫師交流，他已完成超過 10,000 例手術；他向我展示了他在 Xi 與 da Vinci 5 之間的對照結果，並展示了此案例中從時間零點到 12 個月的勃起功能恢復情況。你可以看到曲線從一開始大約 50% 左右，逐步上升到 80% 以上。

And he has very good data, he's one of the world's surgeons. And then he laid his recent da Vinci 5 experience on top of it and have moved the entire curve up by about 10 points.

他的數據非常扎實，他也是世界頂尖的外科醫師之一。接著他把近期的 da Vinci 5 經驗疊加上去，整條曲線大約上移了 10 個百分點。

And so -- and I asked him why, and he has attributed to that to Force Feedback and the ability to sense those forces and be that much gentler around the nurse sparing portion of the prostatectomy, which led to those results. And so that's maybe a little bit of color about how Force Feedback can make a difference in outcomes and even with surgeons who are very, very high up in their use of da Vinci.

所以——我問他原因，他把這歸因於力回饋（Force Feedback）以及感知這些力量的能力，讓他在前列腺切除術中神經保留（nerve sparing）的部分能更溫和地操作，進而帶來這些結果。這或許就是一些背景，說明力回饋如何在結果上產生差異，即使對於非常、非常熟練使用達文西的外科醫師也是如此。

In terms of adoption this quarter, about 8% of da Vinci 5 cases involve Force Feedback that's kind of been kind of a slow increase from where we've started. We only got full full supply later in the quarter. So that affected the 8%. I would say this, our ambitions for that number to be that penetration number to be quite a bit higher. Obviously, to some extent, that requires us to create the evidence that supports the value propositions.

就本季的採用情況而言，大約 8% 的 da Vinci 5 手術案例使用了力回饋；這個比例相較我們起步時算是緩慢上升。我們在本季較晚才取得完整供應，因此影響了這個 8%。我想說的是，我們對這個滲透率的企圖心是希望能高得多。當然，在某種程度上，這需要我們建立能支持其價值主張的證據。

The teams are working hard on that, and we have our eye very close in terms of how that gets adopted and the actual value of using the force feedback instruments is well understood. I would just say there are other offsets as we described. The SP I&A per procedure is quite a bit higher than multiple. And obviously, those procedures are growing at a much higher rate. And on da Vinci 5, because of the integrated insufflation, when integrated insulation is used, which is about 85% of the time, there's an additional about $100 per procedure for the tube sets that connect to the insulator.

團隊正為此努力，我們也非常密切關注其採用進展，而且使用力回饋器械的實際價值是被充分理解的。我也想補充，我們先前提到還有其他抵銷因素。SP 的每例 I&A 明顯高於 Multi，而且這些手術的成長速度也快得多。另外在 da Vinci 5 上，由於整合式充氣（integrated insufflation），當使用整合式充氣時（約 85% 的時間），連接到充氣器的管路組（tube sets）每例還會增加約 100 美元。

So those three can drive offsets in terms of the 3% to 5% and they generally would be expected to grow at a faster pace than the base INA.

因此，這三項因素可以在 3% 到 5% 的範圍內形成抵銷，而且一般預期它們的成長速度會快於基礎 I&A。

Jayson Bedford, Raymond James & Associates.

Jayson Bedford，Raymond James & Associates。

Maybe just for Jamie. On the EUP, how long will it take you to fully implement the program, meaning when do you expect to see the 3% to 5% gross impact on revenue per procedure? And is there any way to kind of frame the expected impact in '27?

我想問 Jamie 一個問題。關於 EUP，你們需要多久才能把這個計畫完整落地？也就是說，你們預期何時會在每例收入上看到 3% 到 5% 的總體影響？另外，有沒有辦法大致說明 2027 年的預期影響？

Yes. It will be country by country. The first is the US. As I said, that submission is in process. So we'd expect to start to roll that out sometime later in Q1 depending on obviously when we get clearance.

好的。這會依國家逐一推進。第一個是美國。如我所說，申報正在進行中。因此我們預期在第一季稍晚開始推出，當然取決於我們何時取得核准。

Europe, it would be next, and that's not until the second half of '27 and then some of the other markets just before or just after that. So I don't think we get to the full impact until the end of the year, frankly.

接著會是歐洲，但要到 2027 年下半年才會開始，其他一些市場則在那之前或之後不久。因此坦白說，我不認為我們會在年底之前看到完整影響。

Matt Taylor, Jefferies.

Matt Taylor，Jefferies。

I did want to follow up on the settlement that you talked about today. You mentioned one time, no fault and just provide some certainty for your customers. I guess just wondering what this practically means for your customers and how they move on from that? And if you could just talk about remanufacturing in general and whether there's been any kind of real headwind.

我想追問一下你們今天提到的和解。你提到一次性、無過失，並且是為了給客戶一些確定性。我想了解這在實務上對你們的客戶意味著什麼，以及他們如何從這件事往前走？另外也請談談一般的再製造（remanufacturing）情況，以及是否出現任何實質逆風。

Yes, sure. Maybe I'll start, and will please weigh in. So this settlement really is an agreement with our customers, specifically regarding third-party instrument marine manufacturers and third-party service providers. And I think the important part here is that it provides a clear framework and how we'll continue to work together in those two specific areas and it lets us focus on really the things that are important. So advancing the safety, quality and security of our products for surgeons, care teams in their patients.

好的，當然。也許我先開始，然後也請你補充。這項和解本質上是我們與客戶之間的協議，特別是針對第三方器械再製造商以及第三方服務供應商。我認為重點在於，它提供了一個清楚的框架，說明我們將如何在這兩個特定領域持續合作，並讓我們能把焦點放在真正重要的事情上：提升我們產品對外科醫師、照護團隊及其病患的安全性、品質與資安。

And so we believe that this certainty that it provides allows us to move forward and really focus on building value with our customers.

因此，我們相信這種確定性讓我們能向前邁進，並真正專注於與客戶共同創造價值。

Just to add briefly, I think the resolution really strengthens our customer relationships and it just provides a defined framework for how we work together on instruments and servicing.

我簡短補充一下，我認為這項解決方案確實強化了我們與客戶的關係，並為我們在器械與維修服務方面如何合作提供了明確的框架。

Chris Pasquale, Barclays.

Chris Pasquale，Barclays。

I wanted to ask about margins. You guys have done a great job improving profitability over the past few years. This quarter was better than expected. Street's modeling operating margin flat next year. So while I appreciate you don't really want to get into '27 in detail right now.

我想問關於利潤率。你們過去幾年在提升獲利能力方面做得很好。本季表現也優於預期。市場目前模型預估明年營業利益率持平。所以我理解你們現在不太想深入談 2027 年的細節。

You talked about offsetting the gross margin headwind from extended use. Are there any other considerations that we should take into account as we think about profitability and your ability to continue to expand margins here going forward?

你們提到會抵銷延長使用（extended use）對毛利率的逆風。那麼，當我們思考獲利能力以及你們未來持續擴大利潤率的能力時，還有沒有其他我們應該納入考量的因素？

Yeah. I think what we've said for some time now is kind of the range of where we'd expect to be on operating margin is between 35% and 40%. And I think that's, frankly, best-in-class in med tech. As we think about it from a strategy perspective, our lean is to invest, invest in areas where we can innovate and bring differentiated capability to our customers and their patients, but also to support investments that allow us to grow at accelerated rates so that we can, again, serve more patients. And where we are right now, 41%, 42%, we have the capacity to invest.

是的。我想我們一段時間以來一直在說，我們預期的營業利益率區間大約在 35% 到 40% 之間。坦白說，我認為這在醫療科技（med tech）領域屬於同業最佳。從策略角度來看，我們的傾向是投資——投資在我們能創新、並為客戶及其病患帶來差異化能力的領域，同時也支持能讓我們以更快速度成長的投資，讓我們能再次服務更多病患。而以我們目前 41%、42% 的水準來看，我們有投資的空間。

And so as we finish our planning process, then want to evaluate that carefully. I'm not ready to say what we'll do on operating expenses, but certainly, if there are opportunities for us to do what I just described, then we'll use that capacity to invest. We'll provide that guidance, obviously, in January.

因此，當我們完成規劃流程後，我們會仔細評估。我現在還不準備說我們在營業費用上會怎麼做，但可以確定的是，如果有機會讓我們做到我剛才描述的事情，我們就會運用這個空間來投資。我們會在一月提供相關指引。

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 turned to Quintuple Aim, better and more predictable patient outcomes, better experiences for patients, better experiences for their care teams lower total cost of care and finally, increased access to care. We believe value creation in surgery and acute care is foundationally human.

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，在從根本上改善外科手術與急性介入治療方面，存在龐大且可持續的機會。我們的團隊持續與醫院、醫師與照護團隊緊密合作，追求客戶所稱的「五重目標（Quintuple Aim）」：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、更低的整體照護成本，最後是提升照護可近性。我們相信，在外科與急性照護中的價值創造，其根本是以人為本。

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

它源自於對病患與照護團隊的尊重、理解，以及對其所處環境中需求的理解。

At Intuitive, we envision a future of care that is less invasive and profoundly better where diseases are identified earlier and treated quickly so patients can get back to what matters most. Thank you for your support on this extraordinary journey. We look forward to talking with you again in three months.

在 Intuitive，我們描繪的未來照護將更微創且顯著更好；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。感謝各位在這段非凡旅程中的支持。我們期待三個月後再次與各位交流。

Ladies and gentlemen, that concludes today's conference call. Thank you for your participation. You may now disconnect.

各位女士、先生，今天的電話會議到此結束。感謝各位的參與。您現在可以掛線。