美敦力 (MDT) 2022 Q3 法說會逐字稿

Good morning, and welcome to a balmy February morning here in Minnesota. I'm Ryan Weispfenning, Vice President and Head of Medtronic Investor Relations, and I'm pleased that you're joining us for Medtronic's Fiscal Year 2022 Third Quarter Earnings Video Webcast.

早上好，歡迎來到明尼蘇達州溫暖的二月早晨。我是副總裁兼美敦力投資者關係負責人 Ryan Weispfenning，很高興您能參加美敦力 2022 財年第三季度收益視頻網絡直播。

Before we start the prepared remarks, I'll share a few details about today's webcast. Joining me are Geoff Martha, Medtronic Chairman and Chief Executive Officer; and Karen Parkhill, Medtronic Chief Financial Officer. Geoff and Karen will provide comments on the results of our third quarter, which ended on January 28, 2022, and our outlook for the remainder of the fiscal year. After our prepared remarks, our portfolio executive VPs will join us and will take questions from the sell-side analysts that cover the company. Today's event should last about an hour.

在開始準備發言之前，我將分享一些關於今天網絡直播的細節。加入我的還有美敦力董事長兼首席執行官 Geoff Martha；和美敦力首席財務官 Karen Parkhill。傑夫和凱倫將就截至 2022 年 1 月 28 日的第三季度業績以及我們對本財年剩餘時間的展望發表評論。在我們準備好講話後，我們的投資組合執行副總裁將加入我們，並回答涵蓋公司的賣方分析師的問題。今天的活動應該持續一個小時左右。

Earlier this morning, we issued a press release containing our financial statements and divisional and geographic revenue summaries. We also posted an earnings presentation that provides additional details on our performance. The presentation can be accessed in our earnings press release or on our website at investorrelations.medtronic.com.

今天早上早些時候，我們發布了一份新聞稿，其中包含我們的財務報表以及部門和地理收入摘要。我們還發布了一份收益報告，提供了有關我們業績的更多詳細信息。可以在我們的收益新聞稿或我們的網站investorrelations.medtronic.com 上訪問該演示文稿。

During today's webcast, many of the statements we make may be considered forward-looking statements and actual results may differ materially from those projected in any forward-looking statement. Additional information concerning factors that could cause actual results to differ is contained in our periodic reports and other filings that we make with the SEC, and we do not undertake to update any forward-looking statement.

在今天的網絡廣播中，我們做出的許多陳述可能被視為前瞻性陳述，實際結果可能與任何前瞻性陳述中的預測結果大不相同。有關可能導致實際結果不同的因素的其他信息包含在我們向 SEC 提交的定期報告和其他文件中，我們不承諾更新任何前瞻性陳述。

Unless we say otherwise, all comparisons are on a year-over-year basis and revenue comparisons are made on an organic basis. Third quarter organic revenue comparisons adjust only for foreign currency as there were no acquisitions or divestitures made in the last 4 quarters that had a significant impact on total company or individual segment quarterly revenue growth. References to sequential revenue changes compare to the second quarter of fiscal '22 and are made on an as-reported basis. And all references to share gains or losses refer to revenue share in the fourth calendar quarter of 2021 compared to the fourth calendar quarter of 2020 unless otherwise stated.

除非我們另有說明，否則所有比較都是按年進行的，收入比較是在有機基礎上進行的。第三季度有機收入比較僅針對外幣進行調整，因為過去 4 個季度沒有對公司總收入或個別部門季度收入增長產生重大影響的收購或資產剝離。與 22 財年第二季度相比，對連續收入變化的引用是在報告的基礎上進行的。除非另有說明，否則所有提及股份收益或損失的內容均指 2021 年第四季度與 2020 年第四季度相比的收入份額。

Reconciliations of all non-GAAP financial measures can be found in our earnings press release or on our website at investorrelations.medtronic.com.

所有非公認會計原則財務指標的對賬可以在我們的收益新聞稿或我們的網站investorrelations.medtronic.com 上找到。

And finally, our EPS guidance does not include any charges or gains that would be reported as non-GAAP adjustments to earnings during the fiscal year.

最後，我們的每股收益指引不包括任何費用或收益，這些費用或收益將被報告為本財年的非公認會計準則收益調整。

And with that, let's head into the warm studio and get started.

有了這個，讓我們進入溫暖的工作室開始吧。

Hello, everyone, and thank you for joining us today. This morning, we reported Q3 results, delivering solid earnings growth in a challenging market. We felt the short-term impacts of Omicron in January, particularly in the U.S., causing our Q3 revenue to fall short of our expectations. The COVID resurgence affected not only procedure volumes, but also created acute periods of worker absenteeism with our customers, suppliers and in our own operations and field teams.

大家好，感謝您今天加入我們。今天上午，我們公佈了第三季度業績，在充滿挑戰的市場中實現了穩健的盈利增長。我們在一月份感受到了 Omicron 的短期影響，尤其是在美國，導致我們的第三季度收入低於我們的預期。 COVID 的複蘇不僅影響了程序量，而且還造成了我們的客戶、供應商以及我們自己的運營和現場團隊中工人曠工的嚴重時期。

Now that said, COVID infections in the U.S. are declining. Available hospital ICU capacity is increasing and procedure volumes are picking up. While some of the impacts from the pandemic, like inflation, supply chain issues and health care worker shortages, will linger, we do expect that our markets, our customers and our industry are on the path to recovery.

話雖如此，美國的 COVID 感染人數正在下降。可用的醫院 ICU 容量正在增加，手術量正在增加。雖然大流行的一些影響，如通貨膨脹、供應鏈問題和醫護人員短缺，將持續存在，但我們確實預計我們的市場、我們的客戶和我們的行業正在復蘇。

Over the last 18 months, we've made significant changes to our operating model, moving to 20 focused operating units as well as making major enhancements to our culture and incentives. These changes have improved our pace of innovation and our competitiveness, as evidenced by recent product filings and approvals that came faster than expected. And we're not finished driving change. We're accelerating improvements to our global supply chain and operations, leveraging our scale to further improve quality, increase product availability and reduce costs.

在過去的 18 個月中，我們對運營模式進行了重大改變，將重點轉移到 20 個運營單位，並對我們的文化和激勵措施進行了重大改進。這些變化提高了我們的創新步伐和競爭力，最近的產品備案和批准速度比預期的要快就證明了這一點。我們還沒有完成推動變革。我們正在加速改進我們的全球供應鍊和運營，利用我們的規模進一步提高質量、增加產品可用性並降低成本。

In addition, we've enhanced our portfolio management and capital allocation processes. Our new operating model is giving us line of sight into what is required to compete and win over the long term in each of our businesses. As a result, we're looking at our portfolio with a more critical eye, with a focus on growth and creating shareholder value. I'd be surprised if there weren't changes over the coming fiscal year, but I don't know yet if they will be smaller or more significant.

此外，我們還加強了投資組合管理和資本分配流程。我們的新運營模式使我們能夠了解在我們的每項業務中長期競爭和贏得勝利所需的條件。因此，我們以更加挑剔的眼光看待我們的投資組合，專注於增長和創造股東價值。如果下一個財政年度沒有變化，我會感到驚訝，但我還不知道它們是否會更小或更重要。

Now let's look at our third quarter results, starting with our market share performance. Now market share is an important metric and a reflection of the culture and incentive changes that we're making in the company. About 60% of our businesses held or won share in the last calendar quarter. While that's down slightly from last quarter due to some supply constraints and where certain businesses are in their product cycles, it is a significant improvement from where Medtronic was just 18 months ago.

現在讓我們看看我們的第三季度業績，從我們的市場份額表現開始。現在，市場份額是一個重要的指標，反映了我們在公司中所做的文化和激勵變化。在上個日曆季度，我們約有 60% 的企業持有或贏得了股份。雖然由於一些供應限制以及某些企業處於產品週期中，這比上一季度略有下降，但與美敦力 18 個月前的情況相比，這是一個顯著的進步。

So starting with our Cardiovascular portfolio. In Cardiac Rhythm Management, one of our largest businesses, we continued to build on our category leadership, adding over 1.5 points of share. We're winning share in both high- and low-power devices. And we recently launched our Micra AV leadless pacemaker in Japan and Micra VR in China, resulting in international Micra growth of over 50% in Q3.

因此，從我們的心血管產品組合開始。在我們最大的業務之一心律管理方面，我們繼續鞏固我們的類別領先地位，增加了超過 1.5 個百分點的份額。我們正在贏得高功率和低功率設備的份額。我們最近在日本推出了 Micra AV 無引線起搏器，在中國推出了 Micra VR，導致第三季度國際 Micra 增長超過 50%。

In Peripheral Vascular Health, we won about 1 point of share with strong growth in our Abre deep venous stents and venous seal closure system. And in Cardiac Surgery, we gained over 1 point of share on the strength of our extracorporeal life support products.

在外周血管健康方面，我們憑藉 Abre 深靜脈支架和靜脈密封閉合系統的強勁增長贏得了約 1 分的份額。在心臟外科領域，我們在體外生命支持產品的優勢上獲得了超過 1 分的份額。

In our Medical Surgical portfolio, we estimate we gained share in GI, driven by momentum from the recently launched Emprint HP Generator and our Beacon endoscopic ultrasound franchise.

在我們的醫療外科產品組合中，我們估計在最近推出的 Emprint HP Generator 和我們的 Beacon 內窺鏡超聲特許經營權的推動下，我們在 GI 中獲得了份額。

In Respiratory Interventions, despite the year-over-year headwind as ventilator sales continue to return to pre-pandemic levels, we estimate we gained about 400 basis points of share. We won share in premium ventilation with our Puritan Bennett 980, in video laryngoscopes with our McGRATH MAC and in core airways with our Taperguard endotracheal tubes.

在呼吸乾預方面，儘管隨著呼吸機銷售繼續恢復到大流行前的水平，同比出現逆風，我們估計我們獲得了約 400 個基點的份額。我們的 Puritan Bennett 980 在優質通氣、McGRATH MAC 視頻喉鏡和 Taperguard 氣管插管的核心氣道中贏得了份額。

In our Neuroscience portfolio, we increased our market share in Cranial & Spinal Technologies. We're launching new spine implants that enhance the overall value of our ecosystem of preoperative planning software, imaging, navigation and robotic systems as well as powered surgical instruments, all of which are transforming care in spine surgery.

在我們的神經科學產品組合中，我們增加了在顱腦和脊柱技術領域的市場份額。我們正在推出新的脊柱植入物，以提高我們的術前規劃軟件、成像、導航和機器人系統以及電動手術器械生態系統的整體價值，所有這些都在改變脊柱手術的護理。

In Neuromodulation, we have great momentum from new products in both Pain Stim and Brain Modulation. In Pain Stim, despite the headwinds from Omicron, we estimate we gained over 1 point of share, driven by both our Intellis with DTM technology and Vanta recharge-free systems.

在神經調節方面，我們從疼痛刺激和大腦調節方面的新產品中獲得了巨大的動力。在 Pain Stim 中，儘管受到 Omicron 的不利影響，但我們估計我們獲得了超過 1 個百分點的份額，這得益於我們的 Intellis 與 DTM 技術和 Vanta 免充值系統。

And in Brain Modulation, while we continue to face headwinds from replacement devices, our business grew 15% on strong adoption of our Percept neurostimulator with BrainSense technology, paired with our SenSight directional lead. Medtronic is the only company with sensing capabilities on our deep brain stimulators, which drove about 10 points of new implant share and over 1 point of overall DBS share in Q3, and we expect this momentum to continue.

在大腦調節方面，雖然我們繼續面臨更換設備的不利因素，但我們的業務增長了 15%，原因是我們大力採用了帶有 BrainSense 技術的 Percept 神經刺激器，再加上我們的 SenSight 定向領先。美敦力是唯一一家在我們的深部腦刺激器上具有傳感能力的公司，在第三季度推動了大約 10 個新植入物份額和超過 1 個 DBS 整體份額，我們預計這種勢頭將繼續下去。

Another business with momentum is our Neurovascular business, where we are back to winning share, picking up about 2 points this quarter. We're seeing strength from our pipeline family of flow diverters for treating intracranial aneurysms. Our flow diversion launches in Japan, CE Mark countries and the United States, coupled with broader portfolio growth in China, propelled Neurovascular to 12% growth this quarter.

另一個勢頭強勁的業務是我們的神經血管業務，我們在這方面重新贏得了份額，本季度上漲了約 2 個百分點。我們從用於治療顱內動脈瘤的分流器管道系列中看到了力量。我們在日本、CE 標誌國家和美國推出的分流產品，加上中國更廣泛的投資組合增長，推動神經血管本季度增長 12%。

Now while the majority of our businesses are winning share, we have some businesses that lost share in Q3 where we are focused on improving our performance.

現在，雖然我們的大多數業務都在贏得份額，但我們有一些業務在第三季度失去了份額，我們專注於提高我們的業績。

In Cardiac Diagnostics, despite year-over-year share loss, we gained share sequentially for the first time in many quarters. We've made good progress increasing our manufacturing capacity for our LINQ II insertable cardiac monitor, and we began our rollout of our AccuRythm artificial intelligence algorithms, which were just enabled for all LINQ II patients in the U.S. We expect ongoing supply improvement and additional AI detection algorithms, along with new indications, to expand the market and drive growth.

在心臟診斷領域，儘管份額同比下降，但我們在多個季度中首次連續獲得份額。我們在提高 LINQ II 可插入式心臟監護儀的製造能力方面取得了良好進展，我們開始推出我們的 AccuRythm 人工智能算法，該算法剛剛為美國所有 LINQ II 患者啟用。我們預計供應將持續改善並增加人工智能檢測算法以及新的適應症，以擴大市場並推動增長。

In our Structural Heart & Aortic business, we lost share in Aortic due to supply constraints and continued pressure from our Valiant Navion recall and competitive launches. At the same time, though, we maintained our TAVR share in Q3, growing in the mid-teens.

在我們的結構心臟和主動脈業務中，由於供應限制以及 Valiant Navion 召回和競爭性發布的持續壓力，我們失去了在主動脈的份額。不過，與此同時，我們在第三季度保持了我們的 TAVR 份額，並在十幾歲左右增長。

In our Surgical Innovations business, we lost a little over 0.5 point of share overall due to acute resin shortage that impacted our flagship LigaSure vessel sealing portfolio. This was partially offset by increased share in advanced stapling, given strong market adoption of our Tri-Staple reinforced reloads, as well as share gains in hernia and sutures. The good news here is that our teams have improved our resin supply, and we expect to be able to meet demand in Q4.

在我們的外科創新業務中，由於嚴重的樹脂短缺影響了我們的旗艦 LigaSure 血管密封產品組合，我們整體失去了 0.5 個多點的份額。鑑於我們的 Tri-Staple 加強型重裝產品在市場上的廣泛採用，以及疝氣和縫合線的份額增加，這部分被高級裝訂的份額增加所抵消。好消息是我們的團隊已經改善了樹脂供應，我們希望能夠在第四季度滿足需求。

In Patient Monitoring, we estimate we lost a few points of share due to a difficult comparison from the strength we had last year in pulse oximetry and capnography monitor sales. However, our share has been relatively consistent for the past 4 quarters.

在患者監測方面，我們估計由於難以與去年在脈搏血氧儀和二氧化碳圖監測儀銷售方面的實力進行比較，我們失去了一些份額。然而，我們的份額在過去 4 個季度相對穩定。

In Pelvic Health, procedures slowed this past quarter and we lost some share. We expect this market to recover, and we are well positioned to compete.

在骨盆健康領域，過去一個季度的手術速度放緩，我們失去了一些份額。我們預計這個市場將會復蘇，我們已經做好了競爭的準備。

In ENT, we lost share for the first time in a long time, given some temporary supply chain disruptions that we expect to have resolved going forward.

在耳鼻喉科，我們很長時間以來首次失去份額，因為我們預計未來會解決一些暫時的供應鏈中斷。

And in Diabetes, we continue to lose share, predominantly in the U.S. Look, we're extremely focused on resolving our warning letter and bringing new products to the U.S. market although timing is difficult to predict. In December, CMS expanded coverage for our CGM sensors, including those integrated with our insulin pumps, and we're pleased that this will take effect for Medicare patients at the end of this month. In the international markets, we launched the 770G in Japan last month, making it the first hybrid closed loop system available in that country. And in Europe, we continue to see success and strong adoption of our 780G with the Guardian 4 sensor.

在糖尿病領域，我們繼續失去份額，主要是在美國。看起來，我們非常專注於解決我們的警告信並將新產品推向美國市場，儘管時間很難預測。 12 月，CMS 擴大了 CGM 傳感器的覆蓋範圍，包括與我們的胰島素泵集成的傳感器，我們很高興這將在本月底對醫療保險患者生效。在國際市場，我們上個月在日本推出了 770G，使其成為該國首個混合閉環系統。在歐洲，我們繼續看到帶有 Guardian 4 傳感器的 780G 的成功和廣泛採用。

Next, let's turn to our product pipeline. We've launched over 200 products in the U.S., Western Europe, Japan and China in the last 12 months, and these are having an impact across our businesses. At the same time, we continue to advance new technologies that are in development with increased investments in R&D. We're expecting these investments to create new markets, disrupt existing ones and accelerate the growth profile of Medtronic.

接下來，讓我們轉向我們的產品管道。過去 12 個月，我們在美國、西歐、日本和中國推出了 200 多種產品，這些產品對我們的業務產生了影響。與此同時，我們繼續推進正在開發中的新技術，並增加了對研發的投資。我們預計這些投資將創造新市場、顛覆現有市場並加速美敦力的增長。

Now starting with our Cardiovascular portfolio. We continue to make progress in Cardiac Rhythm Management on disrupting the ICD market with our Aurora extravascular ICD. Our U.S. pivotal study is fully enrolled. We continue to expect CE Mark approval later this calendar year and U.S. approval next calendar year. Our EV ICD can both pace and shock without any leads inside the heart and veins, and it does this in a single device that is the same size as a traditional ICD. We believe Aurora will accelerate adoption of EV ICDs and make this a $1 billion market by 2030.

現在從我們的心血管產品組合開始。我們繼續在心律管理方面取得進展，通過我們的 Aurora 血管外 ICD 擾亂 ICD 市場。我們的美國關鍵研究已全部註冊。我們繼續期待 CE 標誌在本日曆年晚些時候獲得批准，美國在下個日曆年獲得批准。我們的 EV ICD 可以在心臟和靜脈內沒有任何導線的情況下進行起搏和電擊，並且它在與傳統 ICD 大小相同的單個設備中執行此操作。我們相信 Aurora 將加速 EV ICD 的採用，到 2030 年將其打造為價值 10 億美元的市場。

In Cardiac Ablation Solutions, we're advancing a number of technologies to become a leader in the $8 billion EP ablation market. We're rolling out our DiamondTemp RF ablation system as well as our exclusive first-line paroxysmal AF treatment indication using our cryoablation system.

在心臟消融解決方案中，我們正在推進多項技術，以成為價值 80 億美元的 EP 消融市場的領導者。我們正在使用我們的冷凍消融系統推出我們的 DiamondTemp 射頻消融系統以及我們獨有的一線陣發性 AF 治療適應症。

We also continue to make progress with our Anatomical PulseSelect PFA system, which has breakthrough device designation from the FDA. Our global pivotal trial completed enrollment back in November, and we're very excited about how our PFA system could disrupt the EP ablation market.

我們還繼續在我們的 Anatomical PulseSelect PFA 系統方面取得進展，該系統已獲得 FDA 的突破性設備指定。我們的全球關鍵試驗於 11 月完成了註冊，我們對我們的 PFA 系統如何擾亂 EP 消融市場感到非常興奮。

Last month, we announced our intent to acquire Affera. Affera has several development programs underway, including a differentiated mapping and navigation system that closes a competitive gap in our product portfolio, and a focal PFA system that is a separate and complementary platform to our anatomical PFA system. We're looking forward to welcoming the Affera team into Medtronic.

上個月，我們宣布了收購 Affera 的意圖。 Affera 正在進行多個開發計劃，包括一個差異化的地圖和導航系統，以縮小我們產品組合中的競爭差距，以及一個焦點 PFA 系統，它是我們解剖 PFA 系統的獨立和補充平台。我們期待著歡迎 Affera 團隊加入美敦力。

Moving to our Symplicity renal denervation procedure for hypertension. We continue to enroll our ON MED study and expect to complete the 6-month follow-up in the second half of this calendar year. We'll then submit the data to the FDA as ON MED is the final piece of our submission to seek approval for Symplicity. Adding to our body of evidence, 3-year data from our ON MED pilot study will be presented at the ACC scientific sessions in April.

轉到我們針對高血壓的 Symplicity 腎臟去神經手術。我們繼續註冊我們的 ON MED 研究，並預計在本日曆年下半年完成為期 6 個月的隨訪。然後，我們將把數據提交給 FDA，因為 ON MED 是我們提交申請 Symplicity 批准的最後一部分。除了我們的證據之外，我們的 ON MED 試點研究的 3 年數據將在 4 月的 ACC 科學會議上公佈。

In Structural Heart, we now expect to begin the limited U.S. market release of our Evolut FX valve in Q1, followed by a full market release later in fiscal '23. Evolut FX enhances ease-of-use improvements in deliverability, implant visibility and deployment stability. In China, we expect to launch our Evolut PRO valve this quarter, our first entry into this large and underpenetrated TAVR market. We also continue to advance our transcatheter mitral and tricuspid development programs. In our APOLLO pivotal trial for TMVR, we just had the first implant using our transfemoral delivery system, and we expect this new system to meaningfully accelerate patient enrollment.

在 Structural Heart 中，我們現在預計將在第一季度開始在美國市場有限地發布我們的 Evolut FX 閥門，然後在 23 財年晚些時候全面發布市場。 Evolut FX 增強了交付性、植入物可見性和部署穩定性方面的易用性改進。在中國，我們預計在本季度推出我們的 Evolut PRO 閥門，這是我們首次進入這個龐大且未充分滲透的 TAVR 市場。我們還繼續推進我們的經導管二尖瓣和三尖瓣發育計劃。在我們針對 TMVR 的 APOLLO 關鍵試驗中，我們剛剛使用我們的經股動脈輸送系統進行了第一個植入物，我們希望這個新系統能夠顯著加快患者入組速度。

Moving to our Medical Surgical portfolio and our surgical robotics program. We've made progress improving our supply chain and manufacturing and remain focused on scaling production. At the same time, we continue to add regulatory approvals and expand our limited market release, most recently in Canada, Australia and Israel. And we intend to start our U.S. urology clinical trial soon. In addition to uro and gyn cases, surgeons in Panama, Chile and India are now performing general surgery procedures with Hugo, including advanced cases like colorectal and lower anterior resection surgeries. And we announced earlier this month the first Hugo procedures in Europe.

轉向我們的醫療外科產品組合和我們的外科機器人計劃。我們在改善供應鍊和製造方面取得了進展，並繼續專注於擴大生產規模。與此同時，我們繼續增加監管批准並擴大我們有限的市場發布，最近一次是在加拿大、澳大利亞和以色列。我們打算很快開始我們的美國泌尿外科臨床試驗。除了泌尿外科和婦科病例外，巴拿馬、智利和印度的外科醫生現在正在與 Hugo 一起進行普通外科手術，包括結直腸和下前切除手術等高級病例。我們本月早些時候宣布了歐洲的第一個 Hugo 程序。

In Diabetes, our MiniMed 780G insulin pump, combined with our Guardian 4 sensor, continue to be under active review with the FDA, with approval subject to our warning letter. When approved and launched in the U.S., we expect this system to be highly differentiated and accelerate growth in our Diabetes business. We continue to expect submission of our next-generation sensor, Simplera, to the FDA this quarter. Simplera is fully disposable, easy to apply and half the size of Guardian 4. Finally, we're making progress on multiple next-gen sensor and pump programs, including patch pumps, although we haven't disclosed details for competitive reasons.

在糖尿病領域，我們的 MiniMed 780G 胰島素泵與我們的 Guardian 4 傳感器相結合，繼續接受 FDA 的積極審查，並在我們的警告信下獲得批准。當在美國獲得批准和推出時，我們預計該系統將具有高度差異化，並加速我們糖尿病業務的增長。我們繼續期待本季度向 FDA 提交我們的下一代傳感器 Simplera。 Simplera 是一次性的，易於應用，尺寸只有 Guardian 4 的一半。最後，我們正在多個下一代傳感器和泵程序上取得進展，包括貼片泵，儘管出於競爭原因我們尚未披露細節。

While it will take time, we expect the technology pipeline investments we're making will result in our Diabetes business being accretive to total company growth and eventually grow with this important market.

雖然這需要時間，但我們預計我們正在進行的技術管道投資將導致我們的糖尿病業務增加公司的整體增長，並最終隨著這一重要市場的增長而增長。

Now turning to our Neuroscience Portfolio. We were pleased to receive FDA approval for our diabetic peripheral neuropathy indication for our Intellis and Vanta spinal cord stimulators last month. This came following the FDA's rigorous review of our clinical submission and years earlier than we had previously communicated. The approval represents the beginning of a multiyear market development process which we are uniquely suited to execute given our presence in both the pain stim and the diabetes markets. We believe that DPN market opportunity will reach $300 million by FY '26 and with an annual TAM of up to $1.8 billion, making DPN for SCS one of the biggest market opportunities in med tech.

現在轉向我們的神經科學產品組合。上個月，我們很高興獲得 FDA 批准我們的 Intellis 和 Vanta 脊髓刺激器的糖尿病周圍神經病變適應症。這是在 FDA 對我們的臨床提交進行嚴格審查之後發生的，並且比我們之前傳達的要早幾年。該批准代表了多年市場開發過程的開始，鑑於我們在疼痛刺激和糖尿病市場的存在，我們非常適合執行該過程。我們相信，到 26 財年，DPN 的市場機會將達到 3 億美元，每年的 TAM 高達 18 億美元，使 SCS 的 DPN 成為醫療技術領域最大的市場機會之一。

In addition to DPN, we also continue to make progress on expanding indications for SCS and to nonsurgical refractory back pain and upper limb and neck chronic pain. If that was not enough for Pain Stim, we're also excited about our Inceptiv ECAPS closed-loop spinal cord stimulator which we submitted to the FDA late last year. We expect Inceptiv's closed-loop therapy that optimizes pain relief for patients to revolutionize the SCS market.

除了 DPN，我們還在擴大 SCS 適應症和非手術難治性背痛以及上肢和頸部慢性疼痛方面取得進展。如果這對 Pain Stim 來說還不夠，我們也對我們去年年底提交給 FDA 的 Inceptiv ECAPS 閉環脊髓刺激器感到興奮。我們期待 Inceptiv 的閉環療法能夠優化患者的疼痛緩解，從而徹底改變 SCS 市場。

Finally, in Pelvic Health, we're expecting FDA approval for our next-gen InterStim recharge-free device in the first half of this calendar year. With its designed best-in-class battery, constant current and full-body MRI compatibility at both 1.5 and 3 Tesla, we expect this device will extend our category leadership in sacral neuromodulation.

最後，在骨盆健康方面，我們期待 FDA 在本日曆年上半年批准我們的下一代 InterStim 免充電設備。憑藉其設計的一流電池、恆定電流和 1.5 和 3 特斯拉的全身 MRI 兼容性，我們預計該設備將擴大我們在骶神經調節領域的領先地位。

And with that, I'll turn it over to Karen to discuss our financial performance and our guidance. Karen?

有了這個，我會把它交給凱倫來討論我們的財務業績和我們的指導。凱倫？

Thank you, Geoff. Our third quarter organic revenue increased 2%. While we were tracking to our quarterly guidance in early January, the impacts from this latest wave of COVID affected our revenue in the last month of the quarter. Despite the challenging revenue, we controlled expenses and delivered adjusted EPS in line with our guidance and $0.01 ahead of consensus.

謝謝你，傑夫。我們第三季度的有機收入增長了 2%。雖然我們在 1 月初跟踪我們的季度指導，但最新一波 COVID 的影響影響了我們在本季度最後一個月的收入。儘管收入具有挑戰性，但我們控制了開支並根據我們的指導提供了調整後的每股收益，並且比共識提前了 0.01 美元。

From a geographic perspective, our U.S. revenue was flat and non-U.S. developed markets grew 1%, given the impacts of Omicron. Our emerging markets were relatively stronger, growing 7%, with strength in South Asia, Latin America and the Middle East and Africa.

從地理角度來看，鑑於 Omicron 的影響，我們的美國收入持平，非美國發達市場增長 1%。我們的新興市場相對強勁，增長 7%，在南亞、拉丁美洲、中東和非洲表現強勁。

Converting our earnings into strong free cash flow is a priority. Our year-to-date free cash flow was $4.3 billion, up 23% from last year, and we continue to target a full year conversion of 80% or greater. And we remain focused on allocating our capital to generate strong future growth and shareholder returns. We are increasing our organic R&D investments broadly across the company to fuel the pipeline that Geoff walked through earlier, and we are supplementing this with attractive tuck-in acquisitions.

將我們的收益轉化為強勁的自由現金流是我們的首要任務。我們年初至今的自由現金流為 43 億美元，比去年增長 23%，我們繼續將全年轉化率目標定為 80% 或更高。我們仍然專注於分配我們的資本以產生強勁的未來增長和股東回報。我們正在整個公司廣泛增加我們的有機研發投資，以推動 Geoff 早些時候經歷的管道，我們正在通過有吸引力的整合收購來補充這一點。

Since the beginning of last fiscal year, we've announced 8 acquisitions totaling over $3.2 billion in total consideration, including last month's acquisition of Affera in our Cardiac Ablation business. At the same time, we're increasing our minority investments in companies that could become future acquisitions, as was the case with Affera.

自上一財年年初以來，我們已宣布進行 8 次收購，總對價超過 32 億美元，包括上個月收購 Affera 的心臟消融業務。與此同時，我們正在增加對可能成為未來收購的公司的少數股權投資，Affera 就是這種情況。

We have a commitment to return more than 50% of our free cash flow to our shareholders, primarily through our attractive and growing dividend. We are an S&P dividend aristocrat. And fiscal year-to-date, we paid over $2.5 billion in dividends to our shareholders.

我們承諾將超過 50% 的自由現金流返還給我們的股東，主要是通過我們有吸引力且不斷增長的股息。我們是標準普爾股息貴族。迄今為止，我們向股東支付了超過 25 億美元的股息。

And finally, particularly in periods where we see share price dislocation, we look to execute opportunistic share repurchases, as was the case this quarter. Fiscal year-to-date, we've repurchased over $1.1 billion of our stock.

最後，特別是在我們看到股價錯位的時期，我們希望執行機會性股票回購，就像本季度一樣。本財年迄今為止，我們已經回購了超過 11 億美元的股票。

Turning to guidance. While procedure volumes are still impacted from Omicron in the first few weeks of February, we are beginning to see improvement. Our outlook assumes continued procedure volume recovery through March and April. And we expect to be back to pre-COVID levels in most of our markets before the end of the fourth quarter. Assuming that holds, for the fourth quarter, we're comfortable with current Street consensus for our organic revenue growth of approximately 5.5%. At recent foreign exchange rates, currency would be a headwind on fourth quarter revenue of approximately $185 million.

轉向指導。儘管 Omicron 在 2 月的前幾週仍會影響手術量，但我們開始看到改善。我們的展望假設手術量在 3 月和 4 月持續恢復。我們預計在第四季度末之前，我們的大多數市場將恢復到 COVID 之前的水平。假設這一點成立，對於第四季度，我們對當前的華爾街共識感到滿意，我們的有機收入增長約為 5.5%。以最近的匯率計算，貨幣將成為第四季度約 1.85 億美元收入的逆風。

By segment, we would model Cardiovascular at 7% to 8% growth, Neuroscience at 2.5% to 3.5% growth, Medical Surgical at 7.5% to 8.5% growth and Diabetes down 6% to 7%, all on an organic basis.

按細分市場，我們將模擬心血管增長 7% 至 8%，神經科學增長 2.5% 至 3.5%，內科增長 7.5% 至 8.5%，糖尿病下降 6% 至 7%，所有這些都是有機的。

On the bottom line, we expect fourth quarter non-GAAP diluted EPS in the range of $1.56 to $1.58, in line with current consensus. And at recent rates, we expect currency to have a flat to slightly positive impact on the bottom line.

歸根結底，我們預計第四季度非公認會計原則攤薄後每股收益在 1.56 美元至 1.58 美元之間，符合當前的共識。按照最近的匯率，我們預計貨幣將對利潤產生持平或略微積極的影響。

Before I send it back to Geoff, I want to acknowledge the additional strain that the recent COVID resurgence has placed on our customers and our employees over the past couple of months. I am truly grateful for the perseverance that both health care workers and our employees have demonstrated to ensure patients receive our life-changing therapies around the world.

在我把它發回給 Geoff 之前，我想承認最近的 COVID 死灰復燃在過去幾個月裡給我們的客戶和員工帶來了額外的壓力。我非常感謝醫護人員和我們的員工所表現出的毅力，以確保世界各地的患者接受我們改變生活的療法。

Back to you, Geoff.

回到你身邊，傑夫。

Thank you, Karen. For the last few quarters, I've been closing by commenting on the progress the company is making in various areas of ESG, or environmental, social and governance impacts. Today, I want to highlight that we recently released our global inclusion, diversity and equity 2021 annual report entitled Zero Barriers. The report shares how we are accelerating our efforts to remove barriers to opportunities by creating an inclusive work environment, doubling down on removing bias and amplifying our impact in our local communities.

謝謝你，凱倫。在過去的幾個季度中，我一直在評論公司在 ESG 各個領域或環境、社會和治理影響方面取得的進展。今天，我想強調一下，我們最近發布了題為“零障礙”的 2021 年全球包容性、多樣性和公平性年度報告。該報告分享了我們如何通過創造包容性的工作環境、加倍努力消除偏見和擴大我們在當地社區的影響力來加快消除機會障礙的努力。

Our commitments to ID&E and the UN Sustainable Development Goals compel us to solve health inequities faster. Systemic socioeconomic, racial, geographic and even generational factors all contribute to a person's ability or inability to achieve good health and reach their full potential as a contributing member of society.

我們對 ID&E 和聯合國可持續發展目標的承諾迫使我們更快地解決健康不平等問題。系統性的社會經濟、種族、地理甚至代際因素都有助於一個人有能力或無法實現良好的健康並充分發揮其作為社會貢獻成員的潛力。

We're committed to urgently addressing barriers to education, diagnosis and treatment, as the global crisis of health inequity can be solved by accelerating access to health care technologies. One such inequity is mortality from colorectal cancer. While colorectal is one of the most preventable cancers, low screening rates make it one of the deadliest, with mortality rates 40% higher for the black population in the United States. In addition, Hispanic and Latino adults are more likely to be diagnosed in later stages of the disease, when it's more difficult to treat.

我們致力於緊急解決教育、診斷和治療方面的障礙，因為可以通過加快獲得醫療保健技術來解決全球健康不平等危機。一種這樣的不平等是結直腸癌的死亡率。雖然結直腸癌是最可預防的癌症之一，但低篩查率使其成為最致命的癌症之一，美國黑人的死亡率高出 40%。此外，西班牙裔和拉丁裔成年人更有可能在疾病的後期被診斷出來，此時更難治療。

Today, I'm pleased to announce that Medtronic is collaborating with Amazon Web Services and the American Society for Gastrointestinal Endoscopy to place GI Genius modules at facilities that support low-income and underserved populations across the United States. Our GI Genius system improves the quality of colonoscopies using AI to assist physicians in detecting both precancerous and cancerous growths. Increasing access to technology that can improve clinical outcomes through earlier and more accurate detection can provide a significant positive impact for communities most vulnerable to colorectal cancer. We continue to look for creative solutions like this one to address health inequities.

今天，我很高興地宣布，美敦力正在與亞馬遜網絡服務和美國胃腸內鏡學會合作，將 GI Genius 模塊放置在支持美國低收入和服務不足人群的設施中。我們的 GI Genius 系統使用 AI 提高結腸鏡檢查的質量，以幫助醫生檢測癌前病變和癌變生長。通過更早、更準確的檢測，增加獲得可以改善臨床結果的技術的可及性，可以為最易患結直腸癌的社區帶來顯著的積極影響。我們繼續尋找像這樣的創造性解決方案來解決健康不公平問題。

Now let me close on this note. While the pandemic and its associated impacts have affected our revenue in the past couple of quarters more than we expected, we haven't lost sight of the big picture. We've made significant changes in the company, and we're strengthening our operations, supply chain and global quality systems. We're also laser-focused on capital deployment and portfolio management processes, with a deep commitment to creating shareholder value. And we have several exciting growth catalysts in our pipeline. We expect to benefit as market procedures reaccelerate post Omicron and as we lead in high-growth med tech markets.

現在讓我結束這篇筆記。儘管大流行及其相關影響在過去幾個季度對我們的收入的影響超出了我們的預期，但我們並沒有忘記大局。我們對公司進行了重大變革，我們正在加強我們的運營、供應鍊和全球質量體系。我們還專注於資本部署和投資組合管理流程，並致力於創造股東價值。我們的管道中有幾個令人興奮的增長催化劑。隨著市場程序在 Omicron 之後重新加速以及我們在高增長的醫療技術市場中處於領先地位，我們預計將受益。

While it's been a bumpier ride than I would have liked and we still have challenges to work through, I'm confident in our organization's ability to accelerate and sustain our growth profile over the long term to grow at or above our markets and, as we do so, create value for our stakeholders.

雖然這比我想像的要崎嶇不平，而且我們仍然面臨挑戰，但我相信我們的組織有能力在長期內加速和維持我們的增長狀況，以達到或超過我們的市場增長，並且隨著我們這樣做，為我們的利益相關者創造價值。

And finally, I want to join Karen in thanking all of our employees around the world who, despite the challenges we faced day in and day out, engineered the extraordinary so that we can serve our customers and patients in all 4 corners of the globe. As a result of your efforts, we can fulfill the Medtronic mission: Alleviating pain, restoring health and extending life for millions of people around the world.

最後，我想和凱倫一起感謝我們在世界各地的所有員工，儘管我們日復一日地面臨挑戰，但他們設計了非凡的產品，以便我們能夠為全球四個角落的客戶和患者提供服務。由於您的努力，我們可以完成美敦力的使命：為全球數百萬人減輕疼痛、恢復健康和延長生命。

Now let's move to Q&A. (Operator Instructions) With that, Win, can you please give the instructions for asking a question.

現在讓我們進入問答環節。 （操作員說明）這樣，Win，您能否給出提問的說明。

(Operator Instructions) Lastly, please be advised that this Q&A session is being recorded. For today's session, Geoff, Karen and Ryan are joined by Sean Salmon, EVP and President of the Cardiovascular Portfolio and the Diabetes Operating Unit; Bob White, EVP and President of the Medical Surgical portfolio; and Brett Wall, EVP and President of the Neuroscience Portfolio. (Operator Instructions)

（操作員說明）最後，請注意，此問答環節正在錄製中。對於今天的會議，Geoff、Karen 和 Ryan 以及執行副總裁兼心血管產品組合和糖尿病運營部門總裁 Sean Salmon 加入； Bob White，執行副總裁兼醫療外科產品組合總裁；和神經科學投資組合執行副總裁兼總裁 Brett Wall。 （操作員說明）

We'll take the first question from Robbie Marcus at JPMorgan.

我們將回答摩根大通的 Robbie Marcus 提出的第一個問題。

Great. Congrats on the quarter. Maybe my first question, I think one of the bigger investor questions that's building here, especially with some of the warning letter and the delays in Diabetes and some of the inflation pressure we're seeing with some of your competitors. Any early thoughts on how we should be thinking about fiscal '23? There's a wide range on estimates, so I just wanted to get any early sense you had for us.

偉大的。祝賀本季度。也許我的第一個問題是，我認為這裡正在形成的一個更大的投資者問題，尤其是一些警告信和糖尿病的延誤以及我們在一些競爭對手中看到的一些通脹壓力。關於我們應該如何考慮 23 財年的任何早期想法？估計範圍很廣，所以我只是想了解您對我們的任何早期感覺。

Sure. Maybe I'll -- first of all, thanks for the question. I agree it's a big question, and maybe I'll turn this over to Karen to provide some color commentary on FY '23.

當然。也許我會——首先，謝謝你的提問。我同意這是一個大問題，也許我會把這個交給凱倫，為 23 財年提供一些色彩評論。

Thank you, Geoff and Robbie. So I would first say it's early. And obviously, we're going to give our full year outlook on our Q4 call in May. And we're working through our planning process as we speak. And we've noted before with you that there are more puts and takes than normal for next fiscal year. So let me help by sharing some broad thoughts.

謝謝你，傑夫和羅比。所以我先說現在還早。顯然，我們將在 5 月的第四季度電話會議上給出全年展望。在我們發言的時候，我們正在完成我們的計劃過程。我們之前已經和你一起注意到，下一個財政年度的看跌期權和接受交易比正常情況要多。因此，讓我通過分享一些廣泛的想法來提供幫助。

On revenue, we continue to drive to our long-term organic revenue growth goal of 5-plus percent, for sure. Although I would say on the plus side, the plus side of that LRP may be more difficult in FY '23, just given some of the challenges that we've talked about.

在收入方面，我們肯定會繼續努力實現 5% 以上的長期有機收入增長目標。雖然我會說有利的一面，但考慮到我們已經談到的一些挑戰，LRP 的有利方面在 23 財年可能會更加困難。

We are, as you know, expecting really great product launches, Geoff talked about several of them on the call. And we do expect a continued rebound in procedure volumes in our markets. And as we think about FX on the top line for next year, think about that as being a few hundred million dollar headwind at recent rates.

如您所知，我們期待真正偉大的產品發布，Geoff 在電話會議上談到了其中的幾個。我們確實預計我們市場的手術量會持續反彈。當我們考慮明年的外匯收入時，可以將其視為以最近的匯率計算的幾億美元的逆風。

On the bottom line, you've heard from others around the increased pressure from the macro environment. And we've got that same increased pressure on things like inflation and wage adjustments.

歸根結底，您從其他人那裡聽到了宏觀環境壓力增加的消息。我們在通脹和工資調整等方面也面臨同樣增加的壓力。

And we've noted last month that currency is expected to flip from a tailwind to a headwind next fiscal year. And we've also shared that we've got some dilution from our Affera acquisition. Those last 2 combined could impact EPS by a few hundred basis points.

我們上個月已經註意到，預計下一個財政年度貨幣將從順風轉向逆風。我們還分享說，我們從收購 Affera 中得到了一些稀釋。最後兩個加起來可能會影響每股收益幾百個基點。

While we continue to work to offset these headwinds, we certainly don't want to shortchange our investments in our meaningful growth drivers for the future. And it's those investments that are really going to help us deliver on that plus side of the 5-plus percent over the long-range plan.

雖然我們繼續努力抵消這些不利因素，但我們當然不想減少我們對未來有意義的增長動力的投資。正是這些投資真正有助於我們在長期計劃中實現 5% 以上的收益。

So I would say FY '23 will be a unique and challenging year just given the macro environment and the timing of our major pipeline launches. And on the bottom line, we do expect to grow EPS next year, certainly. But at this stage, we don't expect it to be above revenue growth.

因此，鑑於宏觀環境和我們主要管道啟動的時機，我想說 23 財年將是獨特且充滿挑戰的一年。歸根結底，我們確實預計明年每股收益會增長。但在現階段，我們預計它不會超過收入增長。

I want to make sure, though, that you take away from this that we are still very committed to our long-range plan. We've got investments in quality along with the more-than-modest FX dilution next fiscal year that should subside going forward. And while it's hard to predict the macro factors like inflation and wage adjustments, I'm not sure they'll continue at the pace that we're currently experiencing. And obviously, as we look forward, we expect to have meaningful revenue growth to go along with those investments that we're prioritizing, which will ultimately help drive EPS growth.

不過，我想確保您從這件事中帶走我們仍然非常致力於我們的長期計劃。我們在質量方面進行了投資，下個財政年度的外匯攤薄程度超過適度，這應該會在未來消退。雖然很難預測通貨膨脹和工資調整等宏觀因素，但我不確定它們是否會以我們目前所經歷的速度繼續下去。顯然，正如我們所期待的那樣，我們預計收入將隨著我們優先考慮的投資而實現有意義的增長，這最終將有助於推動每股收益的增長。

So I hope that color is helpful, Robbie.

所以我希望顏色是有幫助的，羅比。

Yes, that's great. And then as my follow-up, Geoff, at the JPMorgan conference, you first mentioned maybe doing some bigger changes to the business. You mentioned it again today. I was just hoping you could give us a little flavor for what you're thinking. Is it divestitures? Is it a bigger breakup of the company? And what's the time frame we should be thinking about for some of the larger potential actions?

是的，那太好了。然後作為我的後續行動，傑夫，在摩根大通會議上，你首先提到可能會對業務進行一些更大的改變。你今天又提到了。我只是希望你能給我們一些關於你所想的東西的味道。是剝離嗎？這是公司更大的分拆嗎？對於一些更大的潛在行動，我們應該考慮什麼時間框架？

Sure, Robbie. Yes, so we're definitely looking at the portfolio more intently. I can't -- however, at this point, I can't really get into specifics. I will -- I'll say we're looking to improve our WAMGR. We're looking to improve the consistency of our growth. Our North Star -- to summarize it, our North Star is durable growth.

當然，羅比。是的，所以我們肯定會更加專注地看待投資組合。我不能——但是，在這一點上，我不能真正進入細節。我會 - 我會說我們正在尋求改進我們的 WAMGR。我們正在尋求提高我們增長的一致性。我們的北極星——總而言之，我們的北極星是持久的增長。

And we're looking at our businesses and we're evaluating them for, one, how well they fit into the portfolio, how well they fit into our strategy. Are we the right owners of these assets? And then how we, Medtronic, add value and grow these businesses? It's still at this point, like I said at the conference, we don't know if these changes will be significant or more limited. But I can assure you, we're deeply, deeply committed to doing the right things for shareholders and all of the Medtronic stakeholders.

我們正在研究我們的業務，我們正在評估它們，一個是它們與投資組合的匹配程度，它們與我們的戰略的匹配程度。我們是這些資產的正確所有者嗎？那麼我們美敦力如何增加價值並發展這些業務？就像我在會議上所說的那樣，目前仍處於這一點，我們不知道這些變化是否會顯著或更有限。但我可以向您保證，我們堅定地致力於為股東和所有美敦力利益相關者做正確的事情。

So we intend to get through this analysis and I think have more over the next several -- over the course of the next fiscal year is what we said at the JPMorgan, and I don't have any more update from that in terms of timing.

所以我們打算通過這個分析，我認為在接下來的幾個 - 在下一個財政年度的過程中是我們在摩根大通所說的，我在時間方面沒有更多更新.

Next question comes from Vijay Kumar at Evercore ISI.

下一個問題來自 Evercore ISI 的 Vijay Kumar。

Vijay, are you there? Do you want to go to the next question and come back to Vijay? Oh, there he is.

維杰，你在嗎？你想去下一個問題然後回到維杰嗎？哦，他來了。

I'm so sorry about that. I guess maybe one -- my first one is on the guidance comments you made, which was helpful. What is the fiscal '23 assuming on Diabetes? Did you guys have that second meeting with the FDA? Is the warning letter going to be delinked with the approval?

我對此感到非常抱歉。我想也許有一個——我的第一個是關於你所做的指導評論，這很有幫助。 23 財年對糖尿病的假設是什麼？你們有第二次與 FDA 會面嗎？警告信會與批准脫鉤嗎？

Or how are you treating Diabetes? In that comment of 5-plus, with plus being difficult. Is that still assuming a 50 to 100 basis points headwind from Diabetes?

或者你是如何治療糖尿病的？在 5+ 的評論中，加號很難。那仍然假設糖尿病會帶來 50 到 100 個基點的逆風嗎？

On the very last part of the question, I'll let Karen and maybe Sean chime in. In terms of -- look, the dialogue with the FDA is ongoing. I mean, we've got an ongoing dialogue on the 780G approval. We've got an ongoing dialogue on the warning letter. Our priority is -- they're both priorities, but our first priority is to work the warning letter issues, and we've been working on these, like as we talked about, for 2 years now, even before the warning letter was issued. So the dialogue with -- like I said, with the FDA is ongoing, and it's very constructive, I would say.

關於問題的最後一部分，我會讓 Karen 和 Sean 插話。就 - 看，與 FDA 的對話正在進行中。我的意思是，我們正在就 780G 的批准進行對話。我們正在就警告信進行對話。我們的首要任務是——它們都是首要任務，但我們的首要任務是處理警告信問題，就像我們談到的那樣，我們已經在這些問題上工作了 2 年，甚至在警告信發出之前.因此，正如我所說，與 FDA 的對話正在進行中，我會說這是非常有建設性的。

Karen, do you want to talk about the last part of the question there?

凱倫，你想談談問題的最後一部分嗎？

Sure, Vijay. It's still too early to get specific. We're in our planning process. And as we talked about before, there are a variety of outcomes and ranges that can happen, depending on the approval. We're obviously focused on getting that approval out as quickly as possible, and we'll be working towards that, but too early to get specific on guidance. We'll give that guidance, including for our business units, in the fourth quarter call.

當然，維杰。現在說具體還為時過早。我們正在規劃過程中。正如我們之前談到的，可能會出現多種結果和範圍，具體取決於批准情況。我們顯然專注於盡快獲得批准，我們將朝著這個方向努力，但現在還為時過早，無法獲得具體的指導。我們將在第四季度電話會議中提供該指導，包括我們的業務部門。

Understood. And maybe, Geoff, my second question on the robot. Some early feedback seems to be positive. Have -- you did mention supply chain has been resolved or you're ramping up production. Maybe some sense for where production is? Or some color on how many surgeons have been trained. What is the order book looking like for the robot would be helpful.

明白了。也許，傑夫，我關於機器人的第二個問題。一些早期的反饋似乎是積極的。有——你確實提到供應鏈已經解決或者你正在提高產量。也許對生產在哪裡有一些意義？或者關於有多少外科醫生接受過培訓的一些顏色。機器人的訂單簿是什麼樣的會有幫助。

Yes. Maybe I'll bring in Bob here in a second to provide some of that -- more color on that. On just overall, we make -- we're making progress on the robot. Demand continues to be strong. We continue to get additional regulatory approvals, a couple more last quarter. We did our first surgery in Europe and are getting good feedback from surgeons there, which I think is a great sign. And the breadth of our procedures continues to grow, get more complex. And so we're feeling good about the -- kind of where the robot is, like that we've got something really powerful on our hands here and we're going to achieve our long-term objectives here. And as we've said before, we anticipate a strong ramp in FY '23. But I'll give Bob. Bob, do you want to add some color here?

是的。也許我會在一秒鐘內把 Bob 帶到這裡來提供其中的一些——更多的顏色。總的來說，我們在機器人方面取得了進展。需求繼續強勁。我們繼續獲得額外的監管批准，上個季度還有更多。我們在歐洲進行了第一次手術，並從那裡的外科醫生那裡得到了很好的反饋，我認為這是一個很好的跡象。我們的程序範圍不斷擴大，變得更加複雜。所以我們對機器人的位置感覺很好，就像我們手上有一些非常強大的東西一樣，我們將在這裡實現我們的長期目標。正如我們之前所說，我們預計 23 財年將出現強勁增長。但我會給鮑勃。鮑勃，你想在這裡添加一些顏色嗎？

Yes. Thanks, Geoff. And Vijay, thanks for the question. It was nice to read your report after the time you spent with Professor Mottrie as well. And certainly, what we've seen, Vijay, is we've seen some nice progress. We're installing more systems across the world. As you know, now that we have our CE Mark approval, Geoff mentioned, some of the general surgery procedures taking place. And we certainly expect to continue to expand the regulatory approvals in more countries. We certainly look to expand in the future to thoracic, colorectal, hernia, bariatric procedures. Obviously, Hugo was designed with all those procedures in mind, working with all those regulatory agencies.

是的。謝謝，傑夫。還有維杰，謝謝你的提問。在您與 Mottrie 教授共度時光之後閱讀您的報告也很高興。當然，維杰，我們已經看到了一些不錯的進展。我們正在世界各地安裝更多系統。如您所知，Geoff 提到，既然我們已經獲得 CE 標誌批准，一些普通外科手術正在發生。我們當然希望繼續在更多國家擴大監管批准。我們當然希望在未來擴展到胸部、結腸直腸、疝氣、減肥手術。顯然，Hugo 的設計考慮了所有這些程序，並與所有這些監管機構合作。

And the feedback itself has been really positive, Vijay. The open council has been excellent, the visualization, staying connected with the OR staff. And we like about that, we really think the council and our whole system design for where health care is moving, which is a real kind of cross-functional team-based approach to physician care delivery.

Vijay，反饋本身非常積極。開放式理事會非常出色，可視化，與手術室工作人員保持聯繫。我們喜歡這一點，我們真的認為理事會和我們的整個系統設計都是針對醫療保健移動的，這是一種真正的基於跨職能團隊的醫生護理提供方法。

So obviously, as you know, you picked up some of this feedback. The way our system is designed, it's also allowing to train multiple surgeons in parallel. And sort to your question, we're training lots of surgeons. We have training centers now opened up in geographies across the world and seeing really good traction there as well.

顯然，如您所知，您收到了一些反饋。我們系統的設計方式還允許同時培訓多名外科醫生。根據你的問題，我們正在培訓很多外科醫生。我們現在在世界各地開設了培訓中心，並且在那裡也看到了非常好的牽引力。

So we're going to do what we told you consistently throughout, which is expand our limited market release into these markets and continue to make progress. But thanks for the question, and thanks for spending time with Professor Mottrie.

因此，我們將始終如一地告訴您，將我們有限的市場發布擴展到這些市場並繼續取得進展。但感謝您提出問題，感謝您與 Mottrie 教授共度時光。

The next question comes from Peter Chickering at Deutsche Bank.

下一個問題來自德意志銀行的 Peter Chickering。

On the guidance questions, I understand that the macro environment for 2023 is pretty challenging. But as you look at both labor and material inflation, do you think that, that would change your long-term EPS targets? Or do you need more revenue growth to offset these margin pressures? Or do you think that you can pass some of those costs all on to your customers over time?

關於指導問題，我知道 2023 年的宏觀環境非常具有挑戰性。但是當你同時關注勞動力和物質通脹時，你認為這會改變你的長期每股收益目標嗎？或者您是否需要更多的收入增長來抵消這些利潤壓力？或者您是否認為隨著時間的推移您可以將其中一些成本全部轉嫁給您的客戶？

Let me take a stab at that. First, there are things that we're doing, I'll let Karen talk about some of this in a second here. But we are, in addition to -- we are obviously facing these inflationary pressures. And even before the inflation kicked in, as part of our organizational kind of new operating model, one of the areas we've talked a lot about, moving to the 20 operating units and putting more into R&D and really speeding up the pace of innovation, and I think that is working. We're getting good evidence around that this is working in terms of the pace of our product launches, and some of these product launches coming much faster than we anticipated, like we talked about -- and I talked about in the commentary like in our Pain Stim market with DPN, diabetic peripheral neuropathy, approval or -- and I can go off a couple of other lists. Our ECAP submission for pain. These are areas that we just sped things up. So I feel good about that.

讓我試一試。首先，我們正在做一些事情，我會讓凱倫在這裡談談其中的一些。但除此之外，我們顯然還面臨著這些通脹壓力。甚至在通貨膨脹開始之前，作為我們組織的新運營模式的一部分，我們已經談論了很多的領域之一，轉移到 20 個運營單位，投入更多的研發，真正加快了創新的步伐，我認為這是有效的。我們得到了很好的證據表明這在我們的產品發布速度方面是有效的，其中一些產品的發布速度比我們預期的要快得多，就像我們談到的那樣——我在評論中談到，就像在我們的疼痛刺激市場與 DPN、糖尿病周圍神經病變、批准或 - 我可以列出其他幾個列表。我們針對疼痛的 ECAP 提交。這些是我們剛剛加快速度的領域。所以我對此感覺很好。

But another area that we had planned to address and now are accelerating is the operations area. And there's an opportunity there to get some more benefits of scale that we have and simplify our global operations. And in simplifying that, that's going to -- I think we're going to also invest in some enhanced capabilities there. That is going to give us a lower cost to serve, if you will, and set us up for cost of goods sold improvements over time. So that is going to help address some of this. You also mentioned price -- and again those plans were put in motion before the inflation, but we've been accelerating it since the inflation has hit.

但我們計劃解決且現在正在加速的另一個領域是運營領域。那裡有機會獲得我們擁有的更多規模優勢並簡化我們的全球運營。在簡化這一點時，我認為我們還將在那裡投資一些增強的功能。如果您願意，這將為我們提供更低的服務成本，並為我們的銷售成本隨著時間的推移而改進做好準備。所以這將有助於解決其中的一些問題。您還提到了價格——這些計劃再次在通貨膨脹之前實施，但自從通貨膨脹來襲以來，我們一直在加速它。

And then price. I mean, price, there are -- we are looking more acutely at our new technology. We have a lot of new products coming out, and we are looking at the pricing of that in the wake of some of the -- of this inflation. And there are select markets around the world where I think we have the ability, we have the opportunity to improve our pricing. So we are looking at pricing as well.

然後價格。我的意思是，價格，有——我們正在更敏銳地看待我們的新技術。我們有很多新產品問世，我們正在考慮在通貨膨脹之後的一些定價。我認為我們有能力在世界各地的一些特定市場，我們有機會提高我們的定價。所以我們也在考慮定價。

So both those levers, reducing our cost to serve and setting ourselves up for cost of goods -- better cost of goods sold over time and then the pricing that I just mentioned.

因此，這兩個槓桿，降低了我們的服務成本並為商品成本做好了準備——隨著時間的推移更好的商品銷售成本，然後是我剛才提到的定價。

Now Karen, do you want to add?

現在，凱倫，你要添加嗎？

Yes, I'll just add a little bit. While it varies by geography, we are seeing wage inflation in our direct labor currently of almost 9%. So that is much higher than typical. And that's just a near-term headwind that we're dealing with. That will impact us a bit in FY '23.

是的，我只是補充一點。雖然它因地域而異，但我們目前看到直接勞動力的工資通脹率接近 9%。所以這比典型的要高得多。這只是我們正在處理的近期逆風。這將在 23 財年對我們產生一些影響。

And on materials right now, we're typically able to drive net material savings through productivity efficiencies and cost-down initiatives. And right now, we're expecting a couple of hundred basis points of inflation on that just in the near term. But again, over the long term, we're focused on driving revenue growth, on driving continued cost down and expense efficiencies, pricing opportunities where we have them. So we're focused on and remain committed to that long-range plan.

現在，在材料方面，我們通常能夠通過提高生產力和降低成本的舉措來推動淨材料節省。目前，我們預計短期內通脹將達到幾百個基點。但同樣，從長遠來看，我們專注於推動收入增長，推動持續降低成本和提高費用效率，並在我們擁有的地方定價機會。因此，我們專注於並繼續致力於該長期計劃。

The next question comes from Matt Miksic at Credit Suisse.

下一個問題來自瑞士信貸的 Matt Miksic。

Can you hear me okay?

你能聽到我的聲音嗎？

Yes, we can hear you, Matt.

是的，我們可以聽到你的聲音，馬特。

Great. So one quick one on sort of your portfolio comments. And then just a clarification on the '23 guidance comments, if I could.

偉大的。因此，對您的投資組合評論進行快速處理。如果可以的話，然後只是對'23 指導意見進行澄清。

So Geoff, I think sometimes when folks ask about portfolio changes or puts and takes to your businesses, they're thinking of, just to put it bluntly, commitment to Diabetes, frankly. So I'd love to get your thoughts on your commitment to that business and how important it is to the portfolio. Where you stand in terms of the process of getting it back at speed?

所以傑夫，我認為有時當人們詢問投資組合的變化或對你的業務進行投資時，坦率地說，他們正在考慮，坦率地說，對糖尿病的承諾。因此，我很想听聽您對您對該業務的承諾以及它對投資組合的重要性的看法。在快速恢復的過程中，您的立場是什麼？

And then I have just one clarification, as I mentioned, for Karen.

然後，正如我所提到的，我對凱倫只有一個澄清。

Sure. On the comments we made about the portfolio, let me start by saying it wasn't intended to be focused on Diabetes. It's a real, I guess, deep dive, I would say, on the whole portfolio, okay, and more intent than we've done in the past.

當然。關於我們對投資組合的評論，讓我首先說它並不打算專注於糖尿病。我想，這是對整個投資組合的真正深入研究，好吧，而且比我們過去所做的更有意圖。

Regarding Diabetes. Look, I'd say we are confident in our turnaround story here. I know the warning letter didn't help. But we are confident in the turnaround story. We believe we have a solid pipeline of new technologies and some near-term growth opportunities. Our clear priority though is resolving the FDA warning letter and getting these new products to market, especially in the U.S., right? It's a situation, when we see the products working in other markets, we know it'll have a huge impact on patients here in the U.S. as well.

關於糖尿病。看，我想說我們對這裡的轉機故事充滿信心。我知道警告信沒有幫助。但我們對扭轉局面充滿信心。我們相信我們擁有堅實的新技術管道和一些近期增長機會。不過，我們明確的優先事項是解決 FDA 警告信並將這些新產品推向市場，尤其是在美國，對嗎？這是一種情況，當我們看到產品在其他市場上運行時，我們知道它也會對美國的患者產生巨大影響。

And we have multiple shots on goal to deliver competitive pump and CGM technology, through our organic R&D, through the Blackstone partnership and through some structured investments. And as we mentioned in the JPMorgan conference, we do have some parts of the pipeline that we haven't provided much detail on for competitive reasons. So we feel -- wish we were further along in Diabetes in terms of not having the warning letter, but it doesn't change the narrative in our mind. We have the technology, we have the pipeline, it's a high-growth market, and we feel good about it.

通過我們的有機研發、Blackstone 合作夥伴關係和一些結構化投資，我們有多個目標可以提供具有競爭力的泵和 CGM 技術。正如我們在摩根大通會議中提到的那樣，我們確實有一些管道部分由於競爭原因我們沒有提供太多細節。所以我們覺得 - 希望我們在沒有警告信方面在糖尿病方面走得更遠，但這並沒有改變我們腦海中的敘述。我們擁有技術，我們擁有管道，這是一個高增長的市場，我們對此感覺良好。

That's great. And then just on -- Karen, I appreciate the color on '23 and I understand it's -- we're a quarter away here from formal '23 guidance. But the few hundred basis point impact on EPS you mentioned from FX and some other items, dilution from Affera, just to put a finer point on it, that's inclusive of the Diabetes impact. And also just to make sure we have the math right, that's somewhere in the range of $0.15, $0.15 to $0.20 or something like that, of a headwind from those items.

那太棒了。然後就 - 凱倫，我很欣賞 23 年的顏色，我理解它 - 我們距離正式的 23 年指導只有四分之一。但是你提到的外彙和其他一些項目對每股收益的幾百個基點的影響，來自 Affera 的稀釋，只是為了更好地說明它，這包括糖尿病的影響。而且只是為了確保我們的數學是正確的，這些項目的逆風在 0.15 美元、0.15 美元到 0.20 美元或類似的範圍內。

Yes, Matt, thank you. Those items -- the few hundred basis points that I talked about are just from the foreign exchange flipping from a tailwind this fiscal year to a headwind next year and from the dilution. So it is -- so you can see the magnitude just from those 2 temporal items. And that foreign exchange flip, I think, at least at current rates, we would say, is much more than modest. And so that's why we point them out.

是的，馬特，謝謝。這些項目——我談到的幾百個基點只是來自外匯從本財年的順風轉向明年的逆風以及稀釋。就是這樣——所以你可以從這兩個時間項目中看到大小。我認為，至少在目前的匯率下，我們會說，這種外匯翻轉遠不止是溫和的。這就是我們指出它們的原因。

Next question comes from Larry Biegelsen at Wells Fargo.

下一個問題來自富國銀行的拉里·比格爾森。

So just one on the recovery and related one on China. It looks like January was soft given your comments at JPMorgan and the results today. So what -- a little bit more color on what you've seen in February and the confidence in the Q4 guidance. It does imply a pretty significant increase, I think, sequentially.

所以只有一篇關於復蘇和相關的一篇關於中國。鑑於您在摩根大通的評論和今天的結果，一月份的情況似乎很溫和。那又如何——對你在 2 月份看到的情況以及對第四季度指引的信心有了更多的了解。我認為，這確實意味著相當顯著的增長。

And just lastly, on China, it was flat in Q3 versus growing high teens in the second quarter. Any color on that and how you guys are thinking about VBP there?

最後，在中國，第三季度與第二季度增長的青少年持平。有什麼顏色嗎？你們如何看待那裡的VBP？

Sure. Larry, on the first part of the question, yes, Omicron impacted cases and it caused a broad-based absenteeism, right? And we use the word absenteeism to separate it from health care worker shortage. And the health care worker shortage, I think, is more -- is going to last longer into FY '23 versus the absenteeism. And that's driven by all the things you've heard about, like burnout, people leaving the workforce. Versus absenteeism was more short term and acute, caused by just the broad number of Omicron cases. And absenteeism applies not just to health care workers, but our own employees working in factories and our distribution centers, our suppliers. It was broad-based.

當然。拉里，關於問題的第一部分，是的，Omicron 影響了案件，並導致了廣泛的曠工，對嗎？我們使用曠工一詞將其與醫護人員短缺區分開來。我認為，與曠工相比，醫護人員短缺會持續更長時間到 23 財年。這是由你聽說過的所有事情驅動的，比如倦怠、人們離開勞動力市場。與曠工相比，曠工更為短期和嚴重，僅由大量 Omicron 病例引起。曠工不僅適用於醫護人員，也適用於我們自己在工廠和配送中心工作的員工，以及我們的供應商。它的基礎廣泛。

And so that absenteeism, plus the COVID cases suppressing elective cases in hospitals, that peaked the second half of January and into the first half of February. And trends are now favorable, as we highlighted -- indicated with our Q4 guidance. And we think procedure volumes will improve throughout March and April and back to pre-COVID levels by the end of our fiscal Q4.

因此，曠工，加上 COVID 病例抑制醫院的選擇性病例，在 1 月下半月和 2 月上半月達到頂峰。正如我們強調的那樣，現在的趨勢是有利的——我們的第四季度指導表明了這一點。我們認為手術量將在整個 3 月和 4 月有所改善，並在我們的財政第四季度末恢復到 COVID 之前的水平。

However, you still have these chronic staffing shortages that will be, from what we're hearing from hospital administrators, persist into FY '23, but how -- into 2023, sorry. But they are -- they will be mitigated by these traveling or temporary staff, where the hospitals are just paying more for these employees and technologies like remote monitoring and telehealth. And so we think that those mitigants will allow them to get back to the normal levels. But it will maybe limit them from going 110% or 120% of pre-COVID levels like we saw in prior waves prior to Delta and Omicron.

但是，根據我們從醫院管理人員那裡聽到的消息，這些長期的人員短缺仍然會持續到 23 財年，但是如何 - 到 2023 年，抱歉。但它們是——這些旅行或臨時工作人員將減輕它們的負擔，醫院只是為這些員工和遠程監控和遠程醫療等技術支付更多費用。因此，我們認為這些緩解措施將使他們恢復到正常水平。但這可能會限制它們達到 COVID 前水平的 110% 或 120%，就像我們在 Delta 和 Omicron 之前的浪潮中看到的那樣。

So that's how we're seeing it, and it does imply a big improvement here in Q4. But we don't see that hospitals have a capacity to kind of handle 110%, 120% kind of levels like we've seen in other waves.

這就是我們的看法，這確實意味著第四季度會有很大的改進。但我們沒有看到醫院有能力像我們在其他浪潮中看到的那樣處理 110%、120% 的水平。

So I hope that answers that question. And then maybe on the China piece, I'll turn that over to Karen.

所以我希望這能回答這個問題。然後也許在中國部分，我會把它交給凱倫。

Yes. Thanks, Geoff. On China, it was a bit flat in Q3 and we did see some regional tenders happening or beginning to happen in the trauma space. And as we see those tenders happening, the channel slows down, they're buying. So that just happens in advance.

是的。謝謝，傑夫。在中國，第三季度有點平淡，我們確實看到一些區域性招標正在或開始在創傷領域發生。當我們看到這些招標發生時，渠道變慢了，他們正在購買。所以這只是提前發生的。

But just on VBP in general in China, we do expect the government to focus on the top 10 medical device products by public insurance spending. And as you know, we've been through stents and other industry players have gone through large joints. I mentioned, we're now seeing this regional trauma tender. And we see 2 more potential national tenders on that list where we have exposure, and that would be in spine and surgical stapling. And obviously, there's a lot of uncertainty around these tenders, including timing.

但僅就中國的 VBP 而言，我們確實預計政府將重點關注公共保險支出排名前 10 位的醫療器械產品。如您所知，我們經歷過支架，其他行業參與者也經歷過大關節。我提到過，我們現在看到了這種區域性的創傷。我們在該名單上看到了另外 2 個潛在的國家招標項目，那就是脊柱和外科縫合。顯然，這些招標存在很多不確定性，包括時間安排。

But just so you know, if you look at our Spine and Stapling business in China, our gross exposure is somewhere between 1% to 1.5% of the total company revenue. And based on what we experienced with stents, there should be offsets to that ultimate -- to the ultimate number, so that the net would be less than the gross that I mentioned because we've got pull-through of products and we'll obviously be working those.

但你知道，如果你看看我們在中國的脊柱和訂書機業務，我們的總風險敞口在公司總收入的 1% 到 1.5% 之間。根據我們在支架方面的經驗，應該有對最終數量的抵消——對最終數量，這樣淨值會小於我提到的總量，因為我們已經獲得了產品的通過率，我們將顯然是在工作。

We are anticipating at least one of those tenders to happen in FY '23. And these are among the things that put pressure on the plus side of our long-term 5% plus goal for next year. So I hope that's helpful.

我們預計其中至少一項招標將在 23 財年進行。這些都是對我們明年 5% 以上的長期目標施加壓力的因素之一。所以我希望這會有所幫助。

The next question comes from Joanne Wuensch at Citi.

下一個問題來自花旗的 Joanne Wuensch。

Can you hear me okay?

你能聽到我的聲音嗎？

Yes, sure, Joanne.

是的，當然，喬安妮。

I want to just build off of Karen's last comments on the plus side of the 5%, somewhat for next year, but even the year after that, what needs to happen in order for you to get there? And specifically, I do have a number of investors who think or say they can't get to the plus side without a Diabetes turnaround.

我想在凱倫的最後評論的基礎上建立 5% 的積極方面，有點是為了明年，但即使是在那之後的一年，你需要做什麼才能達到目標？具體來說，我確實有一些投資者認為或說如果沒有糖尿病的好轉，他們就無法獲得積極的一面。

Well, I think what I like about our position right now is the breadth of -- the strength of the current portfolio and the strength and breadth of the pipeline. And we have several drivers. There's a lot of focus on -- obviously, on Hugo, and we talked about that and we're feeling good there. And certainly, by that time, we'll work through some of these manufacturing and supply chain issues. And we're feeling really good about the quality of what we have here and the impact that Hugo is going to have.

好吧，我認為我現在喜歡我們的職位的廣度 - 當前投資組合的實力以及管道的實力和廣度。我們有幾個司機。有很多關注——顯然，雨果，我們談到了這一點，我們在那裡感覺很好。當然，到那時，我們將解決其中一些製造和供應鏈問題。我們對這裡的質量以及 Hugo 將產生的影響感到非常滿意。

We'll get the Ardian data readout as well. And I'll come back -- we talked about Diabetes. But beyond that, you've got things like -- and

我們還將獲得 Ardian 數據讀數。我會回來的——我們談到了糖尿病。但除此之外，你還有——和

I'll just highlight a few, and I'll start in Cardiovascular. You got our EV ICD coming, we see that market to be $2 billion to $3 billion. And then our Cardiac Ablation Solutions business there for afib, we've got PFA. Of course, our DiamondTemp rollout is -- will peak and we've got PFA coming.

我只強調一些，我將從心血管開始。我們的 EV ICD 即將推出，我們認為該市場將達到 20 億至 30 億美元。然後是我們的心房消融解決方案業務，我們有 PFA。當然，我們的 DiamondTemp 推出將達到頂峰，我們即將推出 PFA。

In MedSurg, beyond Hugo, SI is hitting a nice part of its product cycle here, there's a number of products that will have an impact coming in, in SI.

在 MedSurg 中，除了 Hugo 之外，SI 在其產品週期中發揮了重要作用，有許多產品將在 SI 中產生影響。

And then our Neuroscience Portfolio just across the board is well positioned. You heard in the commentary about Neuromodulation with DPN in pain, ECAPS in pain, and that's strength on strength because our DTM is doing well there. You got DBS with the sensing and the closed loop.

然後我們的神經科學產品組合全面定位。您在評論中聽到了關於疼痛中 DPN 的神經調節、疼痛中的 ECAPS 的評論，這是力量上的力量，因為我們的 DTM 在那裡做得很好。你得到了帶有傳感和閉環的 DBS。

Pelvic Health, that market continues to be a strong growth market and we've got a great product line up there. ENT, we'll be adding Intersect. And I really believe our Spine business is poised with the broad base of enabling technology and just where that market is going, it definitely favors us. And then you heard today that Neurovascular is back to gaining share. We've -- over the years, we've relied on that.

骨盆健康，這個市場仍然是一個強勁的增長市場，我們在那裡有一個很棒的產品線。 ENT，我們將添加相交。而且我真的相信我們的 Spine 業務已準備好擁有廣泛的支持技術基礎，而正是該市場的發展方向，它絕對有利於我們。然後你今天聽說神經血管重新獲得份額。多年來，我們一直依賴於此。

So it's a broad base of technology. And I think with the new operating model, I expect it to keep refilling that pipeline up, that's the focus. So that's what I'd say. We feel good about -- as Karen said, there's more puts and takes next year than normal for sure, and she's gone through that, I think, in good detail. But the -- we're committed to the long-term plan, and it starts with this top line growth. And based on the broad nature of it, we feel good.

所以它是一個廣泛的技術基礎。而且我認為使用新的運營模式，我希望它能夠不斷補充這條管道，這就是重點。這就是我要說的。我們感覺很好 - 正如凱倫所說，明年肯定會比正常情況更多，而且我認為她已經詳細地經歷了這一點。但是 - 我們致力於長期計劃，並從收入增長開始。基於它的廣泛性，我們感覺很好。

And getting back to Diabetes, remember, we do have the 780G with the Guardian 4 sensor. We will have a new sensor beyond that in that time frame with Simplera. And that Simplera sensor could also be paired with our pen from Companion and creating a whole new vector of growth for our Diabetes business there with smart pens paired with our sensor.

回到糖尿病，請記住，我們確實有帶有 Guardian 4 傳感器的 780G。在 Simplera 的那個時間範圍內，我們將擁有一個新的傳感器。 Simplera 傳感器也可以與我們來自 Companion 的筆配對，並通過與我們的傳感器配對的智能筆為我們的糖尿病業務創造一個全新的增長載體。

So there's a number of drivers there. And you take it all, it doesn't all need to happen to get to that 5% plus once you get past FY '23.

所以那裡有很多司機。你把這一切都拿走了，一旦你過了 23 財年，並不需要全部達到 5% 以上。

And Joanne, I just want to emphasize from the -- from my seat, that we are really confident in that 5% plus over the long term. And it is because it's not dependent on any one thing, but it's the strength of the pipeline that Geoff mentioned.

喬安妮，我只想從我的座位上強調，從長遠來看，我們對 5% 以上的增長非常有信心。這是因為它不依賴於任何一件事，而是 Geoff 提到的管道的強度。

The next question comes from the line of Danielle Antalffy from SVB Leerink.

下一個問題來自 SVB Leerink 的 Danielle Antalffy。

So sorry. Can you guys hear me okay?

非常抱歉。你們能聽到我的聲音嗎？

Yes, we can hear you just fine.

是的，我們可以很好地聽到您的聲音。

Okay. Great. And appreciate all the commentary you guys provided as we look out over the next fiscal year. Just a quick question as you think about the ramp in new -- major new product launches. So you've talked about Hugo a little bit here, but there's obviously also Ardian.

好的。偉大的。在我們展望下一個財政年度時，感謝你們提供的所有評論。當您考慮新的主要新產品發佈時，這只是一個快速的問題。所以你在這裡談到了一些雨果，但顯然還有阿迪安。

And just to follow up on Joanne's question, I guess, as we think about fiscal '24 and beyond, so beyond the next fiscal year, how we should be thinking about that ramp. I know we're waiting for the data. But has anything changed as far as thinking about contribution for some of these major new product launches?

只是為了跟進喬安妮的問題，我想，當我們考慮 24 財年及以後，所以在下一財年之後，我們應該如何考慮這個斜坡。我知道我們正在等待數據。但是，就這些重大新產品發布的貢獻而言，有什麼改變嗎？

Well, on the Ardian question, maybe I'll pull in Sean Salmon here to provide an update on Ardian.

好吧，關於 Ardian 的問題，也許我會在這裡邀請 Sean Salmon 來提供有關 Ardian 的最新信息。

So Geoff, I think the data readout on Ardian, we're expecting now in that kind of late fall, early winter time frame of this calendar year. But there may be a milestone in between now and then and give you more confidence. We have the 3-year data from the pilot trial, ON MED's being presented at ACC this year. And why that's important is that will be the first time we've had randomized data with long-term follow-up. So the question around how long does the effect last? It doesn't wear out. That's going to be really important for payers and it's an important inflection point. But we remain very confident. All the body of evidence that we had for Ardian has continued to be very consistent, and we're making preparations to really go after a blockbuster launch here.

所以 Geoff，我認為 Ardian 上的數據讀數，我們現在期待在這個日曆年的那種深秋、初冬的時間框架內。但在這之間可能會有一個里程碑，讓你更有信心。我們有來自試點試驗的 3 年數據，ON MED 今年將在 ACC 上展示。為什麼這很重要，因為這將是我們第一次獲得具有長期隨訪的隨機數據。那麼關於效果持續多長時間的問題？它不會磨損。這對付款人來說非常重要，而且是一個重要的轉折點。但我們仍然非常有信心。我們為 Ardian 掌握的所有證據仍然非常一致，我們正在為真正在這裡推出重磅炸彈做準備。

Good. And another one that we've mentioned a little bit in the commentary, Danielle, that maybe I'll have Brett Wall comment on, is 2 things in Pain. Our Pain business is already well positioned with our DTM.

好的。我們在評論中提到的另一件事，丹妮爾，也許我會讓布雷特沃爾評論，是痛苦中的兩件事。我們的疼痛業務已經通過我們的 DTM 很好地定位。

But the diabetic peripheral neuropathy and the ECAPs submission, do you want to comment on those 2 things, Brett, because those are, I think, together are pretty meaningful.

但是糖尿病周圍神經病變和 ECAPs 提交，你想對這兩件事發表評論嗎，布雷特，因為我認為這些都是非常有意義的。

Yes, sure. Danielle, these 2 things are pretty meaningful. We received the diabetic peripheral neuropathy approval about 2.5 years before we anticipated that. We think that's a market that, as Geoff said in the commentary, is going to grow to $300 million pretty quickly. We are well positioned with that. And the data there that we submitted is very strong data, and it's reflective of the other data that has been presented in that same field. So we have every right to win there, and we will be investing and moving accordingly. In addition, we submitted late last year our ECAPs filing. And ECAPs is a closed-loop algorithm that will be utilized in SCS.

是的，當然。丹妮爾，這兩件事很有意義。我們在預期之前大約 2.5 年獲得了糖尿病周圍神經病變的批准。正如 Geoff 在評論中所說，我們認為這是一個將很快增長到 3 億美元的市場。我們在這方面處於有利地位。我們提交的數據是非常強大的數據，它反映了同一領域中提供的其他數據。所以我們完全有權利在那裡取勝，我們將相應地進行投資和行動。此外，我們去年年底提交了 ECAP 文件。 ECAPs 是一種閉環算法，將在 SCS 中使用。

And we are back to gaining share, really across the Neuromodulation portfolio, but in SCS in particular with DTM. And now with the embodiment of our stimulation programs with the sensing capability to close the loop and allow for really more effective therapy there. So the entirety of this portfolio is set up, as the markets recover and as procedures recover, as we wind down Omicron, for share gain and growth across the field with more effective therapies in this entire area.

我們又重新獲得了份額，實際上是在神經調節產品組合中，但在 SCS 中，尤其是在 DTM 中。現在，我們的刺激程序的實施具有感應能力，可以關閉循環並允許在那裡進行真正更有效的治療。因此，隨著市場的複蘇和程序的恢復，隨著 Omicron 的結束，整個投資組合都已建立，以便在整個領域通過更有效的治療方法獲得整個領域的份額和增長。

Yes. And so just last comment on that. I mean, look, obviously, they're both great opportunities. But the other piece that I really like about them is just how we did this, right? These -- in both cases, you had small; smaller; and in one case with ECAPS, a start-up; smaller, focused companies that signaled the innovation here. And historically, we haven't moved that fast to -- and now we're moving at a much faster pace. And I just love the way we put these focus teams on there, gave them this challenge in both of these instances to move fast. Don't sacrifice quality, but move fast.

是的。所以最後評論一下。我的意思是，看，顯然，它們都是很好的機會。但我真正喜歡他們的另一點就是我們是如何做到的，對吧？這些——在這兩種情況下，你都有小；更小；在 ECAPS 的一個案例中，是一個初創公司；小型、專注的公司在這裡標誌著創新。從歷史上看，我們並沒有那麼快地行動——現在我們的行動速度要快得多。而且我只是喜歡我們將這些重點團隊放在那裡的方式，在這兩種情況下都給了他們挑戰以快速行動。不要犧牲質量，但要快速行動。

And this is the type of thing that we want to see -- we're starting to see across the portfolio with the new operating model, with the leaders we have in place. So some of the new leaders we brought in from outside the company. And like I said earlier, also now beyond innovation, moving on to really improving our capabilities in our end-to-end supply chain to make sure that it's reliable and it sets us up from a cost position as well. So like where the company is headed, like those 2 examples in particular.

這就是我們希望看到的類型——我們開始在整個投資組合中看到新的運營模式，以及我們現有的領導者。所以我們從公司外部引進了一些新的領導者。就像我之前所說的那樣，現在也超越了創新，繼續真正提高我們在端到端供應鏈中的能力，以確保它是可靠的，並且它也使我們從成本位置開始。所以就像公司的發展方向，特別是這兩個例子。

Thanks, Danielle. And I apologize, we're not going to be able to get to all the analysts today, but we do have time for one more question.

謝謝，丹妮爾。我很抱歉，我們今天無法聯繫到所有分析師，但我們確實有時間再提出一個問題。

Our final question comes from Rick Wise at Stifel.

我們的最後一個問題來自 Stifel 的 Rick Wise。

Geoff, maybe just given your commentary about -- and the appreciation for your stepped-up R&D spending and your comment about using a portion of cash flow for continuing M&A, sort of in a sense, an extension of R&D, can you talk a little more, just give us your latest thinking, on how your reflections on your targets? Are there a lot of opportunities? Are there a lot of opportunities to increase your minority investments? Where are you -- what are you prioritizing for the calendar year and the next several years? What are you targeting? Just any updates would be very welcome.

傑夫，也許只是給出了你的評論——以及對你加大研發支出的讚賞，以及你對使用部分現金流進行持續併購的評論，從某種意義上說，是研發的延伸，你能談談嗎？更多，請告訴我們您的最新想法，您對目標的看法如何？機會多嗎？是否有很多機會增加您的少數股權投資？您在哪裡 - 您在日曆年和未來幾年的優先事項是什麼？你的目標是什麼？任何更新都會非常受歡迎。

Sure. Rick, great to hear from you. Thanks for that question. I'll answer it a couple of ways.

當然。瑞克，很高興收到你的來信。謝謝你的問題。我會用幾種方式回答它。

One, this is separate. These tuck-in acquisitions and venture investing, that's separate from the broader portfolio comments I made earlier. This is what we view part of our everyday business here, is doing tuck-ins. And so a couple of things I'd say.

一，這是分開的。這些集中收購和風險投資，與我之前提出的更廣泛的投資組合評論是分開的。這就是我們在這裡看到的日常業務的一部分，就是做折騰。所以我想說幾件事。

One, we have stepped up our venture investing. We separated our venture team maybe 2 years ago from our M&A team to have more focus. We have separate operating mechanisms with these -- with this team, that Karen, myself and several others from the executive committee participate in. And so we have stepped up those investments. And a lot of those investments, some of them are just debt or equity, but some of them are more structured investments to give us opportunities down the line. So that is significantly up.

一是加大風險投資力度。大約 2 年前，我們將風險投資團隊與併購團隊分開，以便更加專注。我們與這些有單獨的運營機制——與這個團隊一起，凱倫、我和執行委員會的其他幾個人都參與其中。所以我們加大了這些投資。其中很多投資，其中一些只是債務或股權，但其中一些是更具結構性的投資，為我們提供了未來的機會。所以這是顯著上升。

And then on the acquisition space, I was hoping, like I said in prior calls, that during COVID, valuations would go down a bit and present opportunities. That didn't happen initially, but valuations have come down a bit. And our pipeline is fuller than it has been over the last 2 years. You see the Intersect deal. That Intersect deal for ENT that we announced and the Affera deal for our Ablation Solutions business, those are the type of like acquisitions, in that billion, multibillion dollar range that have.

然後在收購領域，就像我在之前的電話會議中所說的那樣，我希望在 COVID 期間，估值會有所下降並提供機會。最初並沒有發生這種情況，但估值已經下降了一點。而且我們的管道比過去兩年更充實。您會看到 Intersect 交易。我們宣布的針對 ENT 的 Intersect 交易以及針對我們的消融解決方案業務的 Affera 交易，這些都是類似的收購類型，在十億、數十億美元的範圍內。

In the case of Intersect ENT, will have an immediate impact because they've got meaningful revenue. The Affera deal, it will take a little bit longer as it's still earlier in development, but hugely impactful. What I like about that deal is how it repositions our -- really strengthens our ablation business there by providing the map nav and complements our PFA offerings.

就 Intersect ENT 而言，將產生直接影響，因為他們獲得了可觀的收入。與 Affera 的交易將需要更長的時間，因為它仍處於早期開發階段，但影響巨大。我喜歡這筆交易的地方在於它如何重新定位我們——通過提供地圖導航和補充我們的 PFA 產品，真正加強了我們在那裡的消融業務。

So we're seeing things across the board, if you will. Particularly, I would say, a lot of interesting things in Neuroscience, a lot of interesting things in the Cardiology space as well. So that's how I'd answer that question.

因此，如果您願意，我們正在全面看待事情。特別是，我想說，神經科學中有很多有趣的事情，心髒病學領域也有很多有趣的事情。所以我就是這樣回答這個問題的。

Thanks, Rick. Geoff, please go ahead with your closing remarks.

謝謝，瑞克。傑夫，請繼續你的結束語。

Okay. All right. Thanks, Ryan. Okay. Look, thanks, everybody, for the great questions. And we appreciate -- certainly appreciate your support and your continued interest in Medtronic.

好的。好的。謝謝，瑞恩。好的。看，謝謝大家，為偉大的問題。我們感謝 - 當然感謝您的支持和您對美敦力的持續興趣。

And look, we obviously -- Karen outlaid -- outlined some of the puts and takes that we have that we're working through. But we also have, like I ended on, some extraordinary opportunities in the marketplace, and you combine that with the changes that we've made in the company and continue to make that I think are having a meaningful impact, I'm confident in our ability to work -- move past these -- work through these challenges and move past these challenges and deliver on these opportunities and deliver on that plan, that long-range plan that we've outlined. And we're steadfast in our commitment to deliver durable and higher growth, full stop.

看，我們顯然——Karen outlaid——概述了我們正在處理的一些看跌期權。但我們也有，就像我結束的那樣，市場上有一些非凡的機會，你把它與我們在公司所做的改變結合起來，並繼續做出我認為會產生有意義的影響，我有信心我們的工作能力——克服這些挑戰——克服這些挑戰，克服這些挑戰，抓住這些機會，實施我們已經概述的長期計劃。我們堅定不移地致力於實現持久和更高的增長，句號。

So look, we hope you join us for our Q4 earnings webcast, which we anticipate holding on May 26, where we'll update you on how we finished the fiscal year and then even a more detailed look ahead at fiscal '23.

所以看，我們希望您加入我們的第四季度收益網絡廣播，我們預計將在 5 月 26 日舉行，我們將向您介紹我們如何完成本財年，然後更詳細地展望 23 財年。

So with that, thanks for tuning in today. Please stay healthy and safe, and have a great rest of your day.

因此，感謝您今天收聽。請保持健康和安全，並度過美好的一天。