Procept Biorobotics Corp (PRCT) 2024 Q2 法說會逐字稿

Good afternoon and welcome to PROCEPT BioRobotics second quarter 2024 earnings conference call. (Operator Instructions)

下午好，歡迎參加 PROCEPT BioRobotics 2024 年第二季財報電話會議。（操作員說明）

As a reminder, this call is being recorded for replay purposes. I would now like to turn the call over to Matt Bacso, Vice President of Investor Relations, for a few introductory comments.

謹此提醒，本次通話將會被錄音以供重播。我現在想將電話轉給投資者關係副總裁馬特·巴克索（Matt Bacso），請他發表一些介紹性評論。

Good afternoon, and thank you for joining PROCEPT BioRobotics second quarter 2024 earnings conference Call. Presenting on today's call are Reza Zadno, Chief Executive Officer; and Kevin Waters, Chief Financial Officer. Also present is Sham Shiblaq, Chief Commercial Officer, who will participate in the Q&A session.

下午好，感謝您參加 PROCEPT BioRobotics 2024 年第二季財報電話會議。出席今天電話會議的有執行長 Reza Zadno；和首席財務官凱文沃特斯。首席商務官 Sham Shiblaq 也在場，他將參加問答環節。

Before we begin, I'd like to remind listeners that statements made on this conference call that relate to future plans, events, or performance are forward-looking statements as defined under Private Securities Litigation Reform Act of 1995. While these forward-looking statements are based on management's current expectations and beliefs, these statements are subject to several risks, uncertainties, assumptions, and other factors that could cause results to differ materially from the expectations expressed on this conference call.

在我們開始之前，我想提醒聽眾，本次電話會議上發表的有關未來計劃、事件或業績的聲明屬於《1995 年私人證券訴訟改革法案》所定義的前瞻性聲明。雖然這些前瞻性陳述是基於管理階層目前的預期和信念，但這些陳述受到多種風險、不確定性、假設和其他因素的影響，這些因素可能導致結果與本次電話會議中表達的預期有重大差異。

These risks and uncertainties are disclosed in more detail in PROCEPT BioRobotics' filings with the Securities and Exchange Commission, all of which are available online at www.sec.gov. Listeners are cautioned not to place under reliance on these forward-looking statements, which speak only as of today's date, August 1, 2024.

這些風險和不確定性在 PROCEPT BioRobotics 向美國證券交易委員會提交的文件中進行了更詳細的披露，所有這些文件均可在 www.sec.gov 上在線獲取。請聽眾不要依賴這些前瞻性陳述，這些陳述僅代表截至今天（2024 年 8 月 1 日）的情況。

Except as required by law, PROCEPT BioRobotics undertakes no obligation to update or revise any forward-looking statements to reflect new information, circumstances, or unanticipated events that may arise. During the call, we will also reference certain financial measures that are not prepared in accordance with GAAP. More information about how we use these non-GAAP financial measures as well as reconciliations of these measures to their nearest GAAP equivalent are included in our earnings release.

除法律要求外，PROCEPT BioRobotics 不承擔更新或修改任何前瞻性聲明以反映新資訊、情況或可能出現的意外事件的義務。在電話會議期間，我們也會參考某些未依照公認會計準則制定的財務指標。有關我們如何使用這些非 GAAP 財務指標以及這些指標與其最接近的 GAAP 等值的調整的更多信息，請參閱我們的收益報告。

With that, I'll turn the call over to Reza.

這樣，我會將電話轉給 Reza。

Good afternoon, and thank you for joining us. For today's call, I will provide opening comments and a general business update, followed by Kevin who will then provide additional detail regarding our financial performance and updated 2024 guidance. Starting with our quarterly revenue results. We are pleased to report another strong quarter with total revenue for the second quarter of 2024 of $53.4 million, representing growth of 61% compared to the second quarter of 2023.

下午好，感謝您加入我們。在今天的電話會議中，我將提供開場評論和一般業務更新，然後 Kevin 將提供有關我們財務業績和更新的 2024 年指導的更多詳細資訊。從我們的季度收入結果開始。我們很高興地報告又一個強勁的季度，2024 年第二季度的總收入為 5,340 萬美元，與 2023 年第二季度相比增長了 61%。

Growth in the quarter was driven by strong US system sales, increased utilization from expanded US installed base, and record international revenues. We exited the second quarter of 2024 with a US install base of 400 systems, representing growth of 72% compared to the prior year period.

本季的成長得益於強勁的美國系統銷售、擴大的美國安裝基礎帶來的利用率提高以及創紀錄的國際收入。截至 2024 年第二季度，我們在美國安裝了 400 個系統，與去年同期相比成長了 72%。

Despite 42% of our US install base being active for less than 12 months, US monthly utilization increased approximately 15% compared to the prior year period. The significant increase in new accounts in conjunction with our ability to move accounts faster up the utilization curve demonstrates both our team's consistent commercial execution and growing customer and patient demand for Aquablation therapy.

儘管我們的美國安裝基數中有 42% 的活躍時間不到 12 個月，但美國的月度使用率與去年同期相比增長了約 15%。新帳戶的顯著增加以及我們將帳戶更快提升到利用率曲線的能力證明了我們團隊一致的商業執行力以及客戶和患者對 Aquablation 療法不斷增長的需求。

Multiple factors continue to trend positively, allowing us to execute against our 2024 revenue objectives. Additionally, we continue to make progress, expanding gross margins and maintaining good operating expense control. We believe these underlying fundamentals reflect the technology that is laying the foundation to become the BPH surgical standard of care and a business that will be a leading global urology company.

多種因素持續呈現正向趨勢，使我們能夠執行 2024 年的收入目標。此外，我們繼續取得進展，擴大毛利率並維持良好的營運費用控制。我們相信這些基本原理反映了為成為 BPH 手術護理標準和成為全球領先的泌尿科公司奠定基礎的技術。

Regarding the hospital CapEx environment and PROCEPT's capital rep team, we continue to believe the market is stable to improving compared to the previous 12 months. Specifically, we are having more proactive conversations with hospital CFOs who, just a few quarters ago, were exercising more caution in pursuing general CapEx investment given lingering macro headwinds.

關於醫院資本支出環境和 PROCEPT 的資本代表團隊，我們仍然相信市場與前 12 個月相比穩定改善。具體來說，我們正在與醫院財務長進行更積極的對話，就在幾個季度前，鑑於揮之不去的宏觀阻力，他們在追求一般資本支出投資時更加謹慎。

With a growing and increasingly educated patient population, along with motivated urologists, we are seeing hospitals prioritizing investment in our robotic system to ensure they stay competitive and not lose patients to other area hospitals. Given the disruptive nature of our technology and that achieving consistent resection outcomes are independent of surgeon skill or experience, we believe every BPH hospital can now build a robust BPH practice with Aquablation therapy and not have to refer patients out to specialists.

隨著患者人數的增長和教育程度的提高，以及積極主動的泌尿科醫生，我們看到醫院優先投資我們的機器人系統，以確保他們保持競爭力，不會將患者流失到其他地區醫院。鑑於我們的技術具有顛覆性，並且實現一致的切除結果與外科醫生的技能或經驗無關，我們相信每家 BPH 醫院現在都可以透過 Aquablation 療法建立強大的 BPH 實踐，而不必將患者轉診給專家。

As we turn to our capital pipeline, we remain excited about the opportunity. The number of robot placement opportunities continue to grow nicely, which has been driven by the addition of new capital reps. We enter 2024 with approximately 40 capital sales reps, of which 10 were added in the fourth quarter of 2023. With a productivity ramp of six to nine months, we expect the capital reps added in the fourth quarter of 2023 to start contributing meaningfully to US system sales in the second half of 2024.

當我們轉向資本管道時，我們仍然對這個機會感到興奮。在新資本代表的增加的推動下，機器人安置機會的數量繼續良好增長。進入 2024 年，我們將擁有約 40 名資本銷售代表，其中 10 名是在 2023 年第四季新增的。隨著生產力的提升六到九個月，我們預計 2023 年第四季增加的資本代表將在 2024 年下半年開始對美國系統銷售做出有意義的貢獻。

Even with our recent success, we are still very early in our adoption curve with a long runway in front of us selling to BPH hospitals.

儘管我們最近取得了成功，但我們仍處於採用曲線的早期階段，向 BPH 醫院銷售產品還有很長的路要走。

Next, touching on utilization and surgeon activity. US handpiece and other consumables revenues growth increased 101% compared to the second quarter of 2023. When analyzing our account, we remain pleased with overall utilization trend. In the past 12 months, our US install base has grown 72% compared to the second quarter of 2023. These new accounts take time to ramp to the levels of mature accounts.

接下來，談談利用率和外科醫生活動。與 2023 年第二季相比，美國手機和其他消耗品收入成長 101%。在分析我們的帳戶時，我們對整體利用率趨勢仍然感到滿意。在過去 12 個月中，我們的美國安裝量較 2023 年第二季成長了 72%。這些新帳戶需要時間才能達到成熟帳戶的水平。

We are encouraged by what we are seeing on account-specific utilization and we believe we have multiple proof points where Aquablation therapy is viewed as the receptive standard of care within a given hospital. In addition to adding new accounts, a primary driver of procedure growth continues to be active surgeon growth, which is a combination of new surgeons performing procedures and active surgeon retention rates exceeding 90%.

我們對特定帳戶的使用感到鼓舞，我們相信我們有多個證據表明 Aquablation 療法被視為特定醫院內可接受的護理標準。除了增加新客戶之外，手術成長的主要驅動力仍然是活躍的外科醫生成長，這是新外科醫生執行手術和超過 90% 的活躍外科醫生保留率的結合。

As a company, we benefit greatly from this high level of surgeon retention as our commercial team can focus on training new surgeons. Regarding surgeon interest, in early May, the 2024 American Urological Association Conference, or AUA, was held in San Antonio. Given our recent growth, AUA 2024 was particularly exciting for PROCEPT as it marked the first year we could clearly see and feel growing market acceptance and awareness of Aquablation therapy.

作為一家公司，我們從外科醫生的高保留率中受益匪淺，因為我們的商業團隊可以專注於培訓新的外科醫生。關於外科醫生的興趣，5月初，2024年美國泌尿外科協會會議（AUA）在聖安東尼奧舉行。鑑於我們最近的成長，AUA 2024 對 PROCEPT 來說尤其令人興奮，因為它標誌著我們可以清楚地看到並感受到市場對 Aquablation 療法的接受度和意識不斷增長的第一年。

Specifically, there was a BPA session of PROCEPT presentation that was not sponsored by industry where a significant number of Aquablation therapy papers were presented. The presenters highlighted real-world outcomes that were consistent with the company's clinical trials.

具體來說，有一個 PROCEPT 演示的 BPA 會議，該會議不是由行業贊助的，其中展示了大量 Aquablation 治療論文。演講者強調了與公司臨床試驗一致的現實結果。

This rapid increase in real work Aquablation therapy publications continues to provide more confidence for future adopters of the technology. Throughout the weekend, we also held educational and training sessions where over 100 new surgeons participated. Additionally, our expansion into prostate cancer garnered noticeable attention at the AUA with a growing number of urologists requesting more information on how Aquablation therapy could treat prostate cancer.

Aquablation 療法出版物的實際工作量迅速增加，並繼續為該技術的未來採用者提供更多信心。整個週末，我們還舉辦了教育和培訓課程，有 100 多名新外科醫生參加。此外，我們向前列腺癌的擴張引起了 AUA 的廣泛關注，越來越多的泌尿科醫生要求更多有關 Aquablation 療法如何治療前列腺癌的資訊。

Since prostate cancer is a very slow-moving disease with a low mortality rate, it is no secret that in many low and intermediate risk cases, legacy treatments cause unnecessary harm at the request of patients who demand the cancer be removed from their body. These decisions can lead to a significant decrease in the patient's quality of life.

由於前列腺癌是一種進展緩慢、死亡率較低的疾病，眾所周知，在許多低風險和中風險病例中，應患者要求將癌症從體內切除的要求，傳統治療方法會造成不必要的傷害。這些決定可能會導致患者的生活品質顯著下降。

Given this backdrop, many surgeons at the AUA were very interested in learning more about Aquablation therapy's potential efficacy knowing that the safety profile demonstrated in the BPH is so attractive. Furthering our expansion into prostate cancer, in April, we initiated enrollment of PRCT002, PROCEPT's first IDE study in men with localized prostate cancer.

鑑於這種背景，AUA 的許多外科醫生非常有興趣了解更多有關 Aquablation 療法的潛在功效，因為他們知道 BPH 中所展示的安全性非常有吸引力。為了進一步拓展前列腺癌領域，我們在 4 月啟動了 PRCT002 的招募，這是 PROCEPT 首個針對局限性前列腺癌男性的 IDE 研究。

As a reminder, PRCT002 is an FDA-approved single-arm study of 20 patients with grade Group I and II prostate cancer. I'm excited to announce enrollment is progressing nicely and that we expect to complete enrollment in third quarter. We look forward to tracking these patients in the coming months and plan to provide additional information when it becomes available.

需要提醒的是，PRCT002 是 FDA 批准的單臂研究，受試者為 20 名 I 級和 II 級前列腺癌患者。我很高興地宣布註冊工作進展順利，我們預計將在第三季完成註冊。我們期待在未來幾個月內追蹤這些患者，並計劃在獲得更多資訊時提供更多資訊。

Turning to recent reimbursement and payor coverage updates. Between late March and June, we received positive coverage policies from Blue Cross Blue Shield of Arkansas and Blue Cross Blue Shield of Louisiana. Combined, both plans account for roughly 1.5 million covered lives.

轉向最近的報銷和付款人承保範圍更新。3 月底至 6 月期間，我們收到了阿肯色州 Blue Cross Blue Shield 和路易斯安那州 Blue Cross Blue Shield 的積極承保保單。這兩個計劃總共涵蓋了大約 150 萬人。

While relatively in (inaudible) given our existing 95% payor coverage, we do believe the addition of these Blue Cross Blue Shield plans will have a positive incremental impact on utilization locally considering we have numerous systems in those states.

雖然考慮到我們現有95% 的付款人覆蓋率，相對而言（聽不清楚），但我們確實相信，考慮到我們在這些州擁有眾多系統，增加這些Blue Cross Blue Shield 計劃將對當地的利用率產生正面的增量影響。

Additionally, in mid-July, CMS published its 2025 proposed rule for the Hospital Outpatient Prospective Payment System. The Level 6 APC code for Aquablation has a proposed payment that would provide the hospital $9,209 and the ASC setting $6,666 for each Aquablation procedure which is a 5% and 7% increase, respectively, over the 2024 rates.

此外，7 月中旬，CMS 發布了 2025 年醫院門診預期支付系統擬議規則。Aquablation 的 6 級 APC 代碼提議為醫院提供 9,209 美元的付款，ASC 為每次 Aquablation 手術設定 6,666 美元，分別比 2024 年的費率增加 5% 和 7%。

The final rule is expected to be published in November. Also, as a reminder, in mid-June, we announced that the American Medical Association established a new current procedural terminology or CPT Category I code for Aquablation therapy to treat BPH. The Category I CPT code will replace the existing Category III CPT code starting January 1, 2026.

最終規則預計將於 11 月發布。另外，提醒一下，6 月中旬，我們宣布美國醫學會為治療 BPH 的 Aquablation 療法制定了新的現行程序術語或 CPT I 類代碼。自 2026 年 1 月 1 日起，I 類 CPT 代碼將取代現有的 III 類 CPT 代碼。

With respect to international market development activities, we generated $5.7 million of international revenue in the second quarter of 2024, representing growth of 79% compared to the prior year period. Growth in the second quarter was once again driven primarily by strong sales momentum in the United Kingdom.

在國際市場開發活動方面，我們在 2024 年第二季實現了 570 萬美元的國際收入，較上年同期成長 79%。第二季的成長再次主要受到英國強勁銷售勢頭的推動。

Additionally, we sold our first two systems to Japanese hospitals in the second quarter. Following the completion of the post-market study earlier this year, our Japanese pipeline has increased nicely. Positive ASPs in the market and historical acceptance of new technology gives us confidence in our future investments and our ability to accelerate the penetration of the Japanese market in 2025.

此外，我們在第二季向日本醫院出售了前兩個系統。繼今年稍早完成市場後研究後，我們的日本管道已大幅增加。市場上積極的平均售價和對新技術的歷史接受度讓我們對未來的投資以及我們在 2025 年加速滲透日本市場的能力充滿信心。

Similarly to the excitement we generated at the AUA conference in the United States, we also had a sizable presence at the British Association of Urological Surgeons in Birmingham, England. This was the first conference since NICE granted its standard arrangement recommendation for Aquablation therapy and the interest from surgeons reinforce our confidence in penetrating the UK market.

與我們在美國 AUA 會議上引起的興奮類似，我們在英國伯明翰的英國泌尿科醫生協會也有相當大的影響力。這是自 NICE 授予 Aquablation 治療標準安排建議以來的第一次會議，外科醫生的興趣增強了我們進軍英國市場的信心。

Lastly, I want to comment on new changes made to our Board of Directors. In mid-April, we welcomed Larry Wood to our Board of Directors. Larry joins PROCEPT with over 35 years of medical device experience, most notably at Edwards Lifesciences where he is currently Group President of its TAVR and Surgical Structural Heart business.

最後，我想談談我們董事會的新變化。四月中旬，我們歡迎拉里伍德 (Larry Wood) 加入我們的董事會。Larry 在加入 PROCEPT 時擁有超過 35 年的醫療器材經驗，尤其是在 Edwards Lifesciences 工作時，他目前擔任 TAVR 和外科結構性心臟業務的集團總裁。

Additionally, in mid-July, we welcomed Tom Prescott as our new Chairman of the Board. Tom joins PROCEPT with decades of medical device experience, most notably as President and CEO of Align Technology from 2002 to 2015. Specifically under Tom's leadership, Align transformed the orthodontic dental market, growing revenue from $75 million to near $1 billion when he retired.

此外，七月中旬，我們歡迎湯姆·普雷斯科特 (Tom Prescott) 擔任我們的新董事會主席。Tom 加入 PROCEPT 時擁有數十年的醫療設備經驗，最著名的是 2002 年至 2015 年擔任 Align Technology 的總裁兼執行長。特別是在 Tom 的領導下，Align 徹底改變了矯正牙科市場，收入從 7,500 萬美元成長到他退休時的近 10 億美元。

We believe Larry and Tom's experience and leadership in strategic areas related to commercialization, operations, clinical and regulatory affairs will help PROCEPT efficiently scale in the coming years. We are also pleased that Dr. Fred Moll, who has served as our Chairman since 2021, will continue to serve on our Board of Directors as well.

我們相信 Larry 和 Tom 在商業化、營運、臨床和監管事務相關策略領域的經驗和領導力將有助於 PROCEPT 在未來幾年有效擴展。我們也很高興自 2021 年起擔任我們董事長的 Fred Moll 博士也將繼續在我們的董事會任職。

To conclude my prepared remarks, every key metric we track continues to move in the right direction. In summary, our pipeline and sales funnel continue to grow nicely in what we currently believe is a stable to improving macro environment. On average, the longer an account has been active, the more procedures it performs. We are launching new accounts with more surgeons while sustaining excellent retention rates.

作為我準備好的發言的總結，我們追蹤的每個關鍵指標都繼續朝著正確的方向發展。總而言之，在我們目前認為宏觀環境穩定且不斷改善的情況下，我們的管道和銷售管道持續良好成長。平均而言，帳戶的活躍時間越長，執行的程序就越多。我們正在與更多外科醫生建立新帳戶，同時保持出色的保留率。

Our international business continues to exceed expectations. Our commercial organization is the largest and most tenured in the company's history, which we believe will lead to increased productivity. And lastly, we have continued to exceed our guidance around profitability metrics primarily with the expansion of gross margins throughout 2024.

我們的國際業務持續超出預期。我們的商業組織是公司史上規模最大、任期最長的，我們相信這將提高生產力。最後，我們繼續超越獲利指標的指導，主要是 2024 年毛利率的擴大。

Given this positive momentum, we believe Aquablation therapy is laying the foundation to become the BPH surgical standard of care and PROCEPT is emerging as a leading global urology company.

鑑於這一積極勢頭，我們相信 Aquablation 療法正在為成為 BPH 手術護理標準奠定基礎，PROCEPT 正在成為全球領先的泌尿外科公司。

And with that, I will turn the call over to Kevin.

這樣，我會將電話轉給凱文。

Thanks, Reza. Total revenue for the second quarter of 2024 was $53.4 million, representing growth of 61% compared to the second quarter of 2023. US revenue for the quarter was $47.7 million, representing growth of 59% compared to the prior year period. In the second quarter, we sold 47 AquaBeam Robotic Systems with average selling prices of $378,000, generating total US system revenue of $17.8 million, representing system revenue growth of 20% compared to the second quarter of 2023.

謝謝，雷札。2024 年第二季總營收為 5,340 萬美元，較 2023 年第二季成長 61%。該季度美國營收為 4,770 萬美元，較去年同期成長 59%。第二季度，我們售出了 47 套 AquaBeam 機器人系統，平均售價為 378,000 美元，美國系統總收入為 1,780 萬美元，與 2023 年第二季相比，系統收入成長了 20%。

Also, we did not place any units at an ASC in the US in the second quarter. US handpiece and consumable revenue for the second quarter of 2024 was $27.3 million, representing growth of approximately 101% compared to the second quarter of 2023.

此外，第二季我們沒有在美國的 ASC 中放置任何單位。2024年第二季美國手機和耗材收入為2,730萬美元，較2023年第二季成長約101%。

Handpiece growth was driven by an increase in the install base of AquaBeam Robotic Systems. Additionally, monthly utilization of 7.1 handpieces per account increased approximately 15% compared to the second quarter of 2023. Utilization in the second quarter exceeded our expectations and represents a 4% sequential increase from the first quarter.

AquaBeam 機器人系統安裝基數的增加推動了手機的成長。此外，與 2023 年第二季相比，每個帳戶每月 7.1 手機的使用量增加了約 15%。第二季的利用率超出了我們的預期，比第一季環比成長了 4%。

Overall, we continue to see increased utilization across cohorts, which is a direct reflection of strong commercial execution, which includes training new surgeons, high surgeon retention, and opening new accounts in a timely manner. We shipped approximately 8,000 handpieces in the US in the second quarter, representing unit growth of 105% compared to the second quarter of 2023.

總體而言，我們繼續看到各個隊列的利用率不斷提高，這是強大的商業執行力的直接反映，其中包括培訓新外科醫生、高外科醫生保留率以及及時開設新帳戶。第二季我們在美國出貨了約 8,000 部手機，與 2023 年第二季相比成長了 105%。

Second quarter handpiece average selling prices were approximately $3,200. We also recorded $1.7 million of other consumable revenue in the second quarter of 2024. International revenue for the second quarter was $5.7 million, representing growth of approximately 79%. Gross margin for the second quarter of 2024 was 59%, representing an all-time high and 200 basis points above our second quarter guidance we provided in May.

第二季手機平均售價約 3,200 美元。2024 年第二季度，我們也錄得 170 萬美元的其他消費品收入。第二季國際營收為 570 萬美元，成長約 79%。2024 年第二季的毛利率為 59%，創下歷史新高，比我們 5 月提供的第二季指引高出 200 個基點。

Gross margin expansion in the second quarter was once again due to strong execution from our operations team and our ability to absorb overhead expenses along with revenue overachievement.

第二季毛利率的擴張再次歸功於我們營運團隊的強勁執行力以及我們吸收管理費用以及收入超額完成的能力。

Moving down the income statement. Total operating expenses in the second quarter of 2024 were $58.3 million compared to $44.1 million in the same period of the prior year, and $52.7 million in the first quarter of 2024. The increase was driven primarily by increased sales and marketing expenses, mostly to expand the commercial organization, and increased research and development expenses. We are very pleased with the operating expense leverage we have demonstrated in the first half of 2024.

將損益表向下移動。2024 年第二季的總營運費用為 5,830 萬美元，去年同期為 4,410 萬美元，2024 年第一季為 5,270 萬美元。這一增長主要是由於銷售和行銷費用的增加（主要是為了擴大商業組織）以及研發費用的增加。我們對 2024 年上半年所展現的營運費用槓桿率感到非常滿意。

When comparing revenue growth to operating expense growth, revenues increased 70% in the first six months of 2024 on 31% operating expense growth. Total interest and other income was $1.2 million as quarterly interest expense from our $52 million term loan plus $300,000 of foreign currency losses was offset by a favorable interest income from our cash balances.

將收入成長與營運費用成長進行比較時，2024 年前 6 個月的收入成長了 70%，而營運費用成長了 31%。利息和其他收入總額為 120 萬美元，因為我們 5,200 萬美元定期貸款的季度利息支出加上 30 萬美元的外幣損失被我們現金餘額的有利利息收入所抵消。

Net loss was $25.6 million for the second quarter of 2024 compared to $25.3 million in the same period of the prior year. Adjusted EBITDA was a loss of $18 million compared to a loss of $19.9 million in the second quarter of 2023. Our cash and cash equivalents balance as of June 30 was $217 million.

2024 年第二季淨虧損為 2,560 萬美元，去年同期淨虧損為 2,530 萬美元。調整後 EBITDA 虧損 1,800 萬美元，而 2023 年第二季虧損 1,990 萬美元。截至 6 月 30 日，我們的現金和現金等價物餘額為 2.17 億美元。

We reported cash usage in the quarter of $11.5 million, which is a significant improvement from the $31.6 million usage in the first quarter of 2024. Most of this progress was driven by improvements in working capital. We believe our strong balance sheet will provide the liquidity and capital resources needed to support and grow our current business.

我們報告本季的現金使用量為 1,150 萬美元，比 2024 年第一季的 3,160 萬美元有顯著改善。這項進展大部分是由營運資本的改善所推動的。我們相信，我們強大的資產負債表將提供支持和發展我們目前業務所需的流動性和資本資源。

Moving to our 2024 financial guidance. We now expect full year 2024 total revenue to be approximately $217 million, representing growth of approximately 59% compared to 2023. Starting with US systems. We continue to expect to sell approximately 185 systems in 2024. In terms of cadence, we expect third quarter system sales to be in the low 40s with fourth quarter system sales being our strongest quarter of the year. We also anticipate system average selling prices in the second half of 2024 to be approximately $380,000.

轉向我們的 2024 年財務指引。我們目前預計 2024 年全年總營收約為 2.17 億美元，較 2023 年成長約 59%。從美國系統開始。我們仍預計 2024 年將銷售約 185 套系統。就節奏而言，我們預計第三季系統銷售額將在 40 左右，第四季度系統銷售額將成為我們今年最強勁的季度。我們也預計 2024 年下半年的系統平均售價約為 38 萬美元。

Turning to US handpieces. We expect to sell approximately 33,350 handpieces for the full year with average selling prices of approximately $3,200. We also expect other consumables revenue to be approximately $7.8 million for the full year. Regarding quarterly cadence and given the strength we saw in the second quarter, we expect third quarter utilization to be down slightly compared to the second quarter, with fourth quarter utilization increasing sequentially due to normal seasonal strength in an aging install base. Additionally, we now expect US service revenue to be approximately $11.7 million.

轉向美國手機。我們預計全年銷售約 33,350 支手機，平均售價約為 3,200 美元。我們也預計全年其他消耗品收入約為 780 萬美元。就季度節奏而言，考慮到我們在第二季度看到的強勁勢頭，我們預計第三季度的利用率將比第二季度略有下降，而由於老化安裝基礎的正常季節性強度，第四季度的利用率將連續增加。此外，我們現在預計美國服務收入約為 1,170 萬美元。

Lastly, on international revenue, given another strong quarter and positive momentum in the United Kingdom, we now expect full year international revenue to be approximately $20.5 million, representing annual growth of approximately 73%.

最後，關於國際收入，鑑於英國又一個強勁的季度和積極的勢頭，我們現在預計全年國際收入約為 2050 萬美元，年增長率約為 73%。

Moving down the income statement. We now expect full year 2024 gross margins to be approximately 59%, an increase from our previously issued guidance of 58% to 59%. Regarding quarterly cadence, we continue to expect gross margins to modestly increase sequentially in the second half of the year.

將損益表向下移動。我們目前預計 2024 年全年毛利率約為 59%，高於我們先前發布的 58% 至 59% 的指導值。就季度節奏而言，我們繼續預計下半年毛利率將小幅成長。

Turning to operating expenses. We continue to expect full year 2024 operating expenses to be approximately $231.5 million, representing growth of 29%. In terms of quarterly cadence, we expect the third quarter operating expense to be approximately $59 million. Given current interest rates, we expect to generate net interest income of approximately $6.1 million in 2024.

轉向營運費用。我們繼續預期 2024 年全年營運費用約為 2.315 億美元，成長 29%。就季度節奏而言，我們預計第三季營運費用約為 5,900 萬美元。根據目前利率，我們預計 2024 年將產生約 610 萬美元的淨利息收入。

Given the increase in revenue and gross margin, along with our continued view on operating expenses, we now expect full year 2024 adjusted EBITDA loss to be approximately $67.5 million, an improvement from a loss of $70 million from our previous guidance and up almost $6 million from our initial guidance provided in February.

鑑於收入和毛利率的增加，以及我們對營運支出的持續看法，我們現在預計2024 年全年調整後EBITDA 損失約為6,750 萬美元，比我們之前指導的7,000 萬美元損失有所改善，增加了近600 萬美元根據我們二月提供的初步指導。

At this point, I'd like to turn the call back to Reza for closing comments.

此時，我想將電話轉回給 Reza 以徵求結束意見。

Thanks, Kevin. In closing, I want to thank our employees, customers and shareholders for all their support to help us along our journey to becoming the standard of care for BPH. We will continue to leverage our commercial and clinical investments to execute on our long-term strategy. Have a great day, and I look forward to seeing many of you at upcoming investor conferences. At this point, we will take questions.

謝謝，凱文。最後，我要感謝我們的員工、客戶和股東的所有支持，幫助我們一路走來成為 BPH 照護標準。我們將繼續利用我們的商業和臨床投資來執行我們的長期策略。祝您有美好的一天，我期待在即將舉行的投資者會議上見到你們中的許多人。此時，我們將提出問題。

Operator?

操作員？

(Operator instructions)

（操作員說明）

Craig Bijou, Bank of America Securities.

Craig Bijou，美國銀行證券公司。

Good afternoon, guys. Thanks for taking the questions, and congrats on another strong quarter. So I want to start or I want to ask about two things, but firstly on the expense side. Obviously you really stood out. Your cash burn getting lower was clearly impressive and gross margin coming in better than what you guys had said it was going to be last quarter.

下午好，夥計們。感謝您提出問題，並祝賀又一個強勁的季度。所以我想開始或我想問兩件事，但首先是費用方面。顯然你確實脫穎而出。你們的現金消耗下降顯然令人印象深刻，毛利率也比你們所說的上季好。

So maybe just big picture, Kevin, if you can just kind of talk about your ability to leverage the business on the gross margin line on the OpEx line, and then how we should think about kind of cadence, not just this year, but looking ahead and where can those margins go and how to think about your cash flow moving forward to.

所以也許只是大局，凱文，如果你能談談你在營運支出線上的毛利率線上利用業務的能力，然後我們應該如何考慮節奏，不僅僅是今年，而是尋找未來，這些利潤會去哪裡，以及如何考慮未來的現金流。

Thanks, Craig, for the question. And to address this first, what occurred this quarter in kind of 2024 gross margins, we've been consistent in saying that the biggest contributor for gross margin expansion for us is our ability to leverage the fixed costs that we've built into the business and absorb related overhead on increased revenues. That's really what you saw come to fruition in our second quarter and what's implied is going to continue in our future guidance.

謝謝克雷格的提問。首先，為了解決這個問題，即本季 2024 年毛利率的情況，我們一直表示，毛利率擴張的最大貢獻者是我們利用業務中內置的固定成本的能力並吸收增加收入的相關管理費用。這確實是您在第二季度看到的成果，並且暗示的內容將在我們未來的指導中繼續下去。

And on top of that, we did talk at the end of 2023 about a few operational things around moving to our new facility, around things like first-pass yield and scrap and warranty. We've put a lot of focus in those areas in the first six months of 2024. That really has helped expand gross margins to the 59 % we saw in the second quarter.

最重要的是，我們確實在 2023 年底討論了一些圍繞搬到新工廠的營運問題，例如一次合格率、廢品率和保固等問題。2024 年前六個月，我們將重點放在這些領域。這確實有助於將毛利率擴大到第二季的 59%。

Regarding cadence throughout the rest of the year, we continue to expect this number to expand in the third quarter, I think somewhere in the 59.5% to 60% range, and then exiting the year north of 60% to get to the full year guide, 59%, which is, I think, a tremendous achievement from last year when we were ending the full year at 52%. So good margin improvement there.

關於今年剩餘時間的節奏，我們繼續預計這個數字將在第三季度擴大，我認為在 59.5% 至 60% 的範圍內，然後退出今年的 60% 以達到全年指南，59%，我認為，與去年相比，這是一個巨大的成就，當時我們全年的成長率為52%。那裡的利潤率改善非常好。

That kind of leads into your last question, just kind of longer term potential of the business. On this call, we're not prepared to talk about 2025 on this call. I do think, given the trajectory we're on with margins, particularly exiting the year in the low 40s, given our operating expense leverage ratio, it just gives us increased confidence with this margin profile and with our growth.

這就引出了你的最後一個問題，就是業務的長期潛力。在這次電話會議上，我們不准備在這次電話會議上談論 2025 年。我確實認為，考慮到我們的利潤率軌跡，特別是考慮到我們的營運費用槓桿率，尤其是今年的利潤率在40 左右，這只會讓我們對這種利潤率狀況和我們的成長更有信心。

The longer term process could be a highly profitable business. And that's really good to see come to fruition here in the first six months of '24.

從長遠來看，該過程可能是一項高利潤的業務。很高興看到這一目標在 24 年前六個月就在這裡取得成果。

Thanks, Kevin. And just following up, maybe on the comments on the international business and the record quarter you guys had, I do think that we don't talk enough about the international expansion opportunities that you guys do have. So maybe just talk about what you've seen thus far in the UK. And then obviously Japan is something to look forward to, that's really going to start ramping soon.

謝謝，凱文。接下來，也許是關於國際業務和你們所創紀錄的季度的評論，我確實認為我們對你們所擁有的國際擴張機會的討論還不夠。所以也許只是談談您迄今為止在英國所看到的情況。顯然日本是值得期待的，它很快就會開始成長。

So maybe talk about how the size of those opportunities relative to your current US opportunity.

因此，也許可以談談這些機會的規模與您目前在美國的機會相比如何。

Thanks, Craig. We are very happy with the strong second quarter international driven primarily with the UK. As we have previously said, the NICE endorsement was a great driver for this. Always similar to the US, it started to clink all that up.

謝謝，克雷格。我們對主要由英國推動的第二季國際業務的強勁表現感到非常高興。正如我們之前所說，NICE 的認可是一個巨大的推動力。總是與美國相似，它開始讓這一切變得叮噹作響。

And now we are starting to have a good install base in UK so that we can have more predictable utilization. And I'm happy to say that we also placed two robots in Japan. Having said that, investors should expect that we are going to stay conservative about our cadence and the international team we put in international was about 18 months ago. It's only 2024 was the first year on the international, but we have the same enthusiasm on the clinical data on making the practices more efficient on the international.

現在我們開始在英國擁有良好的安裝基礎，以便我們能夠獲得更可預測的利用率。我很高興地說，我們還在日本放置了兩台機器人。話雖如此，投資人應該預料到我們將對我們的節奏保持保守，而我們在國際上投入的國際團隊大約是 18 個月前。2024年只是國際上的第一年，但我們對臨床數據有著同樣的熱情，致力於讓國際上的實務更有效率。

I'm going to ask if Sham wants to add anything to my comments.

我會問 Sham 是否想在我的評論中添加任何內容。

Sure. Yeah, Craig, I would just add that the process that we're using to commercialize in the UK and Japan is very similar to the process that we've used in the US. So when you think about the structure of the team, you think about onboarding, you think about building the funnel. We have a lot of great data over the years in the US that we've been able to use to build our business, provide predictability, and be able to forecast.

當然。是的，克雷格，我想補充一點，我們在英國和日本用於商業化的流程與我們在美國使用的流程非常相似。因此，當您考慮團隊的結構時，您會考慮入職，並考慮建立漏斗。多年來，我們在美國擁有大量重要數據，我們能夠利用這些數據來建立我們的業務、提供可預測性並能夠進行預測。

And we feel the same way about our UK business now that we've had a nice start to the business there. And then as you mentioned, we're really excited about Japan as well. And so we look at 2025 as being a great year for Japan. This is going to be our first full year in the UK with our business and our team starting to get ramped up. So we're excited to finish out the year and then provide some great visibility in the future years in the UK as well.

我們對英國業務也有同樣的感覺，因為我們在那裡的業務有了良好的開端。正如您所提到的，我們對日本也感到非常興奮。因此，我們認為 2025 年對日本來說是偉大的一年。這將是我們在英國的第一個全年，我們的業務和團隊開始發展。因此，我們很高興能夠結束這一年，並在未來幾年在英國提供一些良好的知名度。

Matthew O'Brien, Piper Sandler.

馬修·奧布萊恩，派珀·桑德勒。

All right, thanks for taking the question. Maybe just starting with the back half guide, what's implied anyway. I looked the last couple of years, you generated 58% and 59% of sales in the back half of the year. At this time you're guiding to more like 54%. So it kind of implies a little bit of a slowdown and given what we've seen on the handpiece side especially, and then with all those reps on the commercial side, I'm just not sure why there's that disconnect. So just anything we should be mindful of in terms of why there might be a slight acceleration in the back half versus what you've done here in the first half,?

好的，感謝您提出問題。也許只是從後半部開始，無論如何都暗示著什麼。我看了過去幾年，下半年的銷售額分別達到了 58% 和 59%。此時您的指導值約為 54%。因此，這意味著有點放緩，特別是考慮到我們在手機方面看到的情況，然後考慮到商業方面的所有這些代表，我只是不確定為什麼會出現這種脫節。那麼，我們應該注意的是，與上半場相比，為什麼後半場可能會出現輕微的加速？

Thanks, this is Kevin. And as you pointed out, we had a really -- I'll start with handpieces utilization. We did have a very strong, stronger than expected even internally second quarter on utilization, increasing 15% sequentially. And if you look at kind of what Q2 of 23 did, utilization was actually down. So our first half, I would argue, is much stronger than our historical trends. And I wouldn't read in anything into kind of the back half versus first half. But I will say, implied in our back half guide, we still do feel it's prudent to manage expectations, just given how sensitive monthly utilization can be quarter to quarter.

謝謝，這是凱文。正如您所指出的，我們確實——我將從手機的使用開始。第二季的利用率確實非常強勁，甚至比內部預期還要強勁，季增了 15%。如果你看看 23 第二季的情況，利用率實際上下降了。因此，我認為，我們的上半年比我們的歷史趨勢強得多。我不會讀任何關於後半場與上半場的內容。但我要說的是，正如我們的後半部分指南所暗示的那樣，我們仍然認為管理預期是謹慎的，考慮到每個季度的月度利用率有多敏感。

And to put that in perspective, we plan to launch almost 100 new accounts in the back half of the year, which is almost 25% of our total install base. And we've been very consistent saying that it takes six to nine months for an account to ramp up. But at the same time, we've been able to overcome that with launching accounts with multiple surgeons and growing utilization quicker than we did historically. So there is a little bit of just expectation management in the back half.

從長遠來看，我們計劃在今年下半年推出近 100 個新帳戶，幾乎占我們總安裝量的 25%。我們一直非常一致地說，一個帳戶需要六到九個月的時間才能增加。但同時，我們已經能夠克服這個問題，與多名外科醫生建立帳戶，並以比以往更快的速度提高利用率。所以後半段有些只是期望管理。

I wouldn't read in anything into that, the thinking there's a slowdown in utilization at all. And then with capital, I'll flip to capital, our guidance does assume a number in the low 40s in the third quarter, which puts the fourth quarter somewhere in the high 50s, think somewhere in the 57% to 59% range. And if you look at the productivity of our sales force, that actually assumes that we have the same productivity on a per rep basis in the fourth quarter of '24 than the fourth quarter of '23.

我不會對此進行任何解讀，認為利用率根本會下降。然後就資本而言，我將轉向資本，我們的指導確實假設第三季的數字在 40 多歲左右，這使得第四季度在 50 多歲左右，認為在 57% 到 59% 的範圍內。如果你看看我們銷售人員的生產力，實際上是假設我們在 24 年第四季與 23 年第四季的每個銷售代表的生產力相同。

So no slowdown there and no real change in what we're seeing with how deals progress through the funnel at all.

因此，我們所看到的交易在漏斗中的進展並沒有放緩，也沒有真正的變化。

Got it. Sorry to leave you out, Reza, but I did have a question for Sham. It's really on the commercial team. Just curious how the commercial team, especially on the capital side is trending because when you expand the Salesforce, I know it's smaller numbers, but still 30%, that can get a little unwieldy and maybe not as much as productive as you want it.

知道了。很抱歉把你排除在外，Reza，但我確實有一個問題要問 Sham。這確實是商業團隊的事。只是好奇商業團隊，尤其是資本方面的趨勢如何，因為當你擴展Salesforce 時，我知道它的數量會減少，但仍然是30%，這可能會變得有點笨拙，而且可能沒有你想要的那麼高效。

So I'm curious how that's trending as far as your expectations. And then is there any updates on the IDNs and the team there and how things are trending with that group? Thank you.

所以我很好奇，就你的期望而言，趨勢如何。那麼 IDN 和那裡的團隊有什麼更新嗎？謝謝。

Thanks, Matt. The one thing I would say on the capital team is we do continue to expand, but when you look at the numbers, in some they're not drastically different than prior years. So the team has gotten bigger. The processes are well in place now to onboard new employees, get them through training, and get them to be more productive.

謝謝，馬特。我要對資本團隊說的一件事是，我們確實在繼續擴張，但當你看一下這些數字時，會發現有些數字與前幾年並沒有太大不同。於是，團隊就變大了。現在，新員工入職、接受培訓並提高工作效率的流程已經就位。

As we've talked about before, we are thrilled with the level of talent we bring in at the rep level, at the management level of bringing in some really experienced managers from the capital environment, many of them robotic capital managers that helps to onboard and helps to get up to speed quickly. We fully expect that team will be very productive the back half of this year, as Kevin mentioned.

正如我們之前談到的，我們對我們在代表層面和管理層面引入的人才水平感到興奮，從資本環境中引入了一些真正經驗豐富的經理，其中許多是機器人資本經理，有助於入職並有助於快速上手。正如凱文所提到的，我們完全預計團隊今年下半年將非常有效率。

Regarding strategic accounts, this is a big difference for us in 2024 versus 2023, we specifically hired a strategic account team and also added a junior capital rep team with the intent to help not only build our pipeline to be able to bring these deals to fruition.

關於策略客戶，這對我們來說是2024 年與2023 年的一個很大的不同，我們專門聘請了一個策略客戶團隊，還增加了一個初級資本代表團隊，目的不僅是幫助建立我們的管道，使這些交易能夠實現。

What we see in strategic accounts that is slightly different than a standalone hospital is when you start to have multiple systems start to bubble up to the purchase phase, the corporate accounts team will work with the IDNs to ensure that they acquire the technology the best way possible for them.

我們在策略客戶中看到的與獨立醫院略有不同的是，當您開始擁有多個系統開始進入購買階段時，企業客戶團隊將與 IDN 合作，以確保他們以最佳方式獲取技術對他們來說是可能的。

When the numbers were smaller, it wasn't as important because you do it local or regional funding. When the numbers get larger, the national accounts team, it becomes very, very important to us. So I'm very happy with the progress so far this year, and I think they'll just be better as time goes on.

當數字較小時，它就不那麼重要了，因為你是透過本地或區域資金來實現的。當數字變得更大時，國民帳戶團隊對我們來說變得非常非常重要。因此，我對今年迄今為止的進展感到非常滿意，我認為隨著時間的推移，他們會變得更好。

Richard Neuwitter, Trulia Securities.

理查德‧紐維特 (Richard Neuwitter)，Trulia 證券公司。

Hi, thanks for taking my questions. And congrats on the strong quarter. First question, just on the system ASP, 380,000, definitely above trend, what we modeled at where you've been. And that's what you're going to see here. Maybe just comment on that and just the capital outlook in the funnel broadly. And then I have a follow up.

您好，感謝您回答我的問題。恭喜季度的強勁表現。第一個問題，就係統 ASP 而言，380,000，絕對高於趨勢，我們根據您所在的位置進行建模。這就是您將在這裡看到的。也許只是評論一下這一點以及漏斗中的資本前景。然後我有一個後續行動。

Yes. Thanks, Rich. This is Kevin and our guide is based on what we see in the funnel. And we have very good line of sight of the deals that are in the pipeline today. Given this, we felt comfortable kind of raising that ASP for the back half of the year to 380 coming off of a 378. ASP in the second quarter, we continue to have very productive conversations with hospital CFOs and administrators about the ROI on our system, the ability for them to retain patients that they may otherwise would have had to referred out, the ability to standardize kind of the treatment algorithm. And all of those things are leading ASPs to creep higher on systems, which is good to see.

是的。謝謝，里奇。這是凱文，我們的指南是基於我們在漏斗中看到的內容。我們對今天正在進行的交易有很好的了解。有鑑於此，我們感覺可以放心地將下半年的平均售價從 378 提高到 380。在第二季的ASP 中，我們繼續與醫院財務長和管理人員就我們系統的投資回報率、他們留住患者的能力（否則他們可能不得不轉診）進行非常富有成效的對話，標準化各種類型的能力治療演算法。所有這些都導致​​ ASP 在系統上的表現越來越好，這是值得高興的。

That's really helpful. Thank you. Maybe just just one other one. I know over the last year, there's been RAC audits by Medicare out there with respect to just looking at prostate size and things like that, needing to get pre-authorization to -- extra pre-authorization steps to get the surgery. I'm just curious. Obviously, it hasn't impacted your utilization or your numbers at all, but I'm just curious if you've seen that at all, how you deal with it out in the field? And just on the insurance backdrop, if there's anything else that's worth calling out. Thanks.

這真的很有幫助。謝謝。也許只是另一件。我知道去年，Medicare 進行了 RAC 審核，僅檢查前列腺大小等，需要獲得預授權 - 額外的預授權步驟才能進行手術。我只是好奇。顯然，它根本沒有影響您的利用率或您的數量，但我只是好奇您是否看到過這種情況，您在現場如何處理它？就保險背景而言，是否還有其他值得一提的地方。謝謝。

I'm going to turn it over to Sham. Sham could probably answer that one better.

我要把它交給Sham。沙姆也許可以更好地回答這個問題。

Sure. Yeah, I'm happy to take the question. So we're very aware of the RAC audits. Maybe I'll give a slight background, small background RAC audits and then talk about ProCEP and our customers and how we're assisting them as they go through that process.

當然。是的，我很高興回答這個問題。所以我們非常了解 RAC 審核。也許我會稍微介紹一下 RAC 審核的背景，然後談談 ProCEP 和我們的客戶，以及我們如何在他們完成流程時為他們提供協助。

RAC audits have been around for a long time. They're very common across healthcare. Medicare started doing it about 15 years ago. Regarding our customers, we started to see this late summer of '23. Now, you all should know that during the COVID years, Medicare was not doing audits for years. They started to do them again last year.

RAC 審計已經存在很久了。它們在醫療保健領域非常常見。Medicare 大約 15 年前就開始這麼做了。至於我們的客戶，我們從 23 年夏末開始看到這一點。現在，你們都應該知道，在新冠疫情期間，醫療保險多年來沒有進行審計。去年他們又開始這麼做了。

And despite the last 9 to 12 months, as you mentioned, we've been able to execute and increase utilization nicely. To provide some more context, this is Medicare specific. And Medicare currently does have a prostate size limitation of 150 grams, as you mentioned. So our FDA labeling doesn't match that. Just to be clear, our FDA labeling does not have a size limitation.

正如您所提到的，儘管過去 9 到 12 個月，我們仍然能夠很好地執行和提高利用率。為了提供更多背景信息，這是 Medicare 特有的。正如您所提到的，醫療保險目前確實對前列腺大小有 150 克的限制。所以我們的 FDA 標籤與此不符。需要明確的是，我們的 FDA 標籤沒有尺寸限制。

So we've begun working with our surgeons and Medicare to have this restriction removed. I would also point out that we recently have been successful with five of the seven Medicare contractors in removing the age restriction. So when we first received our Medicare coverage, there was a restriction of 80 years, and that's been removed now to five of the seven contractors. So we feel confident over time we'll be able to get the size restriction removed as well.

因此，我們已經開始與外科醫生和醫療保險機構合作，取消這項限制。我還想指出的是，我們最近已經成功地與七名醫療保險承包商中的五名取消了年齡限制。因此，當我們第一次獲得 Medicare 保險時，有 80 年的限制，現在對七個承包商中的五個已經取消了這一限制。因此，我們有信心隨著時間的推移，我們也能夠取消尺寸限制。

Regarding the numbers, so you can think about how does this impact the business, we estimate half of our patients in BPH are comprised of traditional Medicare and Medicare Advantage. It's also important to note that RAC audits are only focused on traditional Medicare. So that means that about a quarter of the BPH market will be traditional Medicare. And then you think about the size, less than 10% of our procedures are over 150 grams. So this limitation does have a minimal impact on our ability to expand and achieve our utilization targets.

關於數字，您可以考慮這對業務有何影響，我們估計一半的 BPH 患者由傳統 Medicare 和 Medicare Advantage 組成。另外需要注意的是，RAC 審計僅針對傳統的 Medicare。因此，這意味著約四分之一的 BPH 市場將是傳統醫療保險。然後你想想尺寸，我們的程式只有不到10%超過150克。因此，這種限制確實對我們擴展和實現利用率目標的能力影響很小。

So we continue to work closely with our accounts to ensure their compliance. And we've even been more proactive in recent quarters helping them out. That's worked out well and our accounts are appreciative of the partnership.

因此，我們繼續與我們的客戶密切合作，以確保他們的合規性。最近幾季我們甚至更積極主動地幫助他們擺脫困境。效果很好，我們的客戶對這種合作關係表示讚賞。

Brandon Vasquez, William and Blair.

布蘭登·巴斯克斯、威廉和布萊爾。

Gentlemen, thanks for taking the question. Reza, you had made a comment that about 42% of your active install base in the US is less than 12 months at this point. Despite that, obviously you guys had a nice utilization quarter. Can you talk a little bit about the difference in utilization from maybe those 42% of accounts that are less than 12 months. and then those that are longer than 12 months, anything you can tell us like are those under 12 months on average accretive to the total utilization you guys are seeing or is that still to come? So any commentary around there?

先生們，感謝您提出問題。Reza，您曾評論說，目前您在美國的活躍安裝基數中，大約 42% 的使用時間不到 12 個月。儘管如此，顯然你們的季度利用率還是不錯的。您能否談談 42% 的帳戶使用期限少於 12 個月的使用率差異。然後是那些超過 12 個月的，你可以告訴我們的是，平均 12 個月以下的那些是否會增加你們所看到的總利用率，還是仍然會增加？那麼周圍有什麼評論嗎？

Yes, thanks. As we have said in the past, it takes about three to four quarters for that account to get to about seven per account per month. So the longer the accounts stay with us, the higher is their utilization. So we continue seeing that in our accounts. And for the reasons that we mentioned, standardizing the procedure allows attracting surgeons to that hospital. And I don't know. Kevin, do you want to add anything about the back half of the year?

是的，謝謝。正如我們過去所說，該帳戶大約需要三到四個季度才能達到每個帳戶每月七個左右。因此，帳戶在我們這裡停留的時間越長，其利用率就越高。所以我們繼續在我們的帳戶中看到這一點。由於我們提到的原因，標準化程序可以吸引外科醫生到該醫院。我不知道。凱文，你想補充一下下半年的狀況嗎？

Yes. I guess I could be a little -- I'll provide some specificity to the numbers just in how we see that cohort building over time, maybe to get to the heart of your question. I think it's important to remember, the first quarter, even when we sell a robot, the majority of those accounts are not doing procedures in that given quarter.

是的。我想我可能會提供一些具體的數字，只是為了我們如何看待隨著時間的推移而建立的群體，也許是為了觸及你問題的核心。我認為重要的是要記住，第一季度，即使我們出售機器人，大多數帳戶在該季度都沒有執行程序。

We may sell a handful of handpieces, think on average five, but in general, procedures aren't occurring until the following quarter. So therefore, you have very low utilization in the first quarter, less than two. And then in the second quarter, they start to ramp up, but they perform at less than the corporate average. And our corporate average in this quarter was seven. So they're doing less than seven.

我們可能會出售一些手機，平均為五個，但一般來說，手術要到下個季度才會進行。因此，第一季的利用率非常低，不到兩個。然後在第二季度，他們開始加速，但他們的表現低於公司平均值。本季我們公司的平均水準是七。所以他們做的還不到七個。

Then as Reza mentioned, by the time they get to the third quarter, they're doing roughly the corporate average. And then you really start to see them shine, so to speak, in quarters four, five and six, where they're typically doing north of the corporate average. And that trend's been very consistent.

然後，正如雷扎所提到的，到第三季時，他們的業績大致達到了公司平均值。然後你真的開始看到他們的光芒，可以這麼說，在第四、第五和第六季度，他們的表現通常高於公司平均。而且這種趨勢非常一致。

The one nuance that we have seen, which is a positive thing, is that ramp appears to be moving faster with newer cohorts given our focus on launching accounts with multiple cases and multiple surgeons.

我們看到的一個細微差別（這是一件積極的事情）是，考慮到我們專注於啟動多個病例和多個外科醫生的帳戶，新人群的增長速度似乎更快。

Great, thank you, that's very helpful. And then there was also a comment in the prepared remarks about how surgeons are already coming to you guys and asking about how to treat prostate cancer with Aquablation. Just kind of curious if you guys are seeing that interest kind of creep into some early treatment of prostate cancer already of patients today? Or are they just kind of inquiring information, but you're not really seeing the patients treated yet? Thanks.

太好了，謝謝，這非常有幫助。然後在準備好的評論中也有一則評論說外科醫生已經來找你們詢問如何用 Aquablation 治療前列腺癌。只是有點好奇你們是否看到這種興趣已經滲透到當今患者對前列腺癌的一些早期治療中？或者他們只是詢問信息，但您還沒有真正看到患者接受治療？謝謝。

Thanks. We saw some of that enthusiasm at AUA. That's where we saw clearly the growing market acceptance and awareness of our population. And at the same time, again at AUA, as you remember, on the first day, we had the surgeon panel discussion on both BPH and cancer. So, cancer definitely has some halo effect enthusiasm among surgeons for the potential future of our technology for cancer.

謝謝。我們在 AUA 看到了一些這種熱情。在那裡，我們清楚地看到市場接受度和人們的意識不斷增強。同時，正如您所記得的，在 AUA，第一天我們就 BPH 和癌症進行了外科醫生小組討論。因此，癌症確實在外科醫生中對我們癌症技術的潛在未來產生了一些光環效應的熱情。

At AUA, it was the same, they were asking question about the study, the progression of study, and as I mentioned in our earlier remark, we are expecting in this quarter to finish the PRCT002 study.

在 AUA 也是如此，他們詢問有關研究和研究進展的問題，正如我在先前的評論中提到的，我們預計在本季度完成 PRCT002 研究。

Josh Jennings from TD Cowan.

TD Cowan 的喬什·詹寧斯。

Hi, good evening. Thanks for taking the questions. And it's great to see such a strong first half of the year. I wanted to just ask, and we've talked about this in the past, but just the replacement cycle and just an update on your thoughts there. And I may have even asked this on the last call, I can't remember, but just any plans for the next generation AquaBeam system? And not divulging anything, when could we hear about the enhancements that are being developed today?

嗨，晚上好。感謝您提出問題。很高興看到今年上半年表現如此強勁。我只是想問一下，我們過去已經討論過這個問題，但只是更換週期以及您的想法的最新情況。我甚至可能在上次通話中問過這個問題，我不記得了，但下一代 AquaBeam 系統有什麼計劃嗎？不透露任何訊息，我們什麼時候才能聽到今天正在開發的增強功能？

Yes, thanks Josh. This is Kevin. And, look, I think if you look at our R&D spend sequentially, it's fair to say that we are working on some exciting projects internally. And we do believe we'll be transformative for PROCEPT and continue to allow us to maintain the significant clinical and technological advantage that we've been able to establish in the market.

是的，謝謝喬希。這是凱文.而且，我認為，如果你按順序查看我們的研發支出，可以公平地說，我們正在內部進行一些令人興奮的項目。我們確實相信，我們將為 PROCEPT 帶來變革，並繼續讓我們保持我們在市場上建立的顯著臨床和技術優勢。

We're not prepared today to talk about timing, but our spend has crept up recently, which would suggest that we're accelerating things internally. We talked around things, ease of use, workflow, artificial intelligence, assisted planning, given all the data we have. And those are things we continue to work on. And Reza and I, Sham, we all feel very good about that progress. And hopefully there'll be some time in the not too distant future where we'll be able to talk with more specificity about timing.

我們今天不准備談論時間安排，但我們的支出最近有所增加，這表明我們正在內部加速工作。鑑於我們擁有的所有數據，我們討論了易用性、工作流程、人工智慧、輔助規劃等問題。這些是我們繼續努力的事情。雷札和我，沙姆，我們都對這項進展感到非常滿意。希望在不久的將來我們能夠更具體地討論時間安排。

Great, and sorry to ask a repeat of Brandon's question, but we've been hearing since AUA about physicians being more willing currently to treat patients with common BPH and localized prostate cancer utilization rate is strong. I'm sure there's some contribution there. I don't know if there's any way to quantify that, for one.

很好，很抱歉重複布蘭登的問題，但自 AUA 以來我們一直聽說醫生目前更願意治療常見 BPH 患者，而且局限性前列腺癌的利用率很高。我確信那裡有一些貢獻。我不知道是否有任何方法可以量化這一點。

And then two, sorry, two-tiered question. We've also talked to some Da Vinci surgeons who told us that they are acquiring AquaBeam specifically for this indication. I just want to know if that's a trend as well. Thanks for taking the questions.

然後是兩個，抱歉，兩層問題。我們也與一些達文西外科醫生進行了交談，他們告訴我們，他們正在專門針對這種適應症購買 AquaBeam。我只是想知道這是否也是一種趨勢。感謝您提出問題。

So, as you know, we removed the cancer contraindication for the treatment of BPH. And that is not a significant increase in the market. We are not promoting our product for the treatment of cancer in prostate. All we have presented was the preliminary data that we had from outside the United States, which were presented at AUA, where surgeons and us are excited.

因此，如您所知，我們取消了治療 BPH 的癌症禁忌症。這並不是市場的顯著成長。我們不會宣傳我們的產品用於治療前列腺癌。我們所提供的只是來自美國以外地區的初步數據，這些數據是在 AUA 上公佈的，外科醫生和我們都對此感到興奮。

It's the very strong safety profile of the product, specifically on incontinence, erectile dysfunction, and that's what patients are -- as we said in our prepared remark, patients who want to move the cancer without having the side effects that that's where there are millions of men in the United States on the sidelines. They are avoiding these treatments because of the sidelines. But we are not promoting today for the cancer treatment. We are running these studies.

這是該產品非常強大的安全性，特別是在失禁、勃起功能障礙方面，而這就是患者的情況——正如我們在準備好的評論中所說，患者希望在不產生副作用的情況下轉移癌症，而這就是數百萬患者的情況。他們因為旁觀而避免接受這些治療。但我們今天宣傳的不是癌症治療。我們正在進行這些研究。

Josh, it's Sham. Regarding the patients that are being treated for BPH with Aquablation that also have a form of prostate cancer or lower intermediate disease that's currently under active surveillance or watchful waiting, many of those patients are treated for BPH with our system. And some of that datas were even presented at the AUA. You saw some of that data and we continue to be pretty excited about the opportunity to treat BPH and those patients also having great results long term in other ways as well.

喬什，我是沙姆。對於正在接受 Aquablation 治療 BPH 且患有前列腺癌或目前處於積極監測或觀察等待狀態的中低度疾病的患者，其中許多患者都在使用我們的系統治療 BPH。其中一些數據甚至在 AUA 上進行了展示。您看到了其中一些數據，我們仍然對治療 BPH 的機會感到非常興奮，這些患者在其他方面也取得了長期的良好效果。

And I think that's an opportunity that urologists are very excited to watch us. We're very -- we're keen to report on that data in the future. So we think that's going to be an opportunity. But at this point, obviously we're focused on BPH patients and many of them have cancer. So it does kind of go hand in hand. We'll be treating patients with cancer because of the BPH indication.

我認為這是泌尿科醫生非常興奮地觀看我們的一個機會。我們非常渴望在未來報告這些數據。所以我們認為這將是一個機會。但目前，顯然我們關注的是 BPH 患者，其中許多人患有癌症。所以它確實是齊頭並進的。由於 BPH 適應症，我們將治療癌症患者。

Thank you. If I could just sneak a quick follow-up in. Is this a TAM expanding indication? Or do you guys include this in terms of the number of BPH surgeries as you build your TAM historically?

謝謝。如果我能快速跟進一下就好了。這是 TAM 擴張的跡象嗎？或者你們在建立 TAM 歷史記錄時是否將其納入 BPH 手術數量？

Yes. Currently, the current market includes those patients that have cancer. And so when we think about TAM expansion, that would be just cancer treatment itself. So I don't see this as an expansion for the BPH indication.

是的。目前，目前市場包括患有癌症的患者。因此，當我們考慮 TAM 擴張時，這只是癌症治療本身。所以我不認為這是 BPH 適應症的擴展。

Nathan Treybeck, Wells Fargo.

內森·特雷貝克，富國銀行。

This is Dino Weinstock on for Nathan Treybeck. Congratulations on the strong quarter. On replacements for Q2, it looks like one system came out of the install base alongside the 47 placements. Could you talk about why the system came out of the total install base?

我是迪諾·溫斯托克（Dino Weinstock）代表內森·特雷貝克（Nathan Treybeck）。恭喜季度表現強勁。在第二季的替代品中，看起來有一個系統與 47 個位置一起從安裝庫中退出。您能談談為什麼該系統脫離了總安裝基礎嗎？

Yes. It's a great observation and a system did not come out of that install base actually. So to break this down, we did sell 47 systems in the quarter, but the install base went up 46 which is, I think, what you're alluding to. And this goes back to Q2 of 2023. And if you recall, we placed a system in the second quarter of '23 under an operating lease.

是的。這是一個很好的觀察，而且系統實際上並不是從那個安裝基礎中出來的。因此，為了細分這一點，我們在本季度確實銷售了 47 套系統，但安裝基礎增加了 46 套，我認為這正是您所提到的。這可以追溯到 2023 年第二季。如果您還記得的話，我們在 2023 年第二季以經營租賃方式放置了一個系統。

This was the first operating lease that the company had executed. This system actually converted to a sale this quarter at a very reasonable average selling price. So we included it in our sale number, but it was already in the install base. And when we had put that system under lease in Q2, we said this was going to occur. And it was good to see this account commit to a purchase.

這是該公司執行的第一個經營租賃。該系統實際上在本季度以非常合理的平均售價進行了銷售。因此，我們將其包含在我們的銷售編號中，但它已經在安裝基礎中了。當我們在第二季租賃該系統時，我們表示這將會發生。很高興看到該帳戶承諾購買。

At this point, we're not thinking of changing, obviously, our sales mechanism and how we sell, but it was good to see our first operating lease we've done convert to a sale at an ASP that was not materially different than the rest of our sales. So really good to see.

在這一點上，顯然，我們並沒有考慮改變我們的銷售機制和銷售方式，但很高興看到我們已經完成的第一個經營租賃轉換為以 ASP 進行銷售，該銷售價格與我們的其餘銷售。真的很高興看到。

Got it. That's very helpful. And can you also talk about your expectations for multisystem purchases by IDNs at the corporate level in 2024? And are they necessary to reach above your guidance of 185 placements?

知道了。這非常有幫助。您能否談談您對 2024 年 IDN 在企業層面購買多系統的期望？它們是否有必要達到您指導的 185 個展示位置？

Yes. Look, it's not as black and white as the question may appear on the surface. To be direct, we are not relying on multisystem IDN orders to meet the guidance that we put forward. With that said, what we've seen over the last few quarters is multisystem orders get executed at the corporate level that were already in our funnel that we're planning to be executed at the local level, but now are being used by corporate funds.

是的。看，問題並不像表面上看起來那麼黑白分明。坦白說，我們並不依賴多系統 IDN 訂單來滿足我們提出的指導。話雖如此，我們在過去幾季看到的是，多系統訂單在公司層級執行，這些訂單已經在我們的管道中，我們計劃在本地層級執行，但現在正被公司資金使用。

And I would suggest that we do expect that to continue to happen, but we are not reliant on an unexpected multisystem order from a large IDN to meet the guidance that we provided for our systems in 2024.

我建議我們確實預計這種情況會繼續發生，但我們並不依賴大型 IDN 的意外多系統訂單來滿足我們在 2024 年為我們的系統提供的指導。

Ryan Zimmerman, BTIG.

瑞安·齊默爾曼，BTIG。

Hey, guys, thanks for taking the questions. Just a couple for me this evening. So one, Sham, you were over in the UK We were over there maybe a month ago. The NHS had a big cyber attack. And we talked to a few urologists who had said that there might have been some trickle down to the procedure level.

嘿，夥計們，感謝您提出問題。今晚只給我幾個。所以，Sham，你在英國，我們大約一個月前就到了那裡。NHS 遭遇了大規模網路攻擊。我們訪問了幾位泌尿科醫生，他們表示可能會有一些滲透到手術層面。

I just was curious if you're seeing any of that impact. And just remind us how much of your OUS or your total sales is related to the UK at this point. And then I have a follow-up question on margins.

我只是很好奇你是否看到了這種影響。請提醒我們，此時您的 OUS 或總銷售額中有多少與英國相關。然後我有一個關於利潤的後續問題。

Sure. So yes, we're fully aware of the cyber attack that happened. It actually wasn't widespread in NHS. We had one hospital that dealt with it. And actually, they created protocols to go around cybersecurity.

當然。所以，是的，我們完全了解所發生的網路攻擊。實際上，這種情況在 NHS 中並不普遍。我們有一家醫院可以處理這個問題。事實上，他們創建了協議來解決網路安全問題。

There's many surgeries in that specific hospital, a large hospital in London, that have been shut down. Aquablation wasn't impacted. They actually created a protocol to allow them to continue doing Aquablation due to the safety of the procedure and no additional processes needed. So we felt pretty good about our ability to be able to work around that issue that other companies are dealing with right now. Regarding -- Kevin, do you want to take the last part of that?

倫敦的一家大型醫院，有許多手術室已經關閉。Aquablation 沒有受到影響。他們實際上創建了一個協議，允許他們繼續進行 Aquablation，因為該過程是安全的，並且不需要額外的過程。因此，我們對自己能夠解決其他公司目前正在處理的問題的能力感到非常滿意。關於——凱文，你想聽最後一部分嗎？

Yes. So to your question, in rough numbers, I mean, we haven't -- we're not going to provide a level of specificity, but approximately 50% just ballpark it for you, Ryan, of our international sales are derived from the UK. And I will say that the primary driver of us raising international guidance now on our last two calls has been the momentum we're seeing in the UK. So we're seeing great momentum. We weren't impacted by the cyber attack that Sham referenced.

是的。所以，對於你的問題，我的意思是，從粗略的數字來看，我們不會提供一定程度的具體情況，但瑞安，我們的國際銷售額中大約 50% 是來自於英國。我要說的是，我們現在在過去兩次電話會議中提高國際指導的主要動力是我們在英國看到的勢頭。所以我們看到了巨大的勢頭。我們沒有受到 Sham 提到的網路攻擊的影響。

And you didn't ask, but I'm going to say it anyway. The ASPs we're seeing in the UK. with the NICE endorsement are actually very comparable to the US, which is contributing as well as our improved margins. And I'll turn it back over to you. I think you said you had another question on margins.

雖然你沒問，但我還是要說。我們在英國看到的 ASP。獲得 NICE 認可的產品實際上與美國非常相似，美國也為我們提高了利潤率做出了貢獻。我會把它還給你。我想你說過你還有一個關於利潤的問題。

Yes. No, that's good to hear, guys. On margins, Kevin, so I know you're not going to give the '25 guide on margins. But as I think about just the margin trajectory and the proportion of sales that are capital today versus consumable, what -- first, remind us kind of if you're comfortable on the margin around capital. And just as you move away from capital sales more and more, what kind of leverage do you think you can get from your handpieces in terms of your margin trajectory?

是的。不，很高興聽到這個消息，夥計們。關於利潤，凱文，所以我知道你不會提供 25 年的利潤指南。但當我考慮利潤率軌跡以及當今資本與消費品的銷售比例時，首先，提醒我們您是否對資本利潤感到滿意。隨著您越來越遠離資本銷售，您認為就利潤軌跡而言，您可以從手機中獲得什麼樣的槓桿作用？

If you're going to do 59% this year, you had a nice step-up certainly this quarter with a good utilization. But I'm just wondering what your ability is beyond this to continue to drive your margins higher. Because you talk -- I mean, again, you talked about leverage, particularly on the operating expense side, but I'm curious more on the gross margin line. Thanks for taking the question.

如果今年您的目標是 59%，那麼本季您肯定取得了不錯的進步，利用率也很高。但我只是想知道，除此之外，您還有什麼能力繼續提高利潤率。因為你談到——我的意思是，你再次談到了槓桿，特別是在營運費用方面，但我對毛利率線更好奇。感謝您提出問題。

This is a great question, Ryan. And I'll suggest this, and again, I'm not going to provide guidance to 2025, but hopefully at a 30,000-foot level, I can answer some of your questions. The single biggest driver for our margin expansion is total revenue as opposed to the actual mix between consumable and capital. Longer term, I would suggest that mix becomes more important, but that's even beyond 2025, Ryan. Right now, our overhead absorption is the single biggest driver and that's equally allocated amongst both our capital and disposables.

這是一個很好的問題，瑞安。我會建議這一點，再說一次，我不會提供 2025 年的指導，但希望在 30,000 英尺的高度，我可以回答你們的一些問題。我們利潤率擴張的最大驅動力是總收入，而不是消費品和資本之間的實際組合。從長遠來看，我建議混合變得更加重要，但這甚至超過 2025 年，Ryan。目前，我們的管理費用吸收是最大的驅動因素，它在我們的資本和可支配資金之間平均分配。

So the expansion in '24 that we're seeing is more reflective of absorbing total overhead and some operational efficiencies as opposed to the mix of 60% now of our business being consumables. That will help more longer term. And then just to talk about longer term, look, we're really pleased with the margin expansion we've seen in '24. And we feel we have a business cost structure that allows this improvement to continue. And we talked about seeing comparative margin improvements as we move throughout the next few years.

因此，我們看到的 24 年的擴張更多地反映了吸收總管理費用和一些營運效率，而不是現在我們業務的 60% 是消耗品。從長遠來看，這將有幫助。然後談談長期來看，我們對 24 年的利潤率擴張感到非常滿意。我們認為我們的業務成本結構可以讓這種改進持續下去。我們談到，隨著我們在未來幾年的發展，相對利潤率會有所改善。

And we can do that just by volume alone. But longer term, as a management team, we're really excited about looking at other projects around cost reduction initiatives and things of that nature, particularly on the disposable, but that really doesn't start to manifest itself into our income statement until probably later 2026, 2027.

我們可以僅透過數量來做到這一點。但從長遠來看，作為一個管理團隊，我們真的很高興看到圍繞成本削減計劃和類似性質的其他項目，特別是在一次性項目上，但這實際上並沒有開始體現在我們的損益表中，直到可能2026 年晚些時候、2027 年。

And Kevin, just to follow up, the margin profile of capital relative to consumable, are you comfortable sharing that?

凱文，我想跟進一下資本相對於消費品的利潤率情況，您願意分享一下嗎？

What I would say is the capital is not a drag on our overall margins to the extent it may be for some (technical difficulty).

我想說的是，資本並沒有像某些人拖累我們的整體利潤。（技術難度）。

Mike Kratky, Leerick Partners.

麥克‧克拉基，Leerick Partners。

Hey, guys. This is Brett on for Mike. Thanks for taking the question, and congrats on another great quarter. So I do want to hit on margins again. Obviously, you raised the EBITDA guide by a couple of million, $2.5 million, and the revenue guide by about $3.5 million. So obviously, that's implying a pretty decent incremental margin, pretty high versus what you've shown historically.

嘿，夥計們。這是麥克的布雷特。感謝您提出問題，並祝賀又一個偉大的季度。所以我確實想再次觸及利潤。顯然，您將 EBITDA 指南提高了幾百萬美元，即 250 萬美元，將收入指南提高了約 350 萬美元。顯然，這意味著相當不錯的增量利潤，與歷史上顯示的相比相當高。

Just wanted to get a sense for your confidence and the durability of that incremental margin going forward. And what are some of the key toggles that we can see that can get a flex head up or down going forward?

只是想了解您的信心以及未來增加利潤的持久性。我們可以看到哪些關鍵開關可以讓彎曲頭向上或向下前進？

I apologize if I felt like a broken record here. But again, I think it's durable because the single biggest driver of margin improvement is increased revenues. It's not as if we're reliant on offshoring manufacturing or significant cost reductions in our product to get margin expansion in the near-term. Again, when I was answering Ryan's question, I think those really start to impact the business beyond 2025. And that gives us a high level of confidence with where we're at today that we have a very high fixed cost structure that we think is highly leverageable as we grow revenue.

如果我感覺自己在這裡打破了記錄，我深表歉意。但我再次認為它是持久的，因為利潤率改善的最大驅動力是收入增加。我們並不是依靠離岸製造或大幅降低產品成本來在短期內擴大利潤。同樣，當我回答 Ryan 的問題時，我認為這些真正開始對 2025 年以後的業務產生影響。這讓我們對目前的狀況充滿信心，因為我們擁有非常高的固定成本結構，我們認為隨著收入的成長，這種結構具有很高的槓桿作用。

And we've been telling investors since we went public that we're building this business to support a $500 million-plus business. And with that, you have to create a certain structure of overhead that was detrimental or hurtful to margins in our early years, but we're starting to now see that leverage come to fruition. And given that it's just leverage, we feel very good about our ability moving forward here to expand margins.

自從我們上市以來，我們一直告訴投資者，我們正在建立這項業務來支持價值超過 5 億美元的業務。因此，你必須創造一定的管理費用結構，這在我們早年對利潤率是有害的或有損的，但我們現在開始看到這種槓桿作用正在發揮作用。考慮到這只是槓桿作用，我們對我們擴大利潤率的能力感到非常滿意。

I would also just lastly point out that the operations team here has improved things around first pass yield, around warranty. And a lot of that is attributable to us now fully being in our new facility. We moved facilities last year into a facility that's 4x the size we were previously in. And we had a few speed bumps that we hit in that transition that are now fully behind us. We feel really confident.

我最後還要指出的是，這裡的營運團隊已經在首次通過率和保固方面進行了改進。這在很大程度上要歸功於我們現在完全融入了我們的新設施。我們去年將設施搬進了一個比以前大 4 倍的設施。我們在轉型過程中遇到了一些減速帶，但現在已經完全過去了。我們感到非常有信心。

Got it. That's super helpful. And then just as a follow-up, going back to that 90% retention rate on the existing surgeons that you have, that's obviously very strong. But of that 10% that do fall off, is there anything, any feedback you received that kind of impacts your commercial strategy in the go-to-market? Is there anything there that just would -- you could call out that helps it there?

知道了。這非常有幫助。然後作為後續行動，回到現有外科醫生 90% 的保留率，這顯然非常強勁。但是，在確實下降的 10% 中，您收到的任何回饋是否會影響您進入市場的商業策略？有沒有什麼東西可以——你可以指出來對那裡有幫助？

I'm going to turn it over to Sham and Reza. I want to be clear on the metric and what that actually means. So when we say 90% retention, that means for the second quarter -- 90% of the surgeons that did a procedure in Q1 also did a procedure in Q2. What it doesn't account for are surgeons that are dabblers that perhaps did a procedure in Q4, did not do a procedure in Q1 and then came back in Q2. So the actual retention is actually much higher than 90%.

我要把它交給 Sham 和 Reza。我想弄清楚這個指標及其實際意義。因此，當我們說 90% 的保留率時，這意味著第二季度 - 90% 在第一季進行手術的外科醫生也在第二季度進行了手術。它沒有考慮到那些涉足的外科醫生可能在第四季度進行了手術，在第一季沒有進行手術，然後在第二季度回來了。所以實際的留存率其實遠高於90%。

And I'll turn it over to Sham to maybe just discuss why you would have any fallout at all.

我會把它交給 Sham，也許只是討論為什麼你會產生任何後果。

I would just add that if I take a step back and remember that BPH is a very commonly treated procedure. Over 12,000 urologists that do at least one BPH procedure a year. So with that number in mind, we are going to have low volume BPH surgeons do Aquablation. And we love it because our technology has a low learning curve. It works very, very predictably. And so you have the ability to standardize treatment across different sizes of prostate and shapes.

我想補充一點，如果我退後一步並記住良性前列腺增生是一種非常常見的治療方法。超過 12,000 名泌尿科醫生每年至少進行一次 BPH 手術。因此，考慮到這個數字，我們將讓少量 BPH 外科醫生進行水消融術。我們喜歡它，因為我們的技術學習曲線很低。它的工作原理非常非常可預測。因此，您能夠針對不同尺寸和形狀的前列腺進行標準化治療。

So you have low-volume BPH surgeons who will use our technology, but maybe don't do a lot of BPH surgery. So when you think about that surgeon, somebody who's necessarily fallen out, it's just somebody who doesn't do cases consistently. And then we're in the operating room to support those surgeons. They have a great experience. And we rarely lose surgeons, but not every surgeon does a case every quarter.

因此，小批量 BPH 外科醫生會使用我們的技術，但可能不會進行大量 BPH 手術。所以當你想到那個外科醫生時，一個必然會失敗的人，他只是一個沒有一致地做病例的人。然後我們在手術室為外科醫生提供支援。他們有很棒的經驗。我們很少失去外科醫生，但並不是每個外科醫生每季都會做一個案例。

I'm showing no further questions. I would now like to turn the call back over to Reza Zadno, CEO, for closing remarks.

我沒有再提出任何問題。現在我想將電話轉回給執行長 Reza Zadno，讓其致閉幕詞。

Thank you, everyone, for attending our second quarter earnings call. We hope to see you in the future conferences. And have a nice day.

感謝大家參加我們的第二季財報電話會議。我們希望在未來的會議上見到您。祝你有美好的一天。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。