史賽克 (SYK) 2024 Q1 法說會逐字稿

Welcome to the First Quarter 2024 Stryker Earnings Call. My name is Christine, and I'm your operator for today's call. (Operator Instructions) This conference call is being recorded for replay purposes.

歡迎參加 Stryker 2024 年第一季財報電話會議。我叫克莉絲汀，是今天電話的接線生。 （操作員說明）本次電話會議正在錄音以供重播。

Before we begin, I would like to remind you that the discussions during this conference call will include forward-looking statements. Factors that could cause actual results to differ materially are discussed in the company's most recent filings with the SEC. Also, the discussions will include certain non-GAAP financial measures. Reconciliations to the most directly comparable GAAP financial measures can be found in today's press release that is an exhibit to Stryker's current report on Form 8-K filed today with the SEC.

在我們開始之前，我想提醒您，本次電話會議期間的討論將包括前瞻性陳述。該公司最近向美國證券交易委員會提交的文件中討論了可能導致實際結果出現重大差異的因素。此外，討論還將包括某些非公認會計準則財務措施。在今天的新聞稿中可以找到與最直接可比較的 GAAP 財務指標的調節表，該新聞稿是 Stryker 今天向 SEC 提交的 8-K 表格當前報告的展示。

I will now turn the call over to Mr. Kevin Lobo, Chair and Chief Executive Officer. You may proceed, sir.

我現在將把電話轉給董事長兼執行長 Kevin Lobo 先生。您可以繼續了，先生。

Welcome to Stryker's first quarter earnings call. Joining me today are Glenn Boehnlein, Stryker's CFO; and Jason Beach, Vice President of Finance and Investor Relations. For today's call, I will provide opening comments followed by Jason with the trends we saw during the quarter as well as some product updates. Glenn will then provide additional details regarding our quarterly results before we open the call to Q&A.

歡迎參加 Stryker 第一季財報電話會議。今天加入我的是 Stryker 財務長 Glenn Boehnlein；以及財務和投資者關係副總裁賈森·比奇 (Jason Beach)。在今天的電話會議中，我將由 Jason 提供開場評論，介紹我們在本季看到的趨勢以及一些產品更新。然後，格倫將在我們開始問答電話之前提供有關我們季度業績的更多詳細資訊。

In the first quarter, we delivered organic sales growth of 10% with double-digit growth in MedSurg and Neurotechnology and high single-digit growth in Orthopaedics and Spine despite one less selling day and tough comparables from a year ago. This reflects our team's continued strong commercial execution. Our results were led by very strong U.S. performance, notably in Instruments, Medical, Endoscopy, Trauma and Extremities and Mako. Internationally, growth momentum continued against strong double-digit growth organic sales comparables from the first quarter of last year. We expect this growth rate to accelerate for the remainder of the year as international remains a significant opportunity for us.

第一季度，我們的有機銷售額增長了10%，其中醫療外科和神經技術領域實現了兩位數增長，骨科和脊柱領域實現了高個位數增長，儘管銷售日數減少且與一年前相比比較困難。這反映了我們團隊持續強大的商業執行力。我們的結果由非常強勁的美國表現引領，特別是在儀器、醫療、內視鏡、創傷和四肢以及 Mako 領域。在國際上，與去年第一季有機銷售額強勁的兩位數成長相比，成長動能仍在持續。我們預計這一成長率將在今年剩餘時間內加速，因為國際市場對我們來說仍然是一個重要的機會。

We delivered quarterly adjusted EPS of $2.50, reflecting 16.8% growth compared to the first quarter of 2023, driven by our strong sales performance and margin expansion. As anticipated, we began to accelerate our M&A activity. We just completed the acquisition of mfPHD, a leading provider of modular stainless steel wall systems. This further enhances our communications business unit portfolio within Endoscopy and helps us meet our customers' needs for turnkey operating room design and construction. At the end of the quarter, we also closed on our acquisition of SERF within our Hip business. Our deal pipeline is strong, and we expect to be active over the course of the year.

在我們強勁的銷售業績和利潤率擴張的推動下，我們的季度調整後每股收益為 2.50 美元，較 2023 年第一季增長 16.8%。正如預期的那樣，我們開始加速併購活動。我們剛剛完成了對 mfPHD 的收購，mfPHD 是模組化不銹鋼牆系統的領先供應商。這進一步增強了我們內視鏡領域的通訊業務部門組合，並幫助我們滿足客戶對統包手術室設計和施工的需求。在本季末，我們也完成了對 Hip 業務內 SERF 的收購。我們的交易管道很強大，我們預計今年會很活躍。

With one quarter behind us, we now expect an increased full year organic sales growth of 8.5% to 9.5%, and we are increasing our adjusted EPS range to $11.85 to $12.05 a share. Coming off organic sales growth of 9.7% in 2022 and 11.5% in 2023, this guidance demonstrates the durability of our high growth and is a testament to our commercial strength and extensive pipeline of innovation across the company. Also, it reinforces our ability to meet our target of 200 basis points of operating margin expansion by 2025.

一個季度過去了，我們現在預計全年有機銷售額將增長 8.5% 至 9.5%，並將調整後每股收益範圍提高至每股 11.85 美元至 12.05 美元。 2022 年有機銷售額成長 9.7%，2023 年有機銷售額成長 11.5%，本指引展現了我們高成長的持久性，並證明了我們的商業實力和整個公司廣泛的創新管道。此外，它還增強了我們實現 2025 年營業利潤率擴張 200 個基點的目標的能力。

Next, I want to thank our teams for their ongoing commitment to talent and culture, which is reflected in the recognition of Stryker for the 14th year in a row as one of Fortune's 100 Best Companies to Work For. Our operating model, talent and culture are true differentiators for us. In addition, we recently published our fourth annual comprehensive report, which captures our commitments and disclosures on corporate responsibility.

接下來，我要感謝我們的團隊對人才和文化的持續承諾，這體現在 Stryker 連續 14 年被評為《財富》100 家最佳雇主之一。我們的營運模式、人才和文化是我們真正的差異化因素。此外，我們最近發布了第四份年度綜合報告，其中闡述了我們對企業責任的承諾和揭露。

I will now turn the call over to Jason.

我現在將把電話轉給傑森。

Thanks, Kevin. My comments today will focus on providing an update on the current environment, capital demand and select product highlights.

謝謝，凱文。我今天的評論將重點介紹當前環境、資本需求和精選產品亮點的最新情況。

Procedural volumes remained strong in the first quarter, in line with our expectations, driven by continued adoption in robotic-assisted surgery, demographics, a stable pricing environment and healthy patient activity with surgeons. And while pockets of supply constraints remain, our supply continues to be stable overall. Demand for our capital products remained healthy in the quarter with continued elevated backlog across our Endoscopy and Medical divisions.

第一季的手術量仍然強勁，符合我們的預期，這得益於機器人輔助手術的持續採用、人口統計、穩定的定價環境以及外科醫生健康的患者活動。儘管部分供應限制依然存在，但我們的供應總體保持穩定。本季對我們資本產品的需求保持健康，我們的內視鏡和醫療部門的積壓量持續增加。

Our Mako direct-to-patient campaign continues to perform well, which contributed to our very strong Mako growth with record first quarter installations in both the U.S. and internationally. This will continue to drive our Hips and Knees businesses. In April, we performed our first cases using the Pangea plating system in our Trauma and Extremities division and are gearing up for a full launch. Pangea is the largest launch in trauma's history as it offers a comprehensive system that will enable larger hospital conversions.

我們的 Mako 直接面向患者的活動繼續表現良好，這促進了 Mako 的強勁增長，第一季在美國和國際上的安裝量創下了紀錄。這將繼續推動我們的臀部和膝蓋業務。今年四月，我們在創傷和四肢部門使用 Pangea 電鍍系統進行了第一批病例，並準備全面啟動。 Pangea 是創傷史上最大規模的啟動，因為它提供了一個全面的系統，可以實現更大的醫院改造。

Next, we received approval from the FDA for our new LIFEPAK 35 defibrillator and monitor. This is a flagship product within our emergency care business unit and was one of the catalysts for our acquisition of Physio-Control. LIFEPAK 35 is a modern platform with a touchscreen interface that brings advanced connected capabilities to improve workflow. We will launch this product at the end of Q2, and it will have a multiyear benefit to our Medical division.

接下來，我們的新型 LIFEPAK 35 除顫器和監視器都獲得了 FDA 的批准。這是我們緊急護理業務部門的旗艦產品，也是我們收購 Physio-Control 的催化劑之一。 LIFEPAK 35 是一個具有觸控螢幕介面的現代化平台，可帶來先進的連接功能以改善工作流程。我們將在第二季末推出該產品，它將為我們的醫療部門帶來多年的好處。

Lastly, Mako, Spine and CoPilot are pacing to launch in Q4, followed by the shoulder application at the end of the year. We continue to receive positive feedback from surgeons who have been exposed to these technologies.

最後，Mako、Spine 和 CoPilot 計劃在第四季度推出，然後在年底推出肩部應用程式。我們不斷收到接觸過這些技術的外科醫生的正面回饋。

With that, I will now turn the call over to Glenn.

現在，我將把電話轉給格倫。

Thanks, Jason. Today, I will focus my comments on our first quarter financial results and the related drivers. Our detailed financial results have been provided in today's press release.

謝謝，傑森。今天，我將重點放在我們第一季的財務表現和相關驅動因素。我們詳細的財務業績已在今天的新聞稿中提供。

Our organic sales growth was 10% in the quarter compared to 13.6% in the first quarter of 2023. This quarter, we had one less selling day than 2023. The impact from pricing in the quarter was favorable by 0.7%. We continue to see a positive trend from our pricing initiatives, particularly in our MedSurg and Neurotech businesses, almost all of which again contributed positive pricing for the quarter.

本季我們的有機銷售額成長了 10%，而 2023 年第一季為 13.6%。我們的定價舉措繼續呈現積極趨勢，特別是在我們的 MedSurg 和 Neurotech 業務中，幾乎所有這些業務再次為本季度帶來了積極的定價。

Foreign currency had a 0.5% unfavorable impact on sales in the quarter. In the quarter, U.S. organic sales growth was 11.3%. International organic sales growth was 6.6% against a very strong comparable growth of over 16% in 2023. This performance included positive sales momentum across most of our international markets, particularly in the United Kingdom and Canada and most of our emerging markets.

外幣對本季銷售額產生了 0.5% 的不利影響。本季度，美國有機銷售額成長 11.3%。國際有機銷售額成長率為6.6%，而2023 年的可比成長率非常強勁，超過16%。市場。

Our adjusted EPS of $2.50 in the quarter was up 16.8% from 2023, driven by strong sales growth and operating margin expansion. Foreign currency exchange translation had an unfavorable impact of $0.05.

在強勁的銷售成長和營業利潤率擴張的推動下，本季調整後每股收益為 2.50 美元，較 2023 年成長 16.8%。外幣兌換折算產生了 0.05 美元的不利影響。

Now I will provide some highlights around our quarterly segment performance. In the quarter, MedSurg and Neurotechnology had constant currency sales growth of 12% and organic sales growth of 11.6%, which included 13.5% of U.S. organic growth and 6% of international organic growth. Instruments had U.S. organic growth of 19% with strong double-digit growth across the Orthopaedic Instruments and Surgical Technologies businesses.

現在我將提供有關我們季度業績的一些亮點。本季度，MedSurg 和 Neurotechnology 的固定匯率銷售額成長 12%，有機銷售額成長 11.6%，其中美國有機成長 13.5%，國際有機成長 6%。儀器在美國的有機成長率為 19%，其中骨科儀器和外科技術業務實現了兩位數的強勁成長。

From a product perspective, sales growth was led by almost 50% growth in smoke evacuation and strong performances in power tools, Steri-Shield, waste management and SurgiCount. Endoscopy had U.S. organic sales growth of 11.1% with double-digit growth in its communications and Endo BU businesses. And from a product perspective, standout growth included cameras, light sources, insufflators, booms and sports medicine implants.

從產品角度來看，排煙領域近 50% 的成長以及電動工具、Steri-Shield、廢棄物管理和 SurgiCount 的強勁表​​現帶動了銷售額的成長。內視鏡業務在美國的有機銷售額成長了 11.1%，其中通訊和內視鏡業務部門實現了兩位數成長。從產品角度來看，突出的成長包括相機、光源、氣腹機、吊桿和運動醫學植入物。

Medical had U.S. organic sales growth of 16.8%, led by the solid sales performances in all 3 businesses. This included strong growth in stretchers, cots, Vocera and Sage products. Neurovascular had U.S. organic sales growth of 2.9%, highlighted by solid performances in our hemorrhagic stents and guidewires. Neuro Cranial had U.S. organic sales growth of 7%, driven by strong performance in our CMF business.

在所有 3 個業務的穩健銷售業績帶動下，醫療器材在美國的有機銷售額成長了 16.8%。其中包括擔架、嬰兒床、Vocera 和 Sage 產品的強勁成長。神經血管在美國的有機銷售額成長了 2.9%，這得益於我們的出血支架和導絲的穩健表現。在 CMF 業務強勁表現的推動下，Neuro Cranial 在美國的有機銷售額成長了 7%。

Internationally, MedSurg and Neurotechnology had organic sales growth of 6%, which included strong performances in our emerging markets. Orthopaedics and Spine had both constant currency and organic sales growth of 8%, which included organic growth of 8.3% in the U.S. and 7.4% internationally.

在國際上，MedSurg 和 Neurotechnology 的有機銷售額成長了 6%，其中包括我們在新興市場的強勁表現。骨科和脊椎業務的固定匯率和有機銷售額均成長 8%，其中美國有機成長 8.3%，國際有機成長 7.4%。

Our U.S. Hip business grew 6.8% organically against a very strong comparable of 16.2% in the same quarter last year. This growth reflects continued strong primary hip performance fueled by our Insignia Hip Stem. Our U.S. Knee business grew 3.1% organically against another very strong comparable of 20.7% in the first quarter of 2023. Our Knee growth reflects our market-leading position in robotic-assisted knee procedures and the continued strength of our installed base. Our U.S. Trauma and Extremities business grew 10.3% organic with strong performances across our upper extremities, biologics and core trauma businesses.

我們的美國髖關節業務有機成長 6.8%，而去年同期的可比成長率為 16.2%。這種增長反映了我們的 Insignia 髖關節柄推動的持續強勁的初級髖關節性能。我們的美國膝關節業務有機增長了3.1%，而2023 年第一季的另一個非常強勁的可比業務增長了20.7%。以及我們安裝基礎的持續實力。我們的美國創傷和四肢業務有機成長 10.3%，上肢、生物製品和核心創傷業務表現強勁。

Our U.S. Spine business grew 3.9% organically, led by the performance in our Interventional Spine business. Our U.S. other ortho business grew 45.6% organically, driven by strong Mako installations in the quarter. Internationally, Orthopaedics and Spine grew 7.4% organically, including strong performances in Canada and most emerging markets, particularly driven by strong Mako installations.

在介入脊椎業務的表現帶動下，我們的美國脊椎業務有機成長了 3.9%。在本季 Mako 強勁安裝的推動下，我們的美國其他骨科業務有機成長了 45.6%。在國際範圍內，骨科和脊椎業務有機成長 7.4%，其中加拿大和大多數新興市場表現強勁，尤其是在強大的 Mako 安裝推動下。

Now I will focus on operating highlights in the first quarter. Our adjusted gross margin of 63.6% represents approximately 50 basis points favorability against the first quarter of 2023. This improvement reflects positive pricing trends as well as continued easing of certain cost pressures that we experienced in the first quarter of 2023. Adjusted R&D spending was 6.8% of sales, which was 30 basis points higher than the first quarter of 2023. Our adjusted SG&A was 35% of sales, which was 60 basis points lower than the first quarter of 2023 due to continued discipline in our spending and investments to support our growth.

下面我將重點放在第一季的經營亮點。我們的調整後毛利率為63.6%，較2023 年第一季提高了約50 個基點。調整後的研發支出為6.8佔銷售額的%，比2023 年第一季高出30 個基點。嚴格控制支出和投資以支持我們的業務生長。

In summary, for the quarter, our adjusted operating margin was 21.9% of sales, which was approximately 80 basis points favorable to the first quarter of 2023. Adjusted other income and expense of $49 million for the quarter was $16 million lower than 2023, driven by favorability in interest rates and a higher level of invested cash resulting in higher interest income.

總之，本季調整後的營業利潤率為銷售額的21.9%，比2023 年第一季有利約80 個基點。 ，透過優惠的利率和更高水準的投資現金帶來更高的利息收入。

The first quarter of 2024 had an adjusted effective tax rate of 12.3%, reflecting the impact of our geographic mix and certain discrete tax items. For 2024, we still expect our full year effective tax rate to be in the range of 14% to 15%.

2024 年第一季調整後的有效稅率為 12.3%，反映了我們的地理組合和某些離散稅項的影響。 2024 年，我們仍預計全年有效稅率在 14% 至 15% 範圍內。

Focusing on the balance sheet. We ended the first quarter with $2.4 billion of cash and marketable securities and total debt of approximately $13 billion. Our total debt includes $600 million of debt that is due to be repaid in May and has been prefunded.

重點關注資產負債表。第一季末，我們擁有 24 億美元的現金和有價證券，總債務約 130 億美元。我們的總債務包括 6 億美元的債務，將於 5 月償還，並已預先融資。

Turning to cash flow. Our year-to-date cash from operations is $204 million, reflecting the results of net earnings and normal first quarter seasonal cash outflows. Considering our first quarter results, strong procedural volumes and healthy demand for our capital products, we now expect our full year 2024 organic sales growth to be in the range of 8.5% to 9.5% with the pricing impact to be roughly flat. If foreign exchange rates hold near current levels, we anticipate sales will be moderately unfavorable impacted for the full year, being more negative in the first half of the year. EPS will be negatively impacted at the higher end of our previously guided range of $0.05 to $0.10. With our momentum heading into the rest of the year and our commitment to expanding operating margins, we now expect adjusted net earnings per diluted share to be in the range of $11.85 to $12.05.

轉向現金流。我們年初至今的營運現金為 2.04 億美元，反映了淨利潤和第一季正常季節性現金流出的結果。考慮到我們第一季的業績、強勁的程序量以及對資本產品的健康需求，我們現在預計 2024 年全年有機銷售成長將在 8.5% 至 9.5% 範圍內，定價影響將大致持平。如果匯率維持在目前水準附近，我們預計全年銷售將受到適度不利的影響，上半年的負面影響更大。每股收益將受到我們先前指導範圍 0.05 美元至 0.10 美元上限的負面影響。隨著我們進入今年剩餘時間的勢頭以及我們對擴大營業利潤率的承諾，我們現在預計調整後每股攤薄淨利潤將在 11.85 美元至 12.05 美元之間。

And now I will open up the call for Q&A.

現在我將開啟問答環節。

(Operator Instructions) Our first question will come from Robbie Marcus with JPMorgan.

（操作員說明）我們的第一個問題將來自摩根大通的 Robbie Marcus。

Congrats on a really nice quarter. A lot to ask about, but maybe 2 for me on financials. First, Kevin, it sounds like procedure volumes remain really healthy across the globe, and capital equipment, same. Would love to hear if you're seeing any changes, either up or down, in the environment for capital and procedure volume growth.

恭喜您度過了一個非常美好的季度。有很多問題要問，但對我來說也許有兩個關於財務的問題。首先，凱文，聽起來全球的手術量仍然非常健康，資本設備也是如此。我很想知道您是否看到資本和程序量成長環境有任何變化，無論是上升還是下降。

Yes. Thanks, Robbie. Yes, we're really pleased with the performance in the first quarter, and really nothing has changed. So the good level of volumes that we're seeing in procedures that we saw through 2024 has continued into 2025. And our capital order book remains very strong. So capital equipment, whether it's large capital or small capital, remains very robust. We have a nice healthy backlog, and that gives us the confidence to raise our organic sales growth guide for the full year.

是的。謝謝，羅比。是的，我們對第一季的表現非常滿意，而且確實沒有改變。因此，我們在 2024 年看到的良好交易量水準一直持續到 2025 年。因此，資本設備，無論是大資本或小資本，都保持非常強勁。我們有良好的積壓訂單，這讓我們有信心提高全年的有機銷售成長指南。

And maybe one, probably hasn't been asked on in a while, but your Spine business had a really nice quarter. I wanted to see. Is that more fundamentals and the improvements in technology you've brought to market? Is that gaining some share from disruption of the competitor merger? And is that giving you a foothold ahead of the Spine Mako launch and discussions and how hospitals are open to that?

也許有一個，可能已經有一段時間沒有被問到了，但你的脊椎業務有一個非常好的季度。我想看。這是您推向市場的更多基礎知識和技術改進嗎？這是因為競爭對手合併的破壞而獲得了一些份額嗎？這是否為您在 Spine Mako 發布和討論之前奠定了基礎，以及醫院對此有何態度？

Yes. Thanks, Robbie. Not a major change. I would tell you the Interventional Spine business had a terrific quarter. That was really high growth. Our enabling technologies within Spine, the Q Guidance System has really picked up good momentum as well. The Mako Spine and the CoPilot won't be launched until the fourth quarter. So that's not really having much of an impact. And I wouldn't say that the competitive disruption or the competitive merger is really having much of an impact yet. It's still very early days. So nothing too remarkable, but overall, a good number and a good solid number for our Spine business.

是的。謝謝，羅比。不是重大變化。我想說的是，介入脊椎業務的季度業績非常出色。那確實是高成長。我們在 Spine 中的支援技術 Q Guidance System 也確實取得了良好的發展動能。 Mako Spine 和 CoPilot 直到第四季才會推出。所以這並沒有真正產生太大的影響。我不會說競爭性破壞或競爭性合併確實產生了很大的影響。現在還為時過早。因此，沒有什麼太引人注目的，但總的來說，對於我們的脊椎業務來說，這是一個不錯的數字。

Our next question comes from Lawrence Biegelsen with Wells Fargo Securities.

我們的下一個問題來自富國銀行證券的勞倫斯·比格爾森。

Congrats on a nice quarter here. One for Glenn, one for, I think, Kevin. Glenn, just maybe on the EPS raise of about $0.10 at the midpoint. Can you help us bridge kind of how much of that was operational? How much of that is coming from kind of below the line, other income being a little lower? And obviously, FX is a greater headwind. So just kind of the pieces that led to the $0.10 raise, and I had one follow-up, please.

恭喜您度過了一個愉快的季度。一張是給格倫的，一張是給凱文的。 Glenn，每股收益中點可能會上漲約 0.10 美元。您能幫助我們了解其中有多少是可操作的嗎？其中有多少來自線下，其他收入略低？顯然，外匯是一個更大的阻力。那麼，這就是導致 0.10 美元加薪的部分，我有一個後續行動，請。

Yes. Sure. Thanks, Larry. I think if you look at sort of what happened in OI&E and also what happened with our tax rate, obviously, we had some favorability just for this quarter. I think fundamentally, we're still targeting $250 million roughly in OI&E and attach rate that really is still between 14% and 15%. So we're still sort of holding to the below the op margin line sort of guidance that we had built into our initial guidance that we provided back in January.

是的。當然。謝謝，拉里。我認為，如果你看看 OI&E 發生的情況以及我們的稅率發生的情況，顯然，我們在本季度有一些優惠。我認為從根本上來說，我們的 OI&E 目標仍然是大約 2.5 億美元，附加率實際上仍然在 14% 到 15% 之間。因此，我們仍然堅持低於營運利潤線的指導方針，該指導方針已納入我們在一月份提供的初始指導方針中。

I think, honestly, if you look at the raise in terms of how we think about it, the robustness of the top line, obviously, the earnings that we're able to kick off of that. And then lastly, we're just -- we're feeling that we're seeing good momentum and positivity around the programs that we put in place to drive leverage to get back to that 2019 number. And so all of that really combines to really give us the confidence to give us that $0.10 raise from the midpoint in EPS.

老實說，我認為，如果你從我們的角度來看這次加薪，營收的穩健性，顯然，我們能夠由此開始的收益。最後，我們感覺我們在為推動槓桿率回到 2019 年數字而實施的計劃方面看到了良好的勢頭和積極性。因此，所有這些確實讓我們有信心將每股收益中點提高 0.10 美元。

That's helpful. And Kevin, I'm sure you know investors are concerned about the potential impact of da Vinci 5 on your Endoscopy business. Obviously, it's not having any impact right now. Really strong growth here. I'd love to hear from you kind of if you're willing to share kind of what the potential exposure is and what you can do to help protect your lap tower business long term.

這很有幫助。 Kevin，我相信您知道投資者擔心達文西 5 對您的內視鏡業務的潛在影響。顯然，目前還沒有產生任何影響。這裡的成長確實強勁。如果您願意分享潛在的風險以及您可以採取哪些措施來幫助長期保護您的膝上塔業務，我很樂意聽取您的意見。

Yes. Thanks. I'm a little bit mystified by this concern, to be honest with you. If you attended the Sage's meeting, you could clearly see that we have a very differentiated solution that will frankly enable -- they can grow at whatever rates they're growing with their new product, and we're going to continue to have a very strong performance in endoscopy, both this year and for years to come. The overlap in our businesses is minor. We are multi-specialty. We play -- and most of our procedures, frankly, aren't being done robotically today. We also are the clear leader in fluorescence imaging.

是的。謝謝。老實說，我對這種擔憂有點困惑。如果您參加了Sage 的會議，您可以清楚地看到我們有一個非常差異化的解決方案，坦率地說，它們可以以任何速度以新產品的增長速度增長，而且我們將繼續擁有非常出色的解決方案。我們的業務重疊很小。我們是多專業的。我們玩——坦白說，我們今天的大部分程式都不是由機器人完成的。我們也是螢光成像領域無可爭議的領導者。

Just most recently, we had the American Association of Thoracic Surgery, where we partner with CYTALUX, this new fluorophore, to be able to light up lung cancer for lobectomy procedures, which we're the only company that can do that, that can light up that fluorophore. So surgeons are going to demand this for safer surgery, but that doesn't mean that Intuitive can't grow with their robot. We are really playing in spaces with very little overlap, and both of us can continue to have very strong performance for many, many years to come. So to me, this concern is, frankly, mystifying and not at all for me a concern for our Endoscopy division.

就在最近，我們與美國胸腔外科協會合作，與 CYTALUX 這種新型螢光團合作，能夠在肺葉切除手術中照亮肺癌，我們是唯一一家可以做到這一點的公司，可以照亮螢光團。因此，外科醫生會要求這樣做以實現更安全的手術，但這並不意味著 Intuitive 不能與他們的機器人一起成長。我們確實是在很少有重疊的空間裡打球，而且我們倆都可以在未來很多很多年裡繼續保持非常強勁的表現。因此，坦白說，對我來說，這種擔憂是令人困惑的，對我來說，這種擔憂根本不是我們內視鏡部門的擔憂。

Our next question comes from Ryan Zimmerman with BTIG.

我們的下一個問題來自 BTIG 的 Ryan Zimmerman。

I want to ask about the organic growth and the guidance. If you look at the 10% organic growth this quarter versus the comps and kind of where you're guiding that 9% at the midpoint, the comps essentially do get easier through the balance of the year. And so I'm wondering. Kevin or Glenn, whoever wants to take this, just talk about your guidance view or philosophy for the top line, specifically given the performance and what you think could be better performance for the remainder of the year.

我想問一下有機成長和指導。如果你看看本季 10% 的有機成長與比較，以及你在中點指導 9% 的有機成長，那麼在今年餘下的時間裡，比較基本上確實會變得更容易。所以我想知道。凱文或格倫，無論誰想接受這個，只需談談您對營收的指導觀點或理念，特別是考慮到業績以及您認為今年剩餘時間可能會更好的業績。

Yes. Great. So certainly, if you look at our fourth quarter last year, I wouldn't think that, that was -- those were easy comps. We had a pretty monstrous fourth quarter last year. And so comps is probably the biggest concern that we have, and we do pick up an extra selling day in Q3 and extra selling day in Q4. It's only one quarter, right? There's a lot of uncertainties out there in the marketplace. We feel very good about our business. And I think this is an appropriate raise at this time. Let's see how things go at the end of the second quarter, and we can update you further on the outlook for the year.

是的。偉大的。所以當然，如果你看看我們去年第四季度，我不會認為那些是簡單的比較。去年我們的第四季表現相當糟糕。因此，比較可能是我們最關心的問題，我們確實在第三季和第四季獲得了額外的銷售日和額外的銷售日。這才四分之一，對吧？市場上存在著許多不確定因素。我們對我們的業務感覺非常好。我認為此時加薪是適當的。讓我們看看第二季末的情況如何，我們可以向您進一步介紹今年的前景。

Fair enough. And Kevin, your comments on M&A were pretty pointed. You've highlighted a number of areas previously. I think there was 5 that you specifically called out before. Are you reinforcing those same areas today? Because if I look at just some of the tuck-ins that you've done, it's actually been outside those 4 or 5 areas as of late. And so just curious kind of how you're thinking about the targets for the areas for M&A today.

很公平。凱文，您對併購的評論非常尖銳。您之前已經強調了許多領域。我想你之前專門喊過的有5個。您今天是否在加強這些相同的領域？因為如果我只看一下你所做的一些折邊工作，就會發現最近它實際上已經超出了這 4 或 5 個區域。因此，我很好奇您如何考慮當今併購領域的目標。

Yes. Certainly, when I talk about those 5 areas, those are adjacencies. So we have our core basically supplementing our existing businesses with new technology. That's always going to be the majority of the deals we do. And beyond that, as we think about adjacencies, those are what I'm calling my sort of top 5 priority adjacencies. And what I'd tell you right now is we have an incredibly healthy pipeline of deals.

是的。當然，當我談論這 5 個領域時，它們是相鄰的。所以我們的核心基本上是用新技術來補充我們現有的業務。這始終是我們所做交易的大部分。除此之外，當我們考慮鄰接時，這些就是我所說的前 5 個優先鄰接。我現在要告訴你的是，我們擁有非常健康的交易管道。

Now of course, pipeline doesn't always get realized, right? There's always a washout rate as you go through these processes. But I'm feeling really excited about the pipeline. They are mostly in the tuck-in variety. And so they're just like the one I mentioned for our communications business or our Hip business. You're going to see most of those occur at least for the next couple of quarters. Beyond that, if we do decide to branch out, those other areas I talked about are still of high interest. Nothing has really changed on that front.

當然，現在管道並不總是實現，對嗎？當你經歷這些過程時，總會有一個沖刷率。但我對管道感到非常興奮。它們大多是折疊品種。所以它們就像我提到的我們的通訊業務或我們的時尚業務一樣。至少在接下來的幾個季度中，您將看到其中大部分發生。除此之外，如果我們確實決定拓展業務，我談到的其他領域仍然很受關注。這方面沒有任何真正改變。

Our next question comes from Joanne Wuensch with Citibank.

我們的下一個問題來自花旗銀行的 Joanne Wuensch。

Very nice quarter. Could you unpack 2 particular areas? One is the Instrument sales up 18%. And then the other is other, up 44.2%. Both of those are real bright, shining stars. I'd love to hear what went behind that.

非常好的季度。您能解壓縮 2 個特定區域嗎？一是儀器儀表銷售額成長18%。然後是其他，增長了44.2%。這兩顆都是真正明亮、閃亮的星星。我很想聽聽這背後發生了什麼事。

Yes. Sure. I can start on the Instruments, and I'll let Jason talk about the other ortho. And you're right, these are bright, shining stars. The Instruments division had a fantastic quarter, and it was really, really across both Surgical Technologies as well as Orthopaedic Instruments. Really across the board.

是的。當然。我可以從儀器開始，然後讓傑森談談另一個正交。你是對的，這些都是明亮、閃亮的星星。儀器部門的季度表現非常出色，無論是外科技術還是骨科儀器。真是一刀切。

And if you look at smoke evacuation, we just continued to have tremendous momentum. Obviously, the market has been growing very robustly. But we have a terrific commercial execution, growing almost 50%, which is really awesome. And that was great growth in the U.S. and also really great growth internationally. And we see that continuing, maybe not at 50%, but we see that very high double-digit growth through the rest of this year and into next year, especially as more states decide to mandate smoke evacuation. So that was really a big push.

如果你看看煙霧疏散，我們仍然保持著巨大的勢頭。顯然，市場成長非常強勁。但我們的商業執行力非常出色，成長了近 50%，這真是太棒了。這在美國是巨大的成長，在國際上也是巨大的成長。我們看到這種情況持續下去，也許不會達到 50%，但我們看到今年剩餘時間和明年將出現非常高的兩位數增長，特別是隨著越來越多的州決定強制疏散煙霧。所以這確實是一個很大的推動。

We also have the SurgiCount, plus we've launched a new product that combines the Gauss Surgical quantification of blood loss as well as the sponge counting. So it's all combined into one solution, which is really elegant and really being well received by our customers. So those are probably the 2 biggest catalysts within Surgical Technologies. Neptune waste management continues to roll, but that's not new information.

我們還有 SurgiCount，此外我們還推出了一款新產品，結合了高斯外科失血定量和海綿計數。因此，所有這些都合併為一個解決方案，該解決方案非常優雅，並且深受我們客戶的好評。因此，這些可能是外科技術領域的兩個最大催化劑。海王星廢棄物管理繼續推進，但這並不是什麼新資訊。

And then if you flip over to Orthopaedic Instruments, we have the Steri-Shield doing extremely well. Our power tools, obviously, you know about the new launch that's still, let's call it, just a little -- about 1.5 years in. That's continuing to do very well as well as pulsed lavage and all the other products and just really great commercial execution by the Instruments team. It's really been a flagship division of Stryker, if you go back the last 10-plus years. It delivers very, very consistently, and it did so again in the first quarter.

如果你轉向骨科器械，我們的 Steri-Shield 表現非常好。顯然，我們的電動工具，您知道新推出的產品，我們稱之為，大約 1.5 年。如果你回顧過去十多年，它確實是 Stryker 的旗艦部門。它的表現非常非常一致，並且在第一季再次做到了這一點。

Yes. Joanne, it's Jason. I'll take the other ortho here. So just a couple of additional comments, I guess, to my prepared remarks would be, like I said, we had a record quarter of installation in the first quarter this year. If you remember, we had a record quarter in the fourth quarter of last year. So the momentum is going really well on the Mako front. I commented on the direct-to-patient campaign. We've seen really good results out of that. So we feel good about it, and we like what this will translate in terms of the Hips and Knees business as we move forward as well.

是的。喬安妮，是傑森。我會在這裡拿另一個矯正器。因此，我想，對於我準備好的評論，我想補充幾點，就像我說的，今年第一季我們的安裝量創下了紀錄。如果您還記得的話，去年第四季我們創下了創紀錄的季度業績。所以 Mako 戰線上的勢頭非常好。我對直接面向患者的活動發表了評論。我們已經看到了非常好的結果。因此，我們對此感覺良好，隨著我們的前進，我們也喜歡這對臀部和膝蓋業務的影響。

Our next question comes from Pito Chickering with Deutsche Bank.

我們的下一個問題來自德意志銀行的 Pito Chickering。

Looking at the international growth, can you talk about what you're seeing in Europe versus the higher growth markets like Japan and China? And how should we think about the growth internationally if we're using the 6.8% seen this quarter on a constant currency basis?

看看國際成長，您能談談您在歐洲看到的情況與日本和中國等成長較高的市場相比嗎？如果我們使用本季以固定匯率計算的 6.8% 的成長率，我們應該如何看待國際成長？

Yes. So certainly, Europe continues to be a growth engine for Stryker. I would tell you in the first quarter, it was a little bit softer than it has been, and that was really because we had a big quarter last year. So really more comp related. I do expect Europe is going to continue to pick up in Q2, Q3, Q4. So the overall run rates are really healthy in Europe. And we -- the U.K. was a bit of a standout in the first quarter, but the other regions are all going to be fine. We had a really big, big sales in Germany and Southern Europe last year and so -- in the first quarter. So to me, it's just a comp issue. I'm not at all concerned about our international. We're going to have another strong year in international. So you talked about Europe. What else did you say, sorry? [Was it all] Europe?

是的。因此，可以肯定的是，歐洲仍然是史賽克的成長引擎。我會告訴你，第一季的情況比以往要軟一些，這實際上是因為我們去年的季度表現不錯。所以確實與比較有關。我確實預計歐洲將在第二季、第三季和第四季繼續復甦。因此，歐洲的整體運作率非常健康。我們——英國在第一季表現有點突出，但其他地區都會很好。去年，我們在德國和南歐的銷售額非常大，第一季也是如此。所以對我來說，這只是一個補償問題。我一點也不關心我們的國際賽事。我們將在國際比賽中迎來另一個強勁的一年。所以你談到了歐洲。抱歉，你還說什麼？ [都是]歐洲嗎？

Great. And then the second question was strong utilization across the country for hospitals and good margins. We're seeing hospitals want to increase their CapEx spending. I guess what areas of your portfolio do you think sort of has the most upside for hospitals increase in the CapEx dollars?

偉大的。第二個問題是全國醫院的強勁利用率和良好的利潤率。我們看到醫院希望增加資本支出。我想您認為您的投資組合中的哪些領域對於醫院資本支出的增加具有最大的上升空間？

Yes. Pito, I guess what I would say here, as we look at the overall capital environment, and you can see in our results in the first quarter in our capital business is very strong. So we see opportunities here across the board. I think we mentioned that our backlog continues to be elevated here. So we expect strong capital as we go throughout the year.

是的。 Pito，我想我要在這裡說的是，當我們審視整體資本環境時，你可以在我們第一季的業績中看到我們的資本業務非常強勁。所以我們在這裡看到了全面的機會。我想我們提到我們的積壓工作繼續增加。因此，我們預計全年都會有強勁的資本。

Our next question comes from Shagun Singh Chadha with RBC Capital.

我們的下一個問題來自 RBC Capital 的 Shagun Singh Chadha。

Kevin, you've talked extensively about the super cycle of innovation, and we are seeing strong results here in Q1. Are you able to quantify contribution from new products in Q1? Perhaps talk to us about what's factored into your guidance for 2024. And I guess the key question is, how should investors think about growth drivers for Stryker beyond the current super cycle of innovation? I think you've indicated year 2 and 3 are the peak years. And I think you'd get there in '24 and '25. So how should we think about growth drivers beyond that?

凱文，您廣泛談論了創新的超級週期，我們在第一季看到了強勁的成果。您能量化第一季新產品的貢獻嗎？也許與我們談談您對 2024 年指導的考慮因素。我認為你已經指出第二年和第三年是高峰年。我認為你會在 24 年和 25 年到達那裡。那麼除此之外我們該如何思考成長動力呢？

Yes. Thanks for the question. What I would tell you is we're in this constant rhythm of innovation. And we just had a number of products sort of collide at the same time, but they're constantly being refreshed. So I wouldn't think about this as a fleeting moment. If you think about 9.7% in '22, 11.5% in '23, another potentially double digit, we'll see. We're not guiding to that just yet, but we have a chance certainly to get to another double-digit growth this year, and next year, you're going to have the impact. We're just launching LIFEPAK 35. It's not going to have as much of an impact this year as next year. Pangea not as much impact this year as next year. The Mako applications have really no impact this year. It's really more next year. And then we'll just keep rolling other innovations on top of that.

是的。謝謝你的提問。我要告訴你的是，我們正處於不斷創新的節奏中。我們剛剛有許多產品同時發生衝突，但它們不斷被刷新。所以我不會認為這是轉瞬即逝的時刻。如果你想想 22 年的 9.7%，23 年的 11.5%，還有可能是兩位數，我們拭目以待。我們目前還沒有實現這一目標，但今年我們肯定有機會實現兩位數的成長，而明年，您將產生影響。我們剛推出 LIFEPAK 35。盤古大陸今年的影響沒有明年那麼大。今年 Mako 的申請確實沒有任何影響。明年確實會更多。然後我們將在此基礎上繼續推出其他創新。

So I would just think we were in a rhythm. Assuming the market conditions stay similar, we're in a rhythm where this kind of high growth is what you should come to expect from us with no end in sight as long as we continue to invest as we are, roughly 7% of our growing top line in new product innovation, and we continue to be active with acquisitions because as you know, we acquire high-growth assets. And then after the first year that rolls into organic growth, we had a bit of a pause last year as we're going to refill that tank this year, and that will contribute to organic growth in the years ahead. So I would not look at this as some kind of we reached a peak, and we're starting -- we're going to come down on the other side. Absent some kind of market adjustment, this is -- we're in kind of a new normal, at least for a while.

所以我只是認為我們有節奏。假設市場狀況保持相似，我們的節奏是這樣的，只要我們繼續以目前的方式投資，這種高成長就是你應該期待的，而且看不到盡頭，大約占我們成長的 7%我們在新產品創新方面處於領先地位，我們繼續積極進行收購，因為如您所知，我們收購了高成長資產。然後，在進入有機成長的第一年之後，我們去年停頓了一下，因為我們今年將重新裝滿這個油箱，這將有助於未來幾年的有機成長。因此，我不會將此視為我們達到了某種頂峰，並且我們正在開始 - 我們將在另一邊下降。如果沒有某種市場調整，我們就處於一種新常態，至少在一段時間內是如此。

That's really helpful. And then just a couple of follow-ups on the ortho side. Just any updates on Mako for spine and shoulder robot? Are you still on track for 2024 and a year-end '24 launch for both of those?

這真的很有幫助。然後在正側進行一些後續操作。脊椎和肩部機器人 Mako 有什麼更新嗎？您是否仍計劃在 2024 年以及 24 年底推出這兩款產品？

Shagun, it's Jason. Just -- I'll go back to my prepared remarks, right? As we think about Mako Spine and CoPilot, we're looking at a Q4 launch there. And for Mako shoulder, it will be the end of this year from a launch standpoint.

沙岡，是傑森。只是——我會回到我準備好的發言，對吧？當我們考慮 Mako Spine 和 CoPilot 時，我們正在考慮第四季度的發布。而對於 Mako Shoulder 來說，從發布的角度來看，這將是在今年年底。

Our next question comes from Vijay Kumar with Evercore.

我們的下一個問題來自 Evercore 的 Vijay Kumar。

Kevin, I had one for you on the backlog comments here, both on the procedures and the capital side, right? On procedures, (inaudible), can you comment on any scheduling? I think historically, scheduling was taking time. It was elongated. Have you seen any shortening of that scheduling still elongated? How have cancellations sort of trended? I think on the capital side, you mentioned LIFEPAK. Did that contribute in the backlog? Or is that something that's supposed to come in the coming quarters?

凱文，我有一份關於這裡積壓的意見給你，包括程序和資金方面，對吧？關於程序（聽不清楚），您能對任何日程安排發表評論嗎？我認為從歷史上看，安排工作需要時間。它被拉長了。您是否看到日程安排的縮短仍然延長？取消訂單的趨勢如何？我想在資本方面，你提到了LIFEPAK。這是否導致了積壓？或者這應該在未來幾季出現？

Look, I'd just call it a stable market. It really hasn't changed much, if you think about waiting lists. If you think about staffing, it's continually gotten better over the course of '24. So I would just say it's very stable in terms of the overall market. I don't see shortening at all. I don't see it elongating. It's just as we saw through '24 -- '23, sorry, it's a continuation into '24 of that kind of stable marketplace.

看，我只是稱之為穩定的市場。如果你考慮一下等候名單，情況確實沒有太大變化。如果你考慮一下人員配置，你會發現它在 24 年來不斷變得更好。所以我想說，就整個市場而言，它非常穩定。我根本沒有看到縮短。我沒看到它拉長。正如我們在 24 年 - 23 年所看到的那樣，抱歉，這是這種穩定市場在 24 年的延續。

And the new defibrillator just got approved. So that's not really been a big contributor to our backlog. Our backlog is just a healthy order book of all of our existing products across medical, across even some of the Instruments businesses and Endoscopy. So it really -- there wasn't any kind of new spike, but we've had a healthy backlog. We had it going into '23. We have it going into '24. We continue to get good orders.

新的除顫器剛剛獲得批准。所以這並不是我們積壓的重要因素。我們的積壓訂單只是我們所有醫療現有產品的健康訂單簿，甚至包括一些儀器業務和內視鏡業務。所以，確實沒有任何新的高峰，但我們的積壓情況良好。我們把它帶到了23年。我們將其納入 24 年。我們繼續獲得良好的訂單。

So yes, we're shipping out at a nice rate, but the orders are still coming in at a very healthy rate. So we're really not burning through any kind of meaningful backlog, and that gives us confidence for at least through the rest of this year if -- and as orders continue, and it obviously could potentially spike with some of these new products. That's only going to give us more tailwind for growth.

所以，是的，我們的發貨速度不錯，但訂單進來的速度仍然非常健康。因此，我們確實沒有消耗任何有意義的積壓訂單，這讓我們至少在今年剩餘時間充滿信心，如果訂單繼續增加，並且其中一些新產品顯然可能會激增。這只會為我們帶來更多的成長動力。

That's helpful, Kevin. And Glenn, maybe one for you. Free cash in the quarter looks like there was some timing element. Can you just remind us what kind of free cash conversion should we be expecting for fiscal '24?

這很有幫助，凱文。格倫，也許適合你。本季的自由現金似乎存在一些時間因素。您能否提醒我們，24 財年我們該期待什麼樣的自由現金轉換？

Sure. Yes. I think in Q1, what you saw was just timing between working capital in Q4 and Q1. And then just sort of seasonally in Q1, we have higher cash outflows that occur. So that's the impact of that. On an overall basis, there's no change to the targets that we discussed back at the analyst meeting in November, and that would be the 70% to 80% free cash flow conversion number.

當然。是的。我認為在第一季度，您看到的只是第四季度和第一季營運資金之間的時間安排。然後，在第一季度，我們會出現季節性的更高的現金流出。這就是它的影響。總體而言，我們在 11 月分析師會議上討論的目標沒有變化，即 70% 至 80% 的自由現金流轉換數字。

Our next question comes from Travis Steed with Bank of America.

我們的下一個問題來自美國銀行的 Travis Steed。

Congrats on a good quarter. On the Mako installations, curious -- big insulation number, but curious how many of those are going into competitive accounts. And is that a leading indicator for share gains in ortho?

恭喜季度表現良好。在 Mako 裝置上，很好奇——絕緣體數量很大，但很好奇其中有多少會進入競爭性帳戶。這是 Ortho 股票上漲的領先指標嗎？

Travis, it's Jason. I mean for competitive reasons, we won't necessarily disclose the number in terms of the amount going into competitive accounts. But I will say that number is big for us and continues to be a winner for us in terms of going into competitive accounts.

崔維斯，是傑森。我的意思是，出於競爭原因，我們不一定會透露進入競爭帳戶的金額。但我要說的是，這個數字對我們來說很大，並且在進入競爭性客戶方面仍然是我們的贏家。

Great. And then the 50% growth in smoke evacuation, was that a big step change versus where it's been running at? And I'm just curious if there was something that drove that acceleration in smoke evacuation, if it's kind of better bundling across the portfolio or more reps pushing that product.

偉大的。然後排煙量增加了 50%，與之前的運作情況相比，這是一個巨大的變化嗎？我只是好奇是否有什麼因素推動了煙霧疏散的加速，是否有更好的產品組合捆綁或更多代表推動該產品。

Yes, Travis, it's Jason. I'd say a couple of different things here. The smoke evac business has continued to be, I think, high teens, 20% grower. In smoke-free states, it's higher than that and similar to kind of what we said today in the prepared remarks. So it's been a great tailwind for us, and we think it will be into the future.

是的，崔維斯，是傑森。我想在這裡說幾件不同的事情。我認為，排煙業務一直保持著 20% 的高成長率。在無菸州，這一數字高於此值，類似於我們今天在準備好的發言中所說的內容。因此，這對我們來說是一個巨大的推動力，我們認為這將持續到未來。

Yes. We've also had our supply chain has really improved in terms of being able to meet the tremendous demand that we've had, and that was also a contributor. So we've had tremendous growth, tremendous demand. And our supply chain has really kicked in, in a strong way, and that puts us in a good position not only to deliver in the first quarter but also to deliver in the quarters ahead.

是的。我們的供應鏈也得到了真正的改善，能夠滿足我們所擁有的巨大需求，這也是一個貢獻者。所以我們有巨大的成長和巨大的需求。我們的供應鏈確實以強有力的方式啟動，這使我們處於有利地位，不僅可以在第一季交付，而且可以在未來幾季交付。

Our next question comes from Matthew O'Brien with Piper Sandler.

我們的下一個問題來自馬修·奧布萊恩和派珀·桑德勒。

Just real quick, it sounds like Mako is getting -- Mako Spine is being pushed out. Just I don't know if it's 3 to 6 months. Is that about right? And then is it a software issue, hardware issue, something else you're going to incorporate into it that's causing this modest push?

很快，聽起來 Mako 正在變得——Mako Spine 被推出了。就是不知道是不是3到6個月。是這樣嗎？那麼，是軟體問題、硬體問題還是您要納入其中的其他問題導致了這種適度的推動？

Matt, it's Jason. I mean keep in mind, right, from a regulatory standpoint, there's time lines as it relates to the FDA that can shift things by week, sometimes a couple of months. We've always been targeting a back half launch here. So I wouldn't consider this as a significant change in the time line. As you think about the guidance that we have for this year, there was certainly nothing assumed in terms of our guide relative to the spine or shoulder launch. So no impact there as we think about that.

馬特，是傑森。我的意思是，請記住，從監管的角度來看，與 FDA 相關的時間線可以按週、有時是幾個月進行調整。我們一直以後半部發射為目標。所以我不認為這對時間線有重大改變。當你思考我們今年的指導時，我們的指導中肯定沒有任何關於脊椎或肩部發射的假設。所以我們認為沒有影響。

Got it. And then on the MedSurg side of things, I think, Kevin, you've said double-digit growth is what you expect for the next 5 years there. Is that needing to have the backlog? And I mean is there any way to quantify how significant that backlog is right now and how much of a tailwind it is versus all these new products that you got coming like defibrillators, et cetera? Because the Street is nowhere near double-digit growth for the MedSurg business over the next couple of years.

知道了。然後，在 MedSurg 方面，我想，Kevin，您說過您預計未來 5 年將實現兩位數的成長。那需要積壓嗎？我的意思是，有沒有什麼方法可以量化目前積壓的嚴重程度，以及與除顫器等所有新產品相比，它有多大的推動力？因為未來幾年，華爾街的 MedSurg 業務遠未實現兩位數的成長。

Yes. Look, I don't think I said that. I have to double check the transcript, but I didn't give a precise number of double-digit growth for all that time. What I did say is we are in this high-growth environment based on our innovation cycle, and we're going to continue to have these new products fuel growth. It does depend on the market, right? So if the market stays at this kind of level, could we stay in that kind of double-digit range? Sure, we could. But I -- there's no guarantee that the market will stay this elevated both in terms of procedures as well as the healthy capital environment.

是的。聽著，我想我沒這麼說過。我必須仔細檢查成績單，但我沒有給出一直以來兩位數成長的準確數字。我所說的是，我們正處於基於創新週期的高成長環境中，我們將繼續讓這些新產品推動成長。這確實取決於市場，對嗎？那麼，如果市場保持在這樣的水平，我們能否保持在兩位數的範圍內？當然，我們可以。但我——無法保證市場在程序和健康的資本環境方面都會保持在如此高的水平。

So it does depend on the market. And obviously, you know we outperformed the market, and you can -- depending on the year, it's 300 basis points or whatever that number is. But we're not going to defy gravity. If the market falls down to a certain level, then obviously, our growth would be similarly impacted. So I don't believe I was that precise with double-digit over 5 years. But I do feel bullish about the ability for us to continue to be a very high-growth business.

所以這確實取決於市場。顯然，你知道我們跑贏了市場，而且你可以——根據年份，可以是 300 個基點或任何數字。但我們不會反抗地心引力。如果市場下跌到某個水平，那麼顯然我們的成長也會受到同樣的影響。所以我不相信我在五年內能達到兩位數的精準度。但我確實對我們繼續保持高成長業務的能力感到樂觀。

Our next question comes from Matt Miksic with Barclays.

我們的下一個問題來自巴克萊銀行的馬特·米克西奇。

Congrats on a really strong quarter, which looks to me like and a lot of the feedback I'm getting is that it really is just all about comps. I mean double-digit organic growth against low teens -- low to mid-teens organic growth last year is -- that is at least impressive to us. So congrats on the continued momentum. I had one follow-up, if I could, on the Mako robot and maybe just the nature of the launch. If you could walk us through, is that you're expecting a limited launch and then sort of picking up momentum in 2025? And then, Kevin, if you could maybe talk about some of the either new aspects of that platform or some of the other products that you're kind of excited about in the next couple of quarters that they will start coming to market and adding to growth in the back half in '25. I appreciate it.

恭喜這個季度的表現非常強勁，在我看來，我得到的許多回饋都表明，這確實與競爭有關。我的意思是，相對於青少年的兩位數有機成長——去年的有機成長是青少年中低的——這至少讓我們印象深刻。因此，恭喜您的持續發展動能。如果可以的話，我對 Mako 機器人進行了後續報道，也許只是發布的性質。如果您能向我們介紹一下，您是否預計會進行有限的發布，然後在 2025 年恢復勢頭？然後，凱文，您是否可以談談該平台的一些新方面或您在接下來的幾個季度中感到興奮的其他一些產品，它們將開始進入市場並添加到25 年下半年的成長。我很感激。

Yes. Sure. Thanks. Jason, every quarter, we'll talk to you about new products. And we highlighted a couple this quarter with the LIFEPAK 35 and Pangea in our trauma business, both of which are really super exciting products that are going to contribute to growth for at least a few years to come. As it relates to Mako, so the new spine robot will be 2 parts. One part is the actual robot with a different attachment that will enable the pedicle screw guidance. The second part is the Q Guidance trade that's already being sold today. So that is used for first-line procedures. It's a very lightning fast camera. You saw it at NASS. It's being sold today to do navigated spine procedures. So those 2 components will make up the Mako Spine system.

是的。當然。謝謝。傑森，每個季度我們都會與您討論新產品。本季我們重點介紹了創傷業務中的 LIFEPAK 35 和 Pangea，這兩種產品都是非常令人興奮的產品，至少在未來幾年將促進成長。由於它與 Mako 相關，因此新的脊椎機器人將由 2 個部分組成。其中一部分是具有不同附件的實際機器人，可以實現椎弓根螺釘的引導。第二部分是今天已經出售的 Q Guidance 交易。所以這用於一線程序。這是一台速度快如閃電的相機。你在 NASS 看到過。今天出售它用於進行導航脊椎手術。因此，這兩個組件將構成 Mako Spine 系統。

And then in addition to that, the CoPilot product will be able to do diskectomies and bone preparation with haptic feedback to be able to protect you from getting close to vital structures, spinal cord, et cetera. So that -- and that, again, is going to be compatible with the Q camera in the same screen. So it's a comprehensive ecosystem that will be launched. And we're already seeding the market with 1/2 of the system with the Q Guidance, and then the second half is really whether you're doing makeover pedicle screw placement or using Q Guidance to do the bone preparation. So those are the 3 pieces of our enabling technology solution, part of which we're already selling today. So every time we're selling Q, which is contributing to our spine growth, it's part of the solution that will then be able to be used both with CoPilot as well as with Mako. So hopefully, that clarifies things for you.

除此之外，CoPilot 產品將能夠透過觸覺回饋進行椎間盤切除術和骨骼準備，從而能夠保護您免於接近重要結構、脊髓等。因此，同樣，這將與同一螢幕中的 Q 相機相容。所以這是一個即將推出的綜合生態系統。我們已經用 Q Guidance 為 1/2 的系統播種了市場，然後下半年就是真正的問題，無論您是進行改造椎弓根螺釘放置還是使用 Q Guidance 進行骨骼準備。這些就是我們的支援技術解決方案的三個部分，我們今天已經在銷售其中的一部分。因此，每次我們出售有助於脊椎生長的 Q 時，它都是解決方案的一部分，然後可以與 CoPilot 和 Mako 一起使用。希望這能為您澄清一些事情。

Our next question comes from Danielle Antalffy with UBS.

我們的下一個問題來自瑞銀集團的 Danielle Antalffy。

Congrats on a really strong start to the year. I guess, Glenn, this is probably a question for you on that 150 bps target for operating margin expansion. I mean just based -- I know it's early. You guys just [gave] this about 6 months ago. So not trying to be too greedy, but 80 bps year-over-year in Q1, it sounds like things are actually only getting better from here as it relates to super cycle of product. Inflation presumably starts to continue to ease, hopefully. So I guess just any comments you can make about that 150 bps target based on what you guys did here in Q1. And that's it for me.

祝賀今年取得了非常強勁的開局。我想，Glenn，這可能是關於營業利潤率擴張 150 個基點目標的問題。我的意思是只是基於——我知道現在還為時過早。你們大約 6 個月前剛剛[給了]這個。因此，不要太貪婪，但第一季同比增長 80 個基點，聽起來事情實際上只會從這裡開始變得更好，因為這與產品的超級週期有關。通膨可能會開始繼續緩解，這是有希望的。因此，我想根據你們在第一季所做的事情，你們可以對 150 bps 目標發表任何評論。對我來說就是這樣。

Okay. Yes. First, just so we're clear, the target is 200 basis points over the next 2 years, '24 and '25. And that's what we presented back at Analyst Day back in November. It's also the kind of the guidance we brought out in January. I think if you do the rough math, just based on our guidance, you'll see that we're in the realm of 100 basis points or 100 basis points plus in this first year. .

好的。是的。首先，我們要先明確的是，未來兩年（24 年和 25 年）的目標是 200 個基點。這就是我們在 11 月的分析師日上所展示的內容。這也是我們一月推出的指導方針。我認為，如果你根據我們的指導進行粗略計算，你會發現我們在第一年處於 100 個基點或 100 個基點以上的範圍。 。

And you're correct, 80 basis points is a great start to the year. Seasonally, as we think about how this plays out for this year, we expect sort of second half margin expansion to be stronger than first half just given the seasonality of earnings that we see as the year plays out. No change in sort of our overall approach. If you think about what we did in 2023, you saw margin expansion coming through gross margin. 2024, we think and we expect that we'll see op expenses will lead more of the margin expansion. And then our goals in 2025 will likely be more balanced between gross margin and operating expenses.

你是對的，80 個基點是今年的好開始。從季節性角度來看，當我們考慮今年的情況時，鑑於我們認為今年的獲利季節性，我們預計下半年的利潤率擴張將強於上半年。我們的整體方法沒有改變。如果你想想我們在 2023 年所做的事情，你會發現利潤率的擴張是透過毛利率來實現的。到 2024 年，我們認為並且預計我們將看到營運支出將帶動更多的利潤率擴張。然後我們 2025 年的目標可能會在毛利率和營運費用之間更加平衡。

There are lots of programs we have in place. I mean you've seen the results that we've had in price. We also have low-cost greenfield site, strategic in-sourcing. We'll continue to push shared services efficiencies, IT harmonization. And then honestly, if you just look at the natural leverage that we drive when we're growing at the high levels, that also is a piece of this equation. So we're excited about the Q1 performance. We will still continue to be working on it through the remainder of this year and into next year, and we'll update you quarterly as the earnings calls play forward.

我們有很多計劃。我的意思是您已經看到了我們在價格方面的結果。我們也擁有低成本綠地，策略性內包。我們將繼續推動共享服務效率和 IT 協調。老實說，如果你看看我們在高水準成長時所驅動的自然槓桿，這也是這個等式的一部分。因此，我們對第一季的表現感到興奮。我們仍將在今年剩餘時間和明年繼續致力於此工作，並且隨著財報電話會議的進展，我們將每季向您通報最新情況。

Our next question comes from Matt Taylor with Jefferies.

我們的下一個問題來自傑弗里斯的馬特泰勒。

I was hoping you could talk a little bit more about Pangea and LIFEPAK as 2 upcoming catalysts and maybe frame any acceleration or pickup we could see from those products. How material could they be?

我希望您能多談談 Pangea 和 LIFEPAK 作為兩種即將推出的催化劑，並可能框架我們可以從這些產品中看到的任何加速或提升。它們有多重要？

Yes. Well, I'd say -- if you look at our trauma business, core trauma, so excluding upper extremities and lower extremities, if you look at core trauma, we've been historically the leading nailing company in the marketplace. But we haven't been the leading plating company. Now we have some terrific places, whether it's our clavicle platters, our pelvic products. But we didn't have a comprehensive system of variable angle plating. This is an amazing product launch, very comprehensive and will really be a shot in the arm for plating, which, by the way, is more than half of the procedures in trauma are plating versus nailing.

是的。好吧，我想說 - 如果你看看我們的創傷業務，核心創傷，那麼排除上肢和下肢，如果你看看核心創傷，我們歷來都是市場上領先的釘釘公司。但我們還不是領先的電鍍公司。現在我們有一些很棒的地方，無論是我們的鎖骨拼盤，還是我們的骨盆產品。但我們沒有一個全面的可變角度電鍍系統。這是一次令人驚嘆的產品發布，非常全面，確實會為電鍍帶來一針強心劑，順便說一句，超過一半的創傷手術是電鍍而不是釘釘。

And so we are wildly excited about this launch. We already have an incredibly high-performing core trauma business, fabulous leadership in our core trauma. And now we have a fabulous comprehensive plating solution. We've done roughly 40 cases so far. Feedback has been excellent from the surgeons. We -- it will take us time. We have to build out the sets, and these kind of launches take time to sort of fully roll out. But you're going to start to see the impact as early as Q3. We're going to have some procedures obviously done in Q2. It won't be too big of an impact, but it will start to have more of an impact in Q3, Q4 and beyond.

因此，我們對這次發布感到非常興奮。我們已經擁有令人難以置信的高性能核心創傷業務，在我們的核心創傷領域擁有出色的領導力。現在我們有了一個極好的綜合電鍍解決方案。到目前為止我們已經做了大約40個案例。外科醫生的回饋非常好。我們——這需要時間。我們必須建立場景，而此類發布需要時間才能完全推出。但您最早將在第三季開始看到其影響。我們顯然將在第二季完成一些程序。它不會產生太大的影響，但它將在第三季、第四季及以後開始產生更大的影響。

And as it relates to LIFEPAK, we are bringing in our sales force for a full sort of launch preparation in May, and we'll start to have our first shipments sometime in June. So there won't be much of an impact at all in Q2, but certainly going into Q3, Q4. We did show the product that a recent fire display conference -- firehouses, and the feedback was overwhelmingly positive. People were 7 and 8 rows deep looking at the product. It is -- we're really getting fantastic feedback.

就 LIFEPAK 而言，我們將在 5 月引進銷售人員進行全面的上市準備，並將在 6 月的某個時候開始出貨。因此，第二季不會有太大影響，但肯定會進入第三季、第四季。我們確實在最近的消防展示會議上展示了產品——消防站，反饋非常積極。人們排了 7 排和 8 排深入查看產品。我們真的得到了非常棒的回饋。

And so we're building the product right now and getting ready for a launch. And these kind of launches, because of the price point, you're not going to see probably as big an impact this year as you would see -- you'll see some, obviously. Medical is already performing incredibly well. But you'll see some impact this year, but you're going to see a lot more in the next 2 to 3 years after that. These are long-cycle products. They last a long time, and we know how to replace capital equipment at Stryker, and we're going to be doing that. It's incredibly exciting. The last sort of big defibrillator that we launched was almost 20 years ago. So there is a huge replacement market for this modern and really fully featured product.

因此，我們現在正在建立產品並準備發布。而這類產品的推出，由於價格因素，你今年可能不會看到像你會看到的那樣大的影響——顯然，你會看到一些影響。醫療已經表現得非常好。但今年你會看到一些影響，但在接下來的 2 到 3 年內你會看到更多影響。這些是長週期產品。它們可以使用很長時間，而且我們知道如何更換 Stryker 的固定設備，我們也將這樣做。這太令人興奮了。我們上一次推出大型除顫器已經是近 20 年前的事了。因此，這種現代且功能齊全的產品有一個巨大的替代市場。

Our next question comes from Caitlin Cronin with Canaccord.

我們的下一個問題來自 Canaccord 的 Caitlin Cronin。

Congrats on the strong performance this quarter. Just turning to upper extremity, you noted strong performance there. Any changing dynamics with the CMS ruling and ASC's hospital patient earlier this year? And can we also get a refresher on the new products coming in your Shoulder portfolio and the timing of those?

恭喜本季的強勁表現。剛轉向上肢，您就發現那裡表現強勁。今年稍早 CMS 的裁決和 ASC 的住院病患動態有何變化？我們能否回顧一下您的肩部產品組合中即將推出的新產品以及這些新產品的發佈時間？

Caitlin, it's Jason. As we think about upper extremities, this continues to be a fast grower for us. As we think about kind of transition and the opportunity in the ASC, no change from that perspective. And we expect this will continue to be a fast-growing business for us.

凱特琳，是傑森。當我們想到上肢時，它對我們來說仍然是一個快速成長的領域。當我們考慮 ASC 的轉型和機會時，從這個角度來看並沒有改變。我們預計這將繼續成為我們快速成長的業務。

Yes. And as it relates to product launches, I think we talked about this on the last call, but we have about 5 products that are either going into full launch that we're in partial launch or are being launched. We have a perform fracture system, which is really exciting, a reverse stemless product. We have the pyrocarbon, which is hemiarthroplasty product. We have the hollow lens, which is -- you can visualize the surgery in the operating room. That was a limited launch last year. That's going to move to full launch. And I think it's the fifth one, Jason, the number?

是的。由於它與產品發布有關，我想我們在上次電話會議上討論過這一點，但我們有大約 5 種產品要么即將全面發布，要么正在部分發布或正在發布。我們有一個預製斷裂系統，這確實令人興奮，是一種反向無柄產品。我們有熱解碳，它是半關節成形術產品。我們有空心晶狀體，你可以在手術室裡看到手術過程。這是去年的限量推出。這將轉向全面啟動。我想這是第五個，傑森，數字是多少？

Those were the -- those were the big...

那些是──那些是大的……

Those are the main 4 ones. But there's a fifth one. I can't remember right now. But if you look -- go back to the last call, I think we did highlight all of those products. So this is a business that's been growing roughly 20% every single quarter. That continued. We have a very strong first quarter. And we expect that to continue not seeing any real change in the market dynamics at all where we have tremendous momentum, and we expect that momentum to continue.

這是主要的 4 個。但還有第五個。我現在記不清了。但如果你看一下——回到上次通話，我認為我們確實強調了所有這些產品。所以這是一項每季成長約 20% 的業務。就這樣繼續下去。我們的第一季表現非常強勁。我們預計，在我們擁有巨大動力的地方，市場動態將繼續不會發生任何真正的變化，並且我們預計這種勢頭將繼續下去。

Great. And then just a question (inaudible) given it's post close now what the strengths do you really see that bringing to your Hip portfolio going forward?

偉大的。然後只是一個問題（聽不清楚），鑑於現在已經結束，您真正看到的優勢是什麼，可以為您的臀部投資組合帶來哪些優勢？

Yes. Well, firstly, if you look at our business in Europe, it gives us tremendous market share in France. And the dual-mobility, they were the originators of dual-mobility, and they have a terrific portfolio of products not just for France, but certainly, they're well known throughout Europe. And then eventually even some of those products, we'll be looking to bring those to the United States. So it really gives us a shot in the arm in Europe where, as you know, we've historically had lower market shares than other parts of the world. So we're very excited about this product. The feedback so far from surgeons has been excellent. They're very differentiated products that are -- that have a lot of history behind them and are really well received in the marketplace.

是的。嗯，首先，如果你看看我們在歐洲的業務，你會發現它為我們在法國帶來了巨大的市場份額。而雙移動性，他們是雙移動性的鼻祖，他們擁有出色的產品組合，不僅在法國，而且在整個歐洲都廣為人知。最終，甚至其中一些產品，我們也會尋求將它們帶到美國。因此，這確實給我們在歐洲打了一針強心劑，正如你所知，我們在歐洲的市場份額歷來低於世界其他地區。所以我們對這個產品感到非常興奮。到目前為止，外科醫生的回饋非常好。它們是非常差異化的產品，有著悠久的歷史，並且在市場上非常受歡迎。

Our next question comes from Richard Newitter with Truist.

我們的下一個問題來自 Truist 的 Richard Newitter。

This is actually Sam on for Rich. I appreciate the commentary you guys gave earlier on margins being stronger or expansion being stronger in the second half. But just as we think about the 80 basis points of expansion this quarter, is that reasonable to think about as a floor on a quarterly basis this year? Or maybe should we think about a step back in 2Q?

這實際上是 Sam 為 Rich 所做的。我很欣賞你們早些時候對下半年利潤率更強或擴張更強的評論。但正如我們考慮本季 80 個基點的擴張一樣，將其作為今年季度的下限是否合理？或者也許我們應該考慮在第二季退後一步？

Sam, it's Jason. I'll take this one, and Glenn can pile on anything additional here. But again, to Glenn's comments, as you think about the margin expansion getting to 100 bps on a full year basis being second half weighted, it certainly would imply that you could have a quarter less than that from a margin expansion standpoint. Certainly, margin expansion in every quarter, but I wouldn't necessarily say it'd be to the levels of what you saw in Q1 every quarter.

山姆，是傑森。我想要這個，格倫可以在這裡補充任何其他內容。但同樣，根據格倫的評論，當你考慮到下半年加權的全年利潤率擴張達到100 個基點時，這肯定意味著從利潤率擴張的角度來看，你的利潤率可能會比這一水平少四分之一。當然，每季的利潤率都會擴大，但我不一定會說每季都會達到第一季的水平。

Our next question comes from Joshua Jennings with TD Cowen.

我們的下一個問題來自 TD Cowen 的 Joshua Jennings。

I was hoping to just dig into the 20 bps of pricing pressure experienced by the Orthopaedics and Spine units. Any chance you can help us think more -- provide more details on the pricing headwind experienced by the total joint franchise Knees and Hips? And then at AAOS, it seems like there's -- and still with your guidance that there's optimism that the macro device industry may be in a new kind of era of pricing. Any updated thoughts there? And then just one follow-up.

我希望能深入了解骨科和脊椎部門所經歷的 20 個基點的定價壓力。您是否有機會幫助我們思考更多 - 提供有關全聯合特許經營 Knees and Hips 所經歷的定價逆風的更多詳細信息？然後在 AAOS，似乎仍然有您的指導，人們對宏設備行業可能處於新的定價時代持樂觀態度。有什麼更新的想法嗎？然後只有一個後續行動。

Sure. I mean if you think about pricing, we do sort of -- there are sort of a tale of 2 cities. On the MedSurg side, we generally are able to gain pricing. There's certainly a premium placed on technology, and we work through contracts that provide bands of pricing that allow us to approach customers. On the ortho side, you're right. Traditionally, it's been a market that has had price declines.

當然。我的意思是，如果你考慮定價，我們會做一些——有兩個城市的故事。在 MedSurg 方面，我們通常能夠獲得定價。技術當然受到重視，我們透過合約提供定價範圍，使我們能夠接觸客戶。在正交方面，你是對的。傳統上，這是一個價格下跌的市場。

I would say that as we think about our ortho business 5 years ago or even 6 years ago, we were looking at price declines that were in the 3% to 5% range. And I would say now what we're feeling and based on the contract sort of discipline that we have put in place with customers as well as sort of maybe a little bit of the impact of Mako being a closed system, we're feeling that we see sort of less negative price performance on the ortho side of our business. But we don't necessarily anticipate that ortho will ever get to positive, but we are feeling confident about less negative.

我想說的是，當我們考慮 5 年前甚至 6 年前的骨科業務時，我們看到的價格下降幅度在 3% 到 5% 範圍內。我現在想說的是，我們的感受是，基於我們與客戶簽訂的合約紀律，以及 Mako 作為一個封閉系統的一點影響，我們覺得我們看到我們業務的另一邊的負面價格表現有所減輕。但我們不一定預期正向值會變成正值，但我們對減少負值充滿信心。

And maybe just a follow-up. I was hoping you could share your outlook on the knee and hip markets. I think at AOS, our interpretation of some comments from your team and other orthopedic management teams was that we could see a higher level of growth in those markets relative to the pre-pandemic era. Just wanted to follow up. Any updated thoughts there? And also, there's been concerns about just the utilization headwind after a strong second half last year, broadly in the macro devices industry. And any thoughts on whether we should be thinking about a slowdown in utilization or procedure volumes in orthopedics in the second half here this year?

也許只是後續行動。我希望您能分享您對膝蓋和臀部市場的展望。我認為在 AOS，我們對你們團隊和其他骨科管理團隊的一些評論的解釋是，我們可以看到這些市場相對於疫情前時代的更高水平的成長。只是想跟進。有什麼更新的想法嗎？此外，在去年下半年宏觀設備產業的強勁表現之後，人們也擔心利用率的逆風。對於今年下半年我們是否應該考慮骨科利用率或手術量的放緩，有什麼想法嗎？

Josh, it's Jason. I'll take this one. I'd say a couple of different things here. As we think about the market, our view has really not changed at all here. Even if you go back to Investor Day in November of last year, we said the ortho markets would grow, call that mid-single digit area. And we would outperform that 200 to 300 bps above that. So as we think about the full year this year, that's kind of how we're looking at the markets, and we feel as good as ever about that.

喬什，是傑森。我要這個。我想在這裡說幾件不同的事情。當我們思考市場時，我們的觀點其實沒有任何改變。即使你回到去年 11 月的投資者日，我們也表示鄰位市場將會成長，稱之為中個位數區域。我們的表現將比這個高 200 到 300 個基點。因此，當我們思考今年全年時，這就是我們看待市場的方式，我們對此感覺一如既往。

Our final question comes from Andrew Ranieri with Morgan Stanley.

我們的最後一個問題來自摩根士丹利的安德魯·拉涅利。

Kevin, just 2 for you. Would you mind just talking about the trends you're seeing internationally in Mako? Any plans for geographic expansion in 2024? And really kind of like what utilization levels you're seeing with the Mako system outside the U.S.? And then second, just with the Gauss Surgical product, you touched on that. But can you also give us any more color on where you think you can take the product next within your MedSurg portfolio?

凱文，只給你 2 個。您介意談談您在 Mako 看到的國際趨勢嗎？ 2024 年有地域擴張計畫嗎？真的有點像您在美國以外看到的 Mako 系統的利用率水平嗎？其次，就高斯外科產品而言，您談到了這一點。但您能否進一步說明您認為產品在 MedSurg 產品組合中的下一步應用方向？

Okay. Great. So firstly, on international, what we're seeing is kind of the same dynamic we saw in the U.S. about 5 or 6 years ago. We are installing a large number of robots, and those tend to be leading indicators. And as you install those, then they start to do the procedures, and you see growth in the implants. So there, where we were 5, 6 years ago, it's really picking up in India, Japan, for sure. Even parts of Europe are picking up.

好的。偉大的。首先，在國際上，我們所看到的動態與五、六年前在美國看到的動態相同。我們正在安裝大量機器人，這些往往是領先指標。當你安裝這些時，他們就會開始執行程序，你會看到植入物的生長。所以，五、六年前，印度和日本的情況確實正在好轉，這是肯定的。甚至歐洲部分地區也在復甦。

We already had strength in the U.K., but we're picking up in other parts of Europe. China is still a bit small but starting to pick up as well. Korea is on fire for us with Mako. We're still a bit sluggish in Latin America. I'd say that's still a big opportunity for us, and there are hospitals that are demanding it. And we have to kind of -- we've made some changes in our own structure to really be able to address that opportunity.

我們在英國已經具備實力，但我們在歐洲其他地區正在崛起。中國仍然有點小，但也開始復甦。 Mako 為我們帶來了韓國的熱情。我們在拉丁美洲的發展仍然有點遲緩。我想說這對我們來說仍然是一個很大的機會，而且有些醫院也有這樣的需求。我們必須對自己的結構做一些改變，才能真正能抓住這個機會。

But overall, it's target rich. It's later in the market cycle than it has been in the U.S. and in Australia. Even Canada is starting to really pick up, and that's a very new dynamic. They were very, very late to the Mako story. And so we're very excited not just with the number of installations. You've seen multiple quarters of international really humming on installations. But that is a gift that will keep on giving. We've seen this in every market where you have large installations. It is a precursor for significant high-growth quarter after quarter.

但總體而言，它的目標豐富。它的市場週期比美國和澳洲晚。甚至加拿大也開始真正復甦，這是一個非常新的動態。他們對 Mako 的故事了解得非常非常晚。因此，我們不僅對安裝數量感到非常興奮。您已經看到國際上多個地區都在熱衷於安裝。但這是一份會繼續給予的禮物。我們在每個擁有大型安裝的市場都看到了這一點。這是逐季顯著高成長的先兆。

So very excited about the international opportunity. And it's still early days in many of these markets. So, so far so good. We're excited in the reception. Frankly, the most important thing is utilization. And so as we make sure these robots are being installed, are they being used at a high rate. And frankly, today, the country with the highest utilization for robot is India, the highest in the world. But it's picking up in other markets as well.

對於這個國際機會感到非常興奮。其中許多市場仍處於早期階段。所以，到目前為止一切順利。我們在接待處很興奮。說實話，最重要的是利用率。因此，當我們確保安裝這些機器人時，它們的使用率是否很高。坦白說，如今機器人使用率最高的國家是印度，是全世界最高的。但其他市場的情況也在好轉。

The second part of your question was on Gauss. So yes, we're really excited about Gauss. Obviously, this was an AI solution that we acquired to quantify hemoglobin for delivery as well as other general surgery procedures, and they had sort of a different kind of interface for the health care worker. We've improved that interface to make it a lot easier to use and combined that with our SurgiCount product -- I'm sorry, the, yes, SurgiCount, so the sponge counting. But this is also -- so measuring the blood in the sponge and the canister but also counting the sponges to make sure those sponges are left in the body.

你問題的第二部分是關於高斯的。所以，是的，我們對高斯感到非常興奮。顯然，這是我們獲得的一個人工智慧解決方案，用於量化分娩以及其他普通外科手術中的血紅蛋白，並且它們為醫護人員提供了不同類型的介面。我們改進了該介面，使其更易於使用，並將其與我們的 SurgiCount 產品相結合 - 對不起，是的，SurgiCount，所以海綿計數。但這也是——因此測量海綿和罐子中的血液，同時也要計算海綿的數量，以確保這些海綿留在體內。

There's ideas that we have about how we can connect to this tablet and have other devices tied to the tablet. It's a common tablet being used for both solutions. I'm not ready yet to talk about what that will be. There's a lot of other connectivity discussions going on inside Stryker, particularly with Vocera. At Vocera, obviously, we have the bed now connected to the Vocera badges in that system, and there are a lot of other discussions about what else can we connect with Vocera. It's just a little premature for us to talk to you about what those are. I think I'd rather have those products ready for launch and then talk about it.

關於如何連接到該平板電腦以及如何將其他設備與該平板電腦綁定，我們有一些想法。這是兩種解決方案都使用的常見平板電腦。我還沒準備好談論那會是什麼。 Stryker 內部正在進行許多其他連接性討論，特別是與 Vocera 的討論。顯然，在 Vocera，我們現在已經將床連接到該系統中的 Vocera 徽章，並且還有很多關於我們還可以與 Vocera 連接的其他內容的討論。現在與您討論這些內容還為時過早。我想我寧願讓這些產品準備好發布，然後再談論它。

But clearly, we are looking at workflow and bringing better IT solutions for our customers, really looking at that across the portfolio. How can we improve workflow in the hospitals? How can we reduce errors for hospital acquired conditions? Safety and outcomes is a big focus of many of our MedSurg divisions. And I think we're on a really good track. Did I ever think we'd buy an app on an iPhone, which is really what Gauss is? No. But that's the future. And that's going to be our focus. And Vocera, obviously, was a bigger foray into the digital solution world, but don't expect that this will be the end. And I can see within our deal pipeline, HIT is going to feature and don't be surprised if we continue to do both organic innovation as well as acquisitions to bolster our presence within HIT.

但顯然，我們正在關注工作流程並為客戶帶來更好的 IT 解決方案，真正專注於整個產品組合。如何改善醫院的工作流程？如何減少因醫院獲得性條件而產生的錯誤？安全和結果是我們許多 MedSurg 部門關注的重點。我認為我們正走在一條非常好的軌道上。我是否曾想過我們會在 iPhone 上購買應用程序，而這正是 Gauss 的本質？不，但這就是未來。這將是我們的重點。顯然，Vocera 是對數位解決方案世界的更大的嘗試，但不要指望這會是結束。我可以看到，在我們的交易管道中，HIT 將會佔據重要地位，如果我們繼續進行有機創新和收購來增強我們在 HIT 中的影響力，請不要感到驚訝。

There are no further questions. I will now turn the call over to Kevin Lobo for closing remarks.

沒有其他問題了。我現在將把電話轉給凱文·洛博 (Kevin Lobo) 致閉幕詞。

Thank you for joining our call. As you can see, 2024 is shaping up to be another strong year for Stryker. We look forward to sharing our Q2 results with you in July. Thank you.

感謝您加入我們的通話。如您所見，2024 年將是 Stryker 又一個強勁的一年。我們期待在 7 月與您分享我們第二季的業績。謝謝。