China Remains Competitive: Can ISRG Defend Share Amid Local Rivals?

Core Insights - Intuitive Surgical's (ISRG) business in China is facing challenges due to geopolitical factors and industrial policies affecting capital purchasing decisions [2] - The company reported a slight decline in placements, with only 13 da Vinci systems installed in China during Q3 2025, indicating a constrained and competitive market [3][8] - Despite these challenges, ISRG maintains competitive advantages through global scale, utilization-driven economics, and a strong installed base [4] Company-Specific Developments - ISRG's management acknowledged slow tender processes and a preference for local vendors, which is creating pricing pressure on both capital systems and instruments and accessories [2][3][8] - The company is leveraging refurbished Xi systems and emphasizing per-procedure value to lower entry barriers and sustain customer ROI [4][8] Industry Context - Other U.S.-based robotic surgery device-makers, such as Stryker and Globus Medical, are also experiencing increased competition from local players in China [5] - Stryker is focusing on expanding its Mako SmartRobotics system in Asia, while facing intense price competition in the maturing orthopedic-robot market [6] - Globus Medical is accelerating its internationalization efforts and emphasizing technology depth to compete, but is also encountering pricing pressure from rapidly scaling local suppliers [7]