Financial Data and Key Metrics Changes - Revenue grew 21% year over year to $10.1 billion, with operating margins at 37% reflecting investments in R&D and manufacturing scale [7][15][27] - Proforma EPS increased 22%, marking the third consecutive year of growth above 20% [15] - Free cash flow rose to $2.5 billion from $1.3 billion in 2024, driven by increased profitability and lower capital expenditures [15] Business Line Data and Key Metrics Changes - Total procedures grew 19%, with da Vinci procedures increasing 17% and Ion procedures growing 51% [5][14] - In Q4, da Vinci procedures grew 18%, with general surgery in the U.S. and broad-based growth in international markets driving this increase [15][17] - The installed base of da Vinci systems increased by 12% to over 11,100 systems, while average system utilization rose by 4% [16] Market Data and Key Metrics Changes - U.S. da Vinci procedures increased 15% to over 2 million, while international procedures grew by 23% to over 1.1 million [5][19] - Growth rates were 21% in Europe, 24% in Asia, and 27% in the rest of the world [5] - In Q4, total procedures outside the U.S. grew 22%, with notable increases in Canada, India, Korea, and distributor markets [19] Company Strategy and Development Direction - The company focuses on four strategic priorities: launching da Vinci 5, increasing adoption of focused procedures, building industrial scale and product quality, and enhancing digital tools [4][5] - Plans to expand the da Vinci XIR system and related economic programs to increase access to da Vinci surgery internationally and in U.S. ambulatory surgery centers [7][11] - Continued investment in market access activities and local evidence generation to meet clinical and economic objectives [6] Management's Comments on Operating Environment and Future Outlook - Management believes the company is in the early stages of advancing minimally invasive care, with significant long-term opportunities ahead [4][5] - Anticipated full-year da Vinci procedure growth for 2026 is projected to be between 13%-15%, driven by general surgery in the U.S. and international procedures [32] - The company expects gross profit margins to be within a range of 67%-68% of net revenue for 2026, with potential impacts from tariffs and product mix [33] Other Important Information - The company received FDA clearance for several cardiac procedures on da Vinci 5, with plans for a measured rollout to support training and adoption [8][36] - The My Intuitive Plus digital subscription package is expected to enhance customer engagement and provide additional revenue streams starting in 2026 [55] Q&A Session Summary Question: About FDA approvals for cardiac non-force feedback instruments - Management discussed ongoing support for cardiac surgery and the importance of training pathways and developing specific instrumentation for cardiac procedures [36][37] Question: Expanding footprint in ASCs - Management highlighted the growing opportunity in ASCs for lower acuity procedures and the need for high-quality clinical outcomes and operational infrastructure [41][42] Question: Gross margin and operating expenses assumptions - Management explained the dynamics affecting gross margin, including higher trade-ins and the mix of da Vinci 5 systems, while also addressing operating expense growth expectations [46][47] Question: Position in China and competition - Management acknowledged increased competition in China but expressed confidence in their ability to compete effectively with local robotic companies [49][50]