Intuitive(ISRG) - 2025 Q4 - Earnings Call Transcript

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 [8][16][29] - Proforma EPS increased 22%, marking the third consecutive year of growth above 20% [16] - Free cash flow rose to $2.5 billion, up from $1.3 billion in 2024 [16] Business Line Data and Key Metrics Changes - Total procedures grew 19%, with da Vinci procedures increasing 17% and Ion procedures growing 51% [5][16] - Single-port procedures grew 87%, while multi-port procedures increased 17% [5][11] - In Q4, da Vinci procedures in the U.S. increased 15% to over 2 million, while international procedures grew 23% [6][19] Market Data and Key Metrics Changes - U.S. procedures increased 16%, with da Vinci procedures growing 15% and Ion procedures growing 41% [17] - Internationally, da Vinci procedures grew 21%, with notable growth in Canada, India, Korea, and various European markets [20][21] - Japan's procedure growth was lower than expected due to capital placement challenges, with potential reimbursement changes anticipated in 2026 [21] 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 enhancing digital tools [4][13] - Plans to expand into ambulatory surgery centers (ASCs) and enhance training and support for customers [19][56] - Continued investment in market access activities and local evidence generation to meet clinical and economic objectives [6][7] 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 growth opportunities ahead [4][78] - Anticipated da Vinci procedure growth for 2026 is projected between 13%-15%, driven by general surgery and international procedures [36] - Expected gross profit margin for 2026 is projected to be between 67% and 68% of net revenue, with various factors impacting this guidance [37] Other Important Information - The company placed 1,721 da Vinci systems in 2025, including 870 da Vinci 5 systems [7][23] - The installed base of da Vinci systems increased by 12% to over 11,100 systems, with average system utilization rising by 4% [17][26] - The company plans to introduce additional products and features for da Vinci 5 in 2026 [10] Q&A Session Summary Question: FDA approvals for cardiac non-force feedback instruments - Management discussed the importance of supporting cardiac surgery and the foundational work being done, including training pathways and developing cardiac-specific instrumentation [41][42][44] Question: Advanced imaging features in the robotic ecosystem - Management explained that advanced imaging capabilities are being developed, which will add revenue streams and improve surgical outcomes [48][49] Question: ASC opportunity and key procedures - Management highlighted the growing ASC opportunity, focusing on high-quality clinical outcomes and the need for repeatable procedures [53][55] Question: Gross margin and operating expenses assumptions - Management provided insights into the dynamics affecting gross margin, including higher trade-ins and the mix of da Vinci 5 systems [64][66] Question: Competition in China - Management acknowledged increased competition in China but expressed confidence in their ability to compete effectively with local robotic companies [68][70]