Intuitive Surgical's Q4 2024: Navigating Contradictions in System Utilization, Margins, and Market Dynamics

Procedure and Capital Placement Growth:
- Intuitive Surgical reported full-year procedure growth of 17%, with the launch of da Vinci 5 contributing significantly to this growth.
- The company placed 1,432 multiport systems and 271 Ion systems in the full year, indicating strong capital investments.
- Growth was driven by robust early adoption of da Vinci 5, increased utilization across all platforms, and expansion into new global markets.

Financial Performance and Operating Expenses:
- Total revenue for the year was $8.4 billion, with pro forma operating margin improving by 310 basis points to 37%.
- Pro forma EPS increased by 28%, supported by improved pro forma gross margin by 100 basis points to 69.1%.
- The increase in expenses was attributed to investments in R&D, expansion of manufacturing and commercial footprints, and higher legal expenses.

Da Vinci 5 Launch and Utilization:
- Da Vinci 5 placements reached 362 systems in the first year, with over 32,000 procedures performed.
- Utilization of multiport systems grew by 3%, with significant growth in SP and Ion systems at 12% and 13%, respectively.
- The broad clinical indications and digital features of da Vinci 5 were key factors driving customer interest and adoption.

Geographic and Product Mix Dynamics:
- U.S. procedures grew by 15%, driven by benign general surgery and regional performance in countries like the U.K. and Japan.
- OUS procedures grew by 25%, with strong performance in India, the U.K., Italy, and Japan.
- The procedure mix shift towards benign indications and geographic market expansion influenced financial performance.