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- **Record Revenue Growth**: Q3 2025 revenue of $2.5 billion (+23% YoY) driven by 19% da Vinci and 52% Ion procedure growth.
- **da Vinci 5 Dominance**: 240 systems placed globally, with 18 of top 20 U.S. health systems now standardized to dV5.
- **International Expansion**: First systems in Japan and Europe, SP procedures up 91% with Korea leading adoption.
- **Force Feedback Innovation**: Early data shows 20% reduction in surgical force, with clinical outcome studies underway.
- **Gross Margin Resilience**: 68% gross margin despite tariffs, supported by da Vinci 5 and Ion mix.
- **Challenges Ahead**: China market constrained by competition, bariatrics down 6+ quarters, and U.S. Medicare noise impacting elective procedures.

**【CEO Summary Section】**
- **Revenue Growth**: Q3 2025 revenue reached $2.5 billion, a 23% year-over-year increase, driven by 19% growth in da Vinci procedures and 52% growth in Ion procedures.
- **da Vinci 5 Adoption**: Placed 240 da Vinci 5 systems globally, with 12 in OUS markets. U.S. IDNs now have at least 1 da Vinci 5 in 18 of the top 20 health systems.
- **International Expansion**: First systems placed in Japan and Europe, with positive early feedback. SP procedures grew 91%, led by Korea and international markets.
- **Force Feedback Technology**: Early data shows reduced force application during thoracic procedures, with studies underway to assess clinical outcomes.

**【CFO Financial Commentary】**
- **Financial Performance**: Pro forma EPS of $2.40, up 30% YoY. Gross margin of 68% reflected higher da Vinci 5 and Ion revenue mix, offset by tariffs and facility costs.
- **Capital Spending**: $590 million in systems revenue, 33% growth, with 54% of da Vinci placements under lease agreements. Recurring revenue accounted for 85% of total.
- **Operational Efficiency**: Trade-in transactions increased 245% YoY, driven by U.S. upgrades to da Vinci 5. Lease buyout revenue declined 28% due to delayed buyouts.

**【Clinical Highlights】**
- **Ion Performance**: Ion procedures reached 38,000, with a 52% increase in U.S. utilization and quadrupling in OUS markets. FDA-cleared workflow improvements enhance biopsy accuracy.
- **SP Platform**: 91% procedure growth, led by Korea and early adoption in Europe. FDA clearances for SP stapler and Sensitive Firefly expand versatility.
- **Force Feedback Studies**: Ohio State University study showed 20% reduction in peak force application, supporting gentler surgery. European Respiratory Society data highlights Ion's role in early lung cancer diagnosis.

**【Financial Outlook Update】**
- **Procedure Growth**: Updated da Vinci procedure guidance to 17-17.5% YoY, up from 15.5-17%. Gross margin expected at 67-67.5% for 2025, reflecting tariff impacts and cost reductions.
- **Expense Management**: Operating expenses to grow 11-13% YoY, driven by headcount and R&D. Tax rate estimated at 21-22% due to U.S. tax reforms.

**【Q&A Highlights】**
- **Sustainability of Growth**: U.S. da Vinci utilization up 2% QoQ, driven by da Vinci 5 adoption. OUS growth benefited from 1% holiday timing adjustment.
- **Refurbished Xi Systems**: 20 units sold to date, targeting cost-sensitive sites and ASCs. Commercial teams see segmentation opportunities across customer segments.
- **China Challenges**: Competitive tendering and reimbursement pressures persist. Europe and Japan show early interest in da Vinci 5, but regulatory approvals lag.
- **Bariatrics Drag**: Domestic bariatric procedures down high single digits for 6+ quarters, impacting 3% of da Vinci volume. Surgeon feedback indicates no near-term recovery.
- **Hub Evolution**: Video data collection and AI integration progressing, with potential for intraoperative guidance and outcome optimization in future iterations.

Intuitive Surgical, Inc. (ISRG) Q3 2025 Earnings Call Transcript

Revenue

Sales and Services Revenue

Financing Services Revenue

Other Revenue

Cost of Revenue

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Operating Expenses

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ISRG

ISRG fundamentals

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