[Operator instructions] As a reminder, this conference is being recorded. your options for e-mail notification, please enter your e-mail address below and click Next, we're going to the line of Rick Wise with Stifel. The increase in cash in the second quarter primarily reflected cash from operations and stock exercises. 2 Reasons to Avoid a Roth 401(k) for Your Retirement Savings, Warren Buffett's Latest $2.9 Billion Buy Brings His Total Investment in This Stock to $66 Billion in 4 Years, Want $1 Million in Retirement? Jamie will take you through procedure dynamics in more detail later in the call. INTUITIVE at 2022 Wells Fargo Healthcare Conference. It's a short period, but we believe that there is elasticity, and we've seen elasticity in markets where reimbursements are very low. (2021) Dropped off in 2022. We are in the execution and launch phase of four efforts. . You may automatically receive Intuitive Surgical financial information by e-mail. Second-quarter revenue reflected growth in both procedures and system placements. The meta-analysis combined 18 studies across different countries containing over 11,000 patients, of which just over 5,000 received da Vinci robotic-assisted thoracic surgery and just over 6,000 received VATs. See www.intuitive.com/trademarks. Tycho Peterson -- JPMorgan Chase & Co. -- Analyst. Intuitive has managed multiple ways of working for many years. How are you thinking about competition? INTUITIVE at 2022 Wells Fargo Healthcare Conference. Even then, it's not enough. However, as the installed base of older-generation product declines, the number of trade-ins will decline over time. Now, I'd turn the conference over to our host, Brian King, Head of Investor Relations for Intuitive Surgical. Medistim ASA schlgt ordentliche Dividende fr 2021 vor, zahlbar am 9. You've been spending a lot there. - building a financial model and investor presentation for fundraising . It's the impact on hospitalizations. Gary, a separate topic. May 2021 - Present 1 year 10 months. Revenues are anticipated to be about $1.55 . In the second quarter, we modified the useful life of a deferred-tax asset, which resulted in a current charge to pro forma income. So here's kind of where we stand with the backlog. There are no upcoming events available at this time. Intuitive advances minimally invasive care by innovating at the point of possibility. It's not just the robot. Examining procedure trends more deeply. Jamie will provide additional procedure commentary later in this call. Looking at the past eight quarters in context, our compound annual growth rate for procedures for the period Q2 2019 through Q2 2021 of 16.5% is approximately the growth we would have expected absent the pandemic. Colorectal growth was strong, with solid growth in malignant hysterectomy, thoracic, and prostatectomy procedures. We anticipate iterating our approach as we learn and the year progresses. Transitory was out a few years ago and CMR has been out and now Medtronic. The Motley Fool has a disclosure policy. Statements using words such as estimates, projects, believes, anticipates, plans, expects, intends, may, will, could, should, would, targeted, and similar words and expressions are intended to identify forward-looking statements. On a constant currency basis, fourth quarter 2022 revenue increased 10% compared to the fourth quarter of 2021. That impact was most pronounced in the U.S. and Europe, varied market to market, complicating year-over-year comparisons. Just on the recent spread of COVID and variants and the potential impact on demand and hospitals' ability to do procedures, are you starting to see that impact now? We recognized $26 million of lease buyout revenue in the second quarter, compared with $9 million last year and $19 million last quarter. Investor's Business Daily . Four of the systems placed in the first quarter were SP Systems, reflecting continued measured rollout of SP. We're doing what we call the procedure development and the trial development around other indications, we think there'll be an opportunity in thoracic, as well as other ones beyond it. We also -- the business came back faster than we had anticipated. At the time you receive a -- by the time you're at -- that market penetration rates that are significant. Larry Biegelsen -- Wells Fargo Securities -- Analyst. Our overall second-quarter procedure growth was 68%, compared to a decline of 19% during the second quarter of 2020, which reflected a significant adverse impact from the COVID-19 pandemic. Jamie, I'll let you take it from there. Second-quarter 2021 procedures increased approximately 68% compared with the second quarter of 2020 and increased approximately 13% compared with last quarter. And we've seen both good clinical outcomes, but also high surgeon satisfaction and better ergonomics. And then on SG&A, kind of same kind of question. It's physically demanding. The painful part is the investment troughs are deep in the early and middle years of those product cycles. The constant currency revenue percentage change is calculated by determining the increase in the current period constant currency revenue over the prior period revenue. Today's format will consist of providing you with highlights of our second-quarter results as described in our press release announced earlier today followed by a question-and-answer session. And those two things come together, they also allow hospitals to start to address the backlog that's accumulated. Intuitive Surgical Asensus Surgical . Next, we will go to Amit Hazan with Goldman Sachs. Management addresses these limitations by providing specific information regarding the GAAP amounts excluded from non-GAAP net income attributable to Intuitive Surgical, Inc. and non-GAAP EPS and evaluating non-GAAP net income attributable to Intuitive Surgical, Inc. and non-GAAP EPS together with net income attributable to Intuitive Surgical, Inc. and net income per share attributable to Intuitive Surgical, Inc. calculated in accordance with GAAP. Even though we've seen growth in the procedures that were specifically targeted by extended use instruments, it's hard to discern what is COVID-related versus what is not. Travel and associated costs in support of our field have also not recovered to pre-pandemic levels. The Company defines non-GAAP income from operations as income from operations, excluding amortization of intangible assets, SBC and long-term incentive plan expenses, litigation charges and recoveries, and a gain on the sale of a business. Full Time Faculty & Clinical Coordinator, Surgical Technologist Program Ask us about our $5,000 Sign on Bonus Rasmussen University Rasmussen University is seeking an experienced Surgical Technologist passionate about taking their own experience and translating that into helping students succeed in meeting their educational and professional goals. The next page will display a menu of options. Those things are ongoing now. Intuitive(Nasdaq: ISRG), headquartered in Sunnyvale, California, is a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery. [Operator instructions] And for our first question, we will go to Tycho Peterson. We could see one large competitor approved in the second half of this year. The Company ended the fourth quarter of 2021 with $8.6 billion in cash, cash equivalents, and investments, an increase of $400million during the quarter, primarily driven by cash generated from operations. The Company ended the fourth quarter of 2022 with $6.74 billion in cash, cash equivalents, and investments, a decrease of $651 . The webcast replay of the call will be made available on our website at www.intuitive.com within 24 hours after the end of the live teleconference and will be accessible for at least 30 days. These non-GAAP financial measures also facilitate managements internal comparisons to its historical performance. The Company defines non-GAAP income from operations as income from operations, excluding intangible asset charges, certain acquisition-related items for the re-measurement of contingent consideration, SBC and long-term incentive plan expenses, and litigation charges and recoveries. J Global Clinical Engineering, Special Issue 4, 2021 - Proceedings IV ICEHTMC 2021 - ISSN 2578 2762 1 dicembre 2021 . 5001-10,000 Employees. But once you develop a really capable ecosystem, then it has a lot of platform use, and that investment can be recovered over time. any time, re-enter your e-mail address and click Submit, then adjust your form entries. That's helpful, Gary. (1) Services revenue includes the effect of the following item: (2) Selling, general and administrative includes the effect of the following item: (3) Income from operations includes the effect of the following item: (4) Interest and other income, net includes the effect of the following item: (5) Income tax expense includes the effect of the following items: Excess tax benefits related to share-based compensation arrangements. From the top, I think you said the right thing, which is there's a little bit of a decoupling thus far of infection from hospitalization. An investor who was able to pick up $1,000 worth of Intuitive Surgical shares at its IPO price and held on has seen that investment grow to a whopping . In the United States, procedure growth was strong in the quarter, driven by growth in bariatric surgery, hernia repair, and cholecystectomy. Copyright 2023 Intuitive Surgical. SUNNYVALE, Calif., Jan. 24, 2023 (GLOBE NEWSWIRE) -- Intuitive (the Company) (Nasdaq: ISRG), a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery, today announced financial results for the quarter ended December31, 2022. During the second half of 2022, the Company saw COVID-19 resurgences impact da Vinci procedure volumes in China. Copyright 2023 Intuitive Surgical. The next page will display a menu of options. Thank you for joining us today. Listen to Webcast. A couple of things I'd say. 06/14/22 - 1:20 PM PDT. Yes. And we expect those to come back as COVID goes away and the restrictions on travel and the restrictions on other activities go away. Good afternoon. In the U.S., Q2 procedure results were positively impacted by a continuing recovery from COVID-19, including, we believe, a number of procedures that had been previously deferred. It doesn't seem like the backlog would be exhausted just after one quarter. The year-over-year increase in I&A revenue per procedure reflects increased usage of our advanced instruments, partially offset by the impact of extended use instruments. Thank you for your support on this extraordinary journey. We placed 20 Ion systems in the quarter, bringing the installed base to 70 systems. So we don't really call them out as individual revenue lines. Ladies and gentlemen, thank you for standing by and welcome to the Intuitive Q4 2021 Earnings Release Call. Now that the dust . For full-year 2021, Intuitive Surgical revenues are estimated to be north of $5.7 billion, reflecting a 30% y-o-y growth, while the growth rate is expected to slow to low teens next year . And so we have some indications that we saw backlog reflected in the Q2 results. COVID-19 has had, and will likely continue to have, an adverse impact on the Companys procedure volumes. Gotcha. I think that's what's been driving our success in the early market. Copyright 2023 Intuitive Surgical. Jamie Samath Senior Vice President of Finance Email: investor.relations@intusurg.com. China procedure growth remains strong and broad-based as a result of continued expansion of the installed base under the current quota. We have a broad range of estimates. We will now open the call to your questions. Gross profit, income from operations, net income attributable to Intuitive Surgical, Inc., and net income per diluted share attributable to Intuitive Surgical, Inc. are reported on a GAAP and non-GAAP* basis. The Company placed 369 da Vinci Surgical Systems, a decrease of 4% compared with 385 in the fourth quarter of 2021. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. Our digital learning programs continue to be an important part of our overall learning initiatives. I think the product ecosystem with XI with a 60-millimeter stapler is in good shape, and we're getting good feedback from surgeons in that regard. Fourth quarter 2021 GAAP income from operations included share-based compensation expense of $120 million, compared with $104 million in the fourth quarter of 2020. SP procedures grew 133% year over year, with much of that growth coming from the United States. The pandemic is not behind us, and additional infection growth may again strain hospital resources and impact our results in the future. And then has the elasticity relative to the extended use program and the pricing adjustments played out relative to your expectations? OUS markets grew 51% year over year or 19% on a two-year compound annual growth rate basis. Our focus is in clinical capability and productivity of the installed base we have. Additional revenue statistics and trends are as follows. Please go ahead, sir. In the U.S. and Europe, extended use instruments were nearly fully adopted in the second quarter. Are you seeing any impact thus far? Third, driving depth and excellence in regional performance, particularly in Europe and Asia. Or is this simply and primarily just something about the pandemic accelerating the use of da Vinci and robotics surgery broadly? The compound annual growth rate between the full year of 2019 and the full year of 2021 was approximately 12%. Contents: Prepared Remarks; Questions and Answers; Call Participants; Prepared Remarks: Operator. One on procedures, one on competition. It also reflects lower diagnostic pipelines and perhaps some reluctance for patients to visit hospitals. Listen to Webcast. Fourth quarter 2021 instruments and accessories revenue increased by 13% to $843million, compared with $747million in the fourth quarter of 2020, primarily driven by approximately 19% growth in da Vinci procedure volume, partially offset by stocking orders in the prior year associated with the Companys launch of Extended Use Instruments. And so we watch that number because we know it's highly sensitive. Congrats on the quarter. All of that, to me, indicates that the business feels in balance. Q2 2022 INTUITIVE Earnings Conference Call. Fourth quarter 2022 non-GAAP* net income attributable to Intuitive Surgical, Inc. was $439 million, or $1.23 per diluted share, compared with $473 million, or $1.29 per diluted share, in the fourth quarter of 2021. It flows from respect for and understanding of patients and care teams, their needs, and their environment. Instrument and accessory revenue per procedure of $1,940 increased, compared with $1,900 per procedure for the second quarter of last year, and decreased, compared with $1,950 per procedure in the first quarter. It is in fact a physically taxing procedure, as Gary described. It links into some of the other things you're talking about. Thanks. Cardio medical GmbH 10.4. Where are we going with this one? Get stock recommendations, portfolio guidance, and more from The Motley Fool's premium services. So short answer there is just kind of a reminder of what we're trying to do. Bringing it all together. Intuitive Surgical didn't offer an outlook for 2021. *Stock Advisor returns as of June 7, 2021. You may automatically receive Intuitive Surgical financial information by e-mail. The Companys calculated non-GAAP effective tax rate is generally higher than its GAAP effective tax rate. Submit. The da Vinci surgical systems are designed to help surgeons perform minimally invasive surgery. There are several models of the da Vinci Surgical System. And sequential growth in what they can do with the system remains our focus on SP for now. Product and brand names/logos are trademarks or registered trademarks of Intuitive Surgical or their respective owner. Lastly, we continue to digitally enhance our ecosystem. So we're making those investments to move that forward. We did not repurchase any shares in the quarter. It last split in October of 2017. The Company believes that both management and investors benefit from referring to these non-GAAP financial measures in assessing its performance and when planning, forecasting, and analyzing future periods. Fourth quarter 2022 systems revenue decreased by 4% to $451 million, compared with $470 million in the fourth quarter of 2021. They use specialized instrumentation, including a miniaturized surgical camera and wristed instruments (i.e., scissors, scalpels, and forceps) that are designed to help with precise dissection and reconstruction deep inside the body. And I'm actually curious more what's going on with service and software at the hospitalwide kind of department of surgery level. Second, disciplined execution of our launches, including our advanced instruments, SP, Ion, and digital efforts. We think there's an opportunity to look at correlations between surgeon performance and outcomes. 2021 Intuitive Surgical Inc - - USD 2020 Intuitive Surgical Inc . While we strive for our Foolish Best, there may be errors, omissions, or inaccuracies in this transcript. And I have one follow-up. During 2021, COVID-19 resurgences continued to impact da Vinci procedure volumes. Gary, just with you, just thinking through the My Intuitive and what you're doing at the surgeon level. Given the stronger recovery of procedures we have experienced so far, particularly in the U.S., and strength in U.S. general surgery, we are now increasing our forecast and expect full-year 2021 procedure growth of 27% to 30%. All Rights Reserved. And that is both painful and an opportunity. System placements in the quarter reflected procedure growth and hospitals upgrading to -- in order to access or standardize on fourth-generation capabilities. These forward-looking statements include, but are not limited to, statements related to the expected impacts of the COVID-19 pandemic on the Companys business, financial condition, and results of operations, future results of operations, future financial position, the Companys financing plans and future capital requirements, the Companys potential tax assets or liabilities, and statements based on current expectations, estimates, forecasts, and projections about the economies and markets in which the Company operates and the Companys beliefs and assumptions regarding these economies and markets. And I think you've alluded to adding additional instruments and accessories, so can you talk on the hardware side as well? On the why side, it's -- bariatrics has been a little different than other procedure for us. The stock split will take place after market close on October 5th, 2021. Richard Wolf GmbH 10.6 . Moving on to capital placements. Philip Kim, our head of investor relations, will not be joining on today's call as he's currently on paternity leave following the birth of his daughter. Yes. They're calling on customers. Phone: 408-523 . Q2 growth was driven by particular strength in benign procedures, including bariatrics, hernia repair, cholecystectomy, and benign hysterectomy, reflecting in part, we believe, a partial catch-up in these procedures related to the previous deferral of elective surgeries. Thank you. Jamie will provide spend guidance later in this call. Clinical trial sites completed enrollment for our PRECIsE clinical trial. Fourth quarter 2022 GAAP net income attributable to Intuitive Surgical, Inc. was $325 million, or $0.91 per diluted share, compared with $381 million, or $1.04 per diluted share, in the fourth quarter of 2021. To choose The Company undertakes no obligation to publicly update or release any revisions to these forward-looking statements, except as required by law. Lease buyout revenue has varied significantly quarter to quarter and will likely continue to do so. Key business metrics for the second quarter were as follows. In addition, COVID delayed some R&D work, resulting in underspend on prototypes. Intuitive Surgical's adjusted net . . Some of them are included in our service contracts, some of them are on a per-use basis. The Company excludes a one-time tax benefit from re-measurement of certain deferred tax assets, because it is discrete in nature, and excludes the excess tax benefits or deficiencies associated with SBC arrangements as well as the tax effects associated with non-cash amortization of deferred tax assets related to intra-entity non-inventory transfers, because the Company does not believe these items correlate with the on-going results of its core operations. As I believe that focusing on patient-centered strategies combined with leveraging data for research can help to improve the diagnosis, treatment, and prevention of diseases.<br><br>Patient-centered: I'm raising the bar on patient . So bariatric obviously has been highly laparoscopically penetrated historically. Recovery in the U.K. was healthy in the quarter as NHS increased access to surgeries broadly. Marshall, the operating margin coming in at the 43%, I'm just wondering how much we can extrapolate here? We expect our pro forma rate for the last six months of 2021 to be between 21% and 22% versus our previous guidance of 20% to 21%, reflecting a greater proportion of U.S. income for the year. We don't actually know how much backlog was resolved in the quarter, how much backlog is left or the timing of the recovery of that might be. Foreign currency fluctuations had a 3% unfavorable impact on fourth quarter 2022 revenue. I'll caution that what the next couple of quarters or next four quarters looks like in terms of hospital access to capital and their decision-making, capital is always lumpy. But at this point, it's just too difficult to estimate and, therefore, kind of give you any additional color on. This article is a transcript of this conference call produced for The Motley Fool. Moving on to gross margin and operating expenses. As part of our mission, we believe that minimally invasive care is life-enhancing care. The outlook we are providing on today's call does not reflect risks associated with a significant increase in COVID-related hospitalizations in relation to the Delta variant or other potential new variants.
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