Intuitive Surgical (ISRG-0.90%) investors who weren't expecting it to perform a three-for-one stock split recently woke up to what looked like an overnight loss of more than 60%. While there continues to be COVID hotspots within some of our Asia Pacific markets, overall procedures in the region performed well. Ladies and gentlemen, thank you for standing by and welcome to the Intuitive Q4 2021 Earnings Release Call. China procedure growth remains strong and broad-based as a result of continued expansion of the installed base under the current quota. Shares of Intuitive Surgical jumped as much as 9.8% on Wednesday to a record high of $891.15 after the robotic surgery company crushed first quarter earnings. Yes. We could see one large competitor approved in the second half of this year. The Company calculates constant currency revenue by translating current period revenue using prior period exchange rates. Second-quarter system placements of 328 systems increased 84%, compared with 178 systems for the second quarter of 2020, and increased 10%, compared with 298 systems last quarter. In terms of our underlying numbers, we're growing at a little faster rate in the revision section, sleeves and bypass grow about the same rate. Thank you. Long-term incentive plan expense relates to phantom share awards granted in China by the Companys joint venture, Shanghai Fosun Pharmaceutical (Group) Co., Ltd., to its employees that vest over four years and can remain outstanding for seven to ten years. During the first half of 2022, the Company saw COVID-19 resurgences impact da Vinci procedure volumes in the U.S. and Europe followed by recoveries. Even then, it's not enough. While there is likely some amount of backlog that has not yet been addressed, it is difficult to estimate the extent of the remaining backlog and when it will affect future procedure growth. Non-GAAP income from operations. Or is this simply and primarily just something about the pandemic accelerating the use of da Vinci and robotics surgery broadly? 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 . your options for e-mail notification, please enter your e-mail address below and click There was the usual impact of seasonality from vacations like Easter, but nothing notable within the quarter. Next, we go over to Larry Beigelsen with Wells Fargo. Copyright 2023 Intuitive Surgical. 10/08/22 - 11:00 AM EDT. The stock movement pushed Intuitive . Corporate Governance Guidelines 384.4 KB. The Company 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. In addition, COVID delayed some R&D work, resulting in underspend on prototypes. And basically, still underpenetrated, big opportunity. Having said that, it's a difficult procedure for surgeons to perform. Thanks. Looking forward, we see the following capital revenue dynamics. In Europe, procedure growth varied by country based on the relative impact of and recovery from the pandemic. I think what we're seeing is that the longer diagnostic pipelines have had this kind of double effect from the pandemic. Let me start with why I think it's adopting, and I'm going to turn to Jamie as to where -- what inning of the baseball game are we in, I'll let Jamie take that. INTUITIVE at 43rd Annual Goldman Sachs Global Healthcare Conference. There are no upcoming events available at this time. In terms of penetration or adoption, we're in the early to mid-innings kind of range is what I'd say in the U.S. market. The Company undertakes no obligation to publicly update or release any revisions to these forward-looking statements, except as required by law. Q2 2022 INTUITIVE Earnings Conference Call. Bob Hopkins -- Bank of America Merrill Lynch -- Analyst. (6) Diluted net income per share includes the effect of the following items: Gains (losses) on strategic investments, net of tax, Less: net income attributable to noncontrolling interest in joint venture. Travel and associated costs in support of our field have also not recovered to pre-pandemic levels. ET. Pro forma gross margin for the second quarter of 2021 was 71.7%, compared with 62.4% for the second quarter of 2020 and 71.8% last quarter. Yeah, sure. Please go ahead. Now that the dust . Listen to Webcast. Gary S. Guthart Chief Executive Officer, Member of the Board of Directors. Hi, Gary. I think that's what's been driving our success in the early market. ISRG stock analysts called for adjusted profit of $13.40 per share and $5.33 billion in sales. Keep up-to-date with changes . Jamie, anything? It has been. Non-GAAP gross profit. Intangible asset charges consist of non-cash charges, such as the amortization of intangible assets as well as in-process R&D charges. J Global Clinical Engineering, Special Issue 4, 2021 - Proceedings IV ICEHTMC 2021 - ISSN 2578 2762 1 dicembre 2021 . Submit. 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. 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%. Additional supplemental financial and procedure information has been posted to the Investor Relations section of the Intuitive website at https://isrg.gcs-web.com/. A couple of things I'd say. Women Techmakers Ambassador is responsible for driving diversity and inclusion through organizing local events within the tech community. For the first three quarters of 2021, it reported $1.4 billion in operating income on $4.2 billion in revenues. Yes, Tycho. I think that would be a mistake. 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. That impact was most pronounced in the U.S. and Europe, varied market to market, complicating year-over-year comparisons. We are now slightly increasing our forecast and expect full-year gross profit margin to be between 70.5% and 71.5% of revenue. And I'd just be curious to -- since you all are calling it out repeatedly as an important incremental growth driver, where are we now, in your view, in that, I'm sure, multiyear, long-term adoption process? Bringing it all together. Yeah. Hong Kong. There are several models of the da Vinci Surgical System. Is Intuitive Surgical Stock Still Worth Buying Hand Over Fist in 2023? It's a short period, but we believe that there is elasticity, and we've seen elasticity in markets where reimbursements are very low. Listen to Webcast. Listen to Webcast. On the why side, it's -- bariatrics has been a little different than other procedure for us. Intuitive Surgical 10.5. Unrealized gain (loss) - net of tax expense (recovery) effect of $347 and $37 for the three months ended December 31, 2022 and 2021, respectively; ($859) and $(354) for the six months ended . Some of them are included in our service contracts, some of them are on a per-use basis. Shifting to the extended use program, you know, you've been out for around six months, smaller rollout in Europe in the fourth quarter. Intuitive Surgical -Export management Iqm selezione - 07.2021 . In the U.S. and Europe, extended use instruments were nearly fully adopted in the second quarter. These awards are valued based on certain key performance metrics. *Stock Advisor returns as of June 7, 2021. Fourth quarter 2021 GAAP income from operations increased to $450million, compared with $416million in the fourth quarter of 2020. Procedures recovered nicely in Q2. Investors are cautioned not to place undue reliance on these forward-looking statements, including statements about our results of operations, growth strategy and commercial opportunity. COVID-19 has had, and may continue to have, an adverse impact on the Companys procedure volumes. What's left to do from maybe a product or procedure or instrument point of view? Just in terms of intra-quarter procedure trends, if you're asking, Larry, month by month, there was nothing notable actually that we would call out. We expect these programs to continue their ramp as our labs and development programs recover efficiency. Our flexible robotics program, first targeted toward diagnostic bronchoscopy, has had a strong quarter. Intuitive 360 is an annual conference for executive, clinical, and operational leadership focusing on robotic service line development and the surgical care team. During 2020, da Vinci procedure volumes and system placements were significantly impacted by the COVID-19 pandemic, as healthcare systems around the world diverted resources to respond to COVID-19. Just a couple of comments. I will also summarize our GAAP performance later in my prepared remarks. Looking to our finances in the quarter. Consistent with the last quarter's forecast, we expect our noncash stock compensation expense to range between $450 million and $470 million in 2021. Leasing as a percentage of total sales lag has and will continue to fluctuate with customer and geographic mix. Mai 2022: CI. And I kind of articulated what those were, travel and so forth. Most of our offices globally are reopening with this hybrid approach. And -- but right now, I think that remains to be seen how strong those other systems are. And as we've said in the past, if we can bring the right system with the right instruments, the right imaging, and the right usability, the right ease of use, we think that surgeons will care. User Experience for digital health innovations:<br>I work with startups and corporations and design user-centered products, services, and digital business models. And then given that it's cancer procedure, in some cases, it's a little bit longer follow-up. - building a financial model and investor presentation for fundraising . This presentation contains forward-looking statements. In addition to that, we still think this is a great opportunity to continue to invest in the ecosystem of products and capabilities at this point in time before competition really gets any kind of toehold. Intuitive develops, manufactures and markets the da Vinci surgical system. And at this time, I would like to turn the conference over to our host, senior director of finance, investor relations for Intuitive, Mr. Calvin Darling. Fourth quarter 2021 non-GAAP* net income attributable to Intuitive Surgical, Inc. was $477 million, or $1.30 per diluted share, compared with $434 million, or $1.19 per diluted share, in the fourth quarter of 2020. COVID had a significant impact on da Vinci procedure volumes in the second quarter of 2020. So here's kind of where we stand with the backlog. The decrease relative to these prior periods reflects geographic mix and volume discounts provided to customers purchasing multiple systems. Recovery in the U.K. was healthy in the quarter as NHS increased access to surgeries broadly. The call will be webcast by Nasdaq OMX and can be accessed on Intuitives website at www.intuitive.com or by dialing (844) 867-6169 using the access code 525958. Next, we'll go to Bob Hopkins with Bank of America. Tycho Peterson -- JPMorgan Chase & Co. -- Analyst. Fourth quarter 2022 GAAP income from operations included share-based compensation expense of $129 million, compared with $120 million in the fourth quarter of 2021. We rolled out the extended use instruments in Europe and the U.S. back in the fourth quarter. Gotcha. Intuitive Surgical Investor Presentation. Utilization of clinical systems in the field, measured by procedures per system, increased approximately 55% compared with last year and increased 11% compared with last quarter. as can be seen with the more than 29,000 peer-reviewed scientific articles that reference Intuitive technologies. So I think all of you on the call, you should expect increased alternatives for the customer base. Non-GAAP net income attributable to Intuitive Surgical, Inc. and EPS. COVID has delayed some work in R&D and clinical trials, leading to some underspend in programs, prototypes, and some delay in hiring. So I wouldn't start building lots of leverage into your models. any time, re-enter your e-mail address and click Submit, then adjust your form entries. Can you maybe just talk a little bit about the road map? The da Vinci surgical systems are designed to help surgeons perform minimally invasive surgery. The next page will display a menu of options. I'm just curious what the net effect there is from the savings and expense perspective and R&D, whether this is maybe the beginning of you starting to see some leverage off of the 10% you've been at for the last couple of years. So bariatric obviously has been highly laparoscopically penetrated historically. With respect to operating expenses, on our last call, we forecast to grow full-year pro forma 2021 operating expenses between 18% and 22% above 2020 levels. Lease buyout revenue has varied significantly quarter to quarter and will likely continue to do so. In the quarter, strong trade-ins of older-generation systems for our fourth-generation products and strength in multi-system deals continue to support our thesis that customers that know us best continue to invest with us going forward. Copyright 2023 Intuitive Surgical. The system features an ultra-thin, ultra-maneuverable catheter that allows navigation far into the peripheral lung and provides the unprecedented stability necessary for precision in biopsy. Tuesday, October 18, 2022 4:30 PM EDT . So it takes a while. Fourth quarter 2022 constant currency revenue increased 10% compared to the fourth quarter of 2021. Leasing and alternative financing arrangements enable customer access to capital. Email: investor.relations@intusurg.com. The authors concluded in part, "When compared to open, the robotic-assisted surgery group is associated with a comparable operative time, shorter length of stay and lower reoperation rate through 30 days. Doctors talking to us about further expansion of utilization. - Received full travel grant to attend Google I/O 2019. You may automatically receive Intuitive Surgical financial information by e-mail. OUS markets grew 51% year over year or 19% on a two-year compound annual growth rate basis. Submit. And there's a lot of opportunities for OR efficiencies and standardization, controlling operating costs, controlling consumables costs. And we're pleased. During 2022, the impact of the COVID-19 pandemic on the Companys business has differed by geography and region. We think there is an opportunity to accelerate learning and to drive increased insight for a surgeon into their own progress. System placements came in above plan, and system ASP and I&A revenue per procedure tracked slightly above our expectations, together driving revenue of $1.46 billion in Q2. Last page last E-mail Alerts. Please go ahead, sir. 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. We look forward to talking with you again in three months. A contribution to the Intuitive Foundation reduced fourth quarter 2021 GAAP and non-GAAP* income from operations by $30 million. For more information, please visit the Companys website at www.intuitive.com. Moving on to capital placements. I know last quarter, you kind of brought up the concept of going after thoracic and some additional other areas. Four of the systems placed in the first quarter were SP Systems, reflecting continued measured rollout of SP. Our technologies include the da Vinci surgical system and the Ion endoluminal system. 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. The Company defines non-GAAP net income as net income attributable to Intuitive Surgical, Inc., excluding amortization of intangible assets, SBC and long-term incentive plan expenses, litigation charges and recoveries, a gain on the sale of a business, gains (losses) on strategic investments, adjustments attributable to noncontrolling interest in joint venture, net of the related tax effects, and tax adjustments, including the excess tax benefits or deficiencies associated with SBC arrangements and the net tax effects related to intra-entity transfers of non-inventory assets. Instruments and accessories, training programs, support staff, analytics capability, publication, scientific publications demonstrating what you've done, the analytics, and evidence-based build are all, I think, important. Intuitive Surgical, Inc. is the global technology leader in robotic-assisted minimally invasive surgery (MIS). I think the noise levels will go up. Product and customer mix fluctuate quarter to quarter, which can cause fluctuations in gross margins. Intuitive Surgical Asensus Surgical . Turning to our innovation and commercialization efforts. This growth rate compares with 9% last year and 8% last quarter. . To change your e-mail options at Go ahead, Mr. Hopkins. The compound annual growth rate between the fourth quarter of 2019 and the fourth quarter of 2021 was 10%. (2) Selling, general and administrative includes the effect of the following items: One-time tax benefit from re-measurement of certain deferred tax assets, Discrete tax expense arising from the conclusion of a tax matter, Gains on strategic investments, net of tax, Accounts payable and other accrued liabilities, Total liabilities and stockholders equity, Adjustments attributable to noncontrolling interest in joint venture. Intuitive Surgical has been witnessing an upward estimate revision trend for 2021. Partly, it's delays in getting in and getting tested and starting the journey and then getting in and having a procedure or treatment, whatever that might be. ISRG stock has split before. The pandemic has reordered the quarter in which procedures were performed, and we believe it has delayed some procedures that are likely to return in the future and may cause a small number of patients to permanently forgo surgery. The results of the meta-analysis found that robotic-assisted thoracic surgery compared to VATs was associated with, among others, the following significant findings: 50.4 milliliters lower blood loss, a 50% lower chance of conversion to an open procedure, a 1.1 day shorter stay in the hospital and a 10% less chance of patient experience to postoperative complication. First quarter 2022 non-GAAP* net income attributable to Intuitive Surgical, Inc. was $413 million, or $1.13 per diluted share, compared with $427 million, or $1.17 per diluted share, in the first quarter of 2021. Both gynecology and urology procedure annualized growth strengthened in the quarter, as pandemic pressures eased in the U.S. Fourth quarter 2021 revenue was$1.55 billion, an increase of 17%compared with$1.33 billion in thefourth quarter of 2020. Jamie, I'll let you take it from there. You may automatically receive Intuitive Surgical financial information by e-mail. And U.S. general surgery, in particular, performed well. China continued the strength that we've seen over the last couple of quarters. The tax effects of the non-GAAP items are determined by applying a calculated non-GAAP effective tax rate, which is commonly referred to as the with-and-without method. Today's press release and supplementary financial data tables have been posted to our website. And then on SG&A, kind of same kind of question. Intuitive Surgical Inc. (NASDAQ: ISRG) Q1 2021 earnings call dated Apr. That means that utilization will go up kind of naturally, that that mix moves toward a higher utilization mix. Investors are cautioned not to place undue reliance on such forward-looking statements. The Company believes that these non-GAAP financial measures provide meaningful supplemental information regarding its performance by excluding items such as intangible asset charges, share-based compensation (SBC) and long-term incentive plan expenses, and other special items. So short answer there is just kind of a reminder of what we're trying to do. The fourth quarter 2021 system shipments included 143systems shipped under operating lease and usage-based arrangements, compared with 120 systems in thefourth quarter of 2020. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. Senior Director-Finance & Investor Relations: Julian N. Nikolchev: Senior VP-Corporate Development & Strategy: COVID-19 has had, and will likely continue to have, an adverse impact on the Companys procedure volumes. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. My Intuitive allows surgeons and care team members to access their data, to manage their profile, their learning, and otherwise interact with Intuitive through an easy-to-use mobile app in the palm of their hand. As part of our mission, we believe that minimally invasive care is life-enhancing care. 06/14/22 - 1:20 PM PDT. Fourth quarter 2022 GAAP income from operations decreased to $373 million, compared with $450 million in the fourth quarter of 2021. One on procedures, one on competition. Intuitive Announces Fourth Quarter Earnings, www.intuitive.com/en-us/products-and-services/ion, Less: net income (loss) attributable to noncontrolling interest in joint venture. And our posture to that has been -- it may delay some sales as we may have some competitive conversations and tenders, and we'll lose some. I think that's anecdotal. We kind of outlined what was assumed in the high end of the procedure guidance. Our pro forma effective tax rate for the second quarter was approximately 25%. The next page will display a menu of options. The compound annual growth rate between the second quarter of 2019 and the second quarter of 2021 was 16.5%. The Company defines non-GAAP EPS as non-GAAP net income attributable to Intuitive Surgical, Inc. divided by non-GAAP diluted shares, which are calculated as GAAP weighted-average outstanding shares plus dilutive potential shares outstanding during the period. Readers are cautioned not to place undue reliance on these forward-looking statements, which are based on current expectations and are subject to risks, uncertainties, and assumptions that are difficult to predict, including those risk factors identified under the heading Risk Factors in the Companys Annual Report on Form 10-K for the year ended December 31, 2020, and the Company's Quarterly Report on Form 10-Q for the quarter ended September 30, 2021, as updated by the Companys other filings with the Securities and Exchange Commission. The second quarter of 2020 included $59 million of service credits issued in conjunction with our Customer Relief Program, higher period costs associated with lower production, and higher excess and obsolete inventory charges. See www.intuitive.com/trademarks. Our focus is in clinical capability and productivity of the installed base we have. We think we stand up pretty well to those comparisons, and we're ready to help them pursue their aims as the year proceeds. Intuitive Surgical's Q3 2021 adjusted earnings per share (EPS) is expected to be $1.22 per Trefis analysis, slightly above the consensus estimate of $1.17. And Jamie, as to kind of where we are. These non-GAAP financial measures also facilitate managements internal comparisons to its historical performance. Field and marketing costs will tick up if the pandemic wanes. We continue to operate in a challenging supply chain environment and have experienced longer lead times and delayed deliveries from our suppliers. That concludes our prepared comments. This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. 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. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release and which are based on current expectations and are subject to risks, uncertainties, and assumptions that are difficult to predict, including those risk factors identified under the heading Risk Factors in the Companys Annual Report on Form 10-K for the year ended December31, 2021, and the Companys Quarterly report on Form 10-Q for the quarter ended September 30, 2022, as updated by the Companys other filings with the Securities and Exchange Commission. You have to do it. . Fourth quarter 2022 systems revenue decreased by 4% to $451 million, compared with $470 million in the fourth quarter of 2021. BSD Medical Corporation Medtronic Ethicon Endo-Surgery Olympus Corporation Siemens Healthcare Intuitive Surgical . We are in the execution and launch phase of four efforts. your options for e-mail notification, please enter your e-mail address below and click Now, I'd turn the conference over to our host, Brian King, Head of Investor Relations for Intuitive Surgical. So be curious to hear from you on any procedure trends through the quarter in the U.S. and international. Our digital learning programs continue to be an important part of our overall learning initiatives. Mark the "Pitching to Investors Programme" on the 7th December 2022 in your calendar! Foreign currency fluctuations had a 3% unfavorable impact on fourth quarter 2022 revenue. General surgery growth in the U.S. was strong, and in addition to the positive impact from patient backlogs, reflected increasing access for surgeons to our fourth-generation technology. Youre reading a free article with opinions that may differ from The Motley Fools Premium Investing Services. 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 have a broad range of estimates. Our actual gross profit margin will vary quarter to quarter depending largely on product, regional, and trade-in mix, the impact of product cost reductions, and manufacturing efficiencies and pricing pressure. Thirty-eight percent of systems placed in the second quarter involved trade-ins, which is lower than the 40% last year and the 44% last quarter. To choose your options for e-mail notification, please enter your e-mail address below and click Submit . The Company ended the fourth quarter of 2022 with $6.74 billion in cash, cash equivalents, and investments, a decrease of $651 million during the quarter, primarily driven by share repurchases of $1 billion and capital expenditures, partially offset by cash generated from operations. Please note that this conference call will be available for audio replay on our website at intuitive.com on the latest Events section under our Investor Relations page. To change your e-mail options at Google's Women Techmakers program provides visibility, community, and resources for women in technology. Procedure growth in the U.S. was led by bariatric cholecystectomy and hernia procedures. The Company placed 369 da Vinci Surgical Systems, a decrease of 4% compared with 385 in the fourth quarter of 2021. Forward-looking statements relate to expectations concerning matters that are not historical facts. On the capital side, new system placements continue to be healthy, with the United States, China, Germany, France, and Japan, notable in the quarter. Non-GAAP gross profit. I don't know how much of an update you can give us, but just something on what's happening at that level in terms of software tools and services? Second-quarter spending was below our expectations due to activities restricted by COVID, including clinical development, marketing events, and travel costs. The compound annual growth rate between the full year of 2019 and the full year of 2021 was approximately 12%. Our pro forma spending grew over 24% from a year ago, representing increased investment in our business. Yes. We've seen a few teams come out and field systems that are alternatives to ours. So several of those things are in the markets, the very first kind of Gen 1, some of them are on Gen 2. We're doing that as a combination of My Intuitive plus some of the simulation work that we do, plus some of the machine learning and video analysis work that we do. Sure. And with that, I'd like to turn it over to Jamie. That's great. 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. 10 stocks we like better thanIntuitive SurgicalWhen our award-winning analyst team hasa stock tip, it can pay to listen. China growth in the second quarter continued to be far higher than our other regions, primarily reflecting the 40% system installation growth over the past year.