Intuitive Surgical Inc

Q2 performance: strong growth led by da Vinci + ION adoption - Total procedures +16% YoY driven by da Vinci +15% and ION +36%. - Revenue +19% to $2.89B; recurring revenue +19% to $2.47B (85% of total). - Installed base growth: da Vinci systems +12% and ION systems +21%; exited quarter with ~13k systems installed worldwide. - Financial quality: non-GAAP operating margin 42%; non-GAAP EPS +28% YoY.

Regional / demand signals: US resilient but “deferrable cases” pressured; OUS mixed with China still a challenge - US da Vinci procedures +12%, with after-hours procedures +26%, but overall US growth moderated vs early-year expectations. - Management attributes pressure to patient behavior/coverage dynamics, specifically ACA premium subsidy expiration effects on patients with conditions that can be deferred (noted as a modest adverse impact; disease burden unchanged—expect eventual catch-up). - Outside US +20% da Vinci procedure growth ~in line, with Europe +20% and Asia +20%; rest of world +22%. - China remains challenging: lower tender activity, increased domestic robotic competition, and policy-driven pricing pressure; efforts ongoing via green channel processes and engagement on charge code policy.

Capital placements & platform momentum: da Vinci 5 and SP scaling; ION penetration broadening internationally - Q2 system placements: 468 da Vinci (+18% vs prior year) and 55 ION. - Da Vinci 5 strength: 246 da Vinci 5 placements, including 114 dual consoles; installed base of da Vinci 5 just over 1.7k systems used by >15k surgeons. - da Vinci SP placed 38 systems in Q2; SP procedures +61%. - US SP stapler adoption rising: used in ~60% of eligible cases (up from just under 40% last quarter). International broad launch across Europe + Korea, targeting Japan in Q3. - ION: procedures +36% to 48k, now >400k cumulatively; installed in 12 countries outside the US. Continued progress on ROSE/EBS programs.