However, to gain a more complete understanding of the body of evidence, we encourage all stakeholders to thoroughly review the extensive detail of scientific studies that have been published over the years. So it's hard to time it out, and it doesn't time out over one or two quarters, it times out over years. 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. There are a number of limitations related to the use of non-GAAP measures versus measures calculated in accordance with GAAP. Pagination. Next, we will go to Amit Hazan with Goldman Sachs. This growth rate compares with 9% last year and 8% last quarter. 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 . We have a broad range of estimates. 20, 2021Corporate Participants: Philip Kim Head of Investor Relations. So I wouldn't start building lots of leverage into your models. And so we'll see over time, we'll be able to measure a little bit better over time, and we'll monitor it. And recently, we've had a series of very encouraging conversations on the adoption of bariatrics, very encouraging. Third, driving depth and excellence in regional performance, particularly in Europe and Asia. *Stock Advisor returns as of June 7, 2021. The Companys calculated non-GAAP effective tax rate is generally higher than its GAAP effective tax rate. Next, we're going to the line of Rick Wise with Stifel. 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. We work closely and collaboratively . The Company believes these non-GAAP financial measures are useful to investors, because (1) they allow for greater transparency with respect to key metrics used by management in its financial and operational decision-making, and (2) they are used by institutional investors and the analyst community to help them analyze the performance of the Companys business. 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. 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. It's taking getting the advanced instruments, put them together as a set, getting our workflows and our clinical pathways right, and I think that's been powerful to date. Customer appreciation and recurring use of our products has been growing nicely. And that if it hasn't delivered against the Quad Aim, if these systems can do some cases well, but not all cases well or they have stability issues or other things, that wears in pretty quickly. The high end of the range assumes strength in U.S. general surgery, a return to normalized diagnostic pipelines, the vaccines are effective against any new COVID-19 variants and the vaccine rollouts in OUS markets continue as currently expected by governments around the world. Intuitive Surgical Investor Relations. Just to be clear on your answer to Tycho's question. To make the world smarter, happier, and richer. Dec 2017 - Aug 20213 years 9 months. Tycho Peterson -- JPMorgan Chase & Co. -- Analyst. All Rights Reserved. We kind of outlined what was assumed in the high end of the procedure guidance. We ended the quarter with cash and investments of $7.7 billion, compared with $7.2 billion last quarter. Tuesday, October 18, 2022 4:30 PM EDT . . [Inaudible] on a nice quarter. And there's a lot of opportunities for OR efficiencies and standardization, controlling operating costs, controlling consumables costs. 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. And then given that it's cancer procedure, in some cases, it's a little bit longer follow-up. Hong Kong. Intuitive develops, manufactures and markets the da Vinci surgical system. It's not just the robot. Our installed base of SP Systems is now 79: eight in Korea and 71 in the U.S. We completed first cases associated with a U.S. colorectal clinical trial in the second quarter. You've got COVID. Jamie will provide spend guidance later in this call. Our second-quarter pro forma net income was $477 million or $3.92 per share, compared with $132 million or $1.11 per share for the second quarter of 2020 and $427 million or $3.52 per share for the last quarter. And so we have some catch-up to do in terms of infrastructure and support necessary to support the overall business. And so I think you're going to see this quarter was extraordinary in terms of the operating profit margin and that we'll -- it will be lower in future quarters, given what I just described. One is we are focused on making sure that our ecosystem, our products, our systems, everything goes around it really delivers against the Quadruple Aim all the way through. 06/14/22 - 1:20 PM PDT. It affirms that "RAS devices have been cleared for use in certain types of surgical procedures commonly performed in patients with cancer, such as hysterectomy, prostatectomy and colectomy. Higherfourthquarter revenue was driven by growth in da Vinci procedure volume and system placements. 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. The Company defines non-GAAP net income as net income attributable to Intuitive Surgical, Inc., excluding intangible asset charges, non-cash impairment charges and recoveries, certain acquisition-related items for the re-measurement of contingent consideration, SBC and long-term incentive plan expenses, litigation charges and recoveries, 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, a one-time tax benefit from re-measurement of certain deferred tax assets, and the net tax effects related to intra-entity transfers of non-inventory assets. These awards are valued based on certain key performance metrics. Annualized U.S. procedure growth rates are returning to historical levels for procedures with longer diagnostic pipelines as patients have started returning to screening and diagnostic testing. 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. Our rollout of Ion will continue to be measured while we optimize training pathways in our supply chain. Congrats on the quarter. Fourth quarter 2022 GAAP income from operations decreased to $373 million, compared with $450 million in the fourth quarter of 2021. I would just add, Bob, as you saw the COVID hospitalization rates in the U.S. come down in March and into Q2, that frees hospital resources to increase the level of surgery that we do. We think we can bring some outstanding imaging capabilities, including florescence imaging into that space. Second-quarter OUS procedure volume grew approximately 51%, compared with a 7% decline for the second quarter of 2020 and 23% growth last quarter. Our digital learning programs continue to be an important part of our overall learning initiatives. You have to do it. Additional supplemental financial and procedure information has been posted to the Investor Relations section of the Intuitive website at https://isrg.gcs-web.com/. 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. In the U.S., procedures that are dependent on diagnostic pipelines also grew, albeit at lower rates as compared to benign procedures. Intuitive Surgical, Inc. is the global technology leader in robotic-assisted minimally invasive surgery (MIS). What's left to do from maybe a product or procedure or instrument point of view? We look forward to talking with you again in three months. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability. On the capital side, new system placements continue to be healthy, with the United States, China, Germany, France, and Japan, notable in the quarter. I think that when you think about our product cycles, I would just have you look back earlier in the da Vinci experience in that these are long development cycles. Gotcha. China procedure growth remains strong and broad-based as a result of continued expansion of the installed base under the current quota. Jamie will provide additional procedure commentary later in this call. The Company defines non-GAAP gross profit as gross profit, excluding amortization of intangible assets and SBC and long-term incentive plan expenses. 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. 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. We also -- the business came back faster than we had anticipated. Listen to Webcast. There appears to be some. Jamie Samath Senior Vice President of Finance Accordingly, they are subject to significant volatility based on the performance of these metrics and are not tied to performance of the Companys business within the period. 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. Ion system placements and procedures are excluded from our overall system and procedure counts. To the extent that COVID impacts procedures, it will also impact capital purchases. 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. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. Non-GAAP gross profit, non-GAAP income from operations, non-GAAP net income attributable to Intuitive Surgical, Inc., and non-GAAP EPS exclude items such as intangible asset charges, re-measurement of contingent consideration, SBC and long-term incentive plan expenses, excess tax benefits or deficiencies associated with SBC arrangements, and non-cash amortization of deferred tax assets related to intra-entity transfer of non-inventory assets, which are primarily recurring items. Trade-in activity can fluctuate and be difficult to predict. Our focus right now is not rapid expansion of the installed base. 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. At Intuitive, we envision a future of care that is less invasive and profoundly better, where diseases are identified early and treated quickly, so patients can get back to what matters most. 10/08/22 - 11:00 AM EDT. Copyright 2023 Intuitive Surgical. Outside the U.S., we placed 115 systems in the second quarter, compared with 72 in the second quarter of 2020 and 108 systems last quarter. Invest better with The Motley Fool. Investor's Business Daily . While we strive for our Foolish Best, there may be errors, omissions, or inaccuracies in this transcript. Non-GAAP net income attributable to Intuitive Surgical, Inc. and EPS. To supplement its consolidated financial statements, which are prepared and presented in accordance with accounting principles generally accepted in the United States (GAAP), the Company uses the following non-GAAP financial measures: constant currency revenue, non-GAAP gross profit, non-GAAP income from operations, non-GAAP net income attributable to Intuitive Surgical, Inc., non-GAAP net income per diluted share attributable to Intuitive Surgical, Inc. (EPS), and non-GAAP diluted shares outstanding. Listen to Webcast. Growth in our second largest market, China, continued to be strong with multiple specialties contributing. We know that new system placements are closely tied to anticipated procedure volumes and system utilization in mature markets. 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 . Listen to Webcast. In addition, the components of the costs that the Company excludes in its calculation of non-GAAP net income attributable to Intuitive Surgical, Inc. and non-GAAP EPS may differ from the components that its peer companies exclude when they report their results of operations.