Intuitive Surgical, Inc.

Good day, everyone, and welcome to Intuitive's fourth quarter 2025 earnings conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To participate, you will need to press star 1-1 on your telephone. You will then hear a message advising your hand is raised. To withdraw your question, simply press star 1-1 again. Please note, this conference is being recorded. Now it's my pleasure to turn the call over to the Vice President of Investor Relations, Dan Connolly.

Good afternoon, and welcome to Intuitive's fourth quarter earnings conference call. Joining me today are Dave Rosa, our CEO, and Jamie Samath, our CFO. Before we begin, I would like to remind you that comments on today's call may contain forward-looking statements. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. These risks and uncertainties are described in our Securities and Exchange Commission filings, including our most recent 10-K filed on January 31st, 2025, and Form 10-Q filed on October 22nd, 2025. Our SEC filings can be found through our website at intuitive.com or at the SEC's website. Investors are cautioned not to place undue reliance on such forward-looking statements. Please note that this conference call will be available for audio replay on our website in the events section under our investor relations page. We have posted today's press release and supplementary financial data tables to our website. Our format for this afternoon's earnings conference call is as follows. Dave will review business and operational highlights. Jamie will provide a review of our financial results and procedure highlights. I will review clinical highlights and discuss our updated financial outlook for 2026. And finally, we will host a question and answer session. With that, I will turn it over to Dave.

Good afternoon and thank you for joining us. I'll begin with summarizing our performance in 2025 and sharing our perspective as we enter 2026. 2025 was a strong year for Intuitive, driven by multi-specialty da Vinci procedure growth across the globe. increasing adoption of DaVinci 5, and higher utilization across our three platforms. Physicians use our systems to treat more than 3.1 million patients in the year. Since the first procedure in 1997, more than 20 million patients have been treated using intuitive platforms. While meaningful progress has been made in advancing minimally invasive care, we continue to believe we are in the early stages of this journey. We started 2025 with four strategic priorities. First, focusing on the full launch of DaVinci 5, its regional clearances, and follow-on feature releases. Second, pursuing increased adoption for our focused procedures by country through training, commercial activities, and market access efforts. Third, driving continued progress in building industrial scale, product quality, and manufacturing optimization. And finally, focusing on excellence and availability of our digital tools. I was pleased with our progress across these priorities. In 2025, da Vinci procedures increased approximately 18% with multi-port procedures growing 17% and single port procedures growing 87%. Combined with 51% ion procedure growth, total procedures grew 19% for the year. In the US, da Vinci procedures increased 15% to more than 2 million, with notable contributions from general surgery procedures, including after-hours use. Internationally, da Vinci procedures increased by 23% to over 1.1 million. The growth rates were 21% in Europe, 24% in Asia, and 27% in rest of world markets. As a result, procedures outside the U.S. accounted for roughly 35% of our global procedures, reflecting clinical demand, improved market access, broad training initiatives, and supportive economics. Going forward, we will continue to invest in market access activities and local evidence generation to meet our customers' clinical and economic objectives. In 2025, global system utilization increased 3% across our DaVinci platforms. Multi-port grew 3%, single-port 29%, and ion 9%. Turning to capital, we placed 1,721 DaVinci systems in 2025, including 870 DaVinci 5 systems and 107 SP systems and 195 ion systems. Demand for DaVinci 5 strengthened throughout the year, with customers responding to broader availability as we scaled manufacturing and increasing capability through subsequent software and product releases. In the US, we saw robust demand for system upgrades and dual console systems, reflecting customer interest in standardization, training, and mentoring. In the second half of the year, we launched DaVinci 5 in Europe, the UK, and Japan. For the year, we placed 58 DaVinci 5 systems outside the US, mostly in Europe, and we are pleased with feedback from these early adopters. In 2025, we began offering refurbished da Vinci XI systems as an integral part of our system strategy and placed 42 XIR systems in the year. Looking ahead, we believe there is a sizable long-term opportunity for our da Vinci XIR system and related economic programs to expand access to da Vinci surgery internationally and in U.S. ambulatory surgery centers. Financially, revenue grew 21% year over year to $10.1 billion. Operating margins of 37% reflected our deliberate investments in R&D and manufacturing scale, as well as the impacts of tariffs and newer platform mix. Cost efficiency initiatives helped to partially offset these pressures. Turning to our DaVinci platforms, customer feedback remains positive as DaVinci 5 continues to expand to new indications and geographies. Surgeons highlight the benefits of greater autonomy and enhanced efficiency reflected in the higher utilization trends we're seeing relative to XI. Improved vision, force feedback capabilities, and ongoing UI enhancements have also supported broad interest in DaVinci 5. We are excited to fully launch our force feedback instruments and work with customers to establish the clinical impact of force feedback at scale. This month, We received FDA clearance for several cardiac procedures on DaVinci 5 using non-force feedback instruments. Given the complexity of minimally invasive cardiac surgery, we are planning a measured rollout to support training, education, and adoption. We believe deeply that patients requiring cardiac surgery can benefit from a minimally invasive approach with DaVinci and look forward to actively supporting our customers through these procedures. Over the past year, we released two software updates that improved surgeon awareness in the console, supported better intraoperative decision-making, and established the foundation for future remote updates. In 2026, DaVinci 5 capabilities will continue to grow as we introduce additional products and features. My Intuitive Plus, our digital subscription package offered with DaVinci 5, includes simulation, telecollaboration, and case insights. and is designed to help customers understand their surgical performance, collaborate in real time, and receive personalized training recommendations. Adoption of our telepresence capabilities continues to increase, supported by recent software changes that enable surgeon-initiated scheduling. Surgeons are now able to more easily tap into the collective knowledge of the da Vinci community through real-time case observation, collaboration, and mentoring. Increasingly, We are hearing from IDN executives that they value the ability to connect flagship hospitals within their broader network to provide consistent, high-quality care to more patients. Our Singapore platform continued to build operating and clinical momentum in 2025. Procedures grew 87%, driven by high rates of growth in Korea and the US, with accretive early growth in Europe, Japan, and Taiwan. Our installed base increased by 39% to 377 systems. Since clearance in 2018, we have methodically added indications and capabilities to the platform. In Q4, we received 510 clearance for several additional indications, including nipple sparing mastectomy, inguinal hernia repair, cholecystectomy, and appendectomy. For NSM in particular, we plan a measured rollout to support education, training, and adoption, in 2026 and beyond. Feedback on our single port stapler during its initial launch has been very positive and moving into broad launch this quarter will support deeper penetration and thoracic and colorectal procedures. We have additional regulatory submissions planned for 2026 and will update you on our progress throughout the year. Turning to ION, worldwide procedures grew 51% to just over 144,000. Since FDA clearance in 2019, Physicians have performed over 325,000 ION procedures with a global installed base approaching 1,000 systems. In 2026, we remain focused on growing utilization of existing domestic systems and ensuring excellent early results in international markets. We are committed to expanding capabilities of ION, including our efforts in ROSE, our rapid on-site tissue evaluation technology, and the integration of endobronchial ultrasound. We believe ION with these capabilities will help minimize the time from detection to treatment as we work to improve the survival rate of lung cancer patients. As we enter 2026, our company priorities are as follows. First, the global expansion of our platforms, digital feature releases, and ecosystem enhancements. Second, increased adoption for our focused procedures by country. through training, commercial activities, and market access efforts. Third, building industrial scale, product quality, and manufacturing optimization. And finally, advancing innovation to reach more patients in current and new disease states. With that, I'll turn the time over to Jamie to take you through our business and finances in greater detail.