Intuitive Surgical, Inc. (NASDAQ:ISRG) Q2 2023 Earnings Call Transcript

Gary Guthart: Sure. On the supply chain health side, we are seeing fewer pockets of challenge, but some pockets nonetheless. So there’s been significant focus and attention to make sure that we’re supplying our customers what they need as we grow through a pretty nice procedure growth curve. So they’re calling out improvement in the breadth of supply chain challenge, but cautioning that there are still some pockets that need attention or require attention. We continue to work on multiple things. As you know, we’re working on next generations of our platforms in general, what is a routine activity for us. How we make the decision between upgrading our current generation versus moving it next generation really is around customer value of that switch and the convenience and economics of doing an upgrade versus a platform changeover.

And we expect to do some of both. We are usually working on the next two generations because of the time it takes to develop a platform, not just the next one but the next one after that and current time is really no different. We’re pleased with the performance of our engineering teams in prosecuting those upgrades and technologies. What I will say is, prioritization wise, what we care about is can we improve patient outcomes in a real way or open a new population of patients to the benefits of minimally invasive surgery. So we look at that, we look to improve the surgeon and care team experience, whether that’s in their ergonomics or their workflow and the delight with which they perceive our systems. We work improve efficiencies of overall programs.

We’ll work on things that make hospital programs more efficient and we work to lower the total cost to treat per patient episode. And when we find feature sets and technologies that do that, then we get pretty excited about them and try them hard.

Travis Steed: Great. Super helpful. Thanks, Gary.

Operator: Okay. Our next question is from the line of Robbie Marcus, JPMorgan. Please go ahead.

Robbie Marcus: Yeah. Thanks for taking the question and congrats on a really nice quarter. I heard the comment on prototype expenses are increasing. So I figure I’ll try my luck here and I know you’re not going to tell us when an next-gen or if the next-gen system is coming. But I want to ask around just implications, if and when one does, you have a lot of leases now. Do they have the option to upgrade and will that come through at higher revenues? And how do we think about the prototyping expense and really what that’s for? Thanks.

Jamie Samath: Yeah, I’m not going to be specific on the prototype expense and it’s distributed across a number of programs. Prototype expenses tend to be lumpy within Q2 relative to the comparison point. It just so happened to be a quarter where that was one of the drivers of our expenditure. Nothing more than that, I would say. As we’ve grown the proportion of the installed base under leases, I think it’s about 2,000 systems now that are under lease in the installed base. Generally, they have a technology obsolescence clause. That’s kind of in part a reflection of customer feedback from when we launched Xi. So that’s routinely in our operating lease arrangements. And that clause generally gives customers the opportunity to change that existing lease to the lease of any new next generation technology. And that is not as specified price, by the way, that’s to be negotiated. So I wouldn’t say anything more about price.

Robbie Marcus: Great. And maybe, Jamie, one more for you on the financial side. Another nice quarter of cash flow generation, north of $7 billion on the balance sheet. Interest rates, high. Inflation, high as well. How are you thinking about maximizing the cash here and how should we think about the priorities? Thanks.