da Vinci 5 Expands Globally: Can ISRG Beat Overseas Cost Hurdles?

Intuitive Surgical’s ISRG da Vinci 5 is in early stages of international rollout, which represents long-term opportunity for the company. However, the rollout may face potential hurdles in the near term. Management has reiterated that da Vinci 5 is central to ISRG’s growth strategy, designed to drive higher utilization through improved efficiency, surgeon autonomy and integrated digital capabilities.

During the third quarter, Intuitive Surgical highlighted that it is making progress in advancing regulatory clearances and early commercial activity outside the United States. The company has emphasized it will follow a measured, country-specific trajectory for international adoption. ISRG stated that currently da Vinci 5 is being typically adopted by large academic and flagship hospitals, particularly in Europe and Japan. The company believes that customers are currently evaluating clinical and economic benefits before committing to broader fleet upgrades.

However, Intuitive Surgical was clear that pricing sensitivity and capital budget constraints remain key challenges internationally. Government-funded healthcare systems, especially in parts of Europe and Japan, continue to scrutinize capital expenditures, extending sales cycles and slowing system placements compared to the U.S. market. Management also acknowledged ongoing competitive and reimbursement-related pressures in China, which further complicate near-term expansion.

Intuitive Surgical is following a portfolio-based approach amid these challenges, leveraging leasing structures and alternative configurations to improve affordability while maintaining customer engagement. On its third-quarter earnings call, the company highlighted solid growth in utilization in several international markets that will likely support recurring instruments and accessories revenues even when capital placements lag.

Although ISRG may face some near-term challenges in the adoption of the da Vinci 5, the latest addition to the company’s surgical robotics portfolio holds significant long-term potential to expand its international footprint. However, execution abroad will hinge on navigating cost sensitivity and aligning system economics with local healthcare funding realities.

Peer Update

Zimmer Biomet ZBH is steadily expanding its international footprint while advancing the adoption of its ROSA robotic surgery platform. During the third quarter, Zimmer Biomet reported solid international growth driven by new product introductions, although its performance was tempered by near-term volatility in select emerging markets. Zimmer Biomet continues to invest in leadership and commercial execution across overseas geographies to strengthen long-term growth.

ROSA remains a central pillar of the company’s technology strategy, with strong global placements and rising utilization, particularly in knee procedures. Notably, U.S. ROSA accounts now perform more than half of their knee implants robotically, a benchmark Zimmer Biomet aims to replicate internationally over time. The company is also preparing to launch enhanced ROSA capabilities, including ROSA with OptimiZe, to support broader adoption across global markets. Overall, Zimmer Biomet views international expansion of ROSA as a multi-year opportunity, balancing near-term market challenges with sustained investment in robotics-driven growth.

Stereotaxis STXS is making significant progress with its GenesisX robotic surgery platform, a next-generation solution designed to expand access to robotic electrophysiology procedures. In the second quarter of 2025, Stereotaxis’ GenesisX secured CE Mark approval in Europe, and the first commercial system was manufactured, with FDA clearance expected later this year.

Initial hospital installations are likely to have started in Europe in 2025, and a full U.S. and EU launch is expected in 2026. GenesisX is engineered to avoid costly lab construction, lowering barriers to adoption. With second-quarter operating expenses steady at $6 million, Stereotaxis plans disciplined reinvestment in salesforce expansion and catheter-driven recurring revenues to support commercialization.

ISRG’s Price Performance, Valuation and Estimates

Shares of ISRG have gained 9.7% in the past six months compared with an 12.8% increase for the industry.

From a valuation standpoint, Intuitive Surgical trades at a forward price-to-earnings ratio of 58.13, above the industry average. But it is still lower than its five-year median of 71.52. ISRG carries a Value Score of D.

The Zacks Consensus Estimate for Intuitive Surgical’s 2026 earnings implies an 11.1% rise from the year-ago period’s level.

The stock currently carries a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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This article originally published on Zacks Investment Research (zacks.com).

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