ISRG Q4 Deep Dive: New Product Launches and International Growth Drive Results

Medical technology company Intuitive Surgical (NASDAQ:ISRG) reported revenue ahead of Wall Streets expectations in Q4 CY2025, with sales up 18.8% year on year to $2.87 billion. Its non-GAAP profit of $2.53 per share was 11.6% above analysts’ consensus estimates.

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StockStory’s Take

Intuitive Surgical’s fourth quarter saw results above Wall Street’s expectations, driven by increased global procedure volumes and demand for the new da Vinci 5 system. Management highlighted continued adoption across multiple specialties, particularly in international markets, and noted that procedure growth was especially robust in Europe and Asia. CEO David Rosa pointed to the expansion of the da Vinci 5 in new geographies and indications as a key contributor, as well as growing use in ambulatory surgery centers (ASCs). While the company benefitted from broader system placements and higher recurring revenue, management also acknowledged ongoing pressures from tariffs and a more competitive landscape in China.

Looking ahead, Intuitive Surgical’s guidance is shaped by continued investments in R&D, ongoing expansion of its product portfolio, and anticipated global procedure growth. Management believes that newer technologies, such as Force Feedback instruments and digital tools for da Vinci 5, will further support adoption. CFO Jamie Samath emphasized that growth in ASCs and international markets will be complemented by measured rollouts of platform enhancements and new indications. However, the company cautioned that macroeconomic pressures, reimbursement dynamics, and increased competition in certain regions could impact growth trajectories in the coming year.

Key Insights from Management’s Remarks

Management attributed the quarter’s performance to higher utilization of da Vinci systems, strong procedure growth in international markets, and successful launches of new product features and platforms.

• International procedure growth: Robust adoption of Intuitive’s platforms outside the U.S., especially in Europe and Asia, contributed meaningfully to overall procedure volume, with international procedures rising 23%. Management attributed this to improved market access, expanded training, and favorable economics.

• da Vinci 5 expansion: The full launch and broader availability of the da Vinci 5 system drove increased system placements and upgrades. Customers responded positively to enhanced features such as Force Feedback and improved digital capabilities, and the system was introduced in new markets including Europe, the U.K., and Japan.

• Ambulatory surgery center (ASC) focus: The company increased efforts to support adoption of robotic surgery in ASCs, leveraging refurbished Xi systems (XiR) and tailored economic programs. Management views ASCs as a multiyear expansion opportunity, especially for high-volume, lower-acuity procedures like hernia repairs and cholecystectomies.

• Single-port and Ion momentum: The single-port (SP) platform and Ion system saw significant growth, with SP procedures up 87% and Ion procedures up 51%. New regulatory clearances, such as for nipple-sparing mastectomy and thoracic indications, supported further adoption across geographies.

• Competitive and regulatory headwinds: Management acknowledged intensifying price competition in China and capital budget constraints in Japan and the U.K., noting these factors influenced system placements and win rates in these regions.

Drivers of Future Performance

Intuitive Surgical’s outlook is driven by continued product innovation, international expansion, and expanding access to minimally invasive procedures, offset by macroeconomic and competitive headwinds.

• Product enhancements and new indications: Management expects the rollout of advanced features for da Vinci 5—including Force Feedback instruments, expanded digital tools, and new procedure clearances—to increase system utilization and drive higher recurring revenue, particularly as new digital subscriptions are introduced.

• ASC and international market growth: The company believes that further penetration into ASCs and international markets will be central to growth, supported by tailored system offerings like XiR and increased training initiatives. However, reimbursement changes and capital pressures in some regions could create variability in adoption rates.

• Competitive and regulatory risks: Intensifying competition in China and evolving reimbursement policies in markets like Japan could impact system placements and procedure growth. Management is monitoring these risks closely and adjusting strategies to maintain competitiveness.

Catalysts in Upcoming Quarters

In upcoming quarters, the StockStory team will closely watch (1) the adoption trajectory of the da Vinci 5 system and Force Feedback instruments in newly cleared indications and geographies; (2) expansion of the company’s footprint in ASCs, particularly through refurbished system offerings; and (3) Intuitive’s ability to mitigate intensifying competition and navigate regulatory and reimbursement changes in key international markets. Progress on digital subscription renewals and further clinical validation for new procedures will also be important areas for scrutiny.

Intuitive Surgical currently trades at $528.07, in line with $528 just before the earnings. At this price, is it a buy or sell? Find out in our full research report (it’s free).

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