ISRG's International Growth Outpaces US With 35% Procedure Volume

Intuitive Surgical’s ISRG fourth-quarter 2025 results suggest its demand for its robotic procedures is increasing internationally, with geographic diversification emerging as a key growth driver rather than a temporary tailwind. In 2025, procedures performed outside the United States climbed 23% to more than 1.1 million, higher than the company’s 15% domestic growth rate. International procedures represented roughly 35% of total global procedures. The shift reflects the accelerating adoption of robotic-assisted surgery beyond ISRG’s U.S.-centric base.

The international growth reflected a broad-based uptake rather than a single geography-based demand, with Europe delivering procedure growth of about 21%, Asia expanding 24%, and the rest-of-world markets rising 27%. Management attributed the momentum to improved market access, expanded training initiatives and favorable economic dynamics that are helping hospitals justify capital investments in robotic systems. These factors are particularly relevant in emerging and underpenetrated markets, where procedural growth rates tend to exceed those of mature regions.

Intuitive Surgical is also planning strategically to gain from this rising opportunity. The company signaled plans to continue investing in generating clinical evidence locally and country-specific commercial infrastructure to align with regional reimbursement frameworks and clinical adoption pathways. Such groundwork is critical because robotic surgery adoption typically depends on surgeon training ecosystems, payer support, and institutional familiarity, which require significant upfront investment before scale materializes.

Currently, Intuitive Surgical’s growth narrative is no longer dependent solely on U.S. procedure expansion or system placements. Instead, its trajectory increasingly reflects a global adoption curve. With international markets now representing more than one-third of procedures and growing faster than the core domestic business, the company’s long-term outlook appears tied as much to geographic execution as to technological innovation.

International Market Also Driving Peer Growth

Apart from Intuitive Surgical, several big medtech players like Medtronic MDT and Abbott ABT have expanded internationally, which has become a critical growth factor for them as well.

Medtronic’s third-quarter fiscal 2026 results highlight strengthening global traction, positioning it for continued international expansion in 2026. MDT reported revenues of $9.02 billion with 6% organic growth, supported by balanced geographic performance, including high single-digit growth in Western Europe, mid-single-digit gains in Japan, and steady expansion in China despite procurement pressures. Medtronic’s Diabetes segment exemplifies this trend, delivering double-digit international growth and helping drive overall momentum. The growth momentum for Medtronic is likely to continue going forward on the back of upcoming launches such as Sphere-360 in Europe, pipeline-driven adoption across emerging markets and expanding commercialization initiatives in Japan.

Abbott Laboratories closed 2025 with clear evidence that global markets are becoming its primary growth engine. The company posted adjusted EPS of $1.50 in the fourth quarter of 2025, up 12%, as multiple divisions showed strong international momentum. Established Pharmaceuticals grew 7% with double-digit expansion in India, Latin America, and the Middle East. Abbott Laboratories’ electrophysiology and neuromodulation franchises also reported robust international demand. It expects 2026 organic sales growth of 6.5%–7.5%, driven partly by continued global adoption of its device and diagnostics platforms. With pipeline launches, emerging-market penetration and favorable FX trends, Abbott Laboratories is positioning international markets as a key driver of sustained earnings and revenue growth.

ISRG’s Price Performance, Valuation and Estimates

Shares of ISRG have gained 4.5% over the past six months against the industry’s 7.1% decline.

From a valuation standpoint, Intuitive Surgical trades at a forward price-to-earnings ratio of 49, above the industry average. But it is still lower than its five-year median of 71.18. ISRG carries a Value Score of F.

The Zacks Consensus Estimate for Intuitive Surgical’s 2026 earnings implies a 12.3% rise from the year-ago period’s level.

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

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

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