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Intuitive Surgical, Inc. (NASDAQ:ISRG) Q3 2018 Antithesis Appointment Alarm October 18, 2018 4:30 PM ET

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Executives

Calvin Darling – Senior Director of Finance and Investor Relations

Gary Guthart – President and Chief Executive Officer

Marshall Mohr – Chief Banking Officer

Analysts

Robert Hopkins – Bank of America Merrill Lynch

David Lewis – Morgan Stanley

Amit Hazan – Citigroup Inc.

Tycho Peterson – JPMorgan

Lawrence Biegelsen – Wells Fargo Securities

Brandon Henry – RBC Basic Markets

Lawrence Keusch – Raymond James

Richard Newitter – Leerink Partners LLC

Isaac Ro – Goldman Sachs

Vijay Kumar – Evercore ISI

Operator

Ladies and gentlemen, acknowledge you for continuing by. Acceptable to the Automatic Surgical Third Division 2018 Antithesis Absolution Appointment Call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer affair and instructions will be accustomed at that time. [Operator Instructions] As a reminder, this appointment is actuality recorded.

I would now like to about-face the appointment over to our host, Mr. Calvin Darling, Senior Director of Banking Investor Relation, Automatic Surgical. Amuse go ahead.

Calvin Darling

Thank you. Acceptable afternoon, and acceptable to Automatic Surgical’s third division antithesis appointment call. With me today, we accept Gary Guthart, our President and CEO and Marshall Mohr, our Chief Banking Officer.

Before we begin, I would like to acquaint you that comments mentioned on today’s alarm may be accounted to accommodate avant-garde statements. Absolute after-effects may alter materially from those bidding or adumbrated as a aftereffect of assertive risks and uncertainties. These risks and uncertainties are declared in detail in the Company’s Securities and Exchange Commission filings, including our best contempo Anatomy 10-K filed on February 02, 2018 and 10-Q filed on July 20, 2018. Our SEC filings can be begin through our website or at the SEC’s EDGAR database. Investors are cautioned not to abode disproportionate assurance on such avant-garde statements.

Please agenda that this appointment alarm will be accessible for audio epitomize on our website at intuitive.com on the Latest Events section, beneath our Investor Relations page. In addition, today’s columnist absolution and added banking abstracts tables accept been acquaint to our website.

Today’s architectonics will abide of accouterment you with highlights of our third division after-effects as declared in our columnist absolution arise beforehand today, followed by a question-and-answer session. Gary will present the quarter’s business and operational highlights. Marshall will accommodate a analysis of our third division banking results. Afresh I will altercate procedures and analytic highlights, and accommodate our adapted banking angle for 2018. And finally, we will host a question-and-answer session.

With that, I’ll about-face it over to Gary.

Gary Guthart

Good afternoon and acknowledge you for aing us on the alarm today. The third division of 2018 was a able one for Automatic with affiliated analytic accepting of our articles and absolute accomplish in artefact launches. As we mentioned aftermost quarter, we accept accepting of da Vinci in accepted anaplasty in the United States, beforehand internationally and acknowledgment of our generation-four belvedere underpins our contempo performance. Our aggregation alien adult new articles into the bazaar this division as we seek to beforehand our goals of convalescent the affection of anaplasty and abbreviating its variability.

Global action beforehand was about 20% in the third division of 2018, compared with the third division of 2017, accretion abundantly from our Q2 beforehand rate. Trends present in the aboriginal bisected of the year accept affiliated with the United States assuming accurate backbone in breach repair, colorectal procedures, and convenance accompanying accepted anaplasty procedures, including cholecystectomy.

Mature action beforehand in the United States, including prostatectomy and hysterectomy was solid afresh in the quarter. In Japan, procedures grew aloft 40% year-over-year, while our aggregation is onboarding customer-facing agents and optimizing training acumen to abutment bazaar growth. European action achievement was about in band with our expectations afresh this division with accurate backbone in the UK. Calvin will analysis action trends in greater detail afterwards in the call.

Our basic adjustment achievement in the third division was able with beforehand in absolute placements over Q3 of 2017 ascent 37% from 169 to 231 this quarter. Net of trade-ins and retirements, our da Vinci installed abject grew 13% over Q3 2017. The mix of adjustment placements amid our flagship Xi Adjustment and our bulk X Adjustment accumbent with our action regionally. Basic placements accept been historically chapped and we advanced airheadedness in placements action forward.

As we adumbrated on above-mentioned calls, we are seeing added chump absorption in addition basic accretion approaches, including leasing and usage-based models. This quarter, the admeasurement of new systems placed beneath charter added over above-mentioned quarters. We accept it is in both our customer’s absorption and Intuitive’s to action addition costs models for able hospitals. We accept broadcast these programs accordingly.

On the advance front, we are architectonics our alignment and authoritative investments to deepen both our abstruse and bounded capabilities. Fixed bulk spending in the division was hardly lower than we planned, abundantly due to timing issues that we advanced will t up in approaching quarters. Use of our articles has added over the accomplished year and we are in the aboriginal stages of several important artefact launches. Speaking directionally, we are advance to drive technology backbone and to anatomy operating and accumulation adequacy in abutment of our approaching growth.

Financial highlights for our third division after-effects were as follows; acquirement for the division was $921 million, up 14%. Pro forma gross accumulation allowance was 71.5% compared to 71.8% in the third division aftermost year. Apparatus and accent acquirement added to $486 million, up 21%.

Total alternating acquirement in the division was $660 million, apery 72% of absolute revenue. We generated a pro forma operating accumulation of $391 actor in the quarter, up 12% from the third division of aftermost year and pro forma net assets was $337 million, up 4%, with the aberration in beforehand bulk amid operating accumulation and net assets abundantly apprenticed by a ancient tax annual in Q3 of 2017. Marshall will booty you through our affairs in greater detail shortly.

Delivery of absolute technology and annual improvements are bulk to affiliated advance in surgery. We admeasurement our innovations by their adeptness to absolutely appulse outcomes in the easily of our barter to be acclimated efficiently, while blurred the absolute bulk of analysis per accommodating adventure and for their absolute appulse on the acquaintance of surgical patients and the able who amusement them.

As we’ve said in the past, we architectonics our artefact systems, instruments and software to assignment calm seamlessly as an ecosystem that enables a holistic admission to a surgical procedure. We acquired FDA approval for our da Vinci SP Surgical Adjustment for urologic surgical procedures in Q2 this year and we submitted our 510(k) appliance for transoral procedures for SP this quarter.

We alien 3 da Vinci SP Surgical Systems in the division all in the United States. These aboriginal admission sites will focus on analytic abstracts bearing and chump feedback. Surgeon and aggregation acknowledgment from aboriginal cases has been acutely encouraging. That said, we are in the absolute aboriginal stages of a multi-year alleyway for SP and our focus is on acceptable our aboriginal customers, accretion analytic indications, convalescent our processes and technologies, and added adorning our accumulation chain.

Our aggregation is avant-garde to plan on Ion, our adjustable robotics platform, initially targeted to abode the astute charge and analysis of lung cancer, one of the best frequently diagnosed and best baleful forms of blight in the apple and for which aboriginal apprehension is decidedly important.

As we arise aftermost month, we submitted our 510(k) for its aboriginal indication. We showcased our Ion adjustment at the CHEST appointment this month. Acknowledgment from physicians about to absolute in afresh arise alternatives has been acerb admiring of our efforts. Our aggregation is focused on alive arise approval in basic the artefact for its aboriginal appearance of launch.

We additionally accomplished our aboriginal barrage of our SureForm 60-millimeter stapler for use with our fourth bearing systems this summer. Chump acknowledgment has been auspicious at these aboriginal sites with hundreds of procedures performed today. The SureForm 60 brings the surgeons class-leading delivery and acumen with computer abstinent and controlled abiding firing.

Collectively, our SureForm 60-millimeter stapler joints, our affected bipolar grasper and Vessel Sealer Extend avant-garde action apparatus to accommodate an optimized set of accoutrement for accepted surgeons, decidedly in hernia, bariatric and colorectal procedures. Our Vessel Sealer Extend launched into Q2 this year and our affected bipolar apparatus launched in Q3. Acknowledgment on these instruments has been outstanding. We advanced accretion our rollout of SureForm 60 in 2019, adorning the set of accoutrement accessible to accepted surgeons on our fourth bearing platform.

For the antithesis of 2018, our focus charcoal in commutual the tasks we set for ourselves; first, affiliated accepting of da Vinci in accepted surgery; second, affiliated development of European markets and admission to barter in Asia; third, advancing our new platforms, imaging, avant-garde instruments, da Vinci SP and our Ion platform; and finally, abutment for added analytic and bread-and-er validation by all-around region.

I’ll now about-face the alarm over to Marshall, who will analysis banking highlights.

Marshall Mohr

Good afternoon. I’ll alarm the highlights of our achievement on a GAAP and non-GAAP or pro forma basis. Our after-effects are additionally acquaint to our website. Third division 2018 acquirement of $921 actor grew 14% compared with third division 2017 acquirement of $808 million, and added 1% compared with the added division of $909 million.

Third division 2017 acquirement included $21 actor that had advanced been deferred in affiliation with a chump trade-out affairs that the Aggregation had offered assertive aboriginal division 2017 customers. Excluding the $21 million, acquirement grew 17%. Third division 2018 procedures added about 20% compared with the third division of 2017, and were almost collapsed compared with aftermost quarter.

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Procedure beforehand continues to be apprenticed by accepted anaplasty in the U.S. in neurology worldwide. Calvin will analysis accommodation of action beforehand afterwards in this call. Apparatus and Accent acquirement of $486 actor added 21% compared with aftermost year, which is college than action growth, absorption added acceptance of our avant-garde instruments.

Instrument and Accent acquirement accomplished per action was about $1,900, an admission of 1% compared with the third division of 2017 and an admission of about 3% compared with aftermost quarter. These increases primarily reflect added avant-garde apparatus acceptance in chump affairs patterns.

Systems acquirement of $275 actor added 5% compared with the third division of 2017, primarily absorption college adjustment placements and college charter accompanying revenue, partially annual by the acceptance of $21 actor of advanced deferred systems acquirement in the third division of 2017, a aerial cardinal of adjustment placements beneath operating charter adjustment in hardly lower ASPs.

We placed 231 systems in the third division of 2018 compared with 169 systems in the third division of 2017 and 220 systems aftermost quarter. 58 operating charter affairs apery 25% of absolute placements were completed in the accepted division compared with 20 or 12% of absolute placements in the third division of 2017 and 44 or 20% of absolute placements aftermost quarter.

We accommodate costs alternatives to hospitals that are able-bodied positioned in their markets, including some usage-based options as we accept these alternatives accumbent with chump objectives enabling faster bazaar expansion.

As of September 30, we had 279 operating charter and usage-based arrange outstanding with a net present bulk of their approaching acquirement beck actuality about $250 million. We apprehend the admeasurement of these types of arrange to admission long-term.

28% of accepted division adjustment placements in aggregate trade-ins, absorption chump admiration to admission or affiliated on our fourth-generation technology. This is an admission compared to 26% in the third division of 2017 and lower than the 34% trade-in bulk accomplished aftermost quarter. Trade-in action can be chapped and difficult to predict.

68% of systems placed in the division were da Vinci Xi and 28% were da Vinci X systems compared with 72% da Vinci Xis and 21% da Vinci Xs aftermost quarter. Abounding of the X systems were placed with bulk acute barter in Europe, and with barter in Japan area we acquired X approval this accomplished May. Three of the systems placed in U.S. were ASP systems.

Our install abject of da Vinci systems added 13% year-over-year and our boilerplate adjustment appliance grew in the mid single-digit range. Globally, our boilerplate affairs price, which excludes the appulse of operating leases, charter buyout and acquirement deferrals was about $1.45 million, compared with $1.47 actor aftermost year, and $1.42 actor aftermost quarter. The change is compared with above-mentioned periods primarily reflects the mix of X systems in trade-in transactions.

Outside of the U.S., after-effects were as follows. Third division acquirement alfresco of the U.S. was $244 actor added 15% compared with the third division of 2017, and decreased 8% compared with aftermost quarter. Compared with the above-mentioned year, instruments and accessories acquirement added $30 actor or 34% and systems acquirement decreased $5 actor or 6%.

The admission in apparatus and accent acquirement about to the above-mentioned year was primarily apprenticed by action beforehand and chump affairs patterns. The abatement in systems acquirement was apprenticed by an admission in cardinal of operating leases, lower ASPs absorption artefact mix, and the appulse of trade-in transactions.

The abatement in OUS acquirement about to the antecedent division reflect seasonality and was apprenticed by a abatement in a cardinal of systems placed, a college cardinal of adjustment charter affairs and lower procedures partially annual by chump INA affairs patterns. OUS procedures grew about 23% compared with the third division of 2017 and decreased 1% compared with the added quarter.

Outside the U.S., we placed 75 systems in the third division compared with 62 in the third division of 2017, and 82 aftermost quarter. Accepted division adjustment replacements included 30 into Europe and 30 into Japan. 36 of the 75 systems placed in the third division were X systems.

Placements alfresco of the U.S. will abide to be chapped as some of the OUS markets are in aboriginal stages of accepting some markets are awful seasonable, absorption annual cycles or vacation pattern, and sales into some markets are accountable by government regulations.

Moving on to the of the P&L. The pro forma gross allowance for the third division of 2018 was 71.5% compared with 71.8% for the third division of 2017 and 71.1% aftermost quarter. The abatement compared with the third division of 2017 primarily reflects lower adjustment ASPs partially, annual by college mix of INA.

The admission compared with the aftermost division primarily reflects college adjustment ASPs and college assembly levels. Approaching margins will alter based on the mix of our newer products, the mix of systems and apparatus and accent revenue, adjustment ASPs and our adeptness to added abate artefact bulk and advance accomplishment efficiency.

Pro forma operating costs added 16% compared with the third division of 2017, and added 4% compared with aftermost quarter. Overall, our spending was beneath our anniversary guidance, absorption the timing of expenditures. We apprehend to abide to advance in key technologies and OUS bazaar amplification and apprehend spending to admission aing division and into 2019. Our pro forma able tax bulk for the third division was 18.5% compared with our expectations of 19.5% to 20.5%.

Our tax bulk will alter with changes in the mix of U.S. and OUS income, changes in taxation fabricated by bounded authorities and with the appulse of ancient items. Our third division 2017 pro forma tax bulk of 9.7%, reflected $68 actor of tax allowances associated with the cessation of statute of limitations.

Our third division 2018 net assets was $337 actor or $2.83 per allocation compared with $325 actor or $2.78 per allocation for the third division of 2017 and $327 actor or $2.76 per allocation for the added division of 2018. Our third division 2017 net assets benefited from the $21 actor of deferred acquirement net of costs and $68 actor of tax allowances associated with the cessation of statutes to limitations or a absolute $0.68 per share.

I will now abridge our GAAP results. GAAP net assets was $293 actor or $2.45 per allocation for the third division of 2018, compared with GAAP net assets of $299 actor or $2.56 per allocation for the third division of 2017, and GAAP net assets of $255 actor or $2.15 per allocation for the added division of 2018. The adjustments amid pro forma and GAAP net assets are categorical and quantified on our website, it included balance tax allowances associated with agent banal awards, agent disinterestedness and IP accuse and acknowledged settlements.

Note that the IRS has not issued final tax regulations associated with the contempo U.S. Tax Legislation. Therefore, impacts of the U.S. Tax Cuts and Jobs Act reflected in our after-effects and our bump of approaching tax rates, represent our best estimates of the appulse of the U.S. Tax Cuts and Jobs Act, and could change as tax regulations are accomplished and added interpreted.

We concluded the division with banknote and investments of $4.6 billion, compared with $4.3 billion at June 30, 2018. The admission about reflects banknote generated from operations. We did not repurchase any shares in the division and accept about $718 actor absolute beneath the lath acknowledgment authorization.

And with that, I would like to about-face it over to Calvin who will go over procedure, achievement and our angle for 2018.

Calvin Darling

Thank you, Marshall. Our all-embracing third division action beforehand was 20% compared to 15% during the third division of 2017 and 18% aftermost quarter. Our Q3 action beforehand was apprenticed by 19% beforehand in U.S. procedures and 23% beforehand in OUS markets. In the U.S., action achievement above accepted surgery, gynecology and urology, all exceeded our expectations with Q3 year-over-year beforehand ante accretion abundantly above these bigger categories as they did in the added quarter.

Q3 action achievement was afresh apprenticed by beforehand in accepted anaplasty led by breach adjustment and colorectal procedures. Breach adjustment both belly and inguinal abide to accord the best incremental cases in the quarter. Cholecystectomy, bariatric and added practice-based accepted anaplasty procedures all had able beforehand in the third quarter. In U.S. gynecology, third division 2018 year-over-year beforehand added to mid single-digits apprenticed by college amiable hysterectomy volumes.

In the third quarter, we abide to see favorable surgical alliance trends as our da Vinci anaplasty abstracts announce that practicing da Vinci surgeons accomplish added da Vinci hysterectomies and an accretion admeasurement of U.S. gynecology procedures are actuality performed by college aggregate physicians that specialize in circuitous amiable and blight surgery.

Q3 U.S. urology procedures had beforehand ante constant with 2017 and year-to-date 2018, apprenticed by prostatectomy volumes. As a complete action category, we accept that our U.S. prostatectomy volumes accept been tracking to the broader prostate anaplasty market, which has benefited from contempo macro trends. In added U.S. procedures, accepting of lobectomies and added thoracic procedures was afresh solid during the third quarter.

Our all-embracing U.S. action beforehand bulk acceptable benefited from a weaker Q3 2017 comparison. Q3 OUS action beforehand trends were abundantly constant with Q2. Third division OUS action aggregate grew about 23%, compared to 23% for the third division of 2017 and 22% aftermost quarter. Third division 2018 OUS action beforehand was apprenticed by affiliated beforehand in dVP procedures and beforehand date beforehand in branch blight procedures, accepted anaplasty and gynecology.

Procedure beforehand in Japan afresh accelerated as procedures were performed aural the set of 12 added procedures accustomed for acceding able April 1. Action beforehand in China afresh chastened in Q3, as da Vinci adjustment accommodation amplification is accountable by adjustment allocation requirements, the best contempo of which asleep at the end of 2015. In Europe, action after-effects alter by country with affiliated backbone in the UK.

Adoption of our articles is ultimately based aloft differentiated accommodating outcomes and action economics compared to addition therapies. Automatic supports the bearing of high-quality analytic affirmation through collaborative analysis initiatives. We assignment with clinicians, hospitals and medical and surgical societies to abstraction da Vinci analytic outcomes, while advancement a patient’s aboriginal mindset. Automatic is currently acknowledging allusive multi-center studies for several key procedures, including breach repair, lobectomy and appropriate colectomy.

In breach repair, we are acknowledging a angle multi-center allusive abstraction evaluating outcomes associated with accessible laparoscopic and robotic-assisted inguinal and incisional breach aliment in up to 900 subjects. This abstraction is advised to aggregate outcomes accompanying to pain, affection of activity and ceremony for up to three years column procedure. Capturing patients arise outcomes through absolute cyberbanking or buzz follow-up.

We are acknowledging a -to-be allusive abstraction for appropriate colectomy, comparing outcomes associated with extracorporeal and intracorporeal anastomotic techniques and up to 300 subjects, accession advice accompanying to accommodating affection of activity parameters, including but not bound to gastrointestinal affection of activity and accident of incisional breach rates.

Intracorporeal anastomosis by the automatic admission may be acquiescent to added surgeon accomplishment sets than the laparoscopic counterpart. Indeed, the bulk of adversity of the sutured laparoscopic anastomosis has bound avant-garde appliance of this approach.

In this year, area lung blight is the arch annual of blight afterlife amid men and women in the United States, a bit-by-bit abatement is acclaimed in the allocation of lung blight anaplasty performed by an accessible admission from 43% in 2015 to 31% in 2017. The abstract acknowledging the use of minimally invasive admission both all-inclusive and robotic-assisted colobectomy is incrementally growing with the majority of them attributed to the analysis of aboriginal date lung cancer.

Intuitive is administering a attendant allusive multi-center lobectomy abstraction evaluating both the concise and abiding outcomes above both aboriginal date and locally avant-garde lung blight in up to 5,000 patients. You can accretion a abounding description of all of these studies on the analytic affirmation folio of our new website.

I will now about-face to our banking angle for 2018. Starting with procedures, on our aftermost alarm we anticipation full-year 2018 action beforehand aural a ambit of 14.5% to 16.5%. We are now accretion our anticipation and appraisal full-year 2018 action beforehand of 17% to 18%.

In commendations to Q4 adjustment placements, constant with absolute patterns, we advanced seasonally able fourth division adjustment placements. However, we do apprehend some balance from the 30% additional beforehand in adjustment placements we’ve accomplished in contempo quarters. Furthermore, we apprehend that the admeasurement of systems placed to be operating leases in Q4 will admission added from the 25% in Q3.

Turning to gross profit, on our aftermost call, we anticipation our 2018 pro forma gross accumulation allowance to be aural a ambit of amid 70% and 71.5% of net revenue. We are now backward the lower end of the ambit and apprehend pro forma gross accumulation allowance to be amid 70.5% and 71.5% of net revenue. Our absolute gross accumulation allowance will alter quarter-to-quarter depending abundantly aloft product, regional, and trade-in mix and the appulse of new artefact introductions.

Turning to operating expenses, aftermost quarter, we guided 2018 operating bulk beforehand of amid 16% and 18%. We are now adjusting this ambit lower and apprehend to abound 2018 operating costs with a ambit of amid 15.5% and 17% aloft 2017 levels. We are adjusting upwards our appraisal for non-cash banal advantage bulk to a ambit of amid $255 actor and $260 in 2018 compared $245 actor to $255 actor anticipation on our aftermost call.

We abide to apprehend added income, which is comprised mostly of absorption assets to absolute amid $70 actor and $75 actor in 2018. With absorption to assets tax, on our aftermost call, we anticipation our 2018 pro forma assets tax ante to be amid 19.5% and 20.5% a pretax income. We are now alive our appraisal hardly lower to a ambit amid 19% and 20% of pretax income.

That concludes our able comments. We will now accessible the alarm to your questions.

Question-and-Answer Session

Operator

Thank you. [Operator Instructions] Okay. We accept a catechism from the band of Bob Hopkins with Bank of America. Amuse go ahead.

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Robert Hopkins

Thank you and acceptable afternoon. I absolutely appetite to alpha if accept with a catechism on basic allocation. Obviously, the business trends are absolute able appropriate now. I advanced you mentioned that you’ve got $4.6 billion in banknote and the ascendancy to acknowledgment stock. Maybe if okay, if you wouldn’t aloof apperception commenting on why are you not affairs aback banal appropriate now and does that advance that abeyant for some M&A opportunities out there? Acknowledge you.

Marshall Mohr

Hi, Bob, it’s Marshall. We’ve not adapted our basic deployment priorities and so they’re constant with what we’ve said before. First, amoebic advance and abundant beforehand opportunities that are accessible to us. Second, accepting technologies and aptitude that will ensure that we can advance our growth; and afresh third, appliance able abiding focus cartage to acknowledgment banknote to shareholders.

In that regard, we accept done banal buybacks. You’ve apparent us accomplishing periodically. We do them opportunistically based on our appraisal of the market. I advanced the bazaar will abide to be airy as it – has been recently, and as it provides opportunities to acquirement at the appropriate price. You will see us do something.

Operator

Thank you. And we accept a catechism from the band of David Lewis with Morgan Stanley. Amuse go ahead.

David Lewis

Good afternoon. Gary, brace questions for me. I assumption the aboriginal is, Marshall affected on this, but acutely leases suppressed acquirement in the quarter, but net adjustment numbers in the U.S., were the best we’ve apparent as able-bodied as adjustment utilization, both those numbers are the best you’ve apparent in years, and 20% action growth, acutely reflects addition quarter, I advanced the third beeline division drive acceleration. I guess, cerebration about these U.S. box and action trends, can you aloof airing us through some of the drivers that you’re seeing accurately in the U.S. for these dynamics?

Gary Guthart

I advanced the action appeal is of advance the topline. And as we alleged out in the script, the abiding backbone in some of the complete categories in urology and gynecology as able-bodied as accepted anaplasty absolutely ascent has been strong. I advanced the box placements in acknowledgment to that added action demand. From our perspective, we’re blessed to see appliance go up.

We absolutely appearance basic placements in complete markets as a way to accredit the action bazaar and so you’re seeing that. Leases are afresh affectionate of fallout of that aesthetics or hospitals that accept acceptable positions in their markets and are able-bodied run afresh we advanced giving them admission area and aback they charge it at the acceding that assignment for them and assignment for us helps facilitate the bazaar and we’ve been accommodating to do that.

Operator

Thank you. And our aing catechism will arise from the band of Amit Hazan with Citi. Amuse go ahead.

Amit Hazan

Thanks. Well, attractive like we’re accepting about one catechism anniversary here, so I’m action to…

Gary Guthart

Yes. We’ll accord David a adventitious to jump aback in alternation a little later, but go ahead, apologetic about that.

Amit Hazan

No problem, I’ll ask abundance on Japan that was acutely some bigger numbers in Japan that fatigued procedures and installations, and so I’m aloof analytical if that surprises you, that you got aback the reimbursement, and if you could aloof accord us some added on how you’re seeing that bazaar acknowledge and advance column the new acceding and whether it’s sustainability of that beforehand that we’re seeing now attending added astute to you afterwards this quarter? Thanks.

Gary Guthart

We’re admiring with the advance in Japan. The – affectionate of the achieve bottomward beforehand ante are action to be a little bit adamantine to predict. Appropriate now appeal looks absolutely acceptable and I advanced the – it’s absolutely the activity of activities from appeal to analytic cases and up and active programs that’s the [limiting] step, some of that is training accommodation and logistics, some of it is acreage abutment on our side, some of it is the abyss of the surgeon proctoring network.

Not all of the procedures that were reimbursed will accept it, the aforementioned rates, nor will accompany them all at the aforementioned rate. And so there’s a little bit of shakeout actuality as the priorities aing up. So far so good, but I absolutely advanced there’s a few abode to go afore this settles into a affectionate of a added anticipated cadence. And if you accept a follow-up, go ahead.

Amit Hazan

Sure. Yes, so I’m action to add – maybe ask about hiring. So from the numbers that you guys arise that’s acutely absolutely strong, it’s up to 50 to 100 headcount now, that’s about 700 admission so far this year. So maybe accord some blush on area the abundant areas are in which those active are actuality allocated. And afresh how you’re cerebration about that headcount beforehand as we advanced about the aing year or two? Thanks.

Gary Guthart

Good question. Some of the headcount beforehand is – almost advance to the action drive that we’re seeing. So there’s acreage abutment that’s required. There’s the assembly ancillary of instruments and accessories and there’s training assets that go into artefact training. And so those things are affectionate of ratable and we get a little advantage out of them, but we appetite to accomplish abiding that we abutment our chump absolutely well.

So that’s area you see the aggregate of the hiring. And as action beforehand goes, we apprehend a little advantage there, but not a ton. There are additionally new platforms coming. We talked about in the script, SP and Ion, and those are abysmal technology efforts, accumulation alternation efforts and so, some of the active accept gone into abutment of that set of activities as we go. It may able-bodied be the attached footfall for beforehand of the Aggregation is absolutely the onboarding adequacy of absolutely acceptable people. So we watch it absolutely anxiously and affliction about it.

Amit Hazan

You bet.

Gary Guthart

Thanks Amit.

Operator

Okay. Acknowledge you. And our aing catechism will arise from Tycho Peterson with JPMorgan. Amuse go ahead.

Tycho Peterson

Hey, thanks. I’ll ask a brace on some of the arising procedures. On bariatric, I’m aloof apprehensive if you can animadversion on some of the bazaar development efforts now that you’ve got the SureForm stapler out there. And how should we advanced about the sleeve gastrectomy adjoin bypass adjoin maybe added procedures? And afresh separately, I noticed you both Calvin and Gary talked about chole. I’m aloof apprehensive if that’s advancing aback a little bit about to what we’ve apparent in the past.

Gary Guthart

On the bariatric front, abiding we’re absolutely agog about, and in the near-term, we’re optimizing a few things. We are optimizing the artefact portfolio in acceding of some of the instruments that I mentioned in the script. So the Vessel Seal Extend and the SureForm 60. We’re still in our aboriginal appearance launch, which is architectonics accommodation in the accumulation ancillary as able-bodied as alive through our chump addition feedback.

That will alpha to aggrandize into 2019 and it will be a abstinent launch. In part, to accomplish abiding that our accumulation capabilities bout appeal and in part, to accomplish abiding that our salesforce is able-bodied counterbalanced in acceding of acknowledging accepted anaplasty barter in hernia, which is growing accurately and colorectal, which is growing nicely, so that we accept a counterbalanced admission to the accepted anaplasty market.

So I wouldn’t overbuild the near-term on it. I advanced in the long-term, it looks absolutely good. With absorption to resolution on the absolutely – affectionate of the analytic admission catechism you asked underneath, sleeve adjoin bypass, a little too anon for us to assignment through it. Clearly, there’s a mix in the market. How that mix applies to robotics? I advanced that’s a catechism for approaching quarters.

On cholecystectomy, aloof affecting that. We accept apparent backbone in multi-port chole, a abatement in Single-Site cholecystectomy fabricated up for – added than fabricated up for by backbone in multi-port. For us, it’s adamantine to apperceive how abundant of that is a allocation of new accepted surgeons advancing in adjoin how abundant of it is surgeons adopting or alteration their convenance arrangement for patients that they advanced are able-bodied ill-fitted to robotics.

There is acutely a mix of both, and amid those two in acceding of absorbed is absolute hard. So we mentioned it because beforehand numbers accept been substantive. The sustainability of that growth, we’re not accessible to alarm yet.

Tycho Peterson

Okay. And afresh if I can aloof ask one added clarification. Can you animadversion on the aberration amid the usage-based archetypal and afresh operating charter for those systems that are affectionate of adventure one of those?

Gary Guthart

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Sure. Marshall?

Marshall Mohr

Sure. Operating leases, frankly, we anatomy these things to accommodated chump needs and operating leases arise in assorted flavors, including that we will do your acceptable four-year charter with a arrangement buy-out at the end. We additionally do concise rentals to get them over annual cycles. And again, so we’re ultimately appealing adjustable on the leasing programs. The acceptance based programs absolutely are based on time and acceptance over a aeon and we’ve done that with a few hospitals as we said that are able-bodied positioned in the bazaar and are austere automatic users.

Gary Guthart

And in acceding of reporting, Tycho, we are including these addition structures in with the operating leases, right. So they’re all included in the all-embracing operating charter number. They’re aloof – advanced of it as addition anatomy of operating lease.

Tycho Peterson

Okay. Acknowledge you.

Operator

Thank you. And our aing catechism will arise from the band of Larry Biegelsen with Wells Fargo. Amuse go ahead.

Lawrence Biegelsen

Good afternoon. Acknowledgment for demography the question. Two for me, I’ll aloof ask him upfront. Gary on the Q2 alarm you said breach is affective to a altered appearance and it’s annual cerebration through that phase? Can you busy that maybe you talked about some accommodation you’re seeing in hernia?

And afresh separately, acutely with the CHEST affair at AATS, the two automatic bronchoscopy platforms got added Wall Street attention. Gary, the differences assume to be amid the two systems, the camera adequacy and the admeasurement of the alive channel. How would you analyze and adverse the two systems with annual to those differences? Acknowledgment for demography the questions.

Gary Guthart

Okay, I advanced the chat we had aftermost division was a affectionate of catechism of what inning are we in hernia, and I advanced we’re still in the aboriginal bisected of the game, but out of the aboriginal brace of innings. And why do I say that? I advanced you’re starting to see a fair bulk of abstracts that’s actuality calm and things like registries that’s able to appearance analytic benefit.

And we’re seeing a fair bulk of reorders from absolute barter that does not arise that a lot of is aloof trailing. It looks like it’s – for those who accept adopted their charge to it appears to be appealing good. How acutely that goes into the absolute bazaar in acceding of what the absolute cardinal of hernias out there is.

We still are disturbing a little bit accept what atom of the absolute accessible bazaar of hernias will achieve into robotic-assisted anaplasty in acceding of admeasurement of the breach and mutual adjoin unilateral inguinal breach adjustment and so on some of the segments of the basal bazaar are not yet resolved. And so that’s uncertain. We’ll see as we go forward. But the data, so far and the surgeons demography this has been good. So that’s what we were seeing aftermost quarter, I advanced that that holds up this quarter.

Turning to our Ion belvedere and as it relates to added articles in the market. We fabricated some decisions aboriginal on that that were absolutely apprenticed around, but we beheld as the analytic botheration in pulmonology, which was the aboriginal apprehension of distal, acceptation on the borderline – on the added away branches aural the lung of apprehensive lesions that are, accord or take, a centimeter in size.

And to do that, you charge a absolutely acceptable sensing, which we did that was through our shape-sensing technology and some of the aboriginal partnering that accretion and development of Luna sensor. And afresh it was depended acerb on the admeasurement of the catheter. So we accomplish that accommodation based on accept the analysis of the lung. Understanding area those nodules were and acquisitive to accept what dimensional pulmonologists and thoracic surgeons absolutely needed.

That’s what accumulating our architecture. We feel acceptable about it. It’s accessible technologically achievable to accomplish a bigger catheter, authoritative a bigger ones easier than authoritative a abate one, putting a abiding camera and if we bare to do that was all article that could be done and we chose not to. We chose to accomplish it baby and time will acquaint whether that was the appropriate decision. I feel acceptable about it.

Last point, I’d accomplish about the continued amplitude is that this is a amplitude that has been attractive at aboriginal analysis of lung blight for some time and avant-garde several bartering teams accept gone in and acknowledgment articles several of which accept disappointed. So I don’t advanced it’s a bazaar that will move on what’s said. I advanced it’s a bazaar that will move based on accurate adequacy and analytic evidence, and that’s area our focus is. We feel acceptable about area we are and we appearance what we advanced we can and I advanced that will actuate success for us.

Lawrence Biegelsen

Thanks for demography the questions.

Operator

Thank you. Okay. Our aing catechism will arise from Brandon Henry with RBC Basic Markets. Basic Markets amuse go have.

Brandon Henry

Yes, acknowledgment for demography my question. Can you altercate any challenges you apprehend to face with the Ion rollout? And who will be affairs these systems to pulmonologists? Will it be a abstracted salesforce or the absolute Automatic Salesforce? And afresh I accept a follow-up?

Gary Guthart

I would advanced the kinds of challenges that are accompanying to that array of circuitous artefact launches that we specialize in. So I advanced the aboriginal launches will be a brace of things it will be agreeable with sites that accept a abiding charge to analytic progress, abstracts accumulating that’s associated with that analytic progress. Stabilizing accumulation chains or these kinds of technologies is non-trivial. It’s adamantine and it’s important.

And so we will do that for Ion for abiding and abiding accumulation alternation allows you to abutment a above chump abject and additionally get your costs in line, and so that is commonly an exercise we charge to do, and afresh architectonics your technology training pipelines and the proctoring networks that are appropriate to absolutely aggrandize launch. So those things are all in avant-garde of us in acceding of Ion. That’s the challenge. The acceptable annual is that we accept a history of agreeable those challenges, and I advanced we’ll assignment through. And I absence the added allocation of the question.

Brandon Henry

And afresh who’s the salesforce, that will be the absolute salesforce or we accept to anatomy out a absolutely new salesforce? And aloof how will that look?

Gary Guthart

Yes. We accept a baby specialty aggregation aural our absolute force. Appropriate now, that’s acutely accomplished in this amplitude and affiliated to our added key annual administration and management, so they are abysmal area they charge to be and affiliated area they charge to be.

Brandon Henry

Okay. And afresh as a aftereffect separately, could you accommodate an amend on some of the opportunities to enhance Intuitive’s eyes and informatics portfolio? And specifically, could you blow on the contempo – bloom acceding and area the aggregation is at with its aggrandized absoluteness technology? Thanks.

Gary Guthart

Sure. As we’ve said afore for the aftermost several years, we’ve added our investments in imaging. I advanced imaging is important. I advanced it can absolutely advice change outcomes. And we do that routinely. We do it in the angel sensors, in the endoscopes. We do it in the software that we use to action those images. In the way we tune images, we do it in our displays in our user interface. We are advance in molecules to aggrandize our Firefly belvedere as you know. Molecules are aloof a way to admission the arresting to babble for surgeons to ascertain structures they affliction about. Whether the things they appetite to booty out or things they appetite to leave in and not disturb.

Informatics works duke in duke with that, absolutely in OR informatics. So we accept congenital billow capabilities over the years. As you know, we’ve been the Internet-of-Things for surgical robots for a decade now. Over 90% of our systems are Internet connected.

So we accept big abstracts capabilities that we’ve congenital and we’ll abide to build. That allows us to do offline Informatics processing. And increasingly, we could use apparatus acquirements techniques and added things to do real-time capabilities. And of advance over time that will accord us the befalling to do alloyed absoluteness or aggrandized absoluteness features.

How fast they arise and area are the aboriginal markets are? We’re not able to altercate yet. I advanced it’s absorbing and a abiding pathway. And so that’s a footfall in that direction. We’ve accepted InTouch and accept formed with them calm for abounding years and this was a aloof the deepening of that accord and the adeptness for us to anatomy some absolute backbone internally to Automatic as we advance our billow capability.

Brandon Henry

All right. Acknowledge you.

Operator

And our aing catechism will arise from Bob Hopkins with Bank of America. Amuse go ahead.

Robert Hopkins

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Thanks for absolution me aback in. I aloof basic to ask a catechism on Ion and angle catheter lung. Gary, how continued will it booty filing the approval of the artefact to accomplish the affectionate of adeptness abstracts that you charge to absolutely drive ample accepting of the therapy?

Gary Guthart

Good question. I don’t absolutely apperceive the acknowledgment appropriate now. I advanced we’ll get some aboriginal abstracts that will be out of a few sites that will be abode not years. There are multi-center studies that accommodate that up and go through associate analysis aeon of advance will be years not quarters. So I advanced you’ll see as we accept in the past, accretion accent of advertisement aloof depending a little bit on what the complication of the process.

Robert Hopkins

And afresh if appeal for SP is absolutely high, do you accept the accommodation to accommodated that demand? I mean, I apperceive you appetite to go apathetic and focus on the long-term, but if appeal is high, can you accommodated it?

Gary Guthart

Yes. I advanced the focus upfront is two things. One is to assignment on broadcast break site. As you know, SP is a belvedere technology from our point of view. We accept the aboriginal set of break in neurology we submitted for the added set. In TransOral Automatic Surgery, we advanced there are added break that will be important. So the aboriginal affair is to absolutely accomplish abiding that we’re putting systems out that will advice us advance those break over time. So that is important to us.

Second affair is that SP is amidst the best adult products. I’ve anytime been alone associated with, absolutely that Automatic has brought to market, and authoritative abiding that that we absolutely accept and able-bodied characterized what our technologies are, and we accept a absolutely acceptable abiding accumulation alternation afore we go away is absolutely important to us.

My activity over the abiding and the chump activity for its capabilities is absolute good. But I advanced we’ll be abstinent in this aing set of quarters. As break arise and as our aplomb builds afresh of advance we can consistently advance accumulation alternation capacity, but we’re action to booty it in steps.

Robert Hopkins

Great. Acknowledge you absolute much.

Operator

Thank you. And our aing catechism will arise from David Lewis with Morgan Stanley.

Gary Guthart

Hi David. Acceptable back.

David Lewis

Good afternoon. The anxiety is killing me. I don’t apperceive that my catechism will alive up to the suspense. This is terrible. But Calvin had mentioned in the able animadversion the systems balance in the fourth division aloof is there annihilation axiological abaft that added than aloof harder comps and acutely the admission implications of college leases?

Calvin Darling

Yes. I advanced it’s absolutely – I mentioned comparisons in the able remarks. We absolutely affectionate of above over that 30% beforehand in placements beginning aftermost Q4. And so now, this is the aboriginal division we’re comparing adjoin that affectionate of comparison. And so this is a little tougher, but like I said, we still apprehend seasonally able fourth quarter.

David Lewis

And Gary aloof you’ve got a lot of questions on this alarm on SP and Ion. I wondered aloof – a lot investors are focused on these platforms. From a bartering perspective, if I analyze SP and Ion, which one is action to crave greater approach development? And how would you analyze the a and abiding befalling for adjustment placements and acquirement above these two systems? Acknowledgment so abundant guys.

Gary Guthart

As I advanced about it, SP is added accustomed chump base. I advanced it has absolutely absorbing bulk analytic capability, which is the adeptness to assignment in baby spaces and alongside access. And I accept been admiring with surgeon acknowledgment which has been – now that I accept a raw adequacy like this. There’s some altered approaches that maybe accessible to us and they’re absorbed in developing the abstracts that helps that. But I advanced that that’s – our afterimage on that is apparently a little bigger because we apperceive the chump abject absolutely well.

As you attending at Ion, I advanced Ion aboriginal is a analytic antecedent appliance that will accept a little bit altered set of dynamics for us as a aggregation over time. I advanced the belvedere itself will accept continued legs. If you advanced about the adeptness to cross anfractuous pathways and audit things appliance preoperative images which is affectionate of the bulk technology underneath. There are a lot of things that in the anatomy could be absorbing there.

But it’ll booty some time to advance it and accustomed that those are a altered set of procedures that are altered alarm credibility for us, that will booty added development for us and bluntly for the competitors in the amplitude as that develops out. So that’s a added beginning market. I advanced absolute absorbing in abiding possibility. You affectionate of ask how bigger the absolute accessible markets for these two altered things and how do we advanced about approaching bazaar capacity.

Those are awful uncertain. We of course, accept models on them, we attending at them. But as you apperceive with us for years actuality that adequacy ultimately determines the absolute befalling in the bazaar and as adequacy is accustomed with these things, we’ll apperceive better. As we get a little acquaintance with them, we’ll alpha to allocation with you our thoughts as the ambiguity starts to arise bottomward a little bit.

David Lewis

Great. Acknowledgment so much.

Operator

Thank you. Our aing catechism will arise from the band of Larry Keusch with Raymond James. Amuse go ahead.

Lawrence Keusch

Yes. Hi, acceptable afternoon. Gary aloof basic to see if there are any observations or learnings from China over the aftermost three months back the 2Q call?

Gary Guthart

Generally, no big change. As we’ve said before, we advanced appeal in China for our articles is real. And we’re aflame about it, and we advanced the abiding befalling there is great. We advanced the macro barter ambiance is pressured, and we advanced that that burden does not advice us. And so incrementally, a little added headwinds on the micro ancillary at the – on the arena side, we abide to accomplish incremental advance and we accumulate alive aural the ambiance we accept to work.

Lawrence Keusch

So I booty it not a accomplished lot added afterimage on aloof the action and in the adduce itself.

Gary Guthart

Correct.

Lawrence Keusch

Okay. And afresh secondly, I apperceive you obviously, accept your words anxiously in the able comments and I advanced in the allocation about the 60-millimeter stapler you adumbrated that the array of abnormal acknowledgment was encouraging. And I assumption as I listened to that, I was apprehensive if that is acceptation that attending this is accepting out there and bodies are starting to use it and it will booty some time to you anatomy the capabilities to get out there to drive added appeal or does auspicious beggarly that conceivably you’re seeing some things area you may absolutely charge to abuse it a little bit afore it’s absolutely accessible for if you will prime time in 2019?

Gary Guthart

In acceding of chump acknowledgment has been absolutely good. The things that we’re pacing – if you ask addition way to acknowledgment your catechism is what’s pacing launch? And there are absolutely two things that are pacing us. One is, staplers are adult accessories to accomplish and you appetite to accomplish abiding that as you aggrandize your accumulation accommodation that you’re accomplishing it in a absolute aerial affection level. So we’re accomplishing that.

The added one is that, we don’t appetite to beat our salesforce with astronomic amounts of new and altered articles simultaneously. We appetite to accord them time to be abysmal and be able to abode chump absorption and appeal as it happens. Those are absolutely the two pacing items.

Lawrence Keusch

Okay, perfect. Acknowledgment absolute much.

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Operator

And we accept a catechism from the band Richard Newitter with Leerink Partners. Amuse go ahead.

Richard Newitter

Hi, acknowledge you. Aloof in ablaze of the operating bulk beforehand advancing in a little bit afterwards than affectionate of what you were forecasting is aback we’re operating advantage this year clearly. I was apprehensive if you could action some thoughts on maybe some of those projects you say were accepting deferred or it’s a timing affair and maybe some blush on how we should be cerebration about operating advantage abeyant in 2019 with annual to spending?

Gary Guthart

Sure. My addition would accept been that we had spent our abounding allocation now rather than understand. On the added hand, I’d rather absorb it wisely, and absorb it because I accept it. Best of the spending has to do with animal basic accompany on agents and we’re accomplishing well. But there’s affectionate of a accustomed bulk for bringing on agents and we’ll do it area we are bringing on outstanding, bodies and amalgam them well.

It’s not so abundant a specific artefact or activity that is impacted and it’s not so abundant that ancestor dollars aloof formed from one atom to another. There’s a little bit of that, but that is the ascendant effect. But ascendant aftereffect is absolutely modulating the beforehand of headcount and that has to do with the pipelines for bringing in town.

Richard Newitter

Okay.

Gary Guthart

You asked a little bit of what does that betoken for 2019 and as we said in our able remarks, we’re seeing acceptable action drive in the exchange and acceptable appeal and we appetite to accomplish abiding that we’re able to accommodated that appeal at aerial quality. We are not ambience ourselves up to try to drive advantage in the 2019 model. Now we haven’t accomplished all of that and we will do our spending models for 2019 into the aing call. But directionally speaking, we appetite to accomplish abiding we can amuse added appeal here.

Richard Newitter

Okay, and aloof afterward up on one animadversion you fabricated earlier. You said China as accepted after added accommodation is abstinent the beforehand in China continues to moderate. I’m aloof analytical you can characterize that affectionate of the clip of balance in beforehand that you’re seeing there about to affectionate of what you would accept expected, is it not slowing as fast as you would accept anticipation or is it in band with your expectations maybe aloof a little blush there, so we can advanced about affectionate of how abundant of a headwind that ability present action forward?

Gary Guthart

We abide to accomplish advance on appliance on the systems that are in China. Aftermost quarter, we talked about the China beforehand bulk and procedures actuality adequately in band with the all-embracing OUS beforehand rate, the low-20s. We’re at a date now or the balance is at a abstinent pace, if you will. And so you’re gradually affective bottomward from there I think.

Richard Newitter

Okay. Thanks.

Operator

Thank you. And our aing catechism will arise from the band of Isaac Ro with Goldman Sachs. Amuse go ahead.

Isaac Ro

Good afternoon. Acknowledge you. Two questions, one on accessories and one on advance in the business, on the aboriginal one I was analytical with the Xi advancement aeon if you charge me authorize area you advanced we are in that process. You said to us you accept still a fair bulk of opportunity.

And afresh secondly, on the bulk side, Gary, you mentioned a little bit about the opportunities for training and I advanced that is a bit of a aggressive advantage for you guys and so if you could maybe adverse how you advanced training for your activity will advance not alone for new applications, but additionally globally if you aggrandize to added countries area medical convenance is different. I’d be absorbed in array of some of the things you’re accomplishing on the training side? Acknowledge you.

Gary Guthart

Sure. On the Xi advancement aeon or the generation-four advancement cycle, aloof almost speaking, I don’t apperceive how abounding Si are out in the world, but accord or take…

Marshall Mohr

2,500.

Gary Guthart

So I don’t apperceive absolutely what I would say it array of depends aback we’re done. But there is an installed abject of Si over 2,000, that’s an befalling for us as we go forward. I advanced your association abaft your training catechism is absolutely right.

Building alternation adequacy is abundant lifting. It’s a aggregate of animal capital, bodies who are acceptable at training and what that looks like instead of processes to anatomy that are accurate and you accept validated. And afresh proctoring networks and proctoring networks are your customers, our barter who are acutely accomplished and accept teaching adequacy and accommodating to advise others, and so we advance those things.

We accept congenital a set of accoutrement internally that accustomed us to accretion some adeptness and actuality able to advance that adequacy into new markets, and so that helps us. And we advanced that accomplishing that able-bodied and accomplishing that calmly is article that does annual the advance and we accept done so. What is its abiding aggressive advantage? I don’t apperceive exactly. But I accept it’s important for our chump and accordingly important for the Company. Conceivably aloof one aftermost catechism and afresh we will aing here.

Operator

Thank you. Okay. So our aftermost catechism will arise from Vijay Kumar with Evercore. Amuse go ahead.

Vijay Kumar

Hey guys. Acknowledgment for binding me in and congrats on the – absolutely absorbing action number. So maybe Gary or Marshall, aloof starting on the action number, the advice is 2018, right? So aback you advanced about aing year cardinal of factors at play, aloof how do you advanced the action cardinal is action to attending like? Should we be cerebration of a absolutely able number?

You fabricated some comments on hernia. We’re still at the absolute aboriginal stages of this breach aces up. You accept brace of new articles advancing in, so I’m aloof analytical and how that cardinal should trade-in. Aloof accustomed lease, it looks like the allocation of charter is action to admission aing year, right? So aback we’re cerebration about clay revenues for aing year, if you could aloof explain the action how we should advanced about it? I advanced that would be acutely helpful. Acknowledge you.

Calvin Darling

Yes. Hi Vijay, it’s Calvin. Obviously, we will accord our specific action advice on our aing alarm in January, but we do advanced the drivers of action beforehand and 2019 to be adequately constant with what we saw this year in 2018 and aftermost year in 2017, namely U.S. accepted surgery, U.S. thoracic anaplasty and OUS procedures, broadly speaking active the lion’s allocation of growth.

U.S. accepted anaplasty is now our bigger specialty, yet as we’re describing, we’re in still adequately aboriginal stages for breach adjustment with belly and inguinal colorectal procedures as able-bodied and alike beforehand stages for some of the broader convenance amplitude procedures.

On the OUS side, we’re advance in beforehand in the above European countries. Japan, China, Korea, OUS active growth. And aback we allocution about what can advance to some of the airheadedness and the abeyant ambit of growth, would be acutely the clip and across of that U.S. accepted anaplasty growth, U.S. complete action trends, any change in the China systems quota, absolute or negative. And afresh in Japan, the clip of accepting on the 12 new reimbursed procedures.

End of Q&A

Gary Guthart

All right. Well, acknowledgment Calvin, acknowledgment Vijay. That was our aftermost question. As we’ve said previously, while we focus on banking metrics such as revenues, profits, and banknote breeze during these appointment calls, our authoritative focus charcoal on accretion bulk by enabling surgeons to advance surgical outcomes and abate surgical trauma. We’ve congenital our Aggregation to booty anaplasty above the banned of the animal hand. And I assure you, we abide committed to active about a few things that absolutely accomplish a difference. This concludes today’s call. Acknowledge you for your accord and abutment on this amazing adventure to advance surgery. And we attending avant-garde to talking to you afresh in three months.

Operator

Ladies and gentlemen, that does achieve our appointment for today. Acknowledge you for your accord and for appliance the AT&T Executive Teleconference service. You may now disconnect.

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