Intuitive Surgical, Inc. (NASDAQ:ISRG) Q3 2023 Earnings Call Transcript

Gary Guthart: Okay. On the first one, I think Myriam described it well. Our position on GLP-1s as it relates to bariatric surgery, I think she hit it well at the start of the call, no reason to reiterate it here. On the issue of potential impact beyond bariatrics, there may be some, although I think as you think through the analysis, I think it will be modest. And here’s how we think about it. If you look at obesity and diabetes as risk factors in other domains and other diseases for which surgery is performed, they are sometimes positive correlated risk factors for that disease. In some weird cases, they are negative in cases that it’s actually protective against disease. So it’s not entirely obvious. In most of the diseases that we treat as we look at it, it is not the dominant risk factor.

So as we look out and think about what could it be like in our TAM, we can kind of do a back of the envelope analysis. It is really early. I don’t think anybody knows the exact number. What I can say is that it’s not the dominant risk factor in most things that we look at. And we have a very large unpenetrated TAM. I think we’re still in the early innings of what we’re trying to work on. So, if these drugs are highly effective at avoiding other types of diseases, we will cheer. I still think we have a lot of upside opportunity to pursue.

Jayson Bedford: Fair enough. Thank you.

Operator: And we go to next line, Ryan Zimmerman, BTIG. Please go ahead.

Ryan Zimmerman: Thanks for taking the questions. I think you spoke about some of the new indications in SP. If I’m not mistaken, I think there’s a 30-day follow-up on the thoracic trial. But I’m curious if you could expand maybe when complex colorectal and thoracic cases potentially could become growth drivers for SP adoption and when you expect those – not just those trials to wrap up, but potentially clearances in the U.S. with that?

Gary Guthart: Sure. Myriam, I think you’re best to answer that.

Myriam Curet: Yes. So, we are hoping to submit everything in the foreseeable future. After that, as you know, there’s at least a 90-day turnaround for the IDEs and then – excuse me, for the clearances. And then after that, we will have to put training together – and they’ll see launches together. So I can’t really give you a time line for when that would be, but we know what the work is that needs to be done, and we are starting and moving forward on that.

Ryan Zimmerman: Okay.

Gary Guthart: Our biggest steps are get the data arranged to get it into the FDA and work with them to get clearances. And then as Myriam says, we’ll go through a staged commercialization. So you can expect submissions in the first half of ’24 and then response thereafter.

Ryan Zimmerman: Thank you, Gary. One of the other things, and I don’t know if it’s direct to you, Gary or Jamie, but you did talk about an opportunity to lower product costs as supply chain stresses ease and I know there were some comments earlier about ’24 gross margins. But stepping aside from that, can you quantify the opportunity potentially for what that looks like? Have you gotten your arms around – I know Marshall has been kind of shepherd in these processes. But at what point can you give the Street more color on what that opportunity looks like to drive gross margin gains?

Jamie Samath: We have very well detailed plans for each of the areas that we’re focused on. The teams have the capability and skill. It’s going to take some time. I think the best way I would answer the question is we see a path of overtime probably in the midterm to get back above 70% gross margin.

Ryan Zimmerman: Thank you, Jamie.

Operator: We go to next line, Anthony Petrone, Mizuho Group. Please go ahead.