Dive Brief:

• Intuitive Surgical, maker of the da Vinci robotic system, forecasted mid-teens procedure growth in 2019 on its fourth quarter earnings conference call Thursday and said it would accelerate some investments over the next several quarters to build its business operations in new markets including China, India and Taiwan.
• The company posted fourth quarter procedure growth of 19%, as projected earlier this month, driven by U.S. general surgery and thoracic procedures, with contributions from more mature gynecologic and urologic specialties. That compares to a pace of 17% in the fourth quarter of 2017 and 20% last quarter.
• Intuitive, which had also pre-announced fourth quarter results, reported net income in the quarter was $293 million, or $2.45 a share, compared with a loss of $32 million, or 28 cents a share, a year ago. Fourth quarter revenue rose 17% to $1.05 billion.

Dive Insight:

A number of new competitors are preparing to take on Intuitive, whose da Vinci system has dominated the robot-assisted surgery market since 2000. Analysts are focused on potentially serious threats from Medtronic and Johnson & Johnson, possibly as soon as late 2020. Both medtech giants have suggested they will look to bring lower-cost systems to market. TransEnterix, which in October 2017 became the first abdominal robotics market competitor to Intuitive, has also seen significant sales growth.

Intuitive, however, has advanced a number of initiatives to broaden the appeal of its platform and is now speeding its efforts to establish itself in key markets outside of the United States.

On the company's conference call, Chief Executive Gary Guthart stressed the acceleration of investments to establish the company’s base in China, India and Taiwan for the long term. “As we bring these efforts together, we plan to accelerate our spend rate above our historical norms for the next several quarters,” Guthart told analysts.

He provided an update on the initial phase of the company’s launch of da Vinci SP, which allow surgeons to guide the robot’s instruments and camera through a single port in the body. Fifteen SP systems were installed in 2018 and a few hundred procedures have been performed to date. 

Intuitive submitted a 510(k) application for a transoral robotic surgery indication in the fourth quarter and is responding to FDA questions about the system’s use for head and neck surgery, Guthart said.

The company also is nearing the first phase of its planned limited launch of Ion, a catheter-based platform that can navigate small lung airways to reach nodules for biopsies. Intuitive submitted its 510(k) for Ion last year and has responded to FDA questions this month, Guthart said. The company expects the launch to begin this year.

Intuitive anticipates broadening the launch of its SureForm 60-millimeter stapler for abdominal procedures, including bariatric surgery, in the first half of 2019 in response to surgeon demand, Guthart said.

Shares were down nearly 3% in mid-morning trade on Friday.