Intuitive Surgical (NASDAQ: ISRG) shares fell about 11% on Friday after the robotic surgery company reported second-quarter results that topped Wall Street expectations but disappointed investors with slower US procedure growth and a cautious full-year outlook.
The company reported second quarter revenue of $2.89 billion, up 19% from a year earlier and above analysts' consensus estimate of $2.82 billion.
Adjusted earnings came in at $2.80 per share, exceeding expectations of $2.51.
Despite the earnings beat, investors focused on signs of moderating procedure growth. US procedure growth slowed to 12% in the second quarter from 14% in the first quarter. Management attributed the slowdown to deferred treatments and changes in patient insurance coverage following the expiration of enhanced Affordable Care Act premium subsidies.
For 2026, Intuitive maintained its forecast for worldwide da Vinci procedure growth of 13.5% to 15.5% but said it expects results to be closer to the midpoint of the range. That implied growth of about 14.5% fell short of analysts' expectations of roughly 15.3%.
The company also reaffirmed its outlook for a non-GAAP gross profit margin of 68% to 69% of revenue, including an estimated 1% impact from tariffs, and projected non-GAAP operating expense growth of 11% to 13% for the year.
During Q2, worldwide procedures across the da Vinci and Ion platforms increased about 16% from a year earlier, with da Vinci procedures rising approximately 15% and Ion procedures growing 36%.
Intuitive placed 468 da Vinci surgical systems during the quarter, up from 395 a year earlier, including 246 of its da Vinci 5 systems. The installed base of da Vinci systems grew 12% year over year to 11,710, while the installed base of Ion systems increased 21% to 1,096.
Second-quarter systems revenue rose to $685 million from $575 million a year earlier, driven by higher leasing revenue, increased average selling prices and more system placements. Instruments and accessories revenue climbed 18% to $1.73 billion, supported by higher procedure volumes.
The company ended the quarter with $8.63 billion in cash, cash equivalents and investments, up $650 million from the prior quarter, and repurchased approximately 0.9 million shares for $380 million.