Investor

Presentation
Q4 2015

Forward Looking Statement

These slides and any accompanying oral presentation by
Intuitive Surgical, Inc. contain estimates and forward-looking
statements. Actual results may differ materially from those
expressed or implied as a result of certain risks and
uncertainties. These risks and uncertainties are described in
detail in the Companys Securities and Exchange Commission
filings.

Risks
Serious complications may occur in any surgery, including da
Vinci Surgery, up to and including death. Individual surgical
results may vary. Patients should talk to their doctor to
decide if da Vinci Surgery is right for them. Patients and
doctors should review all available information on nonsurgical and surgical options in order to make an informed
decision. Please also refer to
http://www.daVinciSurgery.com/Safety for Important Safety
Information.

Contents Outline
Company Overview & Business
Model
Business Review

Opportunities & Catalysts for

Growth
Corporate Assets & 2015
Priorities

Corporate Overview and

Business Model

Corporate Overview
Founded in 1995, IPO 2000
Over 3 million da Vinci procedures performed to date
Approximately 570,000 da Vinci procedures performed in
2014
Q3 YTD 2015 da Vinci procedures up approximately 14%
Q3 YTD 2015 Revenue up 12%
3,477 da Vinci System installed base as of 9/30/15
2,344 United States, 586 Europe, 547 Rest of World

Numerous FDA and International Regulatory Clearances

Primary Markets - Urology, Gynecology, General Surgery,
Cardiothoracic
.

Recurring Revenue Model

Instruments &
Accessories

$700-$3,200
per procedure
2014 Rev $1,070M

Annual Service
Agreement
da Vinci Surgical System
$0.6M - $2.5M
2014 Rev = $633M

$100K - $170K/Year
2014 Rev = $429M

2014 Range of Pricing to Meet Multiple

Segments
2014: $1.5M

da Vinci Si-e
$0.6M

da Vinci Surgical System ASP

$2.5M

2014: $1,880

Single-Site
$700

Inst & Accy Rev Per Procedure

$3,200

2014: $140K

da Vinci Si-e
$100K

Annual Service Rev Per System

Typically Benign
Includes company estimates and approximate ranges

Dual Console Xi
Firefly

Endowrist
Vessel Sealer
Stapler

Dual Console Xi
$170K

Typically Cancer

da Vinci Ecosystem
Advanced Platforms

Imaging
Advanced
Instruments
Clinical Validation

Surgeon & Staff

Training
Technical
Support
Clinical Support

Data Analytics &

Genesis

Business Review

Q3 YTD 2015 Commentary

Areas of Strength
Procedure growth U.S. general surgery, U.S. mature
procedure patient trends, and international
Expanding da Vinci Xi market and platform

Japan Clearance End of Q1 15

Phase 2 instruments shipping Q2 15
Xi Table motion CE marked and FDA submission in Q2 15
Xi Single-Site FDA submissions Q3 15

Stapler
Increasing utilization in da Vinci procedures
30mm 510(k) submission Q3 15

Challenges
Gross margin pressure FX headwinds; new product costs

Annual Worldwide Procedures

2015 Guidance:
13-14% Growth

700,000
2014:
9% Growth

600,000
500,000
400,000
300,000
200,000
100,000
0
2009

2010

Urology
Company
Estimates
Company
estimates

2011
Gynecology

2012

2013

General Surgery

2014
Other

2015

U.S. Urology Procedures

100,000

90,000
80,000
70,000
60,000
50,000

40,000
30,000
20,000
10,000
0

2006

2007

2008

2009

Prostate

2010
Kidney

2011

2012*

Other

* U.S. Preventive Services Task Force Recommends Against PSA testing 5/2012
Company estimates

2013

2014

U.S. Gynecology Procedures

250,000
200,000
150,000
100,000
50,000
0
2009

2010

Benign Hysterectomy
Company estimates

2011

2012

2013

Malignant Hysterectomy

2014

Other

U.S. General Surgery Procedures

120,000
100,000
80,000
60,000
40,000
20,000
0
2009

2010

Upper GI / HPB
Company estimates

2011

2012

Lower GI / Colorectal

2013

Other

2014

International Performance
Approximately 121,000
procedures performed in
2014, up 20% from 2013;
Q3 YTD 2015 up 26%
Strength in Asia
procedures: China,
Japan, Korea

Significant investments
supporting long term
growth
Japan: Buildout of
direct sales structure,
efforts to obtain
additional
reimbursements
Europe: Clinical data
and analysis, sales
coverage

OUS Annual Procedures

140,000

120,000
100,000
80,000
60,000
40,000
20,000
0
2009

2010

Europe
Company
Estimates
Company
estimates

2011

2012

Asia

Rest of World

2013

2014

da Vinci Xi
Designed for multi-quadrant
surgical access
Narrower arms with greater
reach
Lighter, slimmer endoscopes
that can move between ports
Computer assisted, streamlined
set up
Compatible surgical simulator

Why Xi Matters
Despite my obvious interest in minimally
invasive surgery I had resisted adopting previous
da Vinci platforms because of what I felt were
limitations. The da Vinci Xi platform is a game
changer for me. I now feel that this technology
will not just equal my standard laparoscopic
abilities but actually will allow me to reach new
levels in providing surgical care to my patients.
B. Harkins, MD, FACS General Surgeon, Texas

System Placement Trend

160
140
120
100
80
60
40
20
0

Q1

Q2

Q3

Q4

Q1

2014
U.S.

Q2
2015

Europe

Japan

Rest-of-World

Q3

System Mix Trend

100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Q114

Q214

Q314
S / Sie

Q414
Si

Q115
Xi

Q215

Q315

Installs by Country and Region

da Vinci System Installed Base

Europe

Canada
25

586
Direct
France 90
Germany 77
UK 55
Belgium 34
Switzerland 28
Sweden 26
Netherlands 21

USA
2,344

Denmark 18
Norway 11
Czech Republic 7
Austria 7
Finland 5
Ireland 3
Other 3

Distribution
Italy 84
Turkey 34
Spain 31
Russia 25
Greece 9
Romania 7
Other 11

Asia
398

Middle
East
36
Brazil 16
Mexico 7
Argentina 6
Chile 5
Venezuela 5
Other 8

Latin
America
47

Saudi Arabia 14
Israel 7
Qatar 6
Other 9

South Africa 4

Intuitive sells directly to customers in the US, Korea, Japan, and the European countries indicated
above. Sales are through distributor partners in all other areas of the world including, Canada, Latin
America, the Middle East, Asia and Australia.

Japan 215
South Korea 53
China 46
India 35
Taiwan 27
Singapore 7
Thailand 6
Other 9

Australia/
New Zealand
37

Trended da Vinci System Installed

Base
3,500
3,000

United States
International

2,500
2,000
1,500
1,000
500
0
Q310

Q311

Q312

Q313

Q314

Q315

Opportunities and Catalysts for

Growth

Open Surgery Remains Common U.S.

Yr: 2004
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Prostate

Malignant
Hyst

Benign Hyst

Robotic
Source: ISI data as well as estimates

Other MIS

Open

Open Surgery Remains Common U.S.

Yr: 2014
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Prostate

Malignant
Hyst

Benign Hyst

Robotic
Source: ISI Data as well as Estimates

Other MIS

Open

Open Surgery Remains Common U.S.

Yr: 2014
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Prostate

Malignant
Hyst

Benign Hyst

Robotic
Source: ISI data as well as estimates

Colorectal

Other MIS

Open

Ventral
Hernia

Thoracic

Open Surgery Remains Common OUS

Yr: 2014
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Prostate

Malignant
Hyst
Other MIS

Colorectal
Robotic

Gastrectomy
Open

Source: ISI data as well as estimates. OUS defined as Western Europe, Canada, Australia, South Korea and Japan

Thoracic

Total Procedure Markets

We estimate 2 4 million procedures available
for products on the market today in countries
for which we have clearances
Over time, opportunity OUS will be greater
than U.S.
Roughly half of opportunity based on
underlying cancer as cause

Clinical and Economic Validation

Overview of the Database
To date, there are approximately 9,500 peer-reviewed clinical
publications studying da Vinci use
Approximately 99% of these studies are independent of ISI
Of these, approximately 1,400 are comparative studies
In 2014, 1,600 new studies were published, of which ~400
were comparative
There are now approximately 25 government sponsored
assessments of da Vinci surgery spanning ~14 countries

Populations Matter
(e.g., Rectal Resection)

Which is the right

comparison?

Market Share %

Open Surgery

da Vinci LAR
Laparoscopy

}
}

Patient Perspective
Open vs MIS
MIS Surgeon Perspective
dV vs Lap

Areas of Investment in Clinical and

Economic Analyses
U.S. Hernia registry, Gynecologic Oncology
registry
Japan Urology and General Surgery
Germany Urology and General Surgery
U.K. Colorectal registry
France Colorectal registry
Numerous economic studies

ISI Investments to Improve Surgery

Advanced imaging (e.g., Firefly Fluorescence
Imaging)
Computer-enhanced precision at tissue (e.g.,
Smart-clamp for stapling)
Less invasive access (e.g., single-port and
natural orifice surgery)
Training technologies (e.g., simulation, dualconsole, setup assist)

Product Milestones
Continue da Vinci Xi Launch:

Xi Vessel Sealer launched Q2 14

Xi Firefly launched Q3 14
Clearance in Korea Q4 14
45mm Xi Stapler launched Q1 15
Clearance in Japan end of Q1 15
Xi Table motion CE Marked and 510(k)
submitted in Q2 15
Xi Single-Site 510(k) submitted Q3 15
30mm Xi Stapler 510(k) submitted Q3 15

Single-Site wristed needle driver for Si

launched Q4 14

Integration of da Vinci Sp
Current Xi Configuration

Deliver technical milestones in 2015 10 Prototypes built

Clinical evaluations Transoral and Transabdominal emphasis

Integration of da Vinci Sp
Xi with Sp Patient Cart and Instruments

Deliver technical milestones in 2015 10 Prototypes built

Clinical evaluations Transoral and Transabdominal emphasis

2015 Priorities and

Corporate Assets

2015 Priorities
Expanding the application of da Vinci in general
surgery, particularly colorectal surgery and hernia
repair
Filling out our product line for da Vinci Xi and
launching in key markets globally
Developing our organizational capabilities and
markets in Europe and Asia
Advancing our technologies to improve surgery
Lowering our direct product costs

Corporate Assets
Extraordinary people

3,477 da Vinci System installed base 9/30/15

Numerous FDA and international regulatory clearances
Extensive instrument and accessory product line

Intuitive Surgical training centers worldwide

Ownership of or exclusive rights to over 1,900 U.S. and
foreign patents and more than 1,500 US and foreign
patent applications
da Vinci patient awareness