Intuitive Surgical Falls After Modest 2026 Procedure Outlook

Intuitive Surgical reported stronger-than-expected second-quarter results but its 2026 procedure forecast weighed on the stock. Shares fell about 12% in premarket trading after management projected da Vinci procedure growth of 13.5% to 15.5% for fiscal 2026 and said growth will likely be near the midpoint of 14.5%.

For the quarter ended June 30, the company reported adjusted earnings of $2.80 per share and revenue of $2.89 billion, above analyst estimates of $2.51 and $2.82 billion, respectively. Revenue rose 19% year over year, led by higher sales of instruments and accessories and increased system placements.

Procedures using the company’s da Vinci and Ion platforms grew about 16% in the quarter. Da Vinci procedures increased roughly 15%, while procedures using the Ion endoluminal system rose about 36%.

Intuitive placed 468 da Vinci systems during the quarter, up from 395 a year earlier. The figure included 246 installations of the da Vinci 5 platform. As of June 30, the global da Vinci installed base stood at 11,710 systems, a 12% increase from a year earlier, and the Ion installed base rose 21% to 1,096 units.

Revenue from instruments and accessories climbed 18% to $1.73 billion. Systems revenue rose to $685 million from $575 million a year earlier. The quarter’s results included a one-time tariff-related refund that added $28 million after tax, or about $0.08 per share, to net income.

For fiscal 2026, Intuitive projected adjusted gross margins of 68% to 69% of revenue, up from prior guidance of 67.5% to 68.5% and incorporating an estimated one percentage-point drag from tariffs. The company also forecast adjusted operating expense growth of 11% to 13%.

Investors and analysts focused on the company’s multi-year procedure outlook given its premium valuation and history of double-digit procedure growth. Intuitive’s shares have fallen about 29% year to date amid concerns about slowing growth, increased competition in robotic surgery and valuation pressure.

TD Cowen lowered its price target to $520 from $585 while maintaining a Buy rating, citing competitive pressures, remanufactured instruments and international challenges. Stifel reiterated a Buy rating with a $670 price target after surveying 100 robotic surgeons, which the firm said reflected continued confidence in the company’s technology and recent da Vinci 5 upgrades. Across 35 analysts covering the stock, 24 recommend buying, 10 rate it a hold and one recommends selling. The average price target has eased to about $521, with individual targets ranging from $366 to $750.

The results follow a warning from a large hospital operator about softer surgical demand and an increase in uninsured patients after the expiration of pandemic-era Affordable Care Act subsidies, a factor market participants flagged as a nearer-term headwind for procedure volumes.

Intuitive’s da Vinci platform remains the market leader in robotic-assisted surgery. The company has expanded its product lineup with the Ion endoluminal system and continues to roll out da Vinci 5 upgrades as competitors enter the market.