Intuitive’s da Vinci procedure growth slowed to about 10% in the U.S. in the third quarter, the company’s slowest reported U.S. growth rate since the COVID-19 pandemic. The slowdown came as Intuitive continued to place more surgical systems while looking for additional ways to increase their use. Worldwide da Vinci procedures grew approximately 14% during the quarter. Intuitive reported third-quarter revenue of $3.05 billion, up 22% from $2.51 billion a year earlier. The company placed 546 da Vinci surgical systems, compared with 427 in the same period of 2025. The company’s third-quarter results provide the financial and operating figures.
Da Vinci Procedure Growth Slows in U.S.
The latest figures show a softer U.S. market even as Intuitive continues to expand its installed base. Wells Fargo analyst Larry Biegelsen asked Intuitive CEO David Rosa whether the slower U.S. growth represented a temporary lull. Rosa described two opportunities for the company. One is increasing da Vinci use in procedures where the system is already established. The other is expanding robotic surgery into additional indications. Rosa identified benign general surgery as a particularly important opportunity. Hospitals and surgeons want to compare robotic surgery with established alternatives, including laparoscopy and open surgery, before expanding their use of the technology. Intuitive customers are developing clinical and economic dashboards to compare robotic surgery with other techniques.
Rosa said those comparisons favour robotics and support his view that the foundations for continued U.S. procedure growth remain in place. The comments suggest that Intuitive sees additional room to expand the market rather than relying only on existing procedure categories.
Benign surgery becomes a growth focus.
Intuitive is looking for additional procedure categories where robotic surgery can gain adoption. Benign general surgery includes procedures commonly performed with laparoscopic or open techniques. Convincing hospitals to change established workflows requires evidence that robotic surgery delivers enough clinical and economic value to justify the added investment. The company is working with customers to evaluate how robotic surgery compares with conventional approaches. Expanding use within existing hospitals could increase procedure volume without requiring a new robotic system for every additional case. That strategy could become more important if da Vinci procedure growth remains below the rates seen in previous periods. Intuitive still sees substantial room to expand, but increasing utilisation will be important alongside new system placements.
Intuitive’s latest filing shows U.S. da Vinci procedures rose 10% in the third quarter, from about 507,000 procedures a year earlier to about 559,000. Outside the U.S., procedures increased 20%, from approximately 290,000 to 347,000. The quarterly filing provides the regional procedure figures.
Pricing changes target adoption.n
Intuitive is changing its pricing structure for instruments and accessories to encourage broader use of robotic surgery. The company expects da Vinci instrument and accessory revenue to fall by 3% to 5% per procedure once the pricing changes are fully implemented. CFO Jamie Samath described the changes as a deliberate choice to broaden adoption in high-volume benign procedures where cost can be a barrier. The strategy involves accepting lower revenue per procedure in selected areas in exchange for the possibility of higher procedure volume over time. Samath said the biggest opportunities lie in procedures outside the United States and cases performed in ambulatory settings. Intuitive believes broader adoption can create more long-term value than maximising revenue from each procedure. The pricing changes are therefore part of a broader effort to increase procedure volume and support future growth in da Vinci procedures.
System placements remain strong.ng
Slower U.S. procedure growth has not been matched by weaker demand for Intuitive’s robotic systems. Intuitive placed 546 da Vinci systems in the third quarter, up from 427 in the same quarter of 2025. The placements included 315 da Vinci 5 systems, compared with 240 a year earlier. Intuitive also placed 56 Ion systems, up from 50 in the third quarter of 2025. The company’s da Vinci installed base reached 12,094 systems at the end of September, up from approximately 10,763 systems a year earlier. The U.S. accounted for 335 of the da Vinci placements during the quarter. Europe accounted for 115, Asia for 78 and other markets for 18 placements. The growing installed base gives Intuitive more capacity for future expansion. Higher use of systems already installed at hospitals can also increase recurring demand for instruments and accessories.
Revenue continues to rise.
The slowdown in procedure volume has not stopped Intuitive’s overall financial expansion. Third-quarter revenue reached $3.05 billion, up 22% from the same quarter last year. Instruments and accessories revenue increased 18% to $1.80 billion, while systems revenue increased 30% to $769 million.GAAP net income attributable to Intuitive Surgical was $523 million, compared with $704 million in the third quarter of 2025. The decline included a $450 million pretax charge related to the settlement of previously disclosed antitrust class-action litigation. Intuitive said it settled without admitting liability or wrongdoing. The settlement remains subject to preliminary and final court approval. The financial results show two different trends. Revenue and system placements continued to grow, while the pace of U.S. procedure growth became a more visible concern.
2026 outlook remains intact
Intuitive maintained its full-year expectation for worldwide da Vinci procedure growth of approximately 14% to 15% in 2026. The company previously expected growth of 13.5% to 15.5%. The new range is narrower, but Intuitive expects to be closer to its midpoint. The outlook indicates that the company still expects strong global procedure volume, even with slower growth in the United States. The difference between domestic and international performance remains important. International procedures grew at twice the U.S. rate during the third quarter. Improving da Vinci procedure growth in the United States will depend on increasing utilisation, expanding into additional procedures and addressing cost concerns in selected areas.
Intuitive looks to expand utilisation
The installed base remains one of Intuitive’s biggest advantages. Every additional da Vinci system gives hospitals and surgical centres more capacity to perform robotic procedures. Higher utilisation can increase procedure volume without requiring a new system for every additional case.
This makes benign general surgery particularly important to the company’s strategy. Intuitive is looking at procedures where robotic surgery can demonstrate value against established approaches. The company’s strategy also extends beyond system placements. Increasing the number of procedures performed on existing systems could provide a more direct path to higher recurring revenue from instruments and accessories. Intuitive is also developing software and AI capabilities around its robotic surgery platform. TechAmerica.ai previously examined the company’s broader AI strategy and its work to bring AI into medical equipment. Those developments are part of Intuitive’s longer-term technology strategy, while the current U.S. challenge is centred on procedure adoption and utilisation.
U.S. growth remains the key test
The latest results do not indicate a collapse in demand for Intuitive’s robotic surgery systems. Revenue increased, system placements rose, and the da Vinci installed base continued to expand. The main concern is the pace of da Vinci procedure growth in the U.S., which reached approximately 10% during the third quarter. Intuitive’s response is focused on expanding robotic surgery into additional procedures, demonstrating its value against established approaches and reducing cost barriers in selected high-volume procedures. The company is also benefiting from stronger international growth. Procedures outside the U.S. increased approximately 20% during the quarter, compared with approximately 10% in the U.S.Whether these measures can improve U.S. performance will become clearer over the next several quarters.
For now, Intuitive remains a growing robotic surgery company, but maintaining adoption momentum in its largest market is becoming a bigger challenge. The MedTech Dive report highlighted the U.S. slowdown, analyst commentary and Intuitive’s response during the company’s third-quarter results discussion.
