ISRG beat cleanly in Q1. Revenue reached $2.77B, up 23.0% YoY, led by instruments/accessories at $1.69B and systems at $651M. Worldwide da Vinci procedure growth of 16% decelerated from Q4 but remained above the 13-15% FY2026 guide. The stock debate shifts from whether Q1 would beat to whether procedure growth can reaccelerate as da Vinci 5 expands globally.

Key Metrics Trends

Metric	Q1 2024	Q2 2024	Q3 2024	Q4 2024	Q1 2025	Q2 2025	Q3 2025	Q4 2025	Q1 2026
Da Vinci procedure growth	16.0%	17.0%	18.0%	18.0%	17.0%	17.0%	20.0%	18.0%	16.0%
Instruments and accessories revenue	$1.2B	$1.2B	$1.3B	$1.4B	$1.4B	$1.5B	$1.5B	$1.7B	$1.7B
Instruments and accessories revenue YoY %	-	-	-	-	+18.0%	+18.5%	+20.1%	+17.5%	+23.3%
Systems revenue	$418M	$448M	$445M	$655M	$523M	$575M	$590M	$786M	$651M
Systems revenue YoY %	-	-	-	-	+25.0%	+28.2%	+32.7%	+20.1%	+24.5%
Services revenue	$314M	$317M	$329M	$347M	$363M	$391M	$396M	$422M	$434M
Services revenue YoY %	-	-	-	-	+15.8%	+23.3%	+20.4%	+21.5%	+19.5%
Total revenue	$1.9B	$2.0B	$2.0B	$2.4B	$2.3B	$2.4B	$2.5B	$2.9B	$2.8B
Total revenue YoY %	-	-	-	-	+19.2%	+21.4%	+22.9%	+18.8%	+23.0%

Revenue remains strongly accelerating on a YoY basis, but the most important operating KPI, da Vinci procedure growth, moved from 18% in Q4 to 16% in Q1. That is still above guidance, but the trajectory is less clean than revenue alone suggests.

Beat/Miss

Guidance

Catalysts

Street Q&A

Contradictions

Read-Throughs

This Quarter vs Consensus

Metric	Consensus	Actual	Variance	Beat/Miss
Revenue	$2.61B	$2.77B	+$161M / +6.2%	Beat
Non-GAAP EPS	$2.08	$2.50	+$0.42 / +20.2%	Beat
da Vinci procedure growth	13-15% FY guide context	16%	Above range, but down from 18%	Beat vs guide
Systems revenue	n/a	$651M	+24.5% YoY	Strong

Pattern: ISRG continues to beat consensus, but the quality of beat depends on procedure growth. Q1 was good, not perfect: revenue and EPS beat, while procedure growth decelerated sequentially.

Guidance Deep Dive

Metric	Prior / Consensus	New / Actual	Signal
FY da Vinci procedures	13-15% growth guide	Q1 actual 16%	Guide still looks conservative
Gross margin tariff impact	Tariffs expected to pressure gross margin	Daloopa document search confirms tariff disclosure in Q1 materials	Watch whether offsets improve through 2026
Revenue mix	Recurring revenue expected to compound	I&A +23.3% YoY and services +19.5% YoY	Recurring model remains intact

Management tone remains confident, but the key controversy is growth durability. Q1 did not contradict the long-term thesis, but the procedure deceleration gives the street a legitimate follow-up question. Source: ISRG 8-K 2026Q1.

Upcoming Catalysts

Catalyst	Timing	Consensus / Watch	Implication
da Vinci 5 global ramp	2026	Placements and trade-ins outside the U.S.	Determines whether systems revenue growth remains elevated
Procedure growth reacceleration	Q2-Q4 2026	Can growth move back toward 18-20%?	Most important thesis variable
Tariff mitigation	2026	Gross margin recovery path	Could swing EPS revisions
Ion adoption	2026	Procedure and revenue growth	Second-platform optionality beyond da Vinci

Street Q&A

Question	Management response	Assessment
Why did procedures decelerate from Q4?	Management framed growth as still above the annual guide and supported by broad procedure adoption.	Partly answered
Can da Vinci 5 sustain system placements?	Management continues to point to broad launch and trade-in demand.	Well answered
How large is the tariff drag?	Q1 materials identify tariff impact as a gross margin headwind.	Needs continued tracking

Contradictions

Indirect Read-Throughs

Theme	Commentary	Read-through
Hospital capital	Systems revenue remained strong despite capital budget concerns.	Positive read-through for high-ROI medtech capital equipment.
Procedure volumes	Procedure growth stayed above guide but slowed sequentially.	Mixed read-through for elective-procedure-exposed medtech.
Tariffs	Tariff disclosures remain a margin concern.	Relevant to device companies with global supply chains.

Data sourced from Daloopa. Document search is currently in beta; transcript and filing snippets may vary.