Intuitive Surgical is facing a tougher race for robotic surgery, even as its da Vinci platform still dominates the field and its latest numbers remain strong. The company, whose stock has fallen more than 17% so far this year, is trying to convince investors that the next leg of growth will come from more procedures, more upgraded systems and the pull of its installed base of more than 12,100 machines worldwide.
That base matters because 81% of Intuitive Surgical’s revenue comes from recurring sales of instruments, accessories and services, a model that keeps bringing in money long after a system is placed in a hospital. Last year, the company reported revenue of $10.1 billion, up 21%, and earnings per share of $7.87, up 22.5%, while the da Vinci Xi, the most widely used multiport robotic surgery system in the world, was used in more than 3 million surgical procedures.
The company’s recent history helps explain why the market has paid so much attention to the stock. Over the past decade, annual revenue rose 272% and annual earnings per share increased 278%, a stretch of expansion that made Intuitive Surgical the dominant manufacturer of robotic surgical systems. But the competitive field is no longer empty. Johnson & Johnson and Medtronic have expanded into robotic surgery, and Restore Robotics has received Food and Drug Administration clearances for four alternative da Vinci-compatible tools.
That pressure makes the next phase of the business more important than the last. Intuitive said it expects worldwide da Vinci procedure growth of 13% to 15% in 2026 and guided for a gross profit margin of 67% to 68% of revenue, after posting a 67.6% margin in 2025. The company also spent $1.3 billion on research and development last year, underscoring how much it is leaning on product development to keep its lead.
The newest system at the center of that push is the da Vinci 5, which features force feedback technology and, the company says, reduces the force applied by up to 43%. In the fourth quarter, 303 of the 532 systems placed in medical settings were da Vinci 5 models, a sign that the rollout is quickly becoming a major part of Intuitive’s story for 2026.
Intuitive says most surgeons using robotics today were trained on the da Vinci platform during residency or fellowship, and hospitals are often reluctant to disrupt established surgical workflows. That gives the company a built-in advantage, but it does not erase the fact that rivals are now in the market and that investors have already marked the shares down sharply. The question for isrg stock is whether the da Vinci 5 and the company’s recurring revenue engine can keep growth ahead of the new competition.
