✦ Single Port, and the Operations That Do Not Exist YetThin moat
Intuitive Surgical (ISRG) — the future bets
377 systems opening procedures where the alternative is a larger incision rather than a better laparoscope.
Da Vinci SP is the platform for procedures that a multi-arm system cannot reach. A single arm delivers three multi-jointed instruments and a fully articulating 3DHD endoscope through one cannula, triangulating around the target anatomy to avoid the instrument collisions that occur in narrow spaces1.
Intuitive is candid about how early it is: "We are in the early stages of launching our da Vinci SP surgical system", with an installed base of 377 systems at the end of 20252. FDA clearance covers urologic, colorectal, general thoracoscopic and certain transoral procedures. South Korea has cleared a broad set, Japan the same set as da Vinci Xi, and European certification under the EU MDR came in January 2024 for endoscopic abdominopelvic, thoracoscopic, transoral otolaryngology, transanal colorectal and breast procedures — commercialised "as part of a measured rollout strategy". Taiwan followed in August 2024.
The strategic value is that single-port access opens procedures that were previously open surgery, rather than converting procedures laparoscopy already does well. Transoral, transanal and breast surgery are not categories where a cheap incumbent technique is waiting; they are categories where the alternative is a larger incision.
That is the opposite of the problem described elsewhere in this file, where growth is concentrating in cholecystectomy and hernia repair against strong laparoscopic incumbents. SP, if it works, adds procedures rather than contesting them.
The constraint is regulatory and clinical, and Intuitive says so: success "is dependent on positive experiences and improved clinical outcomes for the procedures for which it has been cleared as well as securing additional clinical clearances". It plans to seek further FDA indications and to expand approvals in other markets over time.
Count SP systems: 377 at the end of 2025. Against 11,106 da Vinci systems in total, this is a bet at the level of a rounding error that could become a franchise.
377 SP systems installed and new indications opening, from a base of essentially nothing five years ago. Small, and growing off a small number.
Small, and growing off a base of almost nothing. SP matters because it opens procedures where the alternative is a larger incision rather than a better laparoscope — the one place the clinical argument is unambiguous.
Source: Intuitive Surgical Form 10-K, fiscal year ended December 31, 2025 ↗- ReportedA single arm delivers three multi-jointed instruments and a fully articulating 3DHD endoscope through one cannula, triangulating around the target anatomy to avoid the instrument collisions that occur in narrow spaces.Intuitive Surgical Form 10-K, fiscal year ended December 31, 2025 - Item 1 Business (the da Vinci and Ion platforms, instruments with a use count enforced in the instrument itself, training pathways and SimNow, enabling technologies, manufacturing sites, employees by function, and the seasonality of benign procedures) — FY2025 · publ. February 3, 2026 · source ↗
- ReportedIntuitive is candid about how early it is: "We are in the early stages of launching our da Vinci SP surgical system", with an installed base of 377 systems at the end of 2025.Intuitive Surgical Form 10-K, fiscal year ended December 31, 2025 - Item 7 MD&A, business and operating highlights (3,153,000 da Vinci procedures up 18%, 1,721 placements, an installed base of 11,106, utilisation up about 3%, 870 da Vinci 5 placements, Ion procedures and placements, procedures by region and category, and revenue denominated in foreign currencies) — FY2025 · publ. February 3, 2026 · source ↗