⚠ Trade-Ins Are Running OutLow threat

Part of every year's placement number is an existing customer swapping an old machine for a new one, and Intuitive says that source is thinning.

Among the factors it expects to affect future placements, the 10-Q lists "capital replacement trends, including a declining number of older generation systems available for trade-in transactions"¹. The da Vinci Si is a third-generation system launched in 2009; the fleet still running one is finite and shrinking, and each conversion removes a future conversion.

The accounting reflects it in the average selling price. Intuitive's 2025 ASP of approximately $1.60 million was "largely driven by favorable product mix, including from da Vinci 5 sales, partially offset by higher pricing discounts and more trade-ins"² — trade-ins depress ASP because the old machine is credited against the new one.

There is a more useful way to read the same fact. If replacement demand is being consumed, then the placements that remain have to come from new programmes and from capacity additions at existing customers — both of which depend on procedure volume growing, which returns to the demand question that dominates this company's 2026.

The offsetting consideration is that a da Vinci 5 fleet will itself need replacing, and the installed base is far larger now than it was at the last transition: 11,710 systems at mid-2026 against roughly 5,000 a decade ago.

The number is placements excluding trade-ins, which Intuitive does not break out. The proxy is the ASP: a rise driven by mix with fewer trade-ins is healthy; a rise driven only by scarcity of trade-ins would mean the replacement wave has passed.