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Can ISRG Offset China Weakness With Expansion in India and Japan?
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Key Takeaways
ISRG faces China pressure from weak tenders, domestic competition and pricing, with just two systems placed.
ISRG gained da Vinci 5 clearance in India, supporting demand across a broad range of procedures.
ISRG placed 25 systems in Japan versus 15 a year ago as new reimbursement policies supported robotic use.
Intuitive Surgical’s (ISRG - Free Report) geographical growth story is becoming increasingly diversified, with strong momentum in India and improving conditions in Japan helping counterbalance challenges in China. In the second quarter, international da Vinci procedures increased 20%, while Europe and Asia delivered 20% growth each.
China remains the primary regional headwind for ISRG. Management cited lower tender activity, increased domestic robotic competition and policy-driven pricing pressure, alongside changes in charge codes and the 15th Five-Year Plan quota process. System placements were particularly weak, with only two da Vinci systems placed in China during the quarter. Da Vinci 5 is yet to receive clearance in mainland China.
India, meanwhile, is emerging as an important growth market. Management described another strong quarter, with momentum across a broad range of procedures. The clearance of da Vinci 5 in India during the quarter should expand Intuitive Surgical’s ability to address demand with its latest-generation platform. International procedure growth also highlighted India as one of the markets delivering strong results.
Japan offers another potential growth avenue. Policies effective June 1 expanded reimbursement to additional robotic procedures and introduced economic incentives for higher utilization. Intuitive Surgical placed 25 systems in Japan versus 15 a year earlier, while management said recent reimbursement decisions were encouraging. However, adoption is expected to progress gradually, given training requirements and ongoing financial challenges.
China remains a meaningful uncertainty, but India, Japan and other international markets provide diversification. Intuitive Surgical maintained its 2026 da Vinci procedure growth outlook of 13.5-15.5%, with international procedures outside urology among its primary growth drivers.
Peer Updates
Boston Scientific (BSX - Free Report) is broadening its Asian growth base. Unlike ISRG, China remains a key international market for Boston Scientific. Asia-Pacific revenues increased 11% operationally, led by double-digit growth in Japan, China and Korea, with Interventional Cardiology, Electrophysiology and WATCHMAN driving regional performance.
International EP sales increased 23%, and management expects approximately 20% international EP growth for full-year 2026, providing an important growth avenue outside any single market. Japan represents a clearly identified diversification opportunity within Asia for Boston Scientific.
Medtronic (MDT - Free Report) is also expanding in Asia, primarily through Japan. International revenues grew 12%, supported by several businesses delivering double-digit international growth. Within Cardiac Ablation Solutions, Medtronic management highlighted geographic expansion, noting that Sphere-9 was launching in Japan, alongside continued ecosystem development across mapping, ICE technology and ablation. Medtronic is also expanding its international robotics portfolio through a strategic investment and distribution agreement for Cornerstone’s Sentire Surgical System in select markets outside the United States.
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Can ISRG Offset China Weakness With Expansion in India and Japan?
Key Takeaways
Intuitive Surgical’s (ISRG - Free Report) geographical growth story is becoming increasingly diversified, with strong momentum in India and improving conditions in Japan helping counterbalance challenges in China. In the second quarter, international da Vinci procedures increased 20%, while Europe and Asia delivered 20% growth each.
China remains the primary regional headwind for ISRG. Management cited lower tender activity, increased domestic robotic competition and policy-driven pricing pressure, alongside changes in charge codes and the 15th Five-Year Plan quota process. System placements were particularly weak, with only two da Vinci systems placed in China during the quarter. Da Vinci 5 is yet to receive clearance in mainland China.
India, meanwhile, is emerging as an important growth market. Management described another strong quarter, with momentum across a broad range of procedures. The clearance of da Vinci 5 in India during the quarter should expand Intuitive Surgical’s ability to address demand with its latest-generation platform. International procedure growth also highlighted India as one of the markets delivering strong results.
Japan offers another potential growth avenue. Policies effective June 1 expanded reimbursement to additional robotic procedures and introduced economic incentives for higher utilization. Intuitive Surgical placed 25 systems in Japan versus 15 a year earlier, while management said recent reimbursement decisions were encouraging. However, adoption is expected to progress gradually, given training requirements and ongoing financial challenges.
China remains a meaningful uncertainty, but India, Japan and other international markets provide diversification. Intuitive Surgical maintained its 2026 da Vinci procedure growth outlook of 13.5-15.5%, with international procedures outside urology among its primary growth drivers.
Peer Updates
Boston Scientific (BSX - Free Report) is broadening its Asian growth base. Unlike ISRG, China remains a key international market for Boston Scientific. Asia-Pacific revenues increased 11% operationally, led by double-digit growth in Japan, China and Korea, with Interventional Cardiology, Electrophysiology and WATCHMAN driving regional performance.
International EP sales increased 23%, and management expects approximately 20% international EP growth for full-year 2026, providing an important growth avenue outside any single market. Japan represents a clearly identified diversification opportunity within Asia for Boston Scientific.
Medtronic (MDT - Free Report) is also expanding in Asia, primarily through Japan. International revenues grew 12%, supported by several businesses delivering double-digit international growth. Within Cardiac Ablation Solutions, Medtronic management highlighted geographic expansion, noting that Sphere-9 was launching in Japan, alongside continued ecosystem development across mapping, ICE technology and ablation. Medtronic is also expanding its international robotics portfolio through a strategic investment and distribution agreement for Cornerstone’s Sentire Surgical System in select markets outside the United States.