Thanks, Robbie, and delighted to be here today and to represent the good work of the team at Intuitive. I'll start with our forward-looking statement. We will make some forward-looking comments here. I encourage all of you to look at our SEC filings on the investor page of our Intuitive website. I want to start by stepping back and just sharing with you some examples of what motivate us. These are just three examples of many, and I don't want you to take any specific meaning about the three that I chose. But we view ourselves as a solutions provider in healthcare. And just to give you some statistics directionally, lung cancer, largest cancer killer in the United States. The time to definitive detection and assessment of a lung tumor is about a year later than you could have found it if you were looking.
So if you went out looking, you should find these things a year before you do in the most deadly of the cancers we have. I think that's nuts. I think that's crazy. Turn to gynecologic health. Women will suffer with the symptoms of endometriosis for typically greater than five years before it's definitively defined and even longer before it's definitively treated. I find that offensive. I think it's nuts. For mitral valve surgery, for those undergoing mitral valve surgery in the US, roughly 67 % will die the year after that surgery. I think that's crazy. These are just three examples of many, and we're a company that tries to build platforms that help providers and physicians identify things earlier and treat them definitively and allow patients to go on with their lives. That's what we're about, so you've seen our mission.
We think minimally invasive care really matters, and you see our vision, which is those things on that prior slide are unacceptable, and we think we can do something about it, and it's hard and it takes a long time, but we are fully committed. We measure ourselves carefully with metrics that are defined by our customers. Of course, we have internal metrics, but I think the ones that matter most are doing validations and being serious scientists about the things that our customers care about. They have defined it as the quintuple aim, and we're diligent. We want to demonstrate better outcomes in ways that can be validated and peer-reviewed. We want to create better experiences for the patient. We want to have the care teams who use our technology-enabled ecosystems, our platforms, to have better experiences than they have prior.
We think we can lower the total cost to treat per patient episode, and there is ample evidence that that is true, and we want to advance health equity, and I'm going to touch on that a little bit in this talk around access, and we're starting to do that. We're starting to see that, so the quintuple aim is our North Star, as defined by our customers, and we pursue it. Just a quick touch on how we did, kind of where are we in the numbers, so Intuitive by the numbers, about 2.7 million procedures performed by our customers using our systems, our da Vinci systems in the year, about 95,000, almost 100,000 lung biopsies using our flexible robotics platform ION. It was a good capital year with nearly 1,800 systems placed. You can see the splits between multi-port or single-port platform and ION.
Total procedures to date, approaching 17 million for our platforms as a whole. That's bigger than we were and smaller than we will be. Total install base now of our systems or our options, almost 11,000. Peer-reviewed articles are about 4,000 published in 2024, and the database is now over 43,000, so it's large. Just touching on what happened last year, I think this is a good habit for us. Here's what we set out to achieve. We wanted to launch da Vinci 5 and bring it to the market along with some other new clearances in other countries for our other platforms. We want to continue to focus on the successful adoption of our technologies and procedures that matter around the world. We want to focus on quality and our gross margin. We'll tell you more about that at our earnings call.
We want to increase productivity in our SG&A and enabling function areas to make good use of our capital and free some capital to reinvest going forward. Every year has its challenges, and 2024 was no different. Environmental uncertainty and total economics in China remain stressed. They have been all year. GLP-1 impact on total bariatric surgery was a headwind in the year. We made gains relative to other forms of surgery, but surgery as a whole has been deprioritized. We can talk about that in the Q&A. The capital environment in Europe is stressed. It kind of varies as to the reasons why by country. In the UK, there are government policies around deployment of capital that have stressed it. In Germany, there's a change in the healthcare system, but overall, it's been stressed.
In Korea, there's been a large young doctors' strike that's been ongoing for give or take a year that has removed 15%-20% of the workforce from large hospitals, created a real headwind for us, although the team has responded well in the face of that headwind. We've had some areas of strength too. US General Surgery was strong for us. We're pleased with the early launch of da Vinci 5 and customer acceptance thereof. US Capital Performance as a result was strong for us in terms of placements. Ion and SP continued to have strong growth, and I'll share that with you in a minute. Some of our focus on efficiencies is resulting in nice financial performance. We think procedures are a great leading indicator of the acceptance of our products and platforms.
We came in at the high end of the range we thought at the beginning of the year. You can see what the breakouts are in terms of general surgery, urology, gynecology, and other. I'll break out kind of the growth drivers in a minute. Capital trend. On the left side, you see system placements by year. The dark bar is capacity expansion, and the light blue are trade-ins. And you can see that we're at the end of a trade-in cycle because we were coming out with DV5, and you started the beginning of a trade-in cycle with DV5 in 2024. Generally speaking, we're pleased here. Installed-base growth of 15%, procedure growth of 17%, utilization growth of 2%. It's just math. That was good. Good in a capital launch year. Those things pulled together along with good financial performance has driven the revenue for the year at 17% growth.
Dark bar is recurring revenue, a combination of things that are consumed by procedure, services, and leasing, usage-based arrangement. And you see that it's grown to be about 80%. So recurring revenue is about 84% of the business. Starting to stabilize there a little bit. You can ask Jamie a question about that in the Q&A. In terms of growth drivers, I think I'm a big believer in beware of averages. There's no average customer, and there's no average segment. So as we dig in and look at the data, the things that have been driving up the averages are growth beyond urology in the da Vinci business outside the United States. And that's been good for us. We thought it would diversify beyond urology. It has gynecology, thoracic surgery, some places general surgery. So I think that's a positive sign.
General surgery continues to grow off now a large base, and that's been strong for us. Other procedures that are more mature continue to grow at about 11%. Just talking about how we size the business, what we think about. This is what we presented to you in 2024. That 21 million are all surgeries, not just robotic-assisted surgery, in the types of surgeries that we support in the markets that we participate in. So that's the big number. The light bubble, 7 million, that's our belief of what we can capture with the products we have in the market today, in the markets, in the clearances that we have in which we participate. Roll forward a year, and we think those got a little bit bigger. Most of that is demographic shift. As the populations in the countries we serve age, we see growth in end-user markets.
Some of it is some of the optimizations that we're doing with regard to product design, product cost, value engineering that gives us some opportunity. You've seen growth of both of those. To date, we have not put our Ion numbers in this chart. We'll start to show you some of them today. Ion, flexible robotics, we have a single indication for now. That is lung biopsy. We think that where we are today, that adds about 700,000 procedures into the available opportunity. As you look a little further out, it adds about 1.5 million. That's Ion with today's indication. In the future, we'll add additional indications, and when we do, we'll talk to you more about it. I like to share this chart because I think it's a way to think about existing customers, Integrated Delivery Networks.
Those folks who already own our systems, do they continue to invest with us? I think it's an important thing. So what you see in the left chart is how many hospital systems, IDNs, so this is a count of IDNs, own 20 or more da Vincis as a way of saying, okay, they've committed to this as a technology they care about. That's grown 16% year over year. And then the next one over at 63% growth is the number of individual buildings, individual hospitals. You walk in and that hospital has seven or more da Vincis. So you have to walk to OR 8 before you find an OR without a da Vinci system in it. And that grew 63%. So why do I share this with you?
I shared earlier that there's a lot of peer-reviewed literature out there, but peer-reviewed literature is never homogeneous and can be hard to understand. I always look for how people behave with their actions. Their belief systems and their commitment are followed by action, and I think it's an indication of what people believe. One of the areas of growth, remember, 17% procedure growth year over year has been after-hours surgery, so acute care, and one of the things about access is, for those of you close to surgery, if you have an acute event and you need surgery on a fast timeline, you can't wait. What you're likely to get is what that team in the hospital at the time you walk in knows how to do, so if you walk in at 4:00 P.M.
On a Sunday and you need an emergency surgery, you're going to get who's there. That's what you got. There's no guarantee that that's the best thing for you. It is what it is. And what we're seeing is that as our customers think about two things. They think about what's best for their patients, the people they serve, and what's fair and right. Is it fair and right that if you come in at 3:00 P.M., you get something that may not be appropriate versus if you come in at 8:00 A.M. or can plan it? And this is how they're voting. This is what they're doing with their behavior. I think it's interesting, and I think it's compelling. Just to do a fast run through what the different platforms, we have three platforms that customers can use. Our multi-port is the largest one.
17% growth year over year, 2.65 million procedures done by our customers in the year, install base approaching 10K, 14% year over year growth in the install base. There's an enormous amount of work here. In the United States, there are more than 65 different procedural indications that a da Vinci system in multi-port can do. These are multi-specialty platforms that allow hospitals to get a lot of economic value out of them in addition to patient value. And we continue to expand globally with new indications, regulatory clearances, and with new indications in terms of procedure category. So we're not done. da Vinci 5 is part of multi-port. Ion, single indication, flexible robotic system. It is a stage-shifting device for earlier definitive detection of lung cancer. That's what it is currently targeted at. We'll expand that target over time.
78% year over year growth, 95,000 procedures in the year, and over 50% growth in capital placements. You're starting to see us expand internationally, and that's starting to have some success. Single-port, SP, also a soft tissue robot, da Vinci-like capability and narrow access and single incision point surgery. 72% procedure growth, that's an acceleration. 54% growth in system placements. This is on the back of additional regulatory work and indications, both in types of procedures that it can perform and in regional growth rates. I'm pleased here. I'm pleased to see the building of momentum. For those of you who've been following us, you know this was a launch year. Launch years are hard. There's an enormous amount of work. I love them.
I think it's a chance to see if our innovators have matched the needs of the market and that our operations teams can deliver on that, and so this worked out well. We launched at the end of the first quarter last year. 362 systems went in. There have been 32,000 procedures performed on our newest platform so far. There are about 40 different procedure types. It is also a multi-specialty platform, and we're over 2,500 surgeons who have experienced it, so we're getting real feedback about how it's going. I won't belabor this point, but remember that I love these little cards. These are the main features that we have delivered to help our customers get where they want to go. Force feedback. In the 1890s, the co-founder of Johns Hopkins, Halsted, laid out Halsted's principles. In all, there are about eight principles.
There are two of them that talk about the force applied to tissue and the gentleness with which you are expected to handle tissue. Two of those principles, 1890s. They have been unmeasurable at scale since that time. So it's the first time in 130 years that surgeons can now see for themselves how much force they apply to tissue and whether it matters. It is controversial. I think that's fine. And the controversy is, okay, I can measure the force. And we can see that when we turn force sensing and force reflection on, there are differences in force. And some surgeons will passionately say, "It doesn't matter." And they may be right, but I don't think so. There are others who say, "I've never seen this before. I've never known what I've applied.
Where does it matter and what does it apply for clinical outcomes?" Those folks are doing research. You will see a drumbeat of publications as they start to explore that. But I think in the end, more information about how individual surgeons impact tissue is going to matter in surgery, and I'm excited by it. So let's just hit a couple. Force feedback. Here's a quote from one of our early surgeons who are using it. I think tissue tension and the ability to feel that instead of having to look for just visual cues is a massive transformational improvement for robotic surgery. And as I said before, not every peer will agree, but time will tell. We have increased the efficiency of the product through hundreds of design changes around workflow, around the user interface, and the user experience. One of the quotes from Dr.
Pamela Lee, "I think the really nice thing about da Vinci 5 is that it democratizes the bedside assist, makes it easier for my team to get the job done, and surgery is a team sport." With regard to our machine learning and AI technologies, we have built in an enormous amount of increased compute power with our friends at NVIDIA. 10,000 times, four orders of magnitude more compute power than our prior platform. And people ask, "What are you going to do with it?" Well, I'll tell you. So Case Insights is going to transform our value in the way we teach the next generation of surgeons and allow surgeons to be much better, much more quickly than we were. It's an objective set of measures that surgeons can use to evaluate their own performance. This by Dr. Mike Stifelman. So we're excited.
We think we've brought some first-of-their-kind technologies into the surgical field at scale. And I think that that is generating some of the excitement in early adoption. Our platforms grow every year. da Vinci Xi, last year, is a significantly more capable system than it was launched in 2014. And da Vinci 5, that will also grow over time. You'll see sequential releases from us in augmented reality, in data analytics, in machine learning, in telemedicine. These things now, we put a bunch of compute power in. Now the time is to start taking advantage of that compute power for the benefit of surgeons and for patients. So watch those sequential launches as we come.
We have talked to you in the last year or so, maybe the last few years, three years, that we're going to make some investments to support industrial scale, to decrease our marginal costs, to increase the quality of our products, to make availability of our products for our customers easier, more dependable, more repeatable. If the pandemic showed anything to all of us, it's that the robustness and quality of the supply chains is important. This is just a little indication of what's happened in the last year or two about what we've done behind the scenes for our supply chain and our supply base. Our customers have appreciated it. This is real work. It's not the high-profile work that perhaps people get used to, but I think it's a barbell.
I think what we do to help them on the front end in innovation and what we can do for them in the back end in terms of operations excellence has been fantastic, and our team has done a very nice job. I think it's really important to objectively measure the customer perception of us anonymously, and so we work with J.D. Power to see how we're doing. This is our net promoter score. Above 70 is world-class. We came in at 75. When you launch for us, when we launch a new system and it has limited supply, which we did, it was an early launch, those are stressful on net promoter score. Those are hard years. There's two reasons for that. One of them is that technology needs to stabilize.
And so you're trying to get your supply chains right and find and learn and respond to customer feedback. And you have limited supply. And some people don't appreciate that limited supply. So the fact that we came through, when we did pretty well in 75, that says we attended to this launch okay from the customer's perspective, not just our perspective. So as I close here and get ready to move to Q&A, we'd like to share with you what we're focused on in plain words. So on the innovation front, we want to get to full launch of da Vinci 5 in the United States and its global regions. We will take them step by step. We're already out in Korea, but we're working on Europe and others. And we want to start bringing on the follow-on features, the beginning of that journey toward improvement over time.
I'm excited by it. I think it'll be interesting. We said procedures are the leading indicator of the acceptance of our systems and our customers, and it's a measure of the value they're deriving: clinical value, workflow value, satisfaction value, and economic value, and we'll continue to drive those adoption curves and respond to customer need. We're not done yet with our industrial scale investments, and you'll hear more from Jamie over time about where those investments are going. We expect them to return for us, but they're lumpy. Building buildings is a lumpy activity. Moving manufacturing lines is a heavy lift. We're not done, but we're making very nice progress. We're going to finish that, and with all this compute power and some of the things in AI, ML, and with our partners, we're ready for a real focus on digital excellence.
The launch of our tools in the markets we care about, the follow-through with regard to customer satisfaction, the pull-through of those features into validated clinical and economic evidence. So that's what we're going to be focused on this year. I'm extremely excited about 25. I think the team is primed to go work. With that, Robbie, why don't we move forward?
Thank you. Well, great. Maybe we could start with the congratulations on a fantastic fourth quarter here. Maybe a couple of questions on the quarter, then we could talk some more strategy. Maybe we could spend a minute on just some of the metrics we saw. 18% procedure growth, really big beat on sales, both on instruments and placements versus the street. We saw da Vinci 5, I think was 174 in the quarter. Trade-in started. We saw four in South Korea, I imagine, is the outside the US.
So maybe just speak to some of the trends you saw on placements as it relates to the health of the capital equipment markets in the US and around the world and some of the trends in procedures you saw.
Yeah, I failed to introduce Jamie Samath.
I'm sorry, Jamie.
Executive Vice President and CFO.
And good morning, everybody. Let me start with procedures. As Gary said, that's a key metric for us. On the last earnings call in October, we said for the year, procedure growth of 16% to 17% was our expectation. We came in at 17% for the year, 18% in Q4. What we saw in Q4 was kind of a continuation of what we've seen throughout the year. Nice growth in general surgery in the US. And then if you look at our international markets, you see accretive growth: UK, Italy, Japan, and Germany.
That's the idea that Gary described, where we see growth, OUS in particular, in non-neurology procedures. So GYN, general surgery. And that's mostly cancer procedures, but we do also see early-stage benign procedure growth in the international markets. On the system placement side, if you look at it on a year-over-year basis, we were up about 75 systems, or 78 systems, rather. Most of that was in the US, so strong performance in the US That does reflect the kind of launch of da Vinci 5. And you see, obviously, early interest in customers that can get access to that technology while we've been in the limited launch period. As Gary described, we've seen some capital challenges in Europe. And so that's kind of impacting the markets Gary described: UK, Germany, and some others. We did 12 Xi trade-ins in Q4.
And so that was early customers that were able to do trade-ins. We have not really had the supply to start the trade-in cycle. And we've talked about that may be something that customers choose to do as we get into broad launch mid-next year.
Maybe along that, phase one is what you called it, limited launch. I know you have a software update coming, I believe, first half, middle of next year. You had a lot of capacity added with some of these new facilities. Is that mid-year next year when we should expect to move into phase two with the full launch? And when you say full launch, how should we really think about the cadence of that? Is that trade-ins? Is that US full launch? Is that capacity for outside the US? Maybe just help us understand the magnitude.
Yeah, so there are a couple of steps between limited launch and broad launch that do occur. The software update that you described, that's primarily to enable the integrated skill simulator and hub. That was part of a hardware launch that we did in Q3, but it gets enabled with the software launch sometime next year. You also have to expand our internal capacity, make sure that manufacturing is mature, and there are milestones associated with validating it's mature. And some of our suppliers are also in the process of expanding their capacity. So those steps are necessary to get to broad launch. And yes, we've orchestrated that in a way where generally then we expect to be supply-unconstrained. Obviously, that's a function of actually how demand plays out. At that point then, customers who want to evaluate upgrading their fleets will have the opportunity to do that.
We do think that a trade-in cycle is progressive over multiples of years based on our prior experience versus something that just accelerates quickly.
Just help that too. First priority for us, so we're building capacity. The supply chain is getting hardened, getting ready to go. First priority is to make sure that our customers can serve the patients they want to serve. So capacity expansion to help them fill the needs that they have. That's priority one. The next is to make sure that we can supply globally, not just in the US. So that's priority two. And then for those who want to standardize fleets and upgrade, that's priority three. You want to touch on dual console also as kind of supply-constrained early and where we are with dual console.
Yeah, actually what you see reflected in Q4 in terms of system ASP, which is up sequentially and from the prior year, was a higher mix of dual consoles. I think we did 46 da Vinci 5 dual consoles in Q4. That reflects incremental supply that we had. That allows us to more fully support academic customers. And you'll see that progressively expand as we go through into full launch.
Gary, maybe I could touch on the computing power. 10,000 times is such a significant increase. And da Vinci Xi was a fantastic robot. If we look at three to five years from now, what are some of the ways that Intuitive can surprise investors by capturing and harnessing that 10,000 increase?
Yeah, so you kind of start with the end in mind. What are we trying to do?
I think that for years, surgery has been an apprenticed practice, see one, do one, teach one. And there's an opportunity now with the computing power that strong companies are creating and the ability of us to align with that data to convert it from an observational science to a data science. And so I think this idea of surgical data science is really important. We have a commitment to be a leader in surgical data science. What does that mean? What surgical techniques are likely to create great outcomes? What patient populations will benefit from different kinds of surgical techniques? How does surgeon technique vary between surgeons? And then learning curves. What does it take for care teams to get better faster? So that's what we're after. And to do that requires computing power.
Hence the relationship we've built with NVIDIA over the years has been to get the computing power that allows us to answer those questions. And then there's an interesting thing, which is if you start to know the correlation between good surgical technique and outcome, which is really important, you open automation opportunities. And it'll be a little bit like vehicle automation. It's not going to come in one fell swoop. It will be step by step, just like cars can do radar adaptive cruise control and they can do lane keeping and these things. But you can do that in surgery too, and that'll be powerful. So that's what we're trying to do. We will name them various product names. The product names in this setting are not important. What's important is that surgical data science can create pathways to get better outcomes more repeatedly.
I think that's powerful for the field. I think it's powerful for surgeons and for those companies who can do it.
Can we envision a world in the next, I don't know, three-to-five years or some middle term where the robot is doing part of the procedure more accurately than a human could do?
I can envision it because it's already happening today. Some of the products that we have on our systems are an extremely well-orchestrated exchange of control between the surgeon who declares their intent and the robot who executes that intent in things like our advanced instrumentation. There's force feedback systems. There's an exchange of control that goes back and forth. We're already taking those steps. And by the way, our friends and neighbors in radiation oncology are largely there. This isn't new to healthcare and medical device.
A preoperative plan that's planned with preoperative imaging, and then the machine executes that plan, gives feedback to the physician who then tunes the plan. This is already in flight. I think this is a continuum, and I think we're all starting to work down that continuum.
Along those lines with the extra processing power, are there any indications that that can help open up or maybe another way? Are there any new indications that you're seeing physicians interested in and testing out on da Vinci 5 that wasn't on da Vinci Xi?
There's a couple of things. I think da Vinci 5 allows us to move into what we think of as the back half of the adoption curve. As you become more mature and you start engaging those care teams that have been later adopters, their needs are different. Da Vinci 5 does a lot of that.
So does it impact a set of patients? Absolutely. It allows us to go further into the total opportunity. Are the things in da Vinci 5 potentially opening new procedure indications we haven't been at yet? Maybe. And there are some things that are interesting. We're not ready to declare them yet. We want to go do that validation. But I think we'll have a chance to talk to you in the future about where we can go with it.
There's still a large gap between the number of procedures you're doing today and the top of the circle of the addressable market.
When we talk to surgeons, one of the things they say, and you touched on this with democratizing surgery, is that not only is it better and easier for physicians that are experienced, but it makes it potentially a lot easier for new physicians who aren't experienced with robotics to start and engage with da Vinci 5. So maybe speak to what you're seeing and how you anticipate that helping accelerate the conversion from open to robotic surgery.
Yeah, thank you for that. And many of the care teams globally are struggling to find staff. The healthcare workforce in many of the countries that we serve is under stress. And as a result, the idea that, just remember, it's not just the surgeon. It's the surgeon plus the people in the operating room, of which there are four or five.
These kinds of technologies that, if you do them well, can lower the learning curve and the barrier to entry for healthcare providers to bring in good staff, and we're seeing it. Some of the things that we've seen, for example, in Korea, with just a perfect example with the young physicians' strike. You take out 15% to 20% of their workforce overnight with a strike that's been ongoing for a year, and da Vinci SP growth, da Vinci SP, accelerated. Growth accelerated in the midst of this strike, and if you ask, why is that? They come back and they say there's two reasons that's driving that. One of them is that it's easier to train our patient-side staff. It is less complicated than open or lap. The da Vinci SP has been easier to adopt, and patients get better faster and consume fewer resources in the hospital post-surgery.
It's an exact case study and probably what you just raised. So product design matters, but I think that will pull through.
You're in most major med tech markets around the world. Yet when I look at a multinational fully-sized med tech company, it's in over 100 plus countries around the world, you're about to engage in a large trade-in cycle that will have a lot of functional Xis taken into the company. I imagine they're not going to sit in a warehouse gathering dust. I hope not. So how should we think about your strategy with these trade-ins, what you're going to do with it, and then maybe that ties in or not your plans to expand globally?
Yeah, so I would first say that as you've seen us do in the past, you should expect as a trade-in cycle occurs that when we bring back the Xis, we have the opportunity to then have an Xi refurb. That allows us some additional segmentation opportunities in the portfolio. That segmentation opportunity will be largely a function of the need of the hospital for the particular setting that they're evaluating and then the relative economics. And so there's a nice opportunity for us to position the portfolio. You have X as our most kind of cost-effective system. You have a refurbished Xi that you can put in the middle of the portfolio and then da Vinci 5. And of course, for those customers that want a single port system, we have our single port system as a premium offering also.
And so you'd see us position Xi refurb largely for those customers that are looking for an opportunity to have a lower cost of ownership relative to the procedure set that they would do. And that can be in outpatient settings and in those markets internationally that are more cost-conscious in terms of their capital expenditures.
Jamie, you guided 13%-16% procedure volume growth in 2025. That's the same range you started this time last year in 2024. You're usually very good about helping us with what's included at the upper end and the lower end. Any comment there?
Yeah, so 13% at the low end. We assume that bariatrics in the US continues to decline about the same rate that we saw in 2024.
We assume that on a relative basis, China continues to be relatively weak given the environment we see there and the various factors that we've described, including domestic competition. And then given the challenges we've described in Europe for CapEx and capital budgets, we assume that that continues into 2025 and therefore constrains the incremental capacity that they can put in place to support procedure growth. And then basically what you see at the high end is the declines in bariatrics moderate, that China starts to recover and procedure growth therefore improves from what we've seen in recent periods, and that in Europe, the CapEx environment normalizes.
Intuitive Surgical had a heavy R&D and SG&A investment period leading up to the da Vinci 5 launch. You've invested substantially in CapEx to expand manufacturing around the world.
Maybe speak to where we are in your investment cycle and how to think about, I'll tie in also, uses of cash now that you're generating substantial free cash flow as well.
Yeah, maybe let me ask that in terms of what our investment priorities will be, and obviously, we'll provide our full P&L Q4 results on the 23rd along with the rest of our guidance for the P&L, so we continue to invest in industrial scale. Gary described that well earlier. Much of that continues to be in front of us, and we have to continue and execute what remains. Second, given opportunities to continue to improve clinical outcomes, as Gary described in his first slide, and the opportunity for us to grow, which we see as continuing to be significant, you'll see us invest in R&D and innovation to support that.
And then Gary described at the end the priorities for 2025. We'll look to get da Vinci 5 into broad launch, get additional clearances for da Vinci 5. And we're at the early stage of Ion and SP launches in certain OUS markets where we've recently received clearance. So that will also be part of our priority. You've seen in prior periods we have been able to leverage SG&A. We'll continue to look for opportunities within SG&A, not in every function, but we'll continue to look for where there are opportunities to leverage within SG&A.
Well, we're just out of time. I want to thank you for a great discussion, and thank you everybody for attending.
Thanks, Robbie. Thank you.