Dear Owner,

I started with Intuitive in March of 1996 as a mechanical engineer responsible for designing several aspects of our first da Vinci surgical system. My first months were spent in the lab and operating room, trying to understand what was required to perform high-quality, minimally invasive surgery and how robotics could possibly move the field forward. Those early experiences informed the knowledge that behind every design choice, engineering advancement, and surgical intervention there was a patient who trusts their care team, and indirectly, Intuitive and our technology.

Three decades later, this patients-first approach still guides us. 2025 marked 30 years since Intuitive's founding, 20 million total procedures performed with our da Vinci and Ion systems, and 25 years since becoming a public company. While these are remarkable milestones in our pursuit of better patient care, we know that substantial progress is not made in quarters, but in years, and sometimes, decades. In many ways, it feels like our journey is just beginning as advances in technology continue to shape the surgical and interventional landscape and opportunities to improve patient care and outcomes.

Patients first, always.

20.4M+ patients⁴

Serving patients globally in 70+ countries.

In 2024, we launched our fifth-generation multiport system, da Vinci 5. Since then, we have enhanced the system with multiple hardware and software updates while deepening our manufacturing and supply chain capabilities. As of the end of 2025, customers across the United States, Korea, Japan, and Europe had installed more than 1,200 da Vinci 5 systems and used them in more than 270,000 procedures. Customers are responding to improvements in vision, ergonomics, and precision with increased procedural efficiency and greater throughput.

We have also made investments in our digital capabilities; as just one example, physicians and care teams are responding favorably to our initial deployment of My Intuitive+. My Intuitive+ brings together SimNow for skills development; Intuitive Telepresence for case observation, collaboration, and mentoring; and Case Insights for objective performance measurement. We believe these technologies will provide significant value for our stakeholders.

Early data on our Force Feedback instrumentation suggests the potential benefits that can arise when physicians have the ability to measure and then apply objectively gentler force across a broad range of procedures. There is further investigation underway to identify tasks and specific parts of certain procedures that may provide clinical value to patients. We are excited to have greater supply of Force Feedback instrumentation available to our customers in 2026.

We are encouraged that customers have responded to broader availability of da Vinci 5 with increased demand for system upgrades and fleet standardization, thus providing opportunities for prior systems to be repurposed for use in sites of care that may not have had access to da Vinci surgery previously. After hours acute procedures in the U.S. continued to rise as hospitals increased da Vinci system availability—one tangible sign that adoption is expanding in ways that matter to patient access to minimally invasive care.

We designed these innovations and others to support customers globally in their pursuit of the Quintuple Aim as we jointly work to improve outcomes, provide better patient and care team experiences, lower total cost to treat, and expand access to care.

Additional highlights since our correspondence a year ago include:

• In 2025, our customers used our products in over 3.2 million procedures, up 19% from 2024. Da Vinci procedures increased by 18% to over 3.1 million procedures, including 15% growth in the United States and 23% international growth. International da Vinci procedures topped 1.1 million. Ion procedures increased by 51%.
• We placed 1,721 da Vinci systems, including 1,614 multi-port systems and 107 Single Port systems. Ion placements were 195.
• At year end, our total installed base of systems was more than 12,100, with more than 11,100 da Vinci systems—including 377 Single Port systems—and 995 Ion systems installed at customer sites.
• Utilization of our systems, which is the highest endorsement of our products’ value, increased by 3% across da Vinci platforms to just over 300 procedures per system per year. Ion utilization growth was higher by 9%.

• Revenue was approximately $10.1 billion, 21% growth from 2024.
• Research and development spending exceeded $1 billion as our company continued to expand its core capabilities and develop new ones. Throughout 2025, we obtained additional regulatory clearances across both our da Vinci and Ion platforms. In January 2026, we received FDA 510(k) clearance on da Vinci 5 for certain cardiac procedures.
• We expanded our presence with new facilities in California, Germany, and Bulgaria.
• In March 2026, we established direct operations in Italy, Spain, and Portugal with the acquisition of our distributors, and we welcomed approximately 250 employees to our company.

Looking to the future, the ways we think about healthcare and providing patient care are changing rapidly. Cancer diagnoses are increasing with an aging population, healthcare costs are rising around the world, AI is driving faster advancements in discovery, and patients are becoming increasingly educated about their choices.

However, in this ever-changing and dynamic environment, we believe one thing remains durable: providing surgeons and their patients with profoundly better care.

In support of this, our priorities for 2026 are clear:

• Platform growth through the continued global expansion of da Vinci 5, Single Port, and Ion. We will continue to release follow-on digital features and ecosystem enhancements across our platforms.
• Procedure adoption by country through training, commercial activities, and market access efforts.
• Global manufacturing with a continued focus on product quality, building industrial scale, and optimizing manufacturing operations.
• Innovation to reach more patients—advancing early-stage research and development programs for new disease states while expanding the number of procedures in our line of sight.

Thank you for your trust. We will continue to communicate with transparency about where we are making progress and where we need to do more. At our core, we are committed to creating lasting value for patients, the care teams who serve them, and for you as owners.

David J. Rosa
Chief Executive Officer