ISRG Stock Forms Golden Crossover: Will the Uptrend Continue?

Intuitive Surgical ISRG entered a new phase of bullish momentum on Dec. 3, 2025, when it formed a golden crossover — a technical chart pattern in which the 50-day moving average crosses the 200-day moving average. This formation is widely viewed as a long-term bullish signal, indicating strengthening upward momentum and the potential for sustained gains ahead. While not a guarantee of future performance, the golden crossover often reinforces an underlying fundamental story — and in ISRG’s case, the fundamentals have been notably robust.

A strong third quarter, accelerating adoption of the new da Vinci 5 platform, and improving system utilization across regions have collectively strengthened investor confidence. Yet questions remain about potential margin pressures, China-related headwinds and GLP-1 drag on bariatric procedures.

Golden Crossover

The central question now: Does ISRG’s rally have further room to run?

Robust Procedure Growth and Rising Utilization Across Platforms

ISRG’s third-quarter performance showcased the company’s strongest multi-platform momentum in years. Global procedures rose 20%, powered by a 19% expansion in da Vinci surgeries. Growth was broad-based, spanning benign general surgery in the United States and double-digit strength in gynecology and colorectal procedures internationally.

The Ion robotic-assisted bronchoscopy system continues to outpace expectations, with procedures up 52% and utilization rising 14% year over year. Ion’s rapid ascent reflects increasing clinical validation. European studies have shown meaningfully higher diagnostic yields in lung biopsy versus conventional bronchoscopy, positioning Ion as a key differentiator in early-stage lung cancer diagnosis.

The single-port (SP) platform also posted exceptional momentum, with 91% procedure growth, led primarily by Korea and expanding traction in Europe and Japan. Early commercial cases using SP stapling technology in colorectal and thoracic surgery signal the possibility of broader procedural adoption. Upcoming regulatory clearances, including those for nipple-sparing mastectomy, may further widen the platform’s clinical footprint.

dV5 Adoption Accelerates, Reinforcing the Fundamental Bull Case

A defining driver of ISRG’s recent momentum is the rapid adoption of the new da Vinci 5 (dV5) system. Approximately 67,000 dV5 procedures were performed in the quarter, up from 50,000 in the second quarter — a meaningful sequential acceleration. Surgeons cite greater efficiency, enhanced autonomy and improved ergonomics as key benefits validating the platform’s design philosophy.

In the United States, utilization increased 2%, a notable improvement after stagnation in the first half of 2025. International utilization climbed 8%, aided by robust multi-specialty uptake in markets such as India, Korea and Taiwan.

Importantly, the dV5 cycle is still in its early innings. Hospitals upgrading to dV5 often redeploy older Xi units to secondary campuses or ambulatory centers, effectively growing procedural capacity without incremental capital deployment. This cascading effect supports the long-term thesis of expanding access, broadening procedure breadth and deepening entrenchment within surgical workflows.

Global Growth Engines Strengthen the Multi-Year Opportunity

Domestic benign general surgery — particularly cholecystectomy, appendectomy and hernia repair — remains the backbone of ISRG’s U.S. growth. After-hours and acute-care surgeries also increased, benefiting from dV5-driven efficiency gains that help surgeons manage higher case volumes.

International markets continue to be a major pillar of ISRG’s expansion strategy. Non-U.S. da Vinci volumes saw strong contributions from Benign general surgery (+39%), Colorectal (+28%), Hysterectomy (+27%) and Thoracic (+26%).

Collectively, these categories now account for 40% of all non-U.S. da Vinci procedures, indicating a diversified and expanding international mix. ISRG’s strategy of deploying refurbished Xi systems in price-sensitive markets is also paying dividends, opening greenfield opportunities in Asia and Latin America.

Digital Ecosystem and Long-Term Utilization Tailwinds

Management has emphasized that the long-term utilization uplift driven by dV5 is only beginning. The integration of digital tools — including Hub analytics and AI-driven surgical insights — enhances surgeon efficiency, standardizes training and supports reproducibility in high-volume centers.

Future innovation areas such as force-feedback technologies, expanded procedural clearances, and region-specific dV5 approvals further strengthen the multi-year runway for adoption. As hospitals seek technologies that deliver efficiency and measurable outcomes, ISRG’s data-rich ecosystem becomes a critical competitive advantage.

Estimate Revision Favoring ISRG Stock

Reflecting the positive sentiment around ISRG, the Zacks Consensus Estimate for earnings per share has seen upward revisions. In the past 60 days, analysts have raised their EPS estimates for the current and next fiscal year by 5.5% to $8.61 and 4.4% to $9.57, respectively. These estimates indicate year-over-year growth rate of 17.3% and 11.2%.

Headwinds: Margin Pressure, China, and GLP-1 Uncertainty

Despite Intuitive Surgical’s strong operating momentum, several headwinds could temper near-term performance. GLP-1 weight-loss drugs continue to pressure bariatric surgery volumes, which declined at a high-single-digit rate in the third quarter. While bariatrics account for less than 3% of total da Vinci procedures, surgeons remain uncertain about when this trend will stabilize, creating an overhang relative to historical growth rates.

In China, the company faces multiple challenges, including tender delays, tightening hospital budgets, and intensifying local competition that is weighing on both system placements and pricing. Although Intuitive Surgical maintains a meaningful technological edge, the pricing environment remains difficult and is likely to constrain growth.

Margin pressure adds another layer of complexity, with pro forma gross margin declining 90 basis points year over year to 68%. This contraction reflects a combination of tariff impacts, rising facility costs, and a higher mix contribution from newer, lower-margin platforms such as dV5 and Ion. Management expects margins to hover between 67% and 67.5% for 2025 — notably below pre-dV5 launch levels — suggesting that while revenue growth remains robust, profitability expansion may lag in the near term.

Price Performance & Valuation

Over the past three months, ISRG shares have surged 23.1%, far outpacing peers such as Medtronic MDT and Stryker SYK. While shares of Medtronic have gained 7.8% in the past three months, those of Stryker have lost 7.3%.

3-Month Price Performance

Shares of Intuitive Surgical have been declining for most of 2025 before jumping on better-than-expected third-quarter results. This decline has also lowered its valuation from its 5-year high in February 2025. However, it still trades at a premium to the industry’s current valuation and remains well above its peers. ISRG’s shares currently trade at a forward 12-month price-to-earnings (P/E) of 60.51X, significantly higher than the industry average of 30.5X. Currently, Stryker and Medtronic trade at 24.4X and 17.1X, respectively.

P/E F12M of ISRG vs SYK & MDT

Conclusion

The golden crossover could not have arrived at a better time for ISRG. The company is benefiting from accelerating dV5 adoption, strong global procedure growth, expanding multi-platform utilization and deepening digital integration — all of which support a durable long-term growth narrative.

While margin pressures, China headwinds and GLP-1 uncertainties warrant monitoring, none appear disruptive enough to offset ISRG’s momentum. With a broadening international footprint, a growing pipeline of clinical indications and strong competitive positioning, ISRG’s uptrend looks well supported. For long-term investors, the recent bullish technical signal may be the beginning of a sustained upward trajectory.

The company currently holds a Zacks Rank #1 (Strong Buy). You can see the complete list of today’s Zacks #1 Rank stocks here.

This article originally published on Zacks Investment Research (zacks.com).

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