ISRG
Intuitive Surgical
Medtech / Consumables
★ Quality 68/100Price today
$366.70
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See what it is worthcharlieapp.co
A monopoly position
This company has a competitive advantage so strong that its rivals find it practically impossible to replicate.
What this business is made of
The business
Sells the razor at cost; the fortune is in the blades.
Intuitive Surgical makes and sells the da Vinci robotic surgical system. The system is the hook; the recurring money comes from disposable instruments, accessories, and service — about 80% of 2025's $10.1B in revenue. Every procedure burns through parts the hospital buys again.
Over 9,500 installed systems create brutal switching costs: the surgeon trains for years on da Vinci and the hospital amortizes a machine worth millions. Decades of procedure data and thousands of patents raise the wall. Zero debt and 66% gross margin leave room to defend it.
Revenue history
From $5.7B to $10.1B in 4 years. The business grows steadily.
Where each $100 of sales goes
Revenue $10.1B · FY2025
Of every $100 in sales, $72 goes to costs and operations; $28 is left as net profit (28% margin).
Catalysts and risks
Rollout of the da Vinci 5 (launched 2024) accelerating system sales in 2026.
Double-digit annual procedure growth, installed base topping 10,000 systems.
International expansion, especially India and emerging markets with low robotic penetration.
Demanding valuation: the market pays for decades of growth up front, little room for error.
Competition waking up — Medtronic Hugo and J&J Ottava looking to take a bite of the share.
Dependence on hospital capital budgets; in a recession, systems get postponed.
Charlie's note
“A surgical toll booth with zero debt and monopoly margins — the kind of business you want to hold for twenty years. The only problem is the price: it trades well above what an old cheapskate would pay.”
Analysis · June 2026
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