Deutsche Bank analyst Imron Zafar downgraded Intuitive Surgical (ISRG) to Hold from Buy with a price target of $595, down from $610. The stock closed Friday down 4% to $589.20. With the impending launch of new surgical robot systems including Medtronic's (MDT) Hugo, the impact on Intuitive Surgical and its ability to sustain growth that has been best-in-class has been a big area of investor focus, Zafar tells investors in a research note. However, the analyst's recent due diligence yielded confirmation that a growing number of hospital customers, including world-renowned academic centers and even large hospital systems, have begun or are in late stage discussions to potentially soon begin using repaired da Vinci instruments supplied by third parties. Meaningful operating cost savings opportunity is the key driver compelling hospitals to consider using these repaired da Vinci instruments, Zafar tells investors in a research note. This is a new competitive threat, one that will be an "increasingly meaningful headwind" to Intuitive's U.S. Instruments & Accessories segment over the next couple years, says the analyst. Zafar believes this is "being fully overlooked by the Street."

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Piper Sandler raised the firm's price target on Intuitive Surgical to $435 from $425 and keeps an Overweight rating on the shares. The company reported Q1 results that topped consensus on both the top- and bottom-line, the analyst tells investors in a research note. The firm says there were several positive operational updates announced on the earnings call, such as, healthy initial demand for SP in Europe and Chinese regulatory approval for Ion. The Q1 report had "little-to-nothing to pick at," contends Piper. Intuitive remains its favorite large-cap medtech name.

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Sees FY24 gross profit margin 67%-68%. Sees FY24 operating expense up 11%-15%. Sees FY24 capital expenditures 1B-$1.2B. Sees FY24 tax rate 22%-24%. Says five additional procedures will have reimbursement in Japan by June. Says saw particular strength in the U.S. and the U.K. Comments and guidance taken from Q1 earnings conference call.

Pre-earnings options volume in Intuitive Surgical is 2.0x normal with calls leading puts 10:9. Implied volatility suggests the market is anticipating a move near 4.9%, or $18.11, after results are released. Median move over the past eight quarters is 5.6%.