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$193.82 18.81 (10.75%)
10/13/2008 10:02 AM

Intuitive Surgical, Inc. (ISRG)

CAPS Rating:
****

Manufacturer of da Vinci Surgical System, an advanced surgical system that provides the surgeon with range of motion and fine tissue control, previously possible only with open surgery while also allowing the surgeon to work through small ports.

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Avatar MoneyMiser21 (41.61) Submitted: 5/24/08 7:44 PM : Outperform Start Price: $286.00 ISRG Score: -0.05

I've seen one of the Da Vinci robots at work. It's weird at first, but the results don't lie. And the quicker healing time is true.

Therer are two tricky things about Intuitive Surgical as a stock:

1.) Valuing its P/E ratio. ISRG been all over the map in the past 10 years. And the current forward P/E of 56 seems too much.

2.) How much can we believe the analyst growth estimates? 36.8% in 5 years is a phenominal growth rate if a business can achieve it.

Still, doctors say they want the surgical robots that ISRG makes. Whether hospitals will pony up the big bucks for them is another question. There is still some question about insurance paying for them in surgery as well. If these concerns are resolved, then ISRG could go even higher than the estimates.

For ISRG to earn a 15% compunded annual return from the $286 per share level (which is probably where it will open on Tuesday May 27th), it will have to be worth at least $575 per share in five years. Which if the estimates are correct, it should not have a problem getting to that value.

Now for argument's sake, let's assume that the estimates are correct and the company grows its EPS at 36.8% for the next 5 years. We'll use a P/E of 40 because I don't trust P/E's of 50+ on any company, and I'm even hesitant to use 40. That put's today's sticker price at $400, if you want at least a 15% compunded annual return. So we're getting a 28.5% discount as of May 23rd.

Both Jon and Pete Najarian at OptionMonster.com & Fast Money love this business, and have their father as a doctor to help back them up on the medical side.

The technicals seem to vote against buying in now for a short-term trade:

1.) ISRG is below both its 10 day and 50 day moving averages
2.) The Slow Stoc. Oscill. is oversold and trending downward still, but it's nearing a point where it should turn
3.) The MACD 12-26-9 divergence is negative, and below 0.

The one short term reason to buy into this is the news from S&P that came late last week that ISRG is going to replace BSC in the S&P 500. That sent shares up $10 Friday, May 23rd.

Long term, this business seems like it's a buy to me. But I have a sneaking suspicion that the price may fall more before the next earnings report. Gut feeling, nothing else. Mr. Market is fickle as we well know.

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Avatar STORMSTOCKER (30.80) Submitted: 6/04/08 11:08 AM

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ISRG is a true growth stock.....P/E is higher in traditional growth stocks, because you have to weigh their sales to stock price growth/ratio. Sales and Earnings have escalated nicely since inception of the company,also you have to weigh in, "where is their competition?"(........they don't really have any, Yet.....)
The only negative is, if people stop/drop their health insurance to pay for their operations in this recession.
Government employees at the fed and state levels, large corporate employees/unioins; all have good health insurance but the small economy, small business, is being eaten alive by regulation, fuel costs, and escalating benefit costs, .......what is the first cost to "go out the door?", benefits. and if people can't pay for "their hospital bills"
hospitals won't have enough revenue stream to purchase this $2,000,000 robot unit.

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Avatar billbu (98.56) Submitted: 8/07/08 12:43 PM

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Good post, one clarification. You wrote "There is still some question about insurance paying for them in surgery as well"

Insurance will pay for the surgery done with the DaVinci, this is not in question. The question is whether they will reimburse the hospital at a higher rate (The DVS surgeries can be more expensive) based on the shorter expected hospital stay and other mitigating factors. Recent studies cited by ISRG show an OVERALL cost savings, although the surgery itself may cost slightly more. I believe I saw an article saying that some insurance companies are beginning to reimburse at a higher rate for certain DVS procedures, but I'm not sure where I saw that.

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