Intuitive Surgical (NASDAQ:ISRG) shares dropped more than 4% on Wednesday following the company’s reported preliminary Q4 results, with revenue coming in at $1.66 billion, compared to the Street estimate of $1.68 billion.

According to the analysts at Deutsche Bank, the results presented no major surprises: continued broad-based recovery of surgery volumes across key global geographies (China being the notable exception) driving solid procedure growth but an increasingly challenging hospital capital spending environment yielding a 4% year-over-year decline in new da Vinci system installations.

The company’s initial 2023 procedure guide (up 12-16%) is encouraging particularly given management’s history of guiding conservatively to start the year and COVID-related challenges/uncertainties around the increasingly important China market.