Invuity (IVTY) 10-Q 3 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Jul. 31, 2018
Document And Entity Information
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2
Entity Registrant Name	Invuity, Inc.
Entity Central Index Key	1,393,020
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		24,073,678

Condensed Balance Sheets

Condensed Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 15,327	$ 17,962
Short-term investments	8,602	3,040
Restricted cash - current	181	181
Accounts receivable, net	6,668	7,421
Inventory, net	8,534	7,436
Prepaid expenses and other current assets	1,621	1,274
Total current assets	40,933	37,314
Restricted cash	727	727
Property and equipment, net	6,868	7,169
Other long-term assets	201	285
Total assets	48,729	45,495
Current liabilities:
Accounts payable	3,502	3,598
Accrued and other current liabilities	5,629	5,179
Deferred revenue - short term	54
Long-term debt, current portion	4,615
Short-term debt	5,411	5,859
Total current liabilities	19,211	14,636
Deferred rent	2,468	2,569
Deferred revenue - long term	86	36
Long-term debt, net of current portion	24,632	29,116
Total liabilities	46,397	46,357
Commitments and contingencies (Note 8)
Stockholders' equity (deficit):
Preferred stock, $0.001 par value - 10,000,000 shares authorized at June 30, 2018 and December 31, 2017; no shares issued and outstanding at June 30, 2018 and December 31, 2017
Common stock, $0.001 par value - 100,000,000 shares authorized at June 30, 2018 and December 31, 2017; 24,073,537 and 17,179,258 shares issued and outstanding at June 30, 2018 and December 31, 2017	24	17
Additional paid-in capital	208,589	185,255
Accumulated deficit	(206,281)	(186,134)
Total stockholders' equity (deficit)	2,332	(862)
Total liabilities and stockholders? equity (deficit)	$ 48,729	$ 45,495

Condensed Balance Sheets (Paren

Condensed Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2018	Dec. 31, 2017
Condensed Balance Sheets
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	24,073,537	17,179,258
Common stock, shares outstanding	24,073,537	17,179,258

Condensed Statements of Operati

Condensed Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Condensed Statements of Operations and Comprehensive Loss
Revenue	$ 10,501	$ 9,768	$ 20,006	$ 18,791
Cost of goods sold	4,073	3,015	6,996	5,114
Gross profit	6,428	6,753	13,010	13,677
Operating expenses:
Research and development	2,145	2,410	4,027	4,839
Selling, general and administrative	12,498	14,204	27,610	29,057
Total operating expenses	14,643	16,614	31,637	33,896
Loss from operations	(8,215)	(9,861)	(18,627)	(20,219)
Interest expense	(794)	(527)	(1,568)	(1,014)
Interest income	109	53	164	110
Other expense, net	(50)	(52)	(116)	(178)
Loss on extinguishment of debt				(2,303)
Net loss and comprehensive loss	$ (8,950)	$ (10,387)	$ (20,147)	$ (23,604)
Net loss per common share, basic and diluted	$ (0.37)	$ (0.61)	$ (0.95)	$ (1.39)
Weighted-average shares used to compute net loss per common share, basic and diluted	24,047,256	16,986,074	21,102,254	16,972,280

Condensed Statements of Cash Fl

Condensed Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash flows from operating activities
Net loss	$ (20,147)	$ (23,604)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	748	1,009
Stock-based compensation	1,609	1,421
Amortization of debt discount	131	38
Recovery of doubtful receivable accounts	22	(82)
Loss on extinguishment of debt		2,302
Payment of original issue discount		(782)
Accretion of premium (discount) on marketable securities	(30)	4
Changes in operating assets and liabilities:
Accounts receivable	835	262
Inventory	(1,098)	(508)
Prepaid expenses and other current assets	(264)	386
Accounts payable	(131)	716
Accrued and other current liabilities	351	(441)
Deferred rent	(101)	(71)
Net cash used in operating activities	(18,075)	(19,350)
Cash flows from investing activities
Purchases of property and equipment	(413)	(558)
Purchases of marketable securities	(8,586)	(9,462)
Purchase of distribution license		(250)
Maturities of marketable securities	3,050	10,742
Net cash (used in) provided by investing activities	(5,949)	472
Cash flows from financing activities
Proceeds from revolving credit facility, net of payment	(448)	3,518
Proceeds from common stock offerings, net of offering costs	21,700	57
Proceeds from issuance of long-term debt, net of issuance costs		19,701
Payments of long-term debt - related party		(14,193)
Proceeds from issuance of common stock upon exercise of stock options	136	240
Prepayment penalty on long-term debt		(1,950)
Net cash provided by financing activities	21,388	7,373
Net increase (decrease) in cash and cash equivalents and restricted cash	(2,636)	(11,505)
Cash and cash equivalents and restricted cash, at beginning of period	18,871	29,390
Cash and cash equivalents and restricted cash, at end of period	16,235	17,885
Reconciliation of cash, cash equivalents and restricted cash as shown in the condensed statement of cash flows
Total cash, cash equivalents and restricted cash	18,871	29,390
Supplemental disclosures of cash flow information
Interest paid to related party		980
Cash paid for interest	1,247
Non-cash investing and financing activities
Purchases of property and equipment in accounts payable and accrued liabilities at period end	25	$ 16
Common stock offering costs in accounts payable and accrued liabilities	$ 128

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 2018
Organization and Description of Business
Organization and Description of Business	NOTES TO CONDENSED FINANCIAL STATEMENTS (Unaudited) In this Quarterly Report on Form 10-Q, references to “Invuity,” “we,” “us,” “our” and the “Company” refer to Invuity, Inc., unless expressly indicated or the context otherwise requires 1. Organization and Description of Business Invuity, Inc. was incorporated in California on November 29, 2004 and reincorporated in Delaware in May 2015. The Company is a commercial-stage medical technology company that utilizes its proprietary Intelligent Photonics® technology to develop single-use and reusable illuminated surgical devices, which provide surgeons with illumination and direct visualization of surgical cavities during minimal access procedures. The Company’s manufacturing, development and management facilities are located in San Francisco, California. Liquidity and Going Concern The Company has incurred net losses from operations since inception, including $20.1 million in the six months ended June 30, 2018, and has an accumulated deficit of $206.3 million as of June 30, 2018. In March 2018, the Company issued and sold a total of 6,800,000 shares of its common stock at $3.50 per share, resulting in total net proceeds of approximately $21.7 million. The Company has $23.9 million in cash and cash equivalents and short-term investments, and $34.7 million in net debt outstanding at June 30, 2018. The Company is required to comply with a financial covenant relating to certain quarterly minimum Net Revenue (as defined in the debt agreements) requirements on a trailing twelve-month basis. See Note 5 for further details. As of June 30, 2018, the Company was not in compliance with this covenant. As disclosed in Note 10, the Company entered into an Amendment No. 3 to the Credit and Security Agreement (“Term Loan”) with MidCap Financial Trust (“MidCap”) to revise the financial covenant. After the execution of the amendment, the Company was in compliance with the revised covenant. The amendment also added a minimum cash covenant if the Company does not meet a minimum Net Revenue requirement on a trailing twelve month basis for the remainder of 2018. The minimum Net Revenue requirement is $41.5 million for the period ending September 30, 2018, $42.5 million for the period ending December 31, 2018, $45.7 million for the period ending March 31, 2019, and $47.7 million for the period ending June 30, 2019. In addition, the Company must comply with a minimum cash covenant of $5.0 million that is triggered if Net Revenue is not in excess of $45.0 million on a trailing twelve month basis as of December 31, 2018, which ends if and when Net Revenue is in excess of $50.0 million for any twelve month period thereafter. The Company expects to incur additional losses and negative cash flows for the foreseeable future as the Company continues to invest in its sales and marketing efforts and research and development activities to continue to grow its business. The Company believes that its cash, cash equivalents and short-term investments as of June 30, 2018, and expected sales from its products together with additional funding available under the Company’s revolving credit facility will not provide sufficient funds to enable the Company to meet its projected operating requirements for the next twelve months from the issuance of these financial statements. The Company intends to obtain additional funding through public or private financing, collaborative arrangements with strategic partners, or through additional credit lines or other debt financing sources to increase the funds available to support its operating and capital needs. If the Company is not able to perform according to the Company’s 2018 operating plan, the Company’s available capital resources may be consumed more rapidly than currently expected, and therefore may be required to raise additional funds sooner than anticipated. However, the Company may not be able to secure such financing in a timely manner or on favorable terms, if at all. Without additional funds, the Company will be forced to delay, scale back or eliminate some of its sales and marketing efforts, research and development activities, or other operations and potentially delay product development in an effort to provide sufficient funds to continue its operations. The uncertainty around the achievement of the Company’s plans to mitigate the risk of going concern raises substantial doubt about the Company’s ability to continue as a going concern for a one year period from the issuance of these financial statements. The financial statements do not include any adjustments that might result from the outcome of this uncertainty. Basis of Presentation The accompanying unaudited condensed financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and in accordance with the instructions to Form 10‑Q and Rule 10‑01 of Regulation S‑X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for complete financial statements. The unaudited interim condensed financial statements have been prepared on the same basis as the annual financial statements. In the opinion of management, the accompanying unaudited condensed financial statements reflect all adjustments (consisting only of normal recurring adjustments) considered necessary for a fair statement of the financial position, results of operations and cash flows for the periods presented. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited financial statements and notes thereto included in the Company’s Annual Report on Form 10‑K for the year ended December 31, 2017 and filed with the U.S. Securities and Exchange Commission (the “SEC”). The accompanying year-end balance sheet was derived from the audited financial statements included in the Company’s Annual Report on Form 10‑K for the year ended December 31, 2017. The results for the three months and six months ended June 30, 2018 are not necessarily indicative of the results expected for the full fiscal year or any other periods.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2018
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Use of Estimates The Company’s financial statements have been prepared in conformity with U.S. GAAP. The preparation of the financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, management evaluates its estimates, including those related to revenue recognition, fair value of assets and liabilities, inventory, income taxes and stock-based compensation. Actual results could differ from those estimates and assumptions. Cash Equivalents Cash equivalents consist of short-term, highly liquid investments with original maturities of three months or less from the date of purchase. Cash equivalents consist primarily of amounts invested in money market funds. Restricted Cash Restricted cash represents a certificate of deposit held at a financial institution as collateral for a letter of credit related to the Company’s facility lease in San Francisco, California. Fair Value of Financial Instruments The carrying amounts of the Company’s financial instruments, including cash equivalents, short-term investments, accounts receivable and accounts payable, approximate fair value due to their relatively short maturities. As of June 30, 2018 and December 31, 2017, based on Level 2 inputs and the borrowing rates available to the Company for loans with similar terms and consideration of the Company’s credit risk, the carrying value of the Company’s long-term debt approximates its fair value. Customer Concentration Significant customers are those which represent 10% or more of the Company’s total revenue for each period presented in the condensed statements of operations and comprehensive loss or 10% or more of the Company’s net accounts receivable balance at each respective balance sheet date. As of and for the year ended December 31, 2017 and as of and for the three and six months ended June 30, 2018 and 2017, the Company had no customers that represented 10% or more of its revenue or accounts receivable balances. Changes in Significant Accounting Policies Except for the accounting policies for revenue recognition and deferred commissions that were updated as a result of adopting Topic 606, there have been no changes to our significant accounting policies described in the Annual Report on Form 10-K filed with the Securities and Exchange Commission, or SEC, on March 5, 2018, that have had a material impact on the Company’s condensed financial statements and related notes. Revenue Recognition The Company’s revenue is generated from the sale of its products to hospitals and medical centers through direct sales representatives and independent sales agents. The Company accounts for a contract with a customer when there's approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance, collectability of consideration is probable and the risks and rewards of ownership are transferred. In certain circumstances, the Company enters into arrangements in which multiple performance obligations are provided to customers. Under multiple performance obligations arrangements, the Company accounts for individual products and services separately if they are distinct, that is, if a product or service is separately identifiable from other items in the bundled package and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The consideration (including any discounts) is allocated between separate products and services in a bundle based on their individual stand-alone selling price (“SSP”). The SSP is determined based on observable prices at which the Company separately sells the products and services. The Company does not offer rights of return or price protection and does not provide credits or incentives, which may be required to be accounted for as variable consideration when estimating the amount of revenue to be recognized . With the exception of PhotonVue®, whereby customers can purchase service contracts for future periods of time, the Company has no post-delivery obligations other than the standard warranty for the Company’s products. Single use devices Single use device revenues include the Company’s single use products, such as the PhotonGuide® (which is used in conjunction with our reusable retractors), Photonsaber® F, the Photonsaber® Y, and the PhotonBlade®. Revenues from the sale of single use devices are recognized when the Company transfers the risks and rewards of ownership to the customer. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Reusable retractors Reusable retractor revenues include the Company’s reusable products, such as the Eikon® LT, the Breisky, and the Breiten®. Revenues from the sale of reusable retractors are recognized when the Company transfers the risks and rewards of ownership to the customer. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Sales to 3rd party medical device manufacturers At times, the Company sells uniquely modified products to 3 rd party medical device manufacturers. The products are modified based on the specifications provided by 3 rd party medical device manufacturers, who then incorporate these parts into products sold to their customers. Revenues from the sale to 3 rd party medical device manufacturers are recognized when the Company transfers the risks and rewards of ownership to the 3 rd party manufacturers. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Other Other revenues include revenues from sales of accessories and service agreements. Revenues for sales of accessories, such as cables and trays, are recognized when the accessories are delivered to the customer and control is transferred. Revenues from service agreements are accounted for ratably over the term of the service agreement. Segment Reporting The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The majority of the Company’s assets are maintained in the United States. The Company derives its revenue primarily from sales to customers in the United States, based upon the billing address of the customer. The Company started selling in Asia in June 2017 and in Europe and Australia in June 2018. The Company had $20,000 and $141,000 in total international sales for the three months ended March 31, 2018 and June 30, 2018, and $0.2 million in total international sales for the six months ended June 30, 2018. Net loss per Common Share Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potentially dilutive securities. Diluted net loss per common share is the same as basic net loss per common share since the effect of potentially dilutive securities are anti-dilutive. Shares subject to repurchase are excluded from the weighted-average shares. Contract Balances The timing of revenue recognition, billings and cash collections results in accounts receivables and deferred revenues on the Condensed Balance Sheet. Service contracts are usually billed upon initial purchase with the PhotonVue® system, resulting in a contract liability. These contract liabilities are reported as deferred revenues on the Condensed Balance Sheet at the end of each reporting period. Recent Accounting Pronouncements · In May 2014, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2014‑09, Revenue from Contracts with Customers (Topic 606) , which supersedes the revenue recognition requirements in ASC 605, Revenue Recognition . This ASU is based on the principle that revenue is recognized to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The ASU also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to obtain or fulfill a contract. In August 2015, FASB issued ASU No. 2015‑14, Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date , which effectively delayed the adoption date by one year, to an effective date for public entities for annual and interim periods beginning after December 15, 2017. · In March 2016, the FASB issued ASU No. 2016‑08, Revenue from Contracts with Customers (Topic 606): Principal Versus Agent Considerations (Reporting Revenue Gross Versus Net), to clarify certain aspects of the principal-versus-agent guidance in its new revenue recognition standard. · In April 2016, the FASB issued ASU No. 2016‑10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing to clarify on how to identify the performance obligations and the licensing implementation guidance in its new revenue recognition standard. · In May 2016, the FASB issued ASU No. 2016‑12, Revenue from Contracts with Customers (Topic 606): Narrow-Scope Improvements and Practical Expedients, to address certain issues identified by the Transition Resource Group, (the “TRG”) in the guidance on assessing collectability, presentation of sales tax, noncash consideration, and completed contracts and contracts modifications at transition. The adoption of ASC 606, using the modified retrospective approach in the first quarter of 2018 did not have a material impact on the Company’s financial statements. · In February 2016, the FASB issued ASU No. 2016‑02— Leases (“ASC 842”), which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight line basis over the term of the lease, respectively. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term of greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. ASC 842 supersedes the previous leases standard, ASC 840 Leases . The Company expects to adopt the guidance on January 1, 2019. The Company is in the process of evaluating the impact of this new guidance on its financial statements, and expects the balance sheet to include a right of use asset and liability related to its lease arrangements. · In June 2016, the FASB issued ASU No. 2016‑13, Measurement of Credit Losses on Financial Statements (Topic 326) . This update provides financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The update replaces the incurred loss impairment methodology in current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. ASU No. 2016‑13 is effective for public entities for annual periods beginning after December 15, 2019. The Company is in the process of evaluating the impact of this new guidance on its financial statements. · In August 2016, the FASB issued ASU No. 2016‑15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments (a consensus of the FASB Emerging Issues Task Force) . The new guidance is intended to reduce diversity in practice in how certain transactions are classified in the statement of cash flows. This update addresses the following eight specific cash flow issues: debt prepayment or debt extinguishment costs; settlement of zero-coupon debt instruments or other debt instruments with coupon interest rates that are insignificant in relation to the effective interest rate of the borrowing; contingent consideration payments made after a business combination; proceeds from the settlement of insurance claims; proceeds from the settlement of corporate-owned life insurance policies (“COLIs”) (including bank-owned life insurance policies (“BOLIs”); distributions received from equity method investees; beneficial “interests in securitization transactions; and separately identifiable cash flows and application of the predominance principle. ASU No. 2016‑15 is effective for public entities for annual periods beginning after December 15, 2017. The Company adopted this standard in the first quarter of 2018. As a result of the adoption, the Company reclassified $2.0 million of Loss from debt extinguishment from Operating cash outflows in the three months ended March 31, 2017 to financing cash outflows on the Condensed Statements of Cash Flows. · In June 2018, the FASB issued ASU No. 2018-07, Compensation – Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting. The amendments in this update expand the scope of Topic 718 to include share based payment transactions for acquiring goods and services from nonemployees. An entity should apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of cost (that is, the period of time over which share-based payment awards vest and the pattern of cost recognition over that period). The amendments in this Update are effective for private entities for fiscal years beginning after December 15, 2019, and interim periods within fiscal years beginning after December 15, 2020. Early adoption is permitted, but no earlier than an entity’s adoption date of Topic 606. The Company is in the process of evaluating the impact of this new guidance on its financial statements.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2018
Fair Value Measurements
Fair Value Measurements	3. Fair Value Measurements The Company discloses and recognizes the fair value of its assets and liabilities using a hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The hierarchy gives the highest priority to valuations based upon unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to valuations based upon unobservable inputs that are significant to the valuation (Level 3 measurements). The guidance establishes three levels of the fair value hierarchy as follows: Level 1 —Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date. Level 2 —Inputs (other than quoted market prices included in Level 1) are either directly or indirectly observable for the asset or liability through correlation with market data at the measurement date and for the duration of the instrument’s anticipated life. Level 3 —Inputs reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. Consideration is given to the risk inherent in the valuation technique and the risk inherent in the inputs to the model. The Company’s financial instruments consist of Level 1 and 2 assets. Level 1 assets consist primarily of highly liquid money market funds that are included in cash, cash equivalents, and restricted cash. Commercial paper and corporate debt securities are classified in Level 2 of the fair value hierarchy because these valuation inputs are observable or market-corroborated. The following table sets forth the fair value of the Company’s financial assets and liabilities measured at fair value on a recurring basis based on the three-tier fair value hierarchy (in thousands): June 30, 2018 Level 1 Level 2 Level 3 Total Assets Money market funds $ 6,253 $ — $ — $ 6,253 Commercial paper — 12,642 — 12,642 Corporate debt securities — 1,348 — 1,348 $ 6,253 $ 13,990 $ — $ 20,243 December 31, 2017 Level 1 Level 2 Level 3 Total Assets Money market funds $ 13,071 $ — $ — $ 13,071 Commercial paper — 3,763 — 3,763 Corporate debt securities — 1,753 — 1,753 $ 13,071 $ 5,516 $ — $ 18,587 As of June 30, 2018 and December 31, 2017, the carrying value of the Company’s short-term investments approximates their fair value.

Balance Sheet Components

Balance Sheet Components	6 Months Ended
	Jun. 30, 2018
Balance Sheet Components
Balance Sheet Components	4. Balance sheet components Inventory Inventory consisted of the following (in thousands): June 30, December 31, 2018 2017 Raw materials $ 1,968 $ 1,606 Work-in-process 2,701 1,860 Finished goods 3,865 3,970 Total inventory $ 8,534 $ 7,436 Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consisted of the following (in thousands): June 30, December 31, 2018 2017 Prepaid expenses $ 1,570 $ 1,252 Other 51 22 Total prepaid expenses and other current assets $ 1,621 $ 1,274 Property and Equipment, Net Property and equipment, net, consisted of the following (in thousands): June 30, December 31, 2018 2017 Computer equipment and software $ 1,606 $ 1,368 Laboratory and manufacturing equipment 3,116 3,008 Furniture and fixtures 1,550 1,516 Leasehold improvements 7,201 7,155 Assets in progress 188 167 Total property and equipment, gross 13,661 13,214 Less: accumulated depreciation and amortization (6,793) (6,045) Total property and equipment, net $ 6,868 $ 7,169 Depreciation and amortization expense was $0.4 million for the three months ended June 30, 2018, and $0.5 million for the three months ended June 30, 2017. Depreciation and amortization expense was $0.7 million for the six months ended June 30, 2018, and $1.0 million for the six months ended June 30, 2017. Accrued and Other Current Liabilities Accrued and other current liabilities consisted of the following (in thousands): June 30, December 31, 2018 2017 Accrued payroll-related expenses $ 3,885 $ 3,777 Accrued independent sales agent commissions 298 181 Accrued professional fees 830 501 Deferred rent 261 261 Other 355 459 Total accrued and other current liabilities $ 5,629 $ 5,179 As part of a corporate restructuring program the Company implemented in May 2018, the Company recorded $0.9 million in severance expense, of which $0.6 million is included in the total Accrued payroll-related expenses of $3.9 million for the six months ended June 30, 2018. The remaining severance payments of $0.6 million are expected to be fully disbursed by January 2019.

Debt

Debt	6 Months Ended
	Jun. 30, 2018
Debt
Debt	5. Debt MidCap credit and security agreement: On March 10, 2017, the Company entered into a credit and security agreement with MidCap as agent, for up to $30.0 million in term loans. Under the terms of the agreement, the Company borrowed the first term loan of $20.0 million (“Tranche 1”) at closing. The Tranche 1 term loan accrues interest at a floating rate equal to 6.50% per annum, plus the greater of (i) 1.5% or (ii) one month LIBOR. Interest shall accrue on the date of the commencement of funding and is payable in arrears on the first day of each month. Principal was payable in 36 equal monthly installments beginning April 1, 2019, subject to extension to October 1, 2019, if the Company achieves a certain revenue target, until paid in full on March 1, 2022. The Company used $17.2 million of the $20.0 million Tranche 1 term loan to pay off in full the outstanding $15.0 million loan with Health Care Royalty Partners (“HCRP”). The Company also terminated its accounts receivable credit facility with Silicon Valley Bank which was never drawn down. The transaction was accounted for as a debt extinguishment and a loss of $2.3 million was accounted for as loss on extinguishment of debt in the income statement. The loss amount includes a $1.8 million prepayment fee paid to HCRP, a $150,000 fee paid to Silicon Valley Bank for termination of the accounts receivable facility and a $0.3 million non-cash expense related to unamortized issuance costs. The facility terminates in full on March 1, 2022, unless terminated earlier. As of June 30, 2018, the Company had drawn down $5.4 million under the revolving credit facility. In connection with the term loan facility, the Company agreed to issue to each lender warrants to purchase shares of the Company’s common stock upon the drawdown of each tranche in an aggregate amount equal to 2.0% of the amount drawn, divided by the exercise price per share for that tranche. In connection with the Tranche 1 term loan, the Company issued warrants to purchase an aggregate of 50,618 shares of the Company’s common stock, at an exercise price equal to $7.90 per share. These warrants, which were recorded within stockholders’ equity, were fair valued at $279,000 upon issuance using a Black-Scholes valuation model. The assumptions used in the Black-Scholes model consisted of a 10 year contractual term, interest free rate of 2.58%, dividend yield of 0.0% and volatility of 60.0%. The fair value was recorded as a discount to the initial $20.0 million term loan and will be amortized as interest expense over the term of the agreement, which is approximately five years. In connection with the Tranche 2 term loan, the Company issued warrants to purchase an aggregate of 47,790 shares of the Company’s common stock, at an exercise price equal to $8.37 per share. These warrants, which were recorded within stockholders’ equity, were fair valued at $278,000 upon issuance using a Black-Scholes valuation model. The assumptions used in the Black-Scholes model consisted of a 10 year contractual term, interest free rate of 2.24%, dividend yield of 0.0% and volatility of 60.0%. The fair value was recorded as a discount to the initial $10.0 million term loan and will be amortized as interest expense over the term of the agreement, which is approximately five years On September 26, 2017, the Company entered into an Amendment No. 2 to the Term Loan with MidCap and borrowed the second term loan of $10.0 million (“Tranche 2”). The Tranche 2 term loan accrues interest at a floating rate equal to 6.50% per annum, plus the greater of (i) 1.5% or (ii) one month LIBOR. Interest shall accrue on the date of the commencement of funding and is payable in arrears on the first day of each month. Principal was payable in 36 equal monthly installments beginning April 1, 2019, subject to extension to October 1, 2019, if the Company achieved a certain revenue target, until paid in full on March 1, 2022. The Company also entered into a separate Credit and Security Agreement (Revolving Loan) with MidCap on March 10, 2017 that provided for a revolving credit facility of up to $10.0 million based on the eligible accounts receivable and inventory balances, as amended on September 26, 2017. The Company could increase the total commitments under the revolving credit facility by up to an additional $10.0 million, subject to the Company meeting certain conditions. Loans under the revolving credit facility accrued interest at a floating rate equal to 3.25% per annum, plus the greater of (i) 1.5% or (ii) one month LIBOR. Interest was payable in arrears on the first day of each month subsequent to the draw down date. The term loan facility and the revolving credit facility are secured by substantially all of the Company’s assets, including intellectual property. In addition, under the terms of the agreement, the Company is required to meet certain covenants which if the Company is unable to meet, or if the Company does not make its payments, the Company may be found in default and all obligations may be accelerated and become immediately due and payable upon the sole election of the lenders. The Company must also comply with a financial covenant relating to certain quarterly minimum Net Revenue requirements on a trailing twelve month basis. As of June 30, 2018, the Company was not in compliance with this covenant. Additionally, the credit and security agreement with MidCap, includes customary events of default, including failure to pay amounts due, breaches of covenants and warranties, and material adverse effect events. If an event of default occurs, MidCap may require immediate repayment of all amounts due. On July 31, 2018, the Company entered into an Amendment No. 3 to the Term Loan, (the “Term Loan Amendment”). For the Term Loans and the Revolving Loan, the financial covenant, relating to certain quarterly minimum net revenue requirements on a trailing twelve-month basis, was revised. In addition, the amendment also added a minimum cash covenant if the Company does not meet a minimum Net Revenue requirement on a trailing twelve month basis for the remainder of 2018. The minimum Net Revenue requirement is $41.5 million for the period ending September 30, 2018, $42.5 million for the period ending December 31, 2018, $45.7 million for the period ending March 31, 2019, and $47.7 million for the period ending June 30, 2019. In addition, the Company must comply with a minimum cash covenant of $5.0 million that is triggered if Net Revenue is not in excess of $45.0 million on a trailing twelve month basis as of December 31, 2018, which ends if and when Net Revenue is in excess of $50.0 million for any twelve month period thereafter. For the term loan, the exit fee was increased from 6.5% to 7.0% of the total amount of all term loans and the repayment schedule was revised such that principal on each term loan advance is now payable in 39 equal monthly installments beginning January 1, 2019 until paid in full on March 1, 2022. In connection with the Term Loan Amendment, the Company also entered into an Amendment No. 3 to Revolving Loan (the “Revolving Loan Amendment”). For the Revolving Loan, the total commitments were increased from $10.0 million to $15.0 million. After the execution of the amendment, the Company was in compliance with the revised covenant.

Stock Option Plans

Stock Option Plans	6 Months Ended
	Jun. 30, 2018
Stock Option Plans
Stock Option Plans	6. Stock Option Plans In April 2015, the Company’s board of directors and stockholders approved the 2015 Equity Incentive plan (the “2015 Plan”), effective June 11, 2015, covering incentive stock options, nonstatutory stock options and restricted stock awards that may be granted to employees, directors and consultants. During the three months ended June 30, 2018 and 2017, the Company granted 8,840 options and 125,525 options, respectively, to employees and consultants, with a weighted average grant date fair value of $3.62 per share and $7.32 per share, respectively. During the six months ended June 30, 2018 and 2017, the Company granted 325,340 and 734,705 options, respectively, to employees and consultants, with a weighted average grant date fair value of $4.11 per share and $6.65 per share, respectively. The options granted in 2017 included 268,000 options granted to certain executive officers with a market-based condition. The 268,000 options were valued at an aggregate value of $0.7 million using the Monte Carlo Simulation model, which will be amortized over three years from the date of grant. The aggregate intrinsic value of options exercised was $30,000 for the three months and $45,000 for the six months ended June 30, 2018, respectively, and was $0.3 million for both of the three and six months ended June 30, 2017. The weighted-average remaining contractual life of options outstanding was 5.6 and 7.0 years at June 30, 2018 and December 31, 2017, respectively. For vested and expected to vest options, the weighted-average remaining contractual life as of June 30, 2018 and December 31, 2017, was 5.6 and 7.0 years, respectively. For the three months ended June 30, 2018, the Company granted 171,230 restricted stock units (“RSUs”) to non-employee board members (“Outside Directors”) with a grant date fair value, in the aggregate, of approximately $0.6 million. Under the Company’s Restricted Stock Unit Deferral Program for Outside Directors, Outside Directors may elect to defer the receipt of shares upon vesting of RSUs granted under the 2015 Plan. A deferral election will apply to the entirety of the particular RSU award and no partial elections may be made. A deferral election is irrevocable once made. In the event an Outside Director makes a deferral election, the shares of common stock underlying the deferred RSUs will not be distributed to such Outside Director until the earlier of his or her separation of service as a board member or upon a “Change in Control” (as defined in the 2015 Plan) of the Company. Three out of five of the Company’s Outside Directors elected to defer receipt of the RSUs granted to them on the date of the Company’s 2018 Annual Meeting (the “2018 Annual meeting”) under the 2015 plan. The Company also granted 60,000 RSUs to the Interim President and Chief Executive Officer, with a grant date fair value, in the aggregate, of approximately $0.2 million. For the six months ended June 30, 2018, the total RSUs granted were 522,665 with a fair value of $1.9 million, including RSUs granted to Outside Directors described above and 272,985 RSUs granted to executive officers with a fair value of $1.1 million. The RSUs granted to executive officers have a four-year term and vest 25% annually, with the exception of the RSUs granted as part of the new Interim President and Chief Executive Officer’s employment agreement that vest 100% after one year. The RSUs granted to Outside Directors on the date of the 2018 Annual Meeting will vest 100% on the one year anniversary of the 2018 Annual Meeting, with the exception of any RSUs that an Outside Director elected to defer, which RSUs generally will vest 100% on the first anniversary of the date that the Outside Director elected to defer such RSUs. For the three months ended June 30, 2017, the Company granted approximately 72,000 RSUs to Outside Directors with a grant date fair value, in the aggregate, of $0.5 million. The RSUs granted to Outside Directors on the date of the 2017 Annual Meeting will vest 100% on the earlier of the 2018 Annual Meeting of Stockholders or the one year anniversary of the 2017 Annual Meeting, with the exception of any RSUs that an Outside Director elected to defer, which RSUs generally will vest 100% on the first anniversary of the date that the Outside Director elected to defer such RSUs. As previously noted, under the Company’s Restricted Stock Unit Deferral Program for Outside Directors, Outside Directors may elect to defer the receipt of shares upon vesting of RSUs granted under the 2015 Plan. Three out of four of the Company’s Outside Directors elected to defer receipt of the RSUs granted to them on the date of the Company’s 2017 Annual Meeting (the “2017 Annual Meeting”) under the 2015 Plan. For the six months ended June 30, 2017, the total RSUs granted were 153,000 with a fair value of $1.0 million, including the RSUs granted to Outside Directors described above and 71,500 RSUs granted to executive officers with a fair value of $0.5 million. The RSUs granted to executive officers have a four-year term and vest 25% annually. Stock‑Based Compensation The fair value of stock options granted to employees is amortized on a straight-line basis over the requisite service period of the award. Stock‑based compensation related to stock options granted to non-employees is recognized as the stock options are earned. The Company recognized total employee-related stock compensation expenses of $0.6 million and $1.6 million for the three and six months ended June 30, 2018, respectively, and $0.7 million and $1.3 million for the three months and six months ended June 30, 2017, respectively. In addition, the Company recognized non-employee stock-based compensation expense of $29,000 and $48,000 for the three and six months ended June 30, 2018, respectively, and $44,000 and $111,000 for the three and six months ended June 30, 2017, respectively. The following table summarizes stock‑based compensation expense related to stock options and restricted stock units included in the condensed statements of operations and comprehensive loss (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Cost of goods sold $ 59 $ 51 $ 113 $ 96 Selling, general and administrative 481 475 183 1,007 Research and development 90 173 1,313 318 Total stock-based compensation expense $ 630 $ 699 $ 1,609 $ 1,421 As of June 30, 2018, unrecognized compensation expense related to unvested options was $6.9 million, which the Company expects to recognize on a straight‑line basis over a weighted‑average period of 2.6 years. Unrecognized compensation expense related to unvested RSUs was $2.7 million, which the Company expects to recognize on a straight‑line basis over a weighted‑average period of 2.1 years.

Net Loss per Common Share

Net Loss per Common Share	6 Months Ended
	Jun. 30, 2018
Net Loss per Common Share
Net Loss per Common Share	7. Net Loss per Common Share As the Company generated net losses for all the periods presented, all potentially dilutive common securities are determined to be anti-dilutive. The following table sets forth the computation of the basic and diluted net loss per share (in thousands, except share and per share data): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Numerator: Net loss $ (8,950) $ (10,387) $ (20,147) $ (23,604) Denominator: Weighted-average common shares outstanding 24,047,256 16,986,628 21,102,254 16,973,473 Less: weighted-average unvested common shares subject to repurchase — (554) — (1,193) Weighted-average shares used to compute net loss per common share, basic and diluted 24,047,256 16,986,074 21,102,254 16,972,280 Net loss per common share, basic and diluted $ (0.37) $ (0.61) $ (0.95) $ (1.39) The following outstanding shares of potentially dilutive securities have been excluded from diluted net loss per share because their inclusion would be anti‑dilutive: June 30, June 30, 2018 2017 Options to purchase common stock 2,696,767 2,949,908 Restricted stock units 620,315 250,447 Warrants to purchase common stock 235,415 187,625 Total 3,552,497 3,387,980

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2018
Commitments and Contingencies.
Commitments and Contingencies	8. Commitments and Contingencies On February 27, 2017, a purported stockholder class action titled Paciga v. Invuity, Inc., et al., Case No. 3:17-cv-01005, was filed in the United States District Court for the Northern District of California against the Company, its Chief Executive Officer, and its Chief Financial Officer. The complaint alleges that the defendants made false or misleading statements to investors regarding the Company’s business prospects. The complaint purports to assert claims for violation of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (the “Exchange Act”), as amended, and the Securities Exchange Commission Rule 10b-5 on behalf of a purported class consisting of all purchasers of the Company’s common stock between July 19, 2016 and November 3, 2016, and seeks unspecified compensatory damages, attorney fees and costs, and other relief. On May 30, 2017, the Court appointed Mike Paciga as lead plaintiff. The lead plaintiff filed an amended complaint on July 31, 2017. Defendants filed a motion to dismiss on September 14, 2017, and the lead plaintiff filed his opposition to the motion on October 30, 2017. Defendants filed a reply brief on December 4, 2017. The Company intends to defend the litigation vigorously. Based on information currently available, the Company has determined that the amount of any possible loss or range of possible loss is not reasonably estimable. In December 2016, Medtronic, which competes with us across multiple product lines, filed a civil complaint in the State Court of Minnesota against us, alleging tortious interference with contract, and two of our former sales employees, alleging breach of contract, misappropriation of trade secrets and breach of duty of loyalty. The complaint seeks unspecified monetary damages. In April 2018, we entered into an agreement with Medtronic, pursuant to which we agreed to pay $1.0 million to Medtronic, which was paid during the quarter. Medtronic agreed to dismiss this complaint. The Company is, and from time to time may become, involved in legal proceedings arising from the ordinary course of its business. Management is currently not aware of any matters that will have a material adverse effect on the financial position, results of operations or cash flows of the Company.

Disaggregation of Revenues

Disaggregation of Revenues	6 Months Ended
	Jun. 30, 2018
Disaggregation of Revenues
Disaggregation of Revenues	9. Disaggregation of Revenues The Company disaggregates its revenues by product categories, as the Company believes this best depicts how the nature, amount, timing, and uncertainty of revenues and cash flows are affected by economic factors. See details in the tables below. Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 (In thousands) (In thousands) Revenue Single use devices $ 9,245 $ 8,289 $ 17,826 $ 15,337 Reusable retractors 848 926 1,547 2,049 Sales to third party medical device manufacturers 86 278 86 827 Other 322 275 547 578 Total revenue $ 10,501 $ 9,768 $ 20,006 $ 18,791

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2018
Subsequent Events
Subsequent Events	10. Subsequent Events Debt Covenants: As of June 30, 2018, the Company was not in compliance with the financial covenant relating to the Term Loan and the Revolving Loan with MidCap. On July 31, 2018, the Company entered into an Amendment No. 3 to the Term Loan and to the Revolving Loan to revise the financial covenant. After the execution of the amendment, the Company was in compliance with the revised covenant. See Note 5, “Debt”, of the Notes to Condensed Financial Statements included in Part I, Item 1 of this Quarterly Report on Form 10‑Q for more details. The foregoing description does not purport to be complete and is qualified in its entirety by reference to the Term Loan Amendment and the Revolving Loan Amendment, copies of which are attached hereto as Exhibits 10.1 and 10.2, respectively, and incorporated herein by reference.

Summary of Significant Accoun16

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2018
Summary of Significant Accounting Policies
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and in accordance with the instructions to Form 10‑Q and Rule 10‑01 of Regulation S‑X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for complete financial statements. The unaudited interim condensed financial statements have been prepared on the same basis as the annual financial statements. In the opinion of management, the accompanying unaudited condensed financial statements reflect all adjustments (consisting only of normal recurring adjustments) considered necessary for a fair statement of the financial position, results of operations and cash flows for the periods presented. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited financial statements and notes thereto included in the Company’s Annual Report on Form 10‑K for the year ended December 31, 2017 and filed with the U.S. Securities and Exchange Commission (the “SEC”). The accompanying year-end balance sheet was derived from the audited financial statements included in the Company’s Annual Report on Form 10‑K for the year ended December 31, 2017. The results for the three months and six months ended June 30, 2018 are not necessarily indicative of the results expected for the full fiscal year or any other periods.
Use of Estimates	Use of Estimates The Company’s financial statements have been prepared in conformity with U.S. GAAP. The preparation of the financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, management evaluates its estimates, including those related to revenue recognition, fair value of assets and liabilities, inventory, income taxes and stock-based compensation. Actual results could differ from those estimates and assumptions.
Cash Equivalents	Cash Equivalents Cash equivalents consist of short-term, highly liquid investments with original maturities of three months or less from the date of purchase. Cash equivalents consist primarily of amounts invested in money market funds.
Restricted Cash	Restricted Cash Restricted cash represents a certificate of deposit held at a financial institution as collateral for a letter of credit related to the Company’s facility lease in San Francisco, California.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying amounts of the Company’s financial instruments, including cash equivalents, short-term investments, accounts receivable and accounts payable, approximate fair value due to their relatively short maturities. As of June 30, 2018 and December 31, 2017, based on Level 2 inputs and the borrowing rates available to the Company for loans with similar terms and consideration of the Company’s credit risk, the carrying value of the Company’s long-term debt approximates its fair value.
Customer Concentration	Customer Concentration Significant customers are those which represent 10% or more of the Company’s total revenue for each period presented in the condensed statements of operations and comprehensive loss or 10% or more of the Company’s net accounts receivable balance at each respective balance sheet date. As of and for the year ended December 31, 2017 and as of and for the three and six months ended June 30, 2018 and 2017, the Company had no customers that represented 10% or more of its revenue or accounts receivable balances.
Changes in Significant Accounting Policies	Changes in Significant Accounting Policies Except for the accounting policies for revenue recognition and deferred commissions that were updated as a result of adopting Topic 606, there have been no changes to our significant accounting policies described in the Annual Report on Form 10-K filed with the Securities and Exchange Commission, or SEC, on March 5, 2018, that have had a material impact on the Company’s condensed financial statements and related notes.
Revenue Recognition	Revenue Recognition The Company’s revenue is generated from the sale of its products to hospitals and medical centers through direct sales representatives and independent sales agents. The Company accounts for a contract with a customer when there's approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance, collectability of consideration is probable and the risks and rewards of ownership are transferred. In certain circumstances, the Company enters into arrangements in which multiple performance obligations are provided to customers. Under multiple performance obligations arrangements, the Company accounts for individual products and services separately if they are distinct, that is, if a product or service is separately identifiable from other items in the bundled package and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The consideration (including any discounts) is allocated between separate products and services in a bundle based on their individual stand-alone selling price (“SSP”). The SSP is determined based on observable prices at which the Company separately sells the products and services. The Company does not offer rights of return or price protection and does not provide credits or incentives, which may be required to be accounted for as variable consideration when estimating the amount of revenue to be recognized . With the exception of PhotonVue®, whereby customers can purchase service contracts for future periods of time, the Company has no post-delivery obligations other than the standard warranty for the Company’s products. Single use devices Single use device revenues include the Company’s single use products, such as the PhotonGuide® (which is used in conjunction with our reusable retractors), Photonsaber® F, the Photonsaber® Y, and the PhotonBlade®. Revenues from the sale of single use devices are recognized when the Company transfers the risks and rewards of ownership to the customer. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Reusable retractors Reusable retractor revenues include the Company’s reusable products, such as the Eikon® LT, the Breisky, and the Breiten®. Revenues from the sale of reusable retractors are recognized when the Company transfers the risks and rewards of ownership to the customer. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Sales to 3rd party medical device manufacturers At times, the Company sells uniquely modified products to 3 rd party medical device manufacturers. The products are modified based on the specifications provided by 3 rd party medical device manufacturers, who then incorporate these parts into products sold to their customers. Revenues from the sale to 3 rd party medical device manufacturers are recognized when the Company transfers the risks and rewards of ownership to the 3 rd party manufacturers. The Company’s products do not require installation being readily available for use upon transfer of physical possession. Other Other revenues include revenues from sales of accessories and service agreements. Revenues for sales of accessories, such as cables and trays, are recognized when the accessories are delivered to the customer and control is transferred. Revenues from service agreements are accounted for ratably over the term of the service agreement.
Segment Reporting	Segment Reporting The Company manages its operations as a single operating segment for the purposes of assessing performance and making operating decisions. The majority of the Company’s assets are maintained in the United States. The Company derives its revenue primarily from sales to customers in the United States, based upon the billing address of the customer. The Company started selling in Asia in June 2017 and in Europe and Australia in June 2018. The Company had $20,000 and $141,000 in total international sales for the three months ended March 31, 2018 and June 30, 2018, and $0.2 million in total international sales for the six months ended June 30, 2018.
Net loss per Common Share	Net loss per Common Share Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period, without consideration of potentially dilutive securities. Diluted net loss per common share is the same as basic net loss per common share since the effect of potentially dilutive securities are anti-dilutive. Shares subject to repurchase are excluded from the weighted-average shares.
Contract Balances	Contract Balances The timing of revenue recognition, billings and cash collections results in accounts receivables and deferred revenues on the Condensed Balance Sheet. Service contracts are usually billed upon initial purchase with the PhotonVue® system, resulting in a contract liability. These contract liabilities are reported as deferred revenues on the Condensed Balance Sheet at the end of each reporting period.
Recent Accounting Pronouncements	Recent Accounting Pronouncements · In May 2014, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2014‑09, Revenue from Contracts with Customers (Topic 606) , which supersedes the revenue recognition requirements in ASC 605, Revenue Recognition . This ASU is based on the principle that revenue is recognized to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The ASU also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to obtain or fulfill a contract. In August 2015, FASB issued ASU No. 2015‑14, Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date , which effectively delayed the adoption date by one year, to an effective date for public entities for annual and interim periods beginning after December 15, 2017. · In March 2016, the FASB issued ASU No. 2016‑08, Revenue from Contracts with Customers (Topic 606): Principal Versus Agent Considerations (Reporting Revenue Gross Versus Net), to clarify certain aspects of the principal-versus-agent guidance in its new revenue recognition standard. · In April 2016, the FASB issued ASU No. 2016‑10, Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing to clarify on how to identify the performance obligations and the licensing implementation guidance in its new revenue recognition standard. · In May 2016, the FASB issued ASU No. 2016‑12, Revenue from Contracts with Customers (Topic 606): Narrow-Scope Improvements and Practical Expedients, to address certain issues identified by the Transition Resource Group, (the “TRG”) in the guidance on assessing collectability, presentation of sales tax, noncash consideration, and completed contracts and contracts modifications at transition. The adoption of ASC 606, using the modified retrospective approach in the first quarter of 2018 did not have a material impact on the Company’s financial statements. · In February 2016, the FASB issued ASU No. 2016‑02— Leases (“ASC 842”), which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight line basis over the term of the lease, respectively. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term of greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. ASC 842 supersedes the previous leases standard, ASC 840 Leases . The Company expects to adopt the guidance on January 1, 2019. The Company is in the process of evaluating the impact of this new guidance on its financial statements, and expects the balance sheet to include a right of use asset and liability related to its lease arrangements. · In June 2016, the FASB issued ASU No. 2016‑13, Measurement of Credit Losses on Financial Statements (Topic 326) . This update provides financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. The update replaces the incurred loss impairment methodology in current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. ASU No. 2016‑13 is effective for public entities for annual periods beginning after December 15, 2019. The Company is in the process of evaluating the impact of this new guidance on its financial statements. · In August 2016, the FASB issued ASU No. 2016‑15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments (a consensus of the FASB Emerging Issues Task Force) . The new guidance is intended to reduce diversity in practice in how certain transactions are classified in the statement of cash flows. This update addresses the following eight specific cash flow issues: debt prepayment or debt extinguishment costs; settlement of zero-coupon debt instruments or other debt instruments with coupon interest rates that are insignificant in relation to the effective interest rate of the borrowing; contingent consideration payments made after a business combination; proceeds from the settlement of insurance claims; proceeds from the settlement of corporate-owned life insurance policies (“COLIs”) (including bank-owned life insurance policies (“BOLIs”); distributions received from equity method investees; beneficial “interests in securitization transactions; and separately identifiable cash flows and application of the predominance principle. ASU No. 2016‑15 is effective for public entities for annual periods beginning after December 15, 2017. The Company adopted this standard in the first quarter of 2018. As a result of the adoption, the Company reclassified $2.0 million of Loss from debt extinguishment from Operating cash outflows in the three months ended March 31, 2017 to financing cash outflows on the Condensed Statements of Cash Flows. · In June 2018, the FASB issued ASU No. 2018-07, Compensation – Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting. The amendments in this update expand the scope of Topic 718 to include share based payment transactions for acquiring goods and services from nonemployees. An entity should apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of cost (that is, the period of time over which share-based payment awards vest and the pattern of cost recognition over that period). The amendments in this Update are effective for private entities for fiscal years beginning after December 15, 2019, and interim periods within fiscal years beginning after December 15, 2020. Early adoption is permitted, but no earlier than an entity’s adoption date of Topic 606. The Company is in the process of evaluating the impact of this new guidance on its financial statements.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2018
Fair Value Measurements
Financial Assets and Liabilities Measured at Fair Value on Recurring Basis Based on Three-Tier Fair Value Hierarchy	The following table sets forth the fair value of the Company’s financial assets and liabilities measured at fair value on a recurring basis based on the three-tier fair value hierarchy (in thousands): June 30, 2018 Level 1 Level 2 Level 3 Total Assets Money market funds $ 6,253 $ — $ — $ 6,253 Commercial paper — 12,642 — 12,642 Corporate debt securities — 1,348 — 1,348 $ 6,253 $ 13,990 $ — $ 20,243 December 31, 2017 Level 1 Level 2 Level 3 Total Assets Money market funds $ 13,071 $ — $ — $ 13,071 Commercial paper — 3,763 — 3,763 Corporate debt securities — 1,753 — 1,753 $ 13,071 $ 5,516 $ — $ 18,587

Balance Sheet Components (Table

Balance Sheet Components (Tables)	6 Months Ended
	Jun. 30, 2018
Balance Sheet Components
Schedule of Inventory	Inventory consisted of the following (in thousands): June 30, December 31, 2018 2017 Raw materials $ 1,968 $ 1,606 Work-in-process 2,701 1,860 Finished goods 3,865 3,970 Total inventory $ 8,534 $ 7,436
Schedule of Prepaid Expenses and Other Assets	Prepaid expenses and other current assets consisted of the following (in thousands): June 30, December 31, 2018 2017 Prepaid expenses $ 1,570 $ 1,252 Other 51 22 Total prepaid expenses and other current assets $ 1,621 $ 1,274
Schedule of Property and Equipment, Net	Property and equipment, net, consisted of the following (in thousands): June 30, December 31, 2018 2017 Computer equipment and software $ 1,606 $ 1,368 Laboratory and manufacturing equipment 3,116 3,008 Furniture and fixtures 1,550 1,516 Leasehold improvements 7,201 7,155 Assets in progress 188 167 Total property and equipment, gross 13,661 13,214 Less: accumulated depreciation and amortization (6,793) (6,045) Total property and equipment, net $ 6,868 $ 7,169
Schedule of Accrued and Other Current Liabilities	Accrued and other current liabilities consisted of the following (in thousands): June 30, December 31, 2018 2017 Accrued payroll-related expenses $ 3,885 $ 3,777 Accrued independent sales agent commissions 298 181 Accrued professional fees 830 501 Deferred rent 261 261 Other 355 459 Total accrued and other current liabilities $ 5,629 $ 5,179

Stock Option Plans (Tables)

Stock Option Plans (Tables)	6 Months Ended
	Jun. 30, 2018
Stock Option Plans
Summary of Stock-based Compensation Expense Related to Stock Options and Restricted Stock Units Included in Condensed Statements of Operations and Comprehensive Loss	Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Cost of goods sold $ 59 $ 51 $ 113 $ 96 Selling, general and administrative 481 475 183 1,007 Research and development 90 173 1,313 318 Total stock-based compensation expense $ 630 $ 699 $ 1,609 $ 1,421

Net Loss per Common Share (Tabl

Net Loss per Common Share (Tables)	6 Months Ended
	Jun. 30, 2018
Net Loss per Common Share
Schedule of Computation of Basic and Diluted Net Loss per Share	Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Numerator: Net loss $ (8,950) $ (10,387) $ (20,147) $ (23,604) Denominator: Weighted-average common shares outstanding 24,047,256 16,986,628 21,102,254 16,973,473 Less: weighted-average unvested common shares subject to repurchase — (554) — (1,193) Weighted-average shares used to compute net loss per common share, basic and diluted 24,047,256 16,986,074 21,102,254 16,972,280 Net loss per common share, basic and diluted $ (0.37) $ (0.61) $ (0.95) $ (1.39)
Schedule of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares Outstanding	June 30, June 30, 2018 2017 Options to purchase common stock 2,696,767 2,949,908 Restricted stock units 620,315 250,447 Warrants to purchase common stock 235,415 187,625 Total 3,552,497 3,387,980

Disaggregation of Revenues (Tab

Disaggregation of Revenues (Tables)	6 Months Ended
	Jun. 30, 2018
Disaggregation of Revenues
Summary of disaggregation of Revenues	Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 (In thousands) (In thousands) Revenue Single use devices $ 9,245 $ 8,289 $ 17,826 $ 15,337 Reusable retractors 848 926 1,547 2,049 Sales to third party medical device manufacturers 86 278 86 827 Other 322 275 547 578 Total revenue $ 10,501 $ 9,768 $ 20,006 $ 18,791

Organization and Description 22

Organization and Description of Business (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jul. 31, 2018	Mar. 31, 2018	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Organization and Description of Business
Net loss			$ 8,950	$ 10,387	$ 20,147	$ 23,604
Accumulated deficit			206,281		206,281		$ 186,134
Stock issued, shares		6,800,000
Shares Issued, Price Per Share		$ 3.50
Proceeds from Issuance of Common Stock		$ 21,700			21,700	$ 57
Cash and cash equivalents and short-term investments			23,900		23,900
Face value of debt outstanding			$ 34,700		$ 34,700
Revolving Credit Facility | Term loan
Organization and Description of Business
Minimum net revenue requirements period ending September 30, 2018	$ 41,500
Minimum net revenue requirements period ending December 31, 2018	42,500
Minimum net revenue requirements period ending March 31, 2019	45,700
Minimum net revenue requirements period ending June 30, 2019	47,700
Minimum cash covenant	5,000
Minimum net revenue required for not maintain cash covenant for December 31, 2018	45,000
Minimum net revenue required for not maintain cash covenant, there after	$ 50,000

Summary of Significant Accoun23

Summary of Significant Accounting Policies (Detail) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2018USD ($)customer	Mar. 31, 2018USD ($)	Jun. 30, 2017USD ($)customer	Mar. 31, 2017USD ($)	Jun. 30, 2018USD ($)segmentcustomer	Jun. 30, 2017USD ($)customer
Summary of Significant Accounting Policies
Number of operating segments | segment					1
Revenue	$ 10,501		$ 9,768		$ 20,006	$ 18,791
Debt extinguishment cost						$ (2,303)
ASU 2016-15
Summary of Significant Accounting Policies
Debt extinguishment cost				$ 2,000
Asia, Europe and Australia
Summary of Significant Accounting Policies
Revenue	$ 141	$ 20			$ 200
Customer Concentration Risk
Summary of Significant Accounting Policies
Number of Customers | customer	0		0		0	0
Revenue | Customer Concentration Risk
Summary of Significant Accounting Policies
Concentration risk, percentage					10.00%
Accounts Receivable, Net | Customer Concentration Risk
Summary of Significant Accounting Policies
Concentration risk, percentage					10.00%

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Liabilities Measured at Fair Value on Recurring Basis Based on Three-Tier Fair Value Hierarchy (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Assets
Assets	$ 20,243	$ 18,587
Level 1
Assets
Assets	6,253	13,071
Level 2
Assets
Assets	13,990	5,516
Money Market Funds
Assets
Assets	6,253	13,071
Money Market Funds | Level 1
Assets
Assets	6,253	13,071
Commercial Paper
Assets
Assets	12,642	3,763
Commercial Paper | Level 2
Assets
Assets	12,642	3,763
Corporate Debt Securities
Assets
Assets	1,348	1,753
Corporate Debt Securities | Level 2
Assets
Assets	$ 1,348	$ 1,753

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Inventory (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Balance Sheet Components
Raw materials	$ 1,968	$ 1,606
Work-in-process	2,701	1,860
Finished goods	3,865	3,970
Total inventory	$ 8,534	$ 7,436

Balance Sheet Components - Sc26

Balance Sheet Components - Schedule of Prepaid Expenses and Other Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Balance Sheet Components
Prepaid expenses	$ 1,570	$ 1,252
Other	51	22
Total prepaid expenses and other current assets	$ 1,621	$ 1,274

Balance Sheet Components - Sc27

Balance Sheet Components - Schedule of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Property, Plant and Equipment
Total property and equipment, gross	$ 13,661		$ 13,661		$ 13,214
Less: accumulated depreciation and amortization	(6,793)		(6,793)		(6,045)
Total property and equipment, net	6,868		6,868		7,169
Depreciation and amortization	400	$ 500	748	$ 1,009
Computer Equipment and Software
Property, Plant and Equipment
Total property and equipment, gross	1,606		1,606		1,368
Laboratory and Manufacturing Equipment
Property, Plant and Equipment
Total property and equipment, gross	3,116		3,116		3,008
Furniture and Fixtures
Property, Plant and Equipment
Total property and equipment, gross	1,550		1,550		1,516
Leasehold Improvements
Property, Plant and Equipment
Total property and equipment, gross	7,201		7,201		7,155
Assets in progress
Property, Plant and Equipment
Total property and equipment, gross	$ 188		$ 188		$ 167

Balance Sheet Components - Sc28

Balance Sheet Components - Schedule of Accrued and Other Current Liabilities (Detail) - USD ($) $ in Thousands	1 Months Ended	6 Months Ended
	Jan. 31, 2019	Jun. 30, 2018	Dec. 31, 2017
Accrued payroll-related expenses		$ 3,885	$ 3,777
Accrued independent sales agent commissions		298	181
Accrued professional fees		830	501
Deferred rent		261	261
Other		355	459
Total accrued and other current liabilities		5,629	$ 5,179
Severance Costs	$ 600	900
Employee Severance [Member]
Accrued payroll-related expenses		$ 600

Debt - (Detail)

Debt - (Detail) - USD ($)	Jul. 31, 2018	Jul. 30, 2018	Jun. 30, 2018	Sep. 26, 2017	Mar. 10, 2017	Jun. 30, 2018	Jun. 30, 2017
Debt
Loss on extinguishment of debt							$ (2,303,000)
Prepayment penalty on debt							$ 1,950,000
Non-cash expenses related to unamortized issuance costs					$ 300,000
Revolving Credit Facility
Debt
Additional loan amount	$ 15,000,000	$ 10,000,000
Drawn amount			$ 5,400,000
HealthCare Royalty Partners
Debt
Prepayment penalty on debt					1,800,000
Mid Cap | Revolving Credit Facility
Debt
Maximum loan amount					10,000,000
Additional loan amount					$ 10,000,000
Interest rate (as a percent)					3.25%
Applicable margin (as a percent)					1.50%
Silicon Valley Bank | Accounts Receivable Credit Facility
Debt
Termination fee						$ 150,000
Term loan
Debt
Common stock drawdown percent of amount drawn					2.00%
Term loan | Revolving Credit Facility
Debt
Minimum net revenue requirements period ending September 30, 2018	41,500,000
Minimum net revenue requirements period ending December 31, 2018	42,500,000
Minimum net revenue requirements period ending March 31, 2019	45,700,000
Minimum net revenue requirements period ending June 30, 2019	47,700,000
Minimum cash covenant	5,000,000
Minimum net revenue required for not maintain cash covenant for December 31, 2018	45,000,000
Minimum net revenue required for not maintain cash covenant, there after	$ 50,000,000
Term loan | HealthCare Royalty Partners
Debt
Debt instrument, repayment of loan payable					$ 15,000,000
Term loan | Mid Cap
Debt
Maximum loan amount					30,000,000
Drawn amount					$ 20,000,000
Interest rate (as a percent)					6.50%
Applicable margin (as a percent)					1.50%
Loan term period	39 months				36 months
Frequency periodic payment of loan	monthly			monthly	monthly
Loan termination fee (percentage)	7.00%	6.50%
Tranche 1 | Mid Cap
Debt
Maximum loan amount					$ 20,000,000
Drawn amount					$ 20,000,000
Loan term period					5 years
Warrants issued to purchase of shares					50,618
Exercise price of warrants					$ 7.90
Tranche 1 | Mid Cap | Level 3
Debt
Warrants liability					$ 279,000
Contractual term					10 years
Interest free rate					2.58%
Dividend yield					0.00%
Volatility					60.00%
Tranche 1 | Mid Cap | HealthCare Royalty Partners
Debt
Loan paid off					$ 17,200,000
Tranche 2 | Mid Cap
Debt
Maximum loan amount					$ 10,000,000
Drawn amount				$ 10,000,000
Interest rate (as a percent)				6.50%
Applicable margin (as a percent)				1.50%
Loan term period				36 months	5 years
Warrants issued to purchase of shares					47,790
Exercise price of warrants					$ 8.37
Tranche 2 | Mid Cap | Level 3
Debt
Warrants liability					$ 278,000
Contractual term					10 years
Interest free rate					2.24%
Dividend yield					0.00%
Volatility					60.00%

Stock Option Plans - Additional

Stock Option Plans - Additional Information (Detail)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2018USD ($)$ / sharesshares	Jun. 30, 2017USD ($)director$ / sharesshares	Jun. 30, 2018USD ($)director$ / sharesshares	Jun. 30, 2017USD ($)$ / sharesshares	Dec. 31, 2017shares
Aggregate intrinsic value of options exercised	$ 30,000	$ 300,000	$ 45,000	$ 300,000
Amortized period			3 years
Weighted-average remaining contractual life of options outstanding			5 years 7 months 6 days		7 years
Weighted-average remaining contractual life of options outstanding, vested and expected to vest			5 years 7 months 6 days		7 years
Total number of board members | director			5
Employees
Stock options granted | shares	8,840	125,525	325,340	734,705
Weighted average grant date fair value of options, granted | $ / shares	$ 3.62	$ 7.32	$ 4.11	$ 6.65
Aggregate intrinsic value of options exercised			$ 700,000
Outside Directors
Total number of board members | director		4
2015 Plan | Executive
Stock options granted | shares					268,000
Restricted Stock Units
Restricted stock units, granted fair value				$ 1,000,000
Restricted Stock Units | Executive
Stock options granted | shares			272,985
Aggregate intrinsic value of options exercised			$ 1,100,000
Restricted stock units, granted | shares				71,500
Restricted stock units, granted fair value				$ 500,000
Restricted stock units, vesting term			4 years	4 years
Restricted stock units, vesting percentage			25.00%	25.00%
Restricted Stock Units | Outside Directors
Stock options granted | shares	171,230		522,665
Aggregate intrinsic value of options exercised	$ 600,000		$ 1,900,000
Restricted stock units, granted | shares		72,000
Restricted stock units, granted fair value		$ 500,000
Restricted stock units, vesting percentage			100.00%
Restricted Stock Units | President and Chief Executive Officer
Restricted stock units, vesting percentage			100.00%
Restricted Stock Units | 2015 Plan
Stock options granted | shares			60,000
Aggregate intrinsic value of options exercised			$ 200,000
Number of board members elected to defer receipts of restricted stock units awarded. | director			3
Restricted Stock Units | 2015 Plan | Outside Directors
Number of board members elected to defer receipts of restricted stock units awarded. | director		3

Stock Option Plans - Stock-base

Stock Option Plans - Stock-based Compensation (Detail) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	$ 630,000	$ 699,000	$ 1,609,000	$ 1,421,000
Unrecognized compensation expense
Unrecognized compensation expense related to unvested options	6,900,000		$ 6,900,000
Weighted-average expected period to recognize of compensation expense, term			2 years 7 months 6 days
Cost of Goods Sold
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	59,000	51,000	$ 113,000	96,000
Selling, General and Administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	481,000	475,000	183,000	1,007,000
Research and Development
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	90,000	173,000	1,313,000	318,000
Employees
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	600,000	700,000	1,600,000	1,300,000
Non-employees
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost
Total stock-based compensation expense	29,000	$ 44,000	$ 48,000	$ 111,000
Restricted Stock Units
Unrecognized compensation expense
Weighted-average expected period to recognize of compensation expense, term			2 years 1 month 6 days
Unrecognized compensation expense related to RSUs	$ 2,700,000		$ 2,700,000

Net Loss per Common Share - Sch

Net Loss per Common Share - Schedule of Computation of Basic and Diluted Net Loss per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Numerator:
Net loss	$ (8,950)	$ (10,387)	$ (20,147)	$ (23,604)
Denominator:
Weighted-average common shares outstanding	24,047,256	16,986,628	21,102,254	16,973,473
Less: weighted-average unvested common shares subject to repurchase		(554)		(1,193)
Weighted-average shares used to compute net loss per common share, basic and diluted	24,047,256	16,986,074	21,102,254	16,972,280
Net loss per common share, basic and diluted	$ (0.37)	$ (0.61)	$ (0.95)	$ (1.39)

Net Loss per Common Share - S33

Net Loss per Common Share - Schedule of Potentially Dilutive Securities Outstanding Excluded from Computation of Diluted Shares Outstanding (Detail) - shares	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of diluted net loss per share	3,552,497	3,387,980
Options to Purchase Common Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of diluted net loss per share	2,696,767	2,949,908
Restricted Stock Units
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of diluted net loss per share	620,315	250,447
Warrants to Purchase Common Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of diluted net loss per share	235,415	187,625

Commitments and Contingencies (

Commitments and Contingencies (Detail) - USD ($) $ in Millions	Jun. 30, 2018	Apr. 30, 2018	Dec. 31, 2017
Commitments and Contingencies
Commitments And Contingencies
Settlement Agreement Medtronic
Commitments and Contingencies
Commitments And Contingencies		$ 1

Disaggregation of Revenues (Det

Disaggregation of Revenues (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Disaggregation of Revenues
Revenue	$ 10,501	$ 9,768	$ 20,006	$ 18,791
Single use devices
Disaggregation of Revenues
Revenue	9,245	8,289	17,826	15,337
Reusable retractors
Disaggregation of Revenues
Revenue	848	926	1,547	2,049
Sales to third party medical device manufacturers
Disaggregation of Revenues
Revenue	86	278	86	827
Other
Disaggregation of Revenues
Revenue	$ 322	$ 275	$ 547	$ 578